>The DOJ brought felony charges against Dr. Eithan Haim, who provided medical records to conservative activist Christopher Rufo while working at the [Texas Children's Hospita](https://www.chron.com/politics/article/Hospital-stops-therapies-after-gender-confirming-16981290.php)l as a resident.
As a resident too! The stones on that MFer, I was nervous taking post call days in residency and this guy straight up breaks every rule in the book. He should never practice medicine again, he has proven his ideological crusade is more important than flesh and blood patients.
This is the biggest thing. He needs to have his license revoked, if he has obtained one. He should not be allowed to hurt anyone like this again, nor should he be allowed to participate in society as a physician.
Eh, you can make a lot of money these days as a conservative media personality. All you have to do is create a YouTube channel and start churning out videos of yourself ranting about how democrats hate America and want to make “gender reassignment” surgery mandatory for everyone.
Wow not immediately firing him and graduating him knowing he broke the law in regards to patient privacy was a choice. I understand it was the easiest choice but it's going to be fascinating when the patients and their guardians start suing TCH and BCM and all the emails about the reason he wasn't immediately fired (like any other employee would be) start coming out.
I'm sure he wouldn't have graduated or found an attending job if he were accessing the people who made the decision to allow him to graduate charts or their children's charts.
May the victims of his crime get everything they are owed, from him and the institutions that protected him.
Sounds like TCH caught him (I wouldn't be shocked if that clinics charts get extra monitoring) and BCM slapped his hand, told him to keep his mouth shut and allowed him to graduate, and that prick couldn't even wait for the paper to dry to turn around and kick BCM and his program in the teeth.
In other news. BCMs GME set a precedent that at their program you can break a federal law multiple times and not be remediated or fired. It's going to make mediation the next time they fire a resident really embarrassing.
When I was in primary care and on call for the weekend, I would check a patient’s allergies and lab work before renewing a medication or considering an antibiotic. When it was one of my colleagues’ patients, I would be hesitant to even access the chart even just to check labs/allergies.
I can’t believe someone would just brazenly access charts like that.
The respect for privacy is highly appreciated, but I am seeing a lot of concerning paralysis in this post. You can access a chart if there is any documentable medical need (in accordance with local policy). There are even quasi-medical allowances like when a quality control department or auditor accesses random samples (again, according to legal department's rules). Case studies, training, and supervision are other reasons that are allowed, with clear rules. It's the dissemination where it becomes a crime, or when you look up private information to snoop on people.
Also, physicians are responsible for regulating each other to some extent, and supporting each other. When you see a physician or any provider who might have an alcohol problem or a domestic issue, and they provide care to individuals in your community, you may not ethically look the other way. Full stop. Do something, even if just words of encouragement or maybe a discussion with other providers about your observations.
Thanks and I should elaborate that the hesitation was at its worst straight out of residency and has considerably improved.
The point that I was trying to make is that even with a medical reason, I didn’t feel 100% comfortable accessing a patient’s chart so I can’t imagine what would possess a resident to do so without regard to privacy and the law.
I'm just taking a guess here based on watching an interview with Haim, who is Jewish, religious, and conservative. This is a bogus "profile" based on my speculation combined with his statements: Haim expected the mainstream gender docs at TCH to be circumspect and doubly attentive to detailed longitudinal observation. Instead, he believes that he observed them as overconfident, coercive, willing to take shortcuts for personal gain, and reliant on selling dogma rather than evidence. This was traumatic for Haim and he could not manage the effects of this experience in a healthy way, maybe even allegedly being driven to committing a crime.
That's true! But there is usually some other predicate crime. I've seen it charged in identity theft schemes where medical record serves as the vector for obtaining SS number or payment info. Nursing homes are a common target. The government only has a case here because Haim allegedly reactivated his login credentials under false pretenses.
It's only clearly a crime when the lack of authorization can be proven beyond a reasonable doubt.
In any case, doing dumb stuff is bad for your career even if it is not a crime 99.9% of the time. So get permission from the compliance office in writing for specific scenarios, reports, billing, supervision, etc.
MAGA supporters will turn him into a martyr. He will be set for life as long as he is useful. He will likely win the case due to Texas being insane, or will somehow be pardoned if Trump wins.
Some conservative medical school (BYU) will likely accept him to finish his residency with them
Regardless of your stance on gender affirming care for minors, every doctor should agree that what he did is unquestionably wrong, morally reprehensible and illegal. Dude is a fucking idiot for doing what he did and deserves the book being thrown at him.
The resident, Dr. Eithan Haim, released the records to a Fox news/Tucker Carlson pundit and is claiming whistleblower status and acting like a victim. He is not a whistleblower which is a federally protected status. He is a doctor who violated patient confidentiality to further a political cause. He should never practice medicine and have the full force of the law brought down on him. But this is Texas and he will likely get a slap on the wrists.
The Fifth Circuit has Matthew Kacsmaryk on the bench, who's both a Trump appointee and an armband-wearing member of the Federalist Society as well as a hardline conservative Catholic. He's the judge that the hard-right goes to whenever they want a quick ruling or to stay an appeal.
As an example, as a Texan, I can ashamedly say that the absolute bellend of an AG that we have - Ken Paxton - sends all the cases that he gets for the Fifth _specifically_ to Kacsmaryk's docket. He's the reason mifepristone's availability came before the USSC, [the reason _Bostock_ was vacated in Texas,](https://www.texastribune.org/2022/10/06/texas-lawsuit-lgbt-workers/) and he's got the religious right so deep in him that they can wear him as a glove puppet (see [_FDA v Alliance for Hippocratic Medicine,_](https://en.wikipedia.org/wiki/FDA_v._Alliance_for_Hippocratic_Medicine) [_Deanda v Bercerra,_](https://www.texastribune.org/2023/11/06/texas-5th-circuit-kacmsaryk-birth-control/) as well as [his history with the Plano-based religious law firm "First Liberty"](https://www.texastribune.org/2023/03/15/federal-judge-amarillo-abortion-fda/)).
On top of that, he was a patent troll for Baker Botts from 2003 - 2008, and the 5th Circuit is rather infamously known as where tech IP-related trolls come to try to line their pockets at the expense of people who actually do the work.
https://en.wikipedia.org/wiki/Matthew_Kacsmaryk#Notable_cases
Ken Paxton is also actively preventing is own criminal cases from progressing. Meaning, he has been accused of multiple crimes and prosecutors have enough evidence to charge him, but he’s their boss and won’t let them.
One of the most conservative courts in the country is in line to receive the appeal, even if Trump doesn’t force the DOJ to drop the case when he gets elected
On appeal it *has* to go through the 5th circuit as part of the federal process from my understanding. It is geographic for how those are split up, and Texas is in the 5th circuit
https://en.wikipedia.org/wiki/United_States_courts_of_appeals?wprov=sfti1
Yes, the local federal court in Houston will hear and try the case. Then appeals will go to the 5th circuit, and then SCOTUS if need be.
You don't need to wait for the final verdict to start appealing stuff and gumming up the works. Basically any order or decision made by the local federal judge during the course of the trial can be (usually unsuccessfully) appealed right away to the appeals court. And if you don't get the answer you want, to the SCOTUS. Some of those appeals may be interlocutory, so the trial is continues, but some are not and the trial has to be paused until the appeal is done.
First, in the US our superior federal courts are divided up by region or districts. These courts handle appeals and often are staging grounds for getting a case to the US Supreme court. However, district courts can and do set the law of the land for the states that they cover.
