SECOND DI VI SI ON

A NDREWS, P. J.

, M I LLER and BRA NCH, JJ.

N O T IC E : M otions for r e c ons i de r a tion m us t be

ph y sic a l ly r e ce iv ed i n our c le r k ’s offic e w ithin te n

da y s of the da te of de c is ion to be de e m ed tim e ly file d.

http://w w w .ga a ppe a l s .us /r ule s

October 16, 2015



# I n th e Co u r t o f

A p p eals o f

G eo r g ia

A1 5 A1 00 0 . BROW

N et al . v . HOW ARD et al

.

B R A N C H , J u d g e.

C our tne y H o w a

r d s u ed vari o u s m ed i cal pro v i d ers

, al leg i n g t ha t the y c om m itte d

ne glige nc e dur i ng t h e d el i v ery o f Ho ward ’ s d au g h ter Sah ara, t h ereb y cau s in g a s ev ere

b rai n i n ju ry t o t h e ch il d

. Du ri ng t h e l i t i g at i o n, t h e m ed i cal p ro v i d ers s o u g h t d i s co v ery

o f Ho ward ’ s o wn m ed i cal reco rd s

, wh i ch l ed t o a d i s p u t e ab ou t wh et h er an d t o wh at

ex t en t cert ai n o f t h e req u es t ed d o cu m en t s were p ro t ect ed fro m d is co v ery b y a

p ri v i leg e. Th e m ed i cal pro vi d ers ap p eal t h e t ri al co u rt ’ s ru l i n g t h at m o s t o f t h e s u b ject

d o c u m en t s are pri v i l eg ed ; t h ey fu rt h er co n t en d t h e t ri al co u rt erred b y fai l i n g t o

req u i r e a p r i v i leg e l o g th at s p eci fi ed t h e m at t ers t h at were p ri v i l eg ed an d t h e

ap p li cab l e p ri v il eg e. Fo r t h e reas o n s t h at f o l l o w

, we rev ers e an d rem an d wi th

d i rect i o n

.Th i s Co urt rev i ews a t ri al co u rt ’ s d eci s i o n as t o d i s co very m at t ers

, i n cl u d i n g

t h e ap pl i cat io n o f a p ri v i l eg e, fo r an ab u s e o f d i s cret i o n

. Et o wa h En vi r o n men t al

Gr o up v. W

a l s h

, 3 3 3 Ga. Ap p . 4 6 4 , 4 7 5 (3 ) (7 7 4 SE2 d 2 2 0 ) (2 0 1 5 ) (at t o rn ey -cl i en t

p ri v i leg e); W

i l es v. W i l es

, 2 6 4 Ga. 5 9 4

, 5 9 8 (2 ) (4 4 8 SE2 d 6 81 ) (1 9 9 4 ) (p s y ch i at ri s t

p at i en t p ri v i l eg e). Fu rt h er, we al s o m ay rev iew t h e d o cu m en ts at i ss u e t o d et erm i n e

wh et h er t h e t ri al co u rt co rrect l y ap p li ed t h e p ri v i l eg e. See, e.g

., Pl u n ket t v. Gi n s b u r g

,

2 1 7 Ga. Ap p

. 20

, 2 1 (4 5 6 SE2 d 5 95 ) (1 9 95 ); An n a n da l e at S u wa nee v. W

ea t h er l y

,

1 9 4 Ga. Ap p . 8 0 3 , 8 0 4 (3 9 2 SE2 d 2 7 ) (1 9 9 0).

