Case Title: Riggings Homeowners, Inc. v. Coastal Res. Comm'n

Citation: 

Docket Number: 401A13

State: north-carolina

Court: North Carolina Supreme Court

Date: 2014-12-19T00:00:00Z

Document:
NO. COA12-1493 
NORTH CAROLINA COURT OF APPEALS 
Filed:  3 September 2013 
 
 
JUDY HAMMOND, 
 
Plaintiff, 
 
 
 
 
v. 
 
Cumberland County 
No. 11 CVS 8281 
SAIRA SAINI, M.D., CAROLINA 
PLASTIC SURGERY OF 
FAYETTEVILLE, P.C., VICTOR 
KUBIT, M.D., CUMBERLAND 
ANESTHESIA ASSOCIATES, P.A., 
WANDA UNTCH, JAMES BAX, and 
CUMBERLAND COUNTY HOSPITAL 
SYSTEM, INC., 
Defendants. 
 
 
 
 
Appeal by defendants from orders entered 18 June 2012 by 
Judge Mary Ann Tally in Cumberland County Superior Court.  Heard 
in the Court of Appeals 22 April 2013. 
 
McGuireWoods, LLP, by Patrick M. Meacham and Monica E. 
Webb, for defendants-appellants Cumberland County Hospital 
System, Inc., James Bax, and Wanda Untch. 
 
Patterson Harkavy LLP, by Burton Craige and Narendra K. 
Ghosh; and Beaver, Holt, Sternlicht & Courie, P.A., by Mark 
A. Sternlicht, for plaintiff-appellee. 
 
 
DAVIS, Judge. 
 
 
Cumberland County Hospital System, Inc. (“CCHS”), James Bax 
(“Bax”), and Wanda Untch (“Untch”) (collectively “defendants”) 
appeal from the trial court’s orders compelling them to produce 
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certain documents and divulge certain information in discovery 
to Judy Hammond (“plaintiff”).  After careful review, we dismiss 
in part, affirm in part, and remand in part. 
Factual Background 
On 28 September 2011, plaintiff filed a complaint in 
Cumberland County Superior Court against defendants as well as 
Carolina Plastic Surgery of Fayetteville, P.C.; Cumberland 
Anesthesia Associates, P.A.; Sairi Saini, M.D. (“Dr. Saini”); 
and Victor Kubit, M.D. (“Dr. Kubit”),1 which contained the 
following allegations:  Plaintiff reported to Cape Fear Valley 
Medical Center – operated by CCHS – on 17 September 2010 for a 
surgical procedure to remove a possible basal cell carcinoma 
from her face.  Dr. Saini, who was employed by Carolina Plastic 
Surgery of Fayetteville, was responsible for performing the 
procedure, and Dr. Kubit, an anesthesiologist with Cumberland 
Anesthesia 
Associates, 
was 
responsible 
for 
administering 
anesthesia during the surgery.  Bax and Untch, both registered 
nurse anesthetists employed by CCHS, were also involved in the 
provision of anesthesia to plaintiff during the surgery. 
                     
1Defendants Carolina Plastic Surgery of Fayetteville, Cumberland 
Anesthesia Associates, Dr. Saini, and Dr. Kubit are not parties 
to this appeal. 
-3- 
 
