Court Opinion

ID: 9760442
Source: CourtListenerOpinion
Date Created: 2023-08-29 00:55:34.180113+00
Date Added: 2024-06-11T07:29:12.386194
License: Public Domain

GARIBALDI, J.,
dissenting.
The sole issue raised in this interlocutory appeal is whether a nonprofit blood bank can be compelled to disclose the identity of a blood donor to a plaintiff who allegedly contracted Acquired Immune Deficiency Syndrome (AIDS) from the donor’s blood and, if so, in what manner. Plaintiff alleges the negligence of the blood bank that collected and supplied the allegedly contaminated blood, and contends that he needs to question the donor to determine whether the blood bank screened the donor appropriately. The blood bank resists the discovery motion, arguing that the donor’s privacy rights, coupled with the societal interest in a safe and adequate blood supply, outweigh plaintiff’s need for information.
I
In 1984, plaintiff William Snyder1 underwent surgery during which he was infused with various blood products. He recuperated successfully and left the hospital several weeks later.
By March 1985, tests became available to screen donated blood for antibodies to the Human Immunodeficiency Virus (HIV), which had been identified in April 1984 as the cause of AIDS. In October 1986, defendant Bergen Community Blood Center (BCBC), a nonprofit organization that collects and distributes donated blood, wrote to inform St. Joseph’s Hospital that the donor of a certain unit of platelets had now tested positive for HIV antibodies.
*348The identification of the unit with a donor who later tested HIV-positive came about as a result of the “look back” program. Under the program, a positive HIV-antibody test on blood subsequently donated by the same donor (here in May 1985) will cause blood collectors to follow up with the donor and hospitals that received distribution of blood products donated earlier by that person.
The hospital reviewed its records, ascertained that plaintiff had received the unit in question, and, in April 1987, informed plaintiffs physician of the information received from BCBC. The hospital offered its resources for testing and counseling of the patient. Plaintiff, who had no risk factors according to the physician’s note on the hospital report, tested positive for the virus.
In February 1989, plaintiff sued the hospital, the physicians involved in his diagnosis and treatment, BCBC, and the American Association of Blood Banks (AABB). AABB, a national nonprofit association of nonprofit blood banks, oversees collection of approximately half of the nation’s voluntarily-donated blood. The American Red Cross collects the remainder.
Plaintiff asserted strict-liability and negligence claims against all defendants. Following summary judgment motions by defendants, the trial court dismissed all claims except for the negligence claims against AABB, BCBC, and the surgeons, and the punitive damage claims against AABB and BCBC. The court also rejected BCBC’s claims to charitable immunity pursuant to N.J.S.A. 2A:53A-7 and damage limitation under N.J.S.A. 2A:53A-8.
Plaintiff also requested the court to compel BCBC to produce its records of the anonymous donor of the unit in question. BCBC had provided plaintiff with full documentation of the screening process, with only the donor’s name, address, and other identifying information redacted. The disclosed materials include a history and examination checklist of twenty-nine health-related questions presumably asked of the donor by an *349examiner who signed the form, and a form in use at the time of the donation defining AIDS, specifying certain high risk groups and requesting that members of such groups voluntarily refrain from donating blood because of the risks posed by transfusion of blood products. The checklist also indicates that the donor gave negative responses to questions regarding self-injection with drugs, receipt of a tattoo or blood transfusion, and signs of certain symptoms of AIDS-related illnesses such as unexplained fever, night sweats, weight loss, and swollen glands or Kaposi’s Sarcoma.
The trial court denied the discovery motion, reasoning that the donor’s privacy rights and the deterrent effect that disclosure would have on future donors outweighed plaintiff’s need to question the donor. Central to the court’s ruling was its finding that the record, including the donor-information form with the donor’s name redacted, revealed no indication of wrongdoing on the part of BCBC. The court stated in its oral opinion:
[F]rom the record there is no indication that there was any basis of excluding [the donor]. I realize that there’s nothing further there and that you would like to find out if something further was done, but I find that in balancing your right to seek out the basis of a cause of action against the donor’s rights of privacy with regard to his health in general and with regard to AIDS related complications in particular, would far outweigh your right to go seek a cause of action or the basis of a cause of action on the possibility rather than the probability that they did something wrong. There is no basis to conclude or infer that they did something wrong; and therefore, I will deny any access to the donor’s records or access to having the — not to the donor’s records — access to further interrogation or invasion of the privacy rights of the donor.
