Opinion ID: 886563
Heading Depth: 1
Heading Rank: 4

Heading: issues

Text: ¶ 23 Did the District Court abuse its discretion when it ordered Simms to submit to the proposed independent medical examination? ¶ 24 Simms contends that the District Court's order will subject him to painful, invasive and potentially harmful procedures. Furthermore, he maintains that requiring him to travel to Portland, Oregon, for three days of tests is unduly oppressive and overly burdensome. He maintains that the District Court was incorrect when it concluded that the proposed medical examination is permitted by Rule 35, M.R.Civ.P., and abused its discretion when it ordered him to submit to the medical exam in Portland, Oregon. The Defendants maintain that Simms has put his physical and mental condition at issue in this case and that good cause for the proposed medical exam has been demonstrated. Consequently, they contend that the District Court's conclusion that Rule 35, M.R.Civ.P., required Simms attend the examination was correct. ¶ 25 Rule 35, M.R.Civ.P., provides in part: Rule 35. Physical and mental examination of persons. Rule 35(a). Order for examination. When the mental or physical condition (including the blood group) of a party, or of a person in the custody or under the legal control of a party, is in controversy, the court in which the action is pending may order the party to submit to a physical or metal examination by a suitably licenced or certified examiner or to produce for examination the person in the party's custody or legal control. The order may be made only on motion for good cause shown and upon notice to the person to be examined and to all parties and shall specify the time, place, manner, conditions, and scope of the examination and the person or persons by whom it is to be made. ¶ 26 Whether the District Court abused its discretion when it ordered Simms to submit to the proposed medical exam implicates the balance between a defendant's need for an independent examination and a plaintiff's fundamental rights. ¶ 27 In 1891, the United States Supreme Court cited the inalienable right to privacy and to be free from interference from others when it concluded that the common law did not permit a medical examination to be performed without consent. Union Pacific Railway Co. v. Botsford (1891), 141 U.S. 250, 11 S.Ct. 1000, 35 L.Ed. 734. The Court stated: No right is held more sacred, or is more carefully guarded, by the common law, than the right of every individual to the possession and control of his own person, free from all restraint or interference of others, unless by clear unquestionable authority of law. Botsford, 141 U.S. at 251, 11 S.Ct. at 1001. ¶ 28 Subsequently, Rule 35, F.R.Civ.P, was adopted. Rule 35, F.R.Civ.P., permits a court to compel an individual to submit to an independent medical examination when that party puts his or her physical or mental condition at issue. Pursuant to Rule 35, F.R.Civ.P., courts are now permitted to compromise the personal autonomy discussed in Botsford. However, the privacy concerns expressed in Botsford are recognized in the rule, and it is well accepted that a party does not possess an absolute right to obtain an independent medical examination. Rather, the moving party must demonstrate that the adverse party has placed his or her physical or mental condition at issue and that there is good cause for the examination. ¶ 29 In Sibbach v. Wilson & Co. (1941), 312 U.S. 1, 61 S.Ct. 422, 85 L.Ed. 479, a divided Court upheld the constitutionality of Rule 35, F.R.Civ.P. The dissenters noted that Rule 35, F.R.Civ.P., invaded the historic right to individual autonomy discussed in Botsford and impermissibly abridged, enlarged and modified the substantive rights of litigants. See Sibbach, 312 U.S. at 17-19, 61 S.Ct. at 428-29 (5-4 decision)(Frankfurter, J., dissenting). ¶ 30 Subsequently, the seminal federal case interpreting Rule 35, F.R.Civ.P., recognized that a compelled medical exam is the most intrusive and, therefore, the most limited discovery tool. Schlagenhauf v. Holder (1964), 379 U.S. 104, 85 S.Ct. 234, 13 L.Ed.2d 152. In Schlagenhauf the Court noted that there are situations in which the pleadings alone can demonstrate good cause to compel a physical or mental examination. Schlagenhauf, 379 U.S. at 119, 85 S.Ct. at 243. However, the Court concluded that the good cause element of Rule 35, F.R.Civ.P., requires a greater demonstration of need than the traditional relevancy standard