Could Your Child’s Medical Record Become Evidence in a Pennsylvania Custody or PFA Case?

A hospital system is now running patients’ clinical notes and imaging through an AI model that calculates a private intimate partner violence risk score. Patients aren’t typically told this happens. For Pennsylvania parents in a Protection from Abuse case or custody dispute, that score doesn’t stay private; it becomes part of a record that either side’s attorney can request.

If an AI-generated risk score might already be sitting in a record connected to your case, click here to tell us about your situation, or call the LLF Law Firm’s Family Law Team at 888-535-3686.

What Is This AI Screening Tool, and Why Is It Controversial?

The tool is called AIRS — Automated Intimate Partner Violence Risk Support System. Boston’s Brigham and Women’s Hospital is running it in the emergency department and several primary care sites, according to a recent MedPage Today analysis of the technology.

AIRS scans clinical notes, imaging reports, and other hospital data using deep learning and natural language processing, then generates a score for how likely a patient is to be experiencing abuse.

Traditional screening asks direct questions about whether a partner has hit, hurt, or controlled the patient. That gets a disclosure about 7% of the time. AIRS was built to find the other 93%.

Critics of the technology complain that there’s no way to opt out ahead of time. Most patients never learn the screening happened, unless a member of the care team decides to approach them about the score. Even then, removal is something a patient has to request after the fact.

Survivors have said for years that having control over their own disclosure, choosing when to speak up and to whom, matters just as much as whether a provider flags them as a victim at all.

Could an AI Risk Score End Up in a PFA Case or Custody Fight?

A risk score sitting in a chart isn’t sealed off from the outside world. A data breach could expose it. An insurer could request it. So could a court order tied to a custody dispute, and Pennsylvania courts already do this routinely. Once a PFA petition is filed or a custody case turns contentious, medical records touching on a parent’s safety or fitness become subject to subpoena. That’s not automatic, though. Pennsylvania law shields medical records through physician-patient privilege and extra confidentiality for mental health treatment. Once a parent’s fitness is on the table, though, courts tend to find that protection waived, and a risk score buried in a chart can end up in an attorney’s hands anyway.

Of course, a machine-generated label is different from what a clinician would write. It carries no context and no explanation from the patient. If it lands in front of a judge as an exhibit, it arrives without any of the narrative behind it.

Does This Trigger Mandatory Reporting for the Kids in the House?

Pennsylvania’s Child Protective Services Law requires providers to report suspected child abuse. It doesn’t require them to report adult intimate partner violence on its own — but a flagged chart does tend to prompt a follow-up conversation. If that conversation reveals children were present for an incident, or living in an unsafe home, a provider’s reporting duty can attach fast. Sometimes this happens before the flagged parent even knows a conversation is coming, and well before either parent has spoken to an attorney.

What Should You Do If This Applies to You?

A risk score reflects what an algorithm found in a chart, not the fuller picture. It doesn’t capture a custody arrangement already in place. It says nothing about what a parent is prepared to swear to in a courtroom. The Family Law Team at the LLF Law Firm can help you find out what’s in that record and what it means for your case, whether you’re relying on it or answering to it.

Whether you’re building a custody case around a documented pattern of abuse or responding to a flag you never asked for, click here to contact the LLF Law Firm’s Family Law Team or reach us at 888-535-3686 today.