Case Title: Burton v. UIHC

Citation: 566 N.W.2d 182

Docket Number: 

State: iowa

Court: Iowa Supreme Court

Date: 1997-06-18T00:00:00Z

Document:
566 N.W.2d 182 (1997) Karen BURTON, Appellee, v. UNIVERSITY OF IOWA HOSPITALS & CLINICS, Appellant. No. 96-1535. Supreme Court of Iowa. June 18, 1997. Rehearing Denied July 23, 1997. *183 Thomas J. Miller, Attorney General, and Gordon E. Allen, Deputy Attorney General, for appellant. Wallace L. Taylor, Cedar Rapids, for appellee. James A. Albert, Des Moines, for amicus curiae Iowa Freedom of Information Council. J. Kirk Norris, Des Moines, for amicus curiae Association of Iowa Hospitals and Health Systems. Considered by McGIVERIN, C.J., and HARRIS, LAVORATO, NEUMAN, and TERNUS, JJ. LAVORATO, Justice. At issue in this appeal is whether Iowa Code section 135.41 (1993) gives an in-hospital staff committee of a state hospital discretion to deny public inspection of records regarding summaries of nosocomial infections (infections that a person contracts while a patient at the hospital). Assuming the statute does give such discretion, we are then faced with the question whether such hospital must allow public inspection of the summaries pursuant to Iowa Code chapter 22, Iowa's open records law. Contrary to the district court's decision, we hold that the statute does indeed grant the in-hospital staff committee discretion to deny public inspection of the summaries. We further hold that chapter 22 does not supersede such discretion notwithstanding that the summaries are public records. We therefore reverse the district court's grant of summary judgment to the party seeking inspection of the summaries. We remand for entry of summary judgment in favor of the hospital's motion and for an order dismissing the petition of the party seeking inspection. The University of Iowa Hospitals and Clinics (UIHC) collects data on nosocomial infections that arise at the hospital. As mentioned, nosocomial infections are those that a person contracts while a patient at the hospital. Nosocomial infections can be caused in many ways, including lack of adequate hand washing, improper sterilization of medical instruments and devices, improper treatment of water, use of invasive procedures, or utilization of new medical devices and instruments. The Infection Control Subcommittee (ICS) at the hospital monitors and controls access to the nosocomial infection data. On June 19, 1994, Karen Burton wrote to Dr. Richard Wenzel, who was then Chair of the ICS. In her letter Burton requested "immediate access to all records of rates of nosocomial infections at UIHC from 1990 through the most recent period for which records exist." The letter further stated: "This request is made under Iowa Code chapter 22 and excludes only those records identified as confidential in section 22.7, paragraph 2." The same day Burton wrote to University of Iowa Vice-President Ann Rhodes, mentioning earlier conversations with hospital officials. The letter stated: The ICS's senior assistant director, William W. Hesson, denied Burton's June 19 request made to Wenzel. Hesson's letter of denial to Burton, dated June 23, stated: Hesson was also, at all relevant times, assistant director of legal services for the UIHC. On July 8 Burton called assistant attorney general Maureen McGuire. On July 28 McGuire wrote Hesson: After speaking with McGuire, Burton researched the exact types of data the UIHC had on nosocomial infections. Burton then renewed her request via a September 15 letter: In a September 30 letter to Burton, Hesson denied her latest request, again citing the data's alleged confidentiality pursuant to Iowa Code sections 135.40-.42. The letter cites the UIHC's reasons for keeping the data confidential: *185 Several months later, Burton filed this suit requesting an injunction, pursuant to Iowa Code section 22.10, ordering the UIHC to comply with Iowa's Open Records Act (Iowa Code chapter 22). She later amended her petition to include requests for cost, damages, and attorney fees. The UIHC answered, admitting refusal of disclosure, but denying a violation of chapter 22. The UIHC asserted two affirmative defenses: (1) "disclosure is prohibited by section 135.41" and (2) "defendant relied in good faith on advice of counsel." Following discovery, both parties filed motions for summary judgment. Judge August F. Honsell granted Burton's motion for summary judgment and denied the UIHC's motion. Judge Honsell's ruling dealt only with liability under, and the applicability of, Iowa Code chapter 22. He reserved the issues of injunctive relief, damages, and attorney fees. Later Judge Honsell denied the UIHC's motion to reconsider. Following a hearing on the issues of injunctive relief, damages, and attorney fees, Judge Larry J. Conmey denied Burton damages, allowed her attorney fees, and ordered the UIHC to comply with chapter 22. In addition, Judge Conmey enjoined the UIHC from any future violation of chapter 22 as to the documents that are the subject of this lawsuit. The UIHC appealed and Burton cross-appealed. On its appeal, the UIHC challenges Judge Honsell's ruling that the summaries as public records must be disclosed pursuant to chapter 22. On her cross-appeal, Burton challenges Judge Conmey's ruling denying her damages and not awarding her the costs she incurred in retaining her expert witness. The UIHC's appeal is from a summary judgment ruling. Our review is therefore at law. Iowa R.App. P. 4. The district court must render summary judgment Iowa R. Civ. P. 237(c). The parties agree there are