will be at the station understood thank you this case is definitely one of the most unique ones that i've ever had are from a procedural standpoint i would say was downright scary that interesting phenomenon in this case is that it involves information before the court today and for the travel court that the a poet courts in other districts and especially some self say cannot be placed before any tribunals for any purpose whatsoever and here we are talking about there are two different instances in this case where involving a physician peer review in the context of a hospital medical medical staff in this case the defamation that  the subject of our complaint we have maintained all along is not peer review information it was not generated in the course of peer review it has nothing to do with peer review the only thing i connected with peer review is a naked e where my client was the subject of a peer review the medical staff is a general surgeon they deal with death all the time they're actually scared reviewed he was absolutely clear in this pe is absolutely barred from ever coming out there has to be and finding resulting in adverse action against this doctor for any information whatsoever to come out otherwise it's absolutely privileged came out afterwards my client was applying for privileges at two with two other health care entities in the course of verification it was privileges the chief of staff it feels from cottage hospital falsely reported to both entities that my client well after this investigation is closed was the subject of an ongoing peer review that involved other action you know their action is defined as a formal reprimand  or resignation while under investigation or terminations of is relationship with the hospital for clinical reasons or participate participation in an impaired practitioner program that statement on the part of  the court let it in and it's still there today but the investigation of this closed favorable result was identified in the same letter where it said that there's this current investigation didn't happen that's why the complaint in this case even though it's based on a document did not have the document attached because we had just asked her this if we couldn't for any purpose not for a limited purpose but for any purpose so what we did we filed a complaint detailing the allegations that were defamatory that were not connected to peer reviewed we also follow the motion for a protective order that says of the court could govern us through this with respect to how to deal with a part that was absolute privilege in part that wasn't and it brings us here today now that the critical issue here is that dr piper has essentially admitted that his eight met regarding other actions against my client other pending actions and him being subject of peer review as of may twenty eighth two thousand and thirteen was false we see throughout the briefs are continued references to the fact that dr piper correctly stated some things by that doctor from those had no limitations on his privileges it is an active member of the staff there is no representation regarding pending other actions of the four types they specified was false that the promo submitted an affidavit to the court saying that he was not subject of peer review that he a february sixth two thousand and thirteen m i that's in dr premis affidavit that he received a letter saying that it was concluded with no recommendation of adverse action and so that was over and now it says that there's a new final recommendation having been made completely false there was no second peer review there was no recommendation forthcoming and even if there was the medical studies act says that recommendations do you think convoluted but that's where there's a disciplinary proceeding that goes with peer review and disciplinary proceeding was underway and completed with no recommendation for anything against and the other action is where it says that a review was open no final recommendation was made as of the date of the letter that means that on going and so that was open according to dr piper at the time this letter was written and that separate peer review committee that was formed outside of the searchable care committee that's what we are saying never happened and there was no investigation this letter was false we filed our complaint based on defamation based on this statement if you look at the very bottom my eyes are are getting bad but i've memorize it defines what other action can be in this the four types what's interesting here is that three of the four are impossible it says at the top that he is an active member of the medical staff so he could not have be the subject of an ongoing review that either happen or it didn't the former reprimand the same way it happens or it doesn't and there's only one thing that can be covered by an ongoing review that's active participation and impaired  activation of a program which never happened but it's the only possible result based on that the context of the letter that that it could be regardless that the characterization that other action was taken in any event briefs we got off our field this is mentioned but the this is the basic issue there's the peer review privilege into the peer review immunity does that apply when there's no peer review process well no there but he didn't identify this peer review that was underway he didn't say who was on the committee when it was convened when it stopped what they did anything because it never happened when we  to he has to meet his burden to show that it's taking place the only place that we've seen any assertion that a peer review was underway was in this letter and it's not for when we go to  prejudice giving privileges and immunities to the arm to the defendant dr piper with nothing properly before the court saying that there was a period you underway and just  releases has his name printed he didn't even sign it that's why they say that his name appears on it so it's effective now i think it's elementary that the lack of a signature on a release which show that their release is in a fact it was we have st mary's and that he had a contract you know with the medical staff that set you won't disclose anything that's inconsistent with medical staff bylaws so he was he was protected we signed the release he was protected  me one of one directed to one of them but i'm saying that he didn't sign one with respect to the other so this complaint shouldn't be dismissed with prejudice based on a release anyway he could have released one but not the other my ability for what he did he could report about any number of different things he couldn't walk he could make up stuff he could take the records and report them and so but here we just did not have  a peer review to even address by us regarding good faith in faith to get him out of here illinois law says the good faith can only be established a couple of a case that the good faith necessary here can only be established if there is some showing in of an investigation any kind of investigation here there was no investigation whatsoever by dr piper when he said this he said we've asserted he did no investigation he has not come up with anything where he did bessie he's taken our sworn statement and let it go and that is that's critical of the under that analysis of the case i just mentioned good faith on cupola vic says the good faith cannot be established if there wasn't a showing of investigation and it was dr piper's burden to show the investigation in order to give rise to the privilege and since he didn't show any investigation we pointed that out he's never responded to that others never been any indication of any investigation of so ever on that misstates goes outside of good faith and there is a good faith element i believe that has to be complied with in order for release to be a factor but  in this case if we get into the privileges and immunities there still has not been anything establishing when this committee was created who acted on what dr piper's role was on the committee has he has to show that he was a member of the commit in order to get immunity and he has been shown that there's nothing in the record