Doctor faces discipline for shielding patient records in 10-year case

A physician who refused to release records without patient consent during a medical board investigation finally might receive his formal punishment from the board -- 10 years after it was proposed.

In a 4-3 vote, the Court of Appeals of Maryland reversed a lower court decision, reinstating a reprimand and a $5,000 fine by the board against Bethesda, Md., psychiatrist Harold I. Eist, MD. The decision stems from years of litigation, including five challenges in which lower court judges dismissed charges against Dr. Eist and ruled that the board did not have unfettered access to patient records.

In its Jan. 21 ruling, the appeals court said Dr. Eist should have pursued judicial action during the investigation if he believed releasing patient files to the Maryland Board of Physicians violated patient privacy.

In 2001, the medical board requested medical records from Dr. Eist as it investigated claims by a patient's husband that the doctor overmedicated his wife and children. Dr. Eist denied any wrongdoing.

He said he did not immediately turn over records for the patients because they objected. When the patients did not file a formal court objection to the board's request, Dr. Eist later released the files.

The board ultimately dismissed its investigation into Dr. Eist's conduct, but still charged him for failing to cooperate. Dr. Eist fought the reprimand in court.

In its ruling, the appellate court said a health care professional's obligation to provide patient records to the state board is not absolute (link).

But "if the patient and/or the health care provider believe there are grounds for not producing the records, the patient or the health care provider must file a motion to quash the subpoena, or a motion for a protective order pursuant to Maryland [law]," the court said.

The case may not be finished yet.

Alfred F. Belcuore, an attorney for Dr. Eist, has filed a motion to reconsider with the court. The case could still go before the state Supreme Court.

"We are disappointed that a majority of the court did not agree that in the circumstances, Dr. Eist acted in good faith and did not fail to cooperate with the board," Belcuore said in a statement.

A medical board spokeswoman said the board was pleased with the court's decision.

Armin Kuder, Dr. Eist's attorney during the board's initial investigation, questioned why the board spent so much time and energy on repeated appeals after it received the medical records and dismissed the original complaint.

"It was the culmination of a personal campaign against Dr. Eist" that resulted in a fine that seems disproportionate to what he did, he said.

The case was about more than one physician's interaction with the board, said Thomas Keech, an assistant Maryland attorney general and legal counsel to the board. Obtaining permission from patients to access records essentially paralyzes board investigations, he said.

The appellate decision "allows the board to proceed as it has in previous decades," he said.