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Malpractice Rx

Confidentiality confusion, and who’s at fault for fatal misdiagnosis?

Vol. 4, No. 7 / July 2005

Worker claims therapist disclosed confidential information

Cook County (IL) Circuit Court

A public works employee in Illinois received psychotherapy through his city’s wellness program. After the man left his position, he claimed in court that the treating therapist met with his former co-workers, disclosed his receipt of therapy to them, and told them he was unstable and capable of harming himself or others. The former employee argued that the disclosures violated Illinois law, caused him emotional distress, and made him unable to trust mental health professionals.

The defense denied that the therapist had violated the law or had made any disclosures. Instead, the defense argued that the co-workers—not the therapist—had voiced concern about the plaintiff. The defense maintained that the co-workers were confused about who had discussed the plaintiff, and that the therapist had not discussed him.

  • The jury found for the defense.

Dr. Grant’s observations

The courts have recognized and protected the fundamental importance of confidentiality in the therapist/patient relationship.How to avoid ‘foreseeable’ harm,” Current Psychiatry, March 2005, at

Here, the request for consultation might suggest that an honest error in judgment occurred—the psychiatrist was simply puzzled by the patient’s medical symptoms. Although several doctors failed to diagnose NMS, shouldn’t the psychiatrists have been able to diagnose it?

NMS is a side-effect risk of atypical and conventional neuroleptics,Pearls: Identifying NMS with FEVER,”).

The psychiatrists in this case did not conform to the standard of care, and consulting with another doctor did not absolve them of liability.


1. Jaffee v. Redmond, 518 US 1 (1996).

2. Gupta S, Nihalani ND. Neuroleptic malignant syndrome: a primary care perspective. Prim Care Companion J Clin Psychiatry 2004;6:191-4.

3. Pelonero AL, Levenson JL, Pandurangi AK. Neuroleptic malignant syndrome: a review. Psychiatr Serv 1998;49:1163-72.

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