Ellison v. Cocke County, Tenn.

• Decision Date: 24 August 1995
• Docket Number: No. 94-5577,94-5577
• Citation: 63 F.3d 467
• Parties: 10 IER Cases 1658 Rick R. ELLISON, Plaintiff-Appellant, v. COCKE COUNTY, TENNESSEE and David Kickliter, M.D., Defendants-Appellees.
• Court: U.S. Court of Appeals — Sixth Circuit

Page 467

63 F.3d 467

10 IER Cases 1658

Rick R. ELLISON, Plaintiff-Appellant, v. COCKE COUNTY, TENNESSEE and David Kickliter, M.D. Defendants-Appellees.

No. 94-5577.

United States Court of Appeals, Sixth Circuit.

Submitted April 10, 1995.

Decided Aug. 24, 1995.

Thomas M. Leveille (briefed), Knoxville, TN, for Rick R. Ellison.

Robert H. Watson, Jr. (briefed), Watson, Hollow & Reeves, Knoxville, TN, for Cocke County.

M. Lacy West (briefed), Julia C. West (briefed), West & Rose, Kingsport, TN, for David J. Kickliter, M.D.

Before: MARTIN and RYAN, Circuit Judges; GILMORE, District Judge. ^*

MARTIN, J., delivered the opinion of the court, in which GILMORE, District Judge, joined. RYAN, J. (pp. 472-73), delivered a separate opinion concurring in the result.

BOYCE F. MARTIN, JR., Circuit Judge.

Rick R. Ellison appeals the district court order granting the defendants' motion to dismiss for failure to state a claim upon which relief can be granted. He contends that the district court erred in determining that 42 U.S.C. Sec. 290ee-3 (now codified at 42 U.S.C. Sec. 290dd-2) provides no private right of action and in concluding that he could not maintain an action under 42 U.S.C. Sec. 1983. Because we find that no private right of action exists under Section 290dd-2 and that Section 290dd-2 creates no substantive rights that would enable Ellison to invoke a Section 1983 claim, we affirm the decision of the district court.

I.

On January 3, 1992, Ellison was taken to Peninsula Hospital in Blount County, Tennessee, pursuant to an Order of Transport signed by the Honorable Marcus Mooneyham, Judge of the General Sessions Court of Cooke County, Tennessee. Based upon allegations that he was under the influence of drugs and suffering from hallucinations, Ellison remained hospitalized from January 3 to January 10.

After his release, Ellison was terminated from his position with the Cocke County Ambulance Service. The Board of Directors of the Cocke County Ambulance Service then met to establish conditions for his return to work. Dissatisfied with those conditions, Ellison filed a grievance with the Cocke County Legislative Body and requested a hearing. His grievance was referred to an appointed Grievance Committee for hearing.

The Board of Directors and the Grievance Committee requested copies of Ellison's medical records from the hospital, and Ellison executed the necessary releases. Those records concerned Ellison's identity, diagnosis, prognosis, and treatment. The copies provided were purportedly accompanied by a sticker indicating their confidential status. Moreover, Ellison claims that he specifically requested that his grievance and related materials be kept confidential.

However, this request was not honored. At an open meeting of the Grievance Committee, David Kickliter, M.D., read excerpts from Ellison's records that identified allegations of Ellison's drug use and that gave the results of drug tests. This information was later published in two local newspapers, and the story was also covered by a radio station.

II.

Ellison filed suit against Dr. Kickliter and Cocke County on March 4, 1993, claiming violations of 42 U.S.C. Sec. 290ee-3 and related regulations. Specifically, the complaint alleged that Kickliter and Cocke County violated the statute's confidentiality provision by disclosing Ellison's medical records at an open meeting and also asserted a state law claim for invasion of privacy.

Both Kickliter and Cocke County filed motions to dismiss the complaint pursuant to Fed.R.Civ.P. 12(b)(6), claiming that Section 290ee-3 provides no private right of action. Ellison subsequently filed an amended complaint on September 13, 1993, restating his prior allegations and alleging a Section 1983 violation, based upon the same facts. The district court entered an order granting the defendants' motions to dismiss as to Ellison's Section 290ee-3 and Section 1983 claims and dismissing his state law claims without prejudice. This timely appeal followed.

III.

In Cort v. Ash, 422 U.S. 66, 95 S.Ct. 2080, 45 L.Ed.2d 26 (1975), the supreme court articulated the standards for ascertaining when a private right of action can be implied from a statute. It explained:

In determining whether a private remedy is implicit in a statute not expressly providing one, several factors are relevant. First, is the plaintiff 'one of the class for whose especial benefit the statute was enacted,'--that is, does the statute create a federal right in favor of the plaintiff? Second, is there any indication of legislative intent, explicit or implicit, either to create such a remedy or to deny one? Third, is it consistent with the underlying purposes of the legislative scheme to imply such a remedy for the plaintiff? And finally, is the cause of action one traditionally relegated to state law, in an area basically the concern of the States, so that it would be inappropriate to infer a cause of action based solely on federal law?

