Thomas v. Nationwide Children’s Hosp., Inc. — Jan. 2017 (Summary)

DISCOVERY – PEER REVIEW

Thomas v. Nationwide Children’s Hosp., Inc.
Case No. 2:14-cv-1236 (S.D. Ohio Jan. 19, 2017)

The United States District Court for the Southern District of Ohio granted the parents of two children, who were former patients at a hospital, their motion to compel against a hospital that refused to produce documents and limited one of its employee’s deposition, claiming that the information was privileged under the state’s peer review statute.

The issue arose out of the parents’ filing suit against the hospital, claiming that the hospital conspired to violate the rights of the parents and children who sought medical treatment at the hospital by ordering additional medical tests not for the purpose of diagnosing and treating the children but rather to gather evidence for possible criminal prosecution for child abuse.  After the parents requested information regarding the assessments of patient complaints that the hospital received about child abuse diagnoses, the hospital objected to providing certain information and documents, arguing that internal assessments of medical care were protected by the peer review privilege.

Both parties agreed to set aside a ruling on the issue pending other discovery, but the issue reemerged following the deposition of a nurse, who at the time was acting as a Performance Improvement Coordinator in the emergency department during the children’s visit.  The nurse’s role in her capacity was to review customer satisfaction and, if the resolution of a conflict involved writing a letter, the nurse would make an entry into a database system maintained by the hospital.

During the deposition, the hospital would not allow the nurse to answer any questions pertaining to the contents of any information in the database system.  Even though the nurse responded to a letter from the parents, writing that her team had reviewed the situation and concluded that the procedures performed were appropriate and followed hospital and state-mandated procedures, the hospital refused to allow the nurse to answer any questions regarding exactly how she investigated and arrived at her conclusion, citing protection under the peer review privilege.

The court ultimately concluded that the peer review privilege was inapplicable under the circumstances.  The parents’ letter to the nurse merely asserted that a number of additional tests, which were performed unnecessarily and done without their consent, were described inaccurately on their bill and asked for an explanation of why these tests were performed.  Therefore, neither the letter nor its response made any mention of the quality of the care provided or the competency of the physicians involved.

Because the parents’ letter did not question the competence of the health care providers who performed the procedures, but rather queried why the procedures were performed in the first place, the letter, in effect, sought information regarding the hospital’s administrative procedures, not its quality review process. Noting that the peer review statute applies only to activities that are actually peer review proceedings and not to every activity that a hospital labels peer review,  the court concluded that the nurse should have been permitted to answer the foundational questions about the process itself that did not involve determining whether any provider had acted professionally or competently. As such, the court granted the parents’ motion to compel and denied the hospital’s motion to strike.