Ms D always tried to do the right thing. The 30-year old nurse was committed to doing the best for her patients as well as for her co-workers. That is why she was so particularly upset at how and why she was fired from her job. 

The incident leading up to the loss of her job was, according to Ms D, completely unremarkable. She had worked in a midsized hospital, had been there for more than 2 years, and was well-liked by the other staff members. After encouragement by her co-workers, Ms D was considering returning to school to get an advanced practice degree. 

On the day in question, Ms D was working in the postanesthesia care unit, assisting an electrocardiogram technician and physician by prepping a patient for a transesophageal echocardiogram. The patient, who was positive for hepatitis C, was in an examination area behind a curtain. Other patients and medical personnel were nearby and in other curtained-off areas. 

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Prior to the echocardiogram, Ms D made sure that the patient understood what was going to happen and that all the diagnostic tools were available. After doing so, and because she thought it was right to make sure that the physician and technician were protected, she informed them that the patient had hepatitis C and that they should wear gloves. 

Sometime thereafter, the patient filed a complaint with the hospital, alleging that his confidential health information was improperly disclosed because Ms D’s voice was loud enough to be heard by other patients and medical personnel in the area. Ms D was notified that she was being placed on administrative leave while the hospital completed an investigation. After the investigation, Ms D was informed that she was being terminated from her job based on her violation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) for unnecessarily disclosing confidential health information. 

Ms D was shocked at losing her job and believed strongly that the decision was unfair. She consulted with an attorney about whether she could sue the hospital. 

“You were an at-will employee,” the attorney told her. “That basically means that they can fire you for any reason … you understand this?”

“Yes,” said Ms D. “But I never violated HIPAA. And employees of the hospital are saying I did, and it’s ruining my reputation.”

After some discussion, the attorney filed a lawsuit against the hospital, alleging that Ms D was wrongfully terminated from her job, and that she had been defamed by a hospital employee who said that she had been fired for a HIPAA violation. 

The lower court dismissed both counts, and Ms D appealed. On appeal, the Court of Appeals first looked at the alleged wrongful termination. As mentioned by the attorney, Ms D was an at-will employee, meaning that an employee could be fired for almost any justification, unless the employee was fired for refusing to violate the law, or because the employee exercised a statutory right. After looking at the facts in the case, the Court of Appeals agreed with the lower court that Ms D was fired because she had violated patient confidentiality provisions of HIPAA, not because she refused to violate a law or any other exception. The court dismissed the wrongful termination claim.