A tiny federal commission that recalls faulty lawn mowers is now demanding personally identifiable emergency-room records from at least 100 hospitals — names, addresses, diagnoses, suicide attempts, vaccine reactions. The stated purpose is “modernization.” The pattern says something far darker.
When Americans stumble into an emergency room — bleeding, seizing, overdosing, giving birth, in the middle of the worst hour of their lives — they carry with them a foundational assumption: that what happens in that room, with that doctor, is between them and their medical record. That assumption is now being quietly dismantled by an agency most Americans have never heard of, using authority it does not appear to legally possess, in service of an administration that has spent eighteen months proving what it will do with medical data once it has it.
According to a joint investigation by KFF Health News and CNN, the Consumer Product Safety Commission — a five-person agency created in 1972 to protect Americans from dangerous cribs and exploding batteries — has spent the last several months pressuring some of the nation’s largest hospital systems to hand over the personally identifiable emergency-room records of every patient who walks through their doors. Not just injuries linked to consumer products. Every patient. Broken bones from a slip on ice. Vaccine reactions. Suicide attempts. Overdoses. Miscarriages. The full accounting of a person’s worst day, delivered to a Kansas-based private contractor called Konza Health, whose representatives have told hospital executives that participation is “mandatory” or “required.”
It is not, in fact, mandatory. Federal law prohibits public-health authorities from ordering private health data reported to them. The CPSC’s own 214-page operating manual — the document that governs its long-running injury surveillance program — explicitly instructs hospitals to strip names, birthdates, and addresses from case reports. The agency has admitted, in a statement from spokesperson Steve Roney, that it failed to provide the public notice and comment period the law requires before demanding records from ten or more entities. It is going after a hundred.
I. What They Are Asking For
Understand what is actually being demanded, because the euphemisms are doing a great deal of work. In emails to hospital technology officers, Konza Health CEO Laura McCrary provided a list of more than 10,000 diagnostic codes for which the company wants records — an inventory so sprawling it includes childhood injuries from “poisoning by” vaccines and injuries from stingray contact, neither of which the CPSC has any jurisdiction to regulate. Konza’s proposed contract, obtained by KFF Health News, sets no limits at all on what it will pull from an ER record and specifies that patient health information will be retained for at least thirty days. The CPSC wants at least 100 hospitals sending this data by the end of 2026, according to its own mid-year memo to commissioners.
10,000+ conditions requested
Konza’s request list includes broken bones from falls, adult suicide attempts, and vaccine reactions — all of which the CPSC’s own manual says must not be reported.
Konza Health, Kansas
A five-year, up-to-$15.9 million contract. Its president has told hospitals participation is “required” — a claim federal law does not support.
CPSC has leaked before
The agency improperly disclosed the personal health information of roughly 30,000 people, prompting a bipartisan Senate letter of concern from then-chair Sen. Roger Wicker.
Nearly 1 in 5 careerists gone
63 career staffers departed CPSC in 2025 — the most in a decade — after Trump fired the agency’s three Democratic commissioners and the Supreme Court let it stand.
II. The Person Now Running the Data
The identity of the official driving this initiative is not incidental. The CPSC’s Chief Data Officer, Elizabeth Puchek — the one telling hospitals they must formally seek an “exemption” if they refuse to hand over patient records — joined the agency late last year. Her previous job was engineering the data system at U.S. Citizenship and Immigration Services. That is not a detail; that is the through-line. The person now writing the technical architecture that will pull identified emergency-room records from a hundred hospitals into a federal repository is the same person who last built the plumbing at the government’s immigration bureaucracy.
“This idea that they can simply demand patient information from a hospital and that the hospital would provide it — I really don’t understand the basis for that.”
— Alexander Hoehn-Saric, Former CPSC Chairman (fired by Trump)
Sharona Hoffman, a professor of health law at Case Western Reserve University who reviewed the arrangement, was blunt with KFF Health News: “The whole thing is troubling.” She warned that once a private contractor is warehousing identified data on this scale, the risks multiply — theft, resale, marketing exploitation. “Very often, they will use information for marketing because now they’re going to know what conditions people have.” Konza’s president, Laura McCrary, insists the company will strip names and addresses before forwarding records to the CPSC. The public has no way to verify that. The contract itself has not been released.
