Court Opinion

ID: 9724511
Source: CourtListenerOpinion
Date Created: 2023-08-26 10:59:36.984688+00
Date Added: 2024-06-11T18:25:01.804831
License: Public Domain

WOODS, P. J.
I respectfully dissent. I would affirm the trial court on the ground that compelled disclosure of the medical records in question violates the Casmalia residents’ right to privacy.
The majority finds no support for this privacy argument. According to the majority, “the record does not disclose whether the study refers to individually identifiable medical records.” As I read the record, the study is based on medical records which will necessarily be individually identifiable.
The subpoena states that respondent possesses “test results, medical records, analyses and other documents” which are pertinent to the department’s investigation of the Casmalia site, based on the health study of Casmalia residents. Among the specifically requested items are “[a]ny and all medical data, test results, analyses and other records generated as part of the health study conducted by Jan Schienle, including the names of the participants.” (Italics added.)
Both the June 8, 1986, Los Angeles Times article referred to in the majority opinion, and the testimony of Dr. Du Coffe at the June 12 hearing, show that the basis of the study was (1) a questionnaire to Casmalia residents regarding their medical symptoms, (2) a physical examination, and (3) routine lab tests. Some of the residents also had full toxic screenings and pulmonary function tests. There is no reason to believe that each person’s medical records are not identified by that person’s name and other personal data, just as any other medical records would be. Since compelled compliance with the subpoena would reveal the identities and medical conditions of those individuals, I would affirm the trial court in upholding their right to privacy.
*443Although the constitutional right to privacy is not absolute, incursions into individual privacy must be justified by a showing of a compelling interest. (White v. Davis (1975) 13 Cal.3d 757, 775 [120 Cal.Rptr. 94, 533 P.2d 222].) Disclosure may be appropriate where it is “narrowly limited to information directly relevant to the issues . . . and when good cause and materiality to the action establish that the need for disclosure outweighs the right to privacy. [Citation.]” (Cutter v. Brownbridge (1986) 183 Cal.App.3d 836, 843 [228 Cal.Rptr. 545], citing In re Lifschutz (1970) 2 Cal.3d415, 435 [85 Cal.Rptr. 829, 467 P.2d 557, 44 A.L.R.3d 1], and Board of Medical Quality Assurance v. Gherardini (1979) 93 Cal.App.3d 669, 679 [156 Cal.Rptr. 55].)
In Board of Medical Quality Assurance v. Gherardini, supra, 93 Cal.App.3d 669, the court held that the constitutional right to privacy safeguards an individual’s medical records from government data gathering, absent a showing of waiver or good cause. Protecting the patient’s privacy precludes the humiliation that might arise from disclosure of the patient’s ailments, and encourages the patient to fully disclose to the physician all the information necessary for effective diagnosis and treatment. “The state of a person’s gastro-intestinal tract is as much entitled to privacy from unauthorized public or bureaucratic snooping as is that person’s bank account, the contents of his library or his membership in the NAACP.” (Id., at p. 679.)
Gherardini involved an attempt by the Board of Medical Quality Assurance to compel production of hospital records and documents pertaining to five named patients. The declaration in support of the subpoena indicated that the records might contain evidence to substantiate an allegation that a named doctor was negligent or incompetent. Gherardini found that the subpoena failed to establish good cause for invading the patients’ privacy rights, as there were no facts to show how the medical records of the five specified patients were relevant to the general charges against the doctor.
In contrast, the court in Board of Medical Quality Assurance v. Hazel Hawkins Memorial Hospital (1982) 135 Cal.App.3d 561, 565 [185 Cal.Rptr. 405], found no infringement of the right to privacy in compelled disclosure of patients’ hospital charts, as neither the patients’ identities nor identifying medical information would be disclosed.
Here, unlike Gherardini, the records are relevant to the problem under investigation, health hazards caused by the Casmalia facility. However, unlike Hazel Hawkins, it appears that the records will result in disclosure of the patients’ identities. Indeed, the subpoena specifically asks for the subjects’ names. The question is whether good cause has been shown for that infringement of the patient’s privacy rights.
*444I believe that the state has demonstrated a need for the medical data contained in the records, due to the Casmalia residents’ hostility to a government health study. Even though that hostility arises from the state’s past inaction, the fact remains that the state claims it is now attempting to act to protect the residents of Casmalia, and should have the benefit of pertinent information regarding abnormal medical symptoms. While as a general rule the state has no automatic right to the medical records of anyone who sues a toxic waste facility, this case represents a special situation because the state’s long-term refusal to act has created a hostile environment in which the residents now refuse to cooperate in a state-sponsored health study.
No showing has been made, however, that the need for the medical data necessitates disclosure of the identities of the individual patients. The state can analyze whether the records show that a sizeable group of people are experiencing abnormal health problems in the Casmalia area, without knowing the identity of the persons involved in the study.
I further believe that no showing has been made that the individual patients waived their right to privacy. The June 8, 1986, Los Angeles Times article shows that the preliminary findings from the study were summarized and released to the press by respondent, the plaintiff residents’ attorney. There has been no release of the condition or identity of any specific patient.
