Module 02 – Breach of Confidentiality
A 42-year-old male dentist was referred to the radiology department of a hospital for a CT-guided
needle biopsy of a 1.5 cm lung nodule. The nodule was thought to be benign but clarification was needed.
The patient met with the radiologist and the nurse to explain the procedure and possible risks of bleeding,
infection and pneumothorax that may require a chest tube.
Before signing the consent form, the dentist asked to speak to the radiologist privately. The
patient reveled that he was HIV-positive and was worried that his dental practice might suffer “dire
financial consequences” if knowledge of his HIV were to become known. The patient emphasized that he
confidential and every precaution was taken to maintain privacy. The fine needle aspiration was
performed but the sample was insufficient and a small core biopsy was done. After the patient complained
of chest pain, a radiograph was taken and a small pneumothorax was found.
The patient was immediately admitted to the radiology holding area for observation. Two hours
later, the patient complained about shortness of breath and a follow up chest radiograph indicated an
increase in the pneumothorax. A chest tube was put in and the patient was admitted. As part of his
admission, an intern obtained his medical history and did an examine, during this the dentist revealed his
HIV status and it was noted. The next day, a follow up radiograph showed no signs of the pneumothorax.
The patient was discharged.
Six week later the radiologist was contacted by risk management, that a patient complained his
HIV status had been leeked to the community. The radiologist denied discussing this with anyone. The
risk manager said she would investigate further. Eight months later, the radiologist, the hospital and
family physician were sued.
The issue of breach of patient confidentiality was investigated. This disclosed that shortly after