delivered the Opinion of the Court.
In this original proceeding pursuant to C.AR. 21, we determine whether the district court properly exercised its discretion by granting the defendant's motion to recuse the Thirteenth Judicial District Attorney's Office (district attorney) and the Capital Crimes Unit of the Colorado Attorney General's Office (Capital Crimes Unit) from further participation in this case after finding an appearance of impropriety. We issued a rule directing the respondent, Cruz Palomo, to show cause why the district attorney and Capital Crimes Unit, should not be permitted to prosecute a criminal case against Palomo. We now make that rule absolute and conclude that the trial court had insufficient grounds for disqualification of the district attorney and the Capital Crimes Unit.
Specifically, we disagree that the files of Palomo contained medical records as de-seribed in the statute prohibiting the theft of medical records, and therefore infer no potentially criminal wrongdoing either of the personnel director or the district attorney's office as to those files. An employer's personnel records of employee drug tests and physical ability tests that are required as conditions of employment are not medical records for purposes of the theft statute. Further, the defendant has no standing to raise any privilege with respect to the personnel files of the victim, Flora Padilla. However, should the trial court sua sponte find impropriety by the personnel director or the district attorney's investigator in releasing those records, the court should consider appointment of a special prosecutor to pursue the theft charge and to determine the appropriateness of an offer of immunity to the personnel director and should also consider exclusion or limitation of the evidence at trial.
I.
This case arises out of the prosecution of Cruz Palomo (Palomo) for the murder of
During the conversation, the investigators asked for copies of Palomo's and Padilla's personnel files. The investigators told the personnel manager that if necessary, they could seek a subpoena or a search warrant for the files. The investigators testified at the hearing on the defense motion to disqualify the district attorney's office that they told the personnel manager that they did not want any medical or psychological files concerning Palomo or Padilla.
After conferring with Excel's corporate counsel, the personnel manager informed the investigators that Excel needed a written request for the records from the district attorney's office. The investigators provided a written request and the personnel manager released Palomo's and Padilla's personnel files. 1 The investigators then had the files copied for discovery purposes, and provided copies to defense counsel.
Contrary to the investigators' professed directions to delete any documents that might relate to medical or psychological issues, both files did contain the results of employment-required drug screening and physical ability tests. Padilla's personnel file also contained routine medical test results associated with work-related injuries and with a workers' compensation disability claim.
Onee the district attorney filed first degree murder charges against Palomo, Palomo's defense counsel filed a motion to recuse the district attorney's office and the Capital Crimes Unit from further participation in the case. Palomo argued that by asking for and receiving the personnel files, the investigators, along with the Excel personnel manager, committed the offense of theft of medical records, in violation of section 18-4-412, 6 C.R.S. (2000).
Upon learning that he faced possible erimi-nal charges, Excel's personnel manager, through counsel, indicated that if called to testify, he would invoke his right to remain silent. The district attorney offered immunity from prosecution for theft of medical records to the personnel manager, but retracted the offer the next day. The defense argued that the offer and withdrawal of immunity proved that the district attorney had an actual conflict in the case because the personnel director's testimony could implicate the district attorney's office in misconduct.
The district court found that the employment-required drug tests, the physical ability tests of both employees and the results of Padilla's personal medical tests constituted medical records under section 18-4-412. The district court further found that Palomo failed to show the commission of an actual impropriety by the district attorney's office and the Capital Crimes Unit. Nonetheless, the court found:
at least a prima facie showing by the defense that defendant's and others' rights very well may have been violated and as a result, there's not only just civil issues that are involved, but also issues of a criminal nature which, at this point, would affect and may effect witnesses that may be called to testify.
The court further held that there was arguably a claim that the investigators needed a search warrant to obtain Palomo's and Padilla's personnel records. Thus, the district court concluded that a colorable claim could be made that, by providing the files to the investigators without a warrant, the personnel manager committed the offense of theft of medical records.
The district court then characterized the proceedings as "tainted" and the prosecution as "compromised." It disqualified the district attorney's office and the Capital Crimes Unit and ordered appointment of a special prosecutor for the case.
