Quimbey ex rel. Faure v. Community Health Systems Professional Services Corp.
222 F. Supp. 3d 1038
D.N.M.2016Background
- Plaintiff Quimbey moved to compel discovery from Las Cruces Medical Center (Mountain View Regional Medical Center) regarding various peer-review and quality-improvement documents after a December 11, 2012 incident resulting in Ms. Quimbey’s death.
- Defendant invoked New Mexico’s Review Organization Immunity Act (ROIA) and the federal Patient Safety and Quality Improvement Act (PSQIA) to withhold documents, some of which bore a “CHS PSO, LLC Confidential patient safety work product document” stamp.
- Court conducted an in camera review of disputed documents including: a Medication Variance Occurrence Log, Incident/Accident Reports, Stroke Committee minutes/agendas, several Stroke data spreadsheets/compilations, and a Stroke Program Satisfaction Data compilation.
- Legal issues centered on whether ROIA or PSQIA protects the documents from discovery, whether PSQIA preempts ROIA, and whether withheld documents meet the statutory burdens (exclusively generated for peer review / reported to a PSO) or are "critical" to Plaintiff’s case under ROIA.
- The Court found PSQIA expressly (and implicitly in conflict) preempts state peer-review law to the extent documents qualify as patient safety work product (PSWP) reported to a certified PSO; documents stamped as CHS PSO were treated as PSWP and protected.
- The Court split the disputed documents: it denied production for items qualifying as PSWP or protected under ROIA and ordered production (with limited redactions or confidentiality protections) for certain Core Measures and Stroke data spreadsheets found critical to Plaintiff’s case.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does PSQIA preempt ROIA for documents that qualify as patient safety work product? | PSQIA is not an independent privilege in NM; ROIA governs. | PSQIA expressly and impliedly preempts state law for PSWP. | PSQIA preempts ROIA as to documents that qualify as PSWP reported to a certified PSO. |
| Were the Medication Variance Occurrence Log and Incident/Accident Reports protected PSWP? | Queried whether underlying data is "otherwise available" and not exclusively for peer review. | Documents bear CHS PSO stamp and were submitted to a PSO, so they are PSWP. | Court found the stamps credible and held these documents are PSWP; production denied. |
| Are Stroke Committee minutes and agendas protected under ROIA and/or PSQIA, and are they critical? | Minutes likely contain critical information and underlying facts; Plaintiff did not show otherwise availability. | Minutes were generated exclusively for peer review and opinions formed in committee. | Defendant met ROIA exclusivity; on criticality review, minutes/agendas are not critical — production denied. |
| Are various Stroke data spreadsheets/compilations protected and/or critical? | Core Measures and stroke data contain underlying patient-care data and some submitted to Joint Commission; Plaintiff says needed to rebut hospital’s systemic-defense. | Some compilations were generated exclusively for peer review; Core Measures submitted to outside accreditor. | Core Measures compilations (submitted to Joint Commission) not shown to be ROIA-protected — production ordered. Stroke Data Compilation and Stroke Data Spreadsheet 2012 were generated for peer review but are critical to Plaintiff — production ordered with redactions. Core Stroke Data Spreadsheet and Satisfaction compilation not critical — production denied. |
Key Cases Cited
- Southwest Cmty. Health Servs. v. Smith, 755 P.2d 40 (N.M. 1988) (framework for ROIA burden and criticality analysis)
- Chavez v. Lovelace Sandia Health Sys., 189 P.3d 711 (N.M. Ct. App. 2008) (applying ROIA burdens: relevance, exclusivity, and criticality)
- Teasdale v. Marin Gen. Hosp., 138 F.R.D. 691 (N.D. Cal. 1991) (consideration of federal preemption questions for peer-review materials)
- Southern Baptist Hosp. of Fla., Inc. v. Charles, 178 So.3d 102 (Fla. Dist. Ct. App. 2015) (holding PSQIA preempted state law and protected documents qualifying as PSWP)
- Tibbs v. Bunnell, 448 S.W.3d 796 (Ky. 2014) (analyzing limits of PSQIA protection when information maintained for state regulatory oversight)
- Altria Grp. v. Good, 555 U.S. 70 (2008) (Supremacy Clause / preemption principles)
- Gade v. Nat’l Solid Wastes Mgmt. Ass’n, 505 U.S. 88 (1992) (field and conflict preemption doctrines)