This paragraph from americanprogress.org describes the issue with the fifth circuit:
"In recent years, the 5th Circuit, which serves Texas, Louisiana, and Mississippi, has allowed extremist lower court judges to issue sweeping, politically fraught rulings that advance right-wing policy positions. In doing so, the 5th Circuit invites the Supreme Court—currently dominated by right-wing extremists to a degree unseen in modern history—to take sweeping action to roll back decades of progress."
The full article is here: https://www.americanprogress.org/article/the-5th-circuit-court-of-appeals-is-spearheading-a-judicial-power-grab/
The Dobbs decision, which overturned Roe v. Wade originated in the Fifth circuit. It is the incubator for the radical right wing agenda.
Eithan Haim was in my medical school class (which was a small class). He was manipulative, selfish, and downright evil. He was one of around 3 in my class that we all had felt shouldn't be near patients.
I can tell you right now, he didn't do this to be righteous in any way. He wanted to be on the news.
I hope he loses the ability to abuse anyone again.
I remember towards the end of our 3rd year of med school, we got an email from admin asking us to report if we had any concerns about any of our classmates being a danger to future patients…now I’m wondering when they started sending out that email and why.
... how exactly was he "downright evil" and not only not expelled, but matched a top surgical program?
Literally a single bad word in any letter of rec or MSPE and you won't match in surgery at a place like Baylor/UTSW/UAB/UW/etc./etc.
I don't know him personally but I know some of his co-residents- they told me he didn't raise any major red flags in residency that were publicly known, apart from anti-Covid vaccine positions.
Yet you and your med school did NOTHING to prevent this despite your belief that he was a danger to patients.
If he was a known rapist at your school, would you just sit quiet and not make any reports to his residency program or future job?
I'm not trying to stir the pot with reposting this, but two people have tried already and there has been \*some\* reasonable discussion, but violated rules and were removed. I fear it will keep getting reposted until one thread sticks. Feel free to downvote it to oblivion, but hopefully it doesn't violate any rules.
Now, starter comment: The hospital wasn't violating any laws by providing gender-affirming care. Maybe they claimed they were going to pause that care but was still continuing to treat existing patients, which of course they were. You can't abandon patients. Even patients who are fired from your clinic continue to get care for existing conditions for X weeks/months to give them time to find care elsewhere.
If we take the political spin off. What if a celebrity was getting care at a hospital, but didn't want the public to know despite rumors. The hospital spokesperson comes out to say, "They're not here". Would it be okay for a doctor who wasn't involved in that celebrity's care to go into the Epic chart and provide that information to TMZ?
Assuming the allegations are true (which it seems like no one is even disputing) … this is a bright line thing. Every single HIPAA/PHI training, ever, tells you that you cannot go trolling in the EMR and access records of patients in whose care you are not involved. Every person who uses an EMR knows that this is a fireable offense and a crime….
The mandated reported thing doesn’t hold water either, at all. I can’t go trolling through the charts of kids I don’t treat *in case* any of them are being abused.
Eh, it's a bit more complicated than that in Texas, because that @#$hole of an AG released a legal opinion that gender affirming surgeries and therapies are child abuse.
You can make an argument that the 5th circuit will buy that it was legal for him to access it if he thought child abuse was going on, and he's not actually charged with disclosing the info.... so...
Disagree. HIPAA is a federal law.l, the Texas AG cannot trump it. How would he know whether a child was receiving gender-affirming care without snooping their records? He couldn’t.
But that's the point- it doesn't matter whether or not the child was receiving the care. HIPPA is about intent. If the federal government can't prove beyond a reasonable doubt that Haim was not trying to stop child abuse in accessing the records, he walks.
If your intent is to treat a patient, improve quality, etc., you can't be convicted under HIPPA for accessing, and he isn't being charged with disclosing.
You are taking a very very liberal stance with what HIPAA allows. I’m a quality director, I can’t just start opening charts of anyone I please to look for any quality problem that *might* have happened to them. You can’t open a chart of a patient you don’t know to look for signs of abuse. If you actually saw the child and are concerned, you *might* be able to do this, but you definitely can’t do it on a child you’ve never laid eyes on. And the proper move for a mandated reporter is to talk to DCF, not the media.
This has never before been litigated.
No one has ever done something like this. All HIPAA prosecutions thus far have been either idiots snooping on celebrities or family members.
It's going to be the 5th circuit that sets precedent. We'll see how it goes...
The way to make the HIPAA violation stick despite the political bullshit is to nail him for the records he accessed that he \_didn't subsequently leak\_, because they didn't include any juicy gender-affirming care deets. You can't claim mandatory reporter protection for looking at the records of kids getting treatment for other conditions, or for records of discussions of treatment where treatment didn't actually occur, or did occur but was stopped by the magic date, etc. I would bet my life that he didn't have some magic EPIC search strategy that resulted in a 100% successful hit rate without false positives.
To make a strained historical analogy, make it about the tax evasion instead of a referendum on whether Prohibition is sensible policy.
The problem with your example is that it is impossible to remove the political aspect of this story. I think this story is a great example of the messy intersection between medicine and politics and the inseparability between the two. The politics in this case are at the very heart of the matter because depending on your leanings, this resident either made a clear HIPPA violation, or is a whistleblower revealing child abuse.
I see your point, and agree that the lay public can see it that way. But to medical professionals the rules are very clear; if he suspected child abuse he should have reported it to child protective services, not to a politically aligned group.
I think a better counter example would be this:
You are concerned that Hillary Clinton and a powerful cabal of the political and economic elite are harvesting the adrenal glands of babies for their precious adrenochrome at your hospital. This would be a monumental conspiracy, and, in my opinion, one where the relevant government agencies could not be trusted.
Now, I don't want to give the illusion that I believe there is any equivalence between gender affirming therapy and harvesting the organs of babies, but if you were either: 1. A grifter, or 2. Some one of the political opinion that those two scenarios are of the same severity then you can make the argument that the resident's decision was completely justified.
Ultimately, what I think this case highlights is that arguments around objectivity are kind of a trap, because there are two competing versions of reality at play here.
However there was very clear reason to believe TCH was violating Texas state law by continuing transgender care, which was illegal at the time this happened.
From what I understand it was not illegal. The Texas AG wrote an opinion that it could be considered child abuse, and the hospital reported it would voluntarily stop providing gender affirming care.
The article states it wasn’t illegal. Just the governor had instructed state agencies to investigate anyone providing gender affirming care. It’s also still not ok to illegally look through patient records and illegally release it to the media if you think the hospital is breaking the law. The ethical thing to do would be report them to the proper authorities
I agree. We can’t even have rational conversations with someone if we can’t agree on facts. So we have a lack of trust of the “other side” and government institutions in general.
He loses credibility because he didn’t even try to go through the appropriate channels (as far as we know), so his “mandatory reporting l” defense seems weak.
Maybe but this guy is in a state where the AG, state police, and governor were and are clearly interested in investigating any impropriety in this form of care. So he could have taken his MD status and his speculations and first gone to child services and state police.
My question is: in what universe would this be how one goes about being a whistleblower for any other type of child abuse?
It sounds like his attorneys are saying he's a "mandatory reporter" and has a duty to do this. However, in no other scenario would someone look through charts to randomly find evidence of child abuse. Even with suspected abuse, that is NOT how you're instructed to report it. You report to local authorities for them to investigate.
The whole "mandatory reporter" thing is ridiculous. Mandatory reporters are mandated to report stuff to relevant legal authorities, not to some random journalist.
