Case Study: Is Your Patient a Victim of Human Trafficking?

Most healthcare providers are aware of their role and responsibility to identify and report victims of child abuse, elder neglect, and domestic violence. However, there is another type of abuse that is on the rise and being reported in every state throughout the nation. In 2016, human trafficking cases reported in the United States rose over 36 percent from 2015, according to the National Human Trafficking Hotline statistics.

Human trafficking occurs when a trafficker exploits another individual with force, fraud, or coercion to make him or her perform labor or sexual acts. Victims can be any age (adults or minors), any gender, and from any cultural or ethnic group. The trafficker, or abuser, might be a stranger, family member, or friend. This criminal industry is very profitable, generating billions of dollars worldwide. Lack of awareness and misconceptions by healthcare providers allow opportunities for identification of the victims to go unnoticed and unreported.

Victims of abuse rarely find opportunities to interact with other persons without approval from the abuser. A visit to a physician or dental practice may provide a rare opportunity for a patient to receive the help that he or she desperately needs. Research published in the Annals of Health Law in 2014 revealed that 87.8 percent of trafficking survivors reported that they had been seen by a healthcare provider during their trafficking situation.

Human trafficking victims are commonly seen in medical and dental practices with the following conditions:

  • Trauma such as broken bones, bruises, scars, burn marks, or missing teeth
  • Poor dental hygiene
  • Pregnancy
  • Gynecological trauma or multiple sexually transmitted infections (STIs)
  • Anxiety, depression, or insomnia

Victims are usually afraid to seek help for a variety of reasons that usually stem from fear, shame, or language barriers. Healthcare providers and their staff should be trained to recognize the signs of human trafficking and know what steps to take.

Red flags to look for from the victim include:

  • Fearful
  • Depressed or flat affect
  • Submissive to his or her partner or relative
  • Poor physical health
  • Suspicious tattoos or branding
  • Lack of control with personal identification or finances
  • Not allowed to speak for him/herself
  • Reluctant or unable to verify address or contact information
  • Inconsistency with any information provided (medical, social, family, etc.)

Human trafficking is a federal crime and violators that are prosecuted receive prison sentences.  The Trafficking Victims Protection Act was enacted in 2000 and provides tools to address human trafficking on a national and worldwide level. Many states also have laws and penalties for human trafficking.

If you suspect that a patient is a victim of human trafficking, please call the National Human Trafficking Hotline at (888) 373-7888 or go to to report online.

For resources and information on assessment tools, go to the National Human Trafficking Hotline’s Resources for Service Providers or Centers for Disease Control and Prevention.

By Amy Wasdin, RN, CPHRM, Patient Safety Risk Manager II

Reprinted with permission. ©2017 The Doctors Company. For more patient safety articles and practice tips, visit

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

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