Lost $5,000 Because Assistant Revealed Personal Health Information...
(Oklahoma City, OK)
I attended a consultation with a local cosmetic surgeon for a breast augmentation, specifically, a "remove and replace" due to the fact I have had my current implants just over twenty years. The consultation went well and I was provided with an estimate of medical fees to which I was very pleased.
Due to the fact that my mother offered to pay for the surgery, I advised my mother of the amount of the surgery as well as the amount required at the time of scheduling. I did not offer any more information, as frankly, it was none of her business. She was very pleased to hear that the cost was so reasonable and, as agreed, went to the doctor's office to give them the down payment.
After completing that transaction, she asked the assistant who helped her how big the implants were going to be. The assistant replied, "It says here that she wants double C." The assistant then went on to make comments about how that might give me back problems, etc.
My mother left their office in a borderline panic and called me when she got back home. She commented of her disapproval of the size (not knowing that "double C" is what I currently have), that the assistant said I had requested.
She finished the conversation telling me that she had changed her mind and refused to pay for the surgery because of what she learned from her visit to the doctor's office. By the time our conversation ended we were both screaming at each other.
The following day I contacted the doctor's office and spoke to the assistant who handled the transaction with my mother. I asked her to relay to me the details of the conversation she had with my mother, leaving nothing out. She replied that my mother asked about the size, etc. so she advised her of the notes indicating a "double C,", etc.
It was pretty much exactly what I heard from my mother so I knew then that the conversation occurred, without doubt, just as my mother explained. Already knowing that I did not sign any paperwork during the consultation, I sarcastically asked her, "Did I sign some sort of waiver giving you permission to share such information with any person other than myself?" She responded, "well.....no..."
My response was "so it's my understanding that because I did not sign any type of medical release of information, that my HIPAA rights have just been violated. Do you agree?" Surprisingly, her response was, "wellllll....yesssss....."
I immediately demanded to speak with the doctor and she quickly put me on hold. After a couple minutes she got back on the line and said the doctor was busy and that the office manager would call me back so we hung up. Not ten minutes later I received a call from the office manager. She expressed their deepest apologies and asked what they could "do to make it up to you me."
I told her I was unsure and asked her what she thought would be fair. She asked if I would submit a formal written complaint of the facts occurring so she could put a copy in the assistant's file (I am assuming as a reprimand), and also to present to administration to see what they suggested.
I have not done that yet because I would like to know what this case is worth. The financial loss that occurred in this case would be the $5,000 my mother had previously agreed to pay for the surgery, before her unauthorized and inappropriate conversation with the big mouth assistant. Please advise me soon as I am working on my demand letter as we speak. Thank you.
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ANSWER for "Lost $5,000 Because Assistant Revealed Personal Health Information...":
Stephanie (Oklahoma City, OK):
You really don't have much of a case against the cosmetic surgeon or his employees. While HIPAA rules are quite strict, it would be entirely unreasonable for the cosmetic surgeon or her employees to have to hide from your mother the type of surgery she was about to pay for.
Taking your side for a moment, would you have preferred the employee give your mother a "blank" invoice with only the amount due at the bottom? Your mother, as the person paying for a specific medical procedure, had a right to know what she was paying for.
Your claim might have some substance if, before your mother came in to pay the invoice, you had previously told the employee you preferred she not disclose what your mother was about to pay for. Yet, you didn't appear to do that.
If you are thinking about pursuing a HIPAA claim for damages you will need the services of a skilled personal injury attorney with substantial experience in HIPAA matters.
You can't successfully pursue a HIPAA claim on your own. To pursue such a claim means you would have to take on the surgeon's insurance company's attorneys. You can be confident they will not settle such a claim, and you aren't equipped to represent yourself in the required pretrial depositions, interrogatories, pretrial hearings, and the actual trial.
Moreover, it's likely once in trial you would have to call your own mother as an adverse, or hostile witness.
In the likely event you lose the case, the surgeon's insurance company attorneys would have the right to petition the judge to order you pay for all of their legal fees. This would likely be many thousands of dollars.
You can always file a complaint against the surgeon's office (known as a "covered entity") with the U.S. Department of Health and Human Services, Office of Civil Rights. However, doing so would not entitle you to any monetary compensation.
The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.
Best of luck,
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