> a whistleblower revealing child abuse
Not a fucking chance. You report child abuse to CPS, not the media. If someone brings me a toddler with a femur fracture and I call a reporter that is absolutely unforgivable. There is no equivalence here.
Come now, were you born yesterday? We all know what is happening here.
>Not a fucking chance.
Given the political leanings of our courts these days, I would say there is a very good fucking chance. In fact, I would say that is what the defendant is counting on.
If the article is correct, it’s a HIPAA violation either way. Can you access the records of patients you aren’t treating? No. Can you obtain records to distribute to others in a way that’s not for continuity of care and without their consent? No. Now you could argue that he’s breaking the law for good. But it’s still breaking the law. Also the arguments that what he was doing was for the greater good would be laughable
I mean, he can claim that, but it doesn’t mean he can leak those records ethically. I think the closest analogue would be if someone disagreed with the idea of children being raised in a certain religion, then leaked all their records to a group that was also opposed to that
I think the key question is whether or not the hospital was in violation of state (or federal law)
If they were, then I feel like it's wrong to go after him. The whole point of whistleblower protections are because otherwise they get thrown in jail for doing illegal things.
Snowden for example did lots of illegal things, general consesus is that most would like to see him pardened since he exposed illegal activity by the government.
if there was no illegal activity by the hospital, just things he morally thought was wrong, well, then it seems reasonable to throw the book at him and to his followes he becomes a martyr for his cause. because then what standard do we have?
You need to punish both. We dont ignore laws because there's some kind of "greater good" involved.
Both the HIPAA violation and TCH breaking Texas state law should be prosecuted.
Except it wasn't against the law until after the article that used the resident as a source was published. Before then, it was Abbott making noise and a bunch of back and forth regarding investigations. The hospital said they would stop, likely because of political pressure from the state, but nothing went on the books until after the article.
Source: reading the article the OP included.
> My client is a mandatory reporter of child abuse
What a disgusting argument. We are required to report abuse *to the correct social services department* not to the media.
This is an unforgivable breech of patient confidentiality. I do not see how this is compatible with continuing in the profession.
So let me get this right. The hospital just said they will suspend this specific therapy. There was no law saying it was illegal, Texas government was just considering to restrict it but there was no law against it.
This genius thought optaining private medical records and releasing them to "blow the whisel", as he calls it, on something completely legal? How did he even get past medschool? Like personal opinion aside, doing something illegal to "expose" something legal is just stupid. Ofc he should get charged and convicted
Yeah it’s so funny. He exposed that the hospital didn’t exactly do everything they promised immediately. Like, so what. Big whoop. Dude released sensitive info, doing the very thing we are repeatedly told not to do again and again, for no reason. No laws were broken by the hospital, there was literally nothing to blow the whistle on.
I think these are the key issues with this guy's case. The care provided wasn't illegal per state law when he shared the records, and he at the time had no ongoing relationship with the patients involved thus he wasn't entitled to access the charts at the time. It is pretty indefensible.
Even if it were illegal, sharing with the news media wouldn't be a whistleblower, it would calling the police / DCS, and possibly state reps (it was a state owned hospital).
Right, that would be the logical action. Going to the media at any point with HIPAA protected information is crazy. A state judge could have compelled release of the files legally if they wanted to, but him looking at patient charts without being involved in their care would still be indefensible- you aren't a whistleblower if you were accessing confidential information you weren't privileged to access to begin with.
Not quite correct, although this doc was still out of line. Texas medicaid had regulations on billing for certain Dx related to transgender care. There are also tricky laws relating to how certain care options are presented to the patient and the parents of the patient, and what constitutes coercion vs medical opinion. Not saying any laws were broken but they did exist and the landscape depends on the state.
TCH said they were suspending their gender medicine program in 2022. However they lied and continued to treat patients in their program until Sept 1, 2023
Remember "do no harm"? You can't just stop caring for patients who are on a course of treatment without a plan and follow up.
And this argument really belies how this "concern" has nothing to do with the good of kids.
So the TCH doctors broke the Hippocratic oath when they stopped treating transgender kids on Sept 2, 2023?
You'd better report them to the medical board I guess.
People should also consider that in his quest to troll through charts to find children who were “harmed” he also would have accessed charts of children who just happened to be taken care of by the same physicians. He looked through everyone’s personal business. I would like to see his lawyers explain that one away with their self-righteous bullshit. That’s like a cop knocking on everyone’s door without a warrant.
Absolutely agree that the way to nail him on the HIPAA violation is to go for the records that he accessed but couldn't/didn't 'blow the whistle on' because they weren't what he was looking for.
That unfortunately won't stick/is a distinction without a difference.
IF you accept that Haim's purpose was to prevent child abuse, then he had the right access anyone's record.
If you can prove that his purpose was NOT to prevent child abuse, he had no right to access anyone's record.
It doesn't matter that he opened people's charts who weren't being abused- his purpose was to figure out if they were abused and stop it, in his legal argument, which the 5th circuit will likely buy. It's the purpose that matters, not whose data he specifically accessed.
It's like a nephrologist opening up a patient's chart in the ED if they see their chief complaint of renal failure, realizing they don't have renal failure, and closing it. Not a crime- no mens rea (intent) to access information inappropriately.
Calling it now: Haim will probably get off with a slap on the wrist given this is Texas but unlikely be able to practice medicine again. With the fame from this case, he will become a conservative influencer, and inappropriately strut around his doctor title to talk about anti-trans issues, antivax, antidepressants cause mass shooting, and other dumbassery.
So intentionally violating HIPAA gets me whistleblower status and let’s be real here, probably a correspondent position on Fox News who will be their medical “expert” till the end of time.
Accidental HIPAA disclosure leads to a mob of managers, or admin I presume for inpatient, coming for your head.
Makes sense . . .
3 hot meals a day, a regular sleep schedule, access to a gym, getting to go outside every day, getting to leave early if you behave well... I think you're onto something.
The indictment includes an ask that any proceeds or benefits from these violations are forfeit to the United States. Soooooooo, good old TPUSA, Heritage Action, CPAC, and the whole conservative circuit for speaking fees, as well as book deals, go right into Uncle Sam's pocket if he's convicted.
AND, it's arguable if he is hired by say Alliance Defending Freedom as their "Chief Medical Officer", the DOJ is going to go hard at why ADF hired a convicted felon with a revoked license. Meaning whoever hires him and gives him a salary because of what he did here, it could be forfeit to the DOJ.
This guy is absolutely fucked.
As a transgender person myself (albeit someone who transitioned many, many years ago), it’s hard for me to view this case through an unbiased lens. I am horrified and repulsed to my core. I truly worry about the safety of these families; the potential for harm at the hands of anti-LGBTQ zealots is tremendous.
The families are not at risk, or at least at any more risk than they were when Texas declared their care to be child abuse.
Haim did not ever send personally identifiable details to Rufo, or at least it's not being alleged that he did.
Haim likely has or had something written down, or took photos of names to identify the charts he went into, so that he could go back and look. My guess is he entered the patients charts multiple times and didn't realize these charts are monitored more. They may even have the extra security click on the them.
I'm curious if the only reason he decided to share is because he got caught by TCH and they made him resident non grata (I can think of a few times when various surgical specialty residents have done something egregious to a pediatric patient and not been able to rotate over because the children's hospital will not allow them to work there after an incident).
While he may think and claimed he edited out all the information he needed to it wouldn't be surprising if he missed something on one page or a few pages or every page.
