WEST COVINA HOSPITAL, Petitioner, v. THE SUPERIOR COURT OF LOS ANGELES COUNTY, Respondent; TERRY JO TYUS et al., Real Parties in Interest.
L.A. No. 32083
Supreme Court of California
May 29, 1986
41 Cal. 3d 846 | 226 Cal. Rptr. 132 | 718 P.2d 119
Hagenbaugh & Murphy, Horvitz & Levy, Horvitz, Levy & Amerian, Ellis J. Horvitz, David M. Axelrad, Barry R. Levy and David S. Ettinger for Petitioner.
Hassard, Bonnington, Rogers & Huber, David E. Willett and Catherine I. Hanson as Amici Curiae on behalf of Petitioner.
No appearance for Respondent.
Shan K. Thever, Harney, Wolfe, Pagliuso, Shaller & Carr, David M. Harney and Arthur E. Schwimmer for Real Parties in Interest.
BROUSSARD, J.—The issue presented in this writ proceeding is whether
Plaintiff in her individual capacity and as guardian ad litem for her minor daughter brought a medical malpractice action alleging negligence by a surgeon.1 Plaintiff also alleged negligence by the West Covina Hospital in granting surgical privileges and retaining the surgeon on its medical staff. Plaintiff proposes to call as a witness at trial a physician, Dr. Anwar, who served on a medical staff committee of the hospital when the committee was evaluating the allegedly negligent surgeon. Dr. Anwar is to testify about specific details of the evaluation. The record does not show whether the testimony will relate to evaluations before or after the operation or both. Over objections by the hospital, the court ruled that Dr. Anwar could testify so long as he does so voluntarily. The court stated that a committee member may waive the exclusion of section 1157 and may testify to the entire proceeding of a medical staff committee provided patients’ names were not disclosed.2
The hospital then sought a writ of mandate to compel the trial court to vacate its order and to enter an order granting the hospital‘s motion to exclude the testimony. The Court of Appeal, Second Appellate District, Division Two granted the writ, and we granted review.
In Elam v. College Park Hospital (1982) 132 Cal.App.3d 332 [183 Cal.Rptr. 156], it was held that a hospital may be liable in damages to a patient in a malpractice case for negligent selection or retention of medical staff.
We give effect to statutes according to the usual, ordinary import of the language employed in framing them. When statutory language is clear and unambiguous there is no need for construction, and courts should not indulge in it. (People v. Belleci (1979) 24 Cal.3d 879, 884 [157 Cal.Rptr. 503, 598 P.2d 473]; Palos Verdes Faculty Assn. v. Palos Verdes Peninsula Unified Sch. Dist. (1978) 21 Cal.3d 650, 658 [147 Cal.Rptr. 359, 580 P.2d 1155]; Solberg v. Superior Court (1977) 19 Cal.3d 182, 198 [137 Cal.Rptr. 460, 561 P.2d 1148].) A provision that a member of a hospital medical staff committee may not be “required” to testify is not the same as either providing that he may not testify or that the hospital or committee shall have a privilege to preclude testimony.
In other sections of the Evidence Code, in the same chapter as section 1157, the Legislature has shown that it is well aware of the distinctions relating to discovery, privileges, and admissibility of evidence. Thus, cer-
The conclusion that section 1157 excludes involuntary testimony but not voluntary testimony is also supported by the principle that privileges should be narrowly construed since they prevent the admission of relevant and otherwise admissible evidence and may obstruct the attainment of justice. (See e.g., United States v. Nixon (1974) 418 U.S. 683 [41 L.Ed.2d 1039, 94 S.Ct. 3090]; People v. McGraw (1983) 141 Cal.App.3d 618, 622 [190 Cal.Rptr. 461]; but compare Welfare Rights Organization v. Crisan (1983) 33 Cal.3d 766, 769 [190 Cal.Rptr. 919, 661 P.2d 1073, 31 A.L.R.4th 1214] [privilege may be implied from a statute].)
The hospital relies upon the language of subdivision (c) of section 1157, the “prohibition relating to discovery or testimony” in urging that there is an ambiguity in the section. However, there is no ambiguity. The prohibition relating to testimony is obviously the prohibition against requiring testimony.