 
Plaintiff was given total intravenous anesthesia.  During 
the operation, Kubit, Bax, and Untch administered supplemental 
oxygen to plaintiff through a face mask.  Drapes were placed 
around plaintiff’s face in such a way that oxygen escaping from 
the face mask built up under the drapes.  When Dr. Saini used an 
electrocautery device to stop bleeding on plaintiff’s face, the 
oxygen trapped under the drapes ignited and burned the drapes 
near plaintiff’s face.  Plaintiff sustained first and second 
degree burns on her face, head, neck, upper back, right hand, 
and tongue.  Plaintiff also suffered a respiratory thermal 
injury, right bronchial edema, oral stomatitis, and nasal 
trauma, which left her with permanent injuries, including 
scarring. 
An answer was filed on behalf of Bax, Untch, and CCHS, 
generally 
denying 
plaintiff’s 
allegations 
of 
negligence.  
Plaintiff subsequently served separate sets of requests for 
production of documents and interrogatories on Bax, Untch, and 
CCHS.  In their responses, each of them objected to certain 
aspects of these discovery requests on the grounds that they 
sought 
documents 
or 
information 
that 
was 
protected 
from 
disclosure based on the medical review privilege, the work 
product doctrine, and the attorney/client privilege.  Based on 
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these objections, defendants refused to produce the responsive 
documents or provide answers to the challenged interrogatories. 
Plaintiff filed motions to compel discovery from defendants 
pursuant to Rule 37 of the North Carolina Rules of Civil 
Procedure.  In opposing the motions, defendants’ counsel filed 
an affidavit from Harold Maynard (“Maynard”), CCHS’s risk 
manager, regarding the accident review process in existence at 
CCHS.  Attached to the affidavit was a copy of an administrative 
policy of CCHS entitled “Sentinel Events and Root Cause 
Analysis” (“RCA Policy”).  Defense counsel also submitted to the 
trial court a copy of a document labeled “Fire in Operating Room 
RCA” (“RCA Report”) and copies of reports entitled “Risk 
Management Worksheets” (“RMWs”). 
After conducting an in camera review of the documents 
withheld by defendants, the trial court entered separate orders 
on 18 June 2012 granting plaintiff’s motions to compel.  
Defendants appealed to this Court from these orders. 
Analysis 
I. Appellate Jurisdiction 
As a preliminary matter, we must determine whether this 
Court 
possesses 
jurisdiction 
over 
defendants’ 
appeal.  
Defendants’ contentions on appeal can be divided into two 
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categories.  First, they argue that a segment of the documents 
and information requested by plaintiff are immune from discovery 
based on recognized privileges – namely, the medical review 
privilege, the work product doctrine, and the attorney/client 
privilege.  Second, they contend that portions of plaintiff’s 
discovery requests are overbroad and seek information that is 
neither relevant nor reasonably calculated to lead to the 
discovery of admissible evidence pursuant to Rule 26 of the 
North Carolina Rules of Civil Procedure. 
 “An 
order 
compelling 
discovery 
is 
generally 
not 
immediately appealable because it is interlocutory and does not 
affect a substantial right that would be lost if the ruling were 
not reviewed before final judgment.”  Sharpe v. Worland, 351 
N.C. 159, 163, 522 S.E.2d 577, 579 (1999).  However, where a 
party asserts a privilege or immunity that directly relates to 
the matter to be disclosed pursuant to the interlocutory 
discovery order and the assertion of the privilege or immunity 
is not frivolous or insubstantial, the challenged order affects 
a substantial right and is thus immediately appealable.  K2 Asia 
Ventures v. Trota, __ N.C. App. __, __, 717 S.E.2d 1, 4, disc. 
review denied, 365 N.C. 369, 719 S.E.2d 37 (2011). 
-6- 
 
 
For this reason, orders compelling discovery of materials 
purportedly protected by the medical review privilege or work 
product doctrine are immediately reviewable on appeal despite 
their interlocutory nature.  See, e.g., Woods v. Moses Cone 
Health Sys., 198 N.C. App. 120, 123-24, 678 S.E.2d 787, 790 
(2009) (medical review privilege), disc. review denied, 363 N.C. 
813, 693 S.E.2d 353 (2010); Boyce & Isley, PLLC v. Cooper, 195 
N.C. App. 625, 636-37, 673 S.E.2d 694, 701-02 (work product 
doctrine), disc. review denied, 363 N.C. 651, 686 S.E.2d 512 
(2009).  Accordingly, this Court has jurisdiction to review 
defendants’ contentions on appeal that are based on the medical 
review privilege and the work product doctrine.2 
                     
2An interlocutory order compelling production of documents 
alleged to be protected from disclosure by the attorney/client 
privilege also affects a substantial right and is, therefore, 
immediately appealable.  Evans v. United Servs. Auto. Ass'n, 142 
N.C. App. 18, 23-24, 541 S.E.2d 782, 786, cert. denied, 353 N.C. 
371, 547 S.E.2d 810 (2001).  Here, although defendants make a 
passing reference to the attorney/client privilege in their 
brief, 
they 
make 
no 
specific 
argument 
regarding 
the 
applicability of this privilege as required under Rule 28(b)(6) 
of the North Carolina Rules of Appellate Procedure.  Moreover, 
our review of the transcript of the hearing on plaintiff’s 
motions to compel reveals that defendants likewise did not make 
any 
argument 
before 
the 
trial 
court 
concerning 
the 
attorney/client privilege.  As such, defendants have waived any 
argument 
based 
on 
the 
attorney/client 
privilege 
and, 
accordingly, we do not address its applicability in this 
opinion. 
-7- 
 
