Mull v. String
448 So. 2d 952 (1984)
Rule of Law:
When a patient files a lawsuit against a third party that places their medical condition at issue, the patient is deemed to have waived their right to confidentiality, permitting their physician to disclose legally discoverable medical information to that specific defendant or their attorney without authorization.
Facts:
- Rast Mull was treated at Providence Hospital where he claimed he was burned by a heating pad.
- Dr. Samuel Timothy String treated Mull for the burn injury.
- Mull initiated a malpractice action against Providence Hospital regarding the burn.
- Mull's attorney requested a medical report from Dr. String, providing an authorization that explicitly instructed Dr. String not to disclose information to any person without Mull's prior written consent.
- Dr. String sent a letter report detailing Mull's diagnosis and prognosis to Mull's attorney.
- Without Mull's authorization, Dr. String forwarded a copy of this same letter report to Providence Hospital and its attorney.
- Mull also alleged that Dr. String verbally disclosed his medical opinions to other, unspecified individuals without consent.
Procedural Posture:
- Rast Mull filed suit against Dr. Samuel Timothy String in an Alabama circuit court (trial court), alleging breach of fiduciary duty and breach of implied contract.
- Dr. String filed a motion to dismiss the action for failure to state a claim upon which relief could be granted.
- The trial court granted Dr. String's motion to dismiss.
- Mull, as appellant, appealed the dismissal to the Supreme Court of Alabama, with Dr. String as appellee.
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Issue:
Does a physician breach their duty of confidentiality by disclosing a patient's medical information without consent to a third party whom the patient is suing for an injury related to that information, and to other unrelated parties?
Opinions:
Majority - Almon, Justice
No, as to the defendant in the underlying litigation, but Yes, as to other unrelated parties. A patient who initiates litigation concerning their physical condition effectively waives their right to non-disclosure of medical information that would be legally discoverable by the defendant in that lawsuit. This creates a narrow exception to the physician's duty of confidentiality, allowing disclosure to that defendant and their attorney. The court's reasoning rests on the public's interest in the full disclosure of relevant facts to ensure a just disposition of the controversy, an interest which the patient invokes by filing the suit. This is further supported by Alabama's lack of a statutory physician-patient testimonial privilege. However, this waiver is strictly limited and does not permit disclosures to unrelated third parties, as that would undermine the fundamental patient privacy interests recognized in Horne v. Patton. Therefore, Mull's claim regarding Dr. String's disclosure to the hospital was properly dismissed, but his claim regarding disclosures to 'others' states a valid cause of action.
Analysis:
This decision establishes a significant, limited exception to the physician's duty of confidentiality previously established in Alabama by Horne v. Patton. The court balances the patient's privacy rights against the procedural needs of the justice system, concluding that filing a lawsuit acts as a targeted waiver of confidentiality. This precedent clarifies that while a plaintiff's medical history becomes an open book to the opposing party in litigation, the physician's broader duty to protect that information from public disclosure remains intact. This ruling provides guidance for physicians and attorneys on the permissible scope of informal, extra-judicial disclosures once a patient's medical condition is put at issue in a legal proceeding.
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