Univ. of Va. Med. Ctr. v. Jordan — Feb. 2016 (Summary)

WRONGFUL TERMINATION

Univ. of Va. Med. Ctr. v. Jordan
No. 0790–15–2 (Va. Ct. App. Feb. 2, 2016)

The Court of Appeals of Virginia affirmed the ruling of a hearing officer that a state-employed nurse who accessed the medical record of her sick ex-husband, at his request and after he signed appropriate authorization forms, should be reinstated and awarded back pay.

The ex-husband suffered from an advanced stage of multiple myeloma, and he was treated for this disease at the same medical center where the nurse was employed. The nurse and her ex-husband remained close after their divorce, and he executed a number of documents providing the nurse with access to his medical records, including a durable power of attorney, an advanced medical directive, and an authorization form. At her ex-husband’s request, the nurse accessed his medical record to help him understand the significance of some of his test results. An internal audit by the medical center revealed the nurse had accessed her ex-husband’s medical record four times. When questioned by the medical center, the nurse explained she had accessed the records on her ex-husband’s behalf. The ex-husband corroborated the story.

The medical center sought to fire the nurse for “serious misconduct” resulting from numerous violations of company policy. The nurse filed a grievance challenging the medical center’s action, and a hearing officer ruled in her favor. The hearing officer’s decision was affirmed by the Department of Human Resources Management and the circuit court. The medical center then appealed to the court of appeals.

The medical center framed the issue for the appellate court as follows: “The fundamental questions on appeal are whether the Medical Center may develop and enforce policies containing rules that limit employee access to an electronic medical record which it owns and is its property under Virginia law and whether any employee of the Medical Center can authorize another employee to intentionally violate prohibitions and rules established in those policies.”

The court of appeals noted that under state law governing the review of personnel actions by state agencies, it had no authority to second-guess whether the hearing officer correctly interpreted agency policy. The court of appeals could only review whether the hearing officer’s decision was “contradictory to law.” The court ruled that it was not contradictory.

The court of appeals held the nurse was acting as an agent on behalf of her ex-husband when she accessed his medical records for his benefit and at his direction. Furthermore, the court of appeals held that no provision in HIPAA prevented the disclosure because the nurse was acting on her ex-husband’s behalf and he had filled out the necessary authorization form.

The medical center argued that it would be impossible to audit and account for these types of disclosures. The court of appeals rejected the argument, noting that an internal audit had revealed the disclosures and that the medical center need not account for disclosures of patients’ private health information that is made to patients themselves.