Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-4_09-cr-01786/USCOURTS-azd-4_09-cr-01786-0/pdf.json

Parties Involved:
Marthalene Gonzales
Defendant
USA
Plaintiff

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WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

UNITED STATES OF AMERICA, 

Plaintiff, 

vs.

MARTHALENE GONZALES,

Defendant. 

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No. CR 09-1786-TUC-CKJ (DTF)

 

ORDER

Pending before the Court is Defendant’s Notice of Appeal from Magistrate Judge’s

Ruling/Objections to Magistrate Judge’s Ruling [Doc. # 28] and Defendant’s Supplemental

Objections to Magistrate Judge’s Order Regarding Disclosure [Doc. # 39].

Defendant objects to the magistrate judge’s resolution of a non-dispositive issue. The

relevant rule provides:

Nondispositive Matters. A district judge may refer to a magistrate judge for

determination any matter that does not dispose of the case. The magistrate judge must

promptly conduct the required proceedings and, when appropriate, enter on the record

an oral or written order stating the determination. A party may serve and file any

objections to the order within 14 days after being served with a copy of a written

order or after the oral order is made on the record, or at some other time the court sets.

The district judge must consider any timely objections and modify or set aside any

part of the order that is clearly erroneous or contrary to law. Failure to object in

accordance with this rule waives a party's right to review.

Fed.R.Crim.P. 59(a). In other words, this Court reviews the magistrate judge’s decision

under a “clearly erroneous or contrary to law” standard. 28 U.S.C. § 636(b)(1)(A). In fact

“[t]he reviewing court may not simply substitute its judgment for that of the deciding court.”

Grimes v. City and County of San Francisco, 951 F.2d 236, 241 (9th Cir. 1991) (discussing

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Fed.R.Civ.P. 72(a) and 28 U.S.C. § 636(b)(1)(A)). The Ninth Circuit Court of Appeals has

more fully explained this Court’s role in reviewing such a decision:

As to nondispositive matters, the Magistrates Act provides only that the district court

“may reconsider any pretrial matter . . . where it has been shown that the magistrate’s

order is clearly erroneous or contrary to law.” [Citations omitted.] There is no formal

procedure specified for a review of a nondispositive order by the district court. The

Magistrates Act thus treats them differently [than dispositive issues]. Further, the

Magistrates Act’s specification that nondispositive matters are to be reviewed by the

district court under a far more deferential standard – “clearly erroneous” and

“contrary to law” – than dispositive matters indicates that decisions by the magistrate

judge on nondispositive matters are essentially “final decisions of the district court

which may be appealed in due course with other issues.” United States v. Brown, 79

F.3d 1499, 1504 (7th Cir. 1996) (stating but then rejecting this proposition without

further discussion); see also [Thomas v. Arn, 474 U.S. 140, 151 n. 10, 106 S.Ct. 466,

88 L.Ed.2d 435 (1985)] (indicating that Congress “clearly intended [a magistrate

judge’s ruling on a nondispositive motion] to be final unless a judge of the court

exercises his ultimate authority to reconsider the magistrate’s determination.”

(internal quotations omitted)).

United States v. Abonce-Barrera, 257 F.3d 959, 968 (9th Cir. 2001).

Magistrate Judge’s Order of Disclosure

The magistrate judge ordered that “reports that provide any evidence of [Defendant’s]

level of consciousness and level of intoxication including medical notes, medical reports,

toxicology reports, blood screens and statements of [Defendant] made during the process of

diagnosis that bear on her level for October 18, 2004" be provided to him for an in camera

review. This Court must review the magistrate judge’s order to determine whether granting

the disclosure was clearly erroneous or contrary to law. 

Health Insurance Portability and Accountability Act

Defendant argues that the Health Insurance Portability and Accountability Act of 1996

(“HIPAA”) does not provide for the government to have multiple bites at the apple.

Defendant asserts that the government obtained specimens for testing purposes at the time

Defendant was treated on October 18, 2004, and that there is no requirement for a

supplemental release of records. The government asserts that 45 C.F.R. § 164.512(f) permits

a covered entity to disclose protected health information for a law enforcement purpose to

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a law enforcement official if certain conditions are met. The relevant subdivision provides

that a covered entity may make the disclosure in compliance with and as limited by a “court

order or court-ordered warrant, or a subpoena or summons issued by a judicial officer[.]” 45

C.F.R § 164.512(f)(1)(ii). 

