In re State of Minnesota, Petitioner, State of Minnesota, Petitioner,

STATE OF MINNESOTA
IN COURT OF APPEALS
A22-1490

In re State of Minnesota, Petitioner,
State of Minnesota,
Petitioner,

vs.

Luis Alberto Martinez Ramirez,
Respondent.

Filed February 13, 2023
Writ granted
Ross, Judge

Dakota County District Court
File No. 19HA-CR-21-492

Kathryn Keena, Dakota County Attorney, Heather D. Pipenhagen, Assistant County
Attorney, Hastings, Minnesota (for petitioner)

Cathryn Middlebrook, Chief Appellate Public Defender, Jon Stanek, Assistant Public
Defender, St. Paul, Minnesota (for respondent)

Considered and decided by Ross, Presiding Judge; Larkin, Judge; and Bryan, Judge.
SYLLABUS
The statutory privileges afforded to medical and mental-health records by
Minnesota Statutes section 595.02, subdivision 1(d) and (g) (2022), do not permit
disclosures of protected information to a district court for in camera review in a criminal
prosecution without the consent of the patient or another applicable statutory exception.
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SPECIAL TERM OPINION
ROSS, Judge
Respondent Luis Alberto Martinez Ramirez, a defendant accused of engaging in
criminal sexual conduct against a teenage boy, successfully moved the district court to
review the boy’s medical and mental-health records for information material to Ramirez’s
defense. Relying on the supreme court’s recent decision in State v. Conrad (In re Hope
Coalition), 977 N.W.2d 651 (Minn. 2022), the state challenges the district court’s decision
to grant Ramirez’s request by asking this court to prohibit enforcement of the subpoena to
obtain the records. Because the reasoning in Hope Coalition informs us that the statutory
privileges restricting the disclosure of these records are absolute, and because preventing
their disclosure would not violate Ramirez’s constitutional rights, the district court was
bound by law to grant the state’s motion to quash the subpoena. We therefore grant the
state’s writ of prohibition.
FACTS
A 15-year-old boy told his psychiatrist in February 2021 that “Uncle Alex”
repeatedly sexually assaulted him two years earlier. The psychiatrist reported the disclosed
abuse to child protective services, adding that the boy “was in and out of psychosis two
days ago when the disclosure was first made,” that the boy had been hospitalized at a
mental-health facility on January 27, 2021, and that his hospitalization was anticipated to
continue for at least a week. Police learned that “Uncle Alex” is Luis Ramirez. The state
charged Ramirez with one count of first-degree criminal sexual conduct.
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Ramirez asked the district court to review in camera the boy’s medical and mental-
health records from the mental-health facility to determine whether they contained
information material to Ramirez’s defense. The state objected, asserting that the records
were privileged.
The district court granted Ramirez’s motion for in camera review and issued a
subpoena directing the mental- health facility to produce the records. The state
unsuccessfully moved the district court to reconsider and to quash the subpoena. The state
then petitioned this court for a writ of prohibition to prevent the subpoena’s enforcement.
We issued an order granting the state’s petition and reversing the district court’s order
denying the state’s motion to quash the subpoena. We now explain our decision.
ISSUE
Can the district court order the disclosure of privileged medical and mental-health
records for in camera review in a criminal prosecution without the consent of the patient
or another applicable statutory exception?
DECISION
We granted the state’s petition for a writ of prohibition because the subpoenaed
records are subject to a statutory privilege precluding even in camera review and because
disclosure is not required to protect Ramirez’s constitutional rights. We recognize that a
writ of prohibition is reserved for “ex traordinary cases.” Underdahl v. Comm’r of Pub.
Safety (In re Comm’r of Pub. Safety), 735 N.W.2d 706, 710 (Minn. 2007). We will not
issue a writ unless the petitioner meets three requirements: “(1) an inferior court or tribunal
must be about to exercise judicial or quasi-judicial power; (2) the exercise of such power
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must be unauthorized by law; and (3) the exercise of such power must result in injury for
which there is no adequate remedy.” State v. Hartman, 112 N.W.2d 340, 346 (Minn. 1961)
(quotation omitted). These requirements for the writ to issue are “essential,” and “if the
[petitioner] fails to establish any one of them the writ must be denied.” Smith v. Tuman ,
114 N.W.2d 73, 77 (Minn. 1962). A writ of prohibition may also issue “to prevent an abuse
of discretion where there is no other adequate remedy at law.” Wasmund v. Nunamaker,
151 N.W.2d 577, 579 (Minn. 1967). Because district courts are afforded “broad discretion
to make discovery rulings,” State v. Burrell, 697 N.W.2d 579, 604 (Minn. 2005), a writ of
prohibition on a discovery matter should be
issued [only] if it appears that the court is about to exceed its
jurisdiction or where it appears the action of the court relates
to a matter that is decisive of the case; where the court has
ordered the production of information clearly not discoverable
and there is no adequate remedy at law; or in rare instances
where it will settle a rule of practice affecting all litigants.

