Arnold v. Jewish Hosp. — Feb. 2017 (Summary)

PEER REVIEW

Arnold v. Jewish Hosp.
No. 2015-CA-000311-MR, No. 2015-CA-000427-MR (Ky. Ct. App. Feb. 24, 2017)

The Kentucky Court of Appeals affirmed a lower court’s ruling that peer review documents were not admissible at trial in a negligence case brought by the administratrix for the estate of a former patient against a hospital.

After the patient passed away from complications after a colonoscopy performed at the hospital, the hospital initiated the peer review process, which included a partial chart review by an independent physician, three committee meetings, written correspondence with the patient’s attending physicians, and a discussion with the Director of Nursing and Risk Management.

The lower court determined the peer review documents were inadmissible, the administratrix argued on appeal that the documents should have been admitted because they included statements pertaining to the appropriate standard of care not being met, and that there were concerns by the hospital with respect to the lack of communication between surgeons and nursing staff.

The appeals court stated that Kentucky is one of two states that permit discovery of peer review documents, but that just because such documents are discoverable does not mean it is relevant or admissible.  The court found that the peer review documents were not relevant to the issue of whether the hospital complied with the required standard of care, and assuming that the documents were relevant, the probative value of the documents was outweighed by the danger of unfair prejudice and confusion of the jury.  While the documents contained concerns relating to inadequate communication between the attending physicians, nurses, and the lab, they did not include any specifics as to which communications were inadequate or which nurses were involved.  Also, because the peer review committee did not review the case in its entirety or directly speak with the nurses or doctors involved in the case, the jury could have been confused or could have misinterpreted the committee’s concern as the equivalent of a legal standard of care violation. As such, the court concluded that the relevance of the documents was clearly outweighed by their prejudicial effect and affirmed the lower court’s ruling.