DOMAKO v ROWE
Docket No. 89257
Supreme Court of Michigan
September 6, 1991
Rehearing denied 439 Mich 1202
438 Mich 347 | 475 N.W.2d 30
Argued April 2, 1991 (Calendar No. 3).
Docket No. 89257. Argued April 2, 1991 (Calendar No. 3). Decided September 6, 1991. Rehearing denied 439 Mich 1202.
Carol J. Domako and Thomas Domako brought a medical malpractice action in the Wayne Circuit Court against Joseph Rowe, M.D., and others, alleging negligence and loss of consortium. A mediation award was accepted by the plaintiffs, but rejected by the defendant. The court, Marianne O. Battani, J., entered judgment following a jury verdict for the defendant and denied with prejudice the plaintiffs’ motion for judgment notwithstanding the verdict or for a new trial. The Court of Appeals, MACKENZIE, P.J., and DOCTOROFF and T. G. KAVANAGH, JJ., affirmed in an opinion per curiam (Docket No. 112776). The plaintiffs appeal, limited to whether the physician-patient privilege was violated when defense counsel conducted an ex parte interview with the plaintiff‘s treating physician.
In an opinion by Chief Justice CAVANAGH, joined by Justices LEVIN, BRICKLEY, BOYLE, RILEY, and GRIFFIN, the Supreme Court held:
Defense counsel‘s ex parte interview of the plaintiff‘s treating physician was proper because the physician-patient privilege had been waived by lack of timely assertion. After the privilege is waived in a malpractice action, each party is entitled to equal access to relevant information, subject to restrictions against annoyance, embarrassment, oppression, or undue burden or expense.
1. Parties in an action may obtain discovery of any matter not privileged that is relevant to the subject matter involved. In an action for malpractice, the physician-patient statute provides for waiver of the physician-patient privilege where the patient offers a physician as a witness. Similarly, the court rules also provide for waiver. The purpose underlying the privilege is protection of the confidential nature of the physician-patient relationship and encouragement of full disclosure by the patient of symptoms and conditions. The purpose of
2. Rules of discovery are to be liberally construed to further the ends of justice by simplifying and clarifying the issues and by providing accurate information in advance of trial. Ex parte interviews appear to advance these aims, providing there has been a waiver of the physician-patient privilege. No party to litigation has anything resembling a proprietary right to any witness’ evidence; absent a privilege, no party is entitled to restrict an opponent‘s access to a witness. While a physician is different from an ordinary witness as a result of the confidential nature of the physician‘s potential testimony, that confidentiality is adequately preserved by the physician-patient privilege. Once the privilege is waived, there are no sound legal or policy grounds for restricting access to the physician-witness. Although the court rules are silent with regard to informal methods of discovery, prohibition of all ex parte interviews would be inconsistent with the purposes of providing equal access to relevant evidence and efficient, cost-effective litigation.
Justice MALLETT, concurring, stated that in the absence of notice by opposing counsel of an ex parte interview of a party‘s treating physician, the party may not be able to establish proper parameters for questioning through a protective order. To ensure absolutely the party‘s ability to secure a protective order, the party seeking the ex parte interview, at the very least, should provide notice. Such a requirement would not frustrate discovery and would provide a firm basis for mutual expectation of professionalism.
Affirmed.
184 Mich App 137; 457 NW2d 107 (1990) affirmed.
EVIDENCE — PHYSICIAN-PATIENT PRIVILEGE — MALPRACTICE — EX PARTE INTERVIEWS.
An ex parte interview by defense counsel in a malpractice action of the plaintiff‘s treating physician is proper where the physician-patient privilege is waived by lack of timely assertion;
Fieger & Fieger, P.C. (by Geoffrey N. Fieger and Dennis M. Fuller), for the plaintiffs.
Schureman, Frakes, Glass & Wulfmeier (by J. Kelly Carley) for the defendants.
