New York Law Review

Tag: patient confidentiality

  • Short v. Board of Managers, 57 N.Y.2d 399 (1982): Limits on Deletion of Identifying Details Under Freedom of Information Law

    Short v. Board of Managers, 57 N.Y.2d 399 (1982)

    The statutory authority to delete identifying details to facilitate disclosure under the Freedom of Information Law (FOIL) is limited to records where disclosure would constitute an unwarranted invasion of personal privacy and does not extend to records specifically exempted from disclosure by state or federal statute.

    Summary

    John Short sought access to medical records related to Medicaid reimbursements for abortions. The New York Court of Appeals addressed whether a state agency could be compelled to disclose records otherwise exempt from disclosure under FOIL after deleting identifying details. The Court held that the deletion of identifying details only applies to records whose disclosure would constitute an unwarranted invasion of privacy, but not to records exempted by other statutes. Therefore, the medical records, protected by state statutes ensuring patient confidentiality, remained exempt even after the proposed deletion of identifying information. The memorandum was subject to in camera review to determine if statistical or factual data existed.

    Facts

    John Short requested copies of 29 medical records from the Nassau County Medical Center related to Medicaid reimbursement claims for abortions performed between February and April 1972. He also sought a copy of a memorandum from the medical center to a Deputy County Attorney regarding medically related abortions at the center during 1972. The medical center denied the request based on statutory exemptions. Short then initiated a legal action to compel the medical center to release the records.

    Procedural History

    The Supreme Court directed disclosure of the 29 medical records after deletion of personal identifying details, with the medical center determining the extent of deletion. The court denied disclosure of the July 1972 memorandum. The medical center appealed the order to disclose the medical records, while Short cross-appealed the denial of access to the memorandum. The Appellate Division affirmed the Supreme Court’s judgment. Both parties then appealed to the New York Court of Appeals.

    Issue(s)

    1. Whether the Freedom of Information Law requires disclosure of medical records, otherwise exempt under state statutes protecting patient confidentiality, if personal identifying details are deleted?

    2. Whether an interagency memorandum is entirely exempt from disclosure under FOIL, even if it contains statistical or factual data?

    Holding

    1. No, because the authority to delete identifying details applies only to records whose disclosure would constitute an unwarranted invasion of personal privacy, not to records already exempted from disclosure by other statutes like those protecting patient confidentiality.

    2. No, because statistical or factual tabulations or data within an interagency memorandum are subject to disclosure, requiring an in-camera inspection to determine if such data exists.

    Court’s Reasoning

    The Court of Appeals reasoned that the Freedom of Information Law allows agencies to deny access to records specifically exempted from disclosure by state or federal statute, as outlined in Public Officers Law § 87(2)(a). The medical records in question were protected by Public Health Law §§ 2803-c and 2805-g, and Social Services Law § 369, which ensure patient privacy and confidentiality of medical records. The court emphasized that the provision for deleting identifying details, found in Public Officers Law § 89(2), applies only to records whose disclosure would constitute an unwarranted invasion of personal privacy. This provision does not extend to records exempted by other statutes. The court stated, “What is intended and accomplished by subdivision 2 of section 89 is provision of a means by which the single obstacle to disclosure — the invasion of personal privacy — may be overcome, i.e., by deleting identifying details.” Since the medical records were not “otherwise available” due to statutory exemptions, the deletion provision was inapplicable. Regarding the memorandum, the Court acknowledged its general exemption as “inter-agency or intra-agency materials” under § 87(2)(g), but noted the exception for “statistical or factual tabulations or data.” Thus, the case was remanded for an in-camera inspection to determine if such data existed within the memorandum. Chief Judge Cooke dissented in part, arguing that the court has discretionary power to order disclosure of patient records with identifying information deleted to promote public accountability. The majority rejected this argument, holding the statute does not permit such judicial revision.

  • In the Matter of Newman, 35 N.Y.2d 340 (1974): Confidentiality Protections for Methadone Patients in Research Programs

    In the Matter of Newman, 35 N.Y.2d 340 (1974)

    Federal law may provide absolute confidentiality to patient records in drug research programs, preventing compelled disclosure even in criminal proceedings, if authorized by the Attorney General or the Secretary of Health, Education and Welfare.

    Summary

    This case addresses whether a director of a methadone maintenance program could be compelled to produce patient photographs to a grand jury investigating a homicide. The director refused, citing both state physician-patient privilege and federal drug abuse prevention laws. The court held that the photos were not protected by the state privilege but were protected by federal law. The Court of Appeals determined that the 1972 Drug Abuse Office and Treatment Act did not repeal the confidentiality provisions of the 1970 Comprehensive Drug Abuse Prevention and Control Act, when the Attorney General had authorized confidentiality for the research program.

    Facts

    A witness to a homicide believed she had seen the killer at a methadone clinic where she was also a patient. Based on this, a subpoena was issued to Dr. Newman, the director of the NYC Methadone Maintenance Treatment Program, ordering him to produce photographs of male patients at a specific unit of the program who fit a certain age range. Dr. Newman refused, citing patient confidentiality.

    Procedural History

    Dr. Newman moved to quash the subpoena, arguing it violated federal and state confidentiality laws. The motion was denied, and he was held in contempt of court. The Appellate Division affirmed the contempt order, modifying it to include safeguards against unnecessary disclosure. Dr. Newman appealed to the New York Court of Appeals.