In h er s u i t, Ho ward al l eg ed t hat s h e b ecam e p reg n an t i n l at e 2 0 10 an d t h at h er

p reg n an cy p ro ceed ed n o rm al l y fo r 2 7 week s

. At t hat p o i n t

, d u e t o cert ai n s y m p t o m s

,

Ho war d p r es en t ed to W el l s t ar Co b b Ho s p i t al

, b u t t h e fet u s was fo u n d t o b e d o i n g

wel l an d Ho ward was d i s ch arg ed ho m e earl y i n th e m orn i n g o f M ay 3 1

, 2 0 1 1

. On

J u n e 3

, Ho ward ret u rn ed t o W el l s t ar w h en h er “ m em bran es s p o n t an eo u s l y ru p t u red ,”

b u t t e s t s a t t h e h o s p i t al d i d no t co n fi rm t h e ru p t ure an d Ho ward was d i s ch arg ed at

1 : 4 0 a.m

. o n J u ne 4

. On Ju n e 7 at 7 : 4 0 p

. m

., Ho ward ret u rn ed a t h i rd t i m e, t h i s t i m e

wi t h l o wer ab d o m i n al p ai n . Tes t s t ak en as earl y as 1 : 2 0 a.m . an d ag ai n at 3 : 3 0 a.m

.

o n J u n e 8 i n d i cat ed a n eed fo r an i m m ed i at e d el i v ery o f t h e ch i ld

, b u t t h e ch i l d was

n o t d el i vered u n t i l ap p ro x im at el y 6 : 0 0 a.m

. H o ward al l eg es t h at the m e dic a l pr ovide rs

2were neg l i g en t i n p ro v i d i ng care t h ereb y cau s i n g t h e ch il d t o s u s tai n a s ev ere b rai n

i n ju ry

.

Du ri n g di s co v ery

, t h e m ed i cal pro v i d ers as ked Ho ward t o p ro d uce al l o f h er

m ed i cal reco rd s fro m ag e 1 0 t o t h e p res en t, an d req ues t ed t h at s h e i d e n t i fy al l

t reat m en t s h e had r e cei v ed fro m p s y ch o l o g is t s

, p s y ch i at ri st s, cl i n ics

, an d al l o t h er

m ed i cal p ro v i d ers

. In res p o n se, Ho ward o b ject ed o n t h e g ro un d t h at t he req u es t was

o v erl y b ro ad an d u n d u ly b u rd en s o m e b u t n o t o n t he g ro u n d o f p ri v i l eg e. 1 Ho w ard was

t h en d ep o s ed

, du ri n g wh i ch s h e rev eal ed t h at s h e s m o k ed as m an y as fo u r jo i n t s o f

m ari ju an a a d ay pri o r t o learn i n g t hat s h e w a s p r e g n a n t an d t h at s h e was fu rt h er

ex p os ed to o t h er peo p l e s m o k i n g m ari ju an a d uri n g th e rem ai n d er of h er p reg n an cy ;

s h e a l s o ad m i t t ed res um i ng s m o k i n g m ari ju an a aft er s h e d el i v ered t he ch i l d

. Sh e

d en ied u s i n g an y o t h er d ru g s

. Ho ward al s o ad m i t t ed t h at s h e h ad p rev i ou s ly recei v ed

m en t al h eal t h an d s ub s t an ce ab u s e t reat m en t at Co b b Reco v ery Cen ter (“ CRC”) an d

t h at s h e h ad t ak en “ d ru g cl as s es ” t h ere as a co n d i t i o n o f p r o bat i o n ari si n g o u t o f a

1 On ap peal

, t h e m ed i cal p ro vi d e r s d o n o t arg u e t h at t h e t ri al co u rt erred by

co n cl u d in g t h at Ho ward h ad n o t wai v ed th e ap pl i cab l e p ri v il eg e. See g en eral l y

Ken nes t on e Ho sp

. v. H

o ps o n

, 2 7 3 Ga. 1 4 5

, 1 4 9 (5 3 8 SE2 d 7 4 2 ) (2 0 0 0 ) (“ [A] p art y ’ s

s i len ce an d fai l u re t o act in res p o n s e to a req u es t fo r p ri vi l e g ed m at t er fro m a

n o n p art y h eal th care p ro v i d er o r faci li t y u n d er OCGA § 9 -1 1 -3 4 (c) (2 ) d o es n ot

wai v e t h e p art y ’ s p ri v i leg e b y i m p l i cat i o n.”).