The court did assent to plaintiff’s request for data, not including the identities, concerning four donees who had received other components of the donor’s 1984 donation. The court explained that
[s]ince the causation is essential and there is sufficient indication, I will allow for a method of obtaining the information as to who — where the other four components from the same transfusion were sent, requiring the disclosure of whether or not subsequent testing was done, and if so, what was the results of the testing, if any other donor has subsequently died, the cause of death. I believe that that information is sufficient.
*350Plaintiff appealed from the dismissal of the strict-liability claims and the partial denial of the discovery motion. The Appellate Division affirmed the dismissal of the strict-liability claims, describing blood collected at the time in question as an “unavoidably unsafe” product, thereby precluding application of strict-liability principles to all in the collection and distribution chain. However, it found that “[t]he degree of plaintiffs injury, his right to redress from those who may have negligently failed to protect him, and his need for information which only the donor can provide if redress is to be obtained, all justify * * * limited disclosure * * * without unduly prejudicing the interests of the public and the donor’s privacy rights.” The court’s ruling sanctioning limited disclosure instructed the trial court to allow plaintiff minimal contact with the donor to ascertain whether screening procedures were actually followed by the blood bank. The court suggested use of a “veiled” deposition or written interrogatories with questions that would receive prior approval by the court and an alias identification and oath.
In adopting the Appellate Division’s opinion, this Court permits the scope of discovery to include the blood bank’s disclosure, under protective conditions, of the donor’s identity, medical records, and recollections of the pre-donation screening process.
II
I agree with the majority that litigation regarding a blood bank’s negligence in its collection process may result in a situation where only the donor of the allegedly HIV-infected blood can supply information critical to the lawsuit. However, I disagree that this case warrants such disclosure. Although I would not categorically foreclose a plaintiff's access in rare cases, several factors I highlight below represent points unacknowledged by the majority but nonetheless critical for a trial *351court to consider before issuing an order for disclosure, however limited.
First, as with any order for discovery, a court must balance the requesting party’s need for the information against the intrusiveness of the discovery process to the subject party. See In re W.C., 85 N.J. 218, 224, 426 A.2d 50 (1981) (“Whether discovery should be expanded involves ... balancing the beneficial effects of discovery against its disadvantages.”). Here, obvious considerations include the fact that if the donor is still alive (nearly 90% of those in New Jersey diagnosed with AIDS in 1985 are not alive; roughly 70% of those who were diagnosed three years later have also died)2, the donor may be very ill, and contact, even in the form of a veiled deposition or written interrogatories, may be significantly more burdensome than for a relatively healthy person. In addition to the potential personal stress of even minimal involvement with a lawsuit, a donor may desire to be represented by an attorney, adding a financial burden to the process. Also, if the donor has not disclosed to family, friends, or employers his or her HIV-status, any communication from a court or attorneys representing a blood bank or plaintiffs may unwittingly violate the donor’s confidentiality.
In weighing those factors, the trial court must also consider the related statutory framework that specifically safeguards the confidentiality of people with AIDS. I rely on the Legislature’s statutory guidance regarding confidentiality issues related to HIV-infection to determine the weight properly accorded to established principles of discovery. N.J.S.A. 26:5C-7 provides that records maintained by a blood bank that contain identifying information about a person who has or is suspected of having AIDS or HIV infection are confidential. Without prior written consent of the donor, the Act permits disclosure under extremely limited conditions. N.J.S.A. 26:5C-8. For *352example, scientific research personnel may not disclose in any manner the identity of a person with AIDS. N.J.S.A. 26:5C-8b(1). Although the content of records may be released to qualified personnel for management audits, identifying information may not be released unless it is vital to the audit or evaluation. N.J.S.A. 26:5C-8b(2). Donors whose blood tests positive for HIV infection are placed on a confidential deferral list maintained by the blood bank. N.J.A. C. 8:8-6.5(f)(2). Even so, confidentiality remains so important that the names are not automatically transferred to a statewide deferral list. Rather, the Department of Health must deem the transfer to the statewide list appropriate. That list as well is confidential. Ibid.
The statute provides a narrow exception to the overarching policy of non-disclosure.
