Court Opinion

ID: 9853436
Source: CourtListenerOpinion
Date Created: 2023-09-24 05:48:46.265535+00
Date Added: 2024-06-11T09:22:48.258032
License: Public Domain

Jansen, J.
(concurring in part and dissenting in part). I concur in Docket No. 139088 that defendant Mercy Memorial Hospital is entitled to judgment as a matter of law for the reasons set forth in the majority opinion. I also concur that plaintiff, as the cross appellant in Docket No. 139088, has failed to raise an issue that requires reversal, except with regard to the award of costs and attorney fees. I must respectfully dissent, however, in Docket No. 139253, because I cannot agree that Dr. Godsell-Stytz’ conduct was not a proximate cause of plaintiff’s injury.
In her appeal, Dr. Godsell-Stytz raises a total of nine issues. I do not find any of these issues to require reversal.
Dr. Godsell-Stytz first argues that the trial court erred in failing to identify properly plaintiff’s *534claim against her as one alleging malpractice or negligence. She specifically claims that there is no cause of action for breach of the physician-patient privilege.
In Saur v Probes, 190 Mich App 636; 476 NW2d 496 (1991), this Court held that a cause of action exists for a psychiatrist’s unauthorized disclosure of privileged communications. MCL 600.2157; MSA 27A.2157 prohibits a physician from disclosing information acquired when attending a patient in a professional character if the information was necessary to enable the physician to prescribe for the patient as a physician. The statute does not create civil liability for an unauthorized disclosure. However, the purpose of the statute is to protect the confidential nature of the physician-patient relationship and to encourage free discourse between physicians and their patients. Swickard v Wayne Co Medical Examiner, 438 Mich 536, 560; 475 NW2d 304 (1991). As this Court explained in Saur, supra, p 639, the statute exhibits this state’s policy of protecting physician-patient confidences absent a superseding public or private interest. Therefore, a cause of action exists for a physician’s unauthorized disclosure of privileged communications.
Such a cause of action is more akin to an action for a breach of a fiduciary duty or breach of confidentiality rather than an action for negligence or breach of the standard of care. In the absence of any authorization provided by law for the disclosure of the privileged communication, a waiver of the privilege by the patient, or if the disclosure is justified by the supervening interests of society, a third party, or the patient, the breach of the privilege by a physician is rather straightforward. Because an action based on a breach of the physician-patient privilege does not involve the *535type of complex medical terms that are involved in a medical malpractice case, there is no need for expert testimony to establish the standard of care and breach thereof. Accordingly, I see no need for plaintiff to have presented expert testimony, as argued by Dr. Godsell-Stytz, where a jury could easily understand the breach of the physician-patient privilege.
The trial court did not err in denying defendant’s motion for judgment notwithstanding the verdict (jnov) on this ground. Further, because the trial court properly identified the cause of action, it did not err in denying defendant’s requested jury instructions regarding medical malpractice, duty of care, comparative negligence, and more than one proximate cause because those requested instructions were not applicable in this case. MCR 2.516(D)(2).
Dr. Godsell-Stytz next argues that the trial court erred in denying her motion for a directed verdict because plaintiff failed to raise a factual question regarding the issue of proximate cause. Specifically, she argues that plaintiff failed to show sufficient evidence that her conduct was a proximate cause of the revocation of plaintiff’s appointment to the Air Force Academy. I disagree with the majority’s conclusion regarding this issue.
Proving proximate cause requires proof of two separate elements: (1) cause in fact, and (2) legal cause. Cause in fact usually requires a showing that "but for” the defendant’s actions, the plaintiff’s injury would not have occurred. Legal cause usually involves examining the foreseeability of consequences, and whether the defendant should be held legally responsible for those consequences. Skinner v Square D Co, 445 Mich 153, 162-163; 516 NW2d 475 (1994). A plaintiff must first establish cause in fact before legal cause becomes a relevant *536issue. Id., p 163. Usually, proximate cause is a factual issue for the jury to determine. Schutte v Celotex Corp, 196 Mich App 135, 138; 492 NW2d 773 (1992).
