United States Court of Appeals

FOR THE DISTRICT OF COLUMBIA CIRCUIT

Argued October 25, 2023 Decided January 9, 2024

No. 22-7148

HDEEL ABDELHADY,

APPELLANT

v.

GEORGE WASHINGTON UNIVERSITY, ET AL.,

APPELLEES

Appeal from the United States District Court

for the District of Columbia

(No. 1:22-cv-01334)

Hdeel Abdelhady, pro se, argued the cause and filed the 

briefs for appellant.

Gerard J. Emig argued the cause and filed the brief for 

appellees.

Before: SRINIVASAN, Chief Judge, MILLETT and WILKINS, 

Circuit Judges.

Opinion for the Court filed by Circuit Judge WILKINS.

WILKINS, Circuit Judge: Hdeel Abdelhady sued George 

Washington University (the “University”) after she was injured 
2

on the school’s property. In the University’s motions to 

dismiss and for partial summary judgment, it included several 

exhibits that, Ms. Abdelhady argued in a motion to seal, 

referenced private medical treatments and diagnoses. The

District Court denied Ms. Abdelhady’s motion to seal in part. 

Ms. Abdelhady appeals that decision. For the reasons 

explained below, we vacate and remand.

I.

We begin with our jurisdiction to hear this appeal. Section 

1291 of the Judicial Code confers on federal courts of appeals 

jurisdiction to review “final decisions of the district courts.” 28 

U.S.C. § 1291. Ordinarily, “final decisions” are those that 

“trigger the entry of judgment.” Mohawk Indus., Inc. v. 

Carpenter, 558 U.S. 100, 103 (2009). But Section 1291 also 

permits review of a small category of orders that are “collateral 

to” the “merits of the case” and “too important” to be denied 

immediate review. Cohen v. Beneficial Indus. Loan Corp., 337 

U.S. 541, 546 (1949). 

We should exercise great care prior to asserting 

jurisdiction under the collateral order doctrine. The doctrine 

must “never be allowed to swallow the general rule that a party 

is entitled to a single appeal, to be deferred until final judgment 

has been entered.” Digit. Equip. Corp. v. Desktop Direct, Inc., 

511 U.S. 863, 868 (1994) (citation omitted); see also Mohawk, 

558 U.S. at 106. This limited application prevents appellate 

courts from greenlighting “piecemeal, prejudgment appeals,” 

and thereby undermining “efficient judicial administration”

and “encroach[ing] upon the prerogatives of district court 

judges, who play a special role in managing ongoing 

litigation.” Mohawk, 558 U.S. at 106 (internal quotation marks 

omitted).
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Thus, the “small category” of collateral orders that are 

reviewable under Section 1291 “includes only decisions that 

are conclusive, that resolve important questions separate from 

the merits, and that are effectively unreviewable on appeal 

from the final judgment in the underlying action.” Swint v. 

Chambers Cnty. Comm’n, 514 U.S. 35, 42 (1995) (citing 

Cohen, 337 U.S. at 546). Here, the order from which Ms. 

Abdelhady appeals was conclusive on the question of sealing 

and resolved an important question separate from the merits. 

Therefore, we are left with one question: Is an appeal of an 

order denying a motion to seal documents referencing medical 

treatments and diagnoses “effectively unreviewable on appeal 

from the final judgment in the underlying action”? Id. at 42. 

As Mohawk emphasizes, this question does not entail an

“individualized jurisdictional inquiry” that turns on averting a 

“particular injustice.” 558 U.S. at 107 (cleaned up). So if there 

is a way to “adequately vindicate[]” this class of claims “by 

other means,” then Section 1291 “does not provide a basis for 

jurisdiction.” Id. Our “decisive consideration” is whether this 

entire category of claims, “taken as a whole,” requires 

immediate review to avoid imperiling “a substantial public 

interest or some particular value of a high order.” Id. (internal 

quotation marks omitted).

