Court: Ohio Supreme Court; July 9, 2008; Ohio; State Supreme Court
An attorney can be held liable for the unauthorized disclosure of an opposing party's medical information obtained during litigation. In this case, Kenneth Hageman sought psychiatric treatment and revealed homicidal thoughts to Dr. Thomas Thysseril, who diagnosed him with bipolar disorder. During Hageman's divorce proceedings, his wife, represented by attorney Barbara Belovich, sought custody of their child. After Hageman allegedly assaulted his wife, she obtained a civil protection order against him.
Belovich subpoenaed Hageman's medical records from Dr. Thysseril’s office, believing Hageman waived his privacy rights by filing a custody counterclaim. However, Hageman did not sign a release. Belovich subsequently shared Hageman’s medical records with a prosecutor attending the protection order hearing, despite the prosecutor's non-participation.
Hageman and his wife later entered a separation agreement, and his medical records were not admitted as evidence in related proceedings. Following his acquittal in the criminal case, Hageman sued Belovich, his ex-wife, Dr. Thysseril, and associated healthcare entities for unauthorized disclosure of his medical records. While the trial court granted summary judgment to all defendants, the court of appeals reversed the decision regarding Belovich, stating she exceeded her authority by sharing Hageman's psychiatric information with the prosecution. The case was remanded for further proceedings after accepting Belovich's discretionary appeal.
Medical records are generally confidential, protected by various state and federal laws. The Ohio Public Records Act prohibits the release of medical records maintained by public institutions in response to public records requests. Similarly, the Health Insurance Portability and Accountability Act (HIPAA) restricts health-care providers from disclosing medical information, allowing exceptions only under specific circumstances. Ohio law also codifies physician-patient and psychologist-patient privileges, which limit the use of such information in litigation, allowing physical and mental health examinations only when relevant and justified.
In the case of Biddle v. Warren Gen. Hosp., the Ohio Supreme Court recognized the breach of patient confidentiality as a significant wrong, albeit one that is challenging to remedy. The court established a separate tort for breach of confidentiality concerning medical information, identifying two causes of action: one against healthcare providers disclosing confidential information without authorization, and another against third parties inducing such disclosures.
In Hageman's case against Belovich, Belovich contends that the torts recognized in Biddle do not apply to attorneys disclosing healthcare information legally obtained during litigation. Despite the imperfect applicability of Biddle's causes of action to this case, the underlying rationale remains relevant. The Biddle decision emphasizes the importance of a patient's right to medical confidentiality, asserting that it is the patient who should determine the disclosure of their personal medical information. This principle aligns with the broader notion of privacy rights, which underscores an individual's control over their private information.
Hageman acknowledged that he raised his health as an issue in a divorce case while seeking custody of his minor child, necessitating a demonstration of his capability to care for the child, which led him to waive his medical privilege. However, it was determined that such a waiver is strictly limited to the specific case and does not extend to other contexts. Expanding the waiver would contradict confidentiality protections recognized in Ohio and federal law, which are essential for encouraging individuals to seek treatment for medical or psychological issues. Confidentiality fosters a trusting environment necessary for effective psychotherapy, and any potential disclosure of sensitive information could deter individuals from being open during treatment.
The case revealed that if a broad waiver were permitted, it could lead to misuse of medical records obtained through litigation, as the receiving party might exploit the information for purposes beyond the original case. Specifically, Belovich, who represented Hageman's ex-wife, improperly shared Hageman’s psychological records with the prosecutor in a criminal case, escalating legal pressures against him. This raised concerns that such actions could coerce a party into settling legal matters prematurely due to the weight of disclosed medical information.
The ruling established that waivers of confidentiality regarding medical records in litigation are limited to that particular case. Attorneys may utilize these records within the scope of the case but could be liable for unauthorized disclosures to third parties. Additionally, a suggestion was made that a cause of action for unauthorized disclosure could be waived if the disclosing party did not take adequate measures to maintain the privacy of the medical records, such as requesting a protective order.
Hageman did not request a protective order for his medical records and did not authorize Dr. Thysseril to disclose them to Belovich. The trial court did not hold a hearing on this disclosure; Belovich independently executed a subpoena without a signed release, and the records were distributed to the prosecutor shortly after their release to her. These records were never entered into evidence in either the divorce or criminal proceedings, preventing Hageman from objecting or seeking protection against their production. Since the records were not introduced into evidence, they remained confidential before Belovich's disclosure. Disclosing psychological records obtained during a divorce case to a prosecutor in a criminal case constituted a violation of Hageman's confidentiality rights. The principle that waiver of medical confidentiality is limited to the specific case for which records are sought was affirmed, indicating that an attorney may be liable for disclosing such records to unrelated third parties. The court of appeals' judgment was affirmed, and the case was remanded for further proceedings. The dissenting opinions, along with a reference to a previous case (Gill), indicate that mental condition can be made an issue in custody cases, thereby negating physician/patient privilege. A medical record is defined under the Public Records Act as any document related to a patient's medical history, diagnosis, prognosis, or condition, excluding certain exceptions.
