Case Title: Ex parte St. Vincent's Hospital. PETITION FOR WRIT OF MANDAMUS: CIVIL (In re: Kyle Wadley and Wendy Wadley v. St. Vincent's Hospital et al.)

Citation: 

Docket Number: 1061653

State: alabama

Court: Alabama Supreme Court

Date: 2008-03-21T00:00:00Z

Document:
REL: 03/21/08
Notice: This opinion is subject to formal revision before publication in the advance
sheets of Southern Reporter.  Readers are requested to notify the Reporter of Decisions,
Alabama Appellate Courts, 300 Dexter Avenue, Montgomery, Alabama 36104-3741 ((334)
229-0649), of any typographical or other errors, in order that corrections may be made
before the opinion is printed in Southern Reporter.
SUPREME COURT OF ALABAMA
OCTOBER TERM, 2007-2008
_________________________
1061653
_________________________
Ex parte St. Vincent's Hospital
PETITION FOR WRIT OF MANDAMUS
(In re:  Kyle Wadley and Wendy Wadley
v.
St. Vincent's Hospital et al.)
(Jefferson Circuit Court, CV-04-1257)
On Application for Rehearing
LYONS, Justice.
This Court's opinion of February 1, 2008, is withdrawn,
and the following is substituted therefor. 
1061653
2
St. Vincent's Hospital petitions this Court for a writ of
mandamus directing the Jefferson Circuit Court to vacate its
order denying St. Vincent's motion for a protective order
seeking relief from an order requiring it to answer certain
interrogatories and to produce a variety of records, including
the identifying information and the medical and billing
records of 19 nonparties -- the parents and guardians of
fetuses that were stored in St. Vincent's morgue with Kyle and
Wendy Wadley's fetus.  We grant the petition in part, deny it
in part, and issue the writ.
I. Factual Background
On December 13, 2000, Kyle Wadley and Wendy Wadley, who
was pregnant, visited Dr. Timothy L. Stone for a routine
prenatal examination.  During this examination, Dr. Stone
informed the Wadleys that the fetus Wendy was carrying ("the
fetus") had expired at about 15 weeks' gestation.  On December
15, 2000, Dr. Stone admitted Wendy to St. Vincent's Hospital
for delivery of the deceased fetus.
After the delivery, the Wadleys told Dr. Stone (1) that
they did not want an autopsy or any pathological testing
performed on the fetus and (2) that they wanted the fetus to
1061653
From the materials before us on this petition for the
1
writ of mandamus it is unclear whether the nurse's notes were
written in Wendy's medical records or in the medical records
related to the fetus.
3
be cremated.  A nurse witnessed these conversations and noted
the Wadleys' wishes in the medical records.   Wendy alleges
1
that before her discharge from St. Vincent's on December 16,
2000, she asked a nurse when the cremation of the fetus would
occur.  Wendy alleges that the nurse told her that the fetus
would be cremated within a few days at the University of
Alabama at Birmingham ("UAB") hospital because St. Vincent's
did not have a crematorium.  St. Vincent's asserts that the
Wadleys did not request the ashes of the fetus because, it
says, the Wadleys knew that the fetus's ashes would be mixed
with the ashes of other fetuses.
St. Vincent's policies and procedures require that all
fetuses less than 20 weeks' gestation be directed through the
hospital's 
pathology 
department, 
which 
is 
staffed 
by
Cunningham Pathology, LLC, regardless of whether pathological
testing is to occur on the fetuses.  The policies and
procedures further require that a nurse complete (1) a
pathology ticket and (2) a release-to-pathology form that
requires the signature of the parents of the fetus.  Dr. Stone
1061653
4
testified that he completed a pathology ticket for the fetus
because he believed the ticket was needed to identify the
fetus for its transport to UAB.  The Wadleys state that they
never signed a release-to-pathology form for the fetus.  
On December 19, 2000, Dr. Richard Lozano, a pathologist
and an employee of Cunningham Pathology, LLC, performed
postmortem testing on the fetus.  The fetal remains were then
taken from the pathology department to the morgue at St.
