Meikle v. Medcare, LLC: Permanent Disability Allegations Open HIV, Mental Health, and Substance-Use Records to Discovery, With Mandatory Public Health Law § 2785(3) Protections

Introduction

In Meikle v. Medcare, LLC, 2025 NY Slip Op 05075 (App. Div. 2d Dep’t Sept. 24, 2025), the Second Department addressed the scope of discovery into highly sensitive health information in a medical malpractice action. The case squarely considers when a plaintiff’s allegations of severe, permanent physical and psychological injury waive the physician–patient privilege and permit defendants to obtain authorizations for:

Mental health treatment records,
Alcohol and drug treatment records, and
HIV-related information protected by New York’s Public Health Law.

The plaintiff alleged negligent failure to diagnose and treat multiple pelvic conditions, claiming she became “lame and disabled,” suffered “great mental/psychological and physical harm,” and was “permanently injured.” Several defendants moved to compel authorizations for the above categories of records; the plaintiff cross-moved for a protective order. The Supreme Court, Kings County (Knipel, J.), granted the motions to compel and denied the protective order, prompting this appeal.

The appellate decision both affirms robust discovery where a plaintiff’s allegations place her medical and mental conditions in controversy and clarifies that courts must observe the strict protective mechanisms mandated by Public Health Law § 2785(3) when ordering disclosure of HIV-related information.

Summary of the Opinion

The Second Department affirmed the order compelling the plaintiff to provide authorizations for mental health records and alcohol/drug treatment records, concluding that the plaintiff’s allegations of permanent disability and substantial psychological harm waived the physician–patient privilege and rendered those records “material and necessary” to the defense.

As to HIV-related information, the Court held that the plaintiff affirmatively placed her HIV status in issue by alleging permanent injuries and total disability resulting from the defendants’ care. Accordingly, disclosure could be ordered upon a showing of “compelling need” under Public Health Law § 2785(2)(a). However, because the lower court’s order did not incorporate the statutory protections required by § 2785(3) (sealing, in camera proceedings, and anonymization where appropriate), the Second Department remitted for entry of an order conforming to those mandatory safeguards.

The Court also rejected the plaintiff’s argument that the discovery motions should have been denied for movants’ failure to comply with the meet-and-confer requirement of 22 NYCRR 202.7(a), holding that any such failure could be excused where efforts to resolve the dispute would have been futile.

Analysis

Precedents Cited and Their Influence

CPLR 4504; O’Brien v Village of Babylon, 153 AD3d 547 (2d Dept 2017); Gutierrez v Trillium USA, LLC, 111 AD3d 669 (2d Dept 2013); Peterson v Estate of Rozansky, 171 AD3d 805 (2d Dept 2019): These authorities ground the well-settled principle that while physician–patient communications are privileged, a litigant waives that privilege by affirmatively placing his or her medical or mental condition in controversy. Once waived, the party must provide duly executed authorizations for pertinent medical records.
CPLR 3101; Frawley v City of New York, 221 AD3d 973 (2d Dept 2023); Greco v Wellington Leasing L.P., 144 AD3d 981 (2d Dept 2016): The “material and necessary” standard is interpreted liberally in favor of disclosure. Frawley underscores that information bearing on the controversy and assisting trial preparation is discoverable.
Encalada v Riverside Retail, LLC, 175 AD3d 467 (2d Dept 2019); Cabellero v City of New York, 48 AD3d 727 (2d Dept 2008); M.C. v Sylvia Marsh Equities, Inc., 103 AD3d 676 (2d Dept 2013): These cases emphasize the trial court’s broad discretion to supervise discovery and the liberal approach to interpreting requests.
Public Health Law § 2785; Doe v Sutlinger Realty Corp., 96 AD3d 898 (2d Dept 2012): HIV-related information enjoys heightened confidentiality; disclosure requires a judicial finding of “compelling need,” balancing the need for disclosure against privacy interests and the public interest in encouraging testing/treatment and preventing discrimination. Doe illustrates the balancing and the statute’s protective posture.
DiLorenzo v Toledano, 190 AD3d 941 (2d Dept 2021); Diamond v Ross Orthopedic Group, P.C., 41 AD3d 768 (2d Dept 2007): Allegations of permanent injury can place a plaintiff’s “entire medical history” in controversy, broadening the scope of permissible discovery.
Froehlich v Kimco Realty Corp., 207 AD3d 448 (2d Dept 2022); Quinones v 9 E. 69th St., LLC, 132 AD3d 750 (2d Dept 2015): These decisions, cited in contrast, reflect that when a plaintiff disclaims psychiatric injury or asserts only “garden variety” emotional distress, courts may restrict access to mental health records. In Meikle, the plaintiff’s elevated claims of “great mental/psychological harm” and ongoing anguish justified full mental health disclosure.
Nesbitt v Advanced Serv. Solutions, 173 AD3d 1056 (2d Dept 2019): Cited with a “but see,” Nesbitt signals that not every case renders HIV status in issue. Meikle clarifies that the plaintiff’s particular allegations—permanent injuries and total disability tied to the defendants’ care—meet that threshold in this medical malpractice context.
22 NYCRR 202.7(a); Moran v Grand Slam Ventures, LLC, 221 AD3d 994 (2d Dept 2023); DiPasquale v Lim, 218 AD3d 1182 (2d Dept 2023): Although parties ordinarily must confer in good faith before moving to compel, the requirement may be excused where efforts would be futile. Meikle applies this pragmatic exception.

