v. (2010)

Lanzinger, J.

{¶ 1} This case involves a patient who may have contracted a blood-borne disease from a health-care provider during a hospital stay. The issue for our review concerns the patient's ability to obtain discovery to determine the source of his exposure.

I. Case Background

{¶ 2} In May 2006, appellee Donald Ward underwent a procedure to replace his heart valve at Summa Health System (“Summa”). Five months later, Summa notified Ward that he may have been exposed to Hepatitis B during his time at Summa. After he tested positive for the virus, Ward and his wife filed a complaint against Summa and John Does 1 through 6, alleging various claims, including medical malpractice. The Wards also requested an extension of time to file the affidavit of merit required by Civ.R. 10(D)(2), arguing that discovery was needed because Summa had refused to identify the source of Donald Ward's exposure to the virus. The trial court granted the motion.

{¶ 3} In December 2007, the Wards filed a notice of deposition for Donald Ward's surgeon, appellant Robert F. Debski, M.D., who was not a named party to the action. In response to previous discussions regarding the deposition, Debski's attorney sent a letter to the Wards' counsel stating that the doctor would not discuss his own personal medical information but would testify about the surgery he had performed. The Wards refused to limit the scope of the deposition, and Debski filed a motion for a protective order, arguing that the physician-patient privilege protected his right to privacy with regard to his own medical information. The Wards opposed the motion and detailed why they believed that Debski could be the source of exposure. They contended that the physician-patient privilege did not apply, and they explained that they wished to ask Debski (1) whether he has ever had Hepatitis B and if so (2) when he contracted the disease and (3) how and when he became aware that he had the disease. The trial court granted the protective order, finding that the doctor had standing to assert the physician-patient privilege in testifying as to his own medical information and that there had been no waiver of the privilege.¹

{¶ 4} In the meantime, Summa filed a motion to dismiss because the Wards had not yet filed an affidavit of merit as required by Civ.R. 10(D)(2). The trial court granted the Wards an extension of time to file their affidavit and granted a further extension after their attempt to appeal the protective order was dismissed for lack of a final appealable order.

{¶ 5} On December 2, 2008, Summa filed a second motion to dismiss, arguing that dismissal was appropriate because the Wards had failed to comply with the trial court's order to submit an affidavit of merit. The Wards responded that their effort to obtain an affidavit had been hampered by the trial court's discovery rulings. They contended that their inability to identify the source of the Hepatitis B exposure prevented prospective expert witnesses from determining whether the standard of care had been met. The trial court dismissed the case without prejudice based on the Wards' failure to state a claim pursuant to Civ.R. 10(D)(2)(d) and their failure to comply with the court's order under Civ.R. 41(B)(1).

{¶ 6} The court of appeals reversed.² The appellate court examined R.C. 2317.02(B)(1) and determined that “[w]hile Dr. Debski is a physician, the testimony being sought concerns his role as a patient: the Wards do not wish to ask Dr. Debski about his patients or their records; the Wards want to ask Dr. Debski about himself. Nothing in the plain language of the statute prohibits this inquiry. The statute does not prevent patients from testifying. Also, while the Wards seek what clearly could be classified as a ‘communication’ under the statute, they do not seek it from the protected person, the physician; they seek it from an unprotected source, the patient.” Ward v. Summa Health System, 184 Ohio App.3d 254, 2009-Ohio-4859, 920 N.E.2d 421, ¶ 25.

{¶ 7} We accepted jurisdiction of Robert Debski's discretionary appeal.³

II. Legal Analysis

{¶ 8} This case concerns the ability of the Wards to discover information that could lead to the source of Donald Ward's Hepatitis B exposure.

A. Discovery in General

{¶ 9} Parties have a right to liberal discovery of information under the Rules of Civil Procedure. See Moskovitz v. Mt. Sinai Med. Ctr. (1994), 69 Ohio St.3d 638, 661-662, 635 N.E.2d 331. Discovery may be obtained through “deposition upon oral examination or written questions; written interrogatories; production of documents, electronically stored information, or things or permission to enter upon land or other property, for inspection and other purposes; physical and mental examinations; and requests for admission.” Civ.R. 26(A). Even though Dr. Debski is not a party, he can be compelled to give a deposition, as any witness in a civil case may be. See Civ.R. 30 and 31.

{¶ 10} The scope of the information that a party may discover is governed by Civ.R. 26(B)(1), which provides:

{¶ 11} “Parties may obtain discovery regarding any matter, not privileged, which is relevant to the subject matter involved in the pending action, whether it relates to the claim or defense of the party seeking discovery or to the claim or defense of any other party, including the existence, description, nature, custody, condition and location of any books, documents, electronically stored information, or other tangible things and the identity and location of persons having knowledge of any discoverable matter. It is not ground for objection that the information sought will be inadmissible at the trial if the information sought appears reasonably calculated to lead to the discovery of admissible evidence.” (Emphasis added.)