Vincent's.  In January 2001, Cunningham Pathology sent Wendy
a bill for $645.  The Wadleys telephoned Cunningham Pathology
to inquire about the bill because, they say, they believed
that Cunningham Pathology had sent the bill mistakenly.  The
Wadleys testified that, when they heard no more concerning the
bill they believed that Cunningham Pathology had corrected
what they thought to be a billing error.  A collection agency
engaged by Cunningham Pathology later demanded payment from
the Wadleys.  The Wadleys state that in an attempt to
ascertain the basis for the pathology charges, they telephoned
Cunningham Pathology in March 2003 and were told that the bill
was for pathological testing performed on Wendy's placenta per
hospital policy.  In May 2003, Wendy retrieved her medical
1061653
5
records from St. Vincent's, which included a pathology report
describing tests performed on the fetus.
II. Procedural History
On February 26, 2004, the Wadleys sued St. Vincent's,
Cunningham Pathology, Sharp & Stone Obstetric/Gynecology,
P.C., Dr. Stone, and Dr. Lozano in the Jefferson Circuit
Court.  The Wadleys asserted claims of misrepresentation,
fraud, suppression, negligence, wantonness, recklessness, the
tort of outrage, breach of contract, "tortious interference of
a dead body," wrongful handling of a dead body, trespass, and
intentional infliction of emotional distress.  They sought
compensatory, punitive, and all other damages to which they
may be entitled, including damages for mental anguish and
emotional distress.  The Wadleys amended their complaint on
four occasions.  Relevant to this case, in the third amended
complaint, the Wadleys dismissed their claims that St.
Vincent's and Dr. Stone had fraudulently misrepresented that
no testing would be performed on the fetus.
On July 2, 2004, the Wadleys served St. Vincent's with a
request for production of documents.  Request for production
no. 29 sought "copies of any and all pathology or morgue log
1061653
6
books or sign-in records (however designated) for the month of
December 2000."  St. Vincent's objected to this request on the
grounds that it sought irrelevant and immaterial information,
which it says was not reasonably calculated to lead to the
discovery of admissible evidence, and that it sought the
protected health information of nonparties.  However, St.
Vincent's later produced a morgue report with the names of the
patients redacted and a cremation record that indicates that
St. Vincent's cremated the fetus with 19 other fetuses.  The
names of the parents of the 19 other fetuses are redacted from
the cremation record.  St. Vincent's asserts that the
cremation record indicates that it cremated 20 fetuses --
including the fetus -- on June 3, 2002.  Yet the Wadleys note
that in what appears to be a listing of the birth dates of the
20 fetuses cremated, one date is August 3, 2002. 
The Wadleys allege that until St. Vincent's informed them
on August 31, 2004, that it cremated the fetus on June 3,
2002, they believed that UAB had cremated the fetus within a
few days of the delivery on December 15, 2000, as a St.
Vincent's nurse had allegedly represented to them.  Before the
cremation on June 3, 2002, St. Vincent's stored the fetus in
1061653
7
its morgue with other fetuses.  The Wadleys allege that St.
Vincent's stored the 20 fetuses cremated on June 3, 2002, in
one "picnic cooler" in its "freezer."  
The record indicates that St. Vincent's uses an on-site
incinerator to cremate fetal remains because it does not have
a crematorium.  St. Vincent's states that because the
incinerator is used daily for disposing of medical waste, it
cannot reasonably shut down and clean the incinerator to
cremate one fetus.  Thus, St. Vincent's asserts that the
cremations of fetuses occur at the hospital only when a
sufficient number of fetuses accumulate in the morgue to
justify shutting down and cleaning the incinerator to prepare
for the cremations.
After the Wadleys learned about St. Vincent's handling of
the fetus, they amended their complaint to add Count XI,
entitled, "Pattern and Practice - fraud and suppression
counts," which states:
"6. The Plaintiffs hereby adopt and reallege, as
if set out in full herein, each and every one of the
above paragraphs and their prior Complaints.
"7. All of the Defendants' conduct described
herein and in all prior Complaints was in line with
their pattern and practice of committing the fraud
and suppression claimed in this action.  Such fraud
1061653
8
and suppression is more specifically set forth and
adopted herein by separate fraud and suppression
counts in Plaintiffs' Complaints.  Each of those
fraud and suppression counts in the Complaints
hereby adopts and sets forth therein this Pattern
and Practice Count.
"8. Additionally, St. Vincent's promised to
timely have [the fetus] cremated, but did not.
Rather, in accordance with its pattern and practice,
St. Vincent's held [the fetus] in its morgue freezer
for about one-and-one-half-years before allegedly
cremating [the fetus].
