## Facts

- John Doe, an HIV-positive patient, worked a night janitorial job and had not disclosed his HIV status to co-workers.
- Medlantic Health Care Group, Inc. owned Washington Hospital Center (WHC), where Doe received emergency and follow-up care in April 1996.
- A night-shift co-worker, Tijuana Goldring, also worked as a temporary WHC receptionist with access to hospital systems.
- After Doe visited WHC, co-workers began gossiping that he had AIDS or was HIV-positive.
- Evidence supported that Goldring accessed Doe’s confidential WHC medical information without authorization and disclosed it to their co-workers, leading to ridicule at work.
- On May 20, 1996, Doe confronted Goldring and another co-worker and testified he then first had sufficient confirmation that Goldring was the source and that the information came from WHC.
- Doe sued Medlantic on May 20, 1997, including a claim for breach of confidential relationship based on negligent protection of his medical records.
- A jury found for Doe and awarded $250,000 on the breach of confidential relationship claim, but the trial court entered judgment notwithstanding the verdict (JNOV) for Medlantic on statute-of-limitations grounds.

## Issues

1. Under the discovery rule, when did Doe’s breach-of-confidential-relationship claim accrue, and was Doe on inquiry notice of Medlantic’s possible wrongdoing more than one year before suit?
2. Was expert testimony required to establish the standard of care for protecting the confidentiality of medical records, and was the evidence sufficient to show breach and causation?
3. Did evidentiary rulings, weight-of-the-evidence concerns, or alleged attorney misconduct require judgment for Medlantic or a new trial?

## Decision

- The appellate court reversed the JNOV and remanded with instructions to reinstate the jury’s verdict and enter judgment for Doe.
- The court held the accrual/inquiry-notice question was for the jury on this record; the trial judge improperly displaced the jury’s determination.
- The court held expert testimony was not required to establish the confidentiality standard of care in this context and that the evidence permitted a finding that Medlantic breached its duty and caused Doe’s injury.
- The court rejected Medlantic’s cross-appeal arguments concerning hearsay, sufficiency of the evidence, and alleged trial misconduct.

## Legal Principles

- Under the discovery rule, a claim accrues when the plaintiff knows or reasonably should know of the injury, its factual cause, and some evidence of wrongdoing; “inquiry notice” turns on what would be learned after reasonable investigation.
- When discovery-rule accrual depends on disputed facts and competing inferences, the accrual date is generally a fact question for the jury, not a matter for JNOV.
- Breach of a confidential relationship may be shown by unconsented, unprivileged disclosure of nonpublic information learned within a confidential relationship; the patient-provider relationship imposes a heightened duty to maintain medical confidentiality.
- Expert testimony is not required where the confidentiality precautions and lapses are within ordinary juror understanding.
- Evidence of inadequate enforcement of confidentiality protections, unauthorized access to records, and subsequent disclosure can support findings of breach and causation.

## Conclusion

The court ordered reinstatement of the jury’s verdict for an HIV-positive patient, holding that discovery-rule accrual and inquiry notice were properly resolved by the jury and that the patient could prove breach of medical confidentiality without expert testimony where the alleged lapses were understandable to lay jurors.


Doe v. Medlantic Health Care Grp., Inc., 814 A.2d 939 (D.C. 2003)