Because the critical language of the statute, “required to testify,” is clear, we will decline to follow it only when it would inevitably frustrate the manifest purposes of the legislation as a whole or would lead to absurd results. (People v. Belleci, supra, 24 Cal.3d 879, 884; Younger v. Superior Court (Mack) (1978) 21 Cal.3d 102, 113 [145 Cal.Rptr. 674, 577 P.2d 1014]; Silver v. Brown (1966) 63 Cal.2d 841, 845 [48 Cal.Rptr. 609, 409 P.2d 689].)
Thus, the burden on the hospital, in claiming that the quoted phrase should be read to make voluntary testimony inadmissible, is a heavy one. The hospital has not met the burden.
To the contrary, prohibiting involuntary testimony serves a fundamental legislative purpose. The obvious general purpose of section 1157 is to improve the quality of medical care in the hospitals by the use of peer review committees. Accomplishment of the purpose requires that doctors be recruited to serve on the committees. If doctors who serve on such committees
Several legislative policies and concerns are involved in determining the availability of the records and proceedings of peer review committees in judicial proceedings. These policies and concerns were described by Justice Friedman in Matchett v. Superior Court (1974) 40 Cal.App.3d 623, 628-630 [115 Cal.Rptr. 317]. The language has been quoted in full and in part or referred to in numerous cases involving discovery. (Brown v. Superior Court (1985) 168 Cal.App.3d 489, 498 et seq. [214 Cal.Rptr. 266]; Mt. Diablo Hospital Medical Center v. Superior Court (1984) 158 Cal.App.3d 344, 347 [204 Cal.Rptr. 626]; Saddleback Community Hospital v. Superior Court (1984) 158 Cal.App.3d 206, 208 [204 Cal.Rptr. 598]; Snell v. Superior Court (1984) 158 Cal.App.3d 44, 49 [204 Cal.Rptr. 200]; West Covina Hospital v. Superior Court (1984) 153 Cal.App.3d 134, 138-139 [200 Cal.Rptr. 162]; Henry Mayo Newhall Memorial Hosp. v. Superior Court (1978) 81 Cal.App.3d 626, 632-633, fn. 6 [146 Cal.Rptr. 542]; Roseville Community Hospital v. Superior Court (1977) 70 Cal.App.3d 809, 813-814 [139 Cal.Rptr. 170]; Schulz v. Superior Court (1977) 66 Cal.App.3d 440, 444-445 [136 Cal.Rptr. 67].)
The discussion in Matchett and the subsequent cases takes on added importance because of the well-established rule that when, as here, the Legislature amends a statute without altering portions of the provision that have been judicially construed, the Legislature is presumed to have been aware of and acquiesced in the prior judicial construction. (Marina Point, Ltd. v. Wolfson (1982) 30 Cal.3d 721, 734 [180 Cal.Rptr. 496, 640 P.2d 115, 30 A.L.R.4th 1161].)
In Matchett, the court stated: “In an accredited hospital, the organized medical staff is responsible to the hospital governing body for the quality of in-hospital medical care; it evaluates the qualifications of applicants and holders of staff privileges; it recommends appointment, reappointment, curtailment and exclusion from staff privileges; it provides peer group methods
“California law recognizes this public interest by endowing the practitioner-members of hospital staff committees with a measure of immunity from damage claims arising from committee activities. (
“This confidentiality exacts a social cost because it impairs malpractice plaintiffs’ access to evidence. In a damage suit for in-hospital malpractice against doctor or hospital5 or both, unavailability of recorded evidence of incompetence might seriously jeopardize or even prevent the plaintiff‘s recovery. Section 1157 represents a legislative choice between competing
“The statute, then, is aimed directly at malpractice actions in which a present or former hospital staff doctor is a defendant. The statutory exception for ‘any person requesting hospital staff privileges’ cannot be construed as plaintiff contends. To all appearances the exception was designed to set the immunity to one side and to permit discovery in suits by doctors claiming wrongful or arbitrary exclusion from hospital staff privileges. [Citations.]” (Matchett v. Superior Court, supra, 40 Cal.App.3d at pp. 628-630.)
Matchett reflects the various concerns the Legislature balanced in adopting section 1157. Seeking to promote the voluntary participation of professionals in the peer review process so as to improve the quality of in-hospital medical care, the Legislature sought to promote the effectiveness of the committees by protecting the practitioner-members and by providing a measure of confidentiality so as to promote candor and objectivity. However, as Matchett recognizes, there are competing concerns such as the interests of victims of medical malpractice. In addition, by providing exceptions from the prohibitions of compelled discovery and required testimony, the Legislature has recognized that the competing concerns in the designated circumstances take precedence over its intent to promote candor by confidentiality.6
Exclusion of compelled testimony alone serves the purposes and has the effects enumerated in Matchett. Thus, exclusion of compelled testimony will promote voluntary participation and candor and frankness of committee members. To this extent the Legislature has provided a measure of confidentiality which no doubt will seriously jeopardize and prevent recovery by many malpractice plaintiffs.
