In re Christus Santa Rosa Health System
492 S.W.3d 276
| Tex. | 2016Background
- In March 2012 Dr. Gerald Marcus Franklin removed thymus tissue instead of thyroid tissue during surgery on Leslie Baird; a second surgery followed. Christus Santa Rosa convened a medical peer review committee, which did not recommend discipline and closed the file.
- Baird sued for malpractice; Franklin sought to designate Christus as a responsible third party, alleging lack of an available cryostat machine caused the failed surgery.
- Franklin requested Christus’s medical peer review committee records. Christus asserted the statutory medical peer review privilege (Tex. Occ. Code §160.007(a)), submitted affidavits, bylaws, a privilege log, and tendered the documents for in camera review.
- A substitute judge (not the presiding judge) ordered production of the documents under a confidentiality protective order; Christus’s motion for reconsideration was denied. Christus sought mandamus relief.
- The Supreme Court held the trial court abused its discretion by failing to conduct an adequate in camera inspection to determine whether the section 160.007(d) exception (disclosure when the committee "takes action that could result in" discipline) applied, and directed the trial court to perform the proper review.
Issues
| Issue | Plaintiff's Argument (Franklin) | Defendant's Argument (Christus) | Held |
|---|---|---|---|
| Whether medical peer review records are privileged | Franklin did not dispute privilege generally but argued §160.007(d) exception applies so records must be disclosed | Christus asserted records are protected by §160.007(a) and established a prima facie privilege, tendering documents for in camera review | Court: Privilege prima facie established; trial court must inspect documents in camera before compelling production |
| Scope of §160.007(d) exception — when does a committee "take action that could result in" discipline? | Franklin: Any convening/review qualifies because committee could potentially recommend discipline; thus exception applies | Christus: Exception requires more than convening; it requires a voluntary act or recommendation from which disciplinary consequences were possible | Court: Exception requires more than mere convening — a voluntary act or recommendation that could lead to discipline; ambiguous on this record, so in camera review is required |
| Adequacy of the trial court’s in camera review | Franklin implied the judge properly evaluated and ordered disclosure | Christus: substitute judge lacked affidavits and did not adequately review merits of documents; trial court later admitted it did not inspect merits | Court: Trial court abused discretion by failing to conduct a meaningful in camera inspection critical to evaluating the privilege and exception |
| Remedy — mandamus availability | Franklin: disclosure order should stand; appeal adequate | Christus: erroneous disclosure of privileged materials leaves no adequate appellate remedy | Court: Mandamus appropriate; directed trial court to vacate compelled-production orders and re-inspect documents under §160.007(d) |
Key Cases Cited
- Walker v. Packer, 827 S.W.2d 833 (Tex. 1992) (mandamus standard; trial-court abuse of discretion)
- In re E.I. DuPont de Nemours & Co., 136 S.W.3d 218 (Tex. 2004) (trial court must conduct in camera inspection when privilege claim tendered)
- In re Living Ctrs. of Tex., 175 S.W.3d 253 (Tex. 2005) (mandamus if trial court fails to adequately inspect privileged documents)
- In re Mem’l Hermann Hosp. Sys., 464 S.W.3d 686 (Tex. 2015) (medical peer review privilege analysis and burdens)
- Granada Corp. v. Hon. First Ct. App., 844 S.W.2d 223 (Tex. 1992) (burden shifts to party seeking production to prove exception to privilege)
- Mem’l Hosp.—The Woodlands v. McCown, 927 S.W.2d 1 (Tex. 1996) (purpose of peer-review confidentiality)
- Irving Healthcare Sys. v. Brooks, 927 S.W.2d 12 (Tex. 1996) (peer-review privilege fosters candid professional exchange)