Wipf v. Altstiel
Citation | 888 N.W.2d 790 |
Decision Date | 21 December 2016 |
Docket Number | No. 27491.,27491. |
Court | Supreme Court of South Dakota |
Parties | Steven J. WIPF, Plaintiff and Appellee, v. Terry ALTSTIEL, M.D. and Regional Health Physicians, Inc., Defendants and Appellants. |
Brad J. Lee, Gary D. Jensen of Beardsley, Jensen & Lee Prof. LLC, Rapid City, South Dakota, Attorneys for plaintiff and appellee.
Jeffrey G. Hurd, Daniel Duffy of Bangs, McCullen, Butler, Foye & Simmons LLP, Rapid City, South Dakota, Attorneys for defendants and appellants.
ZINTER, Justice (on reassignment).
[¶ 1.] Steven J. Wipf sued Dr. Terry Altstiel and Regional Health Physicians Inc. (Appellants) for medical malpractice. Through discovery, Wipf sought access to operative notes and postoperative notes relating to follow-up care of some of Dr. Altstiel's patients who are not parties to this action. The circuit court ordered Appellants to partially redact and produce the redacted records, and they appealed. We reverse and remand for reconsideration.
[¶ 2.] On April 22, 2011, Dr. Altstiel performed a laparoscopic hernia
repair on Wipf at the Spearfish Regional Surgery Center (SRSC). The purpose of the surgery was to repair a tear or opening in Wipf's abdominal wall. Dr. Altstiel completed the surgery around 10:00 a.m., and Wipf was discharged around 4:00 p.m. Wipf was advised to notify his doctor if he experienced any unusual pain or developed a fever.
[¶ 3.] The following day, Wipf contacted SRSC to report that he was experiencing pain in his upper back, he had a fever, and he had been unable to have a bowel movement since prior to surgery. SRSC advised Wipf to go to the emergency room, and Wipf went to the Sturgis Regional Hospital (SRH). The emergency-department doctor found that Wipf did not have a fever or bowel blockage. Although Wipf's primary complaint was pain, he had not been taking his prescribed pain medication. Wipf was advised to take the pain medication and return if he felt that his condition worsened.
[¶ 4.] Wipf returned to SRH's emergency department three nights later. He reported that he felt nauseous and that he still had been unable to have a bowel movement. Wipf was admitted to the hospital for observation, and he underwent a CT scan
of his abdomen the following morning. The scan revealed fluid and air in the abdomen near an opening in the mid-small bowel. SRH transferred Wipf to the Rapid City Regional Hospital, where he underwent surgery with Dr. Larry Wehrkamp. Dr. Wehrkamp discovered two perforations in the small bowel that measured approximately two centimeters in size.
[¶ 5.] Wipf later sued Appellants for malpractice. Wipf alleged that Dr. Altstiel accidentally perforated Wipf's small bowel during the laparoscopic hernia
repair. Wipf also alleged that Dr. Altstiel failed to inspect and find the perforations before completing the surgery. Dr. Altstiel contended that he inspected Wipf's bowel prior to concluding the surgery and that no perforations were present. Wipf, however, pointed out that Dr. Altstiel did not note the claimed inspection in his operative note. Dr. Altstiel's expert also testified that for him to opine that Dr. Altstiel violated the standard of care, Wipf would have to show an unacceptably high complication rate in similar procedures with different patients. Because Dr. Altstiel estimated that he had conducted approximately 955 laparoscopic hernia repairs over thirteen years, and because Dr. Altstiel's expert testified in his deposition that it would be relevant to consider the past 200–300 procedures, Wipf requested production of Dr. Altstiel's operative notes involving this procedure for the prior five years, including medical reports or notes that related to follow-up care. The circuit court found those records relevant, ordered the doctor and clinic to "redact from these records the personal identifiers for each patient," and ordered them to produce the remaining redacted information.1
We subsequently granted Dr. Altstiel's petition for an intermediate appeal.
[¶ 6.] For purposes of appeal, Dr. Altstiel concedes that the redacted information is relevant.2 However, he claims that the physician-patient privilege in SDCL 19–19–503(b) protects such anonymous, nonidentifying information from discovery. This is a question of first impression in this jurisdiction. If the privilege applies, then according to Dr. Altstiel, liability for malpractice will depend solely on his testimony of his unverifiable estimate of his own complication rate. Further, the inference to be drawn from Dr. Altstiel's failure to note an inspection of the bowel in his operative note will depend solely on Dr. Altstiel's explanation.