no disputed facts. The case essentially involves an interpretation of several statutes and therefore presents solely legal issues. Summary judgment, therefore, is the appropriate remedy. Central Nat'l Ins. Co. v. Insurance Co. of N. Am., 522 N.W.2d 39, 42 (Iowa 1994). In its summary judgment ruling, the district court accurately summarized the positions of the parties in their respective motions: To begin, the code sections relevant to our analysis are Iowa Code sections 22.2, 22.7(2), 135.40, 135.41, and 135.42. These provisions provide: The district court noted that chapter 22 makes the UIHC records public records because the UIHC is a state hospital. See Head v. Colloton, 331 N.W.2d 870, 873 (Iowa 1983) (holding that because the UIHC is a state hospital its records were public records for purposes of Iowa Open Records Act, defining "public records" to include "all records and documents of or belonging to this state"). The court also noted that the summaries do not relate to the condition, diagnosis, care, or treatment of a patient, former patient or outpatient. For this reason, the court concluded, the summaries Burton requested do not fall within any of the categories of confidential information in Iowa Code section 22.7. The court further noted that the summaries are also the subject of sections 135.40 through 135.42 and thus recognized the obvious conflict between chapter 22 and those sections. In resolving the conflict the court reasoned: Like the district court, the UIHC would also construe the statutes together. In doing so, however, the UIHC insists that we should give the terms of the statute their customary and ordinary meaning and give effect to the purposes and intent of the statutes. If we do that, the UIHC argues, we would reach the conclusion that the UIHC's denial of Burton's request was permissible pursuant to the *187 discretionary power given to the UIHC by section 135.41. In addition, the UIHC points out that section 22.7 does not contain the exclusive definition of confidentiality. For example, the argument goes, many other statutes describe particular classes of public records and prescribe particular and specified nondisclosure mandates without mentioning chapter 22. To support its last point, the UIHC lists numerous examples of public records that the legislature has chosen to make confidential and privileged without referring to chapter 22. Iowa Code chapter 68A, the predecessor to chapter 22, was enacted in 1967. See 1967 Iowa Acts ch. 106, §§ 1-8, 11. This was four years after the enactment of sections 135.40-.42. Under the facts, what we have here are several statutes enacted into law at different times but dealing with the same subject matter: public records. (Of course, were the UIHC not a state hospital, its records would not be public records subject to chapter 22.) The district court ruled, and Burton argues here, that chapter 22 controls and allows public access to the summaries. In contrast, the UIHC contends it had discretion under section 135.41 to deny public access. In these circumstances of apparent conflict, we follow the general rule that Polk County Drainage Dist. Four v. Iowa Natural Resources Council, 377 N.W.2d 236, 241 (Iowa 1985) (quoting Baird v. Webster City, 256 Iowa 1097, 1113, 130 N.W.2d 432, 441-42 (1964)). For reasons that follow, we think the UIHC has the better argument. Section 135.41, dealing with publication, mandates that (Emphasis added.) The attorney general response of July 28 correctly observed "that under Iowa Code section 135.41 information that has been obtained for the purpose of studies to reduce morbidity and mortality is available only for medical research and education." (Emphasis added.) The information cannot be released for general publication. The question is whether the word "may" in the above-quoted language of section 135.41 is permissive or mandatory with respect to the "summary of such studies." If permissive, the UIHC has the discretion to withhold disclosure of such summaries. If mandatory, the UIHC has no such discretion and must disclose the information. Wolf v. Lutheran Mut. Life Ins. Co., 236 Iowa 334, 340-41, 18 N.W.2d 804, 808 (1945). There is nothing in section 135.41 to indicate the legislature clearly intended as a policy matter to require disclosure of the summaries in question. To the contrary, requiring disclosure would frustrate the very purpose for collecting nosocomial information: to reduce morbidity or mortality. Public disclosure of nosocomial infection data would have a chilling effect on voluntary reporting by physicians and hospital staff of such infections. What we have said about the necessity to maintain the confidentiality privilege in Iowa Code section *188 147.135(2)(1985) regarding peer review records applies with equal force to infection control summaries: Carolan v. Hill, 553 N.W.2d 882, 886 (Iowa 1996) (quoting Thomas A. Finley et al., Tort Reform and Medical Malpractice: Iowa's Past, Present, and Future, 36 Drake L.Rev. 669, 676 (1986-87)). Contrary to the district court, we conclude that under section 135.41, the UIHC has discretion on whether to disclose the summaries in question. As we alluded to earlier, the district court resolved the apparent conflict between sections 135.40-.42 and chapter 22 by concluding that "[n]othing in sections 135.40-.42 prohibits the release of the data summaries requested by [Burton]." This conclusion made it unnecessary for the district court to address another argument Burton raised to that court. Our conclusion that the UIHC