Because neither good cause nor waiver have been established, I would affirm the trial court on the ground that compelled disclosure of these records violates the resident plaintiffs’ right to privacy.
I also have problems with the majority’s analysis of the physician-patient privilege.
Eighty-nine Casmalia residents who are plaintiffs in the action against the facility declared below that they had unsuccessfully sought help from the state and county for years. Their complaints were ridiculed, and their requests for a publicly sponsored health study were ignored. They believe that the government did not become interested in their plight until problems with the facility reached the nearby, more affluent community of Santa Maria. The medical study in question was conducted at the initiative of their attorney to document their health problems and develop medical profiles for use in their litigation against the facility after the state had refused to act. The residents do not want these records released to the state, which they now perceive as their enemy and the ally of the facility’s owners.
The resident plaintiffs’ perception of the state may arise in part from the dual role of the Department of Health Services in the area of toxic waste disposal. While the Legislature has announced its concern with the threats to public health and the environment caused by improper disposal of haz*445ardous waste (Health & Saf. Code, § 25100), it has also declared it a matter of urgent public necessity that “existing hazardous waste facilities be retained to the extent feasible,” based on the need for such facilities and the decreasing number of them. (Health & Saf. Code, § 25146.5.) This dual objective of the state officials demonstrates, at least, some conflict with the concerns of the Casmalia residents.
The majority opinion states that participation in the group study “does not invoke the same considerations of confidentiality as an individual’s communication with his or her doctor.” This conclusion seems to be based on the assumption that diagnosis was not a component of these consultations. This assumption may not be justified. The fact that these consultations and testing were arranged by an attorney for the purpose of litigation does not negate the probability that they also served a diagnostic purpose. Although some of these patients were aware of, and had complained of, respiratory difficulty, headaches, nausea, or eye irritation, there is no evidence that these complaints had been medically diagnosed or that the patients had any knowledge of such medical findings as the elevated white blood cell counts that the majority opinion reflects were disclosed by these examinations. I cannot conclude as the majority does that the physician-patient privilege does not apply.
The determinative question then is whether the privilege was unavailable because the plaintiffs had put their physical conditions in issue. On this point, there seems some confusion in the discussion in the majority opinion between the pending litigation of the plaintiff residents against the waste facility and the instant investigatory proceeding by the state.
There is no physician-patient privilege “concerning the condition of the patient if such issue has been tendered by . . . [t]he patient. . . .” (Evid. Code, § 996; 2 Jefferson, Cal. Evidence Benchbook, § 37.2, p. 1366.) It is clear that the resident plaintiffs cannot invoke the privilege to preclude disclosure of the medical study in their action against the waste facility, since they tendered the issue of their condition by bringing the action. (City & County of S. F. v. Superior Court (1951) 37 Cal.2d 227, 232 [231 P.2d 26, 25 A.L.R.2d 1418]; Britt v. Superior Court (1978) 20 Cal.3d 844, 862-864 [143 Cal.Rptr. 695, 574 P.2d 766]; 2 Witkin, Cal. Evidence (3d ed. 1986) Witnesses, § 1195.) It is not equally clear that the privilege is unavailable in the instant investigatory proceeding by the state. Eighty-nine of the Casmalia residents admit making repeated complaints to state officials regarding their medical problems. Their action in complaining to the state and requesting a health study, which was refused by the state, cannot be said to constitute a waiver of the privilege as to medical records which did not exist at that time and medical conditions not then known. I therefore conclude the privilege was not waived.
*446The physician-patient privilege is, however, an aspect of the patient’s constitutional right to privacy. (See People v. Stritzinger (1983) 34 Cal.3d 505, 511 [194 Cal.Rptr. 431, 668 P.2d 738]; In re Lifschutz, supra, 2 Cal.3d at pp. 431-432.) As discussed, ante, the state has demonstrated a compelling interest in this medical data, although not in the identities of the patients.
Finally, I must also disagree with the majority’s analysis of the attorney work-product doctrine.
The majority opinion concludes that, due to Government Code section 11183, there is no risk that respondent’s opponent in the law suit, the Casmalia facility, will gain access to this study. That section, however, expressly permits disclosure of information acquired through a state investigation when a state officer is “called upon to testify in any court or proceeding at law.” There is therefore a substantial risk that the results of the study will become available to the facility if the state pursues legal action against the facility based on the information disclosed by the study.
The question then is whether this risk is outweighed by the demonstrated need for disclosure due to the Casmalia residents’ refusal to cooperate with a state-sponsored health study. Again, I believe a showing has been made to justify disclosure of the medical records themselves, but not the names of the individual patients, based on privacy considerations.
It was the duty of the trial court to determine whether the administrative subpoena, as drafted, conformed to legal and constitutional standards. (Fielder v. Berkeley Properties Co. (1972) 23 Cal.App.3d 30, 39 [99 Cal.Rptr. 791].) Since I agree with the trial court that the subpoena contravened those standards, I would affirm.