"9. St. Vincent's had a pattern and practice of
not timely cremating babies and holding them in its
freezer 
for 
unreasonable 
periods 
of 
time 
as
evidenced by St. Vincent's holding at least nineteen
(19) other babies in its freezer for up to two (2)
years before allegedly cremating them as promised to
their parents or custodians.
"10. Upon learning of the Defendants' conduct,
the Wadleys first suffered and continue to suffer
severe emotional distress and mental anguish as a
proximate result of the Defendants' conduct as
described herein."
(Emphasis added.)
The Wadleys later served St. Vincent's with several
consolidated requests for discovery.  In relevant part, the
request served on November 17, 2004, and entitled "Plaintiff's
Second Consolidated Discovery Requests to St. Vincent's
Hospital" states:
"1. Please list the name, mailing address,
social security number, date of delivery, and date
1061653
The trial court issued a ruling that the Alabama Medical
2
Liability Act did not apply to this case.
9
of expiration of each and every fetus or baby that
was to be cremated and was held by St. Vincent's in
its freezer(s) for a period of more than seven days
from January 1, 1999 through December 31, 2003.
"2. Please provide the name, mailing address,
and telephone number of each and every parent or
guardian of the babies or fetuses discussed in
interrogatory 1, above."
Another request served on March 20, 2007, and entitled,
"Plaintiffs' Consolidated Discovery Requests to St. Vincent's
Hospital Post AMLA [Alabama Medical Liability Act, § 6-5-480
et seq. and § 6-5-541 et seq., Ala. Code 1975,] Ruling,"  in
2
relevant part, states:
"1. Please produce complete and unredacted
copies of the medical and billing records of those
nineteen babies, and their mothers' records, that
were held in St. Vincent's Hospital's freezer with
[the fetus] and then cremated with him during the
summer of 2002 (the 'Nineteen babies').
"2. Please produce copies of the medical and
billing records of the Nineteen Babies, and their
mothers' records.  For this request, but only if St.
Vincent's Hospital refuses to fully respond to
Interrogatory 1, above, please redact identifying
information (names, mailing addresses, telephone
numbers, and social security numbers only) thereby
protecting the identities of the Nineteen Babies and
their parents or guardians.  If you have properly
produced 
complete 
and unredacted documents in
response 
to 
Interrogatory 
1, 
above, 
you 
may
disregard this request.
1061653
10
"3. At any time, were any of the parents or
guardians of the Nineteen Babies told that their
baby's body would be or was held for a period of
time longer than 10 days before being cremated?  If
so, for each of the Nineteen Babies, please state in
detail:
"(a) List by name and mailing address and
date 
of 
communication, 
the 
complete
substance of the communications with each
parent or guardian; and
"(b) The full name, mailing address,
telephone number, and title of all persons
or entities that communicated with any of
the parents or guardians of the Nineteen
Babies relating to this subject.
"4. At any time, were any of the parents or
guardians of the Nineteen Babies told that their
baby's body would be or was held in St. Vincent's
Hospital's morgue's freezer for more than 10 days
and up to two years before being cremated?  If so,
for each of the Nineteen Babies, please state in
detail:
"(a) List by name, mailing address and date
of communication, the complete substance of
the communications with each parent or
guardian; and
"(b) The full name, mailing address,
telephone number, and title of all persons
or entities that communicated with any of
the parents or guardians of the Nineteen
Babies relating to this subject.
"5. Please produce all correspondence, notes,
reports, photographs, investigation records, audio
or video recordings, incident reports, and all other
items or documents reflecting any communications or
agreements with the Nineteen Babies' parents or
1061653
Request for production no. 29 requested "copies of any
3
and all pathology or morgue log books or sign-in records
(however designated) for the month of December 2000." 
11
guardians related in any way to the testing,
cremation, or handling of their babies' bodies,
including related billing and collection efforts.
"6. Please produce all correspondence, notes,
reports, photographs, investigation records, audio
or video recordings, incident reports, and all other
items or documents reflecting any communications or
agreements with the Nineteen Babies' parents or
guardians after their mothers were discharged from
St. Vincent's Hospital through the present.
"7. For each and every one of the Nineteen
Babies that St. Vincent's did not advise the babies'
parents or guardians that there would be or was a
delay 
in 
cremation 
(more 
than 
10 
days 
from
death/delivery), please state each and every reason
why St. Vincent's Hospital chose not to notify those
parents and guardians of that information.
