Hdeel Abdelhady v. George Washington University

United States Court of Appeals
FOR THE DISTRICT OF COLUMBIA CIRCUIT
Argued October 25, 2023 Decided January 9, 2024
No. 22-7148
HDEEL ABDELHADY,
APPELLANT
v.
GEORGE WASHINGTON UNIVERSITY, ET AL.,
APPELLEES
Appeal from the United States District Court
for the District of Columbia
(No. 1:22-cv-01334)
Hdeel Abdelhady, pro se, argued the cause and filed the
briefs for appellant.
Gerard J. Emig argued the cause and filed the brief for
appellees.
Before: SRINIVASAN, Chief Judge, MILLETT and WILKINS,
Circuit Judges.
Opinion for the Court filed by Circuit Judge WILKINS.
WILKINS, Circuit Judge: Hdeel Abdelhady sued George
Washington University (the “University”) after she was injured

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on the school’s property. In the University’s motions to
dismiss and for partial summary judgment, it included several
exhibits that, Ms. Abdelhady argued in a motion to seal,
referenced private medical treatments and diagnoses. The
District Court denied Ms. Abdelhady’s motion to seal in part.
Ms. Abdelhady appeals that decision. For the reasons
explained below, we vacate and remand.
I.
We begin with our jurisdiction to hear this appeal. Section
1291 of the Judicial Code confers on federal courts of appeals
jurisdiction to review “final decisions of the district courts.” 28
U.S.C. § 1291. Ordinarily, “final decisions” are those that
“trigger the entry of judgment.” Mohawk Indus., Inc. v.
Carpenter, 558 U.S. 100, 103 (2009). But Section 1291 also
permits review of a small category of orders that are “collateral
to” the “merits of the case” and “too important” to be denied
immediate review. Cohen v. Beneficial Indus. Loan Corp., 337
U.S. 541, 546 (1949).
We should exercise great care prior to asserting
jurisdiction under the collateral order doctrine. The doctrine
must “never be allowed to swallow the general rule that a party
is entitled to a single appeal, to be deferred until final judgment
has been entered.” Digit. Equip. Corp. v. Desktop Direct, Inc.,
511 U.S. 863, 868 (1994) (citation omitted); see also Mohawk,
558 U.S. at 106. This limited application prevents appellate
courts from greenlighting “piecemeal, prejudgment appeals,”
and thereby undermining “efficient judicial administration”
and “encroach[ing] upon the prerogatives of district court
judges, who play a special role in managing ongoing
litigation.” Mohawk, 558 U.S. at 106 (internal quotation marks
omitted).

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Thus, the “small category” of collateral orders that are
reviewable under Section 1291 “includes only decisions that
are conclusive, that resolve important questions separate from
the merits, and that are effectively unreviewable on appeal
from the final judgment in the underlying action.” Swint v.
Chambers Cnty. Comm’n, 514 U.S. 35, 42 (1995) (citing
Cohen, 337 U.S. at 546). Here, the order from which Ms.
Abdelhady appeals was conclusive on the question of sealing
and resolved an important question separate from the merits.
Therefore, we are left with one question: Is an appeal of an
order denying a motion to seal documents referencing medical
treatments and diagnoses “effectively unreviewable on appeal
from the final judgment in the underlying action”? Id. at 42.
As Mohawk emphasizes, this question does not entail an
“individualized jurisdictional inquiry” that turns on averting a
“particular injustice.” 558 U.S. at 107 (cleaned up). So if there
is a way to “adequately vindicate[]” this class of claims “by
other means,” then Section 1291 “does not provide a basis for
jurisdiction.” Id. Our “decisive consideration” is whether this
entire category of claims, “taken as a whole,” requires
immediate review to avoid imperiling “a substantial public
interest or some particular value of a high order.” Id. (internal
quotation marks omitted).
Undoubtedly, individuals generally have a strong interest
in keeping their medical treatments and diagnoses private. See
Hardaway v. D.C. Hous. Auth., 843 F.3d 973, 980–81 (D.C.
Cir. 2016); see also United States v. Kravetz, 706 F.3d 47, 63
(1st Cir. 2013). The need for medical privacy is similarly
recognized by federal and District of Columbia law. See, e.g.,
42 U.S.C. § 1320d-2(d)(2); 45 C.F.R. § 164.502; D.C. Code §
14-307. Indeed, the University agrees that individuals possess
a strong interest in keeping their medical diagnoses and
treatments private. Oral Arg. Rec. 53:30–54:35.

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Given the strength of this interest, we conclude that
maintaining one’s privacy in medical treatments and diagnoses
is a value of “high order” that warrants immediate appellate
review. Mohawk, 558 U.S. at 107 (internal quotation marks
omitted). Delayed review risks widespread and irreversible
dissemination of private medical information that cannot be
remedied on appeal. Cf. Al Odah v. United States, 559 F.3d
539, 544 (D.C. Cir. 2009) (explaining that “appellate review is
futile” once information is disclosed because “the cat is out of
the bag”) (cleaned up); In re Sealed Case (Medical Records),
381 F.3d 1205, 1209–10 (D.C. Cir. 2004) (same).
That said, this is a limited holding. We are not deciding
whether the collateral order doctrine categorically applies to
any order denying a motion to seal. While we recognize that
there is a circuit split on this issue, we have no occasion to
weigh in until resolution of the issue is necessary to our
decision and the issue is fully and adequately briefed.
Compare Vantage Health Plan, Inc. v. Willis-Knighton Med.
Ctr., 913 F.3d 443, 447–50 (5th Cir. 2019) (holding that sealing
and unsealing orders are immediately appealable), Rudd Equip.
Co. v. John Deere Constr. & Forestry Co., 834 F.3d 589, 592–
93 (6th Cir. 2016) (same), Callahan v. United Network for
Organ Sharing, 17 F.4th 1356, 1360–61 (11th Cir. 2021)
(similar), and Apple Inc. v. Samsung Elecs. Co., 727 F.3d 1214,
1220 (Fed. Cir. 2013) (similar), with United States v. Guerrero,
693 F.3d 990, 995–99 (9th Cir. 2012) (holding that the
collateral order doctrine does not extend to an order denying a
motion to seal pretrial competency proceedings). All we are
deciding is that, in these circumstances, the denial of the
motion to seal records containing medical information is
immediately appealable.