3ch arg e o f s i m p l e b at t ery t hat was l at er d ro p ped

. M ed i cal d ocu m en t s p ro d u ced fro m

o t h er s o u rces s h o wed t h at Ho ward tes t e d p o s i t i v e fo r m ari ju an a o n o n e o r m o re

o ccas i o n s d u ri n g h er p reg n an cy

.

As a res u l t , t h e m ed i cal p ro v i d ers req u es t ed t h at Ho ward p ro v i d e a HIPAA 2

-

co m p l ian t a u t h o ri zat i o n t h at wo u l d al l ow CRC t o p ro du ce Ho w ard ’ s CRC reco rd s

.

Ho ward ap p aren t l y refu s ed

, an d t h e m ed ical p ro v id ers m o ved t o co m p el p ro d u ct i o n

o f t he CRC rec o r d s

. H o ward res p o n ded an d o bject ed o n th e g ro u n d t h at t h e

d o c u m e n t s were no t rel ev an t b ecau s e t h ey pert ai n ed on l y to t reat m en t Ho ward

recei v ed s ev eral y ears befo re an d s ev eral y ears aft er h er p reg n an cy

. Sh e al s o o b ject ed

o n th e g ro u n d t h at t h e d o cu m en t s were p ro tect ed b y t h e m en t al h eal t h p ri vi l eg e. Th e

t ri al co urt co n du ct ed a h eari ng o n t h e m o t i o n

, fo l l o w i ng w h ich t h e co urt d i rect ed

Ho ward t o p ro du ce t o t h e co u rt al l CRC reco rd s fo r an i n cam era rev iew, t o p ro d uce

t o t h e co u rt a p ri v i leg e l o g m eet i n g t h e p aram et ers o f Fed eral Ru l e o f Ci v i l Pro ced u re

2 Th e H eat h In s u ran ce Po rt ab i l i ty an d A cco u n tab i l i t y Act o f 19 9 6

. 4 2 U. S. C.

§ 1 32 0 d et s eq

.

42 6 (b ) (5 ) (A), 3 an d t o pro d u ce to t h e m e d i cal p ro vi d ers an y n o n -p ri v i l eg ed

d o cu m en t s

. Ho ward p ro d u ced t o th e co u rt al l CRC d o cu m en t s wi t h an i n d ex

, b ut

t h ere i s n o i n d i cat i o n t h at Ho ward p ro d u ced a pri v i l eg e lo g t h at co m p l i ed wi t h FRCP

2 6

. Ho ward al s o p r o d u c ed t o t h e m ed i cal p ro v id ers t h e CRC b i l l in g reco rd s

. Th e

co u rt s u b s eq uen t l y i s su ed an o rd er i n w h i ch i t s t at ed t h a t i t h ad rev i ewed t h e

d o cu m en t s t o d et erm i ne

(1 ) wh et h er t h e reco rd s are p ri v i l eg ed (2 ) wh et h er th ere are an y n o n

p ri v il eg ed reco rd s i n t h e s ub m i s s io n

, (3 ) wh et h er t h ere h as b een a

wai v er o f t he pri v i l eg e wi t h reg ard t o an y p ri v i leg ed i n fo rm at i o n

, an d

( 4 ) wh et h er to req u i re t h e d i s cl o s u re o f an y reco rd s w h i ch are n o t

p ri v il eg ed o r as t o wh i ch an y p ri v i leg e h as b een wai v ed

.

