1

Filed 9/26/22; certified for publication 10/18/22 (order attached)

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

FIRST APPELLATE DISTRICT

DIVISION TWO

MARIA VIGIL,

Plaintiff and Appellant,

v.

MUIR MEDICAL GROUP IPA, 

INC.,

Defendant and Respondent.

 A160897

 (Contra Costa County

 Super. Ct. No. C1801331)

Maria Vigil filed a class action against Muir Medical Group IPA, Inc. 

(Muir), claiming that it failed to secure patients’ personal information, 

thereby allowing a former employee to download private medical information 

belonging to over 5,000 patients and take it with her when she left her 

employment with Muir. Among other causes of action, the class complaint 

alleges that Muir violated Civil Code1 sections 56.101 and 56.36, 

subdivision (b), of the Confidentiality of Medical Information Act (CMIA) 

(§ 56 et seq.) by negligently releasing class members’ confidential medical 

information. 

Several months after initiating the action, Vigil filed a motion for class 

certification. The trial court denied the motion, finding as to the CMIA claim 

1 Unless otherwise indicated, all statutory references are to the Civil 

Code.
2

that each class member would have to show that the confidential nature of 

his or her medical information had been breached by an unauthorized party, 

as required by Sutter Health v. Superior Court (2014) 227 Cal.App.4th 1546 

(Sutter Health), and therefore that common issues would not predominate. 

Vigil appeals, asserting that the trial court relied on an erroneous 

reading of the CMIA and that a breach of confidentiality can be shown on a 

class wide basis. We reject those arguments, and we affirm, concluding that 

the trial court properly applied the CMIA and exercised its discretion in 

denying class certification. 

BACKGROUND

I. 

The Data Breach and Vigil’s Complaint

Muir is an independent practice association that consists of primary 

care and specialty care providers that provide medical services to patients 

through the John Muir Health system. 

In May 2018, Ute Burness, Chief Executive Officer of Muir, notified 

certain patients that their personal information may have been involved in a 

data breach that occurred in December 2017. According to Burness, Muir 

discovered in March 2018 that a former employee took with her certain 

information in the possession of Muir before her employment ended with 

Muir (the data breach). The letter stated that Muir conducted an 

investigation, and “there is no evidence to date that your personal 

information has been misused in any way.”2 Vigil was one of the patients 

2 The trial court granted Muir’s motion to file under seal some portions 

of the class certification papers and the supporting evidence. Accordingly, we 

will not divulge the content of the sealed portions of the record (Cal. Rules of 

Court, rule 8.46(b)(1)), which largely concern Muir’s internal investigation of 
3

who received this notice. Muir later admitted that the former employee, 

Myrissa Centeno, had downloaded copies of information for over 5,400 

patients that included insurance and clinical information. 

In July 2018, Vigil filed a class action complaint asserting causes of 

action for violation of the Customer Records Act (CRA) (§ 1798.80 et seq.), 

violation of the CMIA (§ 56 et seq.), unlawful and unfair business practices

under the Unfair Competition Law (UCL) (Bus. & Prof. Code, § 17200 et 

seq.), and negligence. The UCL claim was predicated on the statutory and 

negligence claims. The complaint alleged that under the Health Insurance 

Portability and Accountability Act’s (HIPAA) Security Management Process 

standard (45 C.F.R. § 164.308), Muir’s employees should not have had access 

to records concerning approximately 5,500 patients without a “compelling” 

reason, nor should they have been able to take sensitive patient information 

with them. The complaint sought compensatory and punitive damages for 

Muir’s alleged negligence in failing to secure plaintiffs’ personal information. 

The complaint also alleged that this negligence violated the CRA. 

The complaint further alleged that Muir violated sections 56.101, 

subdivision (a), and 56.36, subdivision (b), of the CMIA by negligently 

releasing patients’ medical information without those patients’ authorization. 

Accordingly, the complaint sought statutory damages under the CMIA for 

each class member. 

II. 

Motion for Class Certification

In September 2019, Vigil moved for class certification, appointment of 

her counsel as class counsel and appointment of herself as class 

the data breach and the issue of whether Muir failed to take adequate 

measures to secure patients’ confidential information. 
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representative. As pertinent here, Vigil contended that the complaint 

presented questions common to the class regarding whether Muir was 

negligent in handling class members’ private medical information by failing 

to comply with its own HIPAA security policies, whether this negligence 

caused the data breach, and whether Centeno accessed and retained the 

private medical information without authorization. Vigil supported her 

motion with her declaration, citations to the depositions of two of Muir’s 

HIPAA security officers and some of the deposition exhibits, including Muir’s 

HIPAA policies, and Muir’s discovery responses. 

In opposition, Muir argued, among other things, that a CMIA claim 

requires a showing that the confidential nature of the plaintiff’s medical 

information was breached, and that Sutter Health, supra, 227 Cal.App.4th 

1546 held that there is no breach of confidentiality under the CMIA unless an 

unauthorized party has “actually viewed” the information. (Id. at p. 1550.) 

Thus, according to Muir, individualized issues of fact and law would 

predominate over the common questions because each putative class member 

would have to show that an unauthorized person viewed his or her 

confidential medical information. 

In her reply, Vigil asserted that the case could be decided on a classwide basis because there was evidence that Centeno downloaded, retained, 

and viewed a patient spreadsheet, and the CMIA does not require a showing 

that an unauthorized person read each line of medical data. In support, Vigil 

presented excerpts of the deposition of Janet Kesterson, Centeno’s colleague 

at her current employer, that Vigil contended shows Centeno disclosed to 

Kesterson patient information she obtained from Muir. Kesterson testified 

that in March 2018, their employer tasked her and Centeno with traveling to 

offices to get phone numbers for Medicare members. Centeno told Kesterson 
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there was no need to go to those offices because she had the phone numbers, 

and she “lifted her phone and just scrolled real fast.” Kesterson testified that 

she could not “decipher what information [Centeno] was scrolling through.” 

She “could just tell it was an Excel spreadsheet.” 

