Opinion ID: 488518
Heading Depth: 2
Heading Rank: 1

Heading: Beech Hill Records

Text: 9 Connecticut Mutual contends that it should be granted a new trial on the contract claims because the district court erroneously refused to release to Connecticut Mutual the complete Beech Hill Hospital records of Mr. Whyte on the grounds that federal law prohibited disclosure. Approximately four months before his death, Mr. Whyte was admitted to Beech Hill Hospital in Dublin, New Hampshire for alcoholism treatment. He remained at Beech Hill for 19 days. During discovery, Connecticut Mutual sought to obtain the complete records relating to Mr. Whyte's treatment. Mrs. Whyte, who was in possession of a copy of the records, asserted that the records were confidential under 42 U.S.C. Sec. 290dd-3 (Supp.1985) and the regulations promulgated under that statute, 1 and therefore were not subject to discovery. 10 Section 290dd-3(a) prohibits disclosure of records relating to alcoholism treatment which is conducted, regulated, or directly or indirectly assisted by any department or agency of the United States. 2 Section 290dd-3(b)(2)(C) 3 provides, however, that disclosure may be authorized by court order upon a showing of good cause by the party seeking disclosure. After a hearing, the magistrate to whom the matter was referred ruled that Connecticut Mutual had established good cause. The magistrate concluded, however, that the regulations promulgated under Sec. 290dd by the Secretary of Health and Human Services, particularly 42 C.F.R. Sec. 2.63(a), 4 limited disclosure to objective data only and that Mr. Whyte's statements made during treatment could not be released. The magistrate therefore authorized the release to Connecticut Mutual of sanitized copies of the Beech Hill records containing only objective information. 11 Connecticut Mutual objected to this ruling arguing that Mr. Whyte's statements during treatment were crucial evidence concerning the key issue of his state of mind at the time of his death. Connecticut Mutual argued to the district court that the magistrate had erred for two reasons: first, Sec. 290dd-3 does not apply in this situation because Beech Hill Hospital is not directly or indirectly assisted by the federal government and second, the nonobjective information is discoverable under Fed.R.Civ.P. 34. The district court rejected both arguments and upheld the magistrate's order limiting disclosure to the objective data contained in the records. 12 On appeal, Connecticut Mutual does not argue that Sec. 290dd-3 is not applicable or that Fed.R.Civ.P. 34 allows discovery. Rather, Connecticut Mutual argues, apparently for the first time, that 42 C.F.R. Sec. 2.63 is invalid because it is at odds with the statute under which it was promulgated, specifically Sec. 290dd-3(b)(2)(C). This court has repeatedly held that we will not consider a legal theory not presented to the trial court, however meritorious it may be. 5 Although this rule is not absolute, it is relaxed only in 'horrendous cases when a gross miscarriage of justice would occur' . 6 In addition, the new ground must be 'so compelling as virtually to insure appellant's success'. 7 13 After reviewing the record, we find that upholding the regulation and limiting disclosure to objective data will not result in a gross miscarriage of justice, nor is Connecticut Mutual's new position so compelling as virtually to insure its success. 14 The federal statute, 42 U.S.C. Sec. 290dd-3, expressly authorizes the Secretary of Health and Human Services to develop procedures and criteria for the issuance and scope of orders under subsection (b)(2)(C) of this section, as in the judgment of the Secretary are necessary or proper to effectuate the purposes of this section. 8 As the Supreme Court held in Mourning v. Family Publications Service, Inc., 9 : 15 Where the empowering provision of a statute states simply that the agency may make ... such rules and regulations as may be necessary to carry out the provisions of this Act, ... the validity of a regulation promulgated thereunder will be sustained so long as it is reasonably related to the purposes of the enabling legislation. 10 16 The purpose of Sec. 290dd-3 is clear. Congress recognized that absolute confidentiality is an indispensable prerequisite to successful alcoholism research. 11 Moreover, confidentiality is necessary to ensure successful alcoholism treatment. Without guarantees of confidentiality, many individuals with alcohol problems would be reluctant to participate fully in alcoholism programs. 12 The regulations, especially Sec. 2.63, were specifically drafted with these considerations in mind. Section 2.63 is rationally related to and furthers the congressional purpose of protecting patient confidentiality. 13 That it is more limiting than Sec. 290dd-3(b)(2)(C) is not surprising, given that Congress specifically delegated to the Secretary authority to determine the scope of any court order authorizing disclosure of hospital records covered by the statute. The regulation at issue was promulgated in 1975, 14 and Congress amended 42 U.S.C. Sec. 290dd-3 in 1976. 15 Thus, Congress had the opportunity to require a revision of 42 C.F.R. Sec. 2.63, but declined to do so. 17 Connecticut Mutual argues--also apparently for the first time on appeal--that Sec. 2.63 should not be read literally to prevent disclosure in a case such as the instant one where the patient's state of mind is the crucial issue. Related to this is Connecticut Mutual's policy argument that by bringing suit and putting the patient's state of mind at his death in issue, Mrs. Whyte, Mr. Whyte's widow, has waived the protection accorded under Sec. 2.63. 18 We understand Connecticut Mutual's difficult position, but we are bound by the express and unequivocal language of the regulations. The regulations are clear that only objective data may be disclosed, 16 and no waiver has occurred in this instance. Section 2.63 makes clear that waiver can occur only [w]hen a patient in litigation offers testimony or other evidence pertaining to the content of his communications with a program. 17 Even if Mrs. Whyte is substituted in the place of her husband, the patient, for purposes of this waiver provision, it is beyond question that she did not put the content of his communications with Beech Hill Hospital in question during the trial, and therefore no waiver occurred. 18 Notwithstanding Connecticut Mutual's assertion that Mr. Whyte's statements during treatment provided needed evidence on a key issue, the regulations place the confidentiality necessary to ensure the success of alcoholism treatment programs above that need, 19 and we must respect that decision.