 
However, 
with 
regard 
to 
the 
arguments 
advanced 
by 
defendants based on overbreadth and relevancy, we do not possess 
jurisdiction to consider these contentions because they do not 
invoke a recognized privilege or immunity, and defendants have 
failed to otherwise show that they affect a substantial right.  
See Wind v. City of Gastonia, __ N.C. App. __, __, 738 S.E.2d 
780, 782 (2013) (holding that only questions of whether 
requested files were shielded from discovery by statutory 
privilege were properly before appellate court); K2 Asia 
Ventures, __ N.C. App. at __, 717 S.E.2d at 4 (concluding that 
only portion of discovery order concerning attorney/client 
privilege and work product immunity was immediately appealable). 
For these reasons, we lack jurisdiction to consider 
defendants’ 
arguments 
regarding 
overbreadth 
and 
relevancy.  
Consequently, 
those 
portions 
of 
defendants’ 
appeal 
are 
dismissed. 
II. Medical Review Privilege 
We now turn our attention to those issues on appeal that 
are properly before us.  We begin by examining the applicability 
of North Carolina’s medical review privilege codified in N.C. 
Gen. Stat. § 131E-95. 
 
-8- 
 
 
A. Statutory Framework 
As this Court has recognized, “N.C. Gen. Stat. § 131E–95, 
part of the Hospital Licensure Act, creates protection for 
medical review committees in civil actions against hospitals.”  
Woods, 198 N.C. App. at 124, 678 S.E.2d at 791.  The privilege 
is set out in N.C. Gen. Stat. § 131E-95(b), which provides, in 
pertinent part, as follows: 
The proceedings of a medical review 
committee, the records and materials it 
produces and the materials it considers 
shall 
be 
confidential 
and 
not 
considered public records within the 
meaning of G.S. 132–1 . . . and shall 
not 
be 
subject 
to 
discovery 
or 
introduction into evidence in any civil 
action against a hospital . . . which 
results from matters which are the 
subject of evaluation and review by the 
committee. 
 
N.C. Gen. Stat. § 131E-95(b) (2011). 
“By its plain language, N.C. Gen. Stat. § 131E–95 creates 
three categories of information protected from discovery and 
admissibility at trial in a civil action: (1) proceedings of a 
medical review committee, (2) records and materials produced by 
a medical review committee, and (3) materials considered by a 
medical review committee.”  Woods, 198 N.C. App. at 126, 678 
S.E.2d at 791-92.  The statute goes on to state, however, that 
“information, documents, or records otherwise available are not 
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immune from discovery or use in a civil action merely because 
they were presented during proceedings of the committee.”  N.C. 
Gen. Stat. § 131E-95(b). 
N.C. Gen. Stat. § 131E-76 defines the term “[m]edical 
review committee” as 
any of the following committees formed for 
the purpose of evaluating the quality, cost 
of, or necessity for hospitalization or 
health 
care, 
including 
medical 
staff 
credentialing: 
 
a. A committee of a state or local 
professional society. 
 
b. A committee of a medical staff of a 
hospital. 
 
c. 
A 
committee 
of 
a 
hospital 
or 
hospital system, if created by the 
governing board or medical staff of the 
hospital or system or operating under 
written 
procedures 
adopted 
by 
the 
governing board or medical staff of the 
hospital or system. 
 
d. 
A 
committee 
of 
a 
peer 
review 
corporation or organization. 
 
N.C. Gen. Stat. § 131E-76(5)(a)-(d) (2011). 
On appeal from a trial court’s discovery order implicating 
the medical review privilege, this Court “review[s] de novo 
whether the requested documents are privileged under N.C. Gen. 
Stat. § 131E–95(b).”  Bryson v. Haywood Reg’l Med. Ctr., 204 
N.C. App. 532, 535, 694 S.E.2d 416, 419, disc. review denied, 
-10- 
 
