A woman complained on behalf of her daughter in law (the patient) that a health agency had disclosed health information to the police in breach of the patient's privacy.

The patient's house caught fire and the police, fire and ambulance services were called. Members of the agency's mental health team had been alerted by a phone call and were present when the police arrived. The mental health team had had previous dealings with the patient.

The patient suffered burns to her airway and to other parts of her body. She was conscious but unable to say how the fire started. She was being prepared for transfer by helicopter to hospital.

Although there were divergent accounts given by those involved, I was satisfied that a member of the mental health team advised the police that the patient had had a psychotic problem, that there had been a previous incident where the patient threatened to set fire to her house, that the patient had lost custody of her son, and that the patient might be on medication which could adversely affect proposed treatment.

Rule 11 of the Health Information Privacy Code limits the disclosure of health information by a health agency. I was satisfied that health information had been disclosed by the health agency without the consent of the patient.

The agency relied on the exception in rule 11(2)(d)(ii). This exception allows a disclosure to be made without the consent of the individual concerned if the health agency believes, on reasonable grounds, that it is neither desirable nor practicable to obtain authorisation from the individual, and that the disclosure is necessary to prevent or lessen a serious and imminent threat to the life or health of the individual.

The agency must be satisfied that:
1. There is a serious threat to the life of the victim. There were reasonable grounds to believe that the individual's injuries and potential adverse reaction to treatment constituted a serious threat to her health.

2. The threat is imminent. The ambulance officers were preparing the patient for transfer to hospital by air ambulance and the threat was imminent.

3. Disclosure would prevent or lessen the threat. In Duncan v Medical Practitioners Disciplinary Committee ¹⁹⁸⁶ 1 NZLR 513 it was held that a disclosure of confidential information should be to a responsible body which could address the concern. Given the role of police in emergencies, it was my opinion that disclosure to the police was appropriate.

4. Disclosure is necessary to prevent or lessen the threat. It is valuable in emergency situations to have information about victims' medical condition and possible adverse reaction to medication. I considered the disclosure of information relating to medication was important in this case, and that disclosure of other matters such as the patient's previous history could, by its nature, be regarded as corroboration.

I was of the opinion that the disclosure fell within the exception in rule 11(2)(d)(ii).

The disclosure must only be to the extent necessary for the particular purpose (rule 11 (3)). For the reasons outlined, I was satisfied that this requirement had been met.

Indexing terms: Disclosure of personal information - Health agency - Police - Health information disclosed to Police at fire emergency - Information related to victim's mental condition and possible adverse reaction to medication - Imminent threat to life or health - Health Information Privacy Code 1994, rule 11(2)(d)(ii) and rule 11(3).

July 2001