Tag Archives: peer review

Employment Performance Review Excluded from Peer Review Confidentiality

The Pennsylvania Supreme Court ruled, on March 27, 2018, in Regenelli v. Boggs, Monogahela Valley Hospital and UPMC/ERMI that physician performance reviews of an ER physician, who was provided by ERMI to Mon Valley Hospital, performed by a management physician within ERMI, were not protected peer review activities, and therefore the performance reviews were not … Continue Reading

Blue Cross of Northeastern Pennsylvania Denied Peer Review Protection

The Pennsylvania Superior Court has decided the Pennsylvania Peer Review Protection Act does not apply to alleged peer review activity conducted by Blue Cross of Northeastern Pennsylvania, because Blue Cross is not a professional healthcare provider as defined in the Pennsylvania Peer Review Act.  Blue Cross argued it should have been protected because it’s activities … Continue Reading

Peer Review Privilege: Facts vs. Conclusions

All states have some degree of confidentiality protection for peer review activities and the information generated by those activities, and there is additional federal protection for information gathered and created by Patient Safety Organizations (PSOs), established pursuant to the Patient Safety and Quality Improvement Act (PSQIA) of 2005. However, physicians, hospitals, and medical staffs should … Continue Reading

Pennsylvania Superior Court Rejects Peer Review Confidential for “Business Records”

In Kates v. Doylestown Hospital, the Pennsylvania Superior Court, in a non-precedential decision, held back the Pennsylvania Peer Review Protection Act does not provide confidentiality protection for certain records, stating: Peer review necessarily involves evaluating the quality of care provided by medical professionals or evaluating the qualifications of medical care providers. 0045cept for those portions … Continue Reading

California Decision Allows Physician to Challenge Sham Peer Review as Whistleblower Retaliation

In Fahlen v. Sutter Central Valley Hospitals, the California Supreme Court found: A physician is not required to first exhaust his administrative remedies through the medical staff appeals process in order to challenge sham peer review as whistleblower retaliation; and Dr. Fahlen qualified as a whistleblower for purposes of the California Whistleblower Act. The California … Continue Reading

Peer Review “Interference” Alleged as Tortious Interference with Contract

  Peer Review “Interference” Alleged as Tortious Interference with Contract Many sham peer review cases are based upon breach of contract in states in which the medical staff bylaws are treated as contracts between the hospital and/or medical staff and the individual physicians. Typically, the cause of actions is based upon some failure to provide the … Continue Reading

In what is becoming well settled law, the U.S. District Court for the District of Massachusetts ruled that a medical resident is entitled to seek production of the evaluations and records of other residents as part of a federal discrimination claim, regardless of the confidentiality rules of state peer review statutes.  In Gargiulo v. Baystate … Continue Reading

Attorneys’ Fees Awarded in Failed Peer Review Dispute Pursuant to State Law

In Crow v. Penrose-St. Francis Healthcare System, a Colorado Appeals Court awarded attorneys’ fees to a hospital that successfully defended the claim by a physician seeking damages for breach of contract and torte claims.  The Colorado Rules of Civil Procedures authorized an award of attorneys’ fees when a trial court dismissed an action under Section … Continue Reading

Physician Cannot Revoke Settlement Agreement

Bissada v. Arkansas Children’s Hospital (the “Hospital”) presents an atypical peer review case. The Eighth Circuit Court of Appeals affirmed summary judgment entered on behalf of the Hospital by the District Court on the basis of the existence of a Settlement Agreement, instead of relying upon the usual HCQIA peer review immunity protections.  Dr. Bissada practiced … Continue Reading

Wrongful Databank Report Does Not Justify Defamation Action

Frengell v. InterCare Community Health Network demonstrates the counterintuitive nature of certain peer review actions. Dr. Frengell’s employment was terminated following the inappropriate prescription of narcotics. InterCare reported Dr. Frengell to the National Practitioners’ Data Bank, although the report was not required and the court concluded, and InterCare admitted, that it had not provided any due … Continue Reading

Public Policy of Preserving Physician Patient Relationships Rejected

In Genchi v. Lower Florida Keys Hospital District, a Florida State Appeals Court took the opposite view from the Arkansas Supreme Court in Baptist Health, posted just last week, regarding the importance of preserving physician/patient relationships. In Baptist Health, the Arkansas Supreme Court recognized the potential interference with physician patient relationships posed by the use … Continue Reading