in the discovery process. Schlagenhauf, 379 U.S. at 118-19, 85 S.Ct. at 242-43. It stated: Obviously, what may be good cause for one type of examination may not be so for another. The ability of the movant to obtain the desired information by other means is also relevant. Rule 35, therefore, requires discriminating application by the trial judge, who must decide, as an initial matter in every case, whether the party requesting a mental or physical examination or examinations has adequately demonstrated the existence of the Rule's requirements of `in controversy' and `good cause'.... Schlagenhauf, 379 U.S. at 118, 85 S.Ct. at 243. ¶ 31 In State ex rel. Mapes v. District Court (1991), 250 Mont. 524, 822 P.2d 91, we recognized that the defendant's right to discover a plaintiff's mental or physical condition was predicated on fairness in a proceeding where the plaintiff puts that condition at issue. However, we concluded that the right to discover the conditions at issue was not unlimited and did not entitle a defendant to unnecessarily invade plaintiff's privacy by exploring totally unrelated or irrelevant matters. Mapes, 250 Mont. at 530, 822 P.2d at 95. More recently, this Court affirmed that the right to obtain a physical examination, mental examination, or other related information must be balanced with the plaintiff's right to privacy. Winslow, ¶ 5. ¶ 32 [A] compulsory examination of an individual involves a sensitive question touching closely upon the constitutionally protected sanctity of the person. Monroe v. Northwestern National Insurance Co. (La.1968), 210 So.2d 365, 368. In Montana, the request for an ordered independent medical examination must be weighed against the right to privacy provided for at Article II, Section 10 of the Montana Constitution and the right to safety, health and happiness provided for at Article II, Section 3 of the Montana Constitution. When a proposed examination risks unnecessary, painful or harmful procedures the scale must favor protecting the individual's rights. See Monroe, 210 So.2d 365. ¶ 33 The historical debate concerning ordered examinations and the individual's personal sanctity indicates that the good cause requirement of Rule 35, M.R.Civ.P., examinations is not to be taken lightly. Moreover, good cause for an examination may not constitute good cause for the specific examination requested by a defendant. A court must scrutinize a request for a proposed examination on a case-by-case basis. The time, place, manner, conditions and scope of an examination must be balanced with the plaintiff's inalienable rights. A court is further required to consider the availability of other means through which a defendant can obtain the information necessary to an informed defense. Rule 35, M.R.Civ.P., does not empower a defendant to seek out and employ the most favorable hired gun available no matter the inconvenience to the plaintiff and without regard to the plaintiff's rights. ¶ 34 The Defendants argue that good cause exists based on the Simms' allegations alone. Indeed, good cause for a physical or mental examination may exist based on the allegations in this case. However, the Defendants have misapprehended the meaning of Schlagenhauf. Pleadings do not establish good cause for every requested examination. The proposed examination must be scrutinized and the interests and rights balanced to determine whether the defendants are entitled to the requested examination pursuant to Rule 35, M.R.Civ.P. ¶ 35 The Defendants maintain that they are entitled to have Ochoa conduct a medical exam to rebut the reports and opinions of the physicians and experts who will testify on behalf of Simms. The Defendants further assert that they will be prejudiced if Simms is not examined by an expert, such as Ochoa, who has researched and published articles on CRPS. The District Court held: Plaintiffs' arguments against the use of Dr. Ochoa are not supported. The Court is un-persuaded by the empty assertions regarding Dr. Ochoa's capabilities and harmful practices. Dr. Ochoa's affidavit establishes he is a physician and has enough experience in this area to conduct an IME. ¶ 36 The Defendants direct this Court to Ochoa's affidavit to support their contention that the procedure will not be painful and that Simms will not be harmed. Ochoa's affidavit indicates that the procedures do not include harmful procedures designed to cause pain ... and will not harm Plaintiff's Implanted Pulse Generator. ¶ 37 The fact that a