Defendant further asserts that there is no HIPAA provision that allows for a

supplemental release of records. However, there is no HIPAA provision that prohibits a

supplemental release of records. Rather, HIPAA permits the disclosure if a court order

provides for it. In other words, HIPAA does not prohibit the disclosure but leaves to the

discretion of a court whether the disclosure is permitted. 

Physician - Patient Privilege

Although Defendant acknowledges that Fed.R.Evid. 501 does not include a physicianpatient privilege, Defendant argues that the rule allows for the possibility of privileges

beyond those specifically set forth in the rule. See e.g., Jaffe v. Redmond, 518 U.S. 1, 116

S.Ct. 1923, 135 L.Ed.2d 337 (1996) (policy decisions of the states bear on the whether

federal courts should recognize new privileges). Defendant points out that Arizona

recognizes that communications between physicians and patients are privileged. A.R.S. §§

12-2235 and 12-2292; see also Schoeneweis v. Hamner, 221 P.3d 48 (Ariz.App. 2009). 

The government asserts, however, that health care providers and other entities covered

by HIPPA may disclose protected health information without patient consent in judicial

proceedings. Bayne v. Provost, 359 F.Supp.2d 234, 259 (N.D.N.Y. 2005). The government

asserts that HIPPA is purely procedural in nature and does not create federal

physician-patient or hospital-patient privilege. Social Security Act, § 1173, as amended, 42

U.S.C.A. § 1320d-2; 45 C.F.R. §§ 160.203(b), 164.512(e)(1), 164.514(a); see also

Northwestern Memorial Hosp. v. Ashcroft, 362 F.3d 923 (7th Cir. 2004) (by virtue of an

express provision in Fed.R.Evid. 501, the stringent Illinois medical records privilege applies

to suits in federal court (mainly diversity suits) in which state law supplies the rule of

decision; however, the Illinois privilege does not govern in federal-question suits – the

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enforcement of federal law might be limited if state-law privileges are applicable to all

federal cases).

The government asserts that there is no physician-patient privilege extended to

medical or hospital records because, in the absence of any statute generally providing for

such a privilege, no privilege exists which could be applied. See e.g., Benally v. United

States, 216 F.R.D. 478 (D.Ariz. 2003) (federal rules of evidence require federal courts to

apply state law of privilege to discovery issues when state law provides rule of decision in

case as whole).

The Seventh Circuit has stated:

[Defendant] cannot establish that the medical records were subject to any privilege

of confidentiality. Federal common law has not historically recognized a privilege

between patients and physicians. Northwestern Mem'l Hosp. v. Ashcroft, 362 F.3d

923, 926 (7th Cir.2004) (“[T]he evidentiary privileges that are applicable to

federal-question suits are given not by state law but by federal law, Fed.R.Evid. 501,

which does not recognize a physician-patient (or hospital-patient) privilege.”); see

also Whalen v. Roe, 429 U.S. 589, 602 n. 28, 97 S.Ct. 869, 51 L.Ed.2d 64 (1977)

(“The physician-patient evidentiary privilege is unknown to the common law.”).

[Defendant] acknowledges this shortcoming in his argument, but contends that we

should find such a privilege here. He relies on Jaffee v. Redmond, 518 U.S. 1, 116

S.Ct. 1923, 135 L.Ed.2d 337 (1996), in which the Supreme Court recognized a

privilege between a psychotherapist and a patient and noted that under Rule 501 of

the Federal Rules of Evidence, federal courts may define new privileges. Id. at 8, 10,

116 S.Ct. 1923. But we can find no circuit authority in support of a physician-patient

privilege, even after Jaffee. Indeed, in a decision issued after Jaffee, we declined to

recognize such a privilege, see Northwestern Mem'l Hosp., 362 F.3d at 926, and we

can find no reason to create one now.

United States v. Bek, 493 F.3d 790, 801-02 (7th Cir. 2007); see also In re Grand Jury

Proceedings, 801 F.2d 1164, 1169 (9th Cir. 1986) (rejecting defendant’s claim that

Fed.R.Evid. 501 authorizes court to develop physician-patient privilege; state privilege did

not apply in criminal cases). Indeed, numerous federal courts have determined that there is

no physician-patient privilege in federal proceedings. See e.g., United States v. Moore, 970

F.2d 48, (5th Cir. 1992) (no federal doctor-patient privilege); Hancock v. Dodson, 958 F.2d

1367, (6th Cir. 1992) (no federal physician-patient privilege); Northwestern Memorial Hosp.,

362 F.3d at 926 (HIPAA procedure for obtaining authority to use medical records in

litigation is procedural and does not create federal physician-patient or hospital-patient

privilege); Patterson v. Caterpillar, Inc., 70 F.3d 503, 506 (7th Cir. 1995) (federal privilege

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law controls in ERISA suit and does not recognize physician-patient privilege); United States

v. Bercier, 848 F.2d 917, 920 (8th Cir. 1988) (no physician-patient privilege in federal

criminal proceedings); United States v. Lindstrom, 698 F.2d 1154, 1167 n 9 (11th Cir. 1983)

(no physician-patient privilege at common law, and no statute, so testimony on doctor-patient

relationship is admissible).

