Confidentiality Under Fire

Psychiatric TimesPsychiatric Times Vol 20 No 6
Volume 20
Issue 6

Confidentiality Under Fire - Poetry of the Times

On February 19, 2001, the Maryland Board of Physician Quality Assurance (BPQA) received a complaint against Eist in reference to his treatment of a mother and her two children. The complaint was filed after a bitter divorce and custody proceeding by the patient's estranged husband, who had announced during the proceedings that he was going to make Eist's life miserable. The BPQA issued a subpoena to Eist to submit the medical records of the mother and her two children to them; BPQA did not notify the mother. The subpoena was signed on March 15, 2001, but was not received by Eist until April 19, 2001.

On April 20, Eist informed the BPQA that, without consent from the mother for the release of confidential information, he would be unable to provide the information. On May 1, Eist informed the mother about the request for her medical records and told her that if she did not respond to him, he would forward the records to BPQA.

Eist received a letter from the children's court-appointed attorney on May 4. The children's attorney determined that it "would not be in the best interest of the children to waive their privilege"; five days later, Eist received a message from the mother stating, "I refused to allow you to release my medical records." In view of those letters, Eist sent BPQA a letter informing it of the refusals and suggested that BPQA contact the attorney for the mother and her two children. On May 14, the attorney for the mother notified BPQA that she would not waive her privilege.

On June 27, BPQA prepared a letter demanding the medical records from Eist, claiming that receipt of the records was not contingent upon the consent of the patients. Eist received the letter July 7, and his attorney responded July 11, reiterating that the patients refused to waive their confidentiality to allow Eist to send the medical records. He requested a response from the BPQA on these issues. Hearing no response, on July 18, another letter was sent requesting a response from BPQA regarding the objections of the mother and her two children to release their medical records. No response from BPQA was received until February 4, 2002. The BPQA broke its silence in a notice saying they were filing charges against Eist for failing to cooperate with their investigation.

On June 6, 2002, Eist filed a motion to dismiss the charges.

On August 14, after hearing the motion, Judge Cathy A. Barchi ruled in favor of Eist.

Despite Judge Barchi's ruling, on January 28, 2003, BPQA ruled "that the patients' consent was not relevant," that Eist "had no legal or ethical excuse" for "failure to produce the records for at least ten months," reprimanded him, and fined him $5,000.

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