Case Name: STATE of Louisiana v. Anthony Paul BELLARD
Court: Louisiana Supreme Court
Jurisdiction: Louisiana
Decision Date: 1988-10-31
Citations: 533 So. 2d 961
Docket Number: No. 88-KK-0374
Parties: STATE of Louisiana v. Anthony Paul BELLARD.
Judges: DENNIS, J., concurs with reasons.
Reporter: Southern Reporter, Second Series
Volume: 533
Pages: 961–969

Head Matter:
STATE of Louisiana v. Anthony Paul BELLARD.
No. 88-KK-0374.
Supreme Court of Louisiana.
Oct. 31, 1988.
Rehearing Denied Dec. 1, 1988.
John M. Crocket, Glen Vamvoras, Public Defenders Office, Lake Charles, for applicant.
William J. Guste, Jr., Atty. Gen., Richard P. Ieyoub, Dist. Atty., Saundra M. Issac, Elizabeth S. McCall, Patricia Head-Minaldi, Asst. Dist. Attys., for respondent.

Opinion:
COLE, Justice.
The grand jury indicted Anthony Paul Bellard for aggravated rape, a charge later reduced to violation of La. R.S. 14.81.2, molestation of a juvenile. After trial, a jury found Bellard guilty of molesting his 5-year-old niece, who contracted gonorrhea from the incident. He was sentenced on September 3, 1986 to five years at hard labor. On appeal, the defendant assigned as error the admission of evidence of his own positive test for gonorrhea. He contended the introduction of such evidence violated La. R.S. 15:476 which protects confidential communications between a patient and his physician.
La.R.S. 15:476 provides:
No physician is permitted, whether during or after the termination of his employment as such, unless with his patient's express consent, to disclose any communication made to him as such physician by or on behalf of his patient, or the result of any investigation made into the patient's physical or mental condition, or any opinion based upon such investigation, or any information that he may have gotten by reason of his being such physician; provided, that the provisions of this article shall not apply to any physician, who, under the appointment of the court, and not by a selection of the patient, has made investigation into the patient's physical or mental condition; provided, further, that any physician may be cross-examined upon the correctness of any certificate issued by him.
The court of appeal affirmed the conviction, holding the evidence was properly admitted because it was not protected by the physician-patient privilege since circumstances of the test precluded a finding of confidentiality. State v. Bellard, 514 So.2d 513 (La.App. 3d Cir.1987). On writ application to this Court, we initially reversed and remanded because the physician who diagnosed Bellard's gonorrhea was not court-appointed. State v. Bellard, 521 So.2d 1140 (La.1988). Following that action, the state applied for rehearing and we granted certiorari to consider whether confidentiality of the test results was waived or whether the suspension of physician-patient privilege in La. R.S. 14:403(F) applies to this case. La. R.S. 14:403(F) was raised for the first time in the application for rehearing filed by the state.
FACTS
On September 20, 1985, Dr. Melvin Morris of Lake Charles contacted the local Department of Health and Human Resources (DHHR) child protection agency to report a diagnosis of gonorrhea in a 5-year-old child. Based on this evidence of sexual abuse, social worker Gwendolyn Thompson began an investigation of the child's family and identified her uncle, 22-year old Anthony Paul Bellard, as a suspect. As part of its investigation, DHHR made at least three requests to Mr. Bellard that he submit to a test for venereal disease, all of which he refused. As is also DHHR policy, Ms. Thompson reported the alleged abuse to the Calcasieu Parish sheriff's office.
At the sheriff's office, Detective Robert Fry was assigned to the case. Based on an interview with the victim and the information from DHHR, Detective Fry spoke with Mr. Bellard on October 23. During this meeting, Fry told the defendant he was suspected of abusing his niece, read him the Miranda rights, and advised him to be tested for gonorrhea in order to protect his own health. Detective Fry then provided Mr. Bellard with dates and times of the Calcasieu Parish Health Unit's weekly V.D. clinic.
It was not until November 26, however, that Mr. Bellard did indeed visit the V.D. clinic. He had no symptoms, but a culture was taken and four days later, the fact he had gonorrhea was confirmed. It is unclear if the defendant was already in custody when he returned to the health unit, but he was eventually treated on December 17.