"8. For each and every one of the Nineteen
Babies that St. Vincent's did not advise the babies'
parents or guardians that their baby would be or was
held in St. Vincent's Hospital's morgue's freezer
for up to two years, please state each and every
reason why St. Vincent's Hospital chose not to
notify 
those 
parents 
and 
guardians 
of 
that
information."
(Emphasis in original.)  
St. Vincent's objected to the interrogatories and
requests for production.  On June 29, 2007, the trial court
compelled responses to (1) the Wadleys' request for production
no. 29 served on July 2, 2004,  (2) interrogatories 1 and 2 of
3
1061653
The trial court's order describes these interrogatories
4
as having been served on December 22, 2004; the correct date
is November 17, 2004, and the responses, claiming that the
information is privileged and immaterial and irrelevant to
this cause, were served on December 22, 2004. 
See note 4, ante. 
5
12
the Wadleys' consolidated discovery request served on November
17, 2004,  and (3) requests 1 through 8 of the Wadleys'
4
consolidated discovery request served on March 20, 2007.  The
trial court's order states:
"This Court is very concerned about the privacy
interests of the parents of those 19 children, and
has struggled mightily on this issue.  Given that
the [Alabama Medical Liability Act] does not apply
here, given that the plaintiffs have alleged that
there existed a pattern or practice of fraudulent
conduct, given that the evidence at issue appears
pertinent to that claim, and given our liberal
spirit of discovery, this Court must nevertheless
conclude that the plaintiffs are entitled to the
evidence sought."
On July 18, 2007, St. Vincent's moved the trial court "to
enter an order protecting from discovery the protected health
information of non-parties requested by plaintiffs' request
for production #29 (dated July 2, 2004), interrogatories #1-2
(dated December 22, 2004),
 and requests #1-8 in plaintiffs'
[5]
consolidated discovery requests (dated March 22, 2007)."  On
1061653
13
July 30, 2007, the trial court denied the motion.  On August
23, 2007, St. Vincent's filed this petition. 
III. Standard of Review
"Mandamus is an extraordinary remedy and will be
granted only when there is '(1) a clear legal right
in the petitioner to the order sought, (2) an
imperative duty upon the respondent to perform,
accompanied by a refusal to do so, (3) the lack of
another adequate remedy, and (4) properly invoked
jurisdiction of the court.'  Ex parte Alfab, Inc.,
586 So. 2d 889, 891 (Ala. 1991). In Ex parte Ocwen
Federal Bank, FSB, 872 So. 2d 810 (Ala. 2003), this
Court announced that it would no longer review
discovery orders pursuant to extraordinary writs.
However, we did identify four circumstances in which
a discovery order may be reviewed by a petition for
a writ of mandamus.  Such circumstances arise (a)
when a privilege is disregarded, see Ex parte
Miltope Corp., 823 So. 2d 640, 644-45 (Ala. 2001);
(b) when a discovery order compels the production of
patently irrelevant or duplicative documents the
production of which clearly constitutes harassment
or imposes a burden on the producing party far out
of proportion to any benefit received by the
requesting party, see, e.g., Ex parte Compass Bank,
686 So. 2d 1135, 1138 (Ala. 1996); (c) when the
trial court either imposes sanctions effectively
precluding a decision on the merits or denies
discovery going to a party's entire action or
defense so that, in either event, the outcome of the
case has been all but determined and the petitioner
would be merely going through the motions of a trial
to obtain an appeal; or (d) when the trial court
impermissibly prevents the petitioner from making a
record on the discovery issue so that an appellate
court cannot review the effect of the trial court's
alleged error.  The burden rests on the petitioner
to demonstrate that its petition presents such an
exceptional case –- that is, one in which an appeal
1061653
14
is 
not 
an 
adequate 
remedy. 
 
See 
Ex 
parte
Consolidated Publ'g Co., 601 So. 2d 423, 426 (Ala.
1992)."
