Klaine v. Southern Illinois Hospital Services
2016 IL 118217
| Ill. | 2016Background
- Carol and Keith Klaine sued Dr. Frederick Dressen and later added Southern Illinois Hospital Services (SIHS) for negligent credentialing after reviewing Dr. Dressen’s performance.
- Plaintiffs served discovery; SIHS produced ~1,700 pages but withheld certain documents (privilege log), invoking the Credentials Act and Medical Studies Act confidentiality provisions.
- The trial court reviewed withheld materials in camera and ordered production of three groups; SIHS appealed only the three credentialing applications (Group Exhibit F).
- Group Exhibit F consisted of three SIHS staff-privilege applications submitted by Dr. Dressen (2009, 2010, 2011); Group Exhibit J contained surgeon case histories.
- Appellate court affirmed production of Group Exhibit F (with redactions of an external peer-review report and any patient identifiers per HIPAA rules/45 C.F.R. § 164.512(e)) and remanded; SIHS sought review in the Illinois Supreme Court.
- The Supreme Court reviewed de novo whether statutory confidentiality in the Credentials Act or other statutes created a discovery privilege shielding the applications or required redactions (NPDB reports, nonparty patient treatment data).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Credentials Act §15(h) makes credentialing applications wholly privileged and nondiscoverable | Applications are relevant to negligent-credentialing claim and discoverable | §15(h) labels credentials data "confidential," so applications are privileged and nondiscoverable | Held: §15(h) does not create a blanket discovery privilege; applications must be produced (with limited redactions) |
| Whether the NPDB-related information in the applications is privileged under the Health Care Quality Improvement Act | NPDB reports are relevant and producible in negligent-credentialing litigation | NPDB confidentiality (42 U.S.C. §11137) bars disclosure | Held: NPDB information is not privileged here; federal law and regulations permit/discuss disclosure to hospitals and, in litigation, to plaintiffs under conditions, so NPDB entries need not be shielded |
| Whether nonparty patient-treatment information in the applications is protected by physician-patient privilege or HIPAA from production | Plaintiffs seek only procedure summaries relevant to credentialing | Such nonparty treatment details are privileged under physician-patient privilege or HIPAA and must be redacted | Held: Physician-patient privilege does not bar disclosure of non-identifying procedural/treatment data in the applications; identifying patient data must be redacted per HIPAA/regulations |
| Whether precedent (TTX Co.) requires treating statutory "confidentiality" as a nondiscoverable privilege | Plaintiffs: confidentiality alone does not create privilege; privilege must be explicit | Defendant: TTX shows statutory confidentiality can bar discovery | Held: TTX is inapposite; confidentiality language alone does not create a discovery privilege—privileges must be explicit in statute |
Key Cases Cited
- Norskog v. Pfiel, 197 Ill. 2d 60 (discussion of standard of review for discovery orders and statutory-privilege questions)
- TTX Co. v. Whitley, 295 Ill. App. 3d 548 (tax confidentiality refusal; court distinguished as inapplicable where evidence is relevant)
- Frigo v. Silver Cross Hospital & Medical Ctr., 377 Ill. App. 3d 43 (peer-review/Medical Studies Act scope; not all peer-review-acquired info is nondiscoverable)
- Webb v. Mount Sinai Hosp. & Med. Ctr. of Chicago, 347 Ill. App. 3d 817 (limits on expansive readings of Medical Studies Act that would bar institutional negligence claims)
- Cox v. Yellow Cab Co., 61 Ill. 2d 416 (party claiming a privilege bears burden to show facts giving rise to it)