Extent of burden of proof. 'Unintentional' non-authorized disclosure of records to hospice.

Question

Patient was referred to hospice based on hospitalization record of proven non-existent terminal disease, 
recorded on admission to hospital; 
Recorded by doctor who referred patient to hospital, thus knew that terminal disease was non-existent; 
And record of hospitalization - released by hospital to hospice without authorization -exist, with evidence that records were from hospital software. 
 
Plaintiff still has more burden to prove who exactly did it, regardless all obstacles and objections of defense? 
 
Does law allow defense to argue that unauthorized release of plaintiff's records to hospice was unintentional?

James L. Arrasmith · Answer

Under California law, the plaintiff generally has the burden of proof to establish their case by a preponderance of the evidence. However, in the context of unauthorized disclosure of medical records, there are a few key considerations: 
 
1. California Confidentiality of Medical Information Act (CMIA): This law prohibits healthcare providers from disclosing a patient's medical information without authorization, with some exceptions. If a violation of the CMIA is established, the plaintiff may be entitled to nominal damages of $1,000, even without proving actual damages (Cal. Civ. Code § 56.36(b)(1)). 
 
2. Intentional vs. Unintentional Disclosure: The CMIA does not differentiate between intentional and unintentional disclosures. However, if the disclosure was due to negligence (unintentional), the plaintiff must prove actual damages to recover more than the $1,000 nominal damages (Cal. Civ. Code § 56.36(b)(2)). 
 
3. Identifying the Disclosing Party: The plaintiff has the burden to prove that the defendant healthcare provider disclosed the information. However, if the plaintiff can establish that the records existed in the defendant's custody and were subsequently disclosed to an unauthorized party, the burden may shift to the defendant to prove they did not disclose the information. 
 
4. Obstacles and Objections: The court has the discretion to manage the discovery process and rule on objections. If the defense raises unreasonable obstacles or objections, the plaintiff can seek the court's intervention to compel cooperation or disclosure of evidence. 
 
In summary, while the plaintiff bears the initial burden of proof, the law does not allow the defense to argue that an unauthorized release was unintentional as a complete defense. The plaintiff must establish that the disclosure occurred and that the defendant was responsible, but the intentionality of the disclosure may affect the available damages. The court can also help manage obstacles and objections raised by the defense during the discovery process.

Q: Extent of burden of proof. 'Unintentional' non-authorized disclosure of records to hospice.