Viewing the testimony and legitimate inferences therefrom in a light most favorable to plaintiff, I find that there was a factual question on which reasonable minds could differ to justify submitting the issue to the jury. Regarding the cause in fact element, there is no dispute that Dr. Godsell-Stytz telephoned the Air Force Academy shortly after plaintiffs admission to Pineview and informed Lieutenant Colonel John F. Swiney, Jr., of plaintiffs hospitalization. Lt. Col. Swiney then contacted the Department of Defense Medical Examination Review Board (dodmerb) and plaintiffs medical records were reviewed. Ultimately, plaintiffs appointment was revoked. There was testimony from Colonel Larry Jecha, M.D., that a prior suicide attempt is a disqualifying defect for entry into the military and that the immaturity exhibited by plaintiff under stress was sufficient under the dodmerb’s regulations to disqualify plaintiff. Lt. Col. Swiney testified that excellent health is required for admission, that psychological impairment such as psychosis, suicidal attempts, and emotional instability could disqualify an applicant, and that suicidal ideation would be a great concern if the dodmerb felt this could manifest itself again under the stress of the academy. Finally, applicants to the academy are required to disclose any new illness or injury since completion of the final qualifying medical examination and failure to so comply may cause the applicant to be refused admission.
However, in this case, there was no opportunity for plaintiff to notify the academy of his admission to Pineview because Dr. Godsell-Stytz called on the *537day of plaintiffs admission to Pineview. Thus, there was a factual issue to be determined regarding whether Dr. Godsell-Stytz’ telephone call to the academy caused plaintiffs appointment to be revoked or whether the appointment would have been revoked irrespective of whether she contacted the academy. Therefore, where it was speculative regarding whether plaintiffs appointment would have been revoked had he contacted the academy, and where plaintiff could have presented the admission in a different light, I believe the trial court did not err in denying the doctor’s motion for a directed verdict regarding this issue. There was a factual question regarding whether, but for the doctor’s actions, plaintiff’s injury would not have occurred.
Further, I would find a strict violation of the physician-patient privilege by Dr. Godsell-Stytz and hold her liable for this conduct. Dr. Godsell-Stytz’ conduct was a proximate cause of plaintiffs injury because she contacted the Air Force Academy regarding plaintiff’s hospitalization. I cannot agree that the doctor’s conduct made no difference. Dr. Godsell-Stytz violated the physician-patient privilege and her conduct led to a review of the medical records, which in turn led to the revocation of plaintiff’s appointment. Therefore, there was a question of fact regarding whether Dr. Godsell-Stytz’ conduct proximately caused plaintiffs injury. As our Supreme Court has noted, there may be more than one proximate cause for the same injury and a defendant cannot escape liability for its negligent conduct merely because the negligence of others may also have contributed to the harm. Brisboy v Fibreboard Corp, 429 Mich 540, 547; 418 NW2d 650 (1988).
Regarding the issue concerning legal cause, there was a factual issue whether it was foresee*538able that, by contacting the academy in violation of the duty of confidentiality, there was a risk of harm to plaintiff with regard to his status at the academy. Dr. Godsell-Stytz testified that her husband was a former Air Force Academy cadet and an Air Force officer. She was aware that the information she knew about plaintiff’s condition was important to the academy and she admitted that her primary concern in notifying the academy was to assist plaintiff’s admission to the academy. Such testimony could reasonably permit the jury to find that it was foreseeable to Dr. Godsell-Stytz that plaintiff might lose his appointment because of her disclosure of confidential information to the academy. Accordingly, the trial court did not err in denying the doctor’s motion for a directed verdict regarding the issue of proximate cause where there were factual issues for the jury to resolve.
Dr. Godsell-Stytz also argues that the trial court abused its discretion in not allowing medical records from the Monroe County Community Mental Health Clinic to be admitted. Error may not be predicated on a ruling that excludes evidence unless a substantial right of the party was affected. MRE 103(a)(1).
Plaintiff successfully precluded admission of the medical records via a motion in limine based on relevancy. The trial court agreed with plaintiff that, because Dr. Godsell-Stytz was unaware of the mental health clinic records at the time she notified the academy, the records were irrelevant. No substantial right of the doctor was affected by the refusal to admit the medical records because Dr. Godsell-Stytz admitted that she was unaware of the records when she contacted the academy. Further, the Air Force Academy did not become aware of plaintiff’s prior treatment at the mental *539health clinic until after the investigation started and plaintiff’s appointment was put on hold.
