Warren General Hospital ("WGH") entered into an agreement with the law firm of Heller, Maas, Moro & Magill Co, L.P.A/ ("Heller") to recover payment for outstanding bills for medical services. WGH provided Heller with the records patients who might be eligible for Supplemental Security Income ("SSI") benefits. These records contained patients' names, address, birth dates, employment information and "admitting diagnosis." Heller screened the records and contacted patients who were eligible for SSI benefits in an effort to satisfy the patients' debt to WGH with SSI payments. Heller was paid a contingent fee based on the money WGH recovered. A disgruntled employee sent several of the records to a television news program, and the documents became the focus of an investigative report.
Plaintiffs Gary Ball, Cheryl Biddle and her husband Robert Biddle (now deceased) filed suit in state court, alleging invasion of privacy, intentional infliction of emotional distress and negligence against both WGH and Heller, and alleging breach of implied contract of confidentiality and statutory violations concerning patient confidentiality against WGH. Plaintiffs also charged Heller with improper solicitation of clients. Heller and WGH moved for summary judgment on all claims, which the trial court granted.
The Ohio Court of Appeals reversed the trial court's grant of summary judgment, affirmed the grant of Heller's motions to strike and for a protective order, and reversed the trail court's refusal to maintain this suit as a class action. In overruling summary judgment, the appeals court recognized the tort of breach of confidentiality. The appeals court found that the plaintiffs properly pleaded the bases of the tort, which are invasion of privacy, implied term of contract and statutory privacy actions, as well as negligence, breach of the Code of Professional Responsibility and intentional infliction of emotional distress. The appeals court said that to maintain an action for breach of confidentiality, plaintiff must demonstrate an "unconsented, unpriveged disclosure to a third party of nonpublic information that the defendant has learned within a confidential relationship. The appeals court declined to define which relationships are "confidential", except to say that a physician-patient relationship is confidential, and gave a non-exclusive list of when a physician's disclosure is "privileged" based on statutory requirements of disclosure including occupational or infectious diseases and child abuse. The court found no dispute that the records were nonpublic or that WGH gave them to Heller. The court rejected Heller's and WGH's arguement that plaintiffs consented to the release of records in an "Authorization For Release of Information" that authorizes release "to my insurance company and/or third party payor" of medical record information. WGH was not saved by the confidential relationship between Heller and WGH, because the tort requires only the release to any third party, not necessarily release to the public. Finally on this issue, the appeals court rejected the defense of qualified privilege, saying that the defense does not apply, because it only addresses the malice element of defamation. Even if it did apply, the court said, the public policy protecting the physician-patient relationship is more compelling than the public policy permitting certain disclosures to be protected by a qualified privilege.
The appeals court found a genuine issue of material fact as to whether Heller induced WGH to disclose confidential patient information. The court's decision was based on the nature of the relationship between Heller and WGH and the disputed factual issue of whether Heller should have reasonably anticipated that its actions would induce WGH to release confidential information. The appeals court affirmed summary judgment on the invasion of privacy claim, finding neither publication of plaintiffs confidential information by either Heller or WGH, nor intrusion into plaintiffs' private activities akin to trepass. The appeals court affirmed summary judgement on the intentional infliction of emotional distress issue, finding no outrageous conduct. Plaintiffs' negligence claims were sustained because all of defendants' conduct in question was intentional. The appeals court held that plaintiffs' breach of implied contract claims were appropriately dismissed because the injury sounds more clearly under the tort of breach of confidence, and because the dusty of confidentiality is imposed by law, not contract. Plaintiffs statutory violation claims were dismissed as incorporated in the tort of breach of confidentiality and appropriately dismissed.
The appeals court found no error in the trial court's dismissal of the breach of the Code of Professional Responsibility claim because such complaints are within the jurisdiction of the Ohio Supreme Court. The court affirmed the trial court's striking certain exhibits as making legal conclusions not allowable in a motion for summary judgment. Finally, the appeals court reopened the issue of whether plaintiffs may maintain a class action, which the trial court ruled was moot because it dismissed the entirety of plaintiffs' suit.
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