27 N.Y.3d 46 (2016)

A physician’s duty to maintain patient confidentiality, established by statute, is breached when confidential information is disclosed to those not involved in the patient’s care, and is not dependent on the sensitivity or embarrassment associated with the information; claims for intentional infliction of emotional distress require conduct that is extreme and outrageous, exceeding all bounds of decency.

Summary

The New York Court of Appeals addressed a case involving the filming of a patient’s medical treatment and death in a hospital emergency room for a television documentary. The court held that the hospital and treating physician could be liable for breach of physician-patient confidentiality due to unauthorized disclosure, but that the conduct did not rise to the level of “extreme and outrageous” required for intentional infliction of emotional distress. The court emphasized the breadth of the physician-patient privilege and the high standard for intentional infliction of emotional distress claims, distinguishing this case from prior rulings.

Facts

Mark Chanko was treated at New York-Presbyterian Hospital after being hit by a car. While he was being treated, an ABC News crew filmed a documentary series, with the hospital’s permission, but without Chanko’s or his family’s knowledge or consent. After Chanko’s death, the filming continued, and the events were included in an episode of the documentary series, 16 months later his widow, Anita Chanko, and other family members saw the footage, leading to distress. The family sued the hospital, the physician, and ABC, alleging breach of confidentiality and intentional infliction of emotional distress.

Procedural History

The trial court dismissed most claims but allowed breach of physician-patient confidentiality against the hospital and physician, and intentional infliction of emotional distress against all defendants, to proceed. The Appellate Division reversed, dismissing the entire complaint. The Court of Appeals granted the plaintiffs leave to appeal, addressing the viability of these claims.

Issue(s)

1. Whether the complaint sufficiently states a cause of action against the hospital and physician for breach of physician-patient confidentiality.

2. Whether the conduct of the defendants was sufficiently “extreme and outrageous” to support a claim for intentional infliction of emotional distress.

Holding

1. Yes, because the complaint alleged an unauthorized disclosure of confidential medical information, and the physician-patient privilege should be construed broadly.

2. No, because the defendants’ conduct, while potentially insensitive, did not meet the high threshold of “extreme and outrageous” behavior required for this tort.

Court’s Reasoning

The court found the breach of physician-patient confidentiality claim was adequately stated. The physician-patient privilege, codified in CPLR 4504, aims to encourage open communication between patients and providers by protecting patient privacy. The privilege covers all information acquired during treatment and is not limited to embarrassing information. Here, the hospital and doctor allowed the filming and disclosure to the film crew without the patient’s consent. The court noted that a lack of consent could be inferred from the allegations of the complaint.

Regarding intentional infliction of emotional distress, the court found the defendants’ actions were not sufficiently outrageous. The court emphasized that this tort requires conduct “so outrageous in character, and so extreme in degree, as to go beyond all possible bounds of decency, and to be regarded as atrocious, and utterly intolerable in a civilized community.” The court cited prior cases where the behavior was not found outrageous enough to satisfy this standard. The fact that the footage shown was edited to include less than three minutes of content was a significant factor in the court’s decision. Therefore, the court held that the defendants’ conduct, while reprehensible, did not meet the stringent standard required to support this claim.

Practical Implications

This case clarifies the scope of the physician-patient privilege in New York, emphasizing its broad protection of medical information. It serves as a reminder that any disclosure of such information to unauthorized parties can form the basis of a breach of confidentiality claim. It also underscores the high bar for establishing intentional infliction of emotional distress. Attorneys should carefully assess whether the conduct alleged is truly “extreme and outrageous” and, if not, should consider other causes of action.

This case affects how hospitals, physicians, and media companies must act in their relationships with patients, especially in situations involving filming or recording. It also highlights the need for healthcare providers to balance their need to give information, the privacy concerns of patients, and the need to obtain informed consent before filming medical treatments and sharing patient information with external parties. The standard the court applied for intentional infliction of emotional distress continues to be a major hurdle for plaintiffs seeking damages on this basis.