Following a hearing on the motion, the trial court issued an order 

denying class certification. The court found that Vigil had conceded that the 

CRA does not apply to Muir, and thus the “crux” of Vigil’s case “rest[ed] on 

her claim for breach of the Confidentiality of Medical Information Act.”3 It 

further found that the predominance of common questions requirement was 

not met because under the CMIA, “individualized inquiries would be required 

to prove Defendant’s liability and damages to each of the nearly 5,500 

proposed class members.” Specifically, it concluded that “[l]iability for each 

class member is predicated on whether his or her information was actually 

viewed, which on these facts is not capable of resolution in the aggregate.” 

Vigil appeals from the order denying class certification. 

DISCUSSION

Vigil argues we should reverse the trial court’s order because it relied 

on an erroneous reading of the CMIA in finding a predominance of individual 

issues. We conclude the trial court did not err in its application of the CMIA, 

and the class complaint’s allegations raise questions regarding breach of 

confidentiality and causation that necessarily require individualized 

inquiries regarding many, if not all, of the putative class members. Those 

individualized issues predominate over common questions of law and fact, 

and thus we uphold the order denying class certification. (See Linder v. 

3 On appeal, Vigil does not dispute this finding, and thus for purposes 

of this appeal, we presume the trial court was correct in finding that the CRA 

does not apply here and that this matter turns on the CMIA claim. (See 

Hewlett-Packard Co. v. Oracle Corp. (2021) 65 Cal.App.5th 506, 563.) 
6

Thrifty Oil Co. (2000) 23 Cal.4th 429, 436 (Linder) [“ ‘Any valid pertinent 

reason stated will be sufficient to uphold the order’ ”].)

I.

Legal Standards

A. The Governing Statutes

The CMIA protects the confidentiality of patients’ medical information. 

(Loder v. City of Glendale (1997) 14 Cal.4th 846, 859.) It does so by 

prohibiting health care providers from disclosing a patient’s medical 

information without authorization (§ 56.10) and imposing a duty on health 

care providers who create, maintain, or dispose of medical information to do 

so in a manner that preserves the confidentiality of that information 

(§ 56.101, subd. (a)). Subdivision (b) of section 56.36 provides remedies to 

patients for a health care provider’s “release” of confidential medical 

information in violation of the CMIA. (§ 56.36, subd. (b).)

Here, Vigil alleges Muir violated section 56.101, subdivision (a), 

thereby invoking the remedy in section 56.36, subdivision (b). Subdivision (a) 

of section 56.101 provides in full, “Every provider of health care, health care 

service plan, pharmaceutical company, or contractor who creates, maintains, 

preserves, stores, abandons, destroys, or disposes of medical information 

shall do so in a manner that preserves the confidentiality of the information 

contained therein. Any provider of health care, health care service plan, 

pharmaceutical company, or contractor who negligently creates, maintains, 

preserves, stores, abandons, destroys, or disposes of medical information 

shall be subject to the remedies and penalties provided under subdivisions (b) 

and (c) of Section 56.36.” (§ 56.101, subd. (a).)

Section 56.36, subdivision (b), provides, in turn, “In addition to any 

other remedies available at law, any individual may bring an action against 
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any person or entity who has negligently released confidential information or 

records concerning him or her in violation of this part, for either or both of 

the following: [¶] (1) Except as provided in subdivision (e), nominal damages 

of one thousand dollars ($1,000). In order to recover under this paragraph, it 

is not necessary that the plaintiff suffered or was threatened with actual 

damages. [¶] (2) The amount of actual damages, if any, sustained by the 

patient.”

B. The Case Law Interpreting Sections 56.36 and 56.101 of the 

CMIA

Sutter Health, supra, 227 Cal.App.4th 1546 and its predecessor, 

Regents of University of California v. Superior Court (2013) 220 Cal.App.4th 

549 (Regents), are central to the parties’ arguments in this appeal. Those 

cases address some of the requirements of a CMIA claim under 

sections 56.101, subdivision (a), and 56.36, subdivision (b), and hold that one 

such requirement is a breach of the confidentiality of the plaintiff’s medical 

information.

In Regents, a thief stole an external hard drive and a card containing 

the hard drive’s encryption password from the home of a physician working 

within the Regents health care system. (Regents, supra, 220 Cal.App.4th at 

p. 554.) The plaintiff, whose medical information was on the hard drive along 

with the medical information of more than 16,000 other patients, filed a 

complaint asserting a violation of the CMIA and seeking nominal damages 

for herself and for each of the more than 16,000 patients. (Regents, at 

pp. 554–555.) The complaint alleged that Regents failed to exercise due care 

to prevent the release or disclosure of the medical information, “ ‘and as a 

result it negligently lost possession of the hard drive and encryption 

passwords.’ ” (Id. at p. 555.) Regents demurred to the complaint, and the 

trial court overruled the demurrer. (Id. at pp. 555–556.) Regents sought a 
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writ of mandate requiring the trial court to sustain the demurrer, and the 

appellate court granted review of the trial court’s ruling. (Id. at pp. 557, 571.) 

On review, the court first noted that the parties did not dispute that 

the plaintiff had adequately alleged a violation of the duty imposed on 

Regents by section 56.101, subdivision (a), “to maintain and store medical 

information in a manner that preserves the confidentiality of that 

information.” (Regents, supra, 220 Cal.App.4th at p. 560.) The court thus 

framed the issue before it as “the nature of [the remedy in section 56.36, 

subdivision (b)] as applied to the negligent maintenance or storage of medical 

information.” (Ibid.) That section and the elements of the cause of action it 

creates, the court held, are incorporated by reference into section 56.101 and 

require a “release” of confidential information. (Regents, at pp. 561–562, 

564.) Regents argued that the term “release” in section 56.36 was 

synonymous with “disclose” in section 56.10, subdivision (a), which requires a 

showing of an “affirmative communicative act” by the healthcare provider. 

(Regents, at p. 564.) The court disagreed, finding that under the common or 

ordinary dictionary meanings of those terms, “disclose” is an active verb, 

while “release” is broader and can include passive conduct. (Ibid.) It 

concluded, “a health care provider who has negligently maintained 

confidential medical information and thereby allowed it to be accessed by an 

unauthorized third person—that is, permitted it to escape or spread from its 

normal place of storage—may have negligently released the information 

within the meaning of CMIA.” (Id. at p. 565.) 

