July 2, 2013
JULIAN MATTIELLO, M.D., BRANDYWINE VALLEY NEUROSURGERY AND SPINE, LLC, ANDREW FREESE, M.D., AND COATESVILLE HOSPITAL CORPORATION D/B/A/ BRANDYWINE HOSPITAL APPEAL OF: JULIAN MATTIELLO, M.D. AND BRANDYWINE VALLEY NEUROSURGERY AND SPINE, LLCBENJAMIN DORSEY,
JULIAN MATTIELLO, M.D., BRANDYWINE VALLEY NEUROSURGERY AND SPINE, LLC, ANDREW FREESE, M.D., AND COATESVILLE HOSPITAL CORPORATION D/B/A/ BRANDYWINE HOSPITAL APPEAL OF: COATESVILLE HOSPITAL CORPORATION D/B/A/ BRANDYWINE HOSPITAL
Appeal from the Order entered October 19, 2012 in the Court of Common Pleas of Chester County, Civil Division, at No: 10-04220
BEFORE: PANELLA, OLSON, and STRASSBURGER, [*] JJ.
Julian Mattiello, M.D. (Mattiello), Brandywine Valley Neurosurgery and Spine, LLC (BVN&S), and Coatesville Hospital Corporation (Brandywine Hospital) (collectively Appellants) appeal from the October 19, 2012 order which granted the motion to compel filed by Benjamin Dorsey (Dorsey) in this medical malpractice action despite Appellants' claim that the documents were privileged under the Peer Review Protection Act (PRPA), 63 P.S. §§ 425.1-425.4. We affirm in part, reverse in part, and remand for further proceedings consistent with this memorandum.
The pertinent facts are as follows. Dorsey filed a complaint alleging that he will be confined to a wheelchair for the rest of his life as a result of back surgery negligently performed by Mattiello. As Mattiello had received staff privileges at Brandywine Hospital ten months before the surgery, his surgeries were monitored by a proctor. Mattiello's proctor was Andrew Freese, M.D., who maintained his own private practice (BVN&S). Dorsey amended the complaint to allege corporate negligence against Brandywine Hospital, and pursued discovery from the hospital. Brandywine Hospital claimed that some requested documents were protected by privilege.
On October 19, 2012, following briefing by the parties and an in camera review of the documents, the trial court ordered Brandywine Hospital to produce certain documents. Appellants filed notices of appeal on October 25 and 26, 2012. This Court consolidated the appeals sua sponte by order of December 3, 2012. Appellants present one question for our review.
Did the [t]rial [c]ourt err, in contravention of the [PRPA], in compelling Brandywine Hospital to produce the [specified documents] when thes.e documents were prepared and utilized for peer review, were used by Brandywine Hospital to insure the quality and efficiency of services ordered and/or performed by its physicians, and/or were used by Brandywine Hospital to determine whether or not to grant staff privileges to Dr. Mattiello?
Brandywine Hospital's Brief at 4. See also Brief of Mattiello and BVN&S at 4 (same).
"Generally, an appellate court's standard of review of a trial court's evidentiary rulings is whether the trial court abused its discretion; however, where the evidentiary ruling turns on a question of law our review is plenary." Buckman v. Verazin, 54 A.3d 956, 960 (Pa. Super. 2012) (quoting Dodson v. Deleo, 872 A.2d 1237, 1241 (Pa. Super. 2005)).
The instant appeal involves application of the PRPA, which is designed "to facilitate self-policing in the health care industry." Dodson, 872 A.2d at 1242.
The [PRPA] represents a determination by the legislature that, because of the expertise and level of skill required in the practice of medicine, the medical profession itself is in the best position to police its own activities…. [T]he need for confidentiality in the peer review process stems from the need for comprehensive, honest, and sometimes critical evaluations of medical providers by their peers in the profession. Without the protection afforded through the confidentiality of the proceedings, the ability of the profession to police itself effectively would be severely compromised.
Piroli v. Lodico, 909 A.2d 846, 850 (Pa. Super. 2006) (quoting Young v. Western Pennsylvania Hosp., 722 A.2d 153, 156 (Pa. Super. 1998)).
Accordingly, the Act provides, in relevant part, as follows.
§ 425.4. Confidentiality of review organization's records
The proceedings and records of a review committee shall be held in confidence and shall not be subject to discovery or introduction into evidence in any civil action against a professional health care provider arising out of the matters which are the subject of evaluation and review by such committee and no person who was in attendance at a meeting of such committee shall be permitted or required to testify in any such civil action as to any evidence or other matters produced or presented during the proceedings of such committee or as to any findings, recommendations, evaluations, opinions or other actions of such committee or any members thereof: Provided, however, That information, documents or records otherwise available from original sources are not to be construed as immune from discovery or use in any such civil action merely because they were presented during proceedings of such committee, nor should any person who testifies before such committee or who is a member of such committee be prevented from testifying as to matters within his knowledge, but the said witness cannot be asked about his testimony before such a committee or opinions formed by him as a result of said committee hearings.
63 P.S. § 425.4.
Additionally, the Medical Care Availability and Reduction of Error (MCARE) Act, 40 P.S. §§ 1303.101-1303.910, provides confidentiality for documents produced in compliance with its reporting requirements.
Any documents, materials or information solely prepared or created for the purpose of compliance with [specific provisions of the MCARE Act] which arise out of matters reviewed by the patient safety committee pursuant … or the governing board of a medical facility … are confidential and shall not be discoverable or admissible as evidence in any civil or administrative action or proceeding. Any documents, materials, records or information that would otherwise be available from original sources shall not be construed as immune from discovery or use in any civil or administrative action or proceeding merely because they were presented to the patient safety committee or governing board of a medical facility.
40 P.S. § 1303.311(a).
We now consider the trial court's application of these statutes to the facts of the instant case. First, we note that the trial court has opined that it erred in ordering the production of seven of the documents entitled "Pennsylvania Patient Safety Reporting System Event Report." Although it initially ordered production of the documents, it concluded upon further review that these reports were created solely for the purpose of complying with reporting duties imposed by the MCARE Act. Therefore, the trial court agreed with Appellants that its order was in error to the extent that it required production of certain enumerated documents. See Trial Court Opinion, 12/28/2012, at 9.
For the remaining documents that Appellants claim are protected by privilege, the trial court maintained that the documents were discoverable because (1) they are incident reports containing information otherwise available from original sources, see id. at 7; (2) they relate to Brandywine Hospital's proctoring program, which is separate from the peer review process, see id. at 12; or they were forwarded to the hospital's Medical Executive Committee, and thus were available from another, non-protected source, see id. at 13-14.
Following our review of the certified record, the briefs for the parties, and the relevant law, we conclude that the opinion of the Honorable Jacqueline C. Cody thoroughly and correctly addresses and disposes of the Appellants' issues and supporting arguments. We agree with Judge Cody that the October 19, 2012 order was erroneous insofar as it ordered production of BWH000478, BWH000479, BWH000480, BWH000518, BWH000519, BWH000522, and BWH000523; in all other respects, the order is proper. Accordingly, we adopt the trial court's opinion of December 28, 2012 as our own, and affirm in part and reverse in part the court's disposition of Appellants' issues on the basis of that opinion. The parties shall attach a copy of the trial court's December 28, 2012 opinion in the event of further proceedings.
Order affirmed in part and reversed in part. Case remanded for further proceedings consistent with this memorandum. Jurisdiction relinquished.