Main Line Health was cited twice in recent months for failing to report child sexual assault

A girl who had been 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 care at Bryn Mawr Hospital’s emergency department, where she was allowed to remain anonymous when medical staff collected sexual assault evidence.

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

Health-care workers are among the professionals considered “mandated reporters” under Pennsylvania law, meaning they are required to report to the Department of Human Services any time they suspect abuse against a patient who is under age 18.

Just under 40,000 reports of suspected abuse were made in 2022 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 employees who suspected abuse, according to the most recent Child Protective Services annual report.

While the law requiring mandated reporters to report suspected child abuse is clear, individual cases can be complicated and staff may be unsure who inside the hospital is responsible for filing a report, said Frank Cervone, a longtime child welfare advocate and former director of Philadelphia’s Support Center for Child Advocates.

It’s critical that hospital workers are properly trained on handling child sexual assault, with the goal of making the right call every time, he said.

“They’re the front line of defense and may be the only person to receive the information,” Cervone said. “If they don’t blow the whistle, a troubling situation may continue.”

Children are far more likely to be abused by someone they know than by a stranger, which means cases may often go undetected.

Both Bryn Mawr and Lankenau have retrained staff on mandatory reporting requirements in response to the citations and agreed to monitor cases for compliance.

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

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

Anyone can report suspected abuse to ChildLine, which acts as a clearing house for potential abuse cases. Department of Human Services staff review the reports and decide whether they should be handed off to law enforcement or county children and youth agencies to investigate.

A majority of calls to ChildLine come from mandated reporters — school employees, day-care workers, medical providers, and others who encounter children as part of their profession and who are required to report any suspicions of abuse.

Hospitals — where virtually every employee is considered a mandated reporter — typically designate specific employees, such as social workers, to report child abuse identified by medical providers.

“If a kid comes to an ER for treatment, every person that kid meets with a hospital badge from the time they walk in the building until the time they walk out is likely a mandated reporter,” Cervone said.

The approach is intended to improve efficiency, so a dozen people aren’t reporting the same incident, and to also ensure that no cases are overlooked, if each of those dozen people assumes someone else already reported the incident.

But cases can fall through the cracks during this type of “hand off,” Cervone said.

In other instances, medical staff may be confused about whether they need to report a case.

For example, adults who are victims of sexual abuse are evaluated for sexually transmitted diseases and may receive emergency contraception as part of their medical treatment. Adults can decide whether they want to have a rape kit done anonymously and whether they want to talk to police.

A teenage assault victim may receive similar medical treatment, but cannot decide whether their case is reported. Hospital staff are required to report any instances of abuse among patients under age 18, regardless of the circumstances of the incident and whether the patient knew their attacker, Cervone said.

In the Bryn Mawr case, inspectors said staff had violated hospital policy by allowing the 17-year-old to complete a rape kid anonymously.

Administrators were made aware of the lapse when police contacted them in March 2024 and reported the case to ChildLine.

The report does not provide additional detail about the patient or her case, but says that hospital administrators gave police her contact information.

The Lankenau inspection report did not specify the patient’s age, but said she was under 18 years old.

Inspectors found that while the patient had received appropriate medical care, staff violated policy by not reporting the incident to ChildLine.

Hanover, Main Line Health’s spokesperson, said that system administrators “take our mandatory reporting obligations very seriously” and “took immediate steps” to re-educate staff after the health department citations.

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