[¶ 7.] The physician-patient privilege, codified in SDCL 19–19–503(b), protects a physician-patient's "confidential communications made for the purpose of diagnosis or treatment." But the language of the statute does not address information in a doctor's records that does not identify the patient and cannot be traced back to the patient. Additionally, unlike some jurisdictions that have passed medical information privacy acts or patient's rights legislation that more broadly protect medical information, see 3 Jack B. Weinstein & Margaret A. Berger, Weinstein's Federal Evidence § 514.12[5][c] (Mark S. Brodin, ed., Matthew Bender 2d ed.1998), the South Dakota Legislature has not done so.
[¶ 8.] The text of SDCL 19–19–503 does not protect all of a physician's "medical records." Rather, it only protects physician-patient "confidential communications" contained in medical records. SDCL 19–19–503(b). Because the text of SDCL 19–19–503(b) fails to address either the disclosure of anonymous, nonidentifying information or whether nonidentifying information is a physician-patient "confidential communication," it is informative to consider the cases from other jurisdictions that have similar rules protecting physician-patient "confidential communications." With almost unanimity, the courts applying analogous rules protecting physician-patient "confidential communications" hold that when adequate safeguards ensure the anonymity of the patient, relevant, nonidentifying information is not privileged.3
See Snibbe v. Superior Court, 224 Cal.App.4th 184, 168 Cal.Rptr.3d 548, 554, 556–57 (2014) ( ); Bennett v. Fieser, 152 F.R.D. 641, 642–44 (D.Kan.1994) ( ); Osterman v. Ehrenworth, 106 N.J.Super. 515, 256 A.2d 123, 129 (1969) ( ); Staley v. N. Utah Healthcare Corp., 230 P.3d 1007, 1010–11 (Utah 2010) ( ).
[¶ 9.] Additionally, even courts interpreting broader privilege rules protecting "any communication" or "any information" hold that relevant, adequately protected, nonidentifying information is not privileged. See Ziegler v. Superior Court, 134 Ariz. 390, 656 P.2d 1251, 1254–56 (Ariz.Ct.App.1982) ( ); Cmty. Hosp. Ass'n v. District Court, 194 Colo. 98, 570 P.2d 243, 244–45 (1977) ; (Colo.Rev.Stat. Ann. § 13–90–107(d) (West 1973), which protected "any information acquired in attending the patient, which was necessary to enable him to prescribe or act for the patient") Colorado's privilege rule, ; Fischer v. Hartford Hosp., 31 Conn. L. Rptr. 291 (Conn.Super.Ct.2002) ( ); Tomczak v. Ingalls Mem'l Hosp., 359 Ill.App.3d 448, 295 Ill.Dec. 968, 834 N.E.2d 549, 552–555 (2005) ( ); Terre Haute Reg'l Hosp., Inc. v. Trueblood, 600 N.E.2d 1358, 1360–62 (Ind.1992) ( ); Baptist Mem'l Hosp. v. Johnson, 754 So.2d 1165, 1169–71 (Miss.2000) ( ); State ex rel. Wilfong v. Schaeperkoetter, 933 S.W.2d 407, 409–10 (Mo.1996) ( ).4
[¶ 10.] This type of anonymous, nonidentifying information is not protected by the physician-patient privilege because there is no patient once the information is redacted. As the Utah Supreme Court thoughtfully explained:
To continue reading
Request your trial-
Estate v. Mid Coast Hosp.
...a confidential communication will remove the entire communication from the privilege's protection. See Wipf v. Altstiel, 888 N.W.2d 790, 796-98 (S.D. 2016) (Gilbertson, C.J., dissenting) ("Simply put, ... a patient medical record is a confidential communication, regardless of the informatio......
-
Ferguson v. Thaemert
...incisions, for anterior spinal fusions at or below the L4 level, during the past 5 years without identifying the patient consistent with ... Wipf v. Al [t ]stiel [.]" Dr. Thaemert objected to the request as being irrelevant, not reasonably calculated to lead to the discovery of admissible e......