Wall v. Pahl, 886 N.W.2d 373

Background

Wall, a former patient of Gundersen, obtained an audit trail showing three Gundersen employees (including Pahl and Schimke) accessed his electronic patient health care records without his consent.
Wall sued Pahl and Schimke under Wis. Stat. § 146.82 (confidentiality of patient health care records) for "invasion of privacy of medical records," and sued Gundersen under § 146.83(4)(b) for concealing results of an internal investigation into those accesses.
Defendants moved to dismiss for failure to state a claim; Wall clarified his claims were statutory under ch. 146 (Pahl/Schimke: § 146.82; Gundersen: § 146.83(4)(b)).
The circuit court dismissed all claims, reasoning § 146.82 requires a "release" (disclosure outside the entity), which Wall did not allege; and that § 146.83(4)(b) concerns concealment of "patient health care records," which Wall did not allege Gundersen withheld.
On appeal the court accepted complaint facts as true and analyzed statutory meaning of "release" in § 146.82 and the statutory definition of "patient health care records" in § 146.81(4).

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether an employee's internal access to a patient record without consent constitutes a "release" under Wis. Stat. § 146.82	Wall: Any access by an employer to a patient record is a "release" to that employee and thus violates § 146.82 absent informed consent	Pahl/Schimke: "Release" means disclosure outside the entity; internal access is a "use," not a "release," and not regulated by § 146.82	Held: "Release" in § 146.82 does not apply to internal employee access; dismissal affirmed
Whether Wis. Stat. § 146.82 should be read to include internal "uses" because § 146.816 exempts certain uses/disclosures	Wall: § 146.816 shows state law covers internal access so employees are liable under § 146.82	Defendants: § 146.816 distinguishes "use" (internal) and "disclosure" (outside entity); HIPAA/regulation governs internal uses, so § 146.82 targets external releases	Held: Considering § 146.816 and practical consequences, court rejects treating every internal access as a statutory "release"; HIPAA governs internal uses; private suit under § 146.82 inappropriate
Whether imposing § 146.82 liability for internal access would be workable or reasonable	Wall: Protects privacy by deterring unauthorized employee access	Defendants: Would impose unreasonable burdens and vast liability on healthcare employees and organizations	Held: Court finds Wall's interpretation would lead to absurd/unworkable results and unreasonable burdens; supports limiting "release" to disclosure outside the entity
Whether Gundersen violated § 146.83(4)(b) by concealing investigation results	Wall: Gundersen concealed results of its internal investigation, blocking his ability to investigate, violating the statute	Gundersen: § 146.83(4)(b) prohibits concealing/withholding "patient health care records" as defined by statute; internal investigation notes/info are not patient health care records related to the patient’s health	Held: Dismissed — § 146.83(4)(b) applies only to withholding actual patient health care records; alleged concealment of investigative information not covered

Key Cases Cited

Walberg v. St. Francis Home, 281 Wis. 2d 99 (2005) (standard for accepting complaint facts on motion to dismiss)
Data Key Partners v. Permira Advisers LLC, 356 Wis. 2d 665 (2014) (standard of review for motions to dismiss; may not consider facts outside complaint)
State ex rel. Kalal v. Circuit Court for Dane Cty., 271 Wis. 2d 633 (2004) (statutory interpretation principles; plain meaning, context)
Domino v. Walworth County, 118 Wis. 2d 488 (1984) (statutory interpretation reviewed independently)
Hoida, Inc. v. M&I Midstate Bank, 291 Wis. 2d 283 (2006) (rejecting interpretations that lack sensible stopping point)
State v. Straehler, 307 Wis. 2d 360 (2008) (distinguishing records from mere information for "patient health care record" definition)
Seaton v. Mayberg, 610 F.3d 530 (9th Cir.) (HIPAA does not create private right of action)
Acara v. Banks, 470 F.3d 569 (5th Cir.) (same)
State v. Gribble, 248 Wis. 2d 409 (2001) (appellate court may affirm on different grounds than trial court)