Release of dental records for deceased or missing patients
Originally published in June 2015
Members often ask about their obligation to release dental records for deceased or missing persons, or for patients who may be involved in a criminal investigation.
By following the advice contained in this article, dentists will be able to provide the necessary assistance to the coroner’s office or police without contravening the confidentiality requirements of provincial legislation.
Dental records may be required to identify human remains. This is usually when the manner of death or the condition of the body makes it difficult to establish an identity by more typical methods, such as identification by family members or friends. Dental records may also be helpful in a missing person or criminal investigation.
Of course, dentists wish to cooperate with the coroner or police, particularly during stressful times for the family. However, sometimes they are hesitant to release the information requested, mindful of legal and professional obligations to protect their patients’ confidentiality. Unfortunately this can cause undue delay to an ongoing investigation.
Ontario's Personal Health Information Protection Act (PHIPA) includes provisions relevant to these types of situations. PHIPA states that health information custodians are permitted to disclose personal health information about an individual who is deceased, or is reasonably suspected to be deceased, for the purpose of identifying the individual.
Also, regulations made under the Dentistry Act define professional misconduct as giving information about a patient to a person other than the patient or his/her authorized representative, except with the consent of the patient or his/her authorized representative, unless the dentist is required or allowed to do so by law. A request from a coroner or a court order or warrant from a judge or justice of the peace is sufficient legal authority for release of patient information.
What happens when the Office of the Chief Coroner or a local coroner requests dental records?
Under the provincial Coroner’s Act, coroners have the legal authority to seize anything that they have reasonable grounds to believe is material to an investigation. Dentists must comply with this request and there are penalties prescribed under the Act for not doing so.
A warrant is not required for the seizure of dental records by a coroner. However, in order to facilitate the process, the Office of the Chief Coroner has developed a document called “Coroner’s Authority (or Delegated Authority) to Seize During an Investigation” that includes the name and signature of the coroner and outlines the dental records being seized and where these items should be forwarded.
The seizure of dental records may proceed in a number of ways. A coroner may authorize a legally qualified medical practitioner or a police officer to exercise all or any of the coroner’s powers. Often, a police officer will handle the seizure. All original dental records and radiographs pertaining to the patient in question may be turned over to the police officer for transfer to the coroner’s office.
Alternatively, the coroner may arrange the release of dental records by courier transfer. If the dental records are transferred by courier, the direct costs associated with the transfer are the responsibility of the dentist who is complying with the request.
My patient is suspected of being a victim in an international mass disaster, such as an airplane crash, flood or other accident. How do I deal with requests for dental records from officials outside of Ontario?
In such situations, the local authorities will usually enter into a formal working relationship with the Office of the Chief Coroner of Ontario, which will then make the request for dental records.
What if the request for records is made by the police?
During the course of a missing person or criminal investigation, the Ontario Provincial Police may legally require a dentist to surrender dental records to them by producing a search warrant issued by a judge or a justice of the peace. Health information custodians may also disclose personal health information to police without a warrant in limited circumstances outlined in PHIPA.
What documentation do I need to keep when releasing these patient records?
Whether the dental records are released to a coroner or the police, dentists are advised to keep copies of the following:
all materials and documentation that was provided by the police, the coroner or his/her representative;
- the date and time that the materials were provided;
- the name of the police officer and the police service that he/she represents, as well as the badge number, or the name of the coroner’s representative who attended at the office;
- if the records were transferred by courier, the receipt provided by the courier service confirming the transfer;
- a list of all dental records provided, including a description of each radiograph and the date taken.
If time permits, all dental records should be copied and retained on file in the dentist’s office.
It is important to note that a coroner’s investigation and a missing person or criminal investigation are among the few exceptions when dentists may release the original dental records for a patient.
- The Dentistry Act, 1991, and the Personal Health Information Protection Act, 2004, and the Coroner’s Act, 1990, and the regulations made under these statutes may be found on the Ontario government website at www.e-laws.gov.on.ca.
- Additional information about the release and transfer of dental records.