The Regents court went on to hold, however, that even under this broad 

interpretation of “release,” pleading loss of possession was insufficient to 

state a cause of action under sections 56.101, subdivision (a), and 56.36, 

subdivision (b), for negligent maintenance or storage of confidential medical 
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information. (Regents, supra, 220 Cal.App.4th at pp. 569–570.) “What is 

required is pleading, and ultimately proving, that the confidential nature of 

the plaintiff’s medical information was breached as a result of the health care 

provider’s negligence.” (Id. at p. 570.) The court noted in a footnote that 

section 56.101 allows a health care provider to dispose of, and therefore lose 

possession of, confidential medical records so long as the confidentiality of the 

records is preserved. (Regents, at p. 570, fn. 14.) In the case before it, no one 

knew what happened to the hard drive other than the thief that stole it, and 

thus the court concluded the plaintiff could not allege that her medical 

records “were, in fact, viewed by an unauthorized individual.” (Id. at p. 570.) 

All she alleged was that Regents negligently lost possession of the medical 

information. (Ibid.) Accordingly, the court issued a writ of mandate directing 

the trial court to vacate its order overruling Regents’ demurrer and to enter a 

new order sustaining the demurrer without leave to amend. (Id. at p. 571.) 

The Third District decided Sutter Health the following year. Sutter 

Health involved a stolen desktop computer. (Sutter Health, supra, 

227 Cal.App.4th at p. 1552.) Stored on the computer’s hard drive were the 

medical records of more than four million patients in password-protected but 

unencrypted format. (Ibid.) The plaintiffs filed a complaint asserting 

violations of the CMIA. (Sutter Health, at p. 1552.) The defendant health 

care provider demurred, arguing the complaint did not state a claim under 

the CMIA because it did not allege that any unauthorized person had viewed 

the stolen medical information. (Sutter Health, at p. 1552.) The trial court 

overruled the demurrer, concluding the complaint sufficiently alleged a cause 

of action for breach of the CMIA. (Sutter Health, at p. 1552.) On a petition 

for writ of mandate challenging the order overruling the defendant’s 

demurrer, the Court of Appeal agreed with Regents that the plaintiffs must 
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plead and prove a breach of confidentiality, and it clarified that “[n]o breach 

of confidentiality takes place until an unauthorized person views the medical 

information.” (Sutter Health, at pp. 1553, 1555, 1557.) 

The Third District arrived at this conclusion differently from the 

Second District, however. (Sutter Health, supra, 227 Cal.App.4th at p. 1555.) 

Unlike the Regents court, the Sutter Health court found that the duty of 

confidentiality imposed on health care providers by section 56.101 was not 

violated without an actual confidentiality breach, and that there was no need 

to consider the remedy provided in section 56.36 until such a violation 

occurred. (Sutter Health, at p. 1555.) The Third District relied on the first 

sentence of subdivision (a) of section 56.101—“ ‘Every provider of health 

care . . . who creates, maintains, preserves, stores, abandons, destroys, or 

disposes of medical information shall do so in a manner that preserves the 

confidentiality of the information contained therein.’ ” (Sutter Health, at 

p. 1556.) This language, the court opined, “makes it clear that preserving the 

confidentiality of the medical information, not necessarily preventing others 

from gaining possession of the paper-based or electronic information itself, is 

the focus of the legislation. Therefore, if the confidentiality is not breached, 

the statute is not violated.” (Ibid.) The first sentence of that subdivision 

“allows for change of possession as long as confidentiality is preserved.” 

(Ibid.) The court further reasoned that “[n]o breach of confidentiality takes 

place until an unauthorized person views the medical information,” because 

“[i]t is the medical information, not the physical record (whether in electronic, 

paper, or other form), that is the focus of the Confidentiality Act.” (Id. at 

p. 1557.) 

The court noted that the second sentence of section 56.101, 

subdivision (a), does not repeat the language in the first sentence imposing a 
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duty of confidentiality on the health care provider but this did not change its 

analysis because the second sentence makes the health care provider liable 

for negligence. (Sutter Health, supra, 227 Cal.App.4th at pp. 1557–1558.) 

Applying general negligence principles, the court found that “[t]he duty is to 

preserve confidentiality, and a breach of confidentiality is the injury 

protected against.” (Id. at p. 1558.) “Without an actual confidentiality 

breach there is no injury and therefore no negligence under section 56.101.” 

(Ibid.) 

The court concluded the defendant did not violate section 56.101 

because the plaintiffs had not alleged that their information was viewed. 

(Sutter Health, supra, 227 Cal.App.4th at p. 1559.) Accordingly, the court 

found that there was no reason to look to section 56.36 since it provides 

remedies only when a health care provider “ ‘has negligently released

confidential information or records concerning [the plaintiff] in violation of 

this part . . . .’ ” (Sutter Health, at p. 1558.)

Although Regents and Sutter Health were decided at the pleading 

stage, both hold that a breach of confidentiality under sections 56.101, 

subdivision (a) and 56.36, subdivision (b) requires more than a showing that 

the health care provider negligently maintained or stored confidential 

information and lost possession of the information because of its negligence.

The interpretation of the CMIA in this case arises not on writ review of 

a demurrer ruling but on appeal from a ruling denying class certification. We 

turn, therefore, to the standards for class certification. 

C. Class Certification Standards and Standards of Review

To properly allege a class, Vigil must “demonstrate the existence of an 

ascertainable and sufficiently numerous class, a well-defined community of 
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interest, and substantial benefits from certification that render proceeding as 

a class superior to the alternatives.” (Brinker Restaurant Corp. v. Superior 

Court (2012) 53 Cal.4th 1004, 1021 (Brinker).) Community of interest, or 

commonality, encompasses three factors, including “ ‘predominant common 

questions of law or fact.’ ” (Linder, supra, 23 Cal.4th at p. 435.) “To establish 

the requisite community of interest, the proponent of certification must show, 

inter alia, that questions of law or fact common to the class predominate over 

the questions affecting the individual members . . . .” (Washington Mutual

Bank, FA v. Superior Court (2001) 24 Cal.4th 906, 913.)