Additionally, the records were used by Dr. God-sell-Stytz to impeach plaintiff’s testimony at trial. Thus, the substance of the records were made known at trial. I find no error regarding this issue.
Dr. Godsell-Stytz also contends that the trial court erred in starting the trial in the absence of her lead attorney. Apparently, there was a bad snowstorm in the Detroit area on the date that the trial commenced and lead counsel for Dr. Godsell-Stytz was delayed. Cocounsel for Dr. Godsell-Stytz (who was from the same law firm as the lead counsel), indicated that he could stand in for the lead counsel and, therefore, Dr. Godsell-Stytz was represented by an attorney until lead counsel arrived. Dr. Godsell-Stytz has failed to demonstrate any prejudice resulting from the cocounsel’s participating in the jury voir dire. I find no error on the part of the trial court in this regard.
Dr. Godsell-Stytz further argues that the trial court erred in allowing plaintiff to pursue causes of action based on the privilege statutes. As previously stated, although the physician-patient privilege statute does not create civil liability, this Court has recognized a cause of action for a psychiatrist’s disclosure of privileged communications. Saur, supra, pp 637-638. Accordingly, the trial court did not err in allowing plaintiff to pursue a cause of action based on the breach of the physician-patient privilege.
Further, to the extent that defendant doctor also argues in regard to this issue that the trial court erred in allowing the hospital’s rules and regulations to be introduced into evidence, that the privilege statutes should not have been the basis for jury instructions, and that she did not breach a privilege because plaintiff’s identity is not pro*540tected by the physician-patient privilege, I find these issues to be unpreserved for appellate review because they are not within the scope of the statement of questions presented on appeal. MCR 7.212(C)(4); Preston v Dep’t of Treasury, 190 Mich App 491, 498; 476 NW2d 455 (1991).
Dr. Godsell-Stytz also claims that the trial court abused its discretion in excluding the opinion testimony of Colonel Thomas C. Wilkinson, the director of admissions for the academy, concerning his interpretation of a cadet’s reporting duties. As has been noted, the instructions to appointees booklet includes a paragraph that states that an applicant must report any illness or injury suffered after the final qualifying medical examination. The failure to comply with this requirement may cause the applicant to be refused admission.
MRE 701 provides that a lay witness may give opinion testimony if the opinion is rationally based on the perception of the witness and is helpful to a clear understanding of the witness’ testimony or the determination of a fact in issue. Any opinion by Col. Wilkinson would not necessarily have been helpful to a clear understanding of his testimony or the determination of a fact in issüe. Dr. Godsell-Stytz elicited testimony from Col. Jecha that the situation presented by plaintiff’s actions would have required plaintiff to report under the provision. Therefore, the jury knew of plaintiff’s reporting requirement. A substantial right of Dr. God-sell-Stytz was not affected by the trial court’s ruling. MRE 103(a)(2).
Dr. Godsell-Stytz next argues that the trial court erred in denying her motion for jnov regarding plaintiff’s claim of tortious interference with a business relationship. Plaintiff presented sufficient evidence regarding each element to justify submitting the claim to the jury.
*541The elements of tortious interference with a business relationship are: (1) the existence of a valid business relation or expectancy, (2) knowledge of the relationship or expectancy on the part of the interferer, (3) an intentional interference inducing or causing a breach or termination of the relationship or expectancy, and (4) damages to the party whose relationship or expectancy was disrupted. Winiemko v Valenti, 203 Mich App 411, 416; 513 NW2d 181 (1994).