Undoubtedly, individuals generally have a strong interest 

in keeping their medical treatments and diagnoses private. See 

Hardaway v. D.C. Hous. Auth., 843 F.3d 973, 980–81 (D.C. 

Cir. 2016); see also United States v. Kravetz, 706 F.3d 47, 63 

(1st Cir. 2013). The need for medical privacy is similarly 

recognized by federal and District of Columbia law. See, e.g., 

42 U.S.C. § 1320d-2(d)(2); 45 C.F.R. § 164.502; D.C. Code § 

14-307. Indeed, the University agrees that individuals possess 

a strong interest in keeping their medical diagnoses and 

treatments private. Oral Arg. Rec. 53:30–54:35.
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Given the strength of this interest, we conclude that

maintaining one’s privacy in medical treatments and diagnoses

is a value of “high order” that warrants immediate appellate 

review. Mohawk, 558 U.S. at 107 (internal quotation marks 

omitted). Delayed review risks widespread and irreversible

dissemination of private medical information that cannot be 

remedied on appeal. Cf. Al Odah v. United States, 559 F.3d

539, 544 (D.C. Cir. 2009) (explaining that “appellate review is 

futile” once information is disclosed because “the cat is out of 

the bag”) (cleaned up); In re Sealed Case (Medical Records), 

381 F.3d 1205, 1209–10 (D.C. Cir. 2004) (same).

That said, this is a limited holding. We are not deciding 

whether the collateral order doctrine categorically applies to 

any order denying a motion to seal. While we recognize that 

there is a circuit split on this issue, we have no occasion to 

weigh in until resolution of the issue is necessary to our 

decision and the issue is fully and adequately briefed. 

Compare Vantage Health Plan, Inc. v. Willis-Knighton Med.

Ctr., 913 F.3d 443, 447–50 (5th Cir. 2019) (holding that sealing 

and unsealing orders are immediately appealable), Rudd Equip. 

Co. v. John Deere Constr. & Forestry Co., 834 F.3d 589, 592–

93 (6th Cir. 2016) (same), Callahan v. United Network for 

Organ Sharing, 17 F.4th 1356, 1360–61 (11th Cir. 2021) 

(similar), and Apple Inc. v. Samsung Elecs. Co., 727 F.3d 1214, 

1220 (Fed. Cir. 2013) (similar), with United States v. Guerrero, 

693 F.3d 990, 995–99 (9th Cir. 2012) (holding that the 

collateral order doctrine does not extend to an order denying a 

motion to seal pretrial competency proceedings). All we are 

deciding is that, in these circumstances, the denial of the 

motion to seal records containing medical information is 

immediately appealable. 
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II.

This brings us to the merits: whether the District Court 

erred in denying Ms. Abdelhady’s motion to seal documents 

referencing her medical diagnoses and treatments. We review 

that denial for abuse of discretion, guided by a “strong 

presumption in favor of public access to judicial proceedings.” 

See EEOC v. Nat’l Children’s Ctr., Inc., 98 F.3d 1406, 1409

(D.C. Cir. 1996) (internal quotation marks omitted). 

But as with any presumption, the preference for public 

access is not ironclad. In United States v. Hubbard, 650 F.2d 

293, 317–22 (D.C. Cir. 1980), we identified six factors to guide 

the inquiry into whether the presumption is overcome: (1) the 

need for public access to the documents at issue; (2) the extent 

of previous public access to the documents; (3) the fact that 

someone has objected to the disclosure, and their identity; (4) 

the strength of any property and privacy interests asserted; (5) 

the possibility of prejudice to those opposing disclosure; and 

(6) the purposes for which the documents were introduced 

during the judicial proceedings. We have “repeatedly held that 

those are the factors a court should weigh in ruling on a motion 

to seal or unseal a judicial record.” In re Leopold, 964 F.3d 

1121, 1131 n.9 (D.C. Cir. 2020). Although a district court has 

“wide” discretion when balancing the Hubbard factors, “the 

district court must provide a ‘full explanation’ for its decision, 

detailed enough to permit ‘review of the district court’s 

exercise of its discretion.’” In re L.A. Times Commc’ns LLC, 

28 F.4th 292, 297 (D.C. Cir. 2022) (brackets omitted) (quoting 

Nat’l Children’s Ctr., 98 F.3d at 1410).

