lawson v. halpernreiss
N/A (Superior Court Decision) (2024)
Rule of Law:
A healthcare provider's disclosure of protected health information to a person reasonably able to prevent a serious and imminent threat to health or safety is permitted under HIPAA, particularly when the provider acts in good faith based on actual knowledge.
Facts:
- Around 2:00 a.m. on May 10, 2014, Elizabeth Lawson drove herself alone to the emergency room at Central Vermont Medical Center (CVMC) for treatment of a serious cut to her wrist.
- During Ms. Lawson's treatment, nurse Patricia Halpern-Reiss detected a strong odor of alcohol on her.
- Before discharge, Ms. Lawson was given an alco-sensor breath test, which produced a reading well over twice the legal limit.
- At the time of discharge, Ms. Halpern-Reiss believed that Ms. Lawson might attempt to drive herself home while inebriated and did not have anyone else present to provide a safe ride home.
- Ms. Halpern-Reiss advised an onsite police officer of Ms. Lawson’s intoxication and lack of a safe ride home.
Procedural Posture:
- Elizabeth Lawson filed a complaint against Patricia Halpern-Reiss (nurse) and Central Vermont Medical Center (CVMC) in the Vermont Superior Court, Civil Division, Washington Unit, asserting a claim of negligence against Ms. Halpern-Reiss (Count 1) and a negligent supervision claim against CVMC (Count 2).
- Patricia Halpern-Reiss was dismissed from the case by stipulation of the parties.
- CVMC filed a motion for summary judgment, arguing that Ms. Halpern-Reiss did not breach any duty to Ms. Lawson, Ms. Lawson failed to provide expert testimony for the standard of care under Count 2, and there was no basis for punitive damages.
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Issue:
Does a healthcare provider breach a duty of confidentiality under HIPAA by disclosing a patient's protected health information to a police officer when the provider reasonably believes the patient poses a serious and imminent threat to self or public safety due to intoxication and a lack of safe transportation?
Opinions:
Majority - Superior Judge Mary Miles Teachout
No, a healthcare provider does not breach a duty of confidentiality under HIPAA by disclosing a patient's protected health information to a police officer when the provider reasonably believes the patient poses a serious and imminent threat to self or public safety due to intoxication and a lack of safe transportation, because such a disclosure is expressly permitted under HIPAA's health and safety provisions. The court determined that Ms. Halpern-Reiss was entitled to the presumption of good faith under 45 C.F.R. § 164.512(j) because she had actual knowledge of Ms. Lawson’s very high breath test result, knew Lawson had driven herself to the ER unaccompanied, and had no reason to believe a safe ride was available. The disclosure to the onsite police officer, who was capable of preventing Ms. Lawson from driving while intoxicated, was deemed necessary to prevent a serious and imminent threat to Ms. Lawson’s and the public’s safety, and was not made for law enforcement purposes. The court also clarified that Vermont's patient’s privilege statute (12 V.S.A. § 1612) applies only to judicial proceedings and thus had no bearing on the out-of-court disclosure. Furthermore, Ms. Lawson failed to provide expert testimony regarding the standard of care for CVMC's policies or training, which is required for a negligent supervision claim involving matters outside the ordinary knowledge of laypersons.
Analysis:
This case clarifies the scope of HIPAA's 'serious and imminent threat' exception, affirming that healthcare providers have latitude to disclose protected health information to avert immediate dangers to patient or public safety, such as impaired driving. It emphasizes that such disclosures, made in good faith and based on actual knowledge, fall within permissible boundaries, shielding providers from liability for alleged breaches of confidentiality. The ruling also reinforces the procedural requirement for expert testimony in medical negligence claims that pertain to specialized standards of care or institutional policy, setting a precedent for future challenges to hospital protocols.