 
364 N.C. 602, 703 S.E.2d 158 (2010).  In the present case, 
defendants, as the parties objecting to the disclosure of the 
materials on the basis of this privilege, bear the burden of 
establishing that plaintiff’s discovery requests fall within the 
scope of the privilege.  Hayes v. Premier Living, Inc., 181 N.C. 
App. 747, 751, 641 S.E.2d 316, 318 (2007).  Where, as here, the 
trial court’s order does not contain findings of fact and 
conclusions of law but rather simply lists the documents that 
are discoverable, “it is presumed that the court on proper 
evidence found facts to support its [decision].”  Evans v. 
United Servs. Auto. Ass'n, 142 N.C. App. 18, 27, 541 S.E.2d 782, 
788 (citation and quotation marks omitted), cert. denied, 353 
N.C. 371, 547 S.E.2d 810 (2001).3 
 
B. Application of Medical Review Privilege 
Defendants contend that North Carolina’s medical review 
privilege shields from discovery:  (1) the RCA Report; (2) the 
RMWs; and (3) notes prepared by Maynard (CCHS’s risk manager) 
after the operating room fire. 
The RCA Report is a document consisting of multiple pages, 
containing a “Brief Overview” of the incident resulting in the 
                     
3A trial court is not required to make findings of fact or 
conclusions of law where no request is made by the parties.  
J.M. Dev. Grp. v. Glover, 151 N.C. App. 584, 586, 566 S.E.2d 
128, 130 (2002). 
-11- 
 
 
operating room fire, a description of the post-fire review 
process undertaken by the hospital’s Root Cause Analysis Team 
(“RCA Team”), and the RCA Team’s ultimate recommendations based 
on that review process.  The two RMWs appear to be computer-
generated reports containing several different “Data” sections 
that include set fields for entering information.  In the 
“General Event Data” section of both RMWs is a “Comments” field, 
each of which contains a general description of the events 
surrounding the operating room fire.  As for Maynard’s meeting 
notes, while they were not submitted to either the trial court 
or this Court for review, Maynard’s affidavit describes them as 
“notes reflecting the discussions that occurred” in meetings he 
conducted regarding the fire. 
Defendants invoke the medical review privilege by asserting 
that these documents are all connected with the investigation of 
the operating room fire by the RCA Team.  All of defendants’ 
contentions regarding the applicability of the medical review 
privilege hinge on the proposition that CCHS’s RCA Team is, in 
fact, a medical review committee for purposes of § 131E-76(5).  
If the RCA Team does not constitute a medical review committee 
as 
statutorily 
defined, 
then 
defendants’ 
entire 
argument 
premised on the medical review privilege fails. 
-12- 
 
 
Defendants do not identify in their brief which specific 
prong(s) of § 131E-76(5) they believe the RCA Team falls under 
in order to qualify as a medical review committee.  At oral 
argument, however, counsel for defendants stated that the RCA 
Team would qualify as a medical review committee under either 
subsection (b) or (c) of § 131E-76(5).  After carefully 
reviewing the record, we conclude that defendants failed to meet 
their burden of showing that the RCA Team qualifies as a medical 
review committee for purposes of § 131E-76(5)(b) or (c). 
In order to fall within § 131E-76(5)(b), defendants must 
show that (1) the RCA Team was comprised of the “medical staff 
of a hospital”; and (2) it was “formed for the purpose of 
evaluating 
the 
quality, 
cost 
of, 
or 
necessity 
for 
hospitalization 
or 
health 
care, 
including 
medical 
staff 
credentialing[.]”  N.C. Gen. Stat. § 131E-76(5)(b). 
Defendants have failed to meet even the first of these two 
prongs.  Neither the RCA Report itself nor any other document 
presented by defendants identifies the members of the RCA Team 
as being part of the “medical staff of [CCHS],” as required by 
the statute.  N.C. Gen. Stat. § 131E-76(5)(b).  This omission is 
fatal to defendants’ attempt to avail themselves of this 
provision of § 131E-76(5).  Therefore, we conclude that 
-13- 
 
 
defendants have not shown that the RCA Team constitutes a 
medical review committee under § 131E-76(5)(b). 
In order to qualify as a medical review committee under § 
131E-76(5)(c), the RCA Team must have been “created by the 
governing board or medical staff of the hospital or system or 
operating under written procedures adopted by the governing 
board or medical staff of the hospital or system.”  N.C. Gen. 
Stat. § 131E-76(5)(c).  Maynard, in his affidavit, stated that 
“[i]n general, the peer review committees established to . . . 
prepare a root cause analysis are created by the medical staff 
and governing board of CCHS and operate under the [RCA Policy] . 
. . .”  (Emphasis added.)  The inherent ambiguity of the phrase 
“in general” leaves open the possibility that this sequence of 
events does not occur in every case.  Notably absent from 
Maynard’s 
affidavit 
is 
any 
statement 
that 
the 
RCA 
Team 
established in this specific case to review the operating room 
fire was created by the governing board or medical staff of CCHS 
or that the RCA Team operated under the RCA Policy.  Nor does 
the RCA Report itself provide these details. 
Similarly, defendants have also failed to establish that 
the RCA Policy was, in fact, “adopted by the governing board or 
medical staff of the hospital or system.”  N.C. Gen. Stat. § 
-14- 
 