In re Paul W. Abbott Co., 767 N.W.2d 14, 17 (Minn. 2009) (quotation omitted). The state’s
request for the writ meets this standard.
To resolve whether the district court was obligated to quash the subpoena for the
boy’s records, we first consider the applicable privileges and the circumstances under
which they permit a district court to compel disclosure. The parties agree that the
subpoenaed records are subject to the privileges conferred by Minnesota Statutes
section 595.02, subdivision 1(d) and (g) (2022):
(d) A licensed physician or surgeon, dentist, or chiropractor
shall not, without the consent of the patient, be allowed to
disclose any information or any opinion based thereon which
the professional acquired in attending the patient in a
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professional capacity, and which was necessary to enable the
professional to act in that capacity . . . .
. . . .
(g) A registered nurse, psychologist, consulting psychologist,
or licensed social worker engaged in a psychological or social
assessment or treatment of an individual at the individual’s
request shall not, without the consent of the professional’s
client, be allowed to disclose any information or opinion based
thereon which the professional has acquired in attending the
client in a professional capacity, and which was necessary to
enable the professional to act in that capacity. Nothing in this
clause exempts licensed social workers from compliance with
the provisions of section 626.557 and chapter 260E.

The state argues persuasively that the structure and nature of these statutory provisions
parallel the provision that established the privilege analyzed by the Hope Coalition court
and that we are obligated to hold similarly that the district court may order disclosure only
when the patient consents or another exception applies.
In Hope Coalition, 977 N.W.2d at 657–58, the supreme court considered the
privilege afforded by paragraph (k) of the same statute, which applies to records of sexual-
assault counselors:
(k)
Sexual assault counselors may not be allowed to disclose
any opinion or information received from or about the victim
without the consent of the victim . However, a counselor may
be compelled to identify or disclose information in
investigations or proceedings related to neglect or termination
of parental rights if the court determines good cause exists. In
determining whether to compel disclosure, the court shall
weigh the public interest and need for disclosure against the
effect on the victim, the treatment relationship, and the
treatment services if disclosure occurs. Nothing in this clause
exempts sexual assault counselors from compliance with the
provisions of section 626.557 and chapter 260E.

