Opinion ID: 2352015
Heading Depth: 1
Heading Rank: 3

Heading: Access To Confidential Medical Records

Text: The defendant next argues that the trial court erred in refusing to grant him broader access to Amy's psychotherapy records. The facts associated with the alleged error are as follows. Prior to trial defendant subpoenaed Dr. Lisa Fusaro's (Dr. Fusaro) notes of her counseling sessions with Amy. [3] Pursuant to defendant's request, the trial justice reviewed the notes in camera for relevancy and determined that they were not material to the instant case. At trial, Amy testified that she had attempted suicide in an effort to escape defendant's abuse. Immediately following her testimony, defendant again requested access to Amy's psychotherapy records on the grounds that he could not effectively cross-examine Amy on her testimony without them. He also argued that the records might contain statements Amy made to Dr. Fusaro that were inconsistent with her testimony concerning what she told her mother about her stepfather's abuse. The trial justice denied defendant's request, ruling that the records were both consistent with Amy's testimony and irrelevant to the issue of Amy's credibility. Defense counsel next asked the trial justice if the records revealed whether Amy attributed her suicide attempt to reasons other than abuse by defendant. The trial justice reviewed the records a second time and determined that four pages of Dr. Fusaro's notes were relevant. Those pages were made available to counsel. The defendant contends that he should have been allowed full access to the notes because Amy waived the psychotherapist-patient privilege by testifying about her discussions of the abuse with Dr. Fusaro. We disagree. Under the Confidentiality of Health Care Information Act (the act), G.L.1956 (1995 Reenactment) § 5-37.3-6(a): confidential health care information shall not be subject to compulsory legal process in any type of proceeding, including, but not limited to, any civil or criminal case or legislative or administrative proceedings or in any pre-trial or other preliminary proceedings, and a patient or his or her authorized representative shall have the right to refuse to disclose, and to prevent a witness from disclosing, his or her confidential health care information in any such proceedings. [4] Despite the importance of confidentiality we have also recognized that the Sixth Amendment to the United States Constitution, through the Fourteenth Amendment, and article 1, section 10, of the Rhode Island Constitution guarantee a defendant the right to an effective cross-examination in all criminal matters. Davis v. Alaska, 415 U.S. 308, 315-16, 94 S.Ct. 1105, 1110, 39 L.Ed.2d 347, 353 (1974); State v. Sifuentes, 649 A.2d 500, 502 (R.I.1994); State v. Parillo, 480 A.2d 1349, 1355 (R.I.1984); State v. Myers, 115 R.I. 583, 589, 350 A.2d 611, 614 (1976). This basic right provides the principal means by which the credibility, veracity, perception and recollection of a witness may be tested. State v. Brennan, 526 A.2d 483, 488 (R.I.1987). Consequently this court has held that a per se bar to the introduction of a class of evidence for impeachment purposes may deny a defendant his or her right to effective cross-examination. Parillo, 480 A.2d at 1355; Advisory Opinion to the House of Representatives, 469 A.2d 1161, 1165 (R.I.1983). In this state questions pertaining to the relevancy of evidence and the scope of cross-examination lie within the sound discretion of the trial justice. Brennan, 526 A.2d at 488; State v. Byrnes, 433 A.2d 658, 675 (R.I.1981); State v. Camerlin, 116 R.I. 726, 729, 360 A.2d 862, 865 (1976). In exercising discretion, a trial justice must foster a search for the truth by giving reasonable latitude to the purpose of cross-examination while preserving a fair and orderly trial. State v. Bennett, 122 R.I. 276, 278, 405 A.2d 1181, 1183 (1979). In the instant case we hold that the trial justice's in camera review of the privileged information struck the requisite balance between defendant's constitutional right to effective cross-examination and Amy's right to confidentiality. See Advisory Opinion to the House of Representatives, 469 A.2d at 1166. Many states, including our own, use the tool of in camera review in determining the relevancy of private information. See, e.g., Gunter v. State, 313 Ark. 504, 512-13, 857 S.W.2d 156, 161 (1993); People v. District Court, 743 P.2d 432, 436 (Colo. 1987); State v. Pratt, 235 Conn. 595, 607-08, 669 A.2d 562, 569-70 (1995); People v. Foggy, 121 Ill.2d 337, 349-50, 118 Ill.Dec. 18, 23, 521 N.E.2d 86, 91 (1988); Goldsmith v. State, 337 Md. 112, 133-35, 651 A.2d 866, 875-76 (1995); Commonwealth v. Bishop, 416 Mass. 169, 177-78, 617 N.E.2d 990, 995 (1993); People v. Stanaway, 446 Mich. 643, 677-78, 521 N.W.2d 557, 574 (1994); State v. Cressey, 137 N.H. 402, 414, 628 A.2d 696, 704 (1993); State v. Kalakosky, 121 Wash.2d 525, 549-50, 852 P.2d 1064, 1077 (1993). In camera inspection satisfies due-process requirements when a trial justice turns over material information. Pennsylvania v. Ritchie, 480 U.S. 39, 58, 107 S.Ct. 989, 1002, 94 L.Ed.2d 40, 58 (1987). In Ritchie, the Supreme Court emphasized that a defendant's constitutional right to evidence does not include the unsupervised authority to search through the opponent's files or to make a materiality determination. Id. at 59, 107 S.Ct. at 1002, 94 L.Ed.2d at 58-59. Our own cases are in accord. In State v. Kelly, 554 A.2d 632, 636 (R.I.1989), we held that a per se denial by the trial justice to order the production of a witness's Department of Children, Youth and Families records on the grounds of confidentiality denied the defendant his right to effective cross-examination. The case was remanded to the Superior Court for the trial justice to review the records in camera and to order a new trial only if those records created a basis for impeaching the witness's credibility. Id. Likewise, in State v. Myers, 115 R.I. at 590, 350 A.2d at 614, we remanded the case to the Superior Court for the trial justice to review the testifying witness's juvenile records for a determination of the question of whether the records provided a basis for attacking their credibility. The defendant's reliance on State v. von Bulow, 475 A.2d 995 (R.I.1984), is misplaced. von Bulow dealt with the waiver of the attorney-client privilege. It did not involve a trial justice's determination of the relevancy of information considered private under another statute. Id. at 1007. In the instant case a determination by the trial justice that Amy's psychotherapy records were irrelevant rendered unnecessary any consideration of whether the psychotherapist-patient privilege had been waived.