Donating and receiving organs quite often involves family members partnering toward a single medical goal. Despite the common medical issues between the two parties, keeping personal medical information private is nevertheless essential.
A 21-year-old contacted a hospital transplant program expressing her desire to donate a kidney to her uncle, with whom she and her mother lived. An extensive medical workup of the young lady included a psychological evaluation and an explanation by a registered nurse of the details of the “living donor consent form” written on the hospital’s letterhead.
Included in that lengthy consent were two passages dealing with how personal medical information would be treated. In one section, the consent stated “all information about the donor and recipient will be kept confidential unless there is written permission from the donor or recipient that information be provided.”
In a section that followed, the consent form offered the assurance that “information about your medical evaluation, diagnostic test results [sic] will not be discussed with the potential kidney transplant recipient unless you give written permission.” Signing on behalf of the hospital was a registered nurse coordinator assigned specifically to the donor. (Another nurse coordinator was assigned to the uncle, per protocol.)
As part of her workup over the months leading up to the donation, the young woman underwent regular pregnancy tests. During the course of her evaluation, she had two negative HCG blood tests: one shortly before signing the donor consent form and another one month before the scheduled transplant.
During a pre-operative consult one week before the scheduled surgery, Dr. GS, the general surgeon for the transplant, noted that the donor’s last menstrual period was nearly one month prior. He noted his impression that the young lady was an “excellent kidney donor.” On that day, the donor underwent another HCG screening and a blood cross-match.
When the HCG levels came back four days later, the results showed the woman was pregnant. When the donor’s nurse coordinator had the blood tested further, the results were consistent with a four-week pregnancy.
Given the timing of the news — on the Friday before the Monday surgery — Dr. GS recognized the urgency to let both parties know that the surgery could not go forward. The woman’s assigned nurse made numerous unsuccessful attempts to reach the donor. At one point, the nurse called the donor’s home, where the uncle picked up the phone. During that conversation, the nurse simply asked that the uncle pass along the message that his niece should call the transplant center.
That same Friday, the nurse coordinator assigned to the uncle advised the gentleman that the Monday surgery was being cancelled. Per protocol, the coordinator did not divulge any information to the uncle about his niece’s medical condition. After that conversation, the uncle called Dr. GS’s office wanting to know additional information. According to the uncle, at some point during that conversation, Dr. GS got on the phone to say that the surgery was not going forward because “your niece is expecting.”
In a subsequent lawsuit against Dr. GS, the niece claimed that the disclosure of her pregnancy (divulged to the uncle even before she herself learned the news) constituted a breach of contract, as well as a violation of state privacy laws. She claimed that the family’s knowledge of the pregnancy prevented her from obtaining an abortion. Dr. GS resolved the matter with the donor informally prior to arbitration.
One can surmise the emotional state of any individual who has waited years for a needed organ transplant — only to be advised on the virtual eve of surgery that the procedure cannot go forward. But in such cases, disclosing the personal information of an individual, even if intended to calm the mind of another, can end up just adding to the burdens of both.
Author Gordon Ownby is General Counsel for the Cooperative of American Physicians, Inc. (CAP).
If you have questions about this article, please contact us. This information should not be considered legal advice applicable to a specific situation. Legal guidance for individual matters should be obtained from a retained attorney.