Legal Reasoning

The Court’s reasoning proceeds in three interrelated steps: waiver of privilege through pleadings, the liberal discovery standard for “material and necessary” information, and the special statutory framework governing HIV-related information.

1) Waiver of Physician–Patient Privilege by Affirmatively Placing Conditions in Issue

The plaintiff’s complaint alleged that negligent care rendered her “lame and disabled,” caused “great mental/psychological and physical harm,” and resulted in permanent injury. Such allegations are quintessential examples of affirmative placement of medical and mental conditions in controversy. Under CPLR 4504 and the cited authorities (O’Brien, Gutierrez, Peterson), this operates as a waiver of the physician–patient privilege as to medical information relevant to those conditions, thereby requiring the plaintiff to execute HIPAA-compliant authorizations for the requested records.

Relying on DiLorenzo and Diamond, the Court emphasized that allegations of permanent injury can open a plaintiff’s “entire medical history” to scrutiny, not in the sense of limitless fishing, but insofar as records bear upon the claimed injuries, causation, and damages.

2) Liberal “Material and Necessary” Discovery

The Court reaffirmed that CPLR 3101 requires disclosure of “all matter material and necessary” to the prosecution or defense, construed liberally and with broad trial court discretion (Frawley; Greco; Encalada; Cabellero). Because the plaintiff sought damages for “great mental/psychological harm” and continuing mental, emotional, and psychological anguish, records of mental health treatment and of alcohol/drug treatment bear directly on the nature, extent, etiology, and potential alternative explanations for such claimed harm, making them discoverable.

The Court contrasted decisions narrowing discovery when only “garden variety” emotional distress is pleaded (Froehlich; Quinones). Here, the gravity and breadth of the plaintiff’s allegations supported full disclosure, including behavioral health records.

3) HIV-Related Information: Compelling Need and Mandatory Protections

HIV-related information is governed by Public Health Law § 2785, which permits disclosure only upon a judicial finding of “compelling need,” determined by balancing the need for disclosure with the individual’s privacy and the public interests served by confidentiality (Doe v Sutlinger Realty; PHL § 2785[2][a], [5]). The Court held that the plaintiff’s allegations of permanent injuries and total disability as a result of defendants’ care placed HIV status in issue, supporting a compelling need for disclosure in adjudicating the malpractice claims.

Crucially, the Court identified a procedural deficiency: whenever HIV-related disclosure is ordered, § 2785(3) mandates a protective regime—sealing of the application papers and decision, in camera proceedings on the application and any appeal, and, where appropriate, anonymization to prevent unauthorized disclosure. Because the Supreme Court’s order did not include those statutory protections, remittal was necessary to enter an order compliant with § 2785(3).

The Court’s careful “but see Nesbitt” citation signals that not all cases warrant HIV disclosure; rather, Meikle turns on the plaintiff’s specific allegations in this med-mal context and the statutory balancing.