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II.
This brings us to the merits: whether the District Court
erred in denying Ms. Abdelhady’s motion to seal documents
referencing her medical diagnoses and treatments. We review
that denial for abuse of discretion, guided by a “strong
presumption in favor of public access to judicial proceedings.”
See EEOC v. Nat’l Children’s Ctr., Inc., 98 F.3d 1406, 1409
(D.C. Cir. 1996) (internal quotation marks omitted).
But as with any presumption, the preference for public
access is not ironclad. In United States v. Hubbard, 650 F.2d
293, 317–22 (D.C. Cir. 1980), we identified six factors to guide
the inquiry into whether the presumption is overcome: (1) the
need for public access to the documents at issue; (2) the extent
of previous public access to the documents; (3) the fact that
someone has objected to the disclosure, and their identity; (4)
the strength of any property and privacy interests asserted; (5)
the possibility of prejudice to those opposing disclosure; and
(6) the purposes for which the documents were introduced
during the judicial proceedings. We have “repeatedly held that
those are the factors a court should weigh in ruling on a motion
to seal or unseal a judicial record.” In re Leopold, 964 F.3d
1121, 1131 n.9 (D.C. Cir. 2020). Although a district court has
“wide” discretion when balancing the Hubbard factors, “the
district court must provide a ‘full explanation’ for its decision,
detailed enough to permit ‘review of the district court’s
exercise of its discretion.’” In re L.A. Times Commc’ns LLC,
28 F.4th 292, 297 (D.C. Cir. 2022) (brackets omitted) (quoting
Nat’l Children’s Ctr., 98 F.3d at 1410).
Here, the District Court granted the motion to seal in part,
but only as to an exhibit that identified Ms. Abdelhady’s
treating physicians. As to the remaining documents she sought
to seal, the District Court denied the motion on the grounds that

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they “contain no medical records or details that [Ms.
Abdelhady] herself does not already mention in her redacted
Amended Complaint.” JA 13. But on our inspection of the
record, it appears that some of the documents that Ms.
Abdelhady seeks to seal do, in fact, reference medical
treatments and diagnoses that were redacted in her amended
complaint. Thus, as part of its “scarce explanation for its
denial” of Ms. Abdelhady’s motion to seal, Hardaway, 843
F.3d at 980, the court relied on the incorrect assumption that
Ms. Abdelhady had already disclosed in her redacted complaint
all of the same information she sought to have sealed.
Furthermore, on this record, we cannot determine whether
the District Court considered the need, if any, for public access
to the documents that Ms. Abdelhady sought to seal, and
whether the District Court adequately weighed both Ms.
Abdelhady’s interest in medical privacy and the extent of
previous public access to each of the records at issue. These
factors (which Ms. Abdelhady raised, see JA 15) are relevant
to her motion to seal. Although a district court need not provide
a detailed exposition about every Hubbard factor in response
to every sealing request, it must say enough to allow us to
“infe[r] from the record with reasonable certainty,” Conafay v.
Wyeth Lab’ys, 793 F.2d 350, 354 (D.C. Cir. 1986) (quoting In
re Pope, 580 F.2d 620, 623 (D.C. Cir. 1978)), that it considered
all such factors upon our review for abuse of discretion.
Because the District Court misconstrued the record and
appears not to have weighed all of the Hubbard factors, it
abused its discretion. See Hardaway, 843 F.3d at 980 (“failing
to weigh the six relevant [Hubbard] factors and
mischaracterizing the record” is an abuse of discretion); Nat’l
Children’s Ctr., 98 F.3d at 1410 (remanding where we were
“unable to discern . . . whether the district court considered and
applied the Hubbard factors in exercising its discretion”); see

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also Cooter & Gell v. Hartmarx Corp., 496 U.S. 384, 405
(1990) (“a clearly erroneous assessment of the evidence” is an
abuse of discretion). We therefore remand this case so that the
District Court can consider all of the Hubbard factors and
further explain its decision.
Even so, we emphasize that our remand is not meant to
imply that Ms. Abdelhady’s broad and generalized motion to
seal should have been granted in its entirety. Indeed, whether
Ms. Abdelhady solely wants to redact references to protected
health information or instead seeks to entirely seal the
documents that reference this sensitive information is unclear.
See Fed. R. Civ. P. 5.2(d) (giving the court the option to order
sealing of the entire document or the filing of a redacted version
on the public docket). Ms. Abdelhady’s motion also suggests
that some documents should be sealed simply because they
stem from a sealed administrative proceeding that discussed
her injuries—not because these documents reference sensitive
medical treatments and diagnoses. Though the District Court
may have reasonably found one or more of these arguments
unpersuasive, without a more fulsome explanation of its
assessment of those grounds, “we are unable to review [its]
exercise of its discretion.” Nat’l Children’s Ctr., 98 F.3d at
1410. We are left no choice but to remand.
So ordered.

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