 
131E-76(5)(c).  The policy contains a notation that it was 
“approved by MN” – yet nothing in the record, including 
Maynard’s affidavit, identifies who “MN” is.  For all of these 
reasons, we believe that defendants failed to satisfy their 
burden of proving that the RCA Team constitutes a medical review 
committee for purposes of § 131E-76(5)(c). 
Even assuming arguendo that the RCA Team did qualify as a 
medical review committee, defendants would still have been 
required to “present . . . evidence tending to show that the 
disputed 
[documents] 
were 
(1) 
part 
of 
the 
[RCA 
Team]'s 
proceedings, (2) produced by the [RCA Team], or (3) considered 
by the [RCA Team] as required by” § 131E-95.  Hayes, 181 N.C. 
App. at 752, 641 S.E.2d at 319 (emphasis in original).  This 
Court has 
emphasize[d] that these are substantive, not 
formal, requirements.  Thus, in order to 
determine whether the peer review privilege 
applies, 
a 
court 
must 
consider 
the 
circumstances 
surrounding 
the 
actual 
preparation 
and 
use 
of 
the 
disputed 
documents involved in each particular case.  
The title, description, or stated purpose 
attached to a document by its creator is not 
dispositive, nor can a party shield an 
otherwise available document from discovery 
merely 
by 
having 
it 
presented 
to 
or 
considered by a quality review committee. 
 
Id. (footnote and emphasis omitted). 
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First, with respect to the RCA Report, defendants failed to 
submit any evidence revealing who produced or prepared it.  
While the document, on its cover page, identifies the event that 
is the subject of the report and the members of the team, it 
does not list its author.  Defendants assert – pointing to 
Maynard’s affidavit – that the RCA Team produced the report.  
Maynard’s affidavit, however, states only that “[a] Root Cause 
Analysis Report was prepared . . . .”  (Emphasis added.)  It 
neither identifies the RCA Team members – individually or 
collectively – as the author of the RCA Report nor otherwise 
reveals the document’s author.   
Second, with respect to the computer-generated RMWs, 
defendants refer to these documents not as RMWs – the title 
provided on the face of the printouts – but rather as Quality 
Care Control Reports.  Defendants maintain that these documents 
were prepared by Bax and Stephanie Emanuel (“Emanuel”), another 
nurse present in the operating room during the fire, as part of 
the review process outlined in the RCA Policy.  Although the RCA 
Policy does, in fact, identify Quality Care Control Reports as a 
“means” for initiating a review, the RCA Policy nowhere refers 
to RMWs, and nothing on the face of the RMWs indicates they 
-16- 
 
 
actually are the Quality Care Control Reports contemplated by 
the RCA Policy. 
Nor is it clear who prepared the RMWs.  Both RMWs indicate 
on their face that the information contained in the comments 
section was entered by someone with the initials “RDE” – without 
any further indication of that person’s identity.  However, 
other sections of the RMWs suggest that they may have been 
completed by Emanuel and Bax – although it is not clear that 
this is, in fact, what occurred.  Thus, the source of the 
information contained in the RMWs is unclear. 
Finally, with respect to Maynard’s meeting notes, these 
notes — as discussed below — may fall within the work product 
privilege.  However, defendants have failed to meet their burden 
of establishing that these documents come within the purview of 
the medical review privilege.   
In holding that defendants have failed to sustain their 
burden of proving that the three categories of documents at 
issue are privileged under § 131E-95, we find instructive our 
decision in Bryson v. Haywood Reg’l Med. Ctr., 204 N.C. App. 
532, 694 S.E.2d 416.  In Bryson, the plaintiff – an internist – 
filed suit against the hospital where she had worked, claiming 
that her employment had been terminated in retaliation for her 
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reporting “patient safety issues.”  Id. at 533-34, 694 S.E.2d at 
418.  During discovery, the hospital refused to respond to 
several 
of 
the 
plaintiff’s 
interrogatories 
and 
document 
requests, “contending that they sought disclosure of the 
proceedings, records, and materials produced or considered by a 
medical 
review 
committee, 
which 
constituted 
information 
protected from discovery under N.C. Gen. Stat. § 131E–95(b).”  
Id. at 534, 694 S.E.2d at 418-19.  In response to the 
plaintiff’s motion to compel, the hospital submitted some – but 
not all – of the requested materials to the trial court for in 
camera review.  Id., 694 S.E.2d at 419.  After reviewing the 
filed documents, the trial court entered an order protecting 
some documents from disclosure but directing others to be 
produced.  Id. 
On appeal, the hospital argued that certain internal 
documents ordered by the trial court to be produced were 
“privileged because they relate[d] to internal peer review 
investigations 
of 
patient 
charts 
requested 
by 
its 
Risk 
Management Department.”  Id. at 538, 694 S.E.2d at 421.  In 
rejecting the hospital’s contention, we observed that (1) “the 
documents on their face do not establish that they are 
privileged”; and (2) the hospital “submitted no affidavits or 
-18- 
 
