Opinion ID: 2103681
Heading Depth: 1
Heading Rank: 3

Heading: Ruling Denying Certain Medical Records of the Victim

Text: Appellant also argues that the trial court abused its discretion in denying his request to compel the government or the minor complainant's health care providers to produce certain medical and psychiatric records related to her care and treatment. Specifically, appellant contends that he was entitled to additional records before and after the incident which might reveal that the complainant had been the victim of sexual abuse or had contracted a venereal disease previously. Appellant also sought any statements the child made in connection with the mental health counseling she received after the offenses in order to cope with the trauma of the sexual abuse. A. Factual Background The rulings related to these issues arose in the following context. During the informal discovery process, the government provided appellant with records concerning Dr. Lee's examination of, and test results for, the minor complainant in September 1988, including office visits on September 21 and December 29, 1988. In response to appellant's motion for disclosure of additional medical records pursuant to Super.Ct.Crim.R. 16(a)(1)(D), the government agreed to provide M.D.'s records from Children's Hospital. [5] Subsequently, appellant filed an ex parte motion for a subpoena duces tecum for all of M.D.'s medical records in the possession of Children's Hospital and Dr. Lee. The court then appointed counsel for the child who examined the records from Children's Hospital. M.D.'s counsel recommended the release of medical records in Dr. Lee's possession which were related to the discovery of the gonorrhea, [6] including those for her examination at Children's Hospital on September 26 and October 11, 1988. M.D.'s counsel, on her behalf, also did not oppose the release of the records for one year preceding M.D.'s diagnosis if an in-camera inspection tended to show evidence of sexual abuse at a time other than August 25, 1988. However, her attorney specifically opposed release of any records of post-event psychological counseling or medical records before September 1987 or after October 11, 1988. Essentially adopting M.D.'s attorney's recommendations, the trial court (Judge Kennedy) ordered disclosure of the medical records for a one year period, and appellant received them for the period, between September 27, 1987 through September 26, 1988. At the time of trial, appellant again sought to obtain any psychiatric records for M.D., this time as Jencks material. [7] It was appellant's position that such records might explain the reasons that the child initially denied being sexually abused and the circumstances surrounding her identification of appellant as the perpetrator of the crimes. The government contended that the requested material was not in its possession and that it had chosen not to examine or obtain the child's psychiatric records. Therefore, the trial court (Judge Eilperin) ruled that the material was not producible under Jencks, although the court observed that the defense might be able to obtain them by subpoena. B. Legal Analysis Related to Non-Disclosure of Certain Medical Records The additional medical or mental health records which appellant sought were not producible by the government under Super.Ct.Crim.R. 16 or under Jencks. Rule 16 requires the government to permit inspection of results or reports of physical or mental examination which are within the possession, custody or control of the government... and which are material to the preparation of the defense or are intended for use by the government as evidence in chief at the trial. Super.Ct.Crim.R. 16(a)(1)(D). The requirement that the government have possession of the reports and records is also prerequisite to the obligation for production under the Jencks Act. Frye v. United States, 600 A.2d 808, 810 (D.C.1991); 18 U.S.C. § 1500. [8] The trial court concluded that the remaining records which appellant requested were not Jencks material because they were not in the possession of the government. There is no dispute that the government sought no access to the remaining records which appellant wanted to obtain. The Jencks Act is not `so elastic as to embrace [such] materials' to which the prosecutor has never sought access. See Frye, supra, 600 A.2d at 812. The records involved here were not within the control of the government, but under the control of a private hospital and mental health providers. Thus, appellant's reliance on Butler v. United States, 481 A.2d 431 (D.C.1984), cert. denied, 470 U.S. 1029, 105 S.Ct. 1398, 84 L.Ed.2d 786 (1985) is misplaced. The grand jury transcripts which were the subject of the Jencks request in Butler were in possession of the federal prosecutors. The records involved here were not in possession of the prosecutorial arm of the federal government, nor in the possession of the government at all. Thus, appellant cannot rely on Jencks or Rule 16 to require the government to obtain and produce them. See Frye, 600 A.2d at 811-12. The government is not obligated to obtain records from private sources, which it does not intend to use for trial, to meet the requirements of