Mass. high court weighs privacy of medical records versus public access in malpractice tribunals

BOSTON — The Supreme Judicial Court of Massachusetts heard lawyers’ arguments over whether medical records should be presumptively removed from the public docket in medical‑malpractice proceedings and whether an offer of proof that omitted provider names and standards of care could support tribunal review.

Attorney Chris Sopcich, representing the plaintiff in Kentisha DeSantis v. Beth Israel Deaconess Hospital Milton Inc., told the court medical records are confidential under federal and state law and that, given modern, voluminous electronic records, they “by themselves are good cause.” He said plaintiffs should not be forced “to be victimized twice” by having their full histories publicly accessible online in order to pursue claims.

The issue matters because courts balance the public’s common‑law and constitutional right of access to court records against individual privacy and statutory protections such as the Health Insurance Portability and Accountability Act. Sopcich argued that routine electronic medical files and copy‑and‑paste notes today make traditional public access more intrusive and that many courts already impound medical records routinely.

Appellees’ attorney Megan Pimentel countered that while individuals retain privacy interests in medical information generally, litigation creates carve‑outs and courts must apply the established good‑cause balancing test. She told the justices the plaintiff’s offer of proof in this case was “wholly deficient” because it grouped potential providers together, did not name individual providers, and failed to explain the applicable standard of care for each specialty involved. Pimentel said those defects meant the tribunal lacked the particulars it needed to evaluate the claim even apart from the impoundment issue.

The procedural posture is disputed at the center of the argument. The trial judge denied the plaintiff’s initial motion to impound medical records without prejudice and invited a more particularized showing. The plaintiff did not file the medical‑record exhibits after that ruling; the plaintiff appealed the impoundment denial to a single justice, and the single‑justice denial was reaffirmed. The plaintiff’s offer of proof, filed without the underlying records, was found insufficient by the tribunal based on its content and the court’s standards for offers of proof in medical‑malpractice proceedings.

Justices asked whether plaintiffs could have narrowed or redacted records or placed a narrative summary into the offer of proof. Sopcich acknowledged plaintiffs can submit narratives or redacted excerpts but said such steps often are impractical: a single clinical note can expand into many printed pages in electronic medical records, and extensive redaction invites disputes about completeness. Pimentel emphasized that the rules and precedent require a level of specificity in expert letters — identifying the provider, the standard of care for that provider’s specialty, and how it was breached — and that those requirements can be evaluated without reaching the impoundment argument.

The lawyers also debated the import of HIPAA and the court’s uniform impoundment form. Sopcich argued HIPAA and state law counsel in favor of protection and routine impoundment; Pimentel responded that HIPAA permits use of records in litigation and that uniform impoundment forms do not create a per se rule but rather guide a balancing analysis.

At oral argument counsel and justices discussed practical effects: whether impoundment of source documents would convert tribunal hearings into secret proceedings, how defendants would defend themselves, and whether trial courts have adequate tools to review offers of proof without seeing the underlying records. The transcript shows no decision from the Supreme Judicial Court during the argument.

The case raises a recurring tension in malpractice practice: preserving individual medical privacy in an era of searchable, electronic court dockets while ensuring sufficient public access and procedural specificity so defendants and tribunals can evaluate claims. The justices’ questions focused on whether the plaintiff’s procedural choices — declining to submit records after the denial and filing an expert letter that did not name providers or delineate standards — independently justified the tribunal’s finding that the offer of proof was deficient.