{¶ 12} In this case, the Wards subpoenaed Dr. Debski for deposition and at some point indicated that they intended to ask him about his personal medical information. Debski does not dispute the relevancy of the information sought to the Wards' lawsuit. He nonetheless argues that the Wards are not entitled to discover the information, because it is protected by the physician-patient privilege.

{¶ 13} Ordinarily, a discovery dispute is reviewed under an abuse-of-discretion standard. Tracy v. Merrell Dow Pharmaceuticals, Inc. (1991), 58 Ohio St.3d 147, 151-152, 569 N.E.2d 875. However, if the discovery issue involves an alleged privilege, as in this case, it is a question of law that must be reviewed de novo. Med. Mut. of Ohio v. Schlotterer, 122 Ohio St.3d 181, 2009-Ohio-2496, 909 N.E.2d 1237, ¶ 13.

{¶ 14} We will now examine the scope of the physician-patient privilege.

B. Physician-Patient Privilege-R.C. 2317.02(B)

{¶ 15} The physician-patient privilege did not exist at common law. State Med. Bd. v. Miller (1989), 44 Ohio St.3d 136, 140, 541 N.E.2d 602; Weis v. Weis (1947), 147 Ohio St. 416, 428-429, 34 O.O. 350, 72 N.E.2d 245. Therefore, being in derogation of the common law, any statutory privilege must be strictly construed against the party seeking to assert it and may be applied only to those circumstances specifically named in the statute. Id.

{¶ 16} The General Assembly established the physician-patient privilege in R.C. 2317.02. It states as follows:

{¶ 17} “The following persons shall not testify in certain respects:

{¶ 18} “ * * *

{¶ 19} “(B)(1) A physician or a dentist concerning a communication made to the physician or dentist by a patient in that relation or the physician's or dentist's advice to a patient, except as otherwise provided in this division, division (B)(2), and division (B)(3) of this section, and except that, if the patient is deemed by section 2151.421 of the Revised Code to have waived any testimonial privilege under this division, the physician may be compelled to testify on the same subject.

{¶ 20} “ * * *

{¶ 21} “(5)(a) As used in divisions (B)(1) to (4) of this section, ‘communication’ means acquiring, recording, or transmitting any information, in any manner, concerning any facts, opinions, or statements necessary to enable a physician or dentist to diagnose, treat, prescribe, or act for a patient. A ‘communication’ may include, but is not limited to, any medical or dental, office, or hospital communication such as a record, chart, letter, memorandum, laboratory test and results, x-ray, photograph, financial statement, diagnosis, or prognosis.”

{¶ 22} The physician-patient privilege, however, is not absolute. R.C. 2917.02(B) contains a number of exceptions.⁴ For instance, the privilege does not apply when the patient gives express consent to the release of medical information or when the patient places his medical condition in issue by filing a medical claim or wrongful-death action.

{¶ 23} We have previously discussed the purpose behind the physician-patient privilege:

{¶ 24} “A review of the physician-patient privilege found in R.C. 2317.02(B) indicates that the statute has a specific purpose. It is designed to create an atmosphere of confidentiality, which theoretically will encourage the patient to be completely candid with his or her physician, thus enabling more complete treatment. As this court stated in State v. Antill (1964), 176 Ohio St. 61, 64-65, 26 O.O.2d 366, 368, 197 N.E.2d 548, 551, ‘ * * * [t]he purpose of this privilege is to encourage patients to make a full disclosure of their symptoms and conditions to their physicians without fear that such matters will later become public. * * * ’ In addition, Huzjak v. United States (N.D.Ohio 1987), 118 F.R.D. 61, 63, explains the purpose of the physician-patient privilege:

{¶ 25} “ ‘Under the physician/patient privilege, a treating physician is prohibited from disclosing matters disclosed by the patient to the physician during consultations regarding treatment or diagnosis of the patient. The rationale of this privilege is to promote health by encouraging a patient to fully and freely disclose all relevant information which may assist the physician in treating the patient. Floyd v. Copas, 9 [O.O.3d] 298 (1977). If the patient feared that such information could be revealed by the treating doctor, the patient might refrain from, or be inhibited from, disclosing relevant information. The privilege is designed to provide an assurance of confidentiality.’ ” Miller, 44 Ohio St.3d at 139-140, 541 N.E.2d 602.

{¶ 26} Dr. Debski claims that because he has not waived the physician-patient privilege and none of the statutory exceptions apply, he cannot be compelled to testify about his personal medical information. Even though the court of appeals found that the information sought by the Wards is a “communication” under R.C. 2317.02(B)(5)(a), the court held that the physician-patient privilege did not apply because the plain language of the statute prohibits only a physician or a dentist from testifying about those communications. It is important to recognize that it is Debski's status as a patient, rather than his status as a physician that applies here.

{¶ 27} The appellate court determined that nothing in the statute gives a patient the right to refuse to testify about his or her own medical information.