 
other evidence to support its claim that the documents at issue 
were protected from discovery under N.C. Gen. Stat. § 131E–
95(b).”  Id. at 540, 694 S.E.2d at 422.  Thus, because of the 
defendants’ failure to provide sufficient evidence that the 
medical review privilege applied, id. at 538-39, 694 S.E.2d at 
421, we were compelled to conclude that the hospital had “failed 
to meet its burden of showing that the documents f[e]ll into one 
of the three categories of privileged material under N.C. Gen. 
Stat. § 131E–95(b),” id. at 533, 694 S.E.2d at 418. 
While, unlike in Bryson, defendants here did submit an 
affidavit in support of their argument based on the medical 
review privilege, the affidavit – as explained above – is 
insufficient to satisfy their burden of proving that the RCA 
Report, the RMWs, and Maynard’s meeting notes are privileged 
under § 131E-95.  The mere submission of affidavits by the party 
asserting the medical review privilege does not automatically 
mean that the privilege applies.  Rather, such affidavits must 
demonstrate that each of the statutory requirements concerning 
the existence of the privilege have been met.  Accordingly, 
defendants’ arguments on this issue are overruled.4 
                     
4We note that defendants’ brief contains a cursory, one-sentence 
argument that the documents at issue are also protected by the 
statutory privilege afforded to quality assurance committees in 
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III. Work Product Doctrine 
Defendants also contend that the work product doctrine — 
set out in Rule 26(b)(3) of the North Carolina Rules of Civil 
Procedure — protects from disclosure notes made by Maynard 
regarding his discussions with Bax, Untch, and various other 
individuals possessing knowledge of the operating room fire as 
well as information about the content of these discussions.5 
The work product doctrine prohibits an adverse party from 
compelling “the discovery of documents and other tangible things 
that are ‘prepared in anticipation of litigation’ unless the 
party has a substantial need for those materials and cannot 
                                                                  
N.C. Gen. Stat. § 90-21.22A.  This Court has recognized that the 
privilege applicable to quality assurance committees pursuant to 
§ 90-21.22A “is functionally identical” to the privilege 
afforded to medical review committees under § 131E-95(b).  
Armstrong v. Barnes, 171 N.C. App. 287, 294, 614 S.E.2d 371, 
376, disc. review denied, 360 N.C. 60, 621 S.E.2d 173 (2005).  
Accordingly, for the reasons already discussed, we conclude that 
defendants failed to sustain their burden of proving the 
applicability of § 90-21.22A as well. 
 
5In their brief, defendants mention in passing other discovery 
requests that they contend are protected by the work product 
doctrine.  Defendants, however, fail to advance any specific 
argument regarding the applicability of the work product 
doctrine to the documents or information sought by these 
discovery 
requests. 
 