The denial of class certification to an entire class is an appealable 

order. (Linder, supra, 23 Cal.4th at p. 435.) We review a ruling on class 

certification for abuse of discretion. (Brinker, supra, 53 Cal.4th at pp. 1017, 

1022.) A trial court ruling supported by substantial evidence will not be 

disturbed unless it rests on improper criteria or erroneous legal assumptions. 

(Sav-On Drug Stores, Inc. v. Superior Court (2004) 34 Cal.4th 319, 326–327.) 

We review de novo issues of statutory construction. (Regents, supra, 

220 Cal.App.4th at p. 558.)

II.

Analysis

A. The Trial Court Did Not Err in Its Interpretation of the 

CMIA.

This class action is predicated on Muir’s alleged negligence in 

maintaining and releasing confidential information in violation of 

sections 56.101, subdivision (a), and 56.36, subdivision (b), and thus Vigil and 

the putative class members must plead and prove that “the confidential 

nature of the plaintiff’s medical information was breached as a result of the 

health care provider’s negligence.” (Regents, supra, 220 Cal.App.4th at 

p. 570.) Vigil appears to agree that Muir has not violated sections 56.101, 
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subdivision (a), and 56.36, subdivision (b), unless there is a breach of 

confidentiality. The parties dispute, however, what this showing entails and 

whether it is an individualized showing.

1. The Court Correctly Determined That a Breach of 

Confidentiality Requires an Unauthorized Person to Have 

“Actually Viewed” the Confidential Medical Information.

Vigil first argues that under Regents, confidential information that is 

“viewed, published, accessed, downloaded, copied, or otherwise ‘permitted[] to 

escape from its normal place of storage’ ” is “released” within the meaning of 

section 56.36, subdivision (b), and that a plaintiff need only show that the 

health care provider negligently “released” the confidential medical 

information to establish a claim under sections 56.36, subdivision (b), and 

56.101, subdivision (a). She asserts that Sutter Health wrongly narrowed the 

Regents standard for a negligent release claim by requiring a showing that an 

unauthorized party “actually viewed” the confidential medical information to 

prove a breach of confidentiality. 

Based on the statute’s plain language, we agree with Sutter Health that 

a breach of confidentiality under the CMIA requires a showing that an 

unauthorized party viewed the confidential information. The CMIA does not 

define the term “confidential,” but the ordinary meaning of the word supports 

Sutter Health’s “viewed” requirement. (Angelucci v. Century Supper Club

(2007) 41 Cal.4th 160, 168 [“In interpreting a statute, we first consider its 

words, giving them their ordinary meaning and construing them in a manner 

consistent with their context and the apparent purpose of the legislation”].) 

The common or ordinary dictionary definition of “confidential” is “private” or 

“secret.” (See, e.g., Black’s Law Dict. (11th ed. 2019) p. 373, col. 1 [“meant to 

be kept secret]; Webster’s Third New International Dict. (1961) p. 158, col. 1

[“private, secret”].) Thus, under the ordinary meaning of “confidential,” the 
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confidential nature of information is not breached unless the information is 

reviewed by unauthorized parties. This construction is consistent with the 

purpose of the CMIA to protect patients’ privacy. (See Brown v. Mortensen

(2011) 51 Cal.4th 1052, 1071 [“[T]he interest protected by [the CMIA] is an 

interest in informational privacy”].) 

Moreover, we also agree with Sutter Health’s reasoning that 

section 56.101, subdivision (a), which allows a health care provider to 

“dispose” of or “abandon” medical information so long as the confidentiality of 

that information is preserved, indicates the Legislature did not intend to 

“impose[] liability if the health care provider simply loses possession of the 

medical records.” (Sutter Health, supra, 227 Cal.App.4th at p. 1556.) A 

breach of confidentiality thus entails more than mere loss of possession and 

does not “take[] place until an unauthorized person views the medical 

information.” (Id. at p. 1557.)4

Vigil presents no basis for departing from Sutter Health. We disagree 

that Sutter Health “narrow[ed]” Regents by requiring more than mere loss of 

possession of medical records to establish a breach of confidentiality. After 

noting that the plaintiff could not “allege her medical records were, in fact, 

viewed by an unauthorized individual,” the Second District held her pleading 

was “deficient” because it amounted to no “more than an allegation of loss of 

possession by the health care provider.” (Regents, supra, 220 Cal.App.4th at 

p. 570.) 

4 Indeed, as the court in Regents stated, loss of possession is not 

necessarily required. “[A] breach of confidentiality, of course, can occur 

whether or not the information remains in the actual possession of the health 

care provider.” (Regents, supra, 220 Cal.App.4th at p. 570, fn. 14.) It is an 

unauthorized person’s viewing and/or use of another’s medical records that 

violates the latter’s interest in privacy of the information they contain.
15

Vigil relies on Regents’ plain meaning construction of the term 

“release”—“permit[ting] [the confidential information] to escape or spread 

from its normal place of storage” and “allow[ing] it to be accessed” by an 

unauthorized party—as support for her argument. However, Regents does 

not stand for the proposition that mere loss of possession is sufficient on its 

own to prove a breach of confidentiality under sections 56.101, 

subdivision (a), and 56.36, subdivision (b). The Regents court opined that 

providing an unauthorized party access to confidential information “may” 

support a negligent release claim under the CMIA. (Regents, supra, 

220 Cal.App.4th at p. 565.) But Regents expressly held that mere loss of 

possession was insufficient to establish a “release,” even under a “broad 

interpretation” of that term. (Id. at p. 570.) By “release” in section 56.36, 

subdivision (b) “as incorporated into section 56.101,” the Legislature intended 

“more than an allegation of loss of possession by the health care provider is 

necessary to state a cause of action for negligent maintenance or storage of 

confidential medical information.” (Regents, at p. 570.)