Extending the prohibition to voluntary testimony would further promote candor and frankness and would prevent recovery by additional plaintiffs. However, such extension is not essential to the promotion of the legislative purposes, and it is for the Legislature to determine how far to go in promoting its various goals. The Legislature has recognized in subdivisions (c), (d) and (e) that confidentiality must give way to the need for evidence in the specified circumstances. We have no reason to assume that the Leg-
We conclude that
Bird, C. J., Mosk, J., and Reynoso, J., concurred.
PANELLI, J.—I respectfully dissent. The majority‘s reasoning, that in prohibiting compelled testimony, subdivision (b) of
Section 1157 was enacted in response to two decisions: Brown v. Superior Court (1963) 218 Cal.App.2d 430 [32 Cal.Rptr. 527], and Kenney v. Superior Court (1967) 255 Cal.App.2d 106 [63 Cal.Rptr. 84]. In Brown, the Court of Appeal held that the substance of discussions of a county medical society committee, relating to a malpractice claim against a member of the society, were subject to the “work product” discovery privilege. Kenney allowed discovery of the records of disciplinary proceedings which related to a staff doctor who had been named as defendant in a medical malpractice
Section 1157 reaffirms the Brown holding that medical society review committee proceedings cannot be discovered; extends that exclusion to proceedings of hospital medical staff review committees; nullifies the Kenney holding that the records of such review committees are discoverable; and creates for the protected material an absolute immunity from discovery, rather than the conditional work-product privilege recognized in Brown and Kenney.
However, with respect to evidentiary use of the nondiscoverable matter, section 1157 is facially ambiguous. The statute is silent concerning voluntary testimony. Subdivision (b) provides that no one in attendance at a meeting of the specified committees “shall be required to testify” as to what transpired at that meeting. To say, as the majority do, that in prohibiting compelled testimony the Legislature consciously intended to permit voluntary testimony is, in my view, to give subdivision (b) more meaning than its terms will bear or its purpose permit. A more reasonable view is that in prohibiting compelled testimony the Legislature was addressing the specific concern expressed in Brown, supra, that the purpose of the medical society committee will be defeated if anyone present “must disclose” the substance of the discussion (218 Cal.App.2d at p. 443) and that “requiring such disclosure” would put an end to such meetings (ibid.). Quite simply, the Legislature, like the court in Brown, did not anticipate the possibility of voluntary testimony in view of the manifest purpose of this statute and for that reason failed to expressly prohibit such testimony, thereby leaving the statute ambiguous on this point.
Subdivision (c), in contrast to subdivision (b), refers without limitation to “[t]he prohibition relating to discovery or testimony.”2 In failing to modify “testimony,” but rather, treating as equivalent the prohibitions against discovery and against testimony, this phrase gives rise to the inference that all testimony, like all discovery, is prohibited. Moreover, subdivision (e) supports this inference. That subdivision specifies that the 1983 and 1985 amendments to the section3 do not exclude “use of relevant evidence” in criminal proceedings. This caveat suggests that the use in civil proceedings of relevant evidence within the ambit of the statute is barred.
In Matchett v. Superior Court (1974) 40 Cal.App.3d 623 [115 Cal.Rptr. 317], the same court that decided Brown, supra, and Kenney, supra, considered the purpose and effect of section 1157. Commenting first on the function of hospital medical staff committees charged with responsibility for the competence of staff practitioners, the court stated, “the quality of in-hospital medical care depends heavily upon the committee members’ frankness in evaluating their associates’ medical skills and their objectivity in regulating staff privileges. Although composed of volunteer professionals, these committees are affected with a strong element of public interest.” (Id., at p. 628.)
