Affirmation of Comprehensive Physician-Patient Privilege for Emergency Treatment Records

Introduction

In Re Lucas Trenshaw and Theresa Gardner, Personal Representative for the Estate of Timothy Trenshaw v. Eugene Jennings and All State Enterprise, Inc. (2025 CO 23) is a Colorado Supreme Court decision addressing the scope of the statutory physician-patient privilege under section 13-90-107(1)(d), C.R.S. (2024). The case arose from a fatal highway collision in Custer County. Defendant‐driver Eugene Jennings was injured and treated in a hospital emergency department. His contemporaneous statements about how the crash occurred were recorded in his medical chart. Those records later came into the possession of law enforcement and opposing civil litigants without Jennings’s consent.

When the trial court dissected the medical record, sentence by sentence, and ordered disclosure of five specific lines it deemed not “necessary” for medical treatment, Jennings petitioned this Court under C.A.R. 21 to protect the privilege. The Supreme Court granted relief, holding that any patient communication documented in treating records is fully protected and cannot be parsed in hindsight to defeat the privilege.

Summary of the Judgment

The Supreme Court of Colorado unanimously made absolute the order to show cause, ruling:

The statutory physician-patient privilege covers all information acquired by a treating physician that was “necessary to enable [the physician] to prescribe or act for the patient,” including the patient’s description of how an injury occurred.
A trial court may not review privileged medical records in camera and dissect them sentence by sentence to decide what is privileged.
Once privileged records are improperly obtained by law enforcement or a third party, the privilege holder may seek immediate relief under C.A.R. 21 to prevent further dissemination.
The proper means for opposing parties to learn relevant factual details is through ordinary discovery directed to the patient, not by accessing privileged treatment records.
No waiver of the privilege arose from the form of the privilege assertion or the absence of a formal privilege log under the circumstances.

Analysis

Precedents Cited

Wolf v. People (187 P.2d 926): Held that purely identifying information in a medical record (name, address, phone) is not privileged because it is not “necessary to prescribe or act.”
B.B. v. People (785 P.2d 132): Declined privilege protection for records created to assist in pending litigation rather than treatment.
Hanlon v. Woodhouse (160 P.2d 998): Refused privilege for blood-alcohol results obtained at law enforcement request without treatment purpose.
People v. Covington (19 P.3d 15): Recognized privilege for photographs and observations made by a treating professional during emergency treatment, even if law enforcement requested them.
Cardenas v. Jerath (180 P.3d 415): Confirmed that the privilege protects material in pretrial discovery as well as at trial.
Clark v. District Court (668 P.2d 3): Emphasized the patient’s right to withhold confidential treatment information.
Jordan v. Terumo BCT, Inc. (550 P.3d 628): Analogous attorney-client privilege case reaffirming that underlying facts are discoverable by direct inquiry, but confidential communications remain protected.

Legal Reasoning

The Court interpreted section 13-90-107(1)(d) in light of its purpose: to encourage full disclosure in treatment by shielding sensitive information from forced disclosure. The key points of the reasoning include:

Statutory Text and History: The privilege protects information “necessary to enable [the physician] to prescribe or act for the patient.” Patient descriptions of injury circumstances often inform diagnostic and treatment decisions.
De Novo Review: As a question of law interpreting a statutory privilege, the Court reviewed the trial court’s application without deference.
Rejection of Sentence-by-Sentence Parsing: No prior Colorado case endorses dissecting a medical record line by line to separate “necessary” from “unnecessary” content. Such a standard is unworkable, chills patient candor, and forces judges into medical judgments they are not qualified to make.
Preservation of Confidentiality: Allowing piecemeal review effectively nullifies the privilege, dissuades patients from full disclosure, and undermines public policy favoring candid patient–physician relationships.
Alternative Channels for Fact Discovery: Patients cannot shield facts merely by repeating them to their doctor. Opponents may still obtain factual details through interrogatories, requests for admission, and depositions directed to the patient.
Privilege Waiver Analysis: No express or implied waiver occurred. Jennings timely asserted the privilege and opposing parties were not prejudiced by any technical omission of a privilege log under the exigent circumstances of an improper law-enforcement breach.

Impact

This decision has significant implications for civil and criminal litigation in Colorado:

Courts must respect the integrity of treatment records in pretrial discovery and refrain from in camera sentence-by-sentence analysis to carve out non-privileged content.
Law enforcement agencies are alerted that medical records obtained without consent or warrant may be subject to suppression and immediate protective relief under C.A.R. 21.
Litigants will be guided to obtain factual information through direct discovery from the patient, preserving the confidentiality of the doctor–patient dialogue.
Physicians and hospitals can document patient histories and injury narratives without fear that routine clinical notes will be dissected and disclosed in litigation.
Privilege logs and meet-and-confer procedures under C.R.C.P. 26(b)(5) remain important but cannot override the substantive scope of statutory privilege.

Complex Concepts Simplified

Physician-Patient Privilege: A state law rule that allows a patient to block the disclosure of private communications made to a treating physician if they were necessary to diagnosis or treatment.
C.A.R. 21 Original Jurisdiction: A procedure by which the Colorado Supreme Court may grant immediate relief from an interlocutory order (such as a discovery ruling) when irreparable harm would follow disclosure of privileged materials.
In Camera Review: A private examination of documents by the judge. Here, the Court ruled that routine in camera dissection of privileged records is improper unless strict procedural safeguards have been met.
Fruit of the Poisonous Tree: A criminal law principle that evidence obtained illegally (for example, medical records seized without consent or warrant) may be inadmissible; this opinion signals potential civil analogues.
Implied Waiver: Occurs when a patient injects medical condition into a claim or defense so fully that they must surrender privilege for fairness; exchanging factual statements in treatment does not automatically waive the privilege.

Conclusion

The Colorado Supreme Court’s ruling in In Re Lucas Trenshaw v. Eugene Jennings reaffirms and clarifies that all patient communications and observations recorded in the course of necessary medical treatment are wholly protected by the physician-patient privilege. It categorically rejects a sentence-by-sentence parsing test that would undermine patient trust and privacy. Going forward, litigants must pursue factual information through direct discovery from the patient rather than by accessing confidential treatment notes. This decision solidifies the sacrosanct nature of the doctor–patient relationship and preserves the legislative purpose behind Colorado’s privilege statute.