Snyder v. Mekhjian
| Decision Date | 31 July 1991 |
| Parties | , 60 USLW 2139 William and Roslyn SNYDER, Plaintiffs-Respondents, v. Haroutune MEKHJIAN, M.D., Individually and Haroutune Mekhjian, M.D., P.C.; Youngick Lee, M.D.; Wilmo Orejola, M.D.; Anthony Losardo, M.D.; Leonard Savino, M.D.; John Doe, M.D.; a fictitious name; Richard Roe, M.D.; a fictitious name; John Roe, M.D., a fictitious name; John Smith, M.D., a fictitious name; John Jones, M.D., a fictitious name; St. Joseph's Hospital; St. Joseph's Blood Bank; Anthony Passaro, W Blood Bank, a fictitious name; Dr. John Kalian; Y Blood Bank, a fictitious name; Z Blood Bank, a fictitious name; XYZ Blood Bank, a fictitious name; Jane Doe, a fictitious name; Richard Roe, a fictitious name; Joseph Williams, a fictitious name; Joseph Rogers, a fictitious name; Gregory Smith, a fictitious name; Joseph Smith, a fictitious name; Jane Smith, a fictitious name; William Smith, a fictitious name; Individually and as agents, employees and servants of St. Joseph's Hospital, Defendants, and Bergen Community Blood Center, Defendant-Appellant, and Lawrence Wilkinson, M.D. and American Association of Blood Banks, Defendants-Respondents. |
| Court | New Jersey Supreme Court |
Roger G. Ellis argued the cause, for appellant (Bumgardner, Hardin & Ellis, attorneys; M. Christie Wise, on the briefs).
Edwin R. Matthews argued the cause, for respondent American Ass'n of Blood Banks (Cuyler, Burk & Matthews attorneys; Edwin R. Matthews and Karla M. Donovan, on the brief).
Peter L. Korn argued the cause, for respondent Lawrence Wilkinson, M.D. (McDonough, Korn & Eichhorn, attorneys; Thomas M. Moriarty, on the briefs).
George T. Baxter argued the cause, for respondents William and Roslyn Snyder.
Robert W. Donnelly, Jr., submitted a letter in lieu of brief on behalf of defendants Haroutune Mekhjian, M.D. and Youngick Lee, M.D. (Dughi and Hewitt, attorneys).
Milton Gurny submitted a letter brief on behalf of defendant St. Joseph's Hosp. and Medical Center (Hein, Smith, Berezin, Maloof, Spinella & Rodgers, attorneys).
Michael J. Haas, Deputy Atty. Gen., submitted a letter in lieu of brief on behalf of amicus curiae State Dept. of Health (Robert J. Del Tufo, Atty. Gen. of New Jersey, attorney).
The judgment is affirmed, substantially for the reasons expressed in the Appellate Division opinion, reported at 244 N.J.Super. 281, 582 A.2d 307 (1990).
We granted defendants' motion for leave to appeal, --- N.J. --- (1991), to consider whether a patient who alleges that he received an HIV-positive blood transfusion may obtain limited discovery from the donor when the patient also alleges that a blood bank negligently supplied the blood. In holding in favor of such discovery, the Appellate Division relied on N.J.S.A. 26:5C-9, which permits disclosure for good cause of information regarding a person who has Acquired Immune Deficiency Syndrome (AIDS) or is infected with the Human Immunodeficiency Virus (HIV). 244 N.J.Super. 281, 582 A.2d 307 (1990). This Court now affirms on the opinion below. I concur with that opinion and write separately to emphasize the Court's reliance on the statutory balance of the donor's privacy interest, the plaintiffs' interest in full discovery and compensation for the injuries they have sustained, and society's interest in a safe and adequate blood supply. Our reliance on N.J.S.A. 26:5C-9 is consistent with prior decisions of this Court and illustrates the proper roles of the legislature and the judiciary in cases involving law and bioethics.
-I-
Because this matter arises on an interlocutory appeal from a discovery order and cross-motions for summary judgment, the record, although voluminous, is less complete than it would be after a plenary hearing. From the record, the following facts appear. In August 1984 plaintiff William Snyder underwent open heart surgery at St. Joseph's Hospital in Paterson. In the course of the surgery, he received transfusions of several units of blood products, including one of platelets, unit 29F0784. Defendant Bergen Community Blood Center (BCBC) had collected blood for that unit at a bloodmobile in Hackensack. BCBC is a member of defendant American Association of Blood Banks (AABB), a non-profit association of non-profit banks, the members of which collect about one-half of the nation's blood supply. The American Red Cross collects the other half.