saying that he had any function whatsoever or even what committee was call he just says there was a committee somewhere he doesn't even say that they told him a result and that's as a matter of law dismissed with prejudice when none of the elements were established we weren't given it is improper we were given the opportunity to do discovery we weren't given the protective order all that happened to us in this case is that the court allowed insult to be added to injury by letting even more and when the defamation i'm going defamation is an permissible in the first place and i see that a lot of time really scratch the surface and thank you m you review the record doesn't indicate one way or the other justice right in the heart of my frustration with sitting here is a lot of what was just discussed is found no place in this record there were many representation a violation of medical staff and lies this isn't defamation per se plain so what we need to do is look at the letter that was written and determine as a matter of law whether it was defamatory per s the immunity under the medical studies act we have not the circuit any immunity under the medical studies and every single one of our seven defenses is completely unrelated to the medical studies that we keep hearing about it  and in an argument and how it has to be a part of a peer review process that's that has nothing to do with the basis for the dismissal in this case dr piper's dismissal is based on many things the first was a qualified privilege qualified privilege is a common law creation it has nothing to do with the medical studies that this state has determined that in certain favored circumstances defendants have a qualified privilege the judge case just like here medical professionals sending letters about other medical professionals that's a qualified privilege that the common law has created it has nothing to do with the medical studies the innocent so construed again that defense has nothing to do with the medical studies it simply says if you're kissing someone of defamation per se which is a very rigorous standard where harm is open and obvious on the face of the documenter claiming it's defamatory per se if that document is capable of one innocent construction it is not actionable and we're saying dr piper's letter was capable of a very innocent construction he wrote these two hospitals and he said dr perry is a general surgeon on staff it deals for cottage hospital he has active privileges to operate patients in our hospital there are no say that he said this doctor continues to practice at our hospital as an active operating certain the innocent construction and that latter is just what it sounds he was operating on patients at our hospital he had active unrestricted privileges that innocent construction in unity has nothing to do with the  that in addition to these other defenses he didn't say the words and words are not to be amatory precise a they're capable of innocent destruction he's protected by a qualified privilege the illinois hospital licensing act medical practice act both specifically provide immunity for civil liability under these circumstances and again those statutes provide your own immunity in the plain language and those statues provide that no physician no individual or member of a committee who participate who participates in this type of process can be liable for civil damages and there's a reason for that that's because the state of illinois  said the public interest in good medical care trumps an individual's right to file a civil lawsuit we want to encourage these physicians to engage in this type of dialogue when dr applies for privileges at two hospitals most hospitals should have the ability to ask his current hospital what are the status of his privileges and dr piper answered that question he said he's an active surgeon he's got full just the opposite it says he's operating at our hospital with undistracted privileges so no you know just as you don't it's not defamatory he's even if it's defamatory if we assume it's defamatory he has all these additional things and i said the policy in the state could not be more clear in the opening language of both the illinois licensing hospital licensing act and the illinois medical practice and the language begins with the fact that the state of illinois has a public interest in promoting this type of di illinois medical studies act is an act that deals with an evidentiary privilege and usually that comes up in a case where a patient is suing a physician says i want to know if there were meetings about what happened to me that's what the medical studies act that's what the medical studies to protect what dr piper said here didn't violate the medical studies act in the first instance he said that  had been open and no recommendation had been made that doesn't violate the medical studies and medical studies that protects deliberations the exchange of information discussions recommendations before a final outcome is made that your paper didn't discuss any of them in the letter the fact of a peer review is not protected even under the medical studies so that the initial premise that we somehow violated the medical studies act isn't even correct he didn't reveal any of the deliberations that went on during any peer review process he simply said that one existed and we know that's not protected because the illinois supreme court has approved standard interactive tories in a medical case that language all individuals who provided information concerning staff appointments capabilities to exercise privileges competence and quality improvement activities that's exactly what dr piper's letter  initial investigation or it was clear that was covered because it was a national security process the subject of a defamation suit is not and it was their burden to show that it was and they did nothing to show any pe circumstances where the prize that's absolutely wrong the favorite circumstances are when there's a peer review that the person asserting the privilege has to show again when did it start when did it stop who participate function they refused to say they will not say because it didn't happen the only thing properly before the court is my client's affidavit that says it never happened because he didn't participate in any of it you have to know if there was one of these things underway letter that says there's an ongoing review that never happened dr piper said it in the latter but when it came time to put his right hand up and swear under oath he wouldn't do it and he still won't they still will not say what the other action was they dance around it and say well yes we said he had purposes we said there was no discipline agreed agree i'm talking about the other action what was the other action they won't say i know that  fourteen if you look across the street from a school the court said come on we know this means jerry sandusky who just went to prison for being a child molester you can call the child molester but you said it's a sandusky waiting to happen so this not good enough to say you're chief of staff period you have to say what your function was on the committee how you were involved in the committee that gives you the right to say what you said you haven't done that there's no indication  a member of any committee it's much like if i if i was in in trial and then once the appellate court said you know the chief judge told me i was right on this or that she just didn't hear the case it doesn't matter that they're the chief judge has to be the one who established what investigation he did he hasn't done it i goaded council into explaining where it was where this investigation was referenced or what he did there's nothing but with respect to the feb sixth date i did she said it's nowhere in the record yes it is page three thirty four affidavit of sharon pro exhibit beat through a lot of dr piper dated february six twenty we should have the opportunity to conduct discovery we should have the opportunity to flesh all this out figure out why they said this thing about their action what they meant but in the course right now all we know is that there is an allegation that there was peer review