As Supreme Court Justice Ruth Bader Ginsburg sought to privately battle cancer, federal prosecutors said Monday, her health records reached a dark, conspiratorial corner of the internet where users floated antisemitic conspiracy theories.

Her information, according to prosecutors and court testimony from an FBI agent, was accessed by a former organ transplant coordinator while she was under the care of George Washington University Hospital in 2019 and then posted to the online message board 4chan, which is known for salacious and conspiracy-themed discussions.

Trent James Russell faces a maximum of 22 years in prison on charges that he illegally accessed Ginsburg’s records in violation of federal privacy protections and tens of thousands of dollars in fines if convicted on all counts at his trial in U.S. District Court in Alexandria.

A former organ transplant specialist is on trial after U.S. Supreme Court Justice Ruth Bader Ginsburg’s medical records were leaked online. Nikki Kahn/The Washington Post, file

Russell, 34, has pleaded not guilty in the case, telling investigators probing the leak during an initial interview in February 2019 that it was possible “his cats had run across his keyboard,” according to a court filing.

The investigation began shortly after the data breach, when the Supreme Court police became aware of Ginsburg’s medical chart circulating on social media and contacted the FBI for help, according to court testimony. A former hospital executive testified that the spouse of a George Washington employee also noticed the justice’s chart being posted online and alerted administrators.

The record that first appeared on 4chan quickly spread to Twitter and YouTube, an FBI agent testified Monday. The screenshot, which was displayed in court, shows Ginsburg’s name and the exact dates and times she received radiology, oncology and surgical treatment at the hospital from around 2014 to 2018.

Ginsburg died the year after the data breach, in September 2020, at her home in Washington. She was 87. The second woman to serve on the high court, Ginsburg broke boundaries in law as a mother and a Jewish person entering a field that was largely dominated by White, protestant men. As a justice, she was known for her fierce opinions in support of gender equality and minority rights. A member of the Supreme Court police force testified that he escorted the justice to the hospital at least two or three times as her health began to wane and that the visits were always arranged to be “as discreet as possible” to protect her privacy.

Ginsburg was never referred as a potential organ donor to Russell’s employer, the Washington Regional Transplant Community, a federally designated organization that works to identify patients near death whose organs could be transplanted, witnesses testified.

Lori Brigham, the organization’s founder and former chief executive, said transplant coordinators such as Russell had “no business being inside the chart” of any patient who had not been referred. She said Russell was well aware of the rules because of numerous agreements he signed and training sessions he underwent.

Hospital officials traced the search of Ginsburg’s data to one of Russell’s home computers, witnesses said Monday. U.S. officials said he lied during the initial interview in 2019, saying his phone had been stolen when asked about the leak by investigators. The agents said he then deleted data from a computer hard drive at his home.

His lawyer, Charles Burnham, took issue with the characterization in a court filing, saying “the agents were aware that Mr. Russell had not deleted his hard drive but had in fact ‘formatted’ it which is not the same thing.” Formatting a hard drive entails erasing its data to improve system performance. Burnham did not respond to a request for comment Monday. Russell also told investigators he had shared his hospital log-in credentials with others.

Judge Michael S. Nachmanoff seated 12 jurors and two alternates for proceedings expected to last less than a week. Prosecutors on Monday argued that Russell violated Ginsburg’s right to privacy under the federal Health Insurance Portability and Accountability Act (HIPAA), which protects the confidentiality of patients’ medical information.

“Do the social media posts related to the health records of Justice Ginsburg pertain to hospital business?” the lead prosecutor on the case, Assistant U.S. Attorney Zoe Bedell, asked Nathan Read, who led George Washington University Hospital’s internal investigation of the breach.

Read, who was the hospital’s chief information officer at the time, said the disclosure was not authorized. Russell had access to patient records because he functioned as a contractor and was often on-site to evaluate patients for potential organ transplants, he said. Read said Russell’s access was immediately revoked after he was identified as the suspect in January 2019. But Russell then contacted the hospital’s IT help desk the following month to ask that his permissions be restored, and he was denied, Read testified.

A member of the hospital staff also conducted an unauthorized search that would have turned up Ginsburg’s data around the time of the breach, Read testified, but that individual did not appear to be tech-savvy enough to post the information to social media, and he was ruled out as the culprit. The individual was also fired, Read said.

Brigham testified that Russell, who now resides in Nebraska, was not known for bringing politics or “weird conspiracies” into the workplace. Prosecutors said they found 4chan posts on his hard drive delving into antisemitic conspiracy theories, including one titled “Mossad just tried to assassinate Trump during the White House Christmas Tree Lighting” and a Google search for “dirty jew.”