Here, the District Court granted the motion to seal in part, 

but only as to an exhibit that identified Ms. Abdelhady’s 

treating physicians. As to the remaining documents she sought 

to seal, the District Court denied the motion on the grounds that 
6

they “contain no medical records or details that [Ms. 

Abdelhady] herself does not already mention in her redacted 

Amended Complaint.” JA 13. But on our inspection of the 

record, it appears that some of the documents that Ms. 

Abdelhady seeks to seal do, in fact, reference medical 

treatments and diagnoses that were redacted in her amended 

complaint. Thus, as part of its “scarce explanation for its 

denial” of Ms. Abdelhady’s motion to seal, Hardaway, 843 

F.3d at 980, the court relied on the incorrect assumption that 

Ms. Abdelhady had already disclosed in her redacted complaint 

all of the same information she sought to have sealed.

Furthermore, on this record, we cannot determine whether 

the District Court considered the need, if any, for public access 

to the documents that Ms. Abdelhady sought to seal, and

whether the District Court adequately weighed both Ms. 

Abdelhady’s interest in medical privacy and the extent of 

previous public access to each of the records at issue. These 

factors (which Ms. Abdelhady raised, see JA 15) are relevant 

to her motion to seal. Although a district court need not provide 

a detailed exposition about every Hubbard factor in response 

to every sealing request, it must say enough to allow us to 

“infe[r] from the record with reasonable certainty,” Conafay v. 

Wyeth Lab’ys, 793 F.2d 350, 354 (D.C. Cir. 1986) (quoting In 

re Pope, 580 F.2d 620, 623 (D.C. Cir. 1978)), that it considered 

all such factors upon our review for abuse of discretion. 

Because the District Court misconstrued the record and 

appears not to have weighed all of the Hubbard factors, it 

abused its discretion. See Hardaway, 843 F.3d at 980 (“failing 

to weigh the six relevant [Hubbard] factors and 

mischaracterizing the record” is an abuse of discretion); Nat’l 

Children’s Ctr., 98 F.3d at 1410 (remanding where we were 

“unable to discern . . . whether the district court considered and 

applied the Hubbard factors in exercising its discretion”); see 
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also Cooter & Gell v. Hartmarx Corp., 496 U.S. 384, 405 

(1990) (“a clearly erroneous assessment of the evidence” is an 

abuse of discretion). We therefore remand this case so that the 

District Court can consider all of the Hubbard factors and 

further explain its decision.

Even so, we emphasize that our remand is not meant to 

imply that Ms. Abdelhady’s broad and generalized motion to 

seal should have been granted in its entirety. Indeed, whether 

Ms. Abdelhady solely wants to redact references to protected 

health information or instead seeks to entirely seal the 

documents that reference this sensitive information is unclear. 

See Fed. R. Civ. P. 5.2(d) (giving the court the option to order 

sealing of the entire document or the filing of a redacted version 

on the public docket). Ms. Abdelhady’s motion also suggests

that some documents should be sealed simply because they 

stem from a sealed administrative proceeding that discussed 

her injuries—not because these documents reference sensitive 

medical treatments and diagnoses. Though the District Court 

may have reasonably found one or more of these arguments 

unpersuasive, without a more fulsome explanation of its 

assessment of those grounds, “we are unable to review [its]

exercise of its discretion.” Nat’l Children’s Ctr., 98 F.3d at 

1410. We are left no choice but to remand.

So ordered.