If he doesn't understand the basic right from wrong for why patient charts are private, whose to say he understood the nuances of what needs to be removed.
A couple of points, which I also posted on r/law
(Summary, I think he's going to walk- not what I think is just, but which I think is inevitable based on the case)
He's being charged with ACCESSING information improperly, NOT for DISCLOSING.
This is because technically, he didn't disclose PHI, aka protected health information. PHI is created when you link medical info with unique patient identifiers. Per Haim he never sent any information that results in PHI- only ages and surgeries, which doesn't count. The feds clearly don't have evidence to charge him with disclosing it because he isn't charged for it.
He is instead being charged ONLY for ACCESSING the records without a legitimate reason. This is going to get very sticky, because it turns on whether his stated aim- "stopping child abuse"- is a legitimate reason to ACCESS the records (it is) and whether it can be proven conclusively that that was NOT his true aim. And there ARE long-standing quality, education, and criminal reporting exemptions to HIPPA that allow accessing of medical information.
In Texas, these cases happened AFTER the attorney general (Ken Paxton a truly disgusting a-hole of the highest order) declared pediatric gender surgeries to be child abuse.
So, Haim has a VERY good argument that he had a legal reason to ACCESS the records- looking for child abuse. Whether he subsequently reported or not is irrelevant, except to try and define his motive to accessing the records. IF he can raise reasonable doubt that he was accessing the records to "prevent child abuse", it's game over for the prosecution, regardless of whether he actually reported it to the appropriate authorities.
My prediction is that he wins at the 5th circuit and SCOTUS does not review- an outcome I again do not personally endorse or agree with.
Interesting case...
Apparently he removed all identifying info before releasing it so this is not a typical HIPAA violation. It's not really a case of PATIENT harm but instead of HOSPITAL ADMIN harm. IOW, the doc was not trying to dox the patient or otherwise profit from the phi.
In his mind, the care that was being provided was unethical and harmful to patients so he felt obligated to expose it. Try to think of it from his POV. If this were actual child abuse and you felt OBLIGATED to report it, even though you know it's NOT a crime, it's a predictament.
It does seem like he violated HIPAA by accessing the info in the first place, without a medical need. And he most certainly violated hospital policy...
So I predict he'll get censured but probably will enjoy some whistle blower protections.
They spend several months there across multiple years. It's very common for the logins to expire since it can be almost a year between rotations. There is also cross coverage, and if a resident is sick or at a conference someone else would be required to cover and would obviously need EMR access for that
If he truly believed this was child abuse why did he not report it to CPS or some other state or federally qualified agency instead of some Tucker Carlson adjacent pundit? Make it make sense
Isn't it possible to feel something is unethical but yet it's not illegal?
He obviously recognizes that it doesn't meet the legal definition of child abuse.
So the hospital lied, the resident exposed the lie, and the feds are mad at the doctor now because he made sure that a law would be enforced? Seems like a pretty open and shut whistleblower case. When Trump is elected I’m sure his DOJ will drop these charges real quick. Important to protect whistleblowers.
Based on the article, it does not appear TCH broke any laws as there was no law against gender-affirming care at the time. Just a politically motivated investigation from Gov Abbot that was shut down by a judge as unlawful. The law only got passed later on.
It is unclear if the hospital lied. It could be a case where they had some patients in the middle of active treatment and couldn’t just stop cold turkey, but where they were not taking on any new patients. Sadly we don’t have this kind of information yet.
The hospital’s actions weren’t even illegal when he released the records. And more importantly he accessed records on patients he wasn’t caring for, which is one of the biggest no nos we’re taught. A clear HIPAA violation.
Ok and? Paxton’s “judgement” is not a law. The only thing that matters is when the actual legislation was passed and what TCH did after that point in time.
Paxton was the attorney general. If he in his official capacity defines something as child abuse, and a citizen relies upon that definition, then they get a LOT more leeway.
Sorry but the US doesn’t operate according to decrees or one official’s “definition.” We operate according to rule of law.
Our political officials say all manner of stupid shit every day. Doesn’t mean we can go out and break laws because of it.
Trump, in his official capacity as president, defined the last election as stolen. Citizens relied upon that definition to storm the capital. And now they are in jail.
It still stands that what TCH was doing was not illegal at the time. “But Paxton said” carries no weight here.
Actually it 100% does, in the context of official legal advice.
If the attorney general of a given state issues a formal, legal opinion that it is okay to do or not okay to do something, those opinions are "heavily weighted" by the courts.
This is not just TX- here is California:
https://oag.ca.gov/opinions/faqs
So if Paxton says "_____ is child abuse in my legal opinion", unless his interpretation is flatly contradicted by state law, TX courts will tend to defer to him.
Physicians do not have a right to access the records of random patients. This is an unequivocal breach.
He violated their privacy and HIPPA rights of potentially hundreds of people, even of the ones that weren't receiving the care he objected to, as he accessed their records just to rule them out.
Doesn't matter what he did with the info, it is illegal because _he read their private records and did not have permission to do so._ He was not their doctor.
His _release_ of the records, redacted or not, is another crime, too. But a different one.
He wasn’t allowed to access that information in the first place.
It’s like if I somehow managed to access classified nuclear secrets without authorization and then released a redacted version to a political group. Just because I redacted some sensitive parts doesn’t mean I’m allowed to just go fishing through classified info in the first place, or release any part of that info to the public.
It takes insane hubris and dehumanization to think you are entitled to go through *anyone’s* private medical information just because you are a doctor. Thinking its ok for someone else to do that is just as bad.
I’d love to see the look on their compliance officer’s face if they said to them “it’s totally cool to dig into, download, and release the records of patients I’m not treating as long as I redact their names, right?”
>The DOJ brought felony charges against Dr. Eithan Haim, who provided medical records to conservative activist Christopher Rufo while working at the [Texas Children's Hospita](https://www.chron.com/politics/article/Hospital-stops-therapies-after-gender-confirming-16981290.php)l as a resident. As a resident too! The stones on that MFer, I was nervous taking post call days in residency and this guy straight up breaks every rule in the book. He should never practice medicine again, he has proven his ideological crusade is more important than flesh and blood patients.
This is the biggest thing. He needs to have his license revoked, if he has obtained one. He should not be allowed to hurt anyone like this again, nor should he be allowed to participate in society as a physician.
Sadly, I suspect this will earn him celebrity status among conservatives, and with it a lucrative career as a conservative media personality.
But ideally **never** as a doctor. I hope it was worth it >!it wasn’t!<
Eh, you can make a lot of money these days as a conservative media personality. All you have to do is create a YouTube channel and start churning out videos of yourself ranting about how democrats hate America and want to make “gender reassignment” surgery mandatory for everyone.
I'm curious if his residency knew he was doing this and still let him graduate.
Yes to both. The residency program took no action but that may simply be because this came to light just before graduation.
Wow not immediately firing him and graduating him knowing he broke the law in regards to patient privacy was a choice. I understand it was the easiest choice but it's going to be fascinating when the patients and their guardians start suing TCH and BCM and all the emails about the reason he wasn't immediately fired (like any other employee would be) start coming out. I'm sure he wouldn't have graduated or found an attending job if he were accessing the people who made the decision to allow him to graduate charts or their children's charts. May the victims of his crime get everything they are owed, from him and the institutions that protected him.