Th e t ri al co u rt t h en co ncl u d ed t h at

, wi t h t h e ex cep t io n of t h e b i ll i n g reco rd s al read y

p ro d uced b y

Ho ward

, t h e CRC reco rd s “ are p ri vi l eg ed an d [ ] t h e p r i v i l eg e h as n ot

3 FRCP 2 6 (b ) (5 ) (A) p ro v i d es

,

“ W h en a p art y wi th h o l d s i nfo rm at i o n ot h erwi s e d i sco v erab l e b y

cl ai m in g t h at th e i n fo rm at i o n i s pri v i l eg ed o r s u b ject t o p r o t e c t i o n as

t ri al -p rep arat i o n m at eri al

, t h e p art y m u st : (i ) ex p res s l y m ak e th e cl ai m ;

an d (i i ) d es cri b e t h e nat u re o f t h e d o cu m en t s

, co m m u n i c a t i o ns

, o r

t an g ib l e t h in gs n o t p ro d uced o r di s cl o sed --an d d o s o i n a m an n e r t h at

, wi t h ou t rev eal i n g i nfo rm at i on i t s el f p ri v i l eg ed o r p ro t ect ed

, wi l l en ab l e

o t h er p art i es t o as ses s t h e cl ai m .”

5b een wai v ed .” 4 T h e co urt d i d n o t ad d res s Ho ward ’ s fai l u re t o p ro d uce a p ri v i l eg e l o g.

Th i s Co u rt g ran t ed th e m ed i cal p ro v i d ers ’ req u es t fo r in terl o cu t o ry rev i ew o f t h e t ri al

co u rt ’ s d eci s i o n wi t h reg ard t o t h e d o cu m en t s t he t ri al co u rt d eem ed t o b e p ri v i l eg ed

.

1

. Th e m ed ical p ro v i d ers co n ten d t h e t ri al co u rt erred b y co n cl u d i n g t h at al l o f

t h e CRC reco rd s o t h er th an t h e b i l l i ng reco rd s were p ri v il eg ed

. Th e p rovide r s co n t en d

t h ey are en t i t l ed t o t h o se po rt i o n s o f t h e d o c u m e n t s th at s h ow (a) d at es

, t i m es

, an d

i n d i v i d u al p ro v i d ers o f s erv i ces ren d ered t o Ho ward b y CRC; (b ) an y ed u cat i o n al

s erv i ces p ro v i d ed b y CRC t o Ho ward

, in cl u di n g s u b s t an ce ab u s e c l a s s e s an d jo b

t rai n i n g ; ( c) Ho ward ’ s co m m u n i cat i on s m ad e t o o r reco rd ed b y n o n -l i cen s ed

p ers o n n el o r p ers o n n el n o t l i st ed i n O CGA § 2 4 -5 -5 0 1 (a); an d (d ) co u rt -m an d at ed

o r p ro b at i o n -rel at ed ev al u at i o n s an d d ru g t es t s o f Ho ward co n d uct ed b y CRC.

“ Part i es m ay o b t ai n d is co v ery reg ard i n g an y m at t er, n o t pri v i l eg ed

, wh i ch i s

rel ev an t t o t h e s u b

ject m at ter i n v o l v ed i n t h e p en d i ng act i on [.] ” OCGA § 9 -1 1 -2 6 (b )

(1 ). Geo rg i a l aw p ro v i d es s ev eral p ri v il eg es rel at ed t o m en t al h eal t h

, wh i ch

,

co l l ect i v el y

, are referred t o as t h e “ m en t al h eal th p ri v i l eg e.” S ta t e v. H er en d een

, 2 7 9

4 Th e co u rt al s o s t at ed t hat i t wo u l d m ai n t ai n t h e p ri v il eg ed C R C d o cu m en t s

u n d er s eal , an d t h e d ocu m en ts were d el i vered u n d er s eal t o t h i s Co u rt

.

