Main Line Health twice accused of failing to report sexual assault

A girl who was sexually and physically assaulted by three people sought help at Lankenau Medical Center, but authorities were never notified.

A 17-year-old girl was raped and sought help at the emergency room of Bryn Mawr Hospital, where she was allowed to remain anonymous while medical staff collected evidence of the sexual assault.

In both cases, hospital staff failed to report the child abuse, prompting state health officials in recent months to reprimand the two Main Line Health hospitals for violating state regulations.

Health care workers are among the professions subject to “mandatory reporting” under Pennsylvania state law, meaning they must report any suspected abuse of a patient under the age of 18 to the Department of Social Services.

In 2022, nearly 40,000 reports of suspected abuse were made through ChildLine, Pennsylvania's system for reporting suspected abuse and well-being concerns to child protective services. About 4,400 of those reports came from hospital staff who suspected abuse, according to the child protective services agency's most recent annual report.

While the legal obligation for reporters to report suspected cases of child abuse is clear, individual cases can be complicated and staff may not be sure who in the hospital is responsible for reporting, says Frank Cervone, a longtime child protection activist and former director of the Support Center for Child Advocates in Philadelphia.

It is crucial that hospital staff are adequately trained in dealing with child sexual abuse in order to be able to make the right decision in each case, he said.

“They are the first line of defense and potentially the only person who will receive the information,” Cervone said. “If they don't come forward, the situation can continue to be problematic.”

Children are far more likely to be abused by someone they know than by strangers, so cases often go undetected.

In response to the subpoenas, both Bryn Mawr and Lankenau have retrained their staff on reporting requirements and agreed to monitor compliance.

“Our priority is to provide safe, high-quality and equitable care to our patients and the communities we serve,” Larry Hanover, a spokesman for Main Line Heath, said in a statement.

Mandatory reporting of child abuse

In 2022, ChildLine received 425 cases of child abuse in the Southeast region, which includes Philadelphia, Chester, Delaware Montgomery Bucks and Berks counties. Fifty-two of these cases were substantiated and half of these confirmed cases involved sexual abuse.

Anyone can report suspected abuse to ChildLine, which acts as a clearinghouse for potential abuse cases. Department of Human Services staff review reports and decide whether to forward them to law enforcement or county child and youth services for investigation.

Most calls to ChildLine come from people who have a duty to report abuse – school staff, educators, doctors and other people who work with children and are required to report any suspected abuse.

Hospitals, where virtually every employee is required to report, typically designate specific staff members, such as social workers, to be responsible for reporting cases of child abuse identified by medical professionals.

“When a child comes to the emergency room for treatment, any person the child encounters with a hospital ID card is likely to be required to report from the time they enter the building until the time they leave,” Cervone said.

This approach is intended to improve efficiency so that a dozen people do not report the same incident, and to ensure that cases are not missed if each of those dozen people assumes that someone else has already reported the incident.

However, this type of “handover” can cause cases to fall through the net, Cervone said.

In other cases, medical personnel may not be sure whether they need to report a case.

For example, adult victims of sexual abuse are screened for sexually transmitted diseases and may receive emergency contraception as part of their medical treatment. Adults can decide whether to use a rape kit anonymously and whether to talk to the police.

A juvenile victim of violence may receive similar medical treatment but cannot choose whether to report their case. Hospital staff are required to report all cases of abuse involving patients under 18, regardless of the circumstances of the incident and whether the patient knew their attacker, Cervone said.

Main Line Health responds

In September 2022, Bryn Mawr emergency staff treated a 17-year-old for sexual assault and allowed her to anonymously complete a rape kit, which violates hospital policy. Staff did not report the case to ChildLine.

The administration was made aware of the error when police contacted them in March 2024.

Months later, Lankenau Medical Center was sued for failing to report suspected sexual abuse of a minor who came to the emergency room in May. The patient was treated by three people for sexual abuse and physical abuse.

The Lankenau investigation report did not state the patient’s age, but stated that she was under 18 years old.

Main Line has also established ongoing training for staff to ensure reporting requirements are met in the future, Hanover said.