On Sept. 5, Patricia Wood was admitted to Howard University Hospital after overdosing on cocaine. She had been found unconscious on the street. As emergency-room doctors worked on reviving her, hospital staffers went about trying to find out who she was. She had no ID in her pockets, nor papers, receipts, or anything else to clue the nurses in to her identity. So they filled out her chart and used “Jane Doe” for her name.
It was a name Wood would keep for weeks. She was in no shape to supply the staff with her real nameor any other response. She had suffered a pontine hemorrhage: bleeding in the brain stem. She could breathe only with the aid of a ventilator, making it impossible for her to speak. When Wood finally regained consciousness, social worker Regina Cade wrote that the patient was “not able to verbalize or make gestures with her hands.”
Hospital procedure required Howard to contact the Metropolitan Police Departmentwhich had Wood’s fingerprints on filefor help in identifying its mystery patient. Howard officials are unable to produce any evidence that the hospital notified law enforcement about Wood. When Wood’s family called to see if she might be there, offering her name and description, the hospital turned them away. By the time Wood was identified, she had been in the hospital for almost six weeks.
Wood, a mother of six, grew up in Lynchburg, Va., eventually migrating to the District before succumbing to a drug addiction that relatives say has lasted more than 25 years. Her brother, Haywood Richardson, says she wasn’t the only drug user in the family, but she couldn’t shake the habit. “We went through a lot together,” Richardson says. “Me and her…I stopped, and she didn’t.”
“It hurts, because I couldn’t take her out of it,” Richardson adds. “She’s out there alone.”
Wood hadn’t been in steady contact with her family before her hospitalization. But in Wood’s usual hangout, along Florida Avenue NE near Gallaudet University, people noticed her sudden disappearance. Eventually, the news caught the ear of Richardson’s stepbrother, who passed it along to the rest of the family. He wasn’t sure what had happened, only that it was bad and that the missing woman had to be in either a hospital or a private nursing facility.
“I was scared,” says Stephanie Freeman, Wood’s daughter. “My mom’s been out doing her thing for a long time. I guess I eventually thought I would get a call that was similar to that.”
But Freeman had assumed that if something were to happen to her mother, she’d be able to find out about it. In late September, Richardson drove around Florida Avenue hoping to spot her mom. By early October, Freeman’s aunt and uncle and stepgrandmother had called the morgue, nursing facilities, and all area hospitalsincluding Howardoffering Wood’s name, description, and age. Nobody reported having a Patricia Wood or anyone who matched her particulars. By then, a month had passed since Wood’s admission.
“They said they didn’t have anyone there,” Freeman recalls. “We were trying to keep things positive. I wanted answers as to where she was.”
Wood’s sister Darlene Nataniel says she called Howard University Hospital twice without any luck. When she heard that her sister might be in a Northeast nursing home, she visited the home and urged their staff to call Howard. They did, and this time, Nataniel says, she gave a full description of her sister: skinny, white hair, might have come to the hospital after a cocaine overdose. Howard, she says, again denied having Wood.
“It was difficult,” Nataniel says. “We thought she had died.”
So the family made more calls to more facilities and to three different city police districts. And then they simply waited and worried.
The last time Richardson had seen Wood, whom the family calls “Sweetie,” she talked of moving back to Lynchburg to clean up. She had tried to get off drugs three times before. The last time, she had checked out of a program for the Christmas holidays and never gone back.
Meanwhile, in an enhanced-care unit, Howard staff had learned a few more things about Jane Doe. Drawing on the minimal gestures the patient could make, nurses eventually coaxed Wood’s first name out of her and made a start on her last name. The staff tried to get her age but instead had to guess, figuring Wood was in her 70s. She’s 55.
It is not clear what else the hospital did to determine Wood’s identity. In response to queries about Wood’s case, the hospital replied with an e-mailed statement citing the Health Insurance Portability and Accountability Act (HIPAA)legislation passed by Congress in April. The act aims to protect patients’ privacy, heavily regulating what hospitals can say about a person’s identity and condition.
Area medical professionals question whether HIPAA applies at all to a Jane Doesomeone with no known identity. “I don’t see how it would, really,” says Dr. Jeff Smith, an emergency-room doctor at George Washington University Hospital. “If these patients can’t give us their name, at that point it really is in the best interest to identify a family member.”
And staff at other area hospitals maintain that the law shouldn’t get in the way of making an identification. Deborah Ahern, chief of social work at Georgetown University Hospital, says that if a potential family member called about a Jane Doe, “We’d ask them to come in in person and bring a picture of the person they are looking for.”
That’s exactly what Clarence Hill did a few months after HIPAA became law. Hill, a family advocate with the Washington Hospital Center, says he had a family looking for a loved one who might have been his hospital’s John Doe. He had them come in, and they compared photographs, making a match. “They were elated that they found him,” he says.
At Howard, it was the lack of a family connection for Jane Doe that finally led to action. On Oct. 9, the hospital filed a request in Superior Court, asking that a legal guardian be appointed for its patient. In the hospital records submitted to the court, Dr. Alice O. Adams wrote, “Attempts to extubate have been unsuccessful and prolonged intubation (almost 1 month now) can lead to severe infections + worsening medical state. It is advisable that this patient have a tracheostomy.” Adams needed a guardian to sign off on the procedure.
According to court records, Wood’s social worker, Cade, stated: “There have not been any inquiries on the patient’s behalf by family or friends.”
In the afternoon of that same day, Superior Court Judge Jose Lopez informally designated attorney Kenneth Rosenau Wood’s guardian. The attorney immediately called Howard and the police requesting that his ward be fingerprinted.
By the afternoon of the next day, Officer James Holder of the police department’s Forensics Science Division had fingerprinted Wood and brought the prints to the lab. Holder waited in the lab until evening, when his Jane Doe was finally identified as Patricia Wood.
Six days later, on the morning of Oct. 16, Rosenau was finally given his ward’s name and identity. Wood had been at Howard for 41 days.
One Howard doctor familiar with Wood’s case, Dr. Wayne Davis, says such a wait is not unusual: “Sometimes we have nothing to go on.”
A family reunion at Wood’s bedside didn’t take long to organize. Rosenau found Wood’s family through her last probation officer, who had worked with her until she quit coming to meetings. Within two hours, the attorney had met Freeman, along with Wood’s brother and stepmother, who works in Howard’s dental facility, at the hospital.
First Freeman wanted to know how her mother was doing. Then she wanted to know why it had taken so long for Howard to ID its Jane Doe. She says hospital staffers told her the police don’t fingerprint Jane Does. At least one staffer also cited HIPAA.
Rosenau says Howard read too much into HIPAA. “You can call it a Catch-22. You can call it an overapplication. You can also call it a stupid result,” he says. “Anyone who wrote HIPAA certainly did not intend it to prevent the identification of Jane Does.”
Wood asked her family for coffee, macaroni and cheese, and a cigarette. Freeman remembers the moment she saw her mother: “I could tell that she knew it was me,” she says. “A little later on, she said my name.” CP