The record of a person who has or is suspected of having AIDS or HIV infection may be disclosed by an order of a court of competent jurisdiction which is granted pursuant to an application showing good cause therefor. At a good cause hearing the court shall weigh the public interest and need for disclosure against the injury to the person who is the subject of the record, to the physician-patient relationship, and to the services offered by the program. Upon the granting of the order, the court, in determining the extent to which a disclosure of all or any part of a record is necessary, shall impose appropriate safeguards to prevent an unauthorized disclosure. [N.J.S.A. 26:5C-9]
Even while providing a procedure for disclosure, the statutory language explicitly acknowledges the rights of the individual who is HIV positive and the importance of protecting that person’s privacy, which is a primary aspect of the legislation glossed over by the concurrence.
Moreover, a court may limit or reject a motion for discovery in the interest of justice “to protect a party or person from annoyance, embarrassment, oppression, or undue burden or expense.” R. 4:10-3. Based on analogous rules, courts in other jurisdictions have rejected discovery requests similar to those made here. See, e.g., Coleman v. American Red Cross, 130 F.R.D. 360 (E.D.Mich.1990); Doe v. American Red Cross Blood Servs., 125 F.R.D. 646 (D.S.C.1989); Rasmussen v. South Florida Blood Serv., Inc., 500 So. 2d 533 (Fla.1987); *353Laburre v. East Jefferson Gen. Hosp., 555 So.2d 1381 (La. 1990); Krygier v. Airweld, Inc., 137 Misc.2d 306, 520 N.Y.S.2d 475 (Sup.Ct.1987); Doe v. University of Cincinnati, 42 Ohio App.3d 227, 538 N.E.2d 419 (1988); Taylor v. West Pennsylvania Hosp., 48 Pa.D. & C.3d 178 (1987).
In Doe v. American Red Cross Blood Servs., the plaintiff received an allegedly AIDS-contaminated blood transfusion in January 1985. The plaintiff contended that the defendant blood bank was negligent in its screening process and sought a “veiled” deposition of the donor. 125 F.R.D. at 647. Concluding that the donor’s privacy interests and the potential harm to the nation’s blood supply outweighed the plaintiff’s need to question the donor, the court denied the plaintiff’s discovery request. Id. at 655.
Similarly, in Doe v. University of Cincinnati, the plaintiff, who allegedly had contracted AIDS from a blood transfusion, contended that the supplying blood bank had been negligent in its screening methods. 538 N.E.2d at 424. The plaintiff had been reached as a result of a “look back” program and had tested positive for HIV antibodies. Id. at 421. The court denied the plaintiff’s discovery request for the donor’s identity because the plaintiff’s need for the information was outweighed by the countervailing privacy interests of the donor and the need to maintain an adequate blood supply. Id. at 425. Those considerations also led the courts in Krygier, Rasmussen, Taylor, Laburre, and Coleman to deny discovery regarding donors whose blood had allegedly infected plaintiffs in those cases.
This Court has previously endorsed substantial safeguards for parties subject to discovery requests where the Legislature has indicated an intent to protect the class of which they are members. For example, we have required that a moving party make a “ ‘substantial showing of need and justification’ ” before it is entitled to an order to compel a psychiatric examination of a witness. State v. R. W., 104 N.J. 14, 21, 514 A.2d 1287 *354(1986) (quoting State v. Butler, 27 N.J. 560, 605, 143 A.2d 530 (1958)). As an aid to courts exercising discretion in deciding discovery motions, this Court outlined an open-ended list of considerations, including “the burden imposed on the prosecution, the extent of inconvenience to prosecution witnesses, the inability or difficulty in having the witnesses appear, and the likelihood of subjecting witnesses to intimidation, unnecessary annoyance, harassment or embarrassment.” In re W.C., supra, 85 N.J. at 227, 426 A.2d 50.
In jurisdictions that have permitted some form of disclosure, courts have found either that the information sought from the donor was critical to plaintiffs cause of action or that evidence existed showing wrongdoing by the blood bank or donor. For example, in Tarrant County Hosp. Dist. v. Hughes, 734 S.W.2d 675 (Tex.Ct.App.1987), the defendant hospital, unlike the hospital in the instant case, made no effort to determine whether any of its donors had been diagnosed with HIV or AIDS. Id. at 676. The court found that plaintiff would not likely be able to prosecute her action without access to the donors’ identities. Id. at 679. It consequently upheld the trial court’s discovery order compelling the defendant hospital to disclose the donors’ names and addresses with a provision that plaintiff neither publicly disclose the identities nor contact the donors without further court order. Ibid.