According to BCBC, it made available to donors an AIDS information sheet, captioned "AN IMPORTANT MESSAGE TO ALL BLOOD DONORS." The sheet described AIDS:
WHAT IS AIDS?
AIDS or Acquired Immune Deficiency Syndrome is a condition in which the body's normal defense mechanisms against certain diseases or conditions are reduced. As a result, patients often develop unusual infections such as Pneumocystis pneumonia or a rare form of skin cancer, Kaposi's sarcoma. There is no known cause, preventative measure, laboratory test, or treatment for AIDS.
It also identified those at risk:
WHO IS AT RISK?
It is known, however, that certain groups are at a high risk of contracting the disease. These include:
* those with symptoms and signs suggestive of AIDS;
* sexual partners of AIDS patients;
* sexually active homosexual or bisexual men with multiple partners;
* Haitian entrants to the United States;
* present or past abusers of intravenous drugs;
* patients with hemophilia; and
* sexual partners of individuals at increased risk of AIDS.
The sheet concluded with the request:
Your blood bank is asking that you voluntarily refrain from donating at this time if you are in any of the currently identified high-risk groups. Although the majority of members of these groups are not carriers, there is presently no means of detection and thus no mechanism to identify those few who may be at risk.
BCBC also asserts that it took a medical history from donors asking twenty-nine questions, including:
Are you in general good health?
Ever injected yourself with any drugs?
Signs of swollen glands or Kaposi's sarcoma?
The apparent purpose of these questions was to discover whether the donor was a member of the "identified high risk groups," which include intravenous drug users and sexually active homosexual and bisexual males. Concerning the last question, Kaposi's sarcoma is R. Gray & L. Goody, Attorney's Textbook of Medicine para. 46.51 at 46-48 (3d ed. 1988). According to BCBC, the donor gave negative responses to each of the questions.
The parties disagree on the effectiveness of then-existing tests to determine if blood products were infected with HIV, the cause of AIDS. They agree, however, that starting in 1985 the enzyme-linked immunoabsorbent assay screening test (the ELISA test) enabled blood banks to screen blood for the HIV virus. Except for a two-to-six-month "window" following a person's exposure to the HIV virus, the ELISA test reveals whether a prospective donor has an HIV infection. As part of a nationwide "look back" program conducted by AABB, BCBC ascertained in 1986 that a donor who had contributed to unit 29F0784 was HIV positive. Under the program, when a prospective blood donor tested HIV positive, the blood bank conducted a review to determine whether the donor had made donations before the development of the ELISA test. BCBC informed St. Joseph's that one of the donors to unit 29F0784 had tested HIV positive. St. Joseph's notified Snyder's doctor, who in turn informed Snyder in 1987. Snyder, who was not otherwise at risk, tested HIV positive.
Alleging that the transfusion of platelets had infected him, Snyder and his wife, Roslyn, instituted this action in 1989 against BCBC, its director, St. Joseph's Hospital, and others. Plaintiffs allege in part that BCBC was negligent in its screening of donors. BCBC denies both that it was negligent and that unit 29F0784 was HIV infected, notwithstanding BCBC's discovery in 1986 that one of the contributors was HIV positive. Thus, both negligence and causation are at issue. As part of their pre-trial discovery, plaintiffs seek limited discovery of the donor on both issues. In particular, they want to discover whether in 1984 the donor was HIV infected and whether BCBC followed its own screening procedures. Plaintiffs do not seek the identity of the donor or of the donor's acquaintances, nor do they intend to sue the donor.
After deleting the donor's name and address, BCBC produced the donor's records, but it opposes further discovery. The Law Division found that the donor's interest in confidentiality outweighed plaintiffs' interest in obtaining the information. Finding also that "[t]here is no basis to conclude that [BCBC] did something wrong," the court denied plaintiffs' motion.
The Appellate Division granted plaintiffs' motion for interlocutory relief and reversed. Although it left it to the trial court to determine the extent of discovery, the Appellate Division held that "some access [to the donor] under careful court supervision is appropriate and justifiable." 244 N.J.Super. at 296, 582 A.2d 307. Writing for a unanimous court, Judge Pressler suggested that either a "veiled" deposition or one conducted on written interrogatories might provide plaintiffs adequate discovery and also protect the donor's privacy interests. Id. at 297, 582 A.2d 307.
-II-
In the absence of legislative guidance, courts in other states have divided over the rights of an AIDS-infected blood recipient to make discovery of the donor. Some courts have denied access to the donor because of the donor's privacy interests, see Bradway v. American Nat'l Red Cross, 132 F.R.D. 78 (N.D.Ga.1990); society's interest in...
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