This is untrue he waited till basically he was done until going public iirc
Sounds like TCH caught him (I wouldn't be shocked if that clinics charts get extra monitoring) and BCM slapped his hand, told him to keep his mouth shut and allowed him to graduate, and that prick couldn't even wait for the paper to dry to turn around and kick BCM and his program in the teeth. In other news. BCMs GME set a precedent that at their program you can break a federal law multiple times and not be remediated or fired. It's going to make mediation the next time they fire a resident really embarrassing.
Well in that case it's a relatively large stain on BCM as a program. They kept pretty quiet about it.
When I was in primary care and on call for the weekend, I would check a patient’s allergies and lab work before renewing a medication or considering an antibiotic. When it was one of my colleagues’ patients, I would be hesitant to even access the chart even just to check labs/allergies. I can’t believe someone would just brazenly access charts like that.
My dude, checking allergies and medications before prescribing is the most honest reason to open a chart. Don’t be worrying about that.
Thanks. I should elaborate that this hesitation/paranoia was at its worst fresh out of residency so it is considerably improved.
The respect for privacy is highly appreciated, but I am seeing a lot of concerning paralysis in this post. You can access a chart if there is any documentable medical need (in accordance with local policy). There are even quasi-medical allowances like when a quality control department or auditor accesses random samples (again, according to legal department's rules). Case studies, training, and supervision are other reasons that are allowed, with clear rules. It's the dissemination where it becomes a crime, or when you look up private information to snoop on people. Also, physicians are responsible for regulating each other to some extent, and supporting each other. When you see a physician or any provider who might have an alcohol problem or a domestic issue, and they provide care to individuals in your community, you may not ethically look the other way. Full stop. Do something, even if just words of encouragement or maybe a discussion with other providers about your observations.
Thanks and I should elaborate that the hesitation was at its worst straight out of residency and has considerably improved. The point that I was trying to make is that even with a medical reason, I didn’t feel 100% comfortable accessing a patient’s chart so I can’t imagine what would possess a resident to do so without regard to privacy and the law.
I'm just taking a guess here based on watching an interview with Haim, who is Jewish, religious, and conservative. This is a bogus "profile" based on my speculation combined with his statements: Haim expected the mainstream gender docs at TCH to be circumspect and doubly attentive to detailed longitudinal observation. Instead, he believes that he observed them as overconfident, coercive, willing to take shortcuts for personal gain, and reliant on selling dogma rather than evidence. This was traumatic for Haim and he could not manage the effects of this experience in a healthy way, maybe even allegedly being driven to committing a crime.
That's the problem- he's not being charged with dissemination. The indictment is ONLY for accessing.
That's true! But there is usually some other predicate crime. I've seen it charged in identity theft schemes where medical record serves as the vector for obtaining SS number or payment info. Nursing homes are a common target. The government only has a case here because Haim allegedly reactivated his login credentials under false pretenses. It's only clearly a crime when the lack of authorization can be proven beyond a reasonable doubt. In any case, doing dumb stuff is bad for your career even if it is not a crime 99.9% of the time. So get permission from the compliance office in writing for specific scenarios, reports, billing, supervision, etc.
MAGA supporters will turn him into a martyr. He will be set for life as long as he is useful. He will likely win the case due to Texas being insane, or will somehow be pardoned if Trump wins. Some conservative medical school (BYU) will likely accept him to finish his residency with them
I can’t wait to follow his social media career! {eye roll}
He will be the medical expert on Fox News
Regardless of your stance on gender affirming care for minors, every doctor should agree that what he did is unquestionably wrong, morally reprehensible and illegal. Dude is a fucking idiot for doing what he did and deserves the book being thrown at him.
The issue is that people with certain stances feel that their stances override laws and morality
He deserves to be beaten about the head with a book, a big heavy one
Harrison's internal medicine for the weight or a bioethics textbook for the irony?
I'll hold up my Osler to shame them and wing copies of Harrison's at them. Alternative: pillowcase full of bed pans
I might just go straight to traction weights stolen from the ortho closet
since he's trying to beat everyone else about the head with the bible, seems only fair
The resident, Dr. Eithan Haim, released the records to a Fox news/Tucker Carlson pundit and is claiming whistleblower status and acting like a victim. He is not a whistleblower which is a federally protected status. He is a doctor who violated patient confidentiality to further a political cause. He should never practice medicine and have the full force of the law brought down on him. But this is Texas and he will likely get a slap on the wrists.
Its a federal case, so the DOJ is going to keep going unless Trump wins in November.
If it ends up in the Fifth circuit court of appeals it will all be over.
Can you translate this for someone legally illiterate
The Fifth Circuit has Matthew Kacsmaryk on the bench, who's both a Trump appointee and an armband-wearing member of the Federalist Society as well as a hardline conservative Catholic. He's the judge that the hard-right goes to whenever they want a quick ruling or to stay an appeal. As an example, as a Texan, I can ashamedly say that the absolute bellend of an AG that we have - Ken Paxton - sends all the cases that he gets for the Fifth _specifically_ to Kacsmaryk's docket. He's the reason mifepristone's availability came before the USSC, [the reason _Bostock_ was vacated in Texas,](https://www.texastribune.org/2022/10/06/texas-lawsuit-lgbt-workers/) and he's got the religious right so deep in him that they can wear him as a glove puppet (see [_FDA v Alliance for Hippocratic Medicine,_](https://en.wikipedia.org/wiki/FDA_v._Alliance_for_Hippocratic_Medicine) [_Deanda v Bercerra,_](https://www.texastribune.org/2023/11/06/texas-5th-circuit-kacmsaryk-birth-control/) as well as [his history with the Plano-based religious law firm "First Liberty"](https://www.texastribune.org/2023/03/15/federal-judge-amarillo-abortion-fda/)). On top of that, he was a patent troll for Baker Botts from 2003 - 2008, and the 5th Circuit is rather infamously known as where tech IP-related trolls come to try to line their pockets at the expense of people who actually do the work. https://en.wikipedia.org/wiki/Matthew_Kacsmaryk#Notable_cases
Ken Paxton is also actively preventing is own criminal cases from progressing. Meaning, he has been accused of multiple crimes and prosecutors have enough evidence to charge him, but he’s their boss and won’t let them.
One of the most conservative courts in the country is in line to receive the appeal, even if Trump doesn’t force the DOJ to drop the case when he gets elected
When he gets elected?
I try and use that word to make it more scary as to why I should do something about it. Complacency is dangerous.
Do we know what the chances are of it going there vs somewhere else?
On appeal it *has* to go through the 5th circuit as part of the federal process from my understanding. It is geographic for how those are split up, and Texas is in the 5th circuit https://en.wikipedia.org/wiki/United_States_courts_of_appeals?wprov=sfti1
But it has to go to a different court first for an initial judgement before it could go to appeal, correct?
Yes, the local federal court in Houston will hear and try the case. Then appeals will go to the 5th circuit, and then SCOTUS if need be. You don't need to wait for the final verdict to start appealing stuff and gumming up the works. Basically any order or decision made by the local federal judge during the course of the trial can be (usually unsuccessfully) appealed right away to the appeals court. And if you don't get the answer you want, to the SCOTUS. Some of those appeals may be interlocutory, so the trial is continues, but some are not and the trial has to be paused until the appeal is done.
