ESTATE OF LEONARD P. KRAPPA, DECEASED, BY AND THROUGH HIS ADMINISTRATOR, LEONARD A. KRAPPA AND MARGARET KRAPPA, INDIVIDUALLY AND IN HER OWN RIGHT
MARK LYONS, D.O.; FRANK PIRO, M.D.; JONATHAN C. SULLUM, M.D.; JUAN C. BARRERA, M.D.; JAMES FRANGOS, M.D.; LOUIS DEGENNARO, M.D.; AND COMMUNITY MEDICAL CENTER PETITION OF: COMMUNITY MEDICAL CENTER
Petition for Allowance of Appeal from the Order of the
NOW, this 19th day of December, 2019, the Petition
for Allowance of Appeal is DENIED.
Petitioner's Application for Leave to File Reply to
Answer is DENIED.
that the instant petition does not merit this Court's
review. While this case suggests an issue of significant
interest that may present itself in due course, it does not
properly frame that issue for our consideration now.
Nonetheless, the issue is worth mention, because it is likely
to arise, recur, and materially affect many future disputes.
than two years ago, this Court issued its decision in
Reginelli v. Boggs, 181 A.3d 293 (Pa.
2018). In that case, this Court decided several
interpretive questions arising under the Peer Review
Protection Act ("PRPA"), 63 P.S. §§
425.1-425.4. The PRPA creates a limited evidentiary
privilege for certain records pertaining to physicians'
assessment of other physicians' performance,
i.e., "peer review." The instant case
appears to be the first Superior Court opinion, published or
otherwise, to apply Reginelli.
matter, the files as to which the parties dispute the
PRPA's application were compiled by a "credentialing
committee" in service of determining whether to
"credential" and/or "recredential" two
physicians subject to a medical malpractice suit. Estate
of Krappa v. Lyons, 211 A.3d 869, 871 (Pa. Super. 2019).
Respondent-Plaintiffs sought discovery of the committee's
unredacted files concerning these physicians.
Petitioner-Defendant Community Medical Center asserted
privilege claims as to many of the records, in furtherance of
which it submitted privilege logs encompassing numerous
documents, the vast majority of which it specifically
denominated "peer review documents," and some of
which were described in ways that suggested the denomination
was apt. See, e.g., Privilege Log of the
Credentialing File of Frank A. Piro, M.D., at 2 ¶ 8
(describing a "Medical Staff Peer Recommendation"
as a "[p]eer [r]eview document generated for . . .
quality improvement purposes pursuant [to] MCARE. Not for
redistribution outside [the] Committee."). Thus,
Petitioner invoked the PRPA's protections. After
reviewing the documents in camera, and considering
arguments based upon the then hot-off-the-presses
Reginelli decision, the trial court determined that
none were protected by the privilege. On appeal, the Superior
Court, which conducted its own in camera review,
agreed. Estate of Krappa, 211 A.3d at 871, 875.
Reginelli addressed a number of discrete questions
of statutory interpretation, the aspect of the case relevant
to this matter drew a categorical distinction between peer
review and credentialing, as such. The Superior Court in this
case relied heavily upon this distinction. It is not
necessary here to delve into the lengthy statutory provisions
at issue. It suffices to say that this Court
interpreted the relevant provisions to provide that "a
review organization" is defined by the PRPA to encompass
functionally distinct peer review committees and
credentialing committees. Only the work and files of the
former enjoy the PRPA privilege; files compiled for purposes
of credentialing, as such, are subject to discovery. See
Reginelli, 181 A.3d at 305-06. In doing so, this Court
offered a relatively narrow definition of what comprises a
Court explained as follows:
[A credentialing committee is] a "hospital board,
committee or individual" involved in the review of
"the professional qualifications or activities of its
medical staff or applicants thereto" by a "hospital
board, committee or individual."10 [63 P.S.
§ 425.2.] This . . . category of "review
organizations" does not involve peer review, as that
term is defined in the PRPA, which is limited to the
evaluation of the "quality and efficiency of services
ordered or performed" by a professional health care
provider. [Id.] Review of a physician's
credentials for purposes of membership (or continued
membership) on a hospital's medical staff is markedly
different from reviewing the "quality and efficiency of
service[s] ordered or performed" by a physician when
treating patients. Accordingly, although
"individuals reviewing the professional qualifications
or activities of its medical staff or applicants for
admission thereto," [id.], are defined as a
type of "review organization," such individuals are
not "review committees" entitled to claim the
PRPA's evidentiary privilege . . . .
10 Professional "qualifications" would
include, for instance, a physician's continuing
maintenance of his or her board certifications, and
"activities" could include clinical research
initiatives, continuing education, service on professional
committees or organizations and, more broadly speaking, other
qualifications deemed necessary by the hospital. Credentials
review permits a hospital to retain, and then maintain, a
medical staff of quality professionals.
Reginelli, 181 A.3d at 305-06 (footnotes 11 and 12
omitted; emphasis added). I am concerned that the marked
difference posited by the Reginelli Court will prove
more difficult to discern in practice than it is to describe
in the pages of a judicial opinion.
PRPA embodies the legislature's effort to protect
physicians who candidly reveal concerns about the quality of
care rendered by their peers to committees that conduct such
assessments, so as to ensure candid and reprisal-free
physician assessments by those who are most qualified and
best positioned to make them. See Reginelli, 181
A.3d at 300 ("[The PRPA] was enacted to serve the
legitimate purpose of maintaining high professional standards
in the medical practice for the protection of patients and
the general public based upon the General Assembly's
determination 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." (cleaned up)). Thus, the PRPA's
immunity and confidentiality provisions reflect the
legislature's effort "to foster free and frank
discussion by review organizations." Id.
(quoting Sanderson v. Frank S. Bryan, M.D., Ltd.,
522 A.2d 1138, 1140 (Pa. Super. 1987)); see 63 P.S.
§ 425.1, Historical and Statutory Notes ("An Act
providing for the increased use of peer review groups by
giving protection to individuals and data who report to any
review group."). Such protection is not necessary with
respect to essentially binary or anodyne inquiries, such as
as whether a physician has maintained board certifications,
pursued continuing education, conducted research, or
otherwise attained ...