{¶ 28} Because we must strictly construe the statutory privilege, we conclude that R.C. 2317.02(B) does not protect a person from having to disclose his or her own medical information when that information is relevant to the subject matter involved in a pending civil action. The court of appeals is correct that the statute does not address whether medical information is discoverable from a patient himself. We are not permitted to read such language into the statute. See State ex rel. Sapp v. Franklin Cty. Court of Appeals, 118 Ohio St.3d 368, 2008-Ohio-2637, 889 N.E.2d 500, ¶ 26 (court cannot add exception when plain language of statute does not contain exception); State v. Hughes (1999), 86 Ohio St.3d 424, 427, 715 N.E.2d 540 (“In construing a statute, we may not add or delete words”).

{¶ 29} Although Debski strenuously argues that his status as a nonparty controls the outcome of this case, the reason he was not named as a party is that the Wards do not know whether he is the one who exposed Donald Ward to Hepatitis B. A potential tortfeasor cannot use his or her status as a nonparty to prevent discovery of information that could shed light on whether he or she is the actual tortfeasor.

C. Roe and Schlotterer Are Distinguishable

{¶ 30} Debski responds that the court of appeals' holding is contrary to our decisions in Roe v. Planned Parenthood Southwest Ohio Region, 122 Ohio St.3d 399, 2009-Ohio-2973, 912 N.E.2d 61, and Med. Mut. of Ohio v. Schlotterer, 122 Ohio St.3d 181, 2009-Ohio-2496, 909 N.E.2d 1237. He argues that Roe established that the personal medical information of nonparty patients is absolutely privileged and protected from discovery by R.C. 2317.02(B), the physician-patient privilege. But the holding in Roe is not as broad as Debski claims. We have never held that the physician-patient privilege provides absolute protection against the disclosure of medical information.

{¶ 31} In Roe, the plaintiffs sought to discover abuse reports and medical records of nonparties from a health-care provider. Roe at ¶ 14. The plaintiffs claimed that the disclosure of the medical records was necessary to protect or further a countervailing interest that outweighed the nonparty patients' interest in confidentiality. Id. at ¶ 46, 912 N.E.2d 61. No one disputed R.C. 2317.02's applicability; the Roe plaintiffs sought medical records from a health-care provider. Id. at ¶ 26, 912 N.E.2d 61. Instead, the question was whether to apply the exception to the privilege that had been created in Biddle v. Warren Gen. Hosp. (1999), 86 Ohio St.3d 395, 715 N.E.2d 518. We held that the exception should not be applied. The medical records of the nonparties in Roe were not subject to discovery, because (1) R.C. 2317.02(B) prohibited the health-care provider from releasing them, (2) no statutory exception to the privilege applied, and (3) the nonparty patients had not expressly given their consent to the release of their records.

{¶ 32} Debski also argues that in Schlotterer, we reaffirmed Ohio's longstanding law that the patient is the exclusive holder of the physician-patient privilege and thus the patient is a “protected source.” 122 Ohio St.3d 181, 2009-Ohio-2496, 909 N.E.2d 1237. But Schlotterer, too, is distinguishable because it also involved a litigant's ability to obtain discovery of a nonparty's medical records from a physician. Id. at ¶ 2 and 12, 909 N.E.2d 1237. The case concerned whether the insureds' consent to release medical information to their insurer permitted release of the insureds' medical records to their insurer to allow it to pursue a fraud claim against a physician. The facts in Schlotterer fit squarely within R.C. 2317.02(B).

D. Patients May Still Obtain a Protective Order

{¶ 33} Although we have determined that the physician-patient privilege does not apply in this case, this does not mean that Debski has no potential recourse. As the appellate court indicated, the trial court must still consider whether the doctor is entitled to a protective order.⁵ The trial court granted a protective order because it believed that the physician-patient privilege applied. Privilege, however, is not the only basis to grant a protective order. As Civ.R. 26(C) indicates, protective orders may be granted when justice requires “to protect a party or person from annoyance, embarrassment, oppression, or undue burden or expense.” Upon remand, the trial court must weigh these factors against the Wards' right to discover the information.

III. Conclusion

{¶ 34} We therefore hold that under the circumstances of this case, R.C. 2317.02(B), the physician-patient privilege, does not preclude discovery of medical information from a patient. The judgment of the Summit County Court of Appeals is affirmed.

Judgment affirmed.

Pfeifer, J., concurring.

{¶ 35} I concur in the majority opinion. I write separately to emphasize that the failure of the tortfeasor, the hospital administrators, and their attorneys to tell the plaintiff who it was that exposed him to hepatitis is shameful. Evidence indicating what the tortfeasor and the hospital knew about the hepatitis exposure and when they knew it is critical to a final determination of liability, including potential punitive damages.

{¶ 36} I would go further than the majority opinion. Instead of stating that discovery is not precluded, I would remand with instructions that discovery begin immediately. The need for discovery in this case is so compelling that I would not countenance any more hearings.

LANZINGER, J.