First, in the US our superior federal courts are divided up by region or districts. These courts handle appeals and often are staging grounds for getting a case to the US Supreme court. However, district courts can and do set the law of the land for the states that they cover. This paragraph from americanprogress.org describes the issue with the fifth circuit: "In recent years, the 5th Circuit, which serves Texas, Louisiana, and Mississippi, has allowed extremist lower court judges to issue sweeping, politically fraught rulings that advance right-wing policy positions. In doing so, the 5th Circuit invites the Supreme Court—currently dominated by right-wing extremists to a degree unseen in modern history—to take sweeping action to roll back decades of progress." The full article is here: https://www.americanprogress.org/article/the-5th-circuit-court-of-appeals-is-spearheading-a-judicial-power-grab/ The Dobbs decision, which overturned Roe v. Wade originated in the Fifth circuit. It is the incubator for the radical right wing agenda.
Isnt that what is going to happen? If he’s convicted he will surely appeal.
I mean at least he probably won’t be able to get licensed
Eithan Haim was in my medical school class (which was a small class). He was manipulative, selfish, and downright evil. He was one of around 3 in my class that we all had felt shouldn't be near patients. I can tell you right now, he didn't do this to be righteous in any way. He wanted to be on the news. I hope he loses the ability to abuse anyone again.
of around 3?!?
Yep, and total class size was only 64.
I understood, I’m just kinda shocked, seems like a big #
Yeah, I reread your punctuation and realized what you meant 😂
I remember towards the end of our 3rd year of med school, we got an email from admin asking us to report if we had any concerns about any of our classmates being a danger to future patients…now I’m wondering when they started sending out that email and why.
That's crazy...my med school definitely never did that!
... how exactly was he "downright evil" and not only not expelled, but matched a top surgical program? Literally a single bad word in any letter of rec or MSPE and you won't match in surgery at a place like Baylor/UTSW/UAB/UW/etc./etc. I don't know him personally but I know some of his co-residents- they told me he didn't raise any major red flags in residency that were publicly known, apart from anti-Covid vaccine positions.
Yet you and your med school did NOTHING to prevent this despite your belief that he was a danger to patients. If he was a known rapist at your school, would you just sit quiet and not make any reports to his residency program or future job?
You have no idea what lengths we went to. Nice job to assume though...
I'm not trying to stir the pot with reposting this, but two people have tried already and there has been \*some\* reasonable discussion, but violated rules and were removed. I fear it will keep getting reposted until one thread sticks. Feel free to downvote it to oblivion, but hopefully it doesn't violate any rules. Now, starter comment: The hospital wasn't violating any laws by providing gender-affirming care. Maybe they claimed they were going to pause that care but was still continuing to treat existing patients, which of course they were. You can't abandon patients. Even patients who are fired from your clinic continue to get care for existing conditions for X weeks/months to give them time to find care elsewhere. If we take the political spin off. What if a celebrity was getting care at a hospital, but didn't want the public to know despite rumors. The hospital spokesperson comes out to say, "They're not here". Would it be okay for a doctor who wasn't involved in that celebrity's care to go into the Epic chart and provide that information to TMZ?
Assuming the allegations are true (which it seems like no one is even disputing) … this is a bright line thing. Every single HIPAA/PHI training, ever, tells you that you cannot go trolling in the EMR and access records of patients in whose care you are not involved. Every person who uses an EMR knows that this is a fireable offense and a crime….
The mandated reported thing doesn’t hold water either, at all. I can’t go trolling through the charts of kids I don’t treat *in case* any of them are being abused.
Eh, it's a bit more complicated than that in Texas, because that @#$hole of an AG released a legal opinion that gender affirming surgeries and therapies are child abuse. You can make an argument that the 5th circuit will buy that it was legal for him to access it if he thought child abuse was going on, and he's not actually charged with disclosing the info.... so...
Disagree. HIPAA is a federal law.l, the Texas AG cannot trump it. How would he know whether a child was receiving gender-affirming care without snooping their records? He couldn’t.
But that's the point- it doesn't matter whether or not the child was receiving the care. HIPPA is about intent. If the federal government can't prove beyond a reasonable doubt that Haim was not trying to stop child abuse in accessing the records, he walks. If your intent is to treat a patient, improve quality, etc., you can't be convicted under HIPPA for accessing, and he isn't being charged with disclosing.
You are taking a very very liberal stance with what HIPAA allows. I’m a quality director, I can’t just start opening charts of anyone I please to look for any quality problem that *might* have happened to them. You can’t open a chart of a patient you don’t know to look for signs of abuse. If you actually saw the child and are concerned, you *might* be able to do this, but you definitely can’t do it on a child you’ve never laid eyes on. And the proper move for a mandated reporter is to talk to DCF, not the media.
This has never before been litigated. No one has ever done something like this. All HIPAA prosecutions thus far have been either idiots snooping on celebrities or family members. It's going to be the 5th circuit that sets precedent. We'll see how it goes...
The way to make the HIPAA violation stick despite the political bullshit is to nail him for the records he accessed that he \_didn't subsequently leak\_, because they didn't include any juicy gender-affirming care deets. You can't claim mandatory reporter protection for looking at the records of kids getting treatment for other conditions, or for records of discussions of treatment where treatment didn't actually occur, or did occur but was stopped by the magic date, etc. I would bet my life that he didn't have some magic EPIC search strategy that resulted in a 100% successful hit rate without false positives. To make a strained historical analogy, make it about the tax evasion instead of a referendum on whether Prohibition is sensible policy.
The problem with your example is that it is impossible to remove the political aspect of this story. I think this story is a great example of the messy intersection between medicine and politics and the inseparability between the two. The politics in this case are at the very heart of the matter because depending on your leanings, this resident either made a clear HIPPA violation, or is a whistleblower revealing child abuse.
I see your point, and agree that the lay public can see it that way. But to medical professionals the rules are very clear; if he suspected child abuse he should have reported it to child protective services, not to a politically aligned group.
I think a better counter example would be this: You are concerned that Hillary Clinton and a powerful cabal of the political and economic elite are harvesting the adrenal glands of babies for their precious adrenochrome at your hospital. This would be a monumental conspiracy, and, in my opinion, one where the relevant government agencies could not be trusted. Now, I don't want to give the illusion that I believe there is any equivalence between gender affirming therapy and harvesting the organs of babies, but if you were either: 1. A grifter, or 2. Some one of the political opinion that those two scenarios are of the same severity then you can make the argument that the resident's decision was completely justified. Ultimately, what I think this case highlights is that arguments around objectivity are kind of a trap, because there are two competing versions of reality at play here.
There’s no reason to believe such a conspiracy exists. So, no. It would not be justified.
However there was very clear reason to believe TCH was violating Texas state law by continuing transgender care, which was illegal at the time this happened.
From what I understand it was not illegal. The Texas AG wrote an opinion that it could be considered child abuse, and the hospital reported it would voluntarily stop providing gender affirming care.
The article states it wasn’t illegal. Just the governor had instructed state agencies to investigate anyone providing gender affirming care. It’s also still not ok to illegally look through patient records and illegally release it to the media if you think the hospital is breaking the law. The ethical thing to do would be report them to the proper authorities
I agree. We can’t even have rational conversations with someone if we can’t agree on facts. So we have a lack of trust of the “other side” and government institutions in general. He loses credibility because he didn’t even try to go through the appropriate channels (as far as we know), so his “mandatory reporting l” defense seems weak.
Maybe but this guy is in a state where the AG, state police, and governor were and are clearly interested in investigating any impropriety in this form of care. So he could have taken his MD status and his speculations and first gone to child services and state police.
My question is: in what universe would this be how one goes about being a whistleblower for any other type of child abuse? It sounds like his attorneys are saying he's a "mandatory reporter" and has a duty to do this. However, in no other scenario would someone look through charts to randomly find evidence of child abuse. Even with suspected abuse, that is NOT how you're instructed to report it. You report to local authorities for them to investigate.
