Doe v. Central Iowa Health System
| Citation | 766 N.W.2d 787 |
| Decision Date | 15 May 2009 |
| Docket Number | No. 07-1017.,07-1017. |
| Parties | John DOE, Appellant, v. CENTRAL IOWA HEALTH SYSTEM d/b/a Iowa Health Des Moines d/b/a Iowa Methodist Medical Center and d/b/a Iowa Lutheran Hospital, Appellees. |
| Court | Iowa Supreme Court |
Gretchen R. Jensen and Jeffrey L. Goodman of Goodman & Associates, P.C., West Des Moines, for appellant.
Frank B. Harty, Thomas W. Foley, and Hannah M. Rogers of Nyemaster, Goode, West, Hansell & O'Brien, P.C., Des Moines, for appellees.
In this appeal, we must decide whether the district court was correct when it granted the defendants' motion for judgment notwithstanding the verdict. Because the plaintiff failed to produce sufficient evidence to support his claim that the disclosures of his mental health records were the cause of his emotional distress, we affirm the judgment of the district court.
John Doe, an employee of Central Iowa Health System, brought an action against Central Iowa Health System, Iowa Health System, Iowa Methodist Medical Center, and Iowa Lutheran Hospital1 alleging that in 2003 they unlawfully disclosed his medical and/or mental health information to Doe's coemployees. Doe alleged Iowa Health violated the privacy rules of the Federal Health Insurance Portability and Accountability Act, breached its fiduciary duty, and violated the privacy rules of Iowa Code chapter 228 covering the disclosure of mental health and psychological information. Doe further alleged these violations caused him to suffer humiliation, embarrassment, mental anguish, fear of social ostracism, fear regarding job security, and other severe emotional distress.
The case proceeded to trial on the alleged violation of chapter 228. The Code provides in relevant part:
1. Except as specifically authorized in section 228.3, 228.5, 228.6, 228.7, or 228.8, a mental health professional, data collector, or employee or agent of a mental health professional, of a data collector, or of or for a mental health facility shall not disclose or permit the disclosure of mental health information.
2. Upon disclosure of mental health information pursuant to section 228.3, 228.5, 228.6, 228.7, or 228.8, the person disclosing the mental health information shall enter a notation on and maintain the notation with the individual's record of mental health information, stating the date of the disclosure and the name of the recipient of mental health information.
The person disclosing the mental health information shall give the recipient of the information a statement which informs the recipient that disclosures may only be made pursuant to the written authorization of an individual or an individual's legal representative, or as otherwise provided in this chapter, that the unauthorized disclosure of mental health information is unlawful, and that civil damages and criminal penalties may be applicable to the unauthorized disclosure of mental health information.
3. A recipient of mental health information shall not disclose the information received, except as specifically authorized for initial disclosure in section 228.3, 228.5, 228.6, 228.7, or 228.8. However, mental health information may be transferred at any time to another facility, physician, or mental health professional in cases of a medical emergency or if the individual or the individual's legal representative requests the transfer in writing for the purposes of receipt of medical or mental health professional services, at which time the requirements of subsection 2 shall be followed.
Iowa Code § 228.2 (2003).
At the close of Doe's case, Iowa Health moved for a directed verdict. In their motion for a directed verdict they made the following claims: (1) Iowa Code chapter 228 does not provide Doe with a private cause of action; (2) if chapter 228 does provide a private cause of action, Iowa Health did not violate chapter 228 because any disclosures made were not in violation of chapter 228; (3) any disclosures made by Iowa Health employees was done outside the scope of their employment; (4) Doe failed to present substantial evidence that he suffered any emotional distress caused by the actions of Iowa Health employees.
The court overruled the motion for a directed verdict. In doing so, the court stated it believed chapter 228 created a private cause of action for emotional distress without a showing of physical injury or a showing of outrageous conduct. However, the court did state that in its mind "there is a huge issue in this case about the sufficiency of the evidence to prove emotional distress." The court reserved ruling on the sufficiency of the evidence issue.
At the close of all the evidence, Iowa Health renewed its motion for directed verdict. The court renewed the ruling it made at the end of Doe's evidence and decided to submit the case to the jury. The court used the following marshalling instruction to instruct the jury on the elements Doe had to prove to recover under a private cause of action under section 228.2.