Amici Curiae:
Kitch, Saurbier, Drutchas, Wagner & Kenney, P.C. (by Susan Healy Zitterman and Linda M. Garbarino), for Michigan Hospital Association, Michigan Society of Hospital Attorneys, and Michigan Society of Hospital Risk Management.
Garan, Lucow, Miller, Seward, Cooper & Becker, P.C. (by David J. Cooper and Rosalind Rochkind), for Association of Defense Trial Counsel.
Kerr, Russell & Weber (by Richard D. Weber, Catherine B. Edwards, and Patrick J. Haddad) for Michigan State Medical Society.
Kelman, Loria, Downing, Schneider & Simpson (by Morton E. Schneider and Charles Chomet) for Michigan Trial Lawyers Association.
Sullivan, Ward, Bone, Tyler, Fiott & Asher, P.C. (by Michelle A. Thomas), for William Beaumont Hospital, Henry Ford Health System, Lansing General Hospital, Bronson Hospital, Butterworth Hospital, Mid Michigan Regional Medical Center, and Blodgett Hospital.
Plunkett & Cooney, P.C. (by John P. Jacobs), for Michigan Defense Trial Counsel, Inc.
CAVANAGH, C.J. We granted leave in this medical malpractice case to determine whether the physician-patient privilege was violated when defense counsel conducted an ex parte interview with the injured plaintiff‘s treating physician. We have concluded that no violation occurred, and we affirm the judgment of the Court of Appeals.
I
Joseph Rowe, M.D., performed a total abdominal hysterectomy and a right salpingo-oophorectomy (removal of fallopian tube and ovary) on Carol Domako. There was a large fibroid tumor on the lower anterior of Domako‘s uterus. Domako was discharged from the hospital on January 14, 1985, and shortly thereafter began experiencing urinary incontinence. The cause was later determined to be a vesico-vaginal fistula, an abnormal passage between the bladder and the vagina resulting from a hole in the bladder. Dr. Rowe referred Domako to Dr. Abbassian, a urologist, for repair of the fistula. Dr. Abbassian successfully repaired the fistula during surgery performed on April 17, 1985. After the second postoperative visit, Domako did not see Dr. Abbassian again.
On February 21, 1986, Domako filed a suit, alleging negligence by Dr. Rowe; Domako‘s husband raised a loss of consortium claim. The liability issue concerned whether Dr. Rowe had perforated the bladder during the hysterectomy, thereby causing the fistula, or whether the fibroid tumor pressing against the surface of the bladder caused a depletion of blood and a subsequent weakening of the bladder wall. In the initial stage of discovery, defense counsel subpoenaed relevant medical records. The request for Dr. Abbassian‘s medical records was made under
Mediation of the matter occurred on August 4, 1987, and the defendants set forth in their mediation summary that Dr. Abbassian would be giving opinion testimony regarding the cause of the fistula. The plaintiffs accepted the mediation evaluation of $35,000, but Dr. Rowe rejected it. On November 19, 1987, the plaintiffs filed their witness list which included Dr. Abbassian. The defendants also included Dr. Abbassian on their witness list, declaring him an expert witness since they intended to elicit opinion testimony regarding the cause of the fistula. Again, no objection was received from the plaintiffs.
On April 6, 1988, five days before trial was set to begin, the defendants were scheduled to conduct a de bene esse deposition of Dr. Abbassian because the doctor had a heart condition and they sought to avoid the stress of testifying in person during trial. The plaintiffs did not object in advance. At the deposition, however, the plaintiffs’ attorney stated that he had just become aware of the ex parte contact between Dr. Abbassian and the defendants, and he immediately asserted the physician-patient privilege. The plaintiffs’ counsel accused Dr. Abbassian of betraying the physician-patient privilege and threatened a lawsuit for breach of privilege. Dr. Abbassian then refused to continue, and the deposition was adjourned.