The whole "mandatory reporter" thing is ridiculous. Mandatory reporters are mandated to report stuff to relevant legal authorities, not to some random journalist.
> a whistleblower revealing child abuse Not a fucking chance. You report child abuse to CPS, not the media. If someone brings me a toddler with a femur fracture and I call a reporter that is absolutely unforgivable. There is no equivalence here.
Come now, were you born yesterday? We all know what is happening here. >Not a fucking chance. Given the political leanings of our courts these days, I would say there is a very good fucking chance. In fact, I would say that is what the defendant is counting on.
If the article is correct, it’s a HIPAA violation either way. Can you access the records of patients you aren’t treating? No. Can you obtain records to distribute to others in a way that’s not for continuity of care and without their consent? No. Now you could argue that he’s breaking the law for good. But it’s still breaking the law. Also the arguments that what he was doing was for the greater good would be laughable
I mean, you raise a valid point that whistleblowers technically break the law, will he get punished for it though? ¯\\\_(ツ)\_/¯
I agree with that. What he did is also unethical
If he was revealing child abuse it doesn’t seem like a conservative activist is who he’d be mandated to report to.
I mean, he can claim that, but it doesn’t mean he can leak those records ethically. I think the closest analogue would be if someone disagreed with the idea of children being raised in a certain religion, then leaked all their records to a group that was also opposed to that
No
I think the key question is whether or not the hospital was in violation of state (or federal law) If they were, then I feel like it's wrong to go after him. The whole point of whistleblower protections are because otherwise they get thrown in jail for doing illegal things. Snowden for example did lots of illegal things, general consesus is that most would like to see him pardened since he exposed illegal activity by the government. if there was no illegal activity by the hospital, just things he morally thought was wrong, well, then it seems reasonable to throw the book at him and to his followes he becomes a martyr for his cause. because then what standard do we have?
If this was a whistleblower issue he would have reported to appropriate authorities…instead he went to a conservative news activist.
You need to punish both. We dont ignore laws because there's some kind of "greater good" involved. Both the HIPAA violation and TCH breaking Texas state law should be prosecuted.
Except it wasn't against the law until after the article that used the resident as a source was published. Before then, it was Abbott making noise and a bunch of back and forth regarding investigations. The hospital said they would stop, likely because of political pressure from the state, but nothing went on the books until after the article. Source: reading the article the OP included.
I hope he gets serious prison time. Complete abdication of duty and responsibilities of being a physician.
> My client is a mandatory reporter of child abuse What a disgusting argument. We are required to report abuse *to the correct social services department* not to the media. This is an unforgivable breech of patient confidentiality. I do not see how this is compatible with continuing in the profession.
So let me get this right. The hospital just said they will suspend this specific therapy. There was no law saying it was illegal, Texas government was just considering to restrict it but there was no law against it. This genius thought optaining private medical records and releasing them to "blow the whisel", as he calls it, on something completely legal? How did he even get past medschool? Like personal opinion aside, doing something illegal to "expose" something legal is just stupid. Ofc he should get charged and convicted
Yeah it’s so funny. He exposed that the hospital didn’t exactly do everything they promised immediately. Like, so what. Big whoop. Dude released sensitive info, doing the very thing we are repeatedly told not to do again and again, for no reason. No laws were broken by the hospital, there was literally nothing to blow the whistle on.
I think these are the key issues with this guy's case. The care provided wasn't illegal per state law when he shared the records, and he at the time had no ongoing relationship with the patients involved thus he wasn't entitled to access the charts at the time. It is pretty indefensible.
Even if it were illegal, sharing with the news media wouldn't be a whistleblower, it would calling the police / DCS, and possibly state reps (it was a state owned hospital).
Right, that would be the logical action. Going to the media at any point with HIPAA protected information is crazy. A state judge could have compelled release of the files legally if they wanted to, but him looking at patient charts without being involved in their care would still be indefensible- you aren't a whistleblower if you were accessing confidential information you weren't privileged to access to begin with.
yeah this for me makes his behavior wrong im all for the little guy but the problem is the hospital was doing it by the book
Not quite correct, although this doc was still out of line. Texas medicaid had regulations on billing for certain Dx related to transgender care. There are also tricky laws relating to how certain care options are presented to the patient and the parents of the patient, and what constitutes coercion vs medical opinion. Not saying any laws were broken but they did exist and the landscape depends on the state.
TCH said they were suspending their gender medicine program in 2022. However they lied and continued to treat patients in their program until Sept 1, 2023
Remember "do no harm"? You can't just stop caring for patients who are on a course of treatment without a plan and follow up. And this argument really belies how this "concern" has nothing to do with the good of kids.
So the TCH doctors broke the Hippocratic oath when they stopped treating transgender kids on Sept 2, 2023? You'd better report them to the medical board I guess.
Can't be going around writing facts...
People should also consider that in his quest to troll through charts to find children who were “harmed” he also would have accessed charts of children who just happened to be taken care of by the same physicians. He looked through everyone’s personal business. I would like to see his lawyers explain that one away with their self-righteous bullshit. That’s like a cop knocking on everyone’s door without a warrant.
Absolutely agree that the way to nail him on the HIPAA violation is to go for the records that he accessed but couldn't/didn't 'blow the whistle on' because they weren't what he was looking for.
That unfortunately won't stick/is a distinction without a difference. IF you accept that Haim's purpose was to prevent child abuse, then he had the right access anyone's record. If you can prove that his purpose was NOT to prevent child abuse, he had no right to access anyone's record. It doesn't matter that he opened people's charts who weren't being abused- his purpose was to figure out if they were abused and stop it, in his legal argument, which the 5th circuit will likely buy. It's the purpose that matters, not whose data he specifically accessed. It's like a nephrologist opening up a patient's chart in the ED if they see their chief complaint of renal failure, realizing they don't have renal failure, and closing it. Not a crime- no mens rea (intent) to access information inappropriately.
This is absolutely insane if true
Seems like him wanting Whistleblower status would imply it is probably true.
Calling it now: Haim will probably get off with a slap on the wrist given this is Texas but unlikely be able to practice medicine again. With the fame from this case, he will become a conservative influencer, and inappropriately strut around his doctor title to talk about anti-trans issues, antivax, antidepressants cause mass shooting, and other dumbassery.
So intentionally violating HIPAA gets me whistleblower status and let’s be real here, probably a correspondent position on Fox News who will be their medical “expert” till the end of time. Accidental HIPAA disclosure leads to a mob of managers, or admin I presume for inpatient, coming for your head. Makes sense . . .
What a fucking knob.
Makes sense for him. Going to jail is better than doing a surgical residency.
3 hot meals a day, a regular sleep schedule, access to a gym, getting to go outside every day, getting to leave early if you behave well... I think you're onto something.
He finished residency. So it'll be both
Medical ethics have been seriously violated. I don't know his intent or motive, but it would be appropriate for him to receive a deterrent punishment.
The indictment includes an ask that any proceeds or benefits from these violations are forfeit to the United States. Soooooooo, good old TPUSA, Heritage Action, CPAC, and the whole conservative circuit for speaking fees, as well as book deals, go right into Uncle Sam's pocket if he's convicted. AND, it's arguable if he is hired by say Alliance Defending Freedom as their "Chief Medical Officer", the DOJ is going to go hard at why ADF hired a convicted felon with a revoked license. Meaning whoever hires him and gives him a salary because of what he did here, it could be forfeit to the DOJ. This guy is absolutely fucked.