    Issue(s)

    1. Whether photographs of patients at a methadone clinic constitute privileged information under New York’s physician-patient privilege statute (CPLR 4504(a)).

    2. Whether the 1972 Drug Abuse Office and Treatment Act repealed the confidentiality provisions of the 1970 Comprehensive Drug Abuse Prevention and Control Act, thereby allowing a court to compel disclosure of patient records from a methadone program.

    Holding

    1. No, because the photographs were obtained during administrative admission procedures and served a medical management function rather than enabling the doctor to act in his professional capacity.

    2. No, because the 1972 Act did not explicitly repeal the 1970 Act, and both acts can be harmonized to give effect to both, particularly when the Attorney General had authorized absolute confidentiality for the research program in question.

    Court’s Reasoning

    The court reasoned that the photographs were not “acquired in attending a patient in a professional capacity” under the state statute because they were taken during administrative intake, designed to prevent errors in medication dispensing. As for the federal issue, the court noted that the 1970 Act allowed the Attorney General and the Secretary of HEW to authorize persons engaged in drug research to protect the privacy of research subjects. The 1972 Act allowed for disclosure of patient records upon a court order, but the court found no indication that the 1972 Act was intended to repeal the 1970 Act’s confidentiality provisions.

    The court emphasized that repeals by implication are disfavored and that statutes should be construed to give effect to both if possible. The court also gave weight to the interpretation of the Special Action Office for Drug Abuse Prevention, which stated that the 1972 Act did not amend the 1970 Act’s confidentiality provisions. The court highlighted the importance of absolute confidentiality in drug research programs like methadone maintenance, stating that “the United States Congress has enacted legislation over the last few years to encourage research into [the] causes and cures [of narcotics addiction]. In order to induce those suffering from drug addiction * * * to participate in these research programs, Congress enacted [in 1970] a statute granting absolute confidentiality to such participants, upon proper authorization.” The court concluded that since the Attorney General had granted absolute confidentiality to Dr. Newman’s program, the subpoena could not be enforced.

  • Hyman v. Jewish Chronic Disease Hospital, 15 N.Y.2d 317 (1965): Director’s Right to Inspect Hospital Records

    15 N.Y.2d 317 (1965)

    A director of a corporation, including a hospital, has the right to inspect the corporation’s records to investigate potential wrongdoing, even concerning patient data, subject to reasonable safeguards to protect patient confidentiality.

    Summary

    William Hyman, a director of Jewish Chronic Disease Hospital, sought to inspect hospital records related to alleged improper experimentation on patients. The hospital resisted, arguing patient confidentiality and lack of director liability. The Court of Appeals held that Hyman, as a director, had a right to inspect the records to fulfill his duties, even if patient data was involved. The court emphasized the director’s responsibility to oversee the corporation’s activities and the ability of the court to protect patient privacy through appropriate orders. This case establishes a director’s broad inspection rights to ensure corporate accountability.

    Facts

    William Hyman, a director of the Jewish Chronic Disease Hospital, alleged that the hospital was conducting illegal and improper experiments on patients without their informed consent.
    Hyman sought to inspect the hospital’s records to investigate these allegations.
    The hospital denied Hyman access to the records, citing patient confidentiality and arguing that Hyman, as a director, would not be personally liable for the hospital’s wrongdoing.

    Procedural History

    Hyman petitioned the court for an order compelling the hospital to allow him to inspect the records.
    Special Term initially ruled in favor of Hyman, granting him the right to inspection.
    The Appellate Division reversed the Special Term’s decision.
    Hyman appealed to the Court of Appeals.

    Issue(s)

    Whether a director of a hospital corporation has the right to inspect the hospital’s records, including patient data, to investigate alleged illegal and improper experimentation on patients.

    Holding

    Yes, because a director has a right and obligation to keep informed about the corporation’s policies and activities to fulfill their duties and responsibilities, and the court can implement safeguards to protect patient confidentiality.

    Court’s Reasoning

    The Court of Appeals reasoned that directors have a fundamental right and obligation to stay informed about a corporation’s activities to properly discharge their duties. This right extends to inspecting corporate records, even those containing sensitive information like patient data, especially when investigating potential wrongdoing.
    The court rejected the hospital’s argument that patient confidentiality should bar Hyman’s inspection, noting that any confidentiality concerns could be addressed by the court through appropriate orders, such as concealing patient names. The court stated, “Any such confidentiality could be amply protected by inserting in the court’s order a direction that the names of the particular patients be kept confidential.”
    The court also dismissed the argument that Hyman’s lack of personal liability negated the need for inspection, emphasizing that the potential liability of the corporation itself warranted the director’s inquiry. The court noted, “However, the possibility of liability of the corporation of which he is a director entitles him to learn the truth about the situation on which such alleged liability may be predicated.” The court further emphasized that Hyman was acting in his capacity as a director, fulfilling his duty to oversee the corporation’s affairs, not as a representative of the patients. The fact that the hospital had implemented new rules requiring informed consent was not a barrier to Hyman’s investigation of past actions. The dissenting opinion argued that inspection was unnecessary given ongoing investigations by the State Department of Education and the District Attorney, the petitioner’s existing knowledge of the facts, and the hospital’s new informed consent policy.