Vigil points to other sections of the CMIA that use the term “release” as 

support for her argument that the Legislature intended section 56.36, 

subdivision (b), to refer to the actions of the custodian in “surrendering” or 

“mak[ing] available” private medical information to third parties. But those 

sections set forth the circumstances in which a health care provider may 

release medical information to the patient or to third parties; they do not 

impose liability on the health care provider for its “negligence.” (Compare

§ 56.101, subd. (a) with §§ 56.11, 56.104, 56.07.) Muir, on the other hand, 

contends that the Legislature’s use of the word “negligently” in 

sections 56.101 and 56.36 supports the conclusion in Regents and Sutter 
16

Health that a breach of confidentiality under the CMIA requires more than a 

release of confidential information. We agree.

“ ‘The fundamental purpose of statutory construction is to ascertain the 

intent of the lawmakers so as to effectuate the purpose of the law.’ ” 

(Realmuto v. Gagnard (2003) 110 Cal.App.4th 193, 199.) As Sutter Health

appears to have recognized in its application of general negligence principles 

(Sutter Health, supra, 227 Cal.App.4th at pp. 1557–1558), when the 

Legislature couches its enactment in common law language, we presume that 

it intended to carry over such rules as were part of the common law into 

statutory form. (Presbyterian Camp & Conference Centers, Inc. v. Superior 

Court (2021) 12 Cal.5th 493, 503 (Presbyterian Camp).) The essential 

elements of common law negligence are “the existence of a duty to use due 

care toward an interest of another that enjoys legal protection against 

unintentional invasion” (Bily v. Arthur Young & Co. (1992) 3 Cal.4th 370, 

397), breach of that duty, injury, and causation (Dixon v. City of Livermore

(2005) 127 Cal.App.4th 32, 42). 

Vigil’s interpretation of sections 56.36 and 56.101 conflicts with the 

presumption that the Legislature intended to incorporate those common law 

negligence principles. Imposing liability on a health care provider for the 

release of confidential information without a showing that an unauthorized 

party viewed the information would eliminate the injury and causation 

elements of negligence. “[T]he interest protected by [the CMIA] is an interest 

in informational privacy.” (Brown v. Mortensen, supra, 51 Cal.4th at p. 1071; 

see also Sutter Health, supra, 227 Cal.App.4th at p. 1558 [“a breach of 

confidentiality is the injury protected against” by the CMIA].) Although 

sections 56.101 and 56.36 do not expressly state that a health care provider is 

liable only if its negligence caused a breach of confidentiality, it would be 
17

inappropriate to read the causation and injury elements out of those sections, 

absent a clear expression by the Legislature of the intent to abrogate this 

common law. (See Presbyterian Camp, supra, 12 Cal.5th at p. 503.) No such 

intent appears here. 

Vigil contends Sutter’s reliance on the “duty of confidential[ity] that 

pervades CMIA” is misplaced because some courts have recognized that a 

breach of confidentiality can occur when the information is merely “disclosed” 

or “disseminated,” regardless of whether unauthorized parties viewed the 

information. But the cases Vigil cites as support for this argument do not 

address the CMIA and are inapposite. None stand for the proposition that 

confidentiality is automatically breached whenever the confidential 

information is disseminated to unauthorized parties. 

In U.S. Dept. of Justice v. Landano (1993) 508 U.S. 165, cited by Vigil, 

the court addressed the meaning of “confidential source” as used in an 

exemption from disclosure under the federal Freedom of Information Act 

(FOIA) for records compiled by criminal law enforcement authorities in the 

course of a criminal investigation. (Landano, at p. 167.) The exemption 

applies if the release of criminal investigation records “ ‘could reasonably be 

expected to disclose’ the identity of, or information provided by, a 

‘confidential source.’ ” (Ibid.) In rejecting the defendant’s argument “that a 

source is ‘confidential’ for purposes of [the exemption] only if the source can 

be assured, explicitly or implicitly, that the source’s cooperation with the 

Bureau will be disclosed to no one,” the court concluded “this cannot have 

been Congress’ intent.” (Id. at p. 171.) To read “confidential source” as 

meaning one given “[a] promise of complete secrecy” would mean “the FBI 

agent receiving the source’s information could not share it even with other 

FBI personnel” and the information “would be of little use to the Bureau.” 
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(Id. at p. 173.) The court’s practical construction of the phrase “confidential 

source” in the context of the exemption from FOIA sheds no light on the 

nature of the CMIA’s breach of confidentiality element. 

Similarly inapposite is Berkeley Police Assn. v. City of Berkeley (2008) 

167 Cal.App.4th 385 (Berkeley Police Assn.), in which the court held that 

interpreting a local ordinance to permit public hearings on citizen complaints 

against a police officer would conflict with provisions of the Police Officers 

Bill of Rights (POBRA) because it would result in disclosure of police 

personnel records those provisions required to be kept confidential. (Berkeley 

Police Assn., at pp. 404–405.) The court’s discussion of which records were 

confidential within the meaning of POBRA, which focused on earlier 

California Supreme Court authority interpreting the scope of POBRA’s 

confidentiality provision and on the specific text of the relevant POBRA 

provisions (Berkeley Police Assn., at pp. 395–402), likewise has no bearing on 

the meaning of the CMIA’s language regarding health care providers’ liability 

for breach of confidentiality. 

The third case cited by Vigil, Culinary Foods, Inc. v. Raychem Corp.

(N.D.Ill. 1993) 151 F.R.D. 297, addressed the request of plaintiff, Culinary, 

for a protective order for certain materials it sought to discover from 

Raychem and Raychem’s request for a more restrictive order. The parties 

disputed whether Culinary could disseminate materials determined to be 

confidential to litigants and attorneys involved in similar actions against 

Raychem. (Id. at p. 306.) The court declined to allow such dissemination 

because it “would unduly raise the risk that Raychem’s competitors will 

obtain access to this confidential information” and “make enforcement of this 

protective order overly burdensome to Raychem,” as “evidenced by the fact 

that third parties have in fact received information in violation of protective 
19

orders issued by other courts.” (Id. at p. 307.) Insofar as Vigil’s point in 

citing Culinary Foods is that allowing unauthorized access to confidential 

information can increase the risk that someone will view and/or make use 

that information, that is no doubt true. However, it does not answer the 

question of whether the Legislature, in adopting sections 56.36 and 56.101, 

intended to impose liability in situations where no actual invasion of the 

plaintiff’s privacy occurs. Moreover, the Sutter Health court recognized that 

the change of possession of confidential information increases the risk of a 

confidentiality breach, but nonetheless held that the CMIA “does not provide

for liability for increasing the risk of a confidentiality breach.” (Sutter 

Health, supra, 227 Cal.App.4th at p. 1557.)

