Manitoba Ombudsman blesses response to e-mail incident

Manitoba Ombudsman Jill Perron has issued her report into Manitoba Families’ 2020 e-mail incident. The incident involved the inadvertent e-mailing of personal health information belonging to 8,900 children in receipt of disability services to approximately 100 external agencies and community advocates. It is such a common incident that it is worth outlining the Ombudsman’s incident response findings.

Manitoba Families meant to transfer the information to the Manitoba Advocate for Children and Youth to support a program review. It included information about services received. Some records included diagnoses.

Manitoba Families mistakenly blind copied the external agencies and advocates on an e-mail that included the information in an encrypted file and a follow-up e-mail that included the password to the file. It had made the same mistake about a week earlier. Several agencies alerted Manitoba Families to its error, and it began containment within a half hour.

The Ombudsman held that Manitoba Families’ containment effort was reasonable. She described it as follows.

Attempts at recalling the email began minutes later at 8:29 a.m. and continued at various intervals. Also, at 8:35 a.m., CDS sent an email to all unintended recipients noting in bold that they were incorrectly included on a confidential email from Children’s disAbility Services and requested immediate deletion of the email and any attachments. Follow up calls to the unintended recipients by CDS program staff began to occur that morning to request deletion of the emails and a list was created to track these calls and the outcomes. A communication outline was created for these calls which included a request to delete emails, a further request that emails be deleted from the deleted folder and that any emails that went to a junk email folder also be deleted…

In January 2021, we received additional written communication from the program stating that all agency service providers and advocates were contacted and verified deletion of the personal health information received in error. The log form created to track and monitor the name of the organization, the date and details of the contact was provided to our office.

The Ombudsman reached a similar finding regarding Manitoba Families’ notification effort, though she needed to recommend that Manitoba Families identify the agencies and advocates to affected individuals, which Manitoba Families agreed to do upon request.

What’s most significant – especially given class action proceedings have been commenced – is a point the Ombudsman made about evidence that Manitoba Families appears not to have gathered.

In addition to assuring families about the deletion of the email, additional information such as who viewed the email, if the attachment was opened and read, whether it was forwarded to anyone else or printed, whether it was stored in any other network drive or paper file or, conversely, that no records exist – can be helpful information to provide those affected by a privacy breach. It is best practice, therefore, to provide families with as much assurance as possible about the security of their child’s health information.

The question is, what is one to make of an arguable shortcoming in an incident response investigation? I say “arguable” because the probability of any of these actions occurring is very low in the unique circumstances of this incident, which involved trusted individuals receiving a password-protected and encrypted file. Manitoba Families ought to have collected this evidence because they called the e-mail recipients anyway, it is helpful and was probably available for collection. If it did not do so, however, I believe it is perfectly acceptable to for Manitoba Families to stand by the scope of a narrower investigation and and put the plaintiff to proof.

PHIA Case 2020-1304

IPC wades into shadow IT mess, may never again

The Information and Privacy Commissioner/Ontario issued a decision about a security incident on July 9th in which it made clear, after participating in a health information custodians’ efforts to recover lost data, that this burden falls on custodians alone.

The incident involved a clinician at an unnamed rehabilitation clinic and her estranged spouse, who reported to the clinic that he possessed 164 unique files containing the personal health information of 46 clinic clients on two computers that belonged to the clinician. The clinician explained the existence of the files as a by-product of secure access and inadvertent, though the the files appear to have been purposely moved from temporary storage to a Google drive at some point, possibly by the spouse

The spouse was not particularly cooperative. This led the IPC, who the clinic had notified, to engage with the spouse together with the clinic over a several month period. The IPC took the (questionable) position that the spouse was in breach of duties under section 49(1) of PHIPA.

In the course of these dealings the spouse reported he had also received e-mails with attached assessment reports from the clinician for printing purposes. The clinician said she had thought she had adequately de-identified the reports, though one included a full patient name and others (as the IPC held) contained ample data to render patients identifiable.

All of the detritus was eventually deleted to the satisfaction of the clinic and IPC. The clinic reconfigured its means of providing secure remote access to adresses the risk of local storage and beefed up its administrative policies and training. There is no mention of implementing a digital loss prevention solution.

The IPC decision is notable for two points.

First, the IPC made clear that custodians should not rely on the IPC to help with data recovery (which can be very expensive):

It is clear that interactions between the Clinic and the Spouse had been very challenging, chiefly due to the Spouse’s changing positions throughout this investigation. However, the obligations on a health information custodian to contain the breach remain, even in the face of challenging circumstances.  The Privacy Breach Guidelines are clear that there is an obligation on the health information custodian to retrieve any copies of personal health information that have been disclosed and ensure that no copies of personal health information have been made or retained by anyone who was not authorized to receive the information.  Nothing in the legislation or these guidelines transfers this obligation to the IPC.

Second, the clinic was less skeptical of the clinician than it might otherwise have been, and did not issue discipline. The IPC accepted this, and re-stated its deferential position on employee discipline as follows:

With respect to the Clinic’s decision, I am satisfied that it was reasonable in the circumstances. This office has stated that its role is not to judge the severity or appropriateness of sanctions taken by a custodian against its agents (see PHIPA Decision 74).  However, the IPC can taken into account a custodian’s disciplinary response as part of its assessment of whether the custodian has taken reasonable steps to protect personal health information against unauthorized access.

A Rehabilitation Clinic (Re), 2020 CanLII 45770 (ON IPC).