Petitioner Eisenhower Medical Center (EMC) seeks writ review of an order denying its motion for summary adjudication of a cause of action under the Confidentiality of Medical Information Act (CMIA). (Civ. Code, § 56 et seq.).
A computer was stolen from EMC on March 11, 2011, containing an index of over 500,000 persons to whom EMC had assigned a clerical record number dating back to the 1980's. The information included each person's name, medical record number (MRN), age, date of birth, and last four digits of the person's Social Security number (SSN). This information on the computer was password protected but not encrypted. A couple of weeks later, EMC sent out notice to these individuals informing them of the theft.
Real parties in interest (Plaintiffs) are a few of the individuals whose names were on the index. They filed the underlying action as a putative class action against EMC seeking nominal damages of $1,000 each under the CMIA. The complaint also includes a second cause of action for violation of the Customer Records Act (CRA) (§ 1798.82), which requires notification to consumers when security systems are breached.
EMC moved for summary judgment or adjudication contending that the theft of the computer did not result in a disclosure of medical information of any of the listed persons. Information about an individual's medical history, condition, or treatment is saved only on EMC's servers located in the data center. The index that was on the stolen computer is a subset of information from its master patient index and can be used in case of a power outage or network failure to look up the patient's MRN so that a hard copy of the medical records can be located. The MRN is sequential and contains no
EMC also pointed out that, upon inquiry, a general acute care hospital may disclose without consent the name, address, age, sex, and a general description of the reasons for treatment of a patient. (§ 56.16.)
As for the second cause of action under the CRA, EMC contended that it did not disclose "personal information," which includes a person's name and any of five data elements, including SSN and medical information. A truncated SSN does not qualify, it argued. In any case, it provided timely notice as required under the CRA.
Plaintiffs' opposition first contended that the summary judgment motion is moot because after filing it, they amended the complaint to allege two other computers were stolen in January 2011 resulting in violations of the CMIA. Plaintiffs also argued that EMC had reported the theft of the computer as a breach to federal authorities, the Department of Health and Human Services (HHS), so it must be considered a breach of the CMIA. Plaintiffs primarily argued that the mere fact that a person's name is on the index reveals that he or she was a patient and, thus, there has been a release of medical history. Finally, they assert that the information on the index could be used to hack into the database and perhaps access a patient's medical information.
The trial court denied summary judgment and adjudication. First, it noted that the motion did not address recent amendments to the complaint regarding additional incidents. Its denial was based principally on its belief that the fact that a person was a patient at the hospital is medical information within the meaning of the CMIA. Its order stated that it found EMC had not sustained its burden of proof that there were no triable issues of fact.
EMC seeks review only as to the first cause of action for breach under the CMIA arising from the March 2011 theft. It does not challenge the denial of summary adjudication as to the causes of action arising from the January thefts or under the CRA.
The CMIA provides that no health care provider shall disclose or release medical information regarding a patient of the provider without first obtaining authorization. It specifically provides that an individual may recover $1,000 nominal damages against any person or entity who has negligently released his confidential medical information. The individual does not have to show that he suffered or was threatened with actual damages in order to recover the $1,000. (§ 56.36, subd. (b)(1).)
Section 56.05, former subdivision (g), defined "medical information" as "any individually identifiable information, in electronic or physical form, in possession of or derived from a provider of health care, health care service plan, pharmaceutical company, or contractor regarding a patient's medical history, mental or physical condition, or treatment. `Individually identifiable' means that the medical information includes or contains any element of personal identifying information sufficient to allow identification of the
Another rule of statutory construction is to give effect, whenever possible, to the statute as a whole, and to every word and clause thereof, leaving no part of the provision useless or deprived of meaning. (California Assn. of Psychology Providers v. Rank (1990) 51 Cal.3d 1, 18 [270 Cal.Rptr. 796, 793 P.2d 2].) Applying these rules, the mere fact that a person may have been a patient at the hospital at some time is not sufficient. If interpreted as Plaintiffs wish, then release by a health care provider of personal identification would be sufficient whether or not there was a release of substantive information regarding that person's medical condition, history, or treatment. Under that construction, the fact that an individual's name is on a list released by doctor X or clinic Y is sufficient to violate the law because then it is assumed that the individual was a patient of the latter at some point. Such a construction does not comport with the plain and reasonable meaning of the statute and would render meaningless the clause "regarding a patient's medical history, mental or physical condition, or treatment."
Plaintiffs assert that a patient's medical history must include the fact that one has had medical treatment of sufficiently serious nature to warrant assignment of an MRN and inclusion in EMC's permanent index of EMC patients. However, there is no showing that assignment of an MRN signifies
In this regard, it is noteworthy that the CMIA allows acute care hospitals to disclose certain patient information upon demand under section 56.16.
Lastly, Plaintiffs have contended that EMC's report to HHS of the theft of the desktop computer as a breach of health information is an admission that the index constitutes medical information within the meaning of section 56.05, former subdivision (g). However, the definition of "individually identifiable health information"
Let a peremptory writ of mandate issue directing the Superior Court of Riverside County to set aside its order denying summary adjudication as to the first cause of action for breach under the CMIA arising from the March 2011 theft and to issue a new order granting the motion in accordance with the views expressed herein.
Petitioner is directed to prepare and have the peremptory writ of mandate issued, copies served, and the original filed with the clerk of this court, together with proof of service on all parties.
EMC is to recover its costs.
Richli, J., and King, J., concurred.