Ex parte Dillard Dep't Stores, Inc., 879 So. 2d 1134, 1136-37
(Ala. 2003).  This case does not fall squarely within any one
of the four examples of cases discussed by this Court in Ex
parte Ocwen Federal Bank, FSB, 872 So. 2d 810 (Ala. 2003), in
which review by appeal would be inadequate.  As this Court
stated in Ex parte Crawford Broadcasting Co., 904 So. 2d 221,
224 (Ala. 2004), however, the list of examples in Ocwen
Federal Bank is not exhaustive.  This case presents a
situation in which a discovery order compels the production of
information that implicates privacy considerations analogous
to an evidentiary privilege.  Therefore, review by appeal
after final judgment would be ineffective in this case, and
mandamus review is appropriate.  
Pursuant to Rule 21(a)(1)(E), Ala. R. App. P., St.
Vincent's, as the petitioner, has the burden of providing this
Court with "[c]opies of any order or opinion or parts of the
record that would be essential to an understanding of the
matters set forth in the petition."  St. Vincent's failed to
include in the materials submitted with its petition for the
1061653
It is unclear from the materials before us on this
6
petition for the writ of mandamus whether any of the fetuses
related to this request lived long enough to be issued a
Social Security number.  
15
writ of mandamus a copy of its answer to the Wadleys'
complaint, as last amended.  We review the trial court's order
on the assumption that St. Vincent's has denied all material
allegations of the Wadleys' complaint, as last amended, and
has demanded strict proof thereof. 
IV. Analysis
We must determine whether the trial court exceeded its
discretion by denying St. Vincent's motion for a protective
order 
regarding 
the 
records 
and 
the 
responses 
to
interrogatories the Wadleys sought, which include (1) the
logbooks for St. Vincent's morgue and department of pathology
without redaction of identifying information, (2) the names,
addresses, Social Security numbers,  dates of delivery, and
6
dates of death of all the fetuses that were to be cremated and
that were stored in St. Vincent's morgue for more than seven
days from January 1, 1999, through December 31, 2003, (3) the
names, addresses, and telephone numbers of the parents and
guardians of the fetuses that were to be cremated and that
were stored in St. Vincent's morgue for more than seven days
1061653
16
from January 1, 1999, through December 31, 2003, (4) the
medical and billing records of the 19 other fetuses cremated
on June 3, 2002, in compliance with the March 20, 2007,
request, and (5) the medical records of the mothers of the 19
other fetuses in compliance with the March 20, 2007, request.
The Alabama Rules of Civil Procedure allow broad and
liberal discovery.  Ex parte O'Neal, 713 So. 2d 956, 959 (Ala.
1998).  Rule 26(b)(1), Ala. R. Civ. P., allows parties to
"obtain discovery regarding any matter, not privileged, which
is relevant to the subject matter involved in the pending
action" and, if the information sought may not be admissible
at trial, which is "reasonably calculated to lead to the
discovery of admissible evidence."  When fraud is alleged,
Alabama law is well settled that "the plaintiff is accorded a
considerably wider latitude in the discovery process so that
he will be able to meet the heavy burden of proof placed on
him."  Ex parte Clarke, 582 So. 2d 1064, 1068 (Ala. 1991); see
also Pugh v. Southern Life & Health Ins. Co., 544 So. 2d 143,
145 (Ala. 1988) ("[W]here fraud is alleged, we allow a wider
latitude in the discovery of evidence.").  Specific to the
issue in this case, this Court has recognized that, "[i]n
1061653
St. Vincent's also contends that production of the
7
information is prohibited because § 6-5-551, Ala. Code 1975,
prohibits parties from conducting discovery regarding any
other act or omission.  However, § 6-5-551 is a part of the
Alabama Medical Liability Act, § 6-5-480 et seq. and § 6-5-541
17
fraud cases, where intent, knowledge and scienter constitute
essential elements of the offense, evidence of similar frauds
and misrepresentations [is] commonly admissible."  Dorcal,
Inc. v. Xerox Corp., 398 So. 2d 665, 671 (Ala. 1981). 
A. Whether the Health Information and Records of the
Nonparties Are Privileged
St. Vincent's argues that it has a clear legal right to
the writ of mandamus because, it argues, the interrogatories
and requests for production of records seek confidential and
personal health information of nonparties, which, it argues,
is privileged and should be protected.  St. Vincent's relies
on this Court's recognition in Ex parte Mack, 461 So. 2d 799,
801 (Ala. 1984), that "patients enjoy a right to privacy and
confidentiality with regard to disclosures made within the
doctor-patient relationship."  See also Horne v. Patton, 291
Ala. 701, 287 So. 2d 824 (1974).  St. Vincent's also asserts
that requiring responses to the interrogatories and requests
for production constitutes an intrusion into a nonparty's
constitutionally protected "zone of privacy."   