Meanwhile, Detective Fry obtained a subpoena duces tecum for the results of Mr. Bellard's venereal disease test and a warrant for his arrest. The defendant was charged and indicted and the gonorrhea test result documents and testimony concerning them were subsequently introduced at trial.
A videotaped deposition of the victim was introduced at trial in lieu of direct testimony, a procedure allowed under La. R.S. 15:440.1, et seq. The tape showed her to be a bright, articulate child who was able to clearly describe what happened between her and her uncle.
At the time of the incident, the victim was living in her grandmother's household with other family members, including the 22-year old uncle, Anthony. Her grandmother had gone to the doctor, leaving the victim with Anthony, whom the child called "Dolly." The victim had been playing in the backyard with her 10-year old sister and a cousin. When she went into the house to go to the bathroom, the defendant forcibly took off her clothes and pushed her down onto his bed.
Although the child was crying and trying to get up, the defendant, who had also removed his own clothing, threw her back onto the bed. It was not clear from the victim's testimony whether complete sexual penetration occurred. Nevertheless, during her videotaped testimony, she demonstrated with anatomical male and female dolls how the defendant got on top of her, thrust his body against hers, then got off and back on top of her more than once.
When the defendant stopped, the victim was crying, but her uncle threatened to whip her if she told anyone what had happened. She got dressed, and testified she was bleeding from the incident. When her sister asked her why she was crying and her stepmother asked about the blood on her clothes, she did not tell what had happened because she was afraid of her uncle. The incident came to light when she was subsequently diagnosed as having gonorrhea, a disease which testimony at trial showed is transmitted through sexual contact.
ADMISSIBILITY OF TEST RESULTS Although not called to our attention by counsel, we find La. R.S. 46:56 determinative of aspects of this case.
La. R.S. 46:56 provides:
A. [I]nformation contained in case records of clients of the Department of Health and Human Resources shall be confidential and, except as otherwise provided, it shall be unlawful for any person to solicit, disclose, receive, make use of, or to authorize, knowingly permit, participate in, or acquiesce in the use of . client case records or the information contained therein for any purpose not directly connected with the administration of the programs of the department.
B. For the purposes of this Section, "case records" are [among others] . medical service records, [and] records and investigative reports on abuse or neglect of children [.]
F. The following information shall not be subject to waiver and shall not be released to applicants, recipients, or outside sources, except those outside sources engaged in the administration of the programs of the department: (1) Records pertaining to . investigations of abuse and neglect of children .
(4)(a) For the purpose of this Subsection, those outside sources engaged in the administration of the programs of the Department of Health and Human Resources pertaining to child welfare services shall be local child service agencies, including but not limited to hospitals, clinics, schools, and counterpart agencies in other states engaged in delivering family and children's services, and local and state law enforcement agencies, including . district attorneys_ Information may be released by the department . to an agency engaged in enforcing or prosecuting violators of the child abuse and neglect law or perpetrators of acts against children in violation of the criminal statutes of this state....
Defendant was tested for gonorrhea at the Calcasieu Parish Health Unit, a division of the Department of Health and Human Resources. The local child protection agency, as part of its investigation of the sexual abuse of the victim, had authority to obtain defendant's medical test documents from the clinic. Clearly, under La. R.S. 46:56(F)(4)(a), the child protection agency also had authority to release those records to the district attorney's office. It follows the records and the test results noted therein were not confidential, the thrust of the statute being to make such information available to the district attorney for the purpose of prosecution. The information was released "to an agency engaged in . prosecuting . perpetrators of acts against children in violation of the criminal statutes of this state...."
It also follows the testimony of the medical witnesses in this case relating to the records was admissible. Defendant's objection to the testimony of Dr. W. Edgar Percy, Jr. was without merit. Dr. Percy's testimony was elicited from him not only as Director of the health unit and custodian of the records at issue, but also as an expert in the field of transmission of venereal diseases. He was qualified to explain the records and to express his opinion of the manner in which gonorrhea is transmitted. The testimony of Opal M. Hair, an expert in the field of culture identification, was of like nature.
