Ohio court blocks sweeping records disclosure

Citing privacy concerns, organized medicine helped defeat a request for hundreds of Planned Parenthood records of patients not involved in the case in question.

By — Posted July 20, 2009

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A recent Ohio Supreme Court ruling will ensure that patients' medical records remain private and are not exposed by unrelated litigation, physicians say.

On July 1, the high court rejected a request for the files of hundreds of minor patients who were not a party to a lawsuit alleging violations of the state's abortion consent and child abuse protection statutes. As in most states, Ohio's physician-patient privilege statute generally forbids the disclosure of nonparty medical records, absent patient consent. Any exception to that rule is for the legislature -- not the courts -- to decide, justices ruled in a 5-2 opinion.

The case stemmed from allegations that Planned Parenthood Southwest Ohio Region repeatedly ran afoul of a state law requiring physicians and health care entities to get consent from a minor's parents before performing an abortion. The parents of a 14-year-old who had an abortion without their consent sued the clinic in 2004, claiming it failed to report suspected child abuse. The teen had become pregnant by her 21-year-old soccer coach, who posed as her father to help her obtain the procedure, court records said. Planned Parenthood denied any wrongdoing.

To prove their claims, the parents said they needed access to 10 years' worth of medical records on any other minors who sought abortions at the clinic.

The case galvanized the medical community, which responded with friend-of-the-court briefs arguing that allowing such broad disclosures would not only violate patients' confidentiality rights but also deter them from seeking necessary medical care. Planned Parenthood provided the girl's records, but it refused to turn over other patients' files, citing the physician-patient privilege statute.

The high court ruling "is a very strong affirmation that the confidentiality of medical records, especially of third parties, is not to be infringed or eviscerated. And it sets a [statewide] precedent from the standpoint that it really closes the door to third-party disclosures in any private, civil cases," said Anne Marie Sferra, who represented the Ohio State Medical Assn., the American College of Obstetricians and Gynecologists, and the Litigation Center of the American Medical Association and State Medical Societies. The organizations jointly filed a brief in the case.

Physicians also stressed to the court that simply redacting the requested records by removing patient-identifying information -- as a trial court ordered earlier in the case -- did not resolve the privacy issue.

The justices agreed. "Redaction of personal, identifying information does not remove the privileged status of the records," Justice Evelyn Lundberg Stratton wrote.

Planned Parenthood attorney Daniel J. Buckley said the decision "is a victory for medical privacy, not just for Planned Parenthood, but for health care providers everywhere."

Although the issue centered on an abortion clinic, the medical community worried that such broad discovery demands could be imposed on any health care professionals for information on a wide range of care. Doctors were particularly concerned because the case involved sensitive records that belonged to adolescents.

"Even minors are able to seek care on their own in a number of situations. And if they are not able to do that, or do that with the concern other individuals will have access to their records, minors and patients in general are not likely to come forward to receive the care they feel they need," said Randell K. Wexler, MD, chair of the Ohio Academy of Family Physicians' legislative commission. The academy filed a separate brief in the case along with several other groups.

Brian E. Hurley, who represented the plaintiffs in the case, said the court failed to consider the broader public policy concerns at issue in the case. "We aren't challenging the privacy protections. We agree that should be provided, and the redaction fully met that," he said. "On the other hand, we are seeking records to try to protect abused children, so you have to balance the two."

Two dissenting judges agreed with that sentiment, saying the majority eschewed prior legal precedent establishing that such disclosures may be allowed when necessary "to protect or further a countervailing interest" that outweighs patient confidentiality interests. "This is one of those 'special situations,' " Judge Mary E. Donovan wrote, adding that trial courts have effectively used protective orders to guarantee patient privacy.

The majority's interpretation likely will impede such cases in the future if parties are not able to collect the evidence they need to support their claims, Hurley said. A brief filed by several Ohio county prosecutors also argued that the decision could discourage health care entities from reporting suspected abuse, as required by state law.

But the majority opinion said nothing prevented the plaintiffs from pursuing their claims using their own records or other nonprivileged relevant information. Justices noted that the case centered on Planned Parenthood's alleged violation of duties only to the plaintiffs involved. They "have not filed a class action on behalf of other alleged victims. The case has no criminal implications: [The soccer coach] has already been convicted of the crimes, and the prosecutor has investigated but declined to pursue criminal charges against Planned Parenthood."

As for whether certain public policy issues may outweigh nonparty patients' privacy rights, that "should likewise be addressed by the legislature, not the judiciary," the court said.

While acknowledging the importance of child protection statutes, physicians in court briefs said young patients' interests were best served by reinforcing, rather than weakening, physician-patient privacy.

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Case at a glance

Can plaintiffs access nonparty patient records to prove their individual claims that abortion and child protection laws were violated?

The Ohio Supreme Court said no.

Impact: Physicians said the decision will help ensure that patients seek the medical care they need without fear that their privacy will be compromised through litigation. The plaintiffs and state prosecutors say the ruling may undermine efforts to root out child abuse.

Source: Roe v. Planned Parenthood Southwest Ohio Region, Ohio Supreme Court

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