Legal Definitions - patient-litigant exception

The patient-litigant exception is a legal principle that allows a patient's confidential medical information to be disclosed in court, even without their explicit consent, when that patient has initiated a lawsuit against a healthcare provider concerning their medical care. Normally, the doctor-patient privilege protects the privacy of discussions and records between a patient and their doctor, preventing them from being revealed in legal proceedings. However, when a patient files a lawsuit, such as a malpractice claim, that directly involves their medical treatment, condition, or the quality of care they received, they are considered to have "put their medical condition at issue." In such circumstances, the law recognizes that the healthcare provider needs access to relevant medical information to properly defend themselves, and the privilege is therefore waived for the specific information pertinent to the lawsuit.

• Example 1: A patient undergoes knee surgery and later sues the orthopedic surgeon, alleging that the surgeon's negligence during the procedure caused permanent nerve damage in their leg. The patient claims the surgeon failed to follow standard surgical protocols.

  Explanation: In this scenario, the patient's medical records related to the knee surgery, pre-operative assessments, post-operative care, and any documentation of the alleged nerve damage become directly relevant to the lawsuit. The patient-litigant exception would apply, allowing the surgeon's legal team to access these records to understand the patient's condition, the treatment provided, and to prepare their defense against the malpractice claim.

• Example 2: A patient sues their psychiatrist, claiming that the doctor improperly prescribed a medication at an unsafe dosage, leading to severe adverse psychological effects and hospitalization. The patient alleges the psychiatrist failed to adequately monitor their condition or adjust the treatment plan.

  Explanation: Here, the patient's mental health records, medication history, therapy notes, and communications with the psychiatrist regarding their symptoms and treatment become central to the legal dispute. The patient-litigant exception would permit the psychiatrist's defense to review these confidential records, as the patient's lawsuit directly challenges the appropriateness and impact of the psychiatric care received.

• Example 3: A patient files a lawsuit against their primary care physician, asserting that the doctor repeatedly failed to diagnose a serious illness despite the patient presenting with clear and persistent symptoms over several months. The patient claims this delay in diagnosis led to a worsening of their condition and required more aggressive treatment.

  Explanation: The patient's medical history, records of their visits to the primary care physician, reported symptoms, the doctor's diagnostic process, and any referrals or tests ordered become crucial evidence in this case. The patient-litigant exception would allow the physician's legal team to access these records to demonstrate the care provided, the information available at the time, and to defend against the allegations of diagnostic negligence.