4) Meet-and-Confer Requirement Excused for Futility

Addressing a procedural challenge, the Court held that even if moving defendants did not strictly comply with the 22 NYCRR 202.7(a) certification of good-faith efforts to resolve discovery disputes, that omission was excusable because efforts would have been futile. This application of Moran and DiPasquale reflects a practical approach to discovery motion practice.

Impact

Scope of Sensitive Health Discovery in Med-Mal: Plaintiffs alleging permanent disability and substantial psychological harm should expect courts to compel authorizations for mental health and substance-use treatment records as “material and necessary.” Defense counsel can rely on Meikle to obtain such authorizations when pleadings are expansive, while plaintiffs seeking to limit discovery may consider tailoring allegations to avoid putting broad behavioral health conditions in issue.
HIV Confidentiality Blueprint: Meikle reinforces that HIV-related information can be discoverable upon a showing of compelling need where the plaintiff’s status is affirmatively in issue, but courts must implement the full protective architecture of PHL § 2785(3). Practitioners and trial judges should ensure that any order granting such disclosure simultaneously:
- Seals the application papers and decision,
- Directs that proceedings be conducted in camera, and
- Requires anonymization where appropriate.
Clarification vis-à-vis Nesbitt: The “but see Nesbitt” citation underscores a critical limit: HIV-related disclosure is not routine. Meikle suggests a threshold is met when permanent injury and total disability are alleged in a way that makes HIV status genuinely relevant to causation or damages in the malpractice claim.
Discovery Practice: The Court’s acceptance of a futility exception to the 22 NYCRR 202.7(a) meet-and-confer rule encourages candor about the likelihood of resolution and cautions against perfunctory certifications. That said, parties should still attempt good-faith resolution where feasible to avoid procedural objections.
Trial Management: Meikle provides a roadmap for lower courts: liberal discovery tempered by statutory safeguards for uniquely sensitive information (HIV). Orders compelling HIV-related disclosure should, from the outset, incorporate § 2785(3)’s protections to avoid remittal.

Complex Concepts Simplified

Physician–Patient Privilege (CPLR 4504): A rule that protects communications between a patient and healthcare provider. The patient can waive it—explicitly or by suing and asserting injuries that put their medical condition in issue. Once waived, the opposing party can obtain medical records relevant to the claimed injuries.
“Placing a Condition in Issue”: When a party’s claims or defenses make a particular medical or mental condition directly relevant (e.g., alleging permanent disability or severe psychological harm), the privilege as to that condition is deemed waived.
“Material and Necessary” (CPLR 3101): Information that bears on the controversy and will assist in preparing for trial. New York courts interpret this standard liberally, favoring disclosure.
HIV-Related Information (Public Health Law § 2785): Specially protected. To disclose, a court must find “compelling need” after weighing privacy and public interests. If disclosure is ordered, the court must:
- Seal the application and decision papers,
- Hold proceedings in camera, and
- Use anonymization as needed to prevent unauthorized disclosure.
“Garden Variety” Emotional Distress: A limited, nonclinical claim of ordinary emotional upset (e.g., embarrassment, humiliation). Plaintiffs who confine themselves to such claims may avoid broad discovery of mental health records. Expansive claims of psychological harm, however, open the door to those records.
22 NYCRR 202.7(a) Good-Faith Certification: Before moving to compel, parties generally must certify that they attempted to resolve the dispute. Courts can excuse this requirement if it is clear such efforts would be futile.

Conclusion

Meikle v. Medcare, LLC crystallizes two complementary principles in New York discovery practice. First, expansive allegations of permanent physical disability and significant psychological harm waive the physician–patient privilege and justify compelling authorizations for mental health and substance-use treatment records as “material and necessary” to the defense. Second, while HIV-related information may likewise be discoverable upon a showing of compelling need when the plaintiff’s status is placed in issue, courts must rigorously apply the protective regime of Public Health Law § 2785(3), ensuring sealing, in camera proceedings, and appropriate anonymization.

The decision thus balances liberal discovery with statutory safeguards for uniquely sensitive information. It guides litigants on the consequences of their pleadings, instructs trial courts on the correct handling of HIV-related discovery, and clarifies that procedural formalities like the meet-and-confer requirement can yield to practicality where futility is evident. In the broader legal landscape, Meikle provides a structured, rights-sensitive framework for resolving discovery disputes involving behavioral health and HIV-related records in high-stakes medical malpractice litigation.