III. This Is Not the First Time — It Is the Pattern
The reason to be alarmed is not the CPSC in isolation. It is that the CPSC is the fourth or fifth known federal instrument this administration has pointed at Americans’ medical files in under two years. Once you see the timeline, the “modernization” framing collapses.
The Trump administration rescinds the “sensitive locations” policy that had, since 2011, kept ICE and Customs and Border Protection out of hospitals, schools, and places of worship. Immigration agents can now enter emergency rooms. (Lexology)
The Office of Personnel Management begins demanding federal workers’ medical records as part of a health-data collection scheme with no clear legal authorization. (KFF Health News)
HHS Secretary Robert F. Kennedy Jr. authorizes a private organization to collect Americans’ medical records for his personal studies claiming a vaccine-autism link. (KFF Health News)
The Centers for Medicare & Medicaid Services signs a formal data-sharing agreement giving ICE daily access to the personal information — including Social Security numbers and home addresses — of all 77 million Medicaid enrollees. Never announced publicly. Discovered by the AP. (AP via Federal News Network)
After a federal judge partially blocked the arrangement, CMS resumes sharing basic biographical Medicaid data with ICE for deportation cases. In 28 states — those not part of the 22-state lawsuit — ICE has access to all enrollees. (NPR)
NPR reports that CMS “inadvertently” shared millions of names it wasn’t supposed to with ICE, some of which ended up feeding a Palantir-built ICE targeting app called ELITE. (NPR)
KFF Health News reveals the CPSC’s ER-records demand — extending the surveillance perimeter from consumer-product injuries to every emergency-room visit in America. (KFF Health News)
Each of these moves was described by the administration as innocuous — a technical upgrade, an interagency coordination, a modernization. Each one collected a different slice of American medical life. Together, they build an infrastructure whose scale we have not yet permitted ourselves to name.
IV. Who Pays the Price
Every American who visits an emergency room at a participating hospital is now potentially in this database. But the burden, as it always does, falls unevenly. The people who lose the most are the people who could least afford to lose anything.
Immigrants without status. For fourteen years, an ICE “sensitive locations” policy kept immigration agents from arresting people in emergency rooms. The Trump administration ended that policy on Day One of the second term. According to the Kaiser Family Foundation, ICE agents have since been reported inside emergency departments across the country — in one Glendale, California case, agents camped inside a private hospital for fifteen days. A federal database of identified ER records, combined with the already-operational CMS-to-ICE data pipeline, does not require imagination to weaponize. It requires only a query.
Transgender Americans. An identified national record of every ER visit means an identified national record of every trans person who ever sought emergency care for anything — a broken wrist, a car accident, a mental health crisis, complications from gender-affirming care. In an administration that has spent eighteen months using medical databases for ideological ends, that is not a hypothetical risk profile. It is a targeting list waiting to be sorted.
Survivors of sexual assault and domestic violence. Emergency-room records are how these cases enter the medical system. A federal repository of identified records is a subpoena magnet — for jealous ex-partners, for state prosecutors in abortion-ban states looking for miscarriage evidence, for anyone with the right political access to demand a lookup.
People in mental health crises. The CPSC has been transparent that it wants suicide-attempt data despite its own manual excluding adult suicide attempts from reportable events. A person who calls an ambulance in their darkest moment now does so knowing that a federal contractor may be storing their name against that event for at least thirty days.
Poor and rural Americans. The CPSC is targeting a mix of large urban systems and small, publicly owned hospitals — the safety-net providers that serve people who cannot pay. These are precisely the patients with the fewest options if their local hospital signs Konza’s contract. You cannot opt out of an ER visit when your child is turning blue.
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V. What Experts and Hospitals Are Saying
Some of the country’s largest hospital systems have already told the CPSC to stand down. Mass General Brigham spokesperson Kelly Mitchell said the Boston system has declined to participate: “to protect patient privacy, we are unable to provide these medical records.” Harborview Medical Center in Seattle, through spokesperson Susan Gregg, said it will continue to submit de-identified data on a voluntary basis but is “not obligated to report this information.” Mary Greeley Medical Center in Ames, Iowa — which initially signed on believing participation was mandatory — is reevaluating after learning its federal funding for the program was “no longer available.”