Professional Review Activity vs. Professional Review Action

The case of Wood v. Archbold Medical Center Inc., presents an interesting twist regarding HCQIA immunity. The holding basically provides that “professional review activity” is a lesser level of adverse activity and need not meet the due process standards of HCQIA in order for a hospital to retain HCQIA. In Dr. Wood’s situation, there were three … Continue Reading

Discovery of Peer Review Materials

Two recent decisions emphasize the ongoing battle for discovery of peer review information in negligence cases, and confirm that confidentiality is alive and well, but no longer automatic.  In Shell v. Sudan, the United States District Court for the District of Nebraska ordered that deposition questions regarding a hospital risk analysis tool were not precluded … Continue Reading

Medical Staff Bylaws as Contracts

Cases with opposing interpretations on this issue were decided within the past month. Heretofore, the basic question had been whether medical staff bylaws constituted contracts under state law. The majority of courts deciding these cases have concluded that medical staff bylaws were valid contracts. In the states with the opposite holdings, the basic theory was that bylaws merely … Continue Reading

Hospital Uses After-Acquired Evidence to Support Summary Suspension of Physician

Dr. Gary Ritten was a medical staff member at Lapeer Regional Medical Center in Indiana. He was summarily suspended in September 2005, allegedly in retaliation for refusing to transfer a patient who had not been stabilized as required by EMTALA. The suspension was initially rescinded by the Medical Executive Committee, although it was reinstated by the hospital’s … Continue Reading

Hospital Bears Burden of Proving Peer Review Privilege

In Bansal vs. Mount Carmel Health Systems, Inc., an Ohio state appellate court ruled that the hospital had failed to prove that documents were protected by Ohio’s statutory peer review privilege (Ohio Rev. Code § 2305.25), and reversed a trial court summary judgment decision. Dr. Girraj K. Bansal was removed from the hospital’s call schedule, and then brought … Continue Reading

Peer Review Confidentiality Impacted by Forum Shopping

In Kentucky, common law president permits discovery of peer review documents. Ohio Rev. Code § 2305.252 protects peer review discovery. In Saleba v. Schrand, the estate of a Kentucky resident sued an Ohio physician and Good Samaritan Hospital, located in Cincinnati, Ohio, in Kentucky based upon the results of medical services performed in Ohio. The Kentucky Supreme … Continue Reading

State Courts Continue to Limit Confidentiality of Peer Review Records

The Massachusetts Supreme Court ruled in Board of Registration in Medicine v. Hallmark Health Corp. that the Massachusetts licensing board would subpoena certain hospitals peer review records.  In Director of Health Affairs Policy Planning, University of Connecticut v. Freedom of Information Commission, the Connecticut Supreme Court ruled that the state’s freedom of information act contradicted … Continue Reading

Georgia Supreme Court Rules Peer Review Information Not Always Confidential

In Hospital Authority of Valdosta and Lowndes County v. Meeks, the Georgia Supreme Court ruled that information contained in a physician’s peer review file was not necessarily protected by the Georgia Peer Review Confidentiality Statute. Although the holding is enticing from the physician perspective, the limitations contained in the opinion render the precedent potentially meaningless. The … Continue Reading

Tennessee State Law Immunizes Neglegant Credentialing

Most participants in the credentialing process are familiar with state statutes providing peer review immunity and confidentiality. The Tennessee statute analyzed in Smith v. Pratt and HCA Health Services of Tennessee, Inc. /d/b/a CentennialMedicalCenter take that immunity one step further.  In this malpractice case, the court held that Tennessee Code § 63-6-219 provides immunity for negligent … Continue Reading

Nevada U.S. District Court Enjoins Data Bank Report and Denies HCQIA Immunity

In Chudacoff vs. UniversityMedicalCenter of Southern Nevada, et al., the United States District Court for the District of Nevada granted partial summary judgment on behalf of Richard M. Chudacoff, M.D., enjoining University Medical Center from reporting Dr. Chudacoff to the National Practitioner Data Bank, and granted summary judgment on Dr. Chudacoff’s behalf denying immunity under … Continue Reading