6Ga. 32 3

, 3 2 5 (6 1 3 SE2 d 6 4 7 ) (2 0 0 5). Th e co m p o n en t s o f t h e m en tal h eal t h p ri v i l eg e

i n cl u d e

(5 ) Co m m u ni cat i on s b et ween p s y ch i at ri s t an d p at i en t ;

(6 ) C o m m

u n i cat i on s b et ween li cen sed p s y ch ol o g i s t an d p at ien t as

p ro v i d ed i n Co d e Sect i o n 4 3 -3 9 -1 6 ;

(7 ) Co m m u n icat i o n s b et w een a l icen s ed cl in i cal so ci al w o rk er, cl i n i cal

n u rs e s peci al i s t i n p s y ch i at ri c/ m en t al h ea l t h, l i cen s ed m arri ag e an d

fam i l y t h erap i st , o r l i cen s ed p ro fes s i o n al co un s el or an d p at i en t; [an d ]

(8 ) Co m m u n i cat i o n s b et ween o r am o n g an y ps y ch i at ri s t

, p s y ch o l o g i s t

,

l i cen s ed cl i n i cal s o ci al wo rk er, cl i n i cal n u rs e sp eci al i s t i n

p s y ch i at ri c/ m en t al h eal t h

, l i cen s ed m arri ag e an d fam il y t h erap is t

, an d

l i cen s ed p ro fes s i on al co u n s el o r wh o are ren d eri n g p s y ch o t h erap y o r

h av e ren d ered p sy ch o t h erap y t o a p at i en t

, reg ard in g t h at p at ien t ’ s

co m m u n i cat io ns wh i ch are o t h erwi s e p ri v i l eg ed by p arag rap h (5 ), ( 6 ),

o r (7 ) o f t hi s s u b s ect i o n [.]

OCGA § 2 4 -5 -5 0 1 (a). See al s o OCGA § 4 3 -3 9 -1 6 (“ Th e co n fi d en ti al rel at i o n s an d

co m m u n icat io ns b et ween a li cen s ed p s y ch o l og i s t an d cl i en t are p l aced u p on t h e s am e

b as i s as t h o s e pro v i ded b y l aw b et ween at t o rn ey an d cl i en t ; an d n o t h i n g i n t h i s

ch ap t e r s h al l b e co n s t ru ed to req u i re an y s u ch p ri v i l eg ed co m m u n icat i o n t o b e

d i s cl os ed .”). Th u s , “ [a] n y i n fo rm at i o n . . . wh i ch h ad i t s o ri g in s i n co m m u n i cat i on s

fro m t h e p at i en t s t o t h e [m en tal ] h eal t h p ro v i d ers i s p ri v i l eg ed .” H er en d een

, 2 7 9 Ga.

at 3 2 7 (ci t at i o n s o m i tt ed ).

7Th e m en t al h eal t h p ri v i l eg e “ rem ai n s i nv i o l at e ev en t ho u g h t h e p at ien t ’ s care

an d t reat m en t o r t h e n at ure o r ex t en t o f th e p at i en t ’ s i n ju ri es are p u t i n is s u e i n a ci v i l

p r o c e e d i n g .” Co o ks ey v. La n d r y

, 2 9 5 Ga. 43 0

, 4 32 -4 3 3 (2 ) (7 6 1 SE2 d 6 1 ) (2 0 1 4 )

(ci t at i o n s o m i t ted ). An d “ [t ] h e p s y ch i at ri s t-p at i en t pri v i l eg e i s n o t d i m i n i s h ed b y t h e

fact t h at t h e p at i en t s o ug h t o r co n t em p l at ed treat m en t jo in t l y

wi th o t h er p ers o n s , o r

p ri m ari l y fo r t h e b en efi t of an o t h er p ers o n wh o is i n t r e a t m e n t b y t h e s am e

p s y ch i at ri s t.” Mr oz i n s ki v. Po g u e

, 2 0 5 Ga. Ap p. 7 3 1

, 7 3 3 (1 ) (4 2 3 SE2 d 4 05 ) (1 9 9 2 )

(ad d res s i n g fam i l y t herap y ); S i ms v. S t a te

, 2 51 Ga. 8 7 7

, 8 8 0 (5 ) (3 1 1 SE2 d 1 6 1 )

