715 S.W.3d 321
Tenn.2025Background
- Marshal Castillo died from an internal hemorrhage shortly after being discharged from CHI Memorial Hospital, despite diagnostic scans interpreted as normal.
- His widow, Payton Castillo, filed a healthcare liability suit against the hospital and doctors alleging negligent care.
- After the incident, the hospital convened a Quality Improvement Committee (QIC) to review the case, followed by a "CANDOR" meeting where hospital management disclosed findings to Mrs. Castillo and her family.
- During litigation, Mrs. Castillo sought discovery of statements made at this meeting; the hospital claimed these were privileged under Tennessee's QIC statute (Tenn. Code Ann. § 68-11-272).
- The trial court allowed some discovery; the Court of Appeals affirmed, holding the privilege did not apply; the Supreme Court granted further review.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does QIC privilege under Tenn. Code Ann. § 68-11-272 apply to statements in the CANDOR meeting? | Statements at the CANDOR meeting aren't protected because they aren't part of the QIC and serve a different purpose. | Statements are privileged as they relate to QIC activities regardless of the meeting format. | Privilege applies if statements are based on QIC information, regardless of the CANDOR meeting context. |
| Can the QIC privilege be waived by the healthcare organization? | Privilege can be waived, especially by voluntary disclosure to a third party. | Privilege cannot be waived, as it's designed to protect the QIC process and participants broadly. | Privilege is waivable by the healthcare organization; voluntary disclosure to plaintiff constitutes waiver. |
| Scope of waiver if privilege is found waivable? | Waiver should allow full discovery and use of related materials. | Any waiver should be extremely limited, not extending to all QIC materials or participants. | Waiver is limited to statements actually disclosed in the meeting, not underlying QIC materials or records. |
| Special status for CANDOR meetings under Tennessee law? | No statutory CANDOR protection, so no special status or privilege should attach. | Label of CANDOR meeting should not negate privilege if QIC materials are discussed. | Tennessee law does not recognize CANDOR as a privileged process apart from QIC statute. |
Key Cases Cited
- Lee Med., Inc. v. Beecher, 312 S.W.3d 515 (Tenn. 2010) (addressing how statutory privileges should be interpreted and reviewed)
- Powell v. Community Health Sys., Inc., 312 S.W.3d 496 (Tenn. 2010) (discussing waiver of peer review privilege under earlier statute)
- Stratienko v. Chattanooga-Hamilton Cnty. Hosp. Auth., 226 S.W.3d 280 (Tenn. 2007) (the importance of confidentiality in peer review)
- Federal Insurance Co. v. Arthur Anderson & Co., 816 S.W.2d 328 (Tenn. 1991) (analogy to waiver of statutory privileges, e.g., accountant-client)