7
1061653
et seq., Ala. Code 1975 ("the AMLA"), and the trial court has
ruled that the AMLA does not apply to this case.  St.
Vincent's does not challenge the trial court's determination
as to the AMLA in this proceeding.  An earlier attempt to
obtain interlocutory review by permissive appeal of the trial
court's order holding that the AMLA is not applicable in this
case was denied by this Court.  See Ex parte St. Vincent's
Hosp. (No. 1051597, September 22, 2006).
18
In Mack, a personal-injury action arising from the
defendants' allegedly negligent performance of an abortion at
a clinic, the plaintiff petitioned this Court for a writ of
mandamus directing the trial court to compel answers to
interrogatories requesting the name and address of each person
who had received an abortion at the clinic on the same date as
the plaintiff or who was present during the pre-abortion
counseling the plaintiff participated in at the clinic.  461
So. 2d at 800.  This Court recognized a patient's right to
privacy as to medical information and denied the petition.
461 So. 2d at 801.  It concluded that the trial court did not
exceed its discretion by determining that rights to privacy
and confidentiality of the clinic's patients were "paramount
to any gain that might be achieved by the disclosure of the
information sought by the petitioner."  461 So. 2d at 801. 
In light of Mack, St. Vincent's argues that it has a duty
to 
keep 
its 
patients' 
personal-health 
information 
confidential
1061653
19
and that it would be subject to potential liability based on
the breach of this duty if it produces the information sought
by the Wadleys.  St. Vincent's also notes that the Wadleys
seek entire medical records, and it argues that "no good can
be advanced by wrongfully breaching [the nonparties'] right to
privacy" in this case.  Petition at p. 18.  Therefore, St.
Vincent's contends, this Court should protect nonparty health
information as it did in Mack.
To distinguish Mack from the present case, the Wadleys
note first that Mack was a negligence case and that it did not
involve fraud, suppression, pattern and practice, or punitive
damages.  The Wadleys then argue that this Court's decision in
Mack in fact supports the trial court's order because in Mack
this Court recognized that a doctor's duty not to reveal
confidences arising from the relationship between a doctor and
patient is subject to exception where the interests of the
public intervene.  461 So. 2d at 801.  In Mack, this Court
recognized that a doctor's duty not to make extrajudicial
disclosures of information acquired in the course of the
doctor-patient relationship "is not absolute, but subject to
certain exceptions where the supervening interests of society
1061653
20
or the private interests of the patient intervene."  461 So.
2d at 801 (citing Horne, 291 Ala. 701, 287 So. 2d 824). 
The Wadleys contend that society has a profound interest
in ensuring that hospitals and doctors act both morally and
professionally.  The Wadleys specifically argue that "the
public has an interest in being protected from the wrongful
treatment" of fetuses and in being informed of any such
wrongful treatment.  Accordingly, the Wadleys assert that the
discovery they are requesting falls within the societal-
interest exception to the general rule that confidential
health information of nonparties is protected from discovery.
To determine whether governmental or societal interests
justify an intrusion into the right to medical privacy, this
Court has weighed the factors established by the United States
Court of Appeals for the Third Circuit in United States v.
Westinghouse Electric Corp., 638 F.2d 570, 578 (3d Cir. 1980).
Middlebrooks v. State Bd. of Health, 710 So. 2d 891, 892 (Ala.
1998).  These factors are:
"'[T]he type of record requested, the information it
does or might contain, the potential for harm in any
subsequent nonconsensual disclosure, the injury from
disclosure to the relationship in which the record
was generated, the adequacy of safeguards to prevent
unauthorized disclosure, the degree of need for
1061653
"It is not ground for objection that the information
8
sought will be inadmissible at the trial if the information
sought appears reasonably calculated to lead to the discovery
of admissible evidence." 
21
access, and whether there is an express statutory
mandate, 
articulated 
public 
policy, 
or 
other
recognizable 
public 
interest 
militating 
toward
access.'"
710 So. 2d at 892 (quoting Westinghouse Elec. Corp., 638 F.2d
at 578).