We find the medical records and the testimony relating to those records to be admissible under La. R.S. 46:56.
WAIVER OF PHYSICIAN-PATIENT PRIVILEGE
Although we find R.S. 46:56 dispositive in this case, we still consider the issue of waiver of the physician-patient privilege under La. R.S. 14:403(F), since we believe the two statutes can be read in pari mate-ria to reveal a broad legislative intent to decrease privileges for perpetrators of child abuse and to increase protection for victims of such abuse.
Defendant argues testimony concerning proof of his gonorrhea was improperly admitted because the physician-patient privilege, provided for in La. R.S. 15:476, attached to the relationship between him and the medical witnesses who testified.
We interpreted La. R.S. 15:476 in State v. Walker, 376 So.2d 92 (La.1979), where the defendant was being held in parish prison on a charge of aggravated rape. While in jail, he consulted the prison medical director who diagnosed and treated defendant for gonorrhea. Over objection, the doctor was allowed to testify at trial concerning his treatment of Walker. On appeal, we found the evidence was not discovered during a routine examination performed upon defendant's arrival in jail, but was rather the result of defendant's voluntary consultation with the prison physician. Hence the privilege attached and the evidence should have been excluded.
In this case, the lower courts found the defendant did not voluntarily seek treatment or diagnosis and, therefore, the physician-patient privilege did not attach. State v. Bellard, 514 So.2d 513 (La.App. 3d Cir.1987). We disagree. The court of appeal's findings that arrangements for the test were made by child protection personnel and that the defendant was accompanied to the health unit by Detective Fry are unsupported in the record. Bellard appears to have sought treatment on his own at a free Y.D. clinic offered by a public health unit. His conduct cannot be interpreted as having been such that the expectation of confidentiality under La. R.S. 15:476 was expressly waived.
However, though the physician-patient privilege attached, such privilege is not inviolable. Since privileges are created solely by the legislature, they can also be modified or withdrawn. State v. Smith, 489 So.2d 255 (La.App. 5th Cir.1986); State v. Fuller, 454 So.2d 119 (La.1984). Such abrogation has been provided in the context of La. R.S. 14:403, the child abuse reporting statute. La. R.S. 14:403(F) provides:
(F) Any privilege between husband and wife, or between any professional person and his client, such as physicians, and ministers, with the exception of the attorney and his client, shall not be grounds for excluding evidence at any proceeding regarding the abuse or neglect of the child or cause thereof.
The defendant argues this exception does not apply to criminal proceedings and, even if it does, that he does not fit within the class of persons whose privilege is suspended.
Because of the unusual facts under which this issue arises, the applicability of R.S. 14:403(F) to criminal prosecutions has rarely been argued. In State v. Smith, 489 So.2d at 263-64, the issue of suspension of privilege under R.S. 14:403(F) was raised but not addressed by the court since the testimony was inadmissible on other grounds.
Other jurisdictions having a broad waiver of privilege in their child abuse reporting statutes have applied the waiver in criminal proceedings. See State v. Etheridge, 319 N.C. 34, 352 S.E.2d 673 (1987); State ex. rel. D.M. v. Hoester, 681 S.W.2d 449 (Mo. 1984) (en banc); State v. Efird, 309 N.C. 802, 309 S.E.2d 228 (1983); State v. Fa-galde, 85 Wash.2d 730, 539 P.2d 86 (1975) (en banc). La. R.S. 14:403(F), is a provision contained within the "Miscellaneous Crimes and Offenses" section of our criminal law. It waives "any privilege" at "any proceeding regarding the abuse or neglect of the child or the cause thereof." This criminal proceeding clearly deals with the cause of the abuse of the child victim and, therefore, the waiver of privilege applies.
Defendant's next argument is that, if the waiver applies in criminal proceedings, it applies only to certain persons and he does not fit within the class of persons reached by the statute.
To determine the meaning of criminal statutes, we must give them "a genuine construction, according to the fair import of their words, taken in their usual sense, in connection with the context, and with reference to the purpose of the provision." R.S. 14:3; State v. Pierre, 500 So.2d 382 (La.1987).
