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When a Rhode Island television station produced a story on sleep apnea and broadcast a videotape of a local sleep laboratory, a physician and a hospital found themselves co-defendants in a patient’s breach of privacy suit. A ruling in the case of Manocchia v. Narragansett Television illustrates that health care providers are held to high standard when it comes to protecting patients’ interests.


In 1987, Steven Manocchia consulted a physician at Rhode Island Hospital for diagnosis and treatment of a sleep disorder.  To assess Manocchia’s sleep apnea, the physician monitored Manocchia’s brainwave activity and videotaped him during several sleep periods.


Three years after Manocchia was treated, a reporter from Channel 12, a Providence television station, accepted an invitation from Rhode Island Hospital to visit the sleep lab.  Millman gave the reporter an interview and a videotape of one of the sleep studies.  Millman instructed the reporter to either blot out patient faces electronically or show only patients who could not be identified, if the tape was broadcast.

Channel 12 produced a story on sleep apnea and Manocchia recognized himself in an advertisement for the upcoming show.  He promptly called Channel 12’s news director to say he did not give the station permission to use the tape.  Channel 12 broadcast the tape anyway, apparently believing Manocchia would not be identifiable to others.  Manocchia was upset because the film clip showed him rolling fitfully in bed, grunting, and snoring.


Manocchia sued the physician, Rhode Island Hospital, and Channel 12 for unlawfully releasing his personal medical information.  Among other remedies, Manocchia sought punitive damages.  Before the case went to trial, the doctor, the hospital, and the TV station all asked the court to deny Manocchia’s request for possible punitive damages.


Normally, money awarded in a civil suit is meant to compensate a plaintiff for a loss.  Punitive damages -- additional money awarded to punish the defendant or to deter future bad behavior -- are an exception.  In this case, the court’s words were harsh.  The opinion stated that the physician and Rhode Island Hospital released Manocchia’s confidential healthcare information with wanton and willful disregard of the substantially certain harm this action would cause him.


The court dismissed Manocchia’s punitive damages claim against Channel 12, explaining that a different standard applies to the media.  Channel 12 could be liable for punitive damages only if Manocchia could show personal animosity or ill will in their broadcast of the segment.  The court agreed that Channel 12 acted recklessly, but it found no evidence of spite or ill will.

This case looks like an application of inconsistent standards.  However, it illustrates the balance between important American philosophies.  For a media outlet such as Channel 12 to be potentially liable for punitive damages, the court requires evidence of personal animosity or ill will - a standard just shy of an actualintent to harm - because of the tremendous value society places on freedom of the press.  Only the most serious violations of privacy warrant punitive damages against the media under this test. 


The court’s interpretation of the potential liability of the health care providers was undoubtedly informed by a different philosophy, called fiduciary duty.  Certain professionals are called on to protect the people they provide services to - physicians and attorneys are in this group.  With physicians, this responsibility is imposed because society recognizes both the trust and vulnerability created in the physician/ patient relationship.  In this case, the court saw some evidence that the doctor or Rhode Island Hospital did not act vigorously enough to protect Manocchia’s interests, as fiduciary duty required.


Most physicians and hospitals know they need to protect patients’ medical records.  But protecting patients interests requires more than keeping a lock on the file cabinet.  Physicians and hospitals should get consent to publicize almost anything that makes a patient identifiable.  Film clips of patients; photos used in promotional brochures; case presentations at conferences, in articles, or in book chapters all call for extra sensitivity to patient privacy issues.  When a patient hasn’t consented, a physician or hospital should render that patient’s information unidentifiable.


Some responsibilities cannot be delegated under our laws and the responsibilities that arise under physicians’ fiduciary duty are among these.  Although this seems like a burden on physicians, it is also a reflection of the trust society puts in their integrity.

Patients' Confidentiality When Media Interacts with Hospitals

by Attorney Frank E. Reardon

March 1997