B. Information Independent of the Disposition of the Fetuses
We pretermit consideration of privacy factors as to the
requests for production of records and interrogatories to the
extent they seek information independent of the disposition of
the fetuses.  The information in the records of the 19 other
fetuses and of their parents and guardians concerning matters
such as problems with the pregnancy, the mother's health, and
the circumstances resulting in the death of the fetus is
neither relevant to the Wadleys' allegations nor reasonably
calculated to lead to the discovery of admissible evidence.
See Rule 26(b)(1), Ala. R. Civ. P.   Such evidence has no
8
bearing on the allegations of the Wadleys' complaint dealing
only with disposition of the remains of the fetus.  The trial
court therefore exceeded its discretion in denying St.
1061653
Order of June 29, 2007.
9
22
Vincent's motion for a protective order as to information
independent of the disposition of the fetuses.
C. Information Regarding the Disposition of the 19 Other
Fetuses
The trial court, as previously noted, acknowledged that
it was "very concerned about the privacy interests of the
parents of those 19 children, and has struggled mightily on
this issue."   Such is also the case with this Court.  In
9
balancing the Westinghouse factors, we recognize that the
logbooks of the morgue and the department of pathology and the
medical and billing records of the 19 other fetuses and their
parents and guardians concerning the disposition of the 19
other fetuses after delivery contain extremely sensitive
medical information.  We also recognize that because of the
extremely sensitive nature of the requested information, the
"potential 
for 
harm 
in 
any 
subsequent 
nonconsensual
disclosure" of the information is great.  Westinghouse Elec.
Corp., 638 F.2d at 578.  However, we must balance this factor,
"the type of record requested," and "the information [the
record] does or might contain" with the other Westinghouse
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23
factors, while also considering the general discoverability of
the information under Rule 26, Ala. R. Civ. P.  Id. 
We first note that the unique and egregious nature of the
assertions of fraud in this case create a "recognizable public
interest militating toward access" because the actions that
form the basis of the assertions are so offensive to the
morals and dignity of society.  Westinghouse Elec. Corp., 638
F.2d at 578.  That there is such a public interest is further
bolstered by the fact that the rights of privacy the hospital
seeks to protect on behalf of the patients, namely, to keep
from the patients knowledge of how their fetuses were treated,
involve no risk of a chilling effect on a patient's
willingness to communicate his or her wishes for the
disposition of a fetus to a physician.  Thus, the Westinghouse
factor of whether an "injury from disclosure to the
relationship in which the record was generated" will occur
does not weigh in favor of protecting the requested
information.  Id.
We must also consider the Wadleys' "degree of need for
access" to information regarding the disposition of the 19
other fetuses after delivery in light of the Wadleys' fraud
1061653
The trial court noted in its June 29, 2007, order that
10
St. Vincent's acknowledged the potential relevance of this
evidence in the context of punitive damages on the issue of
reprehensibility.  
24
and fraudulent-suppression allegations.
  Westinghouse Elec.
10
Corp., 638 F.2d at 578.  As noted above, the Wadleys' fraud
and suppression counts allege that St. Vincent's had a pattern
and practice of not timely cremating such fetuses and holding
them in its morgue for unreasonable periods, contrary to
alleged representations as to the timing of such activity. 
The Wadleys contend that the discovery requests are
proper because, they say, the requests are carefully tailored
to their fraud and suppression claims.  The Wadleys assert
that the communications and agreements between St. Vincent's
and the parents and guardians of the 19 other fetuses relating
to testing and cremation issues is critically necessary to
their case and likely to lead to the discovery of admissible
evidence.  The Wadleys specifically contend that whether St.
Vincent's told the parents and guardians of the 19 other
fetuses that the fetuses would be stored in the morgue for
months and possibly years before they were cremated is
relevant to their fraud and fraudulent-suppression claims.  
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St. Vincent's contends that the responses to the requests
for production and the answers to the interrogatories "cannot
possibly support" the Wadleys' fraud claims because, it says,
there is no evidence indicating (1) that anyone with authority
to bind St. Vincent's made any representations to the Wadleys
or (2) that the Wadleys relied on any representations made by
a party to the case in deciding to request cremation of the
fetus.  Reply brief at p. 11.  St. Vincent's further contends
that the Wadleys failed to allege that St. Vincent's did
anything to convince or to persuade them to leave the fetus's
remains for cremation.  Thus, St. Vincent's argues that the
information at issue is patently irrelevant to this case.