Id. at 78, 95 S.Ct. at 2088 (citations omitted). The court has subsequently clarified that in determining whether a private right of action is implicit in a statute, the "focal point is Congress' intent in enacting the statute." Thompson v. Thompson, 484 U.S. 174, 179, 108 S.Ct. 513, 516, 98 L.Ed.2d 512 (1988). Therefore, "unless this congressional intent can be inferred from the language of the statute, the statutory structure, or some other source, the essential predicate for implication of a private remedy simply does not exist." Id. (quoting Northwest Airlines, Inc. v. Transp. Workers, 451 U.S. 77, 101 S.Ct. 1571, 67 L.Ed.2d 750 (1981)). In this case, none of the considerations that guide our inquiry points in favor of implying a private right of action. Indeed, an examination of Section 290dd-2 in light of the Cort factors reveals that Congress did not intend to create a private right of action when enacting the statute.

Against this backdrop, we begin our analysis by examining the language of the statute itself. Transamerica Mortgage Advisors, Inc. v. Lewis, 444 U.S. 11, 16, 100 S.Ct. 242, 245, 62 L.Ed.2d 146 (1979) (citations omitted). Section 290dd-2(a) announces the general confidential status of "[r]ecords of the identity, diagnosis, prognosis, or treatment of any patient which are maintained in connection with the performance of any program or activity relating to substance abuse education, prevention, training, treatment, rehabilitation, or research, which is conducted, regulated, or directly or indirectly assisted by any department or agency of the United States." Section 290dd-2(b) provides that under certain circumstances these records may be disclosed, "in accordance with the prior written consent of the patient." Moreover, Section 290dd-2(f) establishes a criminal penalty applicable to "[a]ny person who violates any provision of this section or any regulation issued pursuant to this section."

Nothing in the language of Section 290dd-2 suggests that Congress intended to create a private right of action for violations of the confidentiality provision. On the contrary, that language establishes that Congress intended the statute to be enforced through the imposition of criminal penalties. Of course the fact that a statute provides for a criminal penalty "does not necessarily preclude the implication of private cause of action for damages." Cort, 422 U.S. at 79, 95 S.Ct. at 2088. However, courts are "especially reluctant" to recognize additional remedies where a statute expressly provides a remedy. Lewis, 444 U.S. at 19, 100 S.Ct. at 247. Furthermore, although the confidentiality provision is designed to benefit "patients," a specific and identifiable class of which Ellison was a member, "the question is not simply who would benefit from the act, but whether Congress intended to confer federal rights upon those beneficiaries." California v. Sierra Club, 451 U.S. 287, 294, 101 S.Ct. 1775, 1779, 68 L.Ed.2d 101 (1981) (citation omitted). Thus, the fact that Ellison, as a patient, might benefit from the confidentiality provision does not end our inquiry.

We next examine the context of the statute at issue, "with an eye toward determining Congress' perception of the law that it was shaping." Thompson, 484 U.S. at 180, 108 S.Ct. at 516 (citations omitted). The underlying purpose of the Drug Abuse Office and Treatment Act of 1972, from which the confidentiality provision of the antecedent Section 290ee-3 derived, was "to bring about the most effective deployment of Federal resources against the devastating growth of drug abuse in the United States." H.R.Rep. No. 92-775, 92d Cong., 2d Sess. (1972), reprinted in 1972 U.S.C.C.A.N. 2045, 2045. The thrust of the Act was wholly administrative and bureaucratic: to coordinate federal drug abuse prevention efforts. Id. at 2048; Ohta v. Muraski, No. 3:93 CV 00554 (JAC), 1993 WL 366525, * 14 (D.Conn. Aug. 19, 1993).

The confidentiality of medical records maintained in conjunction with drug treatment programs was essential to that endeavor. Congress felt that "the strictest adherence" to the confidentiality provision was needed, lest individuals in need of drug abuse treatment be dissuaded from seeking help. H.R.Conf.Rep. No. 92-920, 92d Cong., 2d Sess. (1972), reprinted in 1972 U.S.C.C.A.N.2062, 2072. However, there is no indication that the confidentiality provision was intended to be enforceable by aggrieved private parties; the purpose of the provision was not to create private rights as much as it was to create public penalties in order to deter disclosure. Ohta, 1993 WL 366525, at * 14. Thus, nothing in the statute's legislative history reveals an intent to create a private right of action; it merely emphasizes the importance of preserving the confidentiality of patient records in order to encourage individuals to seek treatment. See H.R.Conf.Rep. No. 92-920, reprinted in 1972 U.S.C.C.A.N. at 20 71-72; Nashua Brookside Hosp., Inc. v. Cappuccio, No....