Records released: $385,000 verdict
September 1, 2000 3 minutes read
Records released: $385,000 verdict
News: A divorced mother's psychiatric records were released without her consent to her former spouse, who was attempting to gain custody of the couple's two minor children. The total verdict against the health facility was $385,000 of which $370,000 was in punitive damages.
Background: The plaintiff and her husband divorced in 1992. She received custody of their two minor children. In 1994, she had a mental breakdown and was hospitalized for four days. Her former husband kept the children during her hospitalization. Later that year, the ex-husband petitioned the court for custody of the children and subpoenaed her hospital records for a deposition. Instead of attending the deposition, the hospital mailed her hospital records to the ex-husband's attorney. The father later dropped his petition for custody.
The plaintiff sued the hospital claiming that it was a breach of the hospital's fiduciary duty to have released her medical records without her consent. She asserted that the hospital should have either sought her consent prior to mailing the records or appeared at the deposition where her privilege of confidentiality could have been asserted.
Her claim for the alleged breach of fiduciary duty was for emotional distress because the records were released to her ex-husband during a custody dispute.
The hospital countered that the plaintiff did not suffer any damages given that the former spouse already knew most of what was contained in her medical records and because the custody action was not pursued to completion. The jury awarded the plaintiff $385,000, which included $370,000 in punitive damages.
What this means to you: In virtually all jurisdictions, medical records are personal and confidential. In many instances, there are additional statutory precautions in place for highly sensitive and "superconfidential" medical records such as those covering psychiatric, drug and alcohol, and HIV/AIDS care and treatment.
For example, in Florida, superconfidential psychiatric records can be released only in two instances:
• if the facility completes a release of information authorization that must be signed by the patient's court-appointed guardian;
• if there is a court order signed by a judge. A subpoena does not suffice.
In addition, facilities should be cautious about releasing psychiatric records to the patient.
While Florida law requires that patients have access to their health records, if, in the opinion of the attending psychiatrist, the release of the records is therapeutically contraindicated to the patient, the physician may legally deny access. Further, each page of a copied, released supersensitive record must be stamped with: "Confidential and privileged information for professional use only."
"The fact that this patient's superconfidential medical records were handled so poorly is indeed surprising," says Jane M. Koubek, manager of medical records at Bayfront/St. Anthony's Health System in St. Petersburg, FL.
"All medical records personnel should be trained to properly handle medical records and should made aware of their sensitive nature. Specifically, records should only be released after appropriate protocols are followed. Protocols for release of records should at a minimum include proper sign-off and review as well as be in compliance with the jurisdiction's governing statues and rules," she says.
The jury's view
In this particular case, even though the mistakenly released records were not used for the purpose for which they were requested, the error in allowing their release was found to have caused the patient significant nonecon-omic damages.
"Once the cat was out of the bag, so to speak, the jury apparently saw the harm caused, regardless of whether or not the reason for the original request was acted upon. It seems that the health facility's only defense was to say, 'Yes we erred, but it did not cause any harm.' However, as the jury found, this point of view does not seem to take into account the tenuous circumstances of the patient," notes Koubek.
"Under any circumstances, medical records must be viewed as highly personal. Even without protective statutes, their special nature should be universally recognized by all health care workers, as this case points out, . . . the mistake was found to be damaging. Risk managers and health information management professionals must take special care in establishing hospital and department polices for the release of information and educate their staff on the potential ramifications for failing to abide with such policies," she concludes.
Reference
Fierstein v. DePaul Health Center, St. Louis County (MO) Circuit Court, Case No. 669440.
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