(1 9 8 4) (s t at em en t s m ad e by hu s b an d d u ri n g j o i n t p s y ch i at ri c co u n s el in g wi t h wi fe

were p ri vi l eg ed ); co m

p are Ka r p o wi cz v. Hyl es

, 2 4 7 Ga. Ap p

. 2 9 2

, 29 4 (1 ) (5 4 3 SE2 d

5 1 ) (2 00 0 ) (m o th er’ s s t at em en t t o l icen sed cl i n i cal ps y ch ol o g i s t w h o t reat ed h er

d au gh t er t h at sh e was afrai d t h a t h e r d au g h t er was u n ab l e t o d i s t i n g u is h fact fro m

real it y was n o t p ri v i l eg ed b ecau s e o n l y d au g h t er, no t m o t h er

, s o u g ht m en t al h eal th

t reat m en t ). Al s o

, d ru g an d al co h o l t reat m en t reco rd s are pro t ect ed b y f e d e r a l l aw

u n d er cert ai n ci rcu m s t an ces

. See S l et t o v. Ho s p

. Au th

. , 2 3 9 Ga. Ap p. 2 0 3, 20 8 (5 2 1

SE2 d 1 9 9) (1 9 9 9), El d ri d ge, J

. , co n cu rri n g s p eci al l y

.

Bu t al l p s y ch i at ri c reco rd s “ are n o t ab s ol u t el y p ri vi l eg ed

. ” Pl un k e t t

, 2 1 7 Ga.

Ap p

. at 2 1

. An d n on p ri vi l eg ed p o rt i o ns o f s u ch reco rd s are s u b ject t o d i s co v ery

.

8Aet n a Ca s

. & Su r

. Co

. v. Ri dg evi ew In s t it u t e

, 1 94 Ga. Ap p

. 8 0 5 (3 9 2 SE2 d 2 8 6 )

(1 9 9 0). Fo r ex am

p le, “ [ t ]h e p ri v i l eg e d o es n o t ex t en d

. . . t o an y co m m u n i cat i on s

m ad e [b y t he p at i en t ] t o n u rs es o r at t en dan t s

, u n l es s [t h e n u rs es o r at t en d an t s ] were

act i ng as ag en t s o f t h e at t en d i n g p s y ch i at ri s t [.] ” Pl u n ket t

, 2 1 7 Ga. A p p

. at 2 1 (ci t at i o n

o m it t ed ). Si m i l arl y

, “ [t ] o t h e ex t en t t hat t h e reco rd s i n q u es t i o n d i s cl o s e i n fo rm at i o n

o r co m m u n i cat i o n s m ad e b et w een [a m en tal h eal t h p ro fes si o n al ] an d pers o n s o t h er

t h an [an o t h er m en tal h eal t h p ro fes s i o n al o r h i s o r h er] ag en t an d s u ch

co m m u n icat io ns are r e l ev an t t o [t h e] d efen s e, t h ey wo u ld b e d is co v erab l e u n d er

Geo rg i a l aw.” Aet na Ca s. & S u r. Co

. , 1 9 4 Ga. Ap p. at 80 6 (1 ) (ci t at i o n o m i t t ed ). An d

wh ere “ n o m en t al h eal t h t reat m en t i s g i v en o r co n t em pl at ed ”

—

fo r i n s t an ce, wh en

a co u rt ap p o i n t s a m en t al h eal t h p r o v i d e r t o ev al uat e a p ers o n ’ s m en tal s t at e as

o p p o s e d t o p ro v i d i n g t reat m en t

— t h e m en t al h eal t h p ri v il eg e i s i n ap p l i cab l e.

Her en d een

, 27 9 Ga. at 3 2 6. Co m p are In r e I. M. G.

, 27 6 Ga. Ap p. 5 98

, 60 3 (1 ) (6 2 4

SE2 d 2 3 6 ) (2 0 05 ) (ev en i f a p at i en t recei v ed t reat m en t i n v o l un t ari l y

, t h e fact t h at s h e

recei v ed p s y ch o t h erap i s t -p atie nt tre atm e n t m e a nt the m e nta l he a lth p r ivil eg e ap p l i es ).