Defendants’ 
failure 
to 
make 
a 
particularized 
argument 
regarding 
these 
specific 
discovery 
requests constitutes waiver of the issue on appeal.  See Latta 
v. Rainey, 202 N.C. App. 587, 597, 689 S.E.2d 898, 908 (2010) 
(holding that where “defendant fail[ed] to make any specific 
argument in his brief” regarding certain issue, the issue was 
deemed abandoned on appeal). 
-20- 
 
 
‘without undue hardship . . . obtain the substantial equivalent 
of the materials by other means.’”  Long v. Joyner, 155 N.C. 
App. 129, 136, 574 S.E.2d 171, 176 (2002) (quoting N.C. R. Civ. 
P. 26(b)(3)), disc. review denied, 356 N.C. 673, 577 S.E.2d 624 
(2003). 
The party asserting the work product doctrine “bears the 
burden of showing (1) that the material consists of documents or 
tangible things, (2) which were prepared in anticipation of 
litigation or for trial, and (3) by or for another party or its 
representatives which may include an attorney, consultant, 
surety, indemnitor, insurer or agent.”  Evans, 142 N.C. App. at 
29, 541 S.E.2d at 789 (citation and quotation marks omitted).  
Our Supreme Court has made clear, however, that “[m]aterials 
prepared in the ordinary course of business are not protected, 
nor does the protection extend to facts known by any party.”  
Willis v. Duke Power Co., 291 N.C. 19, 35, 229 S.E.2d 191, 201 
(1976) (citing C. Wright & A. Miller, Federal Practice and 
Procedure § 2024, at 197 (1970)). 
On appeal, we review “the trial court's application of the 
work product doctrine . . . under an abuse of discretion 
standard.”  Evans, 142 N.C. App. at 27, 541 S.E.2d at 788.  
Under this standard, a trial court’s ruling may be reversed only 
-21- 
 
 
upon a showing that it was manifestly unsupported by reason or 
so arbitrary that it could not have been the result of a 
reasoned decision.  K2 Asia Ventures, __ N.C. App. at __, 717 
S.E.2d at 8 (citation and quotation marks omitted). 
Defendants contend that Maynard’s notes were prepared in 
anticipation of litigation, relying on the following statement 
in Maynard’s affidavit: 
Because of the nature of the event (a fire 
in the operating room) and based on my 
experience as a Risk Manager, I immediately 
anticipated that litigation related to the 
event could result.  In anticipation of 
litigation, I met with members of the 
plaintiff’s family along with Jim Bax, CRNA, 
Dr. Saini, Dr. Kubit and Dr. Ruben Rivers to 
discuss the incident.  I do not recall the 
date of that meeting.  On September 20, 
2010, in anticipation of litigation, I met 
with operating room personnel to discuss the 
event.  This meeting occurred after my 
meeting with Ms. Hammond’s family.  After 
both of these meetings, and in anticipation 
of litigation, I prepared notes reflecting 
the 
discussions 
that 
occurred 
in 
the 
meetings. 
 
 
Plaintiff counters, however, by arguing that the record is 
unclear whether Maynard actually prepared his notes in the 
ordinary 
course 
of 
business 
pursuant 
to 
CCHS’s 
policies 
regarding “Quality Care Reports,” “Reportable Incidents,” and 
the “Patient Safety Response Team.”  If so, plaintiff contends, 
the notes would not qualify for work product immunity under Rule 
-22- 
 
 
26(b)(3) because they would have been prepared pursuant to 
hospital policy as a matter of course following incidents of 
this nature regardless of whether litigation was anticipated.  
See Cook v. Wake County Hosp. Sys., Inc., 125 N.C. App. 618, 
625, 482 S.E.2d 546, 551-52 (1997) (holding that hospital’s 
accident report was not protected from discovery under Rule 
26(b)(3) because “report would have been compiled, pursuant to 
the hospital's [risk management] policy, regardless of whether 
[plaintiff] intimated a desire to sue the hospital or whether 
litigation was ever anticipated by the hospital”). 
 
In this regard, we note that on at least two occasions, 
plaintiff requested that CCHS “[p]rovide all hospital bylaws, 
policies, rules, and/or procedures” relating to “the prevention 
of fire in operating rooms or during surgery . . . .”  CCHS, 
however, never provided plaintiff with the responsive policies.  
Nor did CCHS submit them to the trial court for consideration – 
despite counsel’s acknowledgment during oral arguments at this 
Court that having the requested policies would have been helpful 
to the trial court in determining whether Maynard’s notes were 
prepared in anticipation of litigation as required by Rule 
26(b)(3). 
-23- 
 