The threat, in other words, is real: the CPSC has quietly floated that hospitals which refuse could be found in violation of “information blocking” rules, a designation that carries federal penalties. This is what coercion looks like when a president who has fired the entire Democratic side of an independent commission redirects that commission to extract private medical data from institutions that depend on federal reimbursement. It is not a demand. It is a demand with a knife on the table.
Bethany Pray, chief legal and policy officer at the Colorado Center on Law and Policy, put the resulting bind in the plainest possible terms in an interview with KFF Health News about the parallel Medicaid-ICE arrangement: “People should not have to choose between giving birth in a hospital and wondering if that means the” federal government will come for them. That is now the choice.
California Attorney General Rob Bonta, who leads a 22-state coalition suing over the CMS-ICE data sharing, has already documented what happens when medical data enters this administration’s ecosystem: “a culture of fear that will lead to fewer people seeking vital emergency medical care.” That is a public health crisis being manufactured by federal design.
A President Whose Judgment Is No Longer Discernible From His Grievances
Section 4 of the 25th Amendment exists for precisely this situation: when the Vice President and a majority of the Cabinet determine that the President is “unable to discharge the powers and duties of his office,” they may transmit that finding to Congress and the Vice President becomes Acting President. The mechanism was written in the aftermath of the Kennedy assassination and refined during the closing weeks of the Nixon presidency. It was designed for exactly the kind of decision-making pattern that produced this CPSC scheme: an initiative launched without the legally required public notice, using an agency stripped of its bipartisan governance, run by a data officer transferred from immigration enforcement, targeting the medical records of every ER patient in America — with no coherent public rationale beyond a memo about “modernization.”
The 25th Amendment is not a policy-disagreement tool. It is a capacity tool. And on the question of capacity, the record has been building in public view. On April 10, 2026, House Judiciary Ranking Member Rep. Jamie Raskin (D-Md.) wrote to the White House physician demanding a comprehensive cognitive and neurological evaluation of the President, citing “profound medical difficulty and concern.” Four days later, Raskin introduced legislation, with 50 Democratic co-sponsors, to establish the bipartisan Commission on Presidential Capacity — the very body Section 4 permits Congress to create. Rep. Raja Krishnamoorthi (D-Ill.) has called on Vice President JD Vance and the Cabinet to invoke the amendment. Rep. Jasmine Crockett (D-Tex.) has done the same. On April 30, Sens. Sheldon Whitehouse (D-R.I.) and Jack Reed (D-R.I.) entered into the Congressional Record a statement from 36 physicians — neurologists, psychiatrists, and cognitive-disorders specialists from Harvard, Tufts, Columbia, and George Washington — warning of Trump’s “rapidly worsening, reality-untethered, increasingly dangerous decline” and calling for the 25th Amendment to be invoked.
The connection to the CPSC scheme is not rhetorical. An administration led by a president whose own senior physicians in the medical academy have described his condition in these terms cannot be entrusted with a novel federal apparatus to warehouse the identified emergency-room records of every American who touches the healthcare system. The 25th Amendment case does not rest on any single act of erratic conduct. It rests on the accumulating record — the AI-generated attacks on private citizens, the profane late-night posts, the abandoned ceasefire, the tablet thrown across the Oval Office, the appointees fired outside statutory authority, and now this: a data-collection scheme launched without public notice, run through a compromised agency, aimed at a medical repository that any competent successor administration would recognize as a civil-liberties emergency.
We are honest about the practical barriers. Section 4 requires the Vice President and a majority of the Cabinet — meaning Vance and eight of the fifteen department secretaries, all of whom serve at Trump’s pleasure and none of whom has shown any inclination to move. The Raskin Commission bill faces a Republican-led House. Congressional Republicans, including House Oversight Chair James Comer, have dismissed such efforts. The barriers are real. They do not, however, negate the constitutional case; they clarify why that case must continue to be made in public, on the record, in language that the next administration and the next Congress can pick up. The 25th Amendment is a constitutional tool. Refusing to name when it applies — refusing to say that a president extracting identified ER records through a gutted commission and a private contractor is a president whose judgment is materially impaired — is how the tool corrodes.