Vigil also asserts that a plaintiff would only have to show that an 

unauthorized party “downloaded” or “copied” confidential medical 

information to establish a claim under sections 56.36, subdivision (b), and 

56.101, subdivision (a). However, she fails to present any cogent argument or 

legal authority in support of this conclusion in her opening brief.5 In any 

5

In her reply, Vigil cites for the first time a federal case in support of 

her argument that a breach of confidentiality occurred when Centeno 

downloaded the patient spreadsheet and saved it to her personal phone or 

email account. Even assuming Vigil has not forfeited this argument (see 

Paulus v. Bob Lynch Ford, Inc. (2006) 139 Cal.App.4th 659, 685), that case is 

distinguishable because the plaintiff’s claims arose from defendants’ breach 

of contractual, not statutory, duties. (Allergan, Inc. v. Merz Pharmaceuticals, 

LLC (C.D.Cal., March 9, 2012, No. SACV 11-446 AG (Ex)) 2012 WL 781705,

at p. *11.)

In her reply, Vigil also attempts to factually distinguish this case from 

Sutter Health based on evidence indicating that Centeno was aware of the 

contents of the patient spreadsheet and of its value to her new employer, that 

she downloaded it and retained it after her termination from Muir, and that 

she offered to provide the spreadsheet to her new employer. She fails to 

explain, however, why those facts show Sutter Health was wrongly decided. 
20

event, a party that downloads or copies electronic files, as Centeno allegedly 

did in this case, does not necessarily breach confidentiality if the party has 

not actually viewed the confidential information included in the file. “It is 

the medical information, not the physical record (whether in electronic, 

paper, or other form), that is the focus of the Confidentiality Act).” (Sutter 

Health, supra, 227 Cal.App.4th at p. 1557.) 

Finally, Vigil argues that the rule of Sutter Health will lead to 

unintended or absurd results. But interpreting sections 56.101 and 56.36 to 

impose liability on health care providers for the “release” of confidential 

information would expose health care providers to liability whenever an 

unauthorized party gains possession of the information, regardless of 

whether confidentiality was breached. On this issue, the Sutter Health court 

presented the example of a thief grabbing a computer containing medical 

information on four million patients and then wiping the hard drive without 

viewing the information. (Sutter Health, supra, 227 Cal.App.4th at p. 1558.) 

In that situation, the health care provider would be liable for at least $4 

billion if we were to interpret section 56.101 as providing nominal damages to 

every person whose medical information came into the possession of an 

unauthorized person. (Ibid.) We do not believe the Legislature intended 

such an extreme result. By contrast, the CMIA’s purpose of protecting the 

confidentiality of private medical information is preserved by interpreting 

those sections as requiring a showing that the confidentiality of the 

information was breached because of the health care provider’s negligence. 

Vigil cites Stasi v. Inmediata Health Grp. Corp. (S.D.Cal. 2020) 

501 F.Supp.3d 898 (Stasi) as support for her argument. There, the defendant 

posted confidential medical information on the internet, “making it 

searchable, findable, viewable, printable, copiable, and downloadable by 
21

anyone in the world with an internet connection.” (Id. at p. 924.) Vigil 

argues that under “any conceivable standard,” the confidentiality of the 

information at issue in that case was destroyed once it was published online, 

while that would not be the case under Sutter Health if the plaintiffs could 

not prove that an unauthorized party viewed their information. What she 

ignores is that the court in Stasi upheld Sutter Health’s “viewed” 

requirement. (Stasi, at p. 923.) There, on appeal from a motion to dismiss 

for failure to state a claim, the court found that the complaint’s allegations 

gave rise to a reasonable inference that “someone” viewed the confidential 

information since it was accessible “by anyone in the world with an internet 

connection.” (Id. at p. 924.) Thus, Stasi does not support Vigil’s argument.

We therefore conclude the trial court correctly determined that a 

breach of confidentiality under sections 56.36, subdivision (b), and 56.101, 

subdivision (a), requires a showing that an unauthorized party viewed the 

confidential information at issue. 

2. Vigil Has Not Shown That a Breach of Confidentiality Can 

Be Established on a Class-Wide Basis.

Vigil next challenges the trial court’s finding that each class member 

would have to prove that his or her medical information was viewed by an 

unauthorized party. She argues that such a requirement cannot be found in 

section 56.36, Sutter Health or Regents. Instead, she claims, Regents shows 

that Vigil would not have to prove that Centeno read any of the information 

contained within the patient spreadsheet; her ability to access the 

information is sufficient under the CMIA. But, as previously discussed, the 

mere ability of an unauthorized party to access information cannot support a 

claim under sections 56.101, subdivision (a), and 56.36, subdivision (b). Vigil 

further contends that under Sutter Health, she need only show that Centeno 
22

viewed the confidential records and not individual data entries. Muir 

disagrees, arguing that whether a breach of confidentiality under the CMIA 

occurred is an inherently individualized inquiry. 

We agree that a breach of confidentiality under the CMIA is an 

individualized issue. Regents recognized that sections 56.36, subdivision (b), 

and 56.101, subdivision (a), provide a private cause of action for individual 

patients. This private cause of action, like the right of privacy, “ ‘ “is purely a 

personal one.” ’ ” (Regents, supra, 220 Cal.App.4th at p. 563 & fn. 6.) “The 

remedy provided in subdivision (b) [of section 56.36] is the right of an 

individual whose confidential information has been released in violation of 

CMIA to bring a private cause of action for nominal and/or actual damages.” 