First, plaintiff presented evidence that he had a reasonable and valid expectation of being admitted to the Air Force Academy. No one disputes that plaintiff had received an appointment to the academy in March 1988. Regarding the second element, it is clear that Dr. Godsell-Stytz knew of plaintiff’s appointment to the academy after she spoke with him in the emergency room. Regarding the third element, there was evidence that Dr. Godsell-Stytz contacted the academy in violation of the physician-patient privilege and without plaintiff’s authorization. Dr. Godsell-Stytz’ action was in violation of state law and hospital regulations. Plaintiff presented evidence that Dr. Godsell-Stytz’ contact with the academy resulted in his appointment being placed on deferred status, and ultimately his appointment was revoked following the dodmerb’s investigation. Whether the same result would have occurred had plaintiff notified the academy himself is speculative and at least raises a factual issue for the jury to resolve. Last, plaintiff presented evidence of damages, being the loss of his appointment to the academy and the resulting educational and career damages. Therefore, the trial court did not err in denying Dr. Godsell-Stytz’ motion for jnov regarding the claim of tortious interference with a relationship.
Dr. Godsell-Stytz next argues that the trial court *542erred in failing to disqualify a juror who allegedly misrepresented whether the juror had been a patient at Mercy Memorial.
During voir dire, the prospective jurors were asked whether they had been a patient at Mercy Memorial Hospital. Several jurors responded with differing answers. At the start of the fifth day of trial, defense counsel for Mercy Memorial advised the court that he had learned that one of the jurors either had been less than candid or misunderstood the question. Apparently, one of the jurors had been admitted to the psychiatric unit of the hospital. For confidentiality reasons, the name of the juror was not disclosed on the record. Defense counsel stated on the record that there had been a discussion in chambers and that the parties knew of this problem and had agreed not to automatically remove the juror. Defense counsel for Dr. Godsell-Stytz agreed that the juror would not be removed and that the juror would not be questioned.
Immediately after the jury verdict, counsel for Dr. Godsell-Stytz raised the issue of the juror in question. Counsel requested an interrogation of each juror and argued that if any jurors disclosed that they had not been truthful, then he would move for a mistrial. However, the trial court denied the request, noting that none of the parties desired to question or remove the juror when the issue was first brought to the court’s attention.
On these facts, I believe Dr. Godsell-Stytz waived this issue for appellate review. She agreed not to question or remove the juror. She may not now claim error with regard to something that her own attorney deemed proper at trial. People v McCurdy, 185 Mich App 503, 507; 462 NW2d 775 (1990). To do otherwise would allow her to harbor error as an appellate parachute. People v Shuler, *543188 Mich App 548, 552; 470 NW2d 492 (1991). She is not entitled to a new trial on this basis.
Last, both Mercy Memorial and Dr. Godsell-Stytz have argued that her communication to the Air Force Academy is protected by the First Amendment right to petition the government. This argument merits little consideration. While the First Amendment of the federal constitution protects the right of the people to petition the government for a redress of grievances, this right is clearly not applicable to the facts of this case. Dr. Godsell-Stytz was not contacting the Air Force Academy for a redress of grievances; rather, she stated that she called the Air Force Academy to help plaintiff have a better chance of entering into or staying in the academy. The trial court did not err in denying defendants’ motions for a directed verdict and jnov regarding this issue.
Finally, because I would conclude that the trial court did not err in denying defendant doctor’s motion for a directed verdict or jnov, I would agree with plaintiff that the trial court erred in rescinding that portion of the February 13, 1991, order awarding plaintiff costs and attorney fees against defendant doctor. The trial court’s recision of its order awarding plaintiff attorney fees pursuant to MCR 2.405 was erroneous because Dr. God-sell-Stytz never requested that the order be modified, nor did she object to the entry of the order. Rather, only counsel for codefendant Northern Professional Emergency Physicians, P.C., argued that it was entitled to costs and attorney fees because Northern Professional was the prevailing party. Therefore, I would find that the trial court’s original order awarding attorney fees and costs pursuant to MCR 2.405 to plaintiff against Dr. Godsell-Stytz was not an abuse of discretion. Butzer v Camelot Hall Convalescent Centre, Inc (After *544Remand), 201 Mich App 275, 278; 505 NW2d 862 (1993).
Accordingly, I agree to reverse in Docket No. 139088 and vacate the judgment against Mercy Memorial Hospital. In the cross appeal, I would remand for the trial court to reinstate that portion of the February 13, 1991, order awarding plaintiff attorney fees against Dr. Godsell-Stytz. I would affirm in Docket No. 139253.