Elizabeth Lawson v. Patricia Halpern-Reiss and Central Vermont Medical Center
212 A.3d 1213
Vt.2019Background
- Plaintiff arrived at CVMC emergency room at 2:12 a.m. after lacerating her arm; nurses detected heavy alcohol odor and a breath-alcohol reading of .215.
- Plaintiff was treated, cleared for discharge at 3:05 a.m., and reported she had no ride home.
- A police officer was on duty at the ER under a CVMC–Berlin contract; the charge nurse told the officer that plaintiff was blatantly intoxicated, had driven herself to the hospital, and was about to drive home.
- The officer arrested plaintiff for suspected DUI; the criminal charge was later dismissed.
- Plaintiff sued the nurse and CVMC for negligent disclosure of medical information and inadequate training/policies; after discovery the nurse was dismissed and the trial court granted summary judgment for CVMC, concluding the nurse’s disclosure fell within HIPAA’s good-faith public-safety exception.
- The Vermont Supreme Court recognized a common-law private cause of action for unauthorized disclosure of medical treatment information but affirmed summary judgment for CVMC because the record supported a subjective good-faith belief that disclosure was necessary to prevent imminent harm.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Vermont should recognize a common-law private right of action for damages from a medical provider’s unauthorized disclosure of treatment-obtained information | Lawson: Court should recognize a private tort remedy because HIPAA provides no private right of action and most jurisdictions recognize such a cause of action | CVMC: No existing Vermont tort; HIPAA governs and provides only administrative enforcement; recognition is unnecessary or legislative prerogative | Court recognized the common-law private right of action (breach of duty of confidentiality), adopting HIPAA as guiding framework |
| Whether the nurse’s disclosure was protected by HIPAA’s good-faith exception (i.e., necessary to prevent/lessen a serious and imminent threat) and thus shielded CVMC from liability | Lawson: Material facts dispute whether disclosure was necessary or legally compelled; disclosure may have included unnecessary information (that plaintiff had driven to hospital) suggesting law-enforcement purpose | CVMC: Nurse had a good-faith belief disclosure was necessary to prevent imminent harm (plaintiff driving intoxicated); officer was reasonably able to prevent the threat; HIPAA presumption of good faith applies | Court held summary judgment proper for CVMC: presumption of good faith applied and plaintiff failed to produce evidence rebutting subjective good-faith belief that disclosure aimed to prevent imminent harm |
| Whether the applicable standard of “good faith” is subjective or objective for the HIPAA safety exception | Lawson: (argued implicitly) standard should allow factfinder review; disputes of fact exist | CVMC: Relied on regulation’s presumption and nurse’s testimony of good-faith belief | Court held the HIPAA exception contemplates a subjective good-faith standard (focused on actor’s actual belief); plaintiff failed to rebut presumption |
| Whether disclosure of that plaintiff had driven to the hospital (suggesting a past crime) negates the safety-exception protection | Lawson: Including that plaintiff had driven herself could indicate law-enforcement purpose or unnecessary disclosure | CVMC: Such detail was offered in good faith to prevent future intoxicated driving; officer was appropriate to prevent threat | Court: Even if that statement suggested past conduct, plaintiff offered no evidence nurse had ulterior motives; disclosure did not rebut the presumption of subjective good faith |
Key Cases Cited
- Byrne v. Avery Ctr. for Obstetrics & Gynecology, P.C., 102 A.3d 32 (Conn. 2014) (discusses HIPAA does not create private enforcement and may inform state-law standards)
- Byrne v. Avery Ctr. for Obstetrics & Gynecology, P.C., 175 A.3d 1 (Conn. 2018) (adopts common-law private cause of action for wrongful disclosure of medical information)
- McCormick v. England, 494 S.E.2d 431 (S.C. 1997) (recognizes tort for unauthorized disclosure based on duty of confidentiality)
- Biddle v. Warren Gen. Hosp., 715 N.E.2d 518 (Ohio 1999) (supports independent tort for breach of patient confidence)
- Humphers v. First Interstate Bank of Or., 696 P.2d 527 (Or. 1985) (identifies breach of confidentiality as proper tort basis)
- Peck v. Counseling Serv. of Addison Cty., Inc., 499 A.2d 422 (Vt. 1985) (patient privilege is not absolute; public-safety exceptions exist)
- Hay v. Med. Ctr. Hosp. of Vt., 496 A.2d 939 (Vt. 1985) (caution in recognizing new causes of action but willing to do so when public policy compels)