procedure is not designed to cause pain does not mean that it will not cause pain. Furthermore, nothing in the statement that the procedure will not harm Simms' spinal pulse generator suggests that there is no risk of harm in the procedure. Dr. John Oakley stated under oath that the proposed nerve conduction test is an unorthodox test for CRPS that will be both invasive and painful. Moreover, the other proposed procedures entail inserting electrodes through the skin into the muscles and injecting anesthetics to numb nerve ends. Both procedures are highly invasive and carry an inherent risk of pain and infection. ¶ 38 Simms contends that requiring him to travel to Portland is overly burdensome due to his condition and the availability of local physicians capable of conducting the examination. Dr. Oakley testified, in fact, that there are numerous physicians in Montana who are capable of providing the appropriate exam. The record indicates that a comprehensive independent exam has already been done at the request of the State Compensation Insurance Fund. The Defendants maintain, that travel to Portland for the exam is not unduly oppressive and overly burdensome in light of the fact that Simms has traveled there in the past to attend a rehabilitation program. ¶ 39 Simms willingness to travel in search of treatment for his condition has no bearing on whether he should be required to travel to Portland, against his will, for an invasive examination which is not intended to improve his condition. Simms may travel to the corners of the earth for a cure and still justifiably argue that traveling 750 miles for an invasive and unorthodox examination for the benefit of the Defendants is overly burdensome. ¶ 40 Dr. Oakley, who is personally and professionally familiar with Simms' condition, opined that traveling to Portland would be uncomfortable for Simms and is unnecessary. He stated that the proposed testing and facilities available in Portland would not give Ochoa any superior ability to diagnose the cause or nature of Simms' ailment. In fact, he named a number of pain specialists in Montana who were capable of conducting an independent examination and who would provide an accurate independent diagnosis of his condition. ¶ 41 One need not look further than Ochoa's resume to understand why the defense is so eager have him administer the independent examination in this case. Ochoa is infamous for his opinions about CRPS and has devoted much of his professional career to providing that opinion for hire. While the record indicates that Ochoa has access to facilities unavailable in Montana, nothing suggests that those facilities are necessary for an independent diagnosis, or will produce more reliable results. ¶ 42 We conclude that, in determining whether there is good cause for a proposed examination pursuant to Rule 35, M.R.Civ.P., a district court should consider both the location and nature of the exam. Requiring a party to travel any further than necessary is an abuse of discretion. Out of state exams should be viewed with disfavor when an adequate examination can be conducted in Montana. Furthermore, it should be kept in mind that the examination is not for the purpose of treatment, and invasive procedures, such as several of those proposed in this case which could be painful or present a risk of infection, should not be permitted over the objection of the examined party. Bringing suit to recover for personal injury may place a claimant's physical or mental condition at issue but it does not waive his inalienable right to the integrity of, and personal autonomy over, his body. ¶ 43 Rule 35, M.R.Civ.P., does not permit any proposed examination simply because a plaintiff puts his or her physical or mental condition at issue. A court must consider the parameters discussed in this Opinion when it determines whether good cause for a proposed examination has been demonstrated. The District Court failed to consider the limitations of Rule 35, M.R.Civ.P., when it ordered Simms to submit to the medical exam proposed by Ochoa. When the invasive, painful and burdensome nature of the requested examination and its distant location are considered in the context of Simms' fundamental rights, it is clear that the District Court abused its discretion. ¶ 44 In light of the foregoing conclusions, we reverse the order of the District Court. We Concur: KARLA M. GRAY, C.J., PATRICIA COTTER, W. WILLIAM LEAPHART, JAMES C. NELSON, JIM REGNIER and JIM RICE, JJ.