VI. What This Says About the Priorities of This Presidency
Consider what the CPSC — an agency whose statutory mission is to protect Americans from dangerous products — is not doing right now. It has lost its bipartisan governance. It has lost nearly one in five career staffers. Its remaining leadership, under acting chair Peter Feldman, has diverted an unprecedented share of its attention, its computing infrastructure, and its $15.9 million contract budget to building a system that will pull identified emergency-room records from hospitals across the country. That is what an agency captured for other purposes looks like. It is not defending consumers. It is producing a dataset.
The consistent thread across the Trump administration’s second-term health-data actions is that they invert the traditional relationship between the federal government and the citizen. In each case — OPM, CMS, HHS, and now CPSC — the government treats the citizen’s medical record as raw material to be extracted, and the institution that traditionally protected it (the hospital, the insurer, the physician) as an obstacle to be pressured or bypassed. This is a coherent worldview. It is not a competent-governance worldview. It is a surveillance worldview, and it is being installed inside American healthcare at a speed that the courts, the Congress, and the press are only barely keeping pace with.
Editorial Conclusion
An emergency room is the last place in American life where anyone — undocumented, uninsured, closeted, terrified, bleeding — is supposed to be able to go without first calculating what the government will do with the record of their visit. That protection is not a bureaucratic nicety. It is the reason the ER works at all.
The Consumer Product Safety Commission has no legal authority to demand identified medical records from a hundred hospitals. It skipped the public comment period the law requires. Its own manual forbids the collection. Its contractor is telling hospitals a lie — that participation is “mandatory.” And the pattern of the last eighteen months — OPM, RFK Jr., CMS-to-ICE, Palantir, and now this — makes plain what that dataset is being built to become.
Hospitals must refuse. State attorneys general must sue. Congress must invoke its subpoena power. And the constitutional question of whether a president who governs this way still meets the capacity requirement of his office must be pressed — publicly, formally, and without the euphemisms that have carried us this far. The alternative is a country in which no American, at their worst hour, has any reasonable expectation that the emergency room is a place they can safely enter. That is not a country. That is the surveillance state clearing its throat.
Sources & References
- KFF Health News · CNN (July 27, 2026)Amanda Seitz, Maia Rosenfeld, Darius Tahir — Trump Administration Demands Hospitals Share Emergency Room Records
- The New Republic (July 27, 2026)Hafiz Rashid — Trump Admin Demands Emergency Room Records in Alarming Move
- CPSC Internal DocumentFY 2026 Mid-Year Memo to the Commission
- CPSC Operating Manual (Jan 2025)NEISS Coding Manual — restricts identifying data
- USA Spending · Federal ContractCPSC contract with Konza Health, up to $15.9M
- PBS NewsHourSupreme Court Allows Trump to Fire 3 Democratic CPSC Commissioners
- KFF Health News (April 2026)Trump’s Personnel Agency Is Asking for Federal Workers’ Medical Records
- KFF Health News (June 2026)RFK Jr. Seeks To Peek at Americans’ Medical Records for Clues on Autism
- NPR (July 17, 2026)ICE shared Medicaid data it wasn’t supposed to have with Palantir
- NPR (July 2025)States sue Trump administration for sharing health data with DHS
- Federal News NetworkHHS Authorized to Resume Sharing Medicaid Data with Deportation Officers
- KFF Health NewsWith ICE Using Medicaid Data, Hospitals and States Are in a Bind
- Kaiser Family FoundationHealth Care Providers Warn of Impacts of Increased ICE Presence
- OnLaborHospitals Become Sites of Confrontation for Healthcare Workers and ICE
- LexologyNavigating Immigration Enforcement in Health Care Settings
- U.S. House Judiciary Committee DemocratsRaskin Demands Cognitive Evaluation of Trump
- U.S. House Judiciary (April 14, 2026)Raskin Introduces Commission on Presidential Capacity Legislation
- Rep. Krishnamoorthi Press ReleaseKrishnamoorthi Calls for Trump Removal Under 25th Amendment
- Rep. Crockett Press ReleaseCrockett Calls on Vance, Cabinet to Invoke 25th Amendment
- The Hill OpinionConcerns Grow Over Trump’s Mental Fitness for Presidency
- HHS / HIPAAHIPAA Privacy Rule — Limits on Federal Health-Data Reporting
- CDC Data Modernization PolicyFederal Public Health Cannot Mandate Private Data Reporting
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