In general, Colorado requires that its district attorneys and attorney general prosecute criminal cases. Colo. Const. art. IV, § 1(1); id., art. VI, § 18; § 20-1-102(1)(a), 6 C.R.S. (2000). However, section 20-1-107, 6 C.R.S. (2000), provides that a judge may disqualify the district attorney from a case and appoint a special prosecutor if the district attorney "is interested or has been employed as counsel in any case which it is his duty to prosecute or defend." Although the statute does not define "interested," we have held that a court may properly disqualify a district attorney who has somé involvement in the defendant's case that would "impair that office's ability to prosecute the case fairly." People ex rel. Sandstrom v. Dist. Court,
An "appearance of impropriety" can also be the basis for disqualification. People v. Garcia,
The fundamental inquiry is "whether disqualification appears reasonably necessary to insure [sic] the integrity of the fact-finding process, the fairness or appearance of fairness of trial, the orderly or efficient administration of justice, or public trust or confidence in the criminal justice system." Garcia,
Trial courts have broad discretion in determining whether they should disqualify a district attorney from prosecuting a particular case. McFoariaon,
IIL
In this case, the predicate for the trial court's decision to disqualify the district attorney's office was the conclusion that there was a colorable claim of theft of medical records against the personnel director, and the appearance that the district attorney's office had somehow abetted or induced that crime.
The defense presented expert testimony that the drug-test results and physical ability tests of both employees, and medical information related to Padilla fell under the medical record definition of section 18-4-412. The court noted the uncontested fact that the personnel manager did not have either Palo-mo's or Padilla's permission to release the files and found that the defense had established a prima facie case against the person
[TJhe prosecution's office is compromised to the extent that it may be difficult to make decisions about prosecution in this case without taking into account how those decisions are going to affect [the personnel manager], and other witnesses who ... have relied upon representation and authority of the district attorney's office to give them authorization [to release the files]. That now places those individuals at risk of both civil and eriminal Habilities. And it's that exact conflict which causes the Court some difficulty.
A.
We begin by discussing the trial court's finding that the defense established a prima facie case of theft of medical records against the personnel director. Under the theft of medical records statute:
Any person who, without proper authorization, knowingly obtains a medical record or medical information with the intent to appropriate the medical record or medical information to his own use or to the use of another, who steals or discloses to an unauthorized person a medical record or medical information, or who, without authority, makes or causes to be made a copy of a medical record or medical information commits theft of a medical record or medical information.
§ 18-4-412(1). The statute defines "medical record" as "the written or graphic documentation ... of services pertaining to medical and health care which are performed at the direction of a physician or other Hcensed health care provider on behalf of a patient." § 18-4-411(2)(a) (emphasis added). "Medical information" means "any information contained in the medical record or any information pertaining to the medical and health care services performed at the direction of a physician or other licensed health care provider which is protected by the physician-patient privilege." $ 18-4-411(2)(b).
Palomo's and Padilla's files both contained drug sereening test results and physical ability test results. We do not view those documents as medical records either under the medical record or the medical information definitions of section 18-4-412(2). First, neither test was performed "on behalf of a patient." Employees do not submit to these tests in order to receive some type of treatment. Instead, they submit to the tests for the benefit of the employer as a condition of employment. We note that even the Americans with Disabilities Act of 1990 does not treat a drug test designed to detect the ingestion of illegal substances as a medical examination. 42 U.S.C. § 12114(d)(1) (1994). Thus, any information obtained from a drug test that does not involve a disability is not considered part of an employee's medical ree-ord. Dana Devon, Drug Testing of Health Care Workers: Toward a Coherent Hospital Policy, 23 Am. J.L. & Med. 399, 446 (1997). The drug screening tests and physical ability tests were more akin to employment related written or verbal examinations that the employee undertook in order to qualify for the job.
Second, neither test falls under the physician-patient privilege. The physician-patient privilege states that "[a] physician ... shall not be examined without the consent of his patient as to any information acquired in attending the patient which was necessary to enable him to prescribe or act for the patient." $ 13-90-107(1)(d), 5 C.R.S. (2000). In Hanion v. Woodhouse, we held that the physician-patient privilege did not prevent a doe-tor from testifying about a blood alcohol test performed on a patient because there was "no showing that the running of the aleohol test was in any degree necessary to enable the physician properly to treat defendant."
Because we conclude that the drug screening and physical ability test results do not fall under the definition of either medical record or medical information, the defense failed to establish a prima facie case of theft of Palomo's medical records. Thus, there is no basis for a theft of medical records charge
B.
