## Facts

- Larry L. Horne was treated by Dr. William B. Patton for consideration.
- Horne expressly instructed Patton not to release medical information to Horne’s employer.
- Patton allegedly disclosed Horne’s medical information to the employer without authorization.
- Horne alleged the physician–patient relationship was confidential and created a fiduciary duty of nondisclosure, which Patton breached.
- Horne alleged the disclosure constituted an invasion of privacy and also breached an implied contractual promise of confidentiality arising from medical custom and practice.
- Horne claimed the disclosure proximately caused his termination from employment.
- The trial court sustained demurrers to the complaint as amended; Horne took a voluntary nonsuit and appealed.

## Issues

1. Whether a physician owes a legally enforceable duty to keep patient medical information confidential against unauthorized, extra-judicial disclosure to third parties.
2. Whether allegations of unauthorized disclosure to an employer state claims for (a) breach of fiduciary/confidential duty in tort, (b) invasion of privacy, and/or (c) breach of an implied contract of confidentiality sufficient to withstand demurrer.

## Decision

- The Alabama Supreme Court reversed the judgment sustaining the demurrers and remanded.
- The court held that a physician owes a patient a legal duty of confidentiality regarding information obtained in treatment.
- The court held that unauthorized extra-judicial disclosure can support an action for damages in tort and, depending on pleadings, may also support privacy and implied contract theories.
- The court concluded the amended complaint alleged sufficient facts (confidential relationship, instruction not to disclose, unauthorized disclosure, and proximate harm) to require an answer rather than dismissal at the demurrer stage.

## Legal Principles

- The physician–patient relationship is a confidential relationship that can give rise to a legal duty not to disclose patient information without authorization.
- Unauthorized extra-judicial disclosure of confidential medical information may be actionable in tort for breach of a duty arising from the confidential relationship.
- The absence or scope of testimonial or evidentiary privilege does not control civil liability for voluntary disclosures outside judicial proceedings.
- Unauthorized disclosure of private medical facts may support an invasion-of-privacy claim.
- A confidentiality obligation may also be pleaded as an implied contractual promise based on medical custom and the patient’s reasonable expectation of nondisclosure.
- At the demurrer stage, the court tests legal sufficiency of the pleaded facts, assuming them true, rather than deciding ultimate liability.

## Conclusion

The court recognized a physician’s common-law duty to maintain confidentiality of patient information and held that allegations of unauthorized disclosure to a third party, with resulting harm, stated cognizable claims sufficient to survive demurrer.


Horne v. Patton, 287 So. 2d 824 (Ala. 1973)