Injury Prevention
Violence-inflicted injuries: Reporting laws in the fifty states*,**

Presented at the American College of Emergency Physicians Research Forum, Philadelphia, PA, October 2000.
https://doi.org/10.1067/mem.2002.117759Get rights and content

Abstract

Study Objective: Physicians have an important role in the diagnosis, treatment, and documentation of violence-inflicted injuries. Physicians may also be legally mandated to report these assault-related injuries to law enforcement. Previous studies have shown that physicians may not be aware of the reporting laws in their state. The objective of this study was to review the reporting laws for violence-inflicted injuries in adults in the 50 states and the District of Columbia, with particular emphasis on domestic violence. Methods: Members of a domestic violence research interest group contacted individual state legislatures regarding mandated reporting by health providers of violence-inflicted injuries in adults. This information was then verified by each state’s domestic violence coalition. Statutes regarding child abuse or sexual assault and statutes concerning injuries in incapacitated adults were not included in this study. Results: Five states (Alabama, New Mexico, South Carolina, Washington, and Wyoming) have no specific reporting requirements for health providers treating patients with assault-related injuries. Forty-two states have reporting requirements for injuries resulting from firearms, knives, or other weapons. Twenty-three states have reporting requirements for injuries resulting from crimes. Seven states have statutes that specifically require health providers to report injuries resulting from domestic violence. Conclusion: Forty-five states have laws that mandate physician reports of injuries caused by weapons, crimes, or domestic violence. Physicians need to be aware of the existence of these laws and of their state’s specific requirements. [Houry D, Sachs CJ, Feldhaus KM, Linden J. Violence-inflicted injuries: reporting laws in the fifty states. Ann Emerg Med. January 2002;39:56-60.]

Introduction

The heightened awareness of violence-inflicted injuries and intentional assaults has led to the creation of laws and protocols to deal with victims in the clinical setting, including physician-mandated reporting of these injuries to law enforcement.1 A review of legal statutes in 1994 reported that all but 5 states had laws that, to varying extents, required health providers to report intentional injuries to law enforcement, including injuries resulting from domestic violence.2

The Centers for Disease Control Hospital Ambulatory Medical Care Survey reported that an estimated 1.4 million people were treated in US emergency departments in 1994 for injuries resulting from confirmed or suspected interpersonal violence.3 Ninety-four percent of these patients sustained their injuries during an assault; the remainder of injuries were incurred during other criminal acts, such as burglary or rape. Of these reported injuries, women were more likely than men to have been assaulted by someone with whom they shared an intimate relationship.3 Other studies have reported that domestic assaults account for 2% to 5% of all injuries in women who are treated in the ED.4, 5 Thus, emergency physicians frequently treat patients with violence-inflicted injuries, including victims of domestic violence.

Emergency physicians have an important role in the recognition, treatment, and documentation of intentional trauma and assault; they may also be legally mandated to report these injuries to law enforcement officials in their states. The majority of states have laws regarding health providers reporting injuries resulting from firearms, knives, and burns.2 In addition, several states have laws that specifically mandate reporting of domestic violence injuries to law enforcement.2 However, emergency physicians may not be aware of these laws, specifically those laws involving the reporting of domestic violence–related injuries. Henry et al6 reported that only 24% of physicians in Kentucky were aware of the state statute requiring physicians to report injuries resulting from confirmed or suspected “spouse abuse.” Conversely, Rodriguez et al7 reported that 61% to 86% of physicians in California were aware of the state mandatory reporting statute for domestic violence injuries.

The objective of this study was to review the reporting requirements for violence-inflicted injuries in adults by health providers in the 50 states and the District of Columbia, with particular emphasis on domestic violence.

Section snippets

Materials and methods

This was a collaborative research effort conducted from July 1999 to April 2000 by members of a domestic violence research interest group. Members contacted individual state legislatures regarding the current statutes addressing health provider reporting requirements for assault-related injuries in adults. Each member was asked to provide the current 1999 statutes for at least one assigned state. Copies of the actual statutes were then compiled by one of the researchers. Additionally, each

Results

For 5 states (Alabama, New Mexico, South Carolina, Washington, and Wyoming), no specific health provider reporting requirements for violence-inflicted injuries were found. Forty-two states have laws that require health providers to report injuries resulting from firearms, knives, or other weapons to law enforcement. Of these states, 8 (Alaska, Minnesota, Nevada, New York, Ohio, Rhode Island, West Virginia, and Wisconsin) also specified burns among the reportable injuries.

Twenty-three states

Discussion

As of December 1999, all but 5 states required various classes of health providers to report violence-inflicted injuries in adults to law enforcement and, to varying extents, to report injuries resulting from domestic violence. Overall, 26 states mandated that health providers report injuries resulting from crimes or specifically domestic violence.

Although Hyman et al2 reported that, in 1994, 45 states had reporting requirements for violence-inflicted injuries, progress has been made in this

Acknowledgements

Author contributions: DH and CJS developed the idea for the project. DH, CJS, KMF, and JL collected the data, and DH and CJS verified the data. DH tabulated and inputted the data and performed all statistical calculations. DH wrote the initial draft, and all authors reviewed the initial draft, participated in revisions of the paper, and are responsible for the final version of the paper.

The following Society for Academic Emergency Medicine Domestic Violence Interest Group members contributed to

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Author contributions are provided at the end of this article.

**

Address for reprints: Debra Houry, MD, MPH, Denver Health Medical Center, Emergency Medicine Residency, 601 Broadway, Mailcode 0108, Denver, CO 80204, fax 303-436-7541; E-mail [email protected].

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