Defense counsel filed an emergency motion to bar the plaintiffs from introducing any evidence at
During trial, the plaintiffs called Dr. Abbassian as a witness, and he testified that the fistula had been caused, not by any negligence of Dr. Rowe, but by the large fibroid tumor pressing against the plaintiff‘s bladder causing decreased blood flow and deterioration of the tissue. The jury returned a verdict of no cause of action in favor of the defendants. The trial court denied with prejudice the plaintiffs’ motion for judgment notwithstanding the verdict and, alternatively, for a new trial. The Court of Appeals affirmed, 184 Mich App 137; 457 NW2d 107 (1990). The Court of Appeals also issued an order, pursuant to Administrative Order No. 1984-2, which certified that the opinion was in conflict with Lawrence v Bay Osteopathic Hosp, Inc, 175 Mich App 61; 437 NW2d 296 (1989), and Jordan v Sinai Hosp of Detroit, Inc, 171 Mich App 328; 429 NW2d 891 (1988).
This Court granted leave to appeal, limited to whether the physician-patient privilege was violated when defense counsel conducted the ex parte interview with the plaintiff‘s treating physician. A number of interested groups were permitted to appear as amici curiae in this matter.
II
The process of discovery is extensively addressed by the Michigan Court Rules of 1985. The scope of discovery is outlined in
The applicable privilege is the physician-patient privilege created in this state by statute. At the time of the proceedings in this case,
No person duly authorized to practice medicine or surgery shall be allowed to disclose any information which he may have acquired in attending any patient in his professional character, and which information was necessary to enable him to prescribe for such patient as a physician, or to do any act for him as a surgeon: Provided, however, That in case such patient shall bring an action against any defendant to recover for any personal injuries, or for any malpractice, if such plaintiff shall produce any physician as a witness in his own behalf, who has treated him for such injury, or for any disease or condition, with reference to which such malpractice is alleged, he shall be deemed to have waived the privilege hereinbefore provided for, as to any or all other physicians, who may have treated him for such injuries, disease or condition....2
The statute provides protection for information
When a mental or physical condition of a party is in controversy, medical information about the condition is subject to discovery under
MCR 2.310 to the extent that ... the party does not assert that the information is subject to a valid privilege. [MCR 2.314(A)(1)(b) .]
Just as in the privilege statute, the court rules provide for the waiver of the physician-patient privilege.
The purpose behind the physician-patient privilege is to protect the confidential nature of the physician-patient relationship and to encourage the patient to make a full disclosure of symptoms and conditions. Gaertner v Michigan, 385 Mich 49, 53; 187 NW2d 429 (1971); Schechet v Kesten, 372 Mich 346, 351; 126 NW2d 718 (1964); 81 Am Jur 2d, Witnesses, § 231, p 262. The purpose of provid-
The rules in Michigan allow the assertion of the physician-patient privilege at various stages of the proceedings.3 The court rules do permit, however, an implied waiver when the patient fails to timely assert the privilege.
The rule is rational in its design because the fundamental concept behind the rule of privilege is that one should not be forced to divulge certain information, certain communications, etc. The essence of the privilege is the lack of disclosure, not the time of disclosure. [2 Martin, Dean & Webster, Michigan Court Rules Practice, Rule 2.302, p 168.]
In this case, after the defendants sought information under
After the patient voluntarily allows discovery of the medical information, the plaintiff is not thereafter free to assert the privilege because the plain language of
III
Having concluded that the plaintiff in this matter waived the physician-patient privilege, we must determine whether the defendant was nevertheless precluded from conducting the ex parte interview.
Some courts have held that even where the privilege is waived, discovery is limited to formal
Before the adoption of the Michigan Court Rules of 1985, it seemed to be established that a defense counsel was permitted to conduct ex parte interviews with a plaintiff‘s treating physician following a waiver of the physician-patient privilege. In Gailitis v Bassett, 5 Mich App 382, 384; 146 NW2d 708 (1966), while not expressly referring to ex parte contacts, the Court found “no error in authorizing defendant‘s counsel to interview plaintiff‘s physician.”9 But in Jordan, supra, the
Court stated that it was not clear whether Gailitis was actually authorizing ex parte interviews or merely allowing a deposition. The Court in Jordan further opined that even if Gailitis did authorize ex parte interviews, the decision was “overruled by the new court rules.” 171 Mich App 348. We disagree.