Jencks or Super.Ct.Crim.R. 16. See id.; see also United States v. Chavez-Vernaza, 844 F.2d 1368, 1375 (9th Cir.1987), cert. denied, ___ U.S. ___, 114 S.Ct. 1324, 127 L.Ed.2d 672 (1994). Therefore, we reject this aspect of appellant's argument. [9] Since M.D.'s parent had signed a waiver for release of the records to the government, appellant argues that such a waiver of D.C.Code § 14-307 (1989) constitutes an implied waiver as to other interested persons. Appellant's argument that the execution of a release for disclosure of medical records amounts to an implied waiver of the physician-patient privilege to other interested persons is raised for the first time on appeal. Generally, the court will not consider an issue not raised first in the trial court. See Hunter v. United States, 606 A.2d 139, 144 (D.C.) (quoting Miller v. Avirom, 127 U.S.App.D.C. 367, 369-70, 384 F.2d 319, 321-22 (1967)), cert. denied, ___ U.S. ___, 113 S.Ct. 509, 121 L.Ed.2d 444 (1992); see also Mitchell v. United States, 569 A.2d 177, 180 (D.C.) (appellant is bound by position that his counsel took at trial), cert. denied, 498 U.S. 986, 111 S.Ct. 521, 112 L.Ed.2d 532 (1990). We will reverse only for plain error under such circumstances. See Baxter v. United States, 640 A.2d 714, 717 (D.C.1994). Under the plain error standard, this court will reverse only under exceptional circumstances where a miscarriage of justice would otherwise result. Id.; see also Harris v. United States, 602 A.2d 154, 159-60 (D.C.1992) (en banc). Applying this standard we find no basis for reversal. Appellant's position is that once the child victim's parent executed a consent to release her medical records to the government, she effectively waived the physician-patient privilege codified in D.C.Code § 14-307. This statute prevents a physician from disclosing confidential information about his or her patient's condition acquired during that professional relationship without the consent of the patient. [10] Id.; Street v. Hedgepath, 607 A.2d 1238, 1246 (D.C.1992). Appellant is correct that a patient may waive or be deemed to have waived the physician-patient privilege under certain circumstances. We have recognized that a patient waives the privilege as to relevant evidence by filing a lawsuit which places in issue the patient's medical condition. Hedgepath, supra, 607 A.2d at 1246; see also Sklagen v. Greater Southeast Community Hosp., 625 F.Supp. 991, 992 (D.D.C.1984). A patient-litigant may not authorize disclosure of only those portions of the medical records favorable to that party's position, while withholding other relevant portions which are unfavorable. Sklagen, 625 F.Supp. at 992. An authorization for release of medical information contained in a contract of insurance has been equated with the waiver of the physician-patient privilege where pertinent to a suit for recovery under the policy. Jones v. Prudential Ins. Co., 388 A.2d 476, 483 (D.C. 1978). However, appellant seeks to extend the rule beyond the limits of our prior holdings. Appellant urges the recognition of a general waiver by implication of any medical information, including mental health followup counseling for the victim of a crime, on plain error review. This cannot be done on the basis of this record. Whether an implied waiver has occurred depends upon the facts and circumstances of the particular case. Cates v. Wilson, 321 N.C. 1, 361 S.E.2d 734 (1987); see also Richbow v. District of Columbia, 600 A.2d 1063, 1069-70 (D.C.1991). The facts and circumstances surrounding the claimed implied waiver here were not developed in the trial court. To the extent that some facts existed bearing upon the legal question, neither those facts nor the implied waiver arguments were called to the attention of the court. In any case, waiver determinations are to be carefully scrutinized. Moreover, an implied waiver of the type suggested here has not been addressed by this court previously. [11] The trial court's failure to raise and address, sua sponte, the issue of waiver by implication can not be plain error under the circumstances, and we decline to so hold. See Baxter, supra, 640 A.2d at 717. Moreover, appellant failed to show that the disclosure of additional medical records was required in the interest of public justice. See D.C.Code § 14-307; Brown v. United States, 567 A.2d 426, 428 (D.C.1989), cert. denied, 494 U.S. 1037, 110 S.Ct. 1497, 108 L.Ed.2d 632 (1990). When a party seeks to subpoena records subject to the provisions of D.C.Code § 14-307, that party must make the additional showing set forth in the statute, that the disclosure is required in the interests of public justice. See id. Of course the documents must have evidentiary relevance and not be for the purpose of conducting a fishing expedition. Id. (quoting Cooper v. United States, 353 A.2d 696, 701 (D.C.1976)). In spite of the trial court's inquiry, appellant was unable to show that medical records related to the child's medical care well beyond the time of the offense at issue were required to meet the interests of the public justice standard or that they were relevant. Therefore, we find no error in the trial court's ruling denying release of further medical records for the minor victim.