has discretion on whether to disclose the summaries in question brings into focus that argument. The argument pertains to language that originally appeared in Iowa Code section 68 A. 2. Section 68 A. 2 provided broadly that every citizen of Iowa has the right to examine and copy all public records "unless some other provision of the Code expressly limits such right or requires such records to be kept secret or confidential." One commentator correctly interpreted the qualification this way: Note, Iowa's Freedom of Information Act: Everything You've Always Wanted to Know About Public Records But Were Afraid to Ask, 57 Iowa L.Rev. 1163, 1174-75 (April 1972) (citations omitted). In 1984, the legislature removed from section 68 A. 2 the language "unless some other provision of the Code expressly limits such right or requires such records to be kept secret or confidential." See 1984 Iowa Acts ch. 1185, § 2. This suggests to Burton that there cannot be an exemption to the release of public records statutorily mandated as confidential except as specifically provided in chapter 22. Chapter 22 now provides two sources that qualify the public's right to examine public records. The first source includes the exemptions28 in number as of 1993that are found in Iowa Code section 22.7. Section 22.7 allows the specifically described records in this section to be "kept confidential, unless otherwise ordered by the court, by the lawful custodian of the records, or by another person duly authorized to release such information." The second source includes the injunction to restrain examination procedure found in Iowa Code section 22.8. Notwithstanding the section 22.7 exemptions, section 22.8 allows the district court "to provide an equitable relief valve to the disclosure requirements of" chapter 22. City of Dubuque *189 v. Telegraph Herald, Inc., 297 N.W.2d 523, 528 (Iowa 1980). In other words, section 22.8 is "an equitable remedy independent of" the section 22.7 exceptions, and "is applicable when specific criteria are met." Id. There are two criteria: "the examination would clearly not be in the public interest" and "the examination would substantially and irreparably injure any person or persons." Iowa Code § 22.8. We can speculate on why the legislature deleted the language "unless some other provision of the Code expressly limits such right or requires such records to be kept secret or confidential" from section 68 A. 2. Whatever the reason, such deletion created a conflict where none existed before. The conflict is between the disclosure requirements of chapter 22a general statute covering disclosure of public recordsand the more specific statutes covering disclosure of records like those in sections 135.40-.42. Three rules of statutory construction lead us to conclude that chapter 22 does not trump or supersede specific statutes like sections 135.40-.42 on confidentiality of records. First, if the conflict between a general and specific provision is irreconcilable, the special provision prevails as an exception to the general provision. Iowa Code § 4.7. As mentioned, chapter 22 is a general provision allowing disclosure, with certain exceptions not relevant here, of public records. Sections 135.40-.42 are special provisions covering disclosure of infection data summaries which, under the facts of this case, are public records because they belong to a state hospital. As we earlier concluded, these sections allow the UIHC discretion to keep such records confidential. The irreconcilable conflict between chapter 22 and sections 135.40-.42 requires us to consider the latter as an exception to the former. Second, there is a strong presumption against implied repeal. Lemon v. City of Muscatine, 272 N.W.2d 429, 431 (Iowa 1978). The presumption is even stronger when a repeal is claimed of a special statute by a more general one. Id. at 432. Burton's argument that the legislature's deletion of the language in question now allows chapter 22a general provision on disclosure of public recordsto trump more specific statutes on confidentiality of public records is in reality an implied repeal argument. Burton has not overcome the strong presumption against such a repeal. Last, strained, impractical, and absurd results that defeat the purpose of the legislation in question are to be avoided. Iowa Code § 4.6(5) (in interpreting ambiguous statutes to determine legislative intent, court may consider consequences of a particular construction); Pearson v. Robinson, 318 N.W.2d 188, 190 (Iowa 1982). Accepting Burton's argument potentially subjects all public records now covered with the shield of statutory confidentiality and outside of the protection of the section 22.7 exemptions to public disclosure. Such a result would be contrary to the interests to be protected by such statutes and to the legislative policy underlying them. Had the legislature intended such a drastic result we think it would have clearly said so when it deleted the language in question from section 68 A. 2 in 1984. Because the legislature did not say so convinces us that it did not intend such a result. In sum, we hold that section 135.41 gives the UIHC discretion to deny public disclosure of the infection data summaries notwithstanding chapter 22. The district court's decision to the contrary must therefore be reversed. We remand for entry of summary judgment on the UIHC's motion for summary judgment and for an order dismissing Burton's petition. Our holding renders Burton's cross-appeal issues moot. REVERSED AND REMANDED WITH INSTRUCTIONS.