In Belle Bonfils Memorial Blood Center v. District Court, 763 P.2d 1003 (Colo.1988), the redacted screening records of a donor who tested HIV-positive revealed that the donor answered four questions in ways that might have required him to be deferred, depending on his answers to follow-up questions. The blood bank technician’s handwritten notes did not reflect whether the technician had followed the blood bank’s own guidelines, so the court determined that plaintiff’s negligence claim required limited discovery. However, the court declined to permit an oral deposition, emphasizing that the donor’s identity had to remain undisclosed. Id. at 1013. The court also rejected the use of written interrogatories because of the *355donor’s non-party status. Ibid. It concluded that a deposition on written questions was the only viable discovery technique, with the questions crafted so as not to reveal the donor’s identity. Ibid. These cases illustrate the nature of a compelling need that a trial court might find justifies an order for limited discovery.
Second, a court must consider critically the potential probative value of the information requested in evaluating whether to order discovery. Because HIV-testing of donated blood became routine by March 1985, the subject time period for the instant case and similar lawsuits dates back over six years. Even if the donor’s answers favor plaintiff, their utility will depend on the factfinder’s confidence in the donor’s memory of a short screening interview that occurred more than six years ago. That recall may be especially subject to doubt if the donor has since developed AIDS and undergone many medical treatments. Along those lines, a court may want to order a blood bank to disclose information regarding any prior or successive donations by the donor to better evaluate the possibility of obtaining useful information, given the small likelihood that someone who has donated numerous times will remember the screening procedures on a particular date. Such information should suffice to address plaintiffs’ causation questions at this stage. Additionally, in seeking information on the employment of screening procedures in place at the time of the questioned donation, plaintiffs may be able to interview the employee who actually screened the donor as well as other employees who were instructed to follow the same screening procedures. Plaintiffs may cross examine the employees and call experts to challenge the meticulousness and consistency of employee adherence to procedures.
In evaluating a discovery request for a psychological examination of a young child, this Court emphasized the moving party’s burden to show that the discovery will likely yield material evidence.
*356Where * * * the defense merely raises the issue of potential incompetence without offering evidence impugning the witness’ mental capacity, psychological stability or testimonial credibility, the request for an examination becomes only a fishing expedition. The court must balance the possible emotional trauma, embarrassment, and intimidation to the complainant * * * against the likelihood that the examination will produce material, as distinguished from speculative, evidence.
[State v. R. W., supra, 104 N.J. at 28, 514 A.2d 1287 (emphasis added) (citations omitted).]
The Court emphasized that the possible evidentiary benefits to the moving party must outweigh the invasion of the witness’s right to privacy if the discovery request is carried out. Ibid.
In considering the materiality of plaintiff’s requests, the trial court ought also to be alert to whether plaintiff seeks to show the blood bank’s negligence or actually intends to demonstrate the donor’s negligence and ultimately to hold the donor liable. The court must remain sensitive to the possibility that plaintiff’s discovery motion might actually be an effort to cast a broad net to expose the liability of any party in the donation process and to create the basis for an additional lawsuit against the donor.
This Court in R.W. also instructed that lower courts should consider the “danger to the public interest” that might occur if a discovery request is granted. Ibid. Here, the danger to the public interest may be substantial. Confidentiality has always been central to the blood donation process, in part because of the highly-personalized information requested of donors as part of the screening process. Removal of the assurance of confidentiality may have a chilling effect on the already-small pool of volunteers who donate blood. In light of the national blood policy commitment to maintain an all-volunteer blood donation system, 39 Fed.Reg. 32, 701 (1974), courts must be wary of taking any action that might reduce the willingness of people to donate blood and respond truthfully to screening procedures, which could in turn jeopardize the national blood supply. Courts and commentators have recognized that the prospect of court-ordered inquiry into a donor’s personal life, medical history, and potential association with infectious diseases such as *357AIDS is the kind of disincentive that could have a serious impact on the nation’s blood supply. See Rasmussen v. South Florida Blood Serv., supra, 500 So.2d at 538; LaBurre v. East Jefferson Gen. Hosp., supra, 555 So.2d 1381; Doe v. University of Cincinnati, 42 Ohio App.3d 227, 538 N.E. 2d 419. See generally Wyatt, Payne, Ingram & Quinley, AIDS, Legal and Ethical Concerns for the Clinical Laboratory, 4 J.Med.Tech. 108, 109 (1987) (“The decision as to whether the laboratory will be forced by the court to provide the names will have a profound impact upon voluntary donations.”).