This Court has previously recognized our state‘s open discovery process. In Daniels v Allen Industries, Inc, 391 Mich 398, 403; 216 NW2d 762 (1974), we stated that “Michigan has a strong historical commitment to a far-reaching, open and effective discovery practice. In light of that commitment, this Court has repeatedly emphasized that discovery rules are to be liberally construed ... to further the ends of justice.” See also Prentis v Yale Mfg Co, 421 Mich 670; 365 NW2d 176 (1984). While Daniels was interpreting GCR 1963, 310, the Michigan Court Rules of 1985 in no way acted to restrict discovery or to modify this commitment to open discovery. Indeed, the opposite is true. We find ourselves in agreement with the statement of the Court of Appeals in this case that “the new rules were intended to further liberalize Michigan‘s already open discovery process.” 184 Mich App 148-149.10 The very existence of the early waiver provision evidences further liberalization of the discovery rules. Before the Michigan Court
The purpose of discovery is the simplification and clarification of issues. Discovery should ” ‘provide accurate information in advance of trial as to the actual facts and circumstances of a controversy.... [It] should promote the discovery of the true facts and circumstances of a controversy, rather than aid in their concealment.’ ” Ewer v Dietrich, 346 Mich 535, 541-542; 78 NW2d 97 (1956) (citing Hallett v Michigan Consolidated Gas Co, 298 Mich 582; 299 NW 723 [1941]). Restricting parties to formal methods of discovery would not aid in the search for truth, and it would only serve to complicate trial preparation.
Although the rules are silent on informal methods of discovery, prohibition of all ex parte interviews would be inconsistent with the purpose of
IV
We affirm the judgment of the Court of Appeals holding that the ex parte interview of the plaintiff‘s physician was proper because the physician-patient privilege had been waived by lack of timely assertion. After the privilege is waived in a malpractice action, each party is entitled to equal access to relevant information subject to the restrictions against “annoyance, embarrassment, oppression, or undue burden or expense....”
LEVIN, BRICKLEY, BOYLE, RILEY, and GRIFFIN, JJ., concurred with CAVANAGH, C.J.
MALLETT, J. (concurring). I concur in the result reached by the majority and agree with the analysis contained in part II of the opinion. I do not
Notes
This rule does not prevent the assertion of a privilege at a time or in a manner otherwise permitted by these rules.
AndA party who has a privilege regarding part or all of the testimony of a deponent must either assert the privilege at the deposition or lose the privilege as to that testimony for purposes of the action.
These actions appear to have been designed to obtain tactical advantage, not to protect confidentiality; this is the type of gamesmanship the court rules seek to avoid by requiring an early decision on waiver.
This postulation of a fiduciary duty, separate and apart from the privilege and operating to preclude ex parte interviews, finds no basis in any decision of this Court or in statute. Because the physician-patient privilege is purely statutory and did not exist at common law, New York Life Ins Co v Newman, 311 Mich 368; 18 NW2d 859 (1945), and because the statutory privilege was enacted for the sole purpose of enabling persons to secure medical aid without betrayal of confidences, we are convinced that the concept of fiduciary duty, if it exists, is subsumed by the physician-patient privilege.A physician cannot be treated like an ordinary witness because of the physician-patient privilege and the public policy which supports that privilege. The physician‘s ethical and legal duty not to reveal confidences and the importance and necessity of that trust to both the patient and the medical profession require that both the physician and the patient be protected by the use of only formal methods of discovery. The physician‘s fiduciary duty to his patient precludes any ex parte conferences with his patient‘s adversary. [Emphasis added.]
Just as a physician takes a personal and family history before treating the patient, an attorney needs all the history of the controversy before trial. See Hickman v Taylor, 329 US 495, 501; 67 S Ct 385; 91 L Ed 451 (1947) (the goal of discovery is the “fullest possible knowledge of the issues and facts before trial“).