On the other hand, there is information in Padilla's file that relates to medical tests and examinations performed upon her that pertained to a work-related injury and an unrelated disability claim. 2
Thus, we now turn to the question of whether or not the existence of what could be medical information in Padilla's personnel file itself raises enough of an appearance of impropriety to warrant the removal of the district attorney and Capital Crimes Unit from the case.
We conclude that it does not. Although the appearance of impropriety is a very nebulous standard and trial courts have a large amount of discretion in determining when it exists, we have held that a trial court may not remove a district attorney from a case when the chance of an appearance of impropriety is merely prospective. Riboni v. Dist. Court,
Any possible wrongdoing by the personnel director is limited to Padilla's file. Consequently, any appearance of wrongdoing by the district attorney's office is limited to Padilla's file. Thus, the possibility of a conflict of interest rests on the prospective chance that the prosecution could seek to introduce Padilla's file into evidence. Should that happen, the personnel director might testify that the investigator never told him to redact medical and psychological records from the Padilla file. Such testimony could perhaps buttress a case against the district attorney's office for theft of medical records.
However, this case is in its initial phases. The record fails to indicate whether Padilla's medical records may be relevant in some way to either the prosecution or the defense. In the event that the Padilla medical records become an issue, the trial court must first determine the relevancy of this evidence to the party seeking either its discovery or admission into evidence. Then, the question of whether the personnel manager should testify may become an issue.
This court has held on several occasions that the determination of whether a district attorney should be disqualified in a criminal case depends upon whether the appearance of impropriety is of sufficient consequence to prevent a fair trial. Garcia,
However, in Ribont, we held that an appearance of impropriety did not exist where there was a mere chance that the district attorney could be called as an impeachment witness.
In this case, disqualification would rest at present upon the chance that the prosecution might call the personnel manager to testify regarding Padilla's personnel file. We have no evidence in this record to support a determination that the possibility of that cireum-stance would itself cause such an appearance of impropriety as to prevent Palomo from receiving a fair trial. Therefore, we disagree with the trial court's reliance on a possible future appearance of impropriety to warrant the removal of the district attorney and Capital Crimes Unit.
We also note that Palomo bases his argument on the method by which the prosecution obtained Padilla's personnel file, but Palomo has no standing to assert Padilla's physician-patient privilege.
Hence, it falls not to the defendant in this case to raise issues concerning the medical records in Padilla's file, but rather to the estate or family. The defendant here may certainly bring concerns to the attention of the court, as he has; however, his right to claim injury is limited by the general principles of standing.
Lastly, we observe that the remedy must be tailored to the problem. Here, there are other remedies that the trial court should consider as an alternative to disqualification. Courts should impose the least severe sanctions necessary to remedy improper conduct by the parties. See People v. Dist. Court,
If the information contained in Padilla's personnel file does constitute medical information, then it is protected by the physician-patient privilege. Absent a waiver by the patient, the physician-patient privilege prohibits pretrial discovery of information within the seope of the privilege. People v. Overton, T59 P.2d 772, 774 (Colo.App.1988). The proper remedy in this case could be for the trial court to address the issue as a discovery violation or a suppression matter. If the files either fall under the definition of medical records or are protected by the Fourth Amendment, then the proper remedy could be suppression of the files, not disqualification of the prosecution. Even if the files are not protected by the Fourth Amendment, then there may be civil remedies available to an injured party.
IV.
In conclusion, we hold that the drug screening and physical ability tests present in both files do not fall under the rubric of medical records or medical information for purposes of the theft of medical records statute. Hence, the potential of an appearance of impropriety turns on the information disclosed from Padilla's file. At this stage of the proceedings, the remedy of disqualification for the appearance of impropriety in relationship to the victim's medical records is too severe. There are other remedies that the trial court should consider when timely. Therefore, we conclude that the trial court abused its discretion in finding the present appearance of impropriety sufficient to warrant removal of the district attorney and Capital Crimes Unit in this case. The district attorney and Capital Crimes Unit may proceed with the prosecution. The rule is made absolute, and the trial court is directed to conduct further proceedings in accordance with this opinion.
Notes
. The written request stated: "Please provide to the Office of the District [sic] Attorney any and all records of Cruz Palomo and Flora Padilla."
. We decline to opine about whether there would still be a colorable claim of theft against the personnel director, given the lack of a living victim whose records are at issue.