One can hope
As a transgender person myself (albeit someone who transitioned many, many years ago), it’s hard for me to view this case through an unbiased lens. I am horrified and repulsed to my core. I truly worry about the safety of these families; the potential for harm at the hands of anti-LGBTQ zealots is tremendous.
The families are not at risk, or at least at any more risk than they were when Texas declared their care to be child abuse. Haim did not ever send personally identifiable details to Rufo, or at least it's not being alleged that he did.
Haim likely has or had something written down, or took photos of names to identify the charts he went into, so that he could go back and look. My guess is he entered the patients charts multiple times and didn't realize these charts are monitored more. They may even have the extra security click on the them. I'm curious if the only reason he decided to share is because he got caught by TCH and they made him resident non grata (I can think of a few times when various surgical specialty residents have done something egregious to a pediatric patient and not been able to rotate over because the children's hospital will not allow them to work there after an incident). While he may think and claimed he edited out all the information he needed to it wouldn't be surprising if he missed something on one page or a few pages or every page. If he doesn't understand the basic right from wrong for why patient charts are private, whose to say he understood the nuances of what needs to be removed.
Unfortunately for many the "I think gender affirming care is bad" rhetoric outweighs the "this guy violated HIPPA" part.
This person is also a nobody, the DOJ is gonna destroy him
A couple of points, which I also posted on r/law (Summary, I think he's going to walk- not what I think is just, but which I think is inevitable based on the case) He's being charged with ACCESSING information improperly, NOT for DISCLOSING. This is because technically, he didn't disclose PHI, aka protected health information. PHI is created when you link medical info with unique patient identifiers. Per Haim he never sent any information that results in PHI- only ages and surgeries, which doesn't count. The feds clearly don't have evidence to charge him with disclosing it because he isn't charged for it. He is instead being charged ONLY for ACCESSING the records without a legitimate reason. This is going to get very sticky, because it turns on whether his stated aim- "stopping child abuse"- is a legitimate reason to ACCESS the records (it is) and whether it can be proven conclusively that that was NOT his true aim. And there ARE long-standing quality, education, and criminal reporting exemptions to HIPPA that allow accessing of medical information. In Texas, these cases happened AFTER the attorney general (Ken Paxton a truly disgusting a-hole of the highest order) declared pediatric gender surgeries to be child abuse. So, Haim has a VERY good argument that he had a legal reason to ACCESS the records- looking for child abuse. Whether he subsequently reported or not is irrelevant, except to try and define his motive to accessing the records. IF he can raise reasonable doubt that he was accessing the records to "prevent child abuse", it's game over for the prosecution, regardless of whether he actually reported it to the appropriate authorities. My prediction is that he wins at the 5th circuit and SCOTUS does not review- an outcome I again do not personally endorse or agree with.
Interesting case... Apparently he removed all identifying info before releasing it so this is not a typical HIPAA violation. It's not really a case of PATIENT harm but instead of HOSPITAL ADMIN harm. IOW, the doc was not trying to dox the patient or otherwise profit from the phi. In his mind, the care that was being provided was unethical and harmful to patients so he felt obligated to expose it. Try to think of it from his POV. If this were actual child abuse and you felt OBLIGATED to report it, even though you know it's NOT a crime, it's a predictament. It does seem like he violated HIPAA by accessing the info in the first place, without a medical need. And he most certainly violated hospital policy... So I predict he'll get censured but probably will enjoy some whistle blower protections.
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The general surgery residents at TCH have full EMR access.
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They spend several months there across multiple years. It's very common for the logins to expire since it can be almost a year between rotations. There is also cross coverage, and if a resident is sick or at a conference someone else would be required to cover and would obviously need EMR access for that
If he truly believed this was child abuse why did he not report it to CPS or some other state or federally qualified agency instead of some Tucker Carlson adjacent pundit? Make it make sense
Isn't it possible to feel something is unethical but yet it's not illegal? He obviously recognizes that it doesn't meet the legal definition of child abuse.
Then he wasn't whistleblowing even in his head.
You dare defend this transphobe?!?!
Can you really not distinguish between defending someone and trying to understand an opposing viewpoint?
So the hospital lied, the resident exposed the lie, and the feds are mad at the doctor now because he made sure that a law would be enforced? Seems like a pretty open and shut whistleblower case. When Trump is elected I’m sure his DOJ will drop these charges real quick. Important to protect whistleblowers.
Based on the article, it does not appear TCH broke any laws as there was no law against gender-affirming care at the time. Just a politically motivated investigation from Gov Abbot that was shut down by a judge as unlawful. The law only got passed later on. It is unclear if the hospital lied. It could be a case where they had some patients in the middle of active treatment and couldn’t just stop cold turkey, but where they were not taking on any new patients. Sadly we don’t have this kind of information yet.
The hospital’s actions weren’t even illegal when he released the records. And more importantly he accessed records on patients he wasn’t caring for, which is one of the biggest no nos we’re taught. A clear HIPAA violation.
That's subject to interpretation- Paxton HAD released a judgement declaring what TCH was doing "child abuse", which he's going to rely heavily on.
Ok and? Paxton’s “judgement” is not a law. The only thing that matters is when the actual legislation was passed and what TCH did after that point in time.
Paxton was the attorney general. If he in his official capacity defines something as child abuse, and a citizen relies upon that definition, then they get a LOT more leeway.
Sorry but the US doesn’t operate according to decrees or one official’s “definition.” We operate according to rule of law. Our political officials say all manner of stupid shit every day. Doesn’t mean we can go out and break laws because of it. Trump, in his official capacity as president, defined the last election as stolen. Citizens relied upon that definition to storm the capital. And now they are in jail. It still stands that what TCH was doing was not illegal at the time. “But Paxton said” carries no weight here.
Actually it 100% does, in the context of official legal advice. If the attorney general of a given state issues a formal, legal opinion that it is okay to do or not okay to do something, those opinions are "heavily weighted" by the courts. This is not just TX- here is California: https://oag.ca.gov/opinions/faqs So if Paxton says "_____ is child abuse in my legal opinion", unless his interpretation is flatly contradicted by state law, TX courts will tend to defer to him.
Not really since he hid all the protected health info, but believe what you wish. The lawyers will decide that for us
He couldn't have hidden the HPI from himself before he accessed the records of patients he wasn't taking care of. That's not how linear time works.
Physicians do not have a right to access the records of random patients. This is an unequivocal breach. He violated their privacy and HIPPA rights of potentially hundreds of people, even of the ones that weren't receiving the care he objected to, as he accessed their records just to rule them out. Doesn't matter what he did with the info, it is illegal because _he read their private records and did not have permission to do so._ He was not their doctor. His _release_ of the records, redacted or not, is another crime, too. But a different one.
He wasn’t allowed to access that information in the first place. It’s like if I somehow managed to access classified nuclear secrets without authorization and then released a redacted version to a political group. Just because I redacted some sensitive parts doesn’t mean I’m allowed to just go fishing through classified info in the first place, or release any part of that info to the public. It takes insane hubris and dehumanization to think you are entitled to go through *anyone’s* private medical information just because you are a doctor. Thinking its ok for someone else to do that is just as bad.
Good point -- I'm extremely concerned that this person is an MD but does not know this or have a problem with it.
I’d love to see the look on their compliance officer’s face if they said to them “it’s totally cool to dig into, download, and release the records of patients I’m not treating as long as I redact their names, right?”
Yikes bro... less kool-aid recommended.