In rejecting a request by a plaintiff who allegedly contracted HIV from a blood transfusion to discover a donor’s identity or to conduct a veiled deposition, the federal district court in South Carolina captured many of the concerns related to the public interest in the national blood supply:
The erosion of confidentiality may not only affect the quantity of the blood supply, it eouid well affect its safety. This is because the safety of the blood supply depends largely on donors’ willingness to provide accurate and detailed histories of private and sometimes sensitive medical information, and some donors may be reluctant to supply accurate information out of fear that personal aspects of their lives may be disclosed to persons not connected to the donation process.
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In sum, assurances of confidentiality play a central role in maintaining a healthy and adequate blood supply. Permitting discovery of blood donors necessarily undermines the blood banks’ assurances in that regard. If enough courts permit discovery of donors, blood banks, for purposes of ensuring that the consent of their donors is informed, will have to warn donors that they may be subject to questioning by litigants should their blood contaminate the recipient. Such a warning is likely to cause even the most civic-minded individual to think twice before voluntarily donating his blood to help another. [Doe v. American Red Cross Blood Sens., supra, 125 F.R.D. at 653 (citations omitted).]
The public interest must also be taken into account in assessing a discovery request like the one here. See N.J.S.A. 26:5C-9.
Similarly, a court should consider the actual use of any information obtained. Even if the donor offers recollections favoring the plaintiff, serious questions of the donor’s credibility could arise if defendants do not have an opportunity for *358cross-examination or their own deposition, which is likely given the priority on limiting a donor’s involvement with the lawsuit for confidentiality and other reasons enumerated by the Appellate Division. Courts that permit the introduction of such evidence must consider how they will protect defendants’ constitutional and statutory rights to confront witnesses presented by the opposing party.
Ill
The painful reality of this case is that HIV-infection has caused both Mr. Snyder and the donor substantial suffering. In all likelihood, William Snyder contracted the HIV-virus in the course of heart surgery. The source of the donor’s infection remains unknown. Clearly plaintiff’s case arouses sympathy for the “innocent” manner in which he became ill. As so many sources remind us, the AIDS virus does not discriminate among its victims. Nor should this Court. Our sorrow at Mr. Snyder’s anguish cannot displace our obligation to follow the Legislature’s intent in administering discovery proceedings.
In these tragic cases there is no hard and fast rule on when access to a donor should be allowed. These eases are extremely fact-sensitive, and the courts must decide each case by balancing the interests of the plaintiff, the donor, and society. The determination of whether to authorize disclosure is best left to the trial court. Here, the trial court does not appear to have abused its discretion. As discussed above, the trial court concluded that the record provided no basis for a conclusion that the blood bank was negligent in screening the donor. It found further that the “possibility rather than the probability” of negligence did not outweigh the donor’s privacy interest. The analysis neatly matches this Court’s standard adopted for discovery requests of other protected classes that the moving party show a compelling need and justification for pursuing the information. See State v. R. W., supra, 104 N.J. at 21, 514 A.2d 1287.
*359The record before us supports the trial court's decision. Of course, should plaintiff make an additional showing that reflects a substantial need for the information, as well as a reasonable probability that the sought-after information exists and evidence that all other avenues to that information have been exhausted, the court should reconsider the discovery motion. There may be cases as well in which a donor would not feel burdened by the process. So not to prevent unnecessarily a willing witness from providing requested information, I would require the blood bank involved to inform the donor of the ongoing suit and discovery request. The donor may then choose to waive the privacy protections and respond to plaintiffs inquiries.
I perceive that plaintiffs rarely will be able to establish a compelling need and justification for donor information. However, when one does, a court should allow discovery limited to a narrowly-circumscribed procedure designed to obtain the relevant information while ensuring maximum protection of confidentiality to the donor. Although circumstances may occasionally warrant limited disclosure of a donor’s identity, courts should be extremely wary of the complicated field on which they tread.
I would reverse the ruling of the Appellate Division and reinstate the trial court’s order denying plaintiff’s discovery motion.
Justice POLLACK, concurring in result.
For Affirmance — Chief Justice WILENTZ and Justices CLIFFORD, HANDLER, POLLACK, O’HERN and STEIN — 6
For Reversal — Justice GARIBALDI — 1

Although both William and Roslyn Snyder are plaintiffs in this action, for purposes of clarity references to plaintiff in the text refer specifically to William Snyder.

New Jersey State Department of Health, AIDS Data Analysis Unit (as of April 30, 1991).