Russell worked for a non-profit organ donation company with access to George Washington University Hospital's patient database. In January 2019, someone posted a screenshot of Justice Ginsburg's patient search screen to 4Chan's "Politically Incorrect" thread, where users promoted conspiracy theories that the Justice had died. The screenshot revealed that Justice Ginsburg had been receiving treatment from the hospital for various things related to cancer seemingly since at least 2014.
A jury convicted Russell on charges of unlawfully obtaining individually identifiable health information and destroying records with intent to obstruct an investigation. Chief Judge Diaz, writing for a unanimous panel, rejected Russell's arguments that his statements to federal agents should have been suppressed, that the trial court improperly limited cross-examination, and that the evidence was insufficient to support his conviction.
The evidence against Russell included damaging search logs and his bizarre explanations for how his login credentials were used. When federal agents confronted him with search logs showing queries for "Gins" and "Ginston," Russell suggested that "potentially his cat had run across the keyboard and typed in those letters." The court held this explanation implausible, particularly since Russell had legitimately searched for another patient just seconds before the suspicious searches.
Russell had also attempted to destroy evidence by formatting his computer's hard drive just days after learning that the hospital had revoked his access. Government forensics experts determined that Russell had turned over a secondary gaming drive rather than his desktop's primary hard drive. Even so, investigators recovered data showing that Russell had visited 4Chan's "Politically Incorrect" thread where the medical information was posted, along with antisemitic comments and conspiracy theories about Justice Ginsburg's health.
The Fourth Circuit rejected Russell's argument that the screenshot didn't qualify as "individually identifiable health information" because it didn't reveal specific health conditions or doctor names. Chief Judge Diaz held that information showing Justice Ginsburg's name, treatment dates, and medical services including "radiology and oncology services" fell "well within the heartland of the conduct the statute is aimed at."