47 Pa. D. & C.5th 496
Pennsylvania Court of Common P...2015Background
- Plaintiff (Estate of James L. Brink) sought production of a Sentinel Event Report Marian Hospital submitted to The Joint Commission after Brink’s 2011 inpatient suicide.
- Trial court initially ordered in camera review; Marian submitted the report but failed to provide its 2011 Sentinel Event policy or proof who received/reviewed the report.
- Based on the incomplete record, the court denied PRPA protection and ordered production. Marian timely moved for reconsideration and produced the Sentinel Event policy and a CEO affidavit describing a root cause analysis and participants.
- Marian’s policy required a root cause analysis and action plan within 45 days for sentinel events, expressly contemplated peer review committee notification, maintenance of the RCA in quality/safety, and stated the material is confidential/protected by PRPA.
- The CEO affidavit described a multidisciplinary root cause analysis focused on systems/processes, development of an action plan, and communication of results to patient safety/peer review bodies; Marian asserted the report was peer-review privileged.
- The court granted reconsideration, holding the supplemental materials established the report is protected under Section 4 of the Peer Review Protection Act and denied plaintiff’s motion to compel production of the report.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Sentinel Event Report is protected by PRPA (63 P.S. § 425.4) | Brink: report was prepared by risk management for litigation/investigation and thus is not peer-review privileged | Marian: report is a root cause analysis prepared by quality/peer-review personnel to evaluate care and improve systems, thus privileged | Held: Privileged under PRPA; Marian’s supplemental policy and affidavit establish peer-review purpose and process |
| Whether sending report to The Joint Commission alone creates privilege | Brink: forwarding to Joint Commission does not automatically convert a non-peer-review document into privileged material | Marian: report contained RCA and action plan prepared for peer-review purposes and reviewed by hospital committees and Joint Commission | Held: Court agreed privilege not created merely by sending, but here report itself was generated as part of peer-review process, so protected |
| Whether participation of treating providers or disclosure to legal/insurer defeats privilege | Brink: involvement of treating providers and consultation with counsel suggests non-privileged investigative/litigation purpose | Marian: treating staff were interviewed as part of RCA; counsel/insurer were consulted but did not draft or control the RCA | Held: Interviews of treating staff in RCA and limited consultation with counsel did not negate peer-review protection |
| Burden to establish privilege on motion for reconsideration | Brink: initial record lacked proof of peer-review origin | Marian: timely produced policy and affidavit on reconsideration showing peer-review framework and participants | Held: Marian met its burden on reconsideration; motion granted and production denied |
Key Cases Cited
- Troescher v. Grody, 869 A.2d 1014 (Pa. Super. 2005) (PRPA purpose and interpretation)
- Cooper v. Delaware Valley Med. Ctr., 630 A.2d 1 (Pa. Super. 1993) (role of peer review confidentiality)
- Dodson v. DeLeo, 872 A.2d 1237 (Pa. Super. 2005) (distinguishing non-peer-review business records from peer-review materials)
- Young v. Western Pennsylvania Hosp., 722 A.2d 153 (Pa. Super. 1998) (legislative basis for self-policing and confidentiality)
- Piroli v. Lodico, 909 A.2d 846 (Pa. Super. 2006) (need for confidentiality to enable candid peer evaluations)
- Joe v. Prison Health Servs., Inc., 782 A.2d 24 (Pa. Cmwlth. 2001) (burden to establish documents were produced by a review committee)
- Atkins v. Pottstown Mem. Med. Ctr., 634 A.2d 258 (Pa. Super. 1993) (incident/risk-management reports not protected by PRPA)
- King v. Stefenelli, 862 A.2d 666 (Pa. Super. 2004) (treating physician interviewed in peer-review process does not destroy privilege)