William Wells arrived at the emergency room at St. Mary Medical Center in Long Beach on April 9 mortally wounded. The 60-year-old had been stabbed more than a dozen times by a fellow nursing home resident, his throat slashed so savagely he was almost decapitated.
Instead of focusing on treating him, an employee said, St. Mary nurses and other hospital staff did the unthinkable: They snapped photos of the dying man and posted them on Facebook.
Four staff members were fired and three disciplined, according to a St. Mary spokeswoman. At least two nurses were involved, but none was fired, a union spokesman said.
Hospital officials in California and elsewhere have faced an uneasy relationship with Facebook and other forms of social networking. Managers, struggling to prevent staffers from posting patient information on the sites, have developed no-tolerance policies and blocked employees from using Facebook and similar websites at work. The restrictions are being enforced as hospitals tout such sites as a way to boost their images and reach more patients.
Shoring up patient privacy is particularly important for hospitals, including Cedars-Sinai Medical Center, Kaiser Permanente Bellflower Medical Center and Ronald Reagan UCLA Medical Center in Southern California, that have faced investigations in recent years after employees improperly accessed patient records, including some for celebrity patients.
"It's bad enough if it's an unauthorized person checking something for curiosity's sake. It's another thing to have that then broadcast to dozens or even hundreds of people if not the Internet itself," said Anthony Wright, executive director of Health Access, a Sacramento-based patient advocacy group. "People have an expectation of privacy."
In June, five nurses were fired at Tri-City Medical Center in Oceanside after hospital managers discovered they had been discussing patients on Facebook. Hospital officials reported the incident to the California Department of Public Health, according to hospital spokeswoman Courtney Berlin. The department is investigating, a spokesman said.
Last month, Tri-City required employees to sign a new social media agreement concerning such sites as MySpace, Zoho and Eventful, among others, that noted, "Even if the patient is not identified by name or by the medical record number the information you disclose may identify that patient."
Tri-City officials would not disclose what the nurses wrote on Facebook.
The nurses have appealed their firings, insisting they did not violate patient privacy, according to Chuck Idelson, a spokesman for California Nurses Assn., which represents the nurses. Idelson also declined to say what the nurses wrote that led to the dismissals.
Three year ago, Tri-City officials fired five nurses and five staff members for taking cellphone photos of a suicidal patient and patient X-rays.
In the incident at St. Mary Medical Center, nurses and staff posted a photograph of Wells on their public Facebook accounts for about two days before fellow staffers reported them to hospital officials, according to an employee who saw the photo and Facebook posts. Hospital staffers also circulated the photo in text messages, said the employee, who asked not to be identified for fear of being fired.
Hospital spokeswoman Daa'iyah Jordan confirmed that staffers posted a photograph of a patient online, but would not identify the staffers or patient or say where the photo was posted. She said hospital officials notified the patient's family and regulators at the California Department of Public Health.
The department is investigating that incident, along with eight other potential breaches of patient information at the hospital this year, according to Ralph Montano, a department spokesman.
Facebook spokesman Simon Axten said he could not confirm when the photo was posted or removed, citing the company's confidentiality policy.
Wells died soon after the photo was taken, his suspected attacker was arrested and his death ruled a homicide, according to an autopsy report. His death is being investigated by Long Beach police and the California Department of Social Services, according to the department's spokeswoman, Lizelda Lopez. His relatives declined to comment.
Nurses often use their own Facebook pages and other social networking sites to trade information, seek advice and vent, according to Idelson, the union spokesman. He said he believes it is rare for nurses to post unauthorized patient photographs. He said union officials urge nurses never to post patient-related information online, calling sites intended for social networking "an open book."
"People may think they're protected so that what they post can only be seen by a friend or family member, but life has proved otherwise," Idelson said.