However, at this stage of the proceeding, where we have before
us only the allegations of the complaint, St. Vincent's has no
clear legal right to a determination that the trial court
exceeded its discretion in allowing discovery, thereby cutting
off a plaintiff's right to discovery based on a defendant's
contentions as to the absence of evidence.  
We also note that St. Vincent's argues that "[t]he
non-party medical records which St. Vincent's has been ordered
to produce likely contain little or no detailed information
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26
regarding any conversations between the healthcare providers
and the non-parties concerning the disposition of their fetal
remains."  Reply brief at p. 4 (emphasis added).  However, St.
Vincent's assertion that the compelled discovery is unlikely
to provide relevant information is not dispositive of the
Wadleys' right to discover the information.  Discovery matters
are within a trial court's sound discretion, and this Court
will grant a petition for a writ of mandamus curtailing a
discovery order only if the trial court clearly exceeded its
discretion in issuing the order.  Ex parte Ocwen Fed. Bank,
872 So. 2d at 813.
We conclude that the information contained in the
logbooks of the morgue and pathology department and records of
the 19 other fetuses and their parents and guardians regarding
the disposition of the fetuses after delivery falls within an
exception to a patient's right to confidentiality because of
the supervening societal interest, recognized in Mack, in
knowledge of a hospital's practices regarding the disposition
of fetuses after delivery and the availability of avenues of
discovery in a fraud case based on such activities.  In light
of the discretion granted to a trial court regarding discovery
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27
matters and the wide latitude allowed for discovery when fraud
is alleged, we further conclude that the trial court did not
exceed its discretion in denying St. Vincent's motion for a
protective order regarding the logbooks and records, to the
extent that those records relate to the disposition of the 19
other fetuses, because those records may assist the Wadleys in
proving their fraud and fraudulent-suppression claims.  Ex
parte Allstate Ins. Co., 401 So. 2d 749, 751 (Ala. 1981)
("Evidence of similar misrepresentations made to others by the
defendant is admissible in a fraud action. ... Therefore, the
information sought ... could very easily lead to admissible
evidence."). 
We thus conclude that the trial court did not exceed its
discretion in denying St. Vincent's motion for a protective
order that would have precluded production of records and
responses to interrogatories, which include (1) the logbooks
for St. Vincent's morgue and department of pathology without
redaction 
of 
identifying 
information, 
(2) 
the 
names,
addresses, Social Security numbers, dates of delivery, and
dates of death of all the fetuses that were to be cremated and
were stored in St. Vincent's morgue for more than seven days
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28
from January 1, 1999, through December 31, 2003, (3) the
names, addresses, and telephone numbers of the parents and
guardians of the fetuses that were to be cremated and that
were stored in St. Vincent's morgue for more than seven days
from January 1, 1999, through December 31, 2003, (4) the
medical and billing records of the 19 other fetuses to the
extent the records concern the disposition of the fetuses, and
(5) the medical records of the mothers of the 19 other fetuses
to the extent the records concern the disposition of the
fetuses.  
We invite the trial court to consider using a neutral
intermediary, such as the trial court itself, a court
official, or other appropriate person, to notify, to the
extent practicable, the persons named in the records of the
pendency of this action, of the order of the trial court
compelling disclosure, and of the action of this Court,
preliminary to producing these records for the Wadleys.  The
Court makes this suggestion solely for the humane purpose of
giving the persons named in the records an opportunity to be
apprised of the extremely sensitive facts underlying the
litigation and the fact of the impending production of the
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29
records before those persons are contacted by the Wadleys in
pursuit of further discovery.
V. Conclusion 
We grant the petition in part and deny it in part.  We
direct the trial court to vacate its order of July 30, 2007,
insofar as it denied a protective order providing relief from
responding to requests for production and interrogatories
related to information concerning the mothers' pregnancies and
the death of the fetuses to the extent that this information
does not deal with disposition of the remains of the fetuses.
In all other respects, we deny the petition.
APPLICATION OVERRULED; OPINION OF FEBRUARY 1, 2008,
WITHDRAWN; OPINION SUBSTITUTED; PETITION GRANTED IN PART AND
DENIED IN PART; WRIT ISSUED. 
Cobb, C.J., and See, Woodall, Stuart, Smith, Bolin, and
Parker, JJ., concur.
Murdock, J., concurs in the result.