863 S.E.2d 632
N.C. Ct. App.2021Background
- Patrick Williams presented to an urgent care then was transported to CMC‑Pineville ED on May 6, 2016; he received analgesics and was diagnosed with left lumbar radiculopathy and discharged; he returned the next day, was found to have a ruptured abdominal aortic aneurysm, and died after transfer and surgery.
- Physician assistant Marchelle Allen created a four‑page “diary” (produced) and later a separate two‑page entry submitted via EMP’s internal system to risk management; Defendants initially logged the four‑page diary as privileged and later withheld the two‑page document as medical‑review and other privileges.
- Plaintiff moved to compel production; the trial court ordered production of the withheld two‑page document but kept it under seal pending appeal; Defendants appealed the enforcement order.
- The majority Court of Appeals held the trial court failed to make required findings on the statutory elements of the medical review committee privilege under N.C.G.S. § 90‑21.22A and remanded for specific factual findings and conclusions.
- Judge Murphy dissented: he would have dismissed the appeal for Defendants’ failure to include the sealed document in the appellate record (thereby impairing meaningful review) and, alternatively, would affirm on the merits because Defendants failed to prove the committee met the statute’s requirements.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held | |
|---|---|---|---|---|
| Whether the trial court erred by enforcing a prior discovery order and compelling production of the withheld two‑page document | Williams: the two‑page document was responsive and not protected by the claimed privilege; production was proper | Allen/EMP: the document is protected by the medical review committee (peer review) privilege and was not required to be produced | Majority: remand for trial court to make findings on whether privilege elements are met; enforcement order left intact pending those findings (i.e., insufficient findings—remand) | |
| Whether Defendants met their burden to invoke the medical review committee privilege under N.C.G.S. § 90‑21.22A | Williams: privilege not shown; documents were producible | Allen/EMP: committee materials are privileged; central committee composed of licensed providers; submission via EMP system was for committee use | Majority: trial court must find whether committee members were licensed under Chapter 90, committee purpose met, and whether document was produced/presented to committee; remand for findings. Dissent: Defendants failed to meet burden and privilege not established | |
| Whether the trial court was required to make detailed factual findings and conclusions supporting its privilege ruling | Williams: findings are required to permit appellate review of privilege claim | Allen/EMP: not specified; argued about parameters | Majority: findings on statutory elements are required for meaningful appellate review; remand for specific findings | Dissent: Defendants did not request findings under Rule 52; absent a request, trial court was not obligated to enter findings; presume supporting facts exist and affirm |
| Whether the appeal should be dismissed for failure to include the sealed document in the appellate record | Williams: not applicable (document produced to plaintiff) | Allen/EMP: document was sealed per trial court order; thus not in record | Dissent: dismissal appropriate because Defendants failed to supply sealed document to appellate record, impairing review; Majority reached merits and remanded instead |
Key Cases Cited
- Shelton v. Morehead Mem'l Hosp., 318 N.C. 76 (1986) (explaining purpose of medical review committee privilege to encourage candor and objectivity)
- Hammond v. Saini, 229 N.C. App. 359 (2013) (orders compelling discovery of material claimed protected by medical review privilege affect a substantial right and are immediately appealable)
- Coble v. Coble, 300 N.C. 708 (1980) (trial court findings must be specific enough to permit effective appellate review)
- Dogwood Dev. & Mgmt. Co. v. White Oak Transp. Co., 362 N.C. 191 (2008) (failure to comply with appellate record rules may forfeit review; sanctions up to dismissal available)
- JVC Enters. v. City of Concord, 376 N.C. 782 (2021) (statutory interpretation begins with plain meaning; no resort to other tools when text is clear)
- K2 Asia Ventures v. Trota, 215 N.C. App. 443 (2011) (assertion of a statutory privilege that is not frivolous may implicate a substantial right for immediate appeal)
- Wagoner v. Elkin City Schools’ Bd. of Educ., 113 N.C. App. 579 (1994) (motion to compel reviewed for abuse of discretion)
- Brown v. Brown, 47 N.C. App. 323 (1980) (trial court need not enter findings of fact under Rule 52 absent a timely request)
- CRLP Durham, LP v. Durham City/Cty. Bd. of Adjustment, 210 N.C. App. 203 (2011) (appellate court cannot review issues without the relevant document in the record)