## Facts

- In a marital dissolution proceeding, the parents disputed whether the father could safely share custody of their four-year-old son.
- The mother alleged the father had recurring “seizures” with frightening physical symptoms, impaired speech, and vomiting, often upon waking.
- The father denied a seizure disorder, claiming a medication-controlled “tic.”
- The father submitted a declaration from his treating neurologist stating the condition was controlled and posed no neurological barrier to caring for the child.
- The trial court granted the mother primary physical custody and the father “unrestricted secondary physical custody,” after initially imposing temporary driving limits pending more information.
- The mother subpoenaed medical records from two other physicians who treated the father, seeking all records relating to his treatment.
- The father moved to quash both subpoenas based on physician–patient privilege; the trial court quashed both.
- The mother sought writ relief to compel discovery of the records.

## Issues

1. Whether the father waived physician–patient privilege as to any records held by one treating physician, making the trial court’s blanket order quashing that subpoena an abuse of discretion.
2. Whether the father waived physician–patient privilege as to records held by a different treating physician such that quashing that subpoena was error.
3. Whether the father’s constitutional privacy right barred discovery of medical records in the custody dispute notwithstanding any statutory waiver.

## Decision

- The court granted writ relief in part and denied it in part.
- The trial court abused its discretion by quashing the subpoena to Dr. Cohen because the father waived privilege as to certain communications/records by discussing his condition in the mother’s presence, rendering those communications non-confidential.
- The trial court did not abuse its discretion by quashing the subpoena to Dr. Morrison because the mother did not establish waiver as to that physician’s records, which remained privileged.
- The father’s constitutional privacy interest in medical records did not categorically bar discovery; the child’s best interests could justify limited disclosure, with protective measures to reduce unnecessary exposure.
- The matter was returned for further proceedings consistent with these rulings, including tailored protections for any production.

## Legal Principles

- Physician–patient privilege protects confidential communications; communications made in the presence of a third party are not confidential and fall outside the privilege.
- Waiver of physician–patient privilege is limited in scope; waiver as to one physician or one set of communications does not automatically extend to all treating physicians or all medical records.
- Medical records implicate constitutional privacy rights, but the privacy right is qualified and may yield to a compelling interest, including a court’s need for accurate information to decide child custody and safety.
- When disclosure is justified, courts should use narrowly tailored protective procedures (e.g., in camera review, redaction, and limits on use and dissemination) to confine disclosure to what is necessary for the custody determination.

## Conclusion

The court required production of only those medical records as to which the father’s privilege was waived by non-confidential communications with one physician, upheld the privilege for records held by another physician absent a waiver showing, and held that privacy concerns in custody litigation call for careful balancing and protective limits rather than categorical nondisclosure.


Manela v. Superior Court, 177 Cal. App. 4th 1139, 99 Cal. Rptr. 3d 736 (Cal. Ct. App. 2009)