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Minn. Stat. § 595.02, subd. 1(k) (2022). The Hope Coalition court held that the paragraph
plainly prohibits any disclosure except in cases involving the statute’s express exceptions.
977 N.W.2d at 658. The court consequently concluded that a district court may not order
the disclosure of protected records in criminal prosecutions if no exception applies. Id. at
659.
Ramirez argues that Hope Coalition is limited to paragraph (k) and does not require
us to similarly interpret paragraphs (d) and (g). Ramirez is correct that the Hope Coalition
court interpreted only paragraph (k). Id. at 653. But the supreme court’s analysis provides
the blueprint for the construction and application of paragraphs (d) and (g) because of the
substantively similar manner in which the legislature designed the privileges. Like
paragraph (k), paragraphs (d) and (g) prohibit custodians of protected records from
disclosing them except when a specifically stated exception applies. Following the supreme
court’s approach in Hope Coalition, we hold that a district court may not order the
production of records protected by these privileges absent an express exception. See id. at
659. Ramirez does not argue that any of the statutory exceptions apply here. We therefore
conclude that the district court lacked the statutory authority to compel the facility to
disclose the subpoenaed records.
We turn to whether the district court was nevertheless authorized to compel the
requested disclosure to preserve Ramirez’s constitutional rights to confrontation and due
process. The Hope Coalition court acknowledged that “even an unpierceable statutory
privilege must yield to a defendant’s co nstitutional rights if nondisclosure would violate
those rights.” Id. at 661. Courts considering whether nondisclosure violates a defendant’s
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constitutional rights should weigh the state’s interest in the privilege against the nature of
the defendant’s right. Id. (citing Pennsylvania v. Ritchie, 480 U.S. 39, 60 (1987)). “When
the defendant’s constitutional right does not outweigh a compelling interest of the state,
the privilege remains unpierced.” Id.
Hope Coalition again guides our analysis. The supreme court balanced the
competing interests by first concluding that the state has a “compelling interest in
protecting the privacy of sexual assault victims” because maintaining the victim-counselor
privilege is essential for victims to willingly share pertinent information. Id. at 662. On
balance, the court reasoned that the criminal defendant’s constitutional rights to confront
witnesses and to present a complete defense did not outweigh the state’s interest. Id. It first
considered that the right of confrontation is designed to secure only “the opportunity of
cross-examination, not limitless pretrial discovery.” Id. (quotation omitted). It reasoned
that the lack of access to the requested records did not impair the defendant’s ability to
cross-examine the victim or other state witnesses. Id. It next considered that the records
sought were possessed by a nongovernmental third party and subject to a privilege that
expressly prohibits their disclosure. Id. It therefore concluded that enforcing the privilege
would not violate the defendant’s due-process rights. Id.
We follow the same reasoning here. We observe no distinction between the privacy
concerns inherent in the victim-counselor relationship protected by paragraph (k) and the
privacy concerns inherent in each patient-provider relationship protected by paragraphs (d)
and (g). The records created as part of each relationship will almost certainly include
sensitive personal information that the patient would want to remain confidential. And
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preserving confidentiality is essential to ensuring a patient’s (and victim’s) willingness to
seek help and proper treatment. See id. at 661–62. We likewise see no distinction as to
weighing the defendant’s constitutional rights against the state’s interest. As in Hope
Coalition, the lack of access to the records at issue here does not preclude Ramirez from
confronting and cross-examining witnesses against him, the records sought are maintained
by a private nonparty, and those records are protected by a strict statutory privilege subject
only to narrow exceptions not relevant here. We hold that preserving the confidentiality of
the protected records does not violate Ramirez’s constitutional rights.
We are not persuaded otherwise by Ramirez’s assertion, citing State v. Hummel,
483 N.W.2d 68, 72 (Minn. 1992), that the supreme court has recognized that medical and
mental-health records protected by paragraphs (d) and (g) may be ordered disclosed in a
criminal prosecution when the defendant has made a threshold showing that the records are
likely to contain favorable information. Although Hummel articulates the standard to be
applied when a particular privilege may be pierced, the supreme court did not address the
foundational question of whether a privilege may be pierced in the first place. The Hummel
defendant similarly sought the disclosure of records privileged under paragraphs (d) and
(g). Id. at 71. The supreme court noted that the privileges applied but recognized that “[t]he
medical privilege, like other privileges, sometimes must give way to the defendant’s right
to confront his accusers.” Id. (quotation omitted). The Hummel court held that, when the
privilege may be pierced, in camera review by the district court before disclosure to the
defendant is the appropriate way to balance the interests of the privilege holder against the
rights of the defendant, but that the defendant must first “make some plausible showing
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that the information sought would be both material and favorable to his defense.” Id. at 72
(quotations omitted).
As Ramirez points out, the court in Hope Coalition cited Hummel for the proposition
that Minnesota courts have used this balancing test “to evaluate whether privileged medical
records should be disclosed.” 977 N.W.2d at 660. But the Hope Coalition court then noted
that it had not yet had occasion to apply its “judicial mind” to the validity of the
presumption “that all privileges must sometimes give way to a criminal defendant’s right
to confront their accuser.” Id.; see also Fletcher v. Scott, 277 N.W. 270, 272 (Minn. 1938)
(“The rule of stare decisis is never properly invoked unless in the decision put forward as
precedent the judicial mind has been applied to and passed upon the precise question.”).
And in the Hope Coalition court’s final analysis, it concluded that privileged sexual-
assault-counseling records maintained by a nongovernment third party are in fact not
subject to disclosure by order of the district court in a criminal proceeding for the reasons
discussed. 977 N.W.2d. at 663. While Hummel may have presumed that the medical and
mental-health privileges could be subordinated to the constitutional rights of a criminal
defendant, Hope Coalition clarifies that this presumption was not part of Hummel ’s
holding. Id. at 660. We therefore reject Ramirez’s interpretation of Hummel and hold,
consistent with the framework provided by Hope Coalition, that Ramirez’s constitutional
rights to confrontation and due process do not outweigh the state’s interest in preserving
the confidentiality of the protected records.
Writ granted.