Al s o

, d ru g t es t s req u i red b y an em p l o y er are n o t p ro t ect ed

. Fo s t er v. S wi n n ey

, 2 6 3

Ga. A p p. 5 10

, 5 1 2 (a) (5 8 8 SE2 d 3 07 ) (2 0 0 3). Fi n al l y

, “ t h e fact o f em p l o y m en t o f o r

t reat m en t b y a m en t al h eal t h p ro v i d e r a n d t h e d at es t h ereo f d o n o t fal l w i t h i n t h e

9m en t al h eal t h p ri v i l eg e an d m ay b e d i s cl o s ed

. ” Her en d een

, 2 7 9 Ga. at 3 2 7 (ci t at i on s

o m it t ed ); Ken nes t o ne Ho s p

. , 2 7 3 Ga. at 14 8 ; Mi n cey v. Ga

. De p t

. o f C o mmu n i t

y

Af f a i rs , 3 0 8 Ga. Ap p . 7 4 0 , 7 4 6 (1 ) (7 0 8 SE2 d 6 4 4 ) (2 0 1 1 ).

Ou r rev i ew o f t h e reco rd s at i s s u e s h ows

, am o ng o t h er t h i n g s, d at es of s erv i ce;

t h e nam es o f s ev eral p ers o ns wh o s e pro fes s i o n al s t at us i s u n k n own ; nu m ero u s

d o cu m en t s wh ere, wi t h o u t ad d i t i o n al i nfo rm at i o n ab o ut th e co n t en t o f t he d o cu m en t

,

we are u n ab l e t o t el l wh et h er it h ad i t s o ri g i n i n a co m m u ni cat i on b et ween Ho ward

an d a m en t al h eal t h pro vi d er; d o cu m en t s t hat i n cl u d e un d efi n ed acro n y m s m ak i n g t h e

n at u re o f t h e s ervic e s r e nde red i n d eci p h erab l e; rep o rt s o f a m ed i cal d oct o r co n cern i n g

a m ed i cal d i ag n o s i s ; v ari ou s n o t i ces o f t h e p ri v acy p ract i ces o f t h e Co b b / Do u g l as

Co u n t y Co m

m u n i t y Serv i ces Bo ar d s a n d co n s en t ag reem en t s s i g n ed by Ho ward

reg ard i n g h er ri g h t t o co n fi den t i al it y an d an y ex cep t i on s t h eret o ; s t at em en t s o f

p ay m en t fo r s erv i ces ; i n d i cat io n s t h at Ho ward h as p art i ci p at ed i n g ro u p co u n s el i n g

s es s i on s b u t wi t h o u t sp eci fi cs reg ard i n g t h e gro u p n at u re o f t he s es s i o n s ; m ed i cal ri s k

as s es s m en t d o cu m en t s ; co m m un i cat i on s fro m

Ho ward ’ s m o t h er t o CRC p ers o n n el ;

a l et t er “ To W h o m It M a y C o n c e rn ” reg ard i n g t h e p ro g ram an d t reat m en t Ho ward

was recei v i n g ; d o cu m en t s rep o rt i n g co n v ers at io n s wi t h o t h er n o n -p r o f e s s i o n al s

p res en t ; an d i n d i cat i o n s o f t h e res u l t s o f ran d o m d ru g s creen i n g s

.

