Robley v. Blue Cross/Blue Shield of Miss.
| Docket Number: | 2003-CT-02209-SCT Linked Case(s): 2003-CA-02209-COA ; 2003-CT-02209-SCT ; 2003-CA-02209-COA |
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| Supreme Court: | Opinion Link Opinion Date: 08-10-2006 Opinion Author: COBB, P.J. Holding: THE JUDGMENT OF THE COURT OF APPEALS IS AFFIRMED IN PART AND REVERSED IN PART. THE JUDGMENT OF THE CIRCUIT COURT OF HARRISON COUNTY IS AFFIRMED IN PART AND REVERSED AND REMANDED IN PART |
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| Additional Case Information: |
Topic: Breach of confidentiality - Fiduciary duty - Intentional infliction of emotional distress Judge(s) Concurring: SMITH, C.J., WALLER, P.J., CARLSON, DICKINSON AND RANDOLPH, JJ. Judge(s) Concurring Separately: EASLEY, J. CONCURS IN PART WITHOUT SEPARATE WRITTE Concur in Part, Concur in Result 1: Easley, J. Concurs in Part Concur in Part, Dissent in Part 1: Graves, J., Concurs in Part and Dissents in Part Without Separate Written Opinion Concurs in Result Only: DIAZ J. Procedural History: Jury Trial Nature of the Case: CIVIL - OTHER Writ of Certiorari: Granted Appealed from Court of Appeals |
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| Trial Court: |
Date of Trial Judgment: 09-05-2003 Appealed from: Harrison County Circuit Court Judge: Jerry O. Terry, Sr. Disposition: At the close of the Appellant's case in chief, trial court granted a directed verdict in favor of Appellee. Case Number: A2402-99-00016 |
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| Note: | The Judgment of the Court of Appeals is Affirmed in Part and Reversed in Part. See the original COA opinion at http://www.mssc.state.ms.us/Images/Opinions/CO27254.pdf | |
| Party Name: | Attorney Name: | |||
| Appellant: | CHERYL ROBLEY, PH.D. |
PAUL J. DELCAMBRE, Jr. |
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| Appellee: | BLUE CROSS/BLUE SHIELD OF MISSISSIPPI | JAMES ALTUS McCULLOUGH, II, CHERI D. GREEN, WHITNEY MORGAN STONE |
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Synopsis provided by:  If you are interested in subscribing to the weekly synopses of all Mississippi Supreme Court and Court of Appeals hand downs please contact Tammy Upton in the MLI Press office. |
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| Topic: | Breach of confidentiality - Fiduciary duty - Intentional infliction of emotional distress |
| Summary of the Facts: | : Under a group health insurance contract sponsored by her husband’s employer, Dr. Cheryl Robley and their daughter Kelly had dependent health care coverage. During the 1980's Robley began experiencing severe migraine headaches, and her efforts to treat them failed. As a part of her treatment for the headaches, Robley was prescribed narcotic medication by her physicians. Blue Cross, as Robley’s insurer, was privy to her medical records, including her prescriptions for narcotic medications. In February 1997, Kelly was hospitalized several times at Gulf Coast Community Hospital and its affiliated Wound Care Center in Biloxi for treatment for severe deep abscesses which required continual care after her release, including attending to and rewrapping their dressings. Because of Robley’s history with migraines and her husband’s concerns that he could not properly care for Kelly’s wounds, the staff of the Wound Care Center sought approval from Blue Cross for in-home visits by a home healthcare nurse. Paula Mason, R.N., an employee of the Wound Care Center called Blue Cross seeking approval, and spoke with Sandra McFarland, R.N., who worked for Blue Cross and was the case manager assigned to Robley’s plan. According to Mason, McFarland referred to Robley as a “drug seeker”, a derogatory term for someone who abuses prescription narcotic medication despite the fact that they do not need it. Mason relayed McFarland’s comments to Robley’s husband, within hearing distance of Robley and Kelly. Robley filed suit against Blue Cross seeking damages for both intentional and negligent infliction of emotional distress, as well as breach of confidentiality. Blue Cross filed a motion for partial summary judgment as to the claim of intentional infliction of emotional distress which was granted. Blue Cross filed a second motion for summary judgment in regard to the remaining claims, which the trial court denied. After Robley presented her evidence at trial, Blue Cross moved for a directed verdict. The court granted the motion, and Robley appealed. The Court of Appeals reversed and remanded. The Supreme Court granted certiorari. |
| Summary of Opinion Analysis: | Issue 1: Fiduciary duty The Court of Appeals found that the language of the policy, alone, created a fiduciary relationship. Although every contractual agreement does not give rise to a fiduciary relationship, in Mississippi such a relationship may exist under the following circumstances: the activities of the parties go beyond their operating on their own behalf, and the activities are for the benefit of both; where the parties have a common interest and profit from the activities of the other; where the parties repose trust in one another; and where one party has dominion or control over the other. In this case, the policy creates an arm’s-length relationship where medical records will be kept confidential except where, in the discretion of the company, the same should be disclosed. There is no indication from the policy or from the parties’ course of dealings that they acted in any way other than for their own best interests. The relationship was not conducted for mutual profit and Robley had not, nor should she have, reposed any special degree of trust or confidence in Blue Cross. The Court of Appeals applied language to the policy which did not exist. Therefore, the ruling of the trial court that no fiduciary relationship existed under the policy between Robley and Blue Cross is reinstated. Issue 2: Breach of confidentiality The pivotal question in the present case is whether the alleged disclosure of Robley’s medical history occurred and, if so, whether such disclosure was unnecessary and unreasonable. Robley argues that her medical records should not have been released, because her records were not necessary to further Kelly’s treatment and the records were released to Kelly’s physicians and not Robley’s physicians thereby violating confidentiality. Although the language of the policy seems to give broad authority, Blue Cross does not have unfettered discretion to disseminate Robley’s medical records. There still remains a dispute between McFarland and Mason as to whether the term “drug seeker” was used. There was evidence presented at trial by both which contradicts the other’s story. This conflict should have been decided by the jury rather than the judge. This evidence brings into question whether there was a breach of confidentiality. From the trial judge’s bench ruling, it appears the basis of his decision was Robley’s failure to present evidence of damages sufficient to prove a case of negligence. However, Robley’s expert medical witness testified to a reasonable degree of medical certainty that this disclosure could have caused Robley increased levels of stress and anxiety. In order for one to be liable in a negligence action the test is not whether they were able to foresee the particular type of injury suffered, but whether they could foresee an injury would result from their actions. One could foresee an injury might arise from the unnecessary and unreasonable disclosure of confidential medical records. Thus, the issues of negligent infliction of emotional distress and breach of confidentiality remain jury questions. |
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