In order to recover on his claim of unlawful disclosure of mental health information the Plaintiff must prove all of the following propositions:
1. That an employee of the Defendant disclosed the Plaintiff's mental health information. The term "disclosed" is defined in Instruction No. 13. The term "mental health information" is defined in Instruction No. 13.
2. That the employee who disclosed the Plaintiff's mental health information did so:
a. within the scope of his or her employment. The phrase "within the scope of employment" is defined in Instruction No. 14; or
b. with the authorization of a managerial employee of the Defendant.
3. The disclosure was unlawful. The term "unlawful" is defined in Instruction No. 15.
4. That the unlawful disclosure was the proximate cause of emotional distress to the Plaintiff. The term "emotional distress" is defined in Instruction No. 16.
5. The amount of damage.
If the Plaintiff has failed to prove any of these propositions, the Plaintiff is not entitled to recover damages. If the Plaintiff has proved all of these propositions, he is entitled to recover some amount of damages as explained in Instruction No. 17.
The court further instructed the jury that the only element of damages upon which the jury could return a verdict was for Doe's emotional distress.
The jury found Doe proved all the elements as required by the marshalling instruction and returned a verdict in favor of Doe for $175,000. Iowa Health then filed a motion for judgment notwithstanding the verdict or in the alternative a motion for new trial or remittitur. Iowa Health raised the same issues as it raised in its motion for directed verdict. The district court sustained Iowa Health's motion for judgment notwithstanding the verdict claiming the disclosures by four of Iowa Health's employees were not the proximate cause of any emotional distress to Doe and there was not substantial evidence tending to prove the fifth employee made any disclosure of mental health information while acting within the scope of employment.
Doe appeals the district court order granting Iowa Health's judgment notwithstanding the verdict. In response to Doe's brief, Iowa Health continues to raise the issue that chapter 228 does not imply a private cause of action and Doe failed to establish that any violation by Iowa Health of chapter 228 caused Doe's emotional distress. Iowa Health's claim—Doe failed to establish that any violation by Iowa Health of chapter 228 caused the emotional distress suffered by Doe—is dispositive of this appeal. Therefore, for purposes of this appeal, we will assume without deciding, that Iowa Code section 228.2 implies a private cause of action and that chapter 228 allows recovery for emotional distress without physical injury or a showing of outrageous conduct. In other words, we will assume the court properly instructed the jury on the law and the instructions are the law of the case.
We review the district court's grant of a motion for judgment notwithstanding the verdict for correction of errors at law. Maxim Techs., Inc. v. City of Dubuque, 690 N.W.2d 896, 900 (Iowa 2005). Our task is to determine whether substantial evidence exists to support the elements of the plaintiff's claim, justifying the court to submit the case to the jury. Gibson v. ITT Hartford Ins. Co., 621 N.W.2d 388, 391 (Iowa 2001). In doing so, we review the evidence in the light most favorable to the nonmoving party. Id. Evidence is substantial when reasonable minds would accept the evidence as adequate to reach the same findings. Easton v. Howard, 751 N.W.2d 1, 5 (Iowa 2008).
III. Analysis.
Examining the evidence in the light most favorable to Doe, we find the evidence as follows. On December 4, 2003, Doe attempted suicide by taking an overdose of aspirin. He wanted to die because he did not care about life anymore and he thought it would be the best thing for him. One cause of his emotional distress leading to his suicide attempt was the fact his mother had just passed away of a massive heart attack. Another cause was that his car was repossessed on the day he attempted suicide.
After taking the overdose, Doe sent a text message to one of his friends telling her goodbye. He also thought he might have called or sent a text message to another friend relaying the same information. Another friend actually spoke to Doe and told him that he needed to get to the hospital or she was going to call 911. Doe agreed to go to the hospital and had his father take him. He was admitted to the mental health unit. Doe then had his friends inform his supervisor that he would not be at work because of his hospitalization.
Doe's supervisor came to Lutheran Hospital and visited him in the mental health unit. Doe gave his supervisor permission to tell two of his coemployees that he was in the unit and they could come visit...
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