The U.S. Court of Appeals for the Third Circuit has reopened a suit against a doctor whose discussion of his patient's medical condition with the man's wife became grist in the couple's divorce proceedings.

A jury should decide whether the doctor's disclosure that the patient was prescribed 160 Cialis pills for erectile dysfunction prompted the man's wife to file for divorce on grounds of infidelity, the Third Circuit said Wednesday in the case, captioned Lee v. Park. The ruling reversed an award of summary judgment to the defendant on the issue of whether the doctor was negligent for breaching his duty of care.

But the federal appeals court upheld the motion judge's decision not to disqualify defense counsel for a vulgar outburst he made to plaintiff's counsel in the courtroom.

Palisades Park physician Won Il Park first prescribed Cialis to longtime patient Sang Geoul Lee in 2010. Lee testified that his wife knew only that he received only 10 pills for use within their marriage. He claimed that she was unaware that he procured an additional 160 pills, and that some of them were used during an extramarital affair.

But by February 2012, Lee's wife, Kyung Lee, growing suspicious, phoned Park and asked about the Cialis prescription, and the doctor revealed that he had prescribed the man a total of 170 pills. She filed for divorce, and Lee, a New York resident, filed a suit against his physician.

In September 2014, when U.S. Magistrate Judge Joseph Dickson convened a settlement conference, but before the judge entered the courtroom, the physician's lawyer, Wayne Paulter, used an expletive when addressing Lee's lawyer, Thomas Park. When Park stated the amount his client would accept to settle, Paulter responded, “You guys can go [expletive] yourselves,” according to the plaintiff.

Park, then an associate of Michael Kimm, of Kimm Law Firm in Englewood Cliffs, moved to disqualify Paulter over his remark. At a hearing before Dickson on the motion, Paulter apologized, promised not to act in that manner again, and said the action was uncharacteristic of him. Dickson denied the motion to disqualify Paulter, and U.S. District Judge Esther Salas affirmed that ruling.

Salas also granted summary judgment to the physician on the negligence and negligence per se claims.

On appeal, Judges Michael Chagares, L. Felipe Restrepo and D. Michael Fisher affirmed dismissal of the negligence per se claim, citing the lack of evidence of any statute imposing direct tort liability on a physician who breaches his client's confidentiality. But the panel reversed dismissal of the count for ordinary negligence, calling the present case an exception to the rule that the issue of causation is ordinarily left to the fact finder. The present case is an exception to that rule because it is one where reasonable minds could differ on causation, Chagares wrote for the court. The panel cited the plaintiff's factual assertions about his wife's conduct, including examples of escalating animosity and her anger toward him after her phone call with the doctor, noting that she “came and raided his offices [to search for his pills] DEA-style only after she spoke with [Dr.] Park and not before.”

“Whether charges of sexual infidelity and all of the harm encompassed within such charges would have occurred without Dr. Park's disclosure is unclear, and—based on the evidence—reasonable minds could differ as to whether his alleged breach was the proximate cause of Mrs. Lee's conduct,” the court said.

But the appeals court declined to reverse Salas' decision on the motion for disqualification of Paulter over his crude remark in court. “Such management of litigation and oversight of litigants is best left to the discretion of the District Judge, and the record in this case exhibits no abuse of discretion,” Chagares wrote for the court.

Kimm, who represented the plaintiff at the Third Circuit, said he was pleased with the ruling on the negligence count but feels the appeals court erred on affirming dismissal of his motion to disqualify Paulter.

“It's discouraging to see that openly antagonistic and contemptuous conduct does not result in any court remedy,” Kimm said.

Paulter, who is with Rosenberg, Jacobs & Heller in Morris Plains, New Jersey, represented himself along with Douglas Ciolek of the same firm. Paulter and Ciolek did not respond to telephone or email messages requesting comment about the case.