(Id. at p. 561.) For a negligent maintenance claim under section 56.101, 

subdivision(a), there is no “release[] . . . in violation of [the CMIA]” if there is 

no breach of confidentiality. (§§ 56.36, subd. (b), 56.101, subd. (a).) 

Accordingly, the individual bringing a private cause of action under those 

sections must establish that the confidential nature of his or her information 

was breached because of the health care provider’s negligence. (See Regents, 

at p. 570.)

Contrary to Vigil’s assertion in her opening brief, Sutter Health does 

not stand for the proposition that under the CMIA, a plaintiff need only show 

that an unauthorized party viewed some of the confidential information 

included in a medical record, regardless of whether the information viewed 

concerned the plaintiff. Sutter Health did not address this precise issue, 

which Vigil concedes in her reply. 

Vigil contends that because a negligent release claim leads to lesser 

penalties under subdivision (b) of section 56.36 than an intentional release 
23

claim under subdivision (c) of that section,6 a negligent release claim requires 

a correspondingly less stringent evidentiary standard. But the legislative 

history she cites as support for this argument suggests that the purpose of 

the penalties under that section is deterrence, which in turn indicates that 

the increased penalties were intended to correspond with the increased 

culpability of the person or entity that discloses or uses medical information 

in violation of the CMIA. (See Assem. Com. on Judiciary, Analysis of Sen. 

Bill No. 19 (1999-2000 Reg. Sess.) July 13, 1999, p. 9 [“While the new civil 

penalties in the bill appropriately apply to ‘knowing and willful’ violations, 

the author believes that lesser penalties for negligent conduct that leads to 

an unauthorized disclosure should also be included in order to deter those 

releases as well”].) There is nothing in this history that suggests a negligent 

release claim does not require an individualized showing for the breach of 

confidentiality element.

Vigil argues for the first time in her reply that based on the plain 

language of section 56.36, subdivision (b), each class member would only have 

to prove that the medical records negligently released by the health care 

provider concerned them. Even assuming she has not forfeited this argument 

(Paulus v. Bob Lynch Ford, Inc., supra, 139 Cal.App.4th at p. 685), it lacks 

merit. Section 56.36, subdivision (b), provides that the medical records or 

information must have been “negligently released . . . in violation of this 

part.” (§ 56.36, subd. (b).) As mentioned, there is no “release[] . . . in 

6 Subdivision (c) of section 56.36 sets forth administrative fines and 

penalties to be imposed on a person or entity that uses or discloses medical 

information in violation of the CMIA. The amount of the fines and penalties 

increase when the use or disclosure is knowing and willful instead of 

negligent. (§ 56.36, subd. (c).)
24

violation of” section 56.101, subdivision (a), if the confidential nature of the 

information was not breached. (§§ 56.36, subd. (b), 56.101, subd. (a).)

Accordingly, we conclude that each class member would have to show 

that his or her medical information was viewed by an unauthorized party to 

recover under the CMIA. 

B. The Trial Court Did Not Abuse Its Discretion in Finding a 

Predominance of Individual Issues.

Since Vigil has not shown that a breach of confidentiality can be 

established on a class wide basis, the question then is whether the common 

questions predominate over those individualized questions. 

The key inquiry in determining whether the predominance 

requirement has been met is whether “the issues which may be jointly tried, 

when compared with those requiring separate adjudication, must be 

sufficiently numerous and substantial to make the class action advantageous 

to the judicial process and to the litigants.” (City of San Jose v. Superior 

Court (1974) 12 Cal.3d 447, 460.) “Presented with a class certification 

motion, a trial court must examine the plaintiff’s theory of recovery, assess 

the nature of the legal and factual disputes likely to be presented, and decide 

whether individual or common issues predominate.” (Brinker, supra, 

53 Cal.4th at p. 1025; see also Ayala v. Antelope Valley Newspapers, Inc. 

(2014) 59 Cal.4th 522, 530 [the question at the class certification stage is 

“whether the operative legal principles, as applied to the facts of the case, 

render the claims susceptible to resolution on a common basis”].) 

“ ‘As a general rule if the defendant’s liability can be determined by 

facts common to all members of the class, a class will be certified even if the 

members must individually prove their damages.’ ” (Brinker, supra, 

53 Cal.4th at p. 1022.) However, “class treatment is not appropriate ‘if every 
25

member of the alleged class would be required to litigate numerous and 

substantial questions determining his individual right to recover following 

the “class judgment” ’ on common issues.” (Duran v. U.S. Bank National 

Assn. (2014) 59 Cal.4th 1, 28.) “ ‘Only in an extraordinary situation would a 

class action be justified where, subsequent to the class judgment, the 

members would be required to individually prove not only damages but also 

liability.’ ” (Id. at p. 30.) Here, based in part on Sutter Health’s “viewed” 

requirement, the trial court found that class treatment was not warranted 

because individualized inquiries would be required to prove Muir’s liability 

and damages for each of the nearly 5,500 putative class members. 

In challenging the trial court’s determination, Vigil contends there are 

common questions regarding whether Centeno had unauthorized access to 

the patient spreadsheet and whether Muir was negligent in protecting that 

document. The evidence she presented on those issues below consists of the 

depositions of two of Muir’s HIPAA security officers, a report from the 

investigation of the data breach, and Muir’s policies. Based on this evidence, 

the question whether Muir failed to use due care in maintaining patients’ 

private medical information is a significant issue susceptible to common 

proof. However, Vigil’s burden “is not merely to show that some common 

issues exist, but rather, to place substantial evidence in the record that 

common issues predominate.” (Lockheed Martin Corp. v. Superior Court

(2003) 29 Cal.4th 1096, 1108.) 

On this record, the trial court did not abuse its discretion in concluding 

individual issues would predominate over common issues. The record 

demonstrates that Centeno may have viewed some of the information on the 

patient spreadsheet, but Vigil presented no evidence indicating whose 

information was viewed. There is also no evidence suggesting that other 
26

unauthorized parties viewed the information in the patient spreadsheet or 

that it was posted or disclosed in a public forum like the information at issue

in Stasi or in Berkeley Police Assn. Therefore, most, if not all, of the almost 

5,500 potential class members would be unable to maintain their CMIA 

claims against Muir unless they could establish that an unauthorized party 

viewed their confidential medical information and that Muir’s negligence 

caused this breach of confidentiality. 