The version of La. R.S. 14:403 in effect when the act was committed and at time of trial provided:
A. The purpose of this section is to protect children whose physical or mental health and welfare are adversely affected by abuse and/or neglect and may .be further threatened by the conduct of those responsible for their care and protection by providing for the mandatory reporting of suspected cases by any person having reasonable cause to believe that such case exists. It is intended that as a result of such reports the protective services of the state shall be brought to bear on the situation in an effort to prevent further abuses, and to safeguard and enhance the welfare of these children. This section shall be administered and interpreted to provide the greatest possible protection as promptly as possible for such children. B. For the purpose of this Section, the following terms shall mean:
(3) "Abuse" is the infliction, by a person responsible for the child's care, of physical or mental injury or the causing of the deterioration of a child including but not limited to such means as sexual abuse,
(5) For purposes of Paragraph (3), . "a person responsible for a child's care" includes the child's parent, guardian, foster parent, an employee of a public or private residential facility, an employee of any public or private day care center, or other person providing residential care.
By providing for waiver of privilege within the context of the child abuse reporting statute, we believe the legislature intended to abrogate the privilege in cases where reports are mandated. Thus, R.S. 14:403(F) would apply in proceedings where the defense of privilege is raised by a person "responsible for the child's care."
Defendant would have us interpret the provisions in R.S. 14:403 as requiring reports of abuse only where the reporter suspects abuse by one "legally or contractually" responsible for the child. He argues he had no such responsibility for the victim's care and, therefore, cannot be reached by the waiver.
Clearly, within the context of a child abuse reporting statute, a person can be responsible for the care of a minor child without standing in loco parentis to that child. Pope v. State, 284 Md. 309, 396 A.2d 1054, 1063 (1979). It has. also been found that a babysitter is a person "responsible for a child's care" within the context of a child abuse reporting statute. State v. Odenbrett, 349 N.W.2d 265, 267 (Minn. 1984). La. R.S. 14:403 includes in the class of persons responsible for a child's care "[anjother person providing residential care."
Considering the entire record, it is reasonable to conclude the defendant and the victim were members of the same household. The child, who was 5 years old at the time, was left in the care of defendant while her grandmother went to the doctor. She was molested by the defendant when she went in the house to go to the bathroom. Keeping in mind the admonition of the legislature that R.S. 14:403 "be administered and interpreted to provide the greatest possible protection" for victims of child abuse, we find the waiver provision in R.S. 14:403(F) applicable to the facts in this case. Accordingly, the testimony of the physician concerning proof of defendant's gonorrhea was also properly admitted under La. R.S. 14:403(F).
CONVICTION AND SENTENCE AFFIRMED.
DENNIS, J., concurs with reasons.
LEMMON, J., concurs and assigns reasons.
. La. R.S. 14:81.2 provides:
Molestation of a juvenile is the commission by anyone over the age of seventeen of any lewd or lascivious act upon the person or in the presence of any child under the age of seventeen, where there is an age difference of greater than two years between the two persons, with the intention of arousing or gratifying the sexual desires of either person, by the use of force, violence, duress, menace, psychological intimidation, threat of great bodily harm, or by the use of influence by virtue of a position of control or supervision over the juvenile. Lack of knowledge of the juvenile's age shall not be a defense.
. We have noted La. R.S. 40:1065 which deals with the reporting of venereal diseases and which requires physicians to report the name and address of a person affected with a venereal disease if he fails or refuses for a period of ten days after diagnosis to submit to proper treatment. We find it unnecessary to consider the applicability of this provision in the context of the physician-patient privilege afforded by La. R.S. 15:476.
. Other laws relating generally to the subject matter are Articles 15 and 123 of the Code of Juvenile Procedure. The latter provides that reports and records concerning matters under the juvenile jurisdiction of the court may be released to a district attorney in connection with the performance of his duties. The former bestows juvenile jurisdiction over proceedings under R.S. 14:403 (which deals with child abuse and the waiver of the physician-patient privilege —R.S. 14:403(F>).
. The statute was amended in 1986 and again in 1987.