A spokesman for the California Department of Public Health confirmed the agency was conducting an investigation at Betty Ford, but declined to release details. Spokesman Ralph Montano said this week that details may be released later, but he could not confirm that the inquiry was related to Lohan or an interview by the fired employee.
Detectives are investigating Lohan for misdemeanor battery at the request of a Betty Ford Clinic worker who was involved in a fight with the "Mean Girls" star shortly around 1 a.m. on Dec. 12.
Lohan's attorney, Shawn Chapman Holley, has declined comment on the incident, but said it was the actress who called police.
The worker later conducted an on-camera interview with celebrity website TMZ, which also posted an e-mail the worker apparently sent to supervisors after the fight. The woman, identified by TMZ as Dawn Holland, was promptly fired by Betty Ford.
Criminal defense attorney Steve Cron, who is not involved in the case, said both Betty Ford and Holland are likely to face some repercussions. Betty Ford, which described the Lohan incident as the first time in 28 years that it had a breach of patient confidentiality, could face a civil fine, he said.
"I don't see any criminal prosecution, but I do see some investigation to see whether this is a systemic problem or just an isolated incident with one wayward employee," Cron said.
A Betty Ford spokesman declined comment on whether the renowned rehab center reported the incident to state or federal authorities.
There is both a historical expectation and legal requirements for confidentiality in rehab settings, said Dr. Westley Clark of the Maryland-based Substance Abuse and Mental Health Services Administration.
"We want people to be able to get care, to be as candid as possible," Clark said, adding that he couldn't specifically speak about the Lohan incident.
Safeguarding celebrities' medical records has been an issue in California, with health care workers prosecuted and disciplined for peering into - and selling - confidential information.
In 2008, it was revealed that 1,041 patients had their records inappropriately accessed at UCLA medical facilities since 2003, resulting in 165 hospital employees being either fired, suspended or receiving reprimands. A former Ronald Reagan UCLA Medical Center employee pleaded guilty that year to selling the medical records of Britney Spears, Farrah Fawcett and other celebrities to the National Enquirer. She died before sentencing.
Both Clark and Cron said there is an exemption to confidentiality guidelines when a rehab worker reports a crime. The exemption does not extend to revealing details to the media, they said.
Cron said he thought the Betty Ford employee clearly violated federal laws, and may have actually aided Lohan from being punished by a Los Angeles judge overseeing her probation for a 3-year-old drunken driving case.
Los Angeles Superior Court Judge Elden Fox had warned Lohan to remain out of trouble and not refuse any drug tests when he ordered the actress to remain at Betty Ford until Jan. 3. If the judge suspects she violated her probation, he could convene a hearing where Holland would likely be called to testify about the incident.
"If I'm Lindsay Lohan's lawyer, I'm going to rip her to pieces," Cron said.
Any fallout - for Lohan, Betty Ford or Holland - will likely take some time.
Riverside County Sheriff's Deputy Herlinda Valenzuela said detectives do not expect to conclude their investigation into Lohan until at least next week, and possibly not until January.
Montano declined to say how long the investigation at Betty Ford would last, but its results could then be turned over to the state's Office of Health Information Integrity. Acting Director Alex Kam said it could take some time for the investigation to reach his office.
Lohan, 24, is due to be released from Betty Ford on Jan. 3 and the investigation creates an even more uncertain future for the 24-year-old actress.
She is no longer slated to star as porn actress Linda Lovelace in a biopic and does not have any other confirmed acting roles slated.
The actress is due back in court on Feb. 25 for a hearing at which Fox may either loosen the terms of her probation, or address the Betty Ford incident.