 
We are unable to determine on the record currently before 
us whether the trial court abused its discretion in compelling 
the production of Maynard’s notes in the face of defendants’ 
work product objection.  Nor do we believe that the trial court 
was capable of making a determination of whether these notes 
were made in the ordinary course of the hospital’s business 
without first examining the policies requested by plaintiff and 
determining whether the notes were made pursuant to hospital 
policy. 
In concluding that a remand to the trial court is necessary 
on this issue, we are guided by our decision in Diggs v. Novant 
Health, Inc., 177 N.C. App. 290, 628 S.E.2d 851 (2006), disc. 
review denied, 361 N.C. 426, 648 S.E.2d 208 (2007).  In Diggs, 
the plaintiff suffered injuries during a surgical procedure and 
brought a medical malpractice claim against the hospital where 
the procedure was performed and against the members of the 
medical staff involved.  Id. at 293-94, 628 S.E.2d at 854.  
During discovery, the plaintiff moved to compel the defendants 
to produce any documents “discuss[ing]” the plaintiff’s injury 
or “any problems . . . during her . . . hospitalization.’”  Id. 
at 310, 628 S.E.2d at 864. 
-24- 
 
 
The defendants objected to the disclosure, arguing that the 
responsive documents – contained in their “’Risk Management 
file’” – “were protected from production by the attorney-client 
privilege and the work product doctrine . . . .”  Id.  After 
reviewing the documents in camera, the trial court denied in 
part and granted in part the plaintiff’s motion to compel.  Id.  
On appeal, the plaintiff contended that the trial court erred to 
the extent that it did not compel production of all the 
responsive documents. 
This Court, after explaining that the work product doctrine 
shields from discovery only those “documents prepared ‘in 
anticipation of litigation,’” reviewed the submitted documents 
in light of the hospital’s “policy ‘for the reporting of all 
unexpected events’” in order to determine whether the documents 
were prepared pursuant to that policy.  Id. at 310-11, 628 
S.E.2d at 864-65.  However, after “carefully examin[ing] the 
documents and the information provided by [the] defendants 
regarding the nature of those documents[,]” id. at 310, 628 
S.E.2d at 864, we were “unable to determine from the current 
record whether the documents at issue were generated pursuant to 
[the hospital’s risk management] policy[,]” id. at 312, 628 
S.E.2d at 865. 
-25- 
 
 
In particular, we observed that while “certain documents 
appear to correspond to the reports and summaries required by 
the hospital's policy,” they were not specifically labeled as 
such, and thus we could not properly determine their status.  
Id. at 312, 628 S.E.2d at 865.  Thus, we “remand[ed] to the 
trial 
court 
for 
further 
review 
as 
to 
these 
documents,” 
emphasizing 
that 
the 
“defendants 
b[ore] 
the 
burden 
of 
demonstrating that the specified documents” were protected.  Id. 
Similarly, here, for the reasons set out above, we remand 
to the trial court for it to conduct an analysis of whether 
Maynard’s notes are protected by the work product doctrine based 
on its review not only of Maynard’s affidavit and the other 
evidentiary submissions in the record but also based on its 
review of the pertinent policies of CCHS.  We note our concern 
regarding the inordinate amount of time defendants have taken to 
provide the requested policies to plaintiff.  We direct the 
trial court, on remand, to issue a deadline for defendants to 
submit the policies at issue both to plaintiff and to the trial 
court.  After the trial court has completed its review, it shall 
issue a new order containing its determination of whether the 
work product doctrine serves as a bar to the issuance of an 
order compelling the production of these meeting notes.  We 
-26- 
 
 
leave it to the trial court’s discretion whether defendants 
should be required to also submit the notes themselves to the 
court for an in camera inspection. 
Finally, we reject defendants’ argument that the trial 
court abused its discretion in compelling them to respond to 
plaintiff’s interrogatories despite their objections based on 
the work product doctrine.  It is well established that the work 
product doctrine only applies to documents or other tangible 
things.  See Long, 155 N.C. App. at 136-37, 574 S.E.2d at 176 
(holding that “plaintiff's interrogatories did not violate Rule 
26(b)(3)” because they “did not ask defendants for documents or 
tangible things”). 
Conclusion 
For the reasons stated above, we dismiss defendants’ appeal 
in part, affirm the trial court’s orders granting plaintiff’s 
motions to compel in part, and vacate and remand that portion of 
the trial court’s orders compelling the production of Maynard’s 
meeting notes. 
DISMISSED IN PART; AFFIRMED IN PART; REMANDED IN PART. 
Chief Judge MARTIN and Judge BRYANT concur.