©Richard E. Best 1998-2006 All Rights Reserved
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MEDICAL QUALITY REVIEW
Evidence Code §ll57
BURDEN OF PROOF ON PARTY ASSERTING
PROTECTION
NATURE OF MEDICAL
REVIEW COMMITTEE
NATURE OF PROTECTION
PROTECTED MATERIAL
UNPROTECTED MATERIAL
EXCEPTION: PERSON
REQUESTING HOSPITAL STAFF PRIVILEGES
CRIMINAL PROCEEDINGS
Alexander v. Superior Court (1993), 5 Cal.App.4th 1218
Brown v. Superior Court (1985), 168 Cal.App.3d 489
California Eye Institute v. Superior Court(1989)215 Cal.App.3d
1477
Cedars-Sinai Medical Center v. Suprerior Court (1993), 12
Cal.App.4th 579
County of Kern V. Superior Court ( 82 Cal..App.3d 396
Hinson disapproved
Matchett v. Superior Court (1974), 40 Cal.App.3d 623
Mt.Diablo Hospital Med. Ctr. v. Superior Court (1984),158
Cal.App.3d 344
People v. Superior Court(Memorial Med. Ctr.)(1991), 234 Cal.App.3d
363
Santa Rosa Memorial Hospital v. Superior Court (19 ), 174
Cal.App3d 711
Scripps Memorial Hospital v. Superior Court (1995), 37 Cal.App.4th
1720
Snell v. Superior Court (1984), 158 Cal.App.3d 44
University of So. Calif. v. Superior Court(1996), 45 Cal.App.4th
1283
West Covina Hospital v. Superior Court (1986), 41 Cal.3d 846
BURDEN OF PROOF
ON PARTY ASSERTING PROTECTION
Santa Rosa Memorial Hospital v. Superior Court (19 ), at p.727 [Court must look beyond form to substance and in camera review normally required]
NATURE
OF
MEDICAL REVIEW COMMITTEE [EC 1157(a)]
Statutory requirements
1."...organized comittees...of staffs in hospitals
peer review body B&P Code 805
review committees of local & state professsional societies
2.having responsibility of evaluation and improvement of the quality of careSanta Rosa Memorial Hospital v. Superior Court [Committee membership not restricted to physicians; Infection control committee w/in 1157: established by hospital by-laws; composed of 6 physicians +nurses+administrators; responsible for investigation, control & prevention of infection; infection control program required by state]
Protection of proceedings & records from discovery; not privilege or prohibition on admissibility
Person in attendance not required to testify as to what transpired at meeting i.e. can't stop voluntary testimonyWest Covina Hospital
Alexander v. Superior Court
Santa Rosa Memorial Hospital [service on committee doesn't protect all knowledge or all documents that person possesses; do subject records or knowledge reveal committee proceedings or records ?]
PROTECTED
MATERIAL [EC 1157(a)&(b)]
proceedings
recordsNot limited to documents generated by committee
Alexander v. Superior Court [app. for staff privileges]
I.D. of committee members protected
Cedars-Sinai Medical Ctr. v. Superior Court, p.581
Placing doc in committee file does not create protection
Santa Rosa Memorial Hospital v. Superior Courttestimony as to what transpired at meeting
Not prohibition on voluntary testimony
West Covina Hospital
Whether investigation was conducted
Brown [R.D. encourages investigations if have to answer]
Whether hospital by-laws required medical malpractice insurance and enforced requirement
Brown [Snell case holding rejected]
Interrogatories: answer without divulging proceedings or records
West Covina
Mt. Diablo
Brown v. Superior Court at p.[ hospital has burden of proof to show that interrogatory cannot be answered without divulging proceedings or records of protected committee]
Administrative files: delete protected material
Matchett
County of Kern
Brown
Mt. Diablo
EXCEPTION:PERSON
REQUESTING
HOSPITAL STAFF PRIVILEGES [Sec.
1157(c)]
Inapplicable to Dr. seeking monetary damages for exclusion or restriction
California Eye Institute v. Superior Court [ Disc. denied Dr. seeking $ for restriction of privileges after privileges fully restored]
Protection does apply
Scripps Memorial Hospital (4th Dist. 1995)
Protection does not apply and prosecutors can subpoena documents [SF & LA]
People v. Superior Court (Memor. Med.Ctr (1991 2d Dist)