In our research, we have not found any state cases, and the parties 

have not provided any, that concern the predominance requirement in a 

CMIA case or in a similar data breach action. The few federal cases that 

address CMIA claims, however, suggest that individual questions regarding 

whether a breach of confidentiality occurred and whether the health care 

provider’s negligence caused the breach can be numerous and varied. In In re

Premera, for example, the defendant was a health care provider that 

maintained patients’ confidential information in a centralized database. (In 

re Premera Blue Cross Customer Data Security Breach Litigation (D.Or. 2016) 

198 F.Supp.3d 1183, 1188.) In January 2015, it discovered that hackers had 

breached its computer network beginning in May 2014. (Id. at pp. 1189–

1190.) The plaintiff subsequently filed a complaint for violation of the CMIA, 

which the defendant moved to dismiss. (Premera, at pp. 1190–1191.) The 

court concluded the plaintiff had adequately alleged a CMIA claim because in 

May 2015, she discovered on her credit report an inquiry for a car loan that 

she did not recognize, and her checking account had been fraudulently 

accessed “around the same time period.” (Premera, at p. 1202.)

Similarly, in Falkenberg, the court determined on a motion to dismiss 

that plaintiffs had adequately alleged a claim for violation of the CMIA after 

a thief stole a password-protected laptop containing plaintiffs’ and other 
27

patients’ confidential information. (Falkenberg v. Alere Home Monitoring, 

Inc. (N.D.Cal., Feb. 23, 2015, No. 13-cv-00341-JST) 2015 WL 800378, at 

pp. *1, *3.) The court found that the plaintiffs’ CMIA claim was supported by 

allegations that their confidential medical information was viewed by an 

unauthorized party because they alleged that they gave the defendant that 

information, that they suffered identity theft sometime from three weeks to 

“weeks-and-months” from when the defendant’s laptop containing the 

plaintiffs’ information was stolen, that they had never suffered identity theft 

previously, that they took extra precautions to ensure their information was 

not disclosed to unknown third parties, and that the thieves opened 

fraudulent accounts using the plaintiffs’ social security numbers, information 

that the defendant had and which was “not generally as available as date of 

birth, full name, and address.” (Falkenberg, at p. *3.) The court noted that 

where a plaintiff claims a data breach caused them to be the victim of 

identity theft, there must be a “ ‘nexus’ ” between the alleged identity theft 

and the data breach “ ‘beyond allegations of time and sequence,’ ” and that 

there was such a nexus in that case. (Id. at p. *4.)

Applying the principles of those cases, the case here would require an 

assessment of each putative class member’s circumstances to determine 

whether his or her information was viewed by an unauthorized party and 

whether the data breach caused this breach of confidentiality. This 

assessment includes questions regarding whether third parties used 

plaintiffs’ information, whether this use was without authorization, the 

timing of this misuse, whether plaintiffs took measures to protect against the 

misuse of their information, whether the information used was involved in 

the data breach, and whether third parties could have obtained this 

information through other means. 
28

Federal courts have denied class certification in data breach cases 

based on similar inquiries. (See Gardner v. Health Net, Inc. (N.D.Cal., 

Sept. 13, 2010, No. cv-10-2140) 2010 WL 11579028, at pp. *4–*5 [class 

treatment not warranted in data breach case where individualized inquiries 

would be required to prove the defendant’s liability for negligence and other 

claims based on the injury and causation elements: “the theft of a potential 

class member’s identity could be the result of any number of causes”]; 

McGlenn v. Driveline Retail Merchandising, Inc. (C.D.Ill., Jan. 19, 2021, 

No. 18-cv-2097) 2021 WL 165121, at pp. *8–*9 [the plaintiff failed to establish 

a predominance of common questions in data breach case involving almost 

16,000 potential class members where the evidence showed that some 

putative class members may have suffered identity theft while others did not, 

and there were individualized issues on causation, given that some members 

were involved in other data breaches].)

We conclude substantial evidence supports the trial court’s 

determination. On the record before us, each class member’s “right to recover 

depends on facts peculiar to his case.” (City of San Jose v. Superior Court, 

supra, 12 Cal.3d at p. 459; Duran v. U.S. Bank National Assn., supra, 

59 Cal.4th at p. 30.) Although it is only a general rule that a class cannot be 

maintained where liability turns on the facts of individual cases, the 

problems of proof here appear sufficiently pervasive and substantial as to 

support the trial court’s denial of class certification based on the 

predominance of those questions. 

DISPOSITION

The order is affirmed. Muir shall recover its costs on appeal.
29

STEWART, J.

We concur.

RICHMAN, Acting P.J.

MILLER, J.

Vigil v. Muir Medical Group (A160897)
1

Filed 10/18/22 after nonpublished opinion filed 9/26/22

CERTIFIED FOR PUBLICATION

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

FIRST APPELLATE DISTRICT

DIVISION TWO

MARIA VIGIL,

Plaintiff and Appellant,

v.

MUIR MEDICAL GROUP IPA, 

INC.,

Defendant and Respondent.

 A160897

 (Contra Costa County

 Super. Ct. No. C1801331)

BY THE COURT:

The opinion in the above-entitled matter filed on September 26, 2022, 

was not certified for publication in the Official Reports. For good cause, the 

requests for publication are granted and pursuant to California Rules of 

Court, rule 8.1105, it now appears that the opinion should be published in the 

Official Reports, and it is so ordered.

Dated: ________________________ ________________________________

RICHMAN, Acting P.J.
2

Trial Court: Contra Costa County Superior Court

Trial Judge: Hon. Edward G. Weil

Counsel: 

Sommers Schwartz, Trenton R. Kashima; Finkelstein & Krinsk, Jeffrey R. 

Krinsk, John J. Nelson for Plaintiff and Appellant.

Reed Smith, Steven J. Boranian, David J. de Jesus, Emily F. Lynch for 

Defendant and Respondent.

Vigil v. Muir Medical Group IPA (A160897)