As the Matchett court noted, section 1157 “expresses a legislative judgment that the public interest in medical staff candor extends beyond damage immunity and requires a degree of confidentiality. . . . It evinces a legislative judgment that the quality of in-hospital medical practice will be elevated by armoring staff inquiries with a measure of confidentiality. [¶] This confidentiality exacts a social cost because it impairs malpractice plaintiffs’ access to evidence. In a damage suit for in-hospital malpractice against doctor or hospital [fn.] or both, unavailability of recorded evidence of incompetence might seriously jeopardize or even prevent the plaintiff‘s recovery. Section 1157 represents a legislative choice between competing public concerns. It embraces the goal of medical staff candor at the cost of impairing plaintiffs’ access to evidence. [¶] The statute, then, is aimed directly at malpractice actions in which a present or former hospital staff doctor is a defendant.” (40 Cal.App.3d at p. 629.)
The Courts of Appeal have uniformly held that the statutory exceptions set forth in subdivision (c) of section 11574 apply only to actions by phy-
Although the majority purport to recognize the legislative purpose articulated in Matchett, supra, they inexplicably and without any cited authority ascribe to the Legislature the additional purpose of encouraging voluntary participation on committees by relieving doctors of the “evidentiary burdens” in malpractice cases of “compelled discovery and required testimony.” Exclusion of compelled testimony but not voluntary testimony, the majority assert, strikes a proper balance between the competing legislative concerns of promoting voluntary participation on peer review committees and frank discussion, on the one hand, and providing an injured plaintiff access to evidence, on the other. When a doctor volunteers to testify, the argument goes, exclusion of voluntary testimony “[is] not necessary to encourage participation in the peer review program,” and any adverse effect such testimony may have on the confidentiality of the proceedings is outweighed by the plaintiff‘s need for evidence.
This argument sets up a false balance and ignores the primary purpose of section 1157—to assure the candor and honest evaluation of each staff member‘s competence essential to effective peer review, by removing the threat that the confidential discussion could be made public through medical malpractice litigation at the whim of any member of the review committee. To interpret section 1157 as do the majority would eliminate its utility in fostering open, frank and candid discussion. “The Legislature . . . sought to impose confidentiality on committee proceedings in order to allow committee members to be able to admit and thereafter deal with the faults of staff
apply to the statements made by any person in attendance at a meeting of any of those committees who is a party to an action or proceeding the subject matter of which was reviewed at that meeting, or to any person requesting hospital staff privileges, or in any action against an insurance carrier alleging bad faith by the carrier in refusing to accept a settlement offer within the policy limits.”
To declare, as does subdivision (a), that certain matters are absolutely immune from discovery, yet to permit, as would the majority, their disclosure (i.e., “discovery“) at trial, not only achieves an absurd result, but renders sterile the immunity provisions of the statute (cf. Schulz v. Superior Court, supra, 66 Cal.App.3d at p. 445) and makes illusory the confidentiality the statute seemingly provides.
I agree with Justice Beach‘s Court of Appeal opinion in this case where he stated: “[T]o permit unrestricted trial testimony about a medical staff committee meeting by any person at the meeting who happens to be willing to disclose the contents of what would otherwise be completely confidential proceedings . . . would punch a judicially created and legislatively unintended hole in the crucial shield of confidentiality provided to medical staff committees in medical malpractice actions. Such interpretation would directly contravene the vital policy underlying that immunity. . . . Candor and objectivity are essential to the effectiveness of these committees performing a vital role in monitoring and improving the quality of care in California hospitals. Yet, few physicians will candidly participate, or participate at all, in a committee meeting if the confidentiality of that meeting can be breached at the whim of any person attending.”
The majority‘s interpretation would, in my view, also have a serious adverse practical effect on the trial of the underlying action. Code of Civil Procedure section 2037 et seq. establish a discovery mechanism for expert witnesses who are to give trial testimony. The clear and obvious purpose of these provisions is to remove the element of surprise from the trial of lawsuits. Yet the majority‘s holding which permits the voluntary testimony of a peer review committee member at trial—evidence which they admit is not discoverable pretrial—will bring about the very result which section 2037 et seq. intended to avoid. Ironically, in most cases, the victim of the surprise expert testimony will be the plaintiff. As pointed out by amicus, “the Legislature could not have intended a result which stands in stark contrast to every discovery mechanism and so profoundly violates fundamental notions of fair play.”
Consequently, unless and until the Legislature declares otherwise, I would construe section 1157 as creating an absolute bar to disclosure of the protected proceedings by either discovery or testimony, whether voluntary or compelled.6 I would affirm the Court of Appeal‘s decision to grant the peremptory writ.
Grodin, J., and Lucas, J., concurred.
Petitioner‘s application for a rehearing was denied July 21, 1986. Grodin, J., Lucas, J., and Panelli, J., were of the opinion that the application should be granted.