10M an y o f t h es e d o cu m en t s

, h o wev er, are o b v i o u sl y n o t rel ev an t to t h e p res en t

p ro ceed in g s

. Nev ert h el es s

, becau s e s o m e o f th e d o cu m en t s m ay b e b o th rel ev an t an d

n o n -p ri v i l eg ed

, t h e tri al co u rt erred b y co n cl u d i ng th at al l o f t h e d o cu m en t s ot h er t h an

t h e p ro d uced bi ll i n g d o cu m en t s a r e p ri vi l eg ed

. Pl un ket t

, 2 1 7 Ga. Ap p

. at 2 2

. An y

rel ev an t an d n o n-p ri v i l eg ed d ocu m en t s s h o u l d b e p ro d uced ev en i f red act i o n s are

n eces s ary

. Th i s Co u rt i s u n ab l e t o co m p l et e t he rev i ew o f t h e d o cu m en t s wi t h o ut

ad d it i o n al in fo rm at i o n n o t av ai l ab l e t o t h i s Co u rt

, s u ch as

, a m o n g o th er t h i n g s

, t h e

p r o f e s s i o n al s tat u s o f cert ai n i n d i v id u al s

, wh et h er t h e i n fo rm at i o n i n s o m e o f t h e

d o cu m en t s h ad i t s o ri g i n i n a co m m u n i cat i o n b et ween Ho ward an d a m en t al h eal th

p ro v id er, an d wh et h er cert ai n d o cu m en t s refl ect t reat m en t o t h er t h an m en t al h eal th

t reat m en t

. Acco rd i n g l y

, t hi s cas e i s rem an d ed t o t h e t ri a l c o u r t f o r an i n cam era

rev i ew i n co n fo rm an ce w i t h t h i s o p i n i o n

, “ i .e., to s ep arat e p ri v i l eg ed v ers u s n o n

p ri v i leg ed i n fo rm at io n an d p ro v i d e a red act ed co p y

. ” Id

. (rev ers in g t ri al co u rt ’ s o rd er

d et erm i n i n g th at en ti re p s y ch i at ri s t ’ s f ile w as p ri vi l eg ed an d rem an d i n g fo r ad d i t i o n al

i n cam era rev i ew); s ee al s o H er en d een

, 2 7 9 Ga. at 3 2 8 (rem an d i n g cas e fo r in cam era

rev i ew t o d et erm i ne wh at d o cu m en t s were p ri v i l eg ed ).

2

. T h e m ed i cal p ro v i d ers co n t en d t h e t ri al co u rt al s o erred b y b arri n g an y

d i s co v ery o f t h e CRC reco rd s w i t h o u t req u iri n g H oward t o p ro d u ce a p ri v i l eg e l o g

11i n co m

pl i an ce wi t h Ru l e 2 6 (b ) (5 ) (A) o f t h e Fed eral Ru l es o f Ci v i l p ro ced u re as i t

h ad p rev i o u s ly o rd ered

. Th e tri al co u rt had ord ered Ho w ard t o p rep are s u ch a l o g in

res p o n s e t o t h e m ed i cal p ro v i d ers ’ m o t io n t o co m p el p ro d u ct i on o f t h e CRC reco rd s

,

b u t i t d i d n ot s peci fy a p en al t y fo r n o n co m p li an ce. In i t s o rd er fo l l o w i n g t h e in

cam era rev i ew of t h e CRC d o cu m en t s

, t h e t ri al co urt di d n o t ad d res s H o ward ’ s fai l u re

t o pro du ce a p ri v i l eg e l o g

. Becau s e t h e tri al co u rt h as n o t ad d res s ed Ho w ard ’ s fai l u re

t o p ro d u ce a p ri v i leg e l o g , t h ere i s n o t h i ng fo r th i s Co u rt t o rev i ew; we are n o t ab l e

t o as s es s wh et h er th e t ri al co urt b reach ed i t s d i s cret i o n

. Up o n rem an d

, t h e t ri al co u rt

s h o u ld ad d res s Ho ward ’ s fai l u re t o co m p l y w i t h t h e co u rt ’ s o wn ru l i n g t o p rep are

s u ch a l o g

.

Ju d g men t r ever

s ed a n d ca s e r ema n d

ed wi t h d i r ect i o n

. An d rews

, P. J

., an d

M i l ler, J ., co n cu r.

12