Doe v. Quest Diagnostics, Inc.

395 S.W.3d 8, 2013 WL 1136512, 2013 Mo. LEXIS 16
CourtSupreme Court of Missouri
DecidedMarch 19, 2013
DocketNo. SC 92790
StatusPublished
Cited by33 cases

This text of 395 S.W.3d 8 (Doe v. Quest Diagnostics, Inc.) is published on Counsel Stack Legal Research, covering Supreme Court of Missouri primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Doe v. Quest Diagnostics, Inc., 395 S.W.3d 8, 2013 WL 1136512, 2013 Mo. LEXIS 16 (Mo. 2013).

Opinion

LAURA DENVIR STITH, Judge.

John Doe appeals the trial court’s judgment in favor of Quest Diagnostics Clinical Laboratories, Inc. (Quest Laboratories) on Mr. Doe’s claim for wrongful disclosure of his Human Immunodeficiency Virus (HIV) test results in violation of Missouri statutory requirements. He argues that the trial [11]*11court should not have submitted an affirmative defense instruction requiring the jury to find for Quest Laboratories if it found that Mr. Doe gave Quest Laboratories “written authorization” to disclose his HIV test results, as there was no substantial evidence that he provided any such “written authorization.”

This Court agrees and reverses the judgment in favor of Quest Laboratories on this count. A jury instruction must be supported by substantial evidence. Section 191.656.2(l)(c)1 requires a written authorization for disclosure by the subject of the test. Here there was no evidence that Mr. Doe provided such a written authorization. The trial court committed prejudicial error in submitting the question whether Mr. Doe’s action in handing a form to the laboratory on which a doctor’s assistant had written a facsimile number in a box entitled “Ordering Physician and/or Payors ” should be considered a written authorization by Mr. Doe.

Mr. Doe also appeals the judgment against him on his claim that Quest breached a fiduciary duty to him in disclosing the test results because the instruction wrongly, he contends, required the jury to find that Quest Laboratories was negligent. No Missouri case or case in other jurisdictions has been cited that has recognized such a relationship between laboratory and patient. This Court need not reach the issue whether it would recognize such a relationship if the necessary proof of trust and confidence were shown and if there were no other available remedy for a breach of confidentiality. Here, section 191.656 already imposes a duty of confidentiality and creates a remedy for its breach. Where an adequate remedy at law already exists under Missouri statute, this Court will not create a new equitable remedy as requested by Mr. Doe.

This Court also affirms the trial court’s grant of a directed verdict to Quest Laboratories’ parent, Quest Diagnostics, Inc. (Quest Diagnostics). Mr. Doe failed to show that it was directly liable for the alleged tortious conduct or that the corporate veil should be pierced so that it could be held liable for the torts of its subsidiary, Quest Laboratories.2 Finally, this Court rejects Quest’s argument that Mr. Doe’s claims should never have been submitted to the jury because he did not file an affidavit of merit pursuant to section 538.225, RSMo. The purpose of the affidavit requirement of section 538.225 is to avoid ungrounded medical malpractice claims. Mr. Doe’s claim is not one of medical malpractice but breach of a statutorily imposed duty of confidentiality.

The judgment is reversed in part, and the case is remanded.

I. FACTUAL AND PROCEDURAL BACKGROUND

John Doe has been living with HIV since about 1999. In order to determine whether Mr. Doe’s medication regime is successfully suppressing the virus, his physician, Matthew German, M.D., has routinely ordered certain laboratory tests to be performed on his blood. On July 24, 2006, Dr. German completed a “requisition” form, directing Quest to perform two such tests on Mr. Doe’s blood. The requisition form is a written order to the laboratory setting out what tests are to be performed as well as to whom, how and where the results are [12]*12to be reported. Dr. German and his medical assistant, Faith Mustone, completed the form and gave it to Mr. Doe to take to Quest, but Mr. Doe accidentally left the form in Dr. German’s office. When he realized he had forgotten the form, Mr. Doe telephoned Ms. Mustone. She said he could come back and get a new requisition form or she could fax one to him at the Wayman A.M.E. Church, where Mr. Doe worked as a personal assistant to the pastor. Mr. Doe requested that the form be faxed, and he gave her the number “3xx-xxx8.”

In the upper, left-hand quadrant of the requisition form was a two-inch-by-four-inch box titled “Ordering Physician and/or Payors.” The box contained the names of three physicians and had a checkmark next to Dr. German’s name, meaning that Dr. German was the ordering physician. The remainder of the box was empty white space. Dr. German and Ms. Mustone would sometimes use the empty space to order tests that were not listed or to provide the laboratory with billing information for insurance providers. It was in this box on Mr. Doe’s requisition form that Ms. Mustone wrote “Faxed to 3xx-xxx8” to indicate that she had sent the form by fax to the number provided by Mr. Doe. Mr. Doe received the faxed form at the church and took it with him to the Quest office in the Central West End of the City of St. Louis to have the blood work done.

A Quest patient services supervisor testified that when a patient comes into Quest for testing, a phlebotomist enters the information from the requisition form into a computer system. The phlebotomist then prints out a computerized requisition form, which contains the entered information. Mary Petty was the phlebotomist who entered Mr. Doe’s information and drew his blood. Ms. Petty later testified that she interpreted the notation made by Ms. Mu-stone on the original requisition form, “Faxed to 3xx-xxx8,” as a directive to fax Mr. Doe’s test results to the number indicated. She thought this even though on Mr. Doe’s requisition form there was a box labeled “Fax results to,” and that box was blank, containing neither a number nor a signature. Ms. Petty testified that she nonetheless thought the form directed her where to fax the test results because she had noticed that doctors commonly ignored the box provided for fax numbers and instead wrote their sending directives in the larger, blank space above — the location where Ms. Mustone wrote the church fax number. She also said that doctors use a variety of terms to indicate a fax request, including “FAX,” “FX,” “FA,” “F” and “Faxed.”

For these reasons, although she did not have a signed authorization from Mr. Doe to send his test results to anyone other than him or his doctor, Ms. Petty said she had no basis to question that Mr. Doe’s results were to be sent to the number written in the blank space of his requisition form and entered “FAX 3xx-xxx8” into the Quest computer system, and this number then appeared on the computerized requisition form. At no point did Ms. Petty discuss the “Faxed to” notation with Mr. Doe, Dr. German or Ms. Mustone to clarify its meaning, nor did she say she believed that the patient had placed the “faxed to” notation in the blank space in the top box.

After a patient’s blood is drawn, the phlebotomist writes the patient’s name on the sample, initializes the computerized requisition form, and sends the computerized form, original requisition form and sample to the main laboratory for testing. The day after Mr. Doe’s blood draw, he went on vacation. In the meantime, Quest generated the test results and faxed to Dr. [13]*13German and to 3xx-xxx8 a two-page report along with a cover letter indicating that the fax contained confidential medical information. Dr. German indicated that it would be difficult for someone without medical knowledge to interpret the results, but the report clearly contains three references to HIV.

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Cite This Page — Counsel Stack

Bluebook (online)
395 S.W.3d 8, 2013 WL 1136512, 2013 Mo. LEXIS 16, Counsel Stack Legal Research, https://law.counselstack.com/opinion/doe-v-quest-diagnostics-inc-mo-2013.