Baptist Health Richmond, Inc. v. Hon William G. Clouse Jr Judge, Madison Circuit Court, Division I
2016 Ky. LEXIS 430
| Ky. | 2016Background
- Eva Louise Nall died after laparoscopic surgery; her husband, Tim Agee, sued Baptist Health and others for medical negligence.
- Agee requested production of incident reports, investigation reports, root cause analyses, sentinel-event and similar documents relating to Nall.
- Baptist Health refused production, asserting documents were protected as "patient safety work product" under the Patient Safety and Quality Improvement Act (PSQIA/Act).
- The trial court applied a "sole purpose" standard, ordering production only of materials not created solely for reporting to a Patient Safety Organization (PSO); Baptist sought a writ prohibiting enforcement. The Court of Appeals denied the writ.
- This Court reviewed Tibbs v. Bunnell and HHS guidance, concluded neither the Act nor HHS permitted providers to shield state-mandated records by placing them in a patient safety evaluation system, and vacated the trial court’s order remanding for an in camera review per a limited framework.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether documents in a provider's patient safety evaluation system are protected from discovery by the PSQIA | Agee: State-mandated records and originals should be discoverable; PSQIA cannot be used to evade disclosure obligations | Baptist: Documents collected/maintained in the patient safety system and reported to a PSO are privileged patient safety work product | The Court: State-required records (original provider records) are not protected merely because they reside in the patient safety system; if provider complied with external obligations, no court intrusion needed; if not, court may do an in camera review and separate state-mandated content from privileged material |
| Proper standard for determining PSQIA protection ("sole purpose" vs broader protection) | Agee: "Sole purpose" test insufficient to protect state-mandated records from discovery | Baptist: Materials placed in the patient safety system should remain protected unless removed | The Court: Rejects absolute "sole purpose" sheltering; adopts middle ground—documents that are ordinarily part of state-mandated reports are not privileged even if housed in the patient safety system |
| Who bears burden to show compliance with reporting obligations | Agee: (implicit) provider should not be permitted to assert privilege without proof of compliance | Baptist: (implicit) privilege claimed unless proven otherwise | The Court: Provider bears burden to prove compliance with statutory/regulatory reporting; if provider fails, requester must show what is generally contained in state-mandated reports |
| Role of trial court in review when compliance is contested | Agee: Court should ensure state-mandated records are produced | Baptist: Court should defer because PSQIA protects materials in patient safety system | The Court: If provider failed to meet external obligations, trial court may conduct in camera review and segregate non-privileged, state-mandated information from privileged patient safety work product |
Key Cases Cited
- Tibbs v. Bunnell, 448 S.W.3d 796 (Ky. 2014) (analyzed scope of PSQIA privilege and state-mandated reporting; persuasive but not controlling on reasoning)
- Ware v. Commonwealth, 47 S.W.3d 333 (Ky. 2001) (stare decisis principles regarding precedent and plurality opinions)