Dennis Willard v. State of Iowa
2017 Iowa Sup. LEXIS 31
| Iowa | 2017Background
- Plaintiff Dennis Willard was severely injured in an auto accident and, while sedated and intubated at the University of Iowa Hospitals & Clinics (UIHC), underwent an abdominal CT during which his left shoulder later was found dislocated.
- A UIHC employee filed a Patient Safety Net (PSN) incident report after the CT; UIHC routes PSNs into an internal quality/safety process (possible root cause analysis, safety oversight review, morbidity/mortality uses).
- Willard sued the State (UIHC) for medical negligence and sought production of the PSN and related documents during discovery.
- The State asserted the materials were privileged under Iowa’s morbidity and mortality statutes, Iowa Code §§ 135.40–.42, and resisted disclosure.
- The district court ordered production, finding the State did not show the PSN was used in a study under § 135.40 and that § 135.42 limited admissibility but not discoverability; the State appealed interlocutorily.
- The Iowa Supreme Court reversed, holding PSNs fall within the statutory morbidity and mortality privilege and are not discoverable under § 135.42.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether a PSN qualifies as "information ... to be used in the course of any study for the purpose of reducing morbidity or mortality" under § 135.40 | Willard: PSN was not shown to have been used in any morbidity/mortality study, so it is not protected | State: PSN fits within the broad statutory scope; PSNs are used in quality improvement and safety studies and thus are protected | Held: PSN and related documents fall within § 135.40 and are privileged as morbidity and mortality information |
| Whether § 135.41 (publication/confidentiality) applies to bar disclosure to the plaintiff | Willard: § 135.41 protects disclosures to third parties, not the injured patient requesting his own PSN | State: § 135.41 generally limits use/publication and preserves confidentiality; scope supports non-disclosure | Held: § 135.41 is not limited to third-party requests, but the provision does not require producing the PSN (plaintiff sought the documents themselves, not a summary) |
| Whether § 135.42 ("shall not be used or offered or received in evidence in any legal proceedings") precludes discovery | Willard: § 135.42 bars admissibility at trial but does not preclude discovery | State: The statute’s phrase "shall not be used" should be read broadly to prohibit use in legal proceedings including discovery; breadth supports protection | Held: Applying textual canons and legislative purpose, § 135.42 is construed broadly — PSNs and related documents are not discoverable under the morbidity and mortality privilege |
Key Cases Cited
- Jones v. Univ. of Iowa, 836 N.W.2d 127 (Iowa 2013) (standard for reviewing discovery rulings)
- Carolan v. Hill, 553 N.W.2d 882 (Iowa 1996) (statutory peer-review/morbidity privilege scope governed by statute; privileges construed narrowly but statutory words control)
- Burton v. Univ. of Iowa Hosps. & Clinics, 566 N.W.2d 182 (Iowa 1997) (hospital discretion re: releasing summaries of morbidity/mortality studies)
- Sioux Pharm., Inc. v. Eagle Labs., Inc., 865 N.W.2d 528 (Iowa 2015) (statutory interpretation principles)
- State v. Howse, 875 N.W.2d 684 (Iowa 2016) (statutory-interpretation methodology)
- Tibbs v. Bunnell, 448 S.W.3d 796 (Ky. 2014) (discussing PSQIA and policy encouraging error-reporting and protection)
- Dep’t of Fin. & Prof’l Regulation v. Walgreen Co., 970 N.E.2d 552 (Ill. App. Ct. 2012) (federal Patient Safety Act’s evidentiary protections and policy context)