The Court finds the ruling of the magistrate judge was not clearly erroneous of

contrary to law. 

Fourth Amendment

Defendant asserts that the intrusion into Defendant’s private medical records five

years after an alleged offense, and where the government received the necessary information

at the time of the offense, constitutes an unreasonable search and seizure. The government

asserts that, because the magistrate judge has the authority to order disclosure of medical

records, the Order does not involve the Fourth Amendment or any search and seizure by the

government. Armstrong v. Commonwealth of Ky, 205 S.W.3d 230 (Ky.App. 2006) 

While an analysis of a reasonable expectation of privacy and a probable cause

determination may not be appropriate, the issuance of a subpoena does require

reasonableness. See United States v. Palmer, 536 F.2d 1278, 1282 (9th Cir. 1976) (standard

for subpoena is reasonableness); see also Doe v. United States, 253 F.3d 263-64 (6th Cir.

2001) (while Fourth Amendment requires probable cause for issuance of search warrant,

subpoenas are analyzed under a general reasonableness standard). 

As the government has pointed out, a “subpoena may order the witness to produce any

books, papers, documents, data or other objects the subpoena designates. The court may

direct the witness to produce the designated items in court before trial or before they are to

be offered in evidence. When the items arrive, the court may permit the parties and their

attorneys to inspect all or part of them.” Fed.R.Crim.P. 17(c). Further, to obtain production

prior to trial under the rule, the moving party must show (1) that the documents are

evidentiary and relevant; (2) that they are not otherwise procurable reasonably in advance

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of trial by exercise of due diligence; (3) that the party cannot properly prepare for trial

without such production and inspection in advance of trial and that the failure to obtain such

inspection may tend to unreasonably delay the trial; and (4) that the application is made in

good faith and is not intended as a general fishing expedition. United States v. Nixon, 418

U.S. 683, 699-700 (1974).

Defendant disputes the government’s assertion that blood and urine samples

previously obtained by the government are unavailable and insufficient. Defendant points

out that the AUSA has informed her that portions of the government’s blood and urine

samples are available for retesting. In other words, the government has not shown that the

government needs the test results from Kino Hospital. The government asserts, however,

that while the samples are available for testing, because of the passage of time, the samples

are no longer viable to provide accurate, reliable toxicology results.

Further, the government asserts that it is anticipated that the records will include a

blood based drug screen. The government asserts that these records are relevant to the

instant charges and would be admissible at trial as medical records. The government asserts

that it cannot obtain these documents using a grand jury or an administrative subpoena and,

if the documents are produced in advance of trial, objections as to their admissibility can be

dealt with prior to trial. Furthermore, the government asserts that production of the

documents in advance of trial would prevent delays at trial.

The government has shown that the records are evidentiary and relevant. Not only

will the records potentially provide corroborating evidence (test results), but the records may

provide additional evidence regarding Defendant’s level of consciousness and intoxication

and statements made by Defendant. That the government has already tested the urine does

not alter the fact that the records are evidentiary and relevant.

Moreover, the government has shown that the records are not otherwise procurable

reasonably in advance of trial by exercise of due diligence, that the records are needed to

properly prepare for trial and avoid unreasonable delays, and that the request is made in good

faith and is not intended as a general fishing expedition. The Court finds the subpoenaing

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of the records by the government to be reasonable and, therefore, in compliance with the

Fourth Amendment.

In light of the Court’s findings herein, the Court finds the magistrate judge’s order for

an in camera review was not clearly erroneous or contrary to law. Defendant’s objections

are overruled and the Court will deny Defendant’s requested relief. 

Accordingly, IT IS ORDERED Defendant’s Objections to Magistrate Judge’s Ruling

[Doc. # 28] and Defendant’s Supplemental Objections to Magistrate Judge’s Order

Regarding Disclosure [Doc. # 39] are DENIED.

IT IS FURTHER ORDERED this matter is referred back to the magistrate judge for

the completion of the in camera review.

DATED this 2nd day of February, 2010.

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