Opinion ID: 2791284
Heading Depth: 1
Heading Rank: 5

Heading: analysis

Text: The legislature has facilitated the process for accessing a party’s nonprivileged medical records, including mental health records, by requiring a party to provide a patient’s waiver to the requesting party under Iowa Code section 622.10. To decide when and how a party will be required to provide a waiver to allow another party in a civil case to access mental health records, we must construe section 622.10. In construing a statute, our goal is to determine legislative intent. See Auen v. Alcoholic Beverages Div., 679 N.W.2d 586, 590 (Iowa 2004). To do this, we look at the words the legislature used, not the words the legislature should have used. Id. When the legislature fails to define words in a statute, we examine the context in which the words appear and give them their ordinary and common meanings. Id. We cannot “extend, enlarge, or otherwise change the meaning of a statute” under the guise of construction. Id. The language of section 622.10 is clear and unambiguous. The legislature has determined the patient–physician privilege is not absolute in the context of civil litigation. When a person files a lawsuit, that person waives his or her privilege in mental health records in which the condition of the person in whose favor the prohibition is made is an element or factor of the claim. Iowa Code § 622.10(2). By filing a lawsuit, a party does not give up his or her right to contest the discoverability of his or her mental health records. Our job is to decide how a court determines when, in civil litigation, a party waives his or her privilege in a certain medical record under section 622.10(2) and the record becomes discoverable under rule 1.503. 15 We start the discussion by noting that in most actions the parties are able to determine when a party waives his or her privilege in a medical record under section 622.10(2). The parties will only ask the court to decide this dispute in those rare cases where the parties cannot resolve it themselves. This case presents one of those situations in which the parties have been unable to resolve their dispute. It is no different from other discovery disputes that our courts deal with on a regular basis. Although Fagen’s pleading may be imprecise in describing the nature and extent of the damages he seeks in alleging mental disability, and although he has not precisely characterized in his discovery responses the types of damages he seeks, he has objected to Iddings’s request for a patient’s waiver on the ground the records sought do not relate to the condition for which damages are claimed in this case or to any defense that might be asserted. Fagen has a right to raise this objection. Once raised, the court must examine the record and the arguments of counsel to decide this dispute. We think using some of the protocols of McMasters will inform the district court’s approach in identifying which mental health records of a person must be produced under rule 1.503 as a consequence of waiver resulting from the person’s filing of a civil lawsuit. These protocols will enable the court to determine when the record relates to the condition alleged by a party. As we have already noted, a person does not waive the privilege in all of his mental health records by merely filing a civil action. When a party refuses upon request to provide a patient’s waiver under section 622.10, the court must make sure the party seeking the waiver is not permitted to go on an unlimited fishing expedition into a 16 party’s mental health records. Therefore, the person requesting the waiver must make a showing that he or she has a reasonable basis to believe the specific records are likely to contain information relevant to an element or factor of the claim or defense of the person or of any party claiming through or under the privilege. In doing so, the person seeking the patient’s waiver need not establish the records sought actually contain admissible evidence concerning an element or factor of the claim or defense. The person seeking the patient’s waiver need only advance some good-faith factual basis demonstrating how the records are reasonably calculated to lead to admissible evidence germane to an element or factor of the claim or defense. An important requirement of this showing is the person seeking the patient’s waiver must show a nexus between the records sought and a specific claim or defense made in the case. If a party can make this showing, the patient–physician privilege is lost as to those records and the party requesting the waiver shall be entitled to the waiver to obtain those records within the scope of discovery. If the court requires a party to sign and deliver a patient’s waiver, the party seeking the records must keep confidential the records obtained with the waiver. See McMaster, 509 N.W.2d at 759–60. The patient’s waiver authorizes access only to records meeting the requirements of the protocol. If a party needs to disseminate the records to a third party to prepare for trial, the court should allow such dissemination with the appropriate safeguards. Finally, the records are not admissible as evidence unless the party can show the records are necessary as evidence in the proceeding. See id. 17 IX. Application of Protocol to the Facts of This Case. In this appeal, Fagen objects to providing the waiver because he claims he is only seeking damages for mental pain and suffering that any normal person would have experienced because of the assault and is not calling a mental health professional to support his claim. Assuming this to be true, Iddings must have a reasonable basis to believe the records are likely to contain information concerning the mental pain and suffering Fagen is claiming. Before the court can require Fagen to sign a waiver for the anger-management counseling records Iddings seeks, Iddings must advance some good-faith factual basis demonstrating how the records are reasonably calculated to lead to admissible evidence germane to mental pain and suffering that any normal person would have experienced because of the assault alleged by Fagen. Based on the record on appeal, we are unable to apply this protocol to the facts of this case. First, Fagen’s petition alleges more than mere mental pain and suffering. It alleges Fagen suffered a mental disability. A mental disability connotes an incapacity to perform certain mental functions. However, at the hearing on this matter before the district court, Fagen said he was not seeking damages for a mental disability, but rather damages for garden-variety pain and suffering and mental distress. Second, the record on appeal does not include discovery documents identifying the mental injury damages Fagen is seeking. The briefs and pleadings indicate he is only claiming damages for gardenvariety pain and suffering and mental distress, which he defines as the emotional suffering any normal person would have experienced because of the assault he endured, and not as a specific psychiatric or 18 psychological condition. He also claims in his brief and pleadings that he does not intend to introduce expert witnesses to support this claim. However, the record on appeal does not include discovery documents limiting his claim to a garden-variety mental distress claim. Additionally, the record does not include any discovery responses stating the extent or nature of his mental distress claim. Furthermore, the record does not include medical records regarding his physical injuries to gain further insight into his damage claims in this case. Third, the record does not include the portions of Fagen’s deposition revealing the nature of any anger-management counseling he received. We do not know who performed the counseling, the time the counseling took place, and the circumstances that caused the counseling. Finally, Iddings asserts he should get all of Fagen’s mental health records. Iddings has not shown how all of these records are relevant to Fagen’s specific claim for mental distress. Accordingly, on our review of the record, Iddings’s request for these specific records is too general in light of the protocols we announce in this opinion. Iddings contends he needs Fagen’s mental health records to establish a baseline of Fagen’s mental condition prior to the assault. He fails, however, to show a good-faith factual basis demonstrating how the records are reasonably calculated to lead to admissible evidence germane to Fagen’s claim. Iddings presents no facts that Fagen’s mental health immediately prior to the assault was anything but normal. He presents no facts as to how counseling sessions from grade school are reasonably calculated to lead to admissible evidence regarding a baseline. Consequently, we are unable to determine from the record before us and the arguments made by the parties whether Iddings is entitled to 19 a waiver releasing the specific records he seeks. Thus, we reverse the order requiring Fagen to sign the requested patient’s waiver and remand the case to the district court to allow the parties to present the appropriate evidence called for by this protocol and to apply the protocol before deciding if Fagen should sign a patient’s waiver.