Title: Smith v. Delaware North	Cos.

State: maryland

Issuer: Maryland Supreme Court

Document:

Brenda Smith v. Delaware North Companies, et al., No. 103, September Term, 2015.  Opinion 
by Greene, J.  
 
EVIDENCE 
— 
ADMISSIBILITY 
OF 
CONSENT 
ORDERS 
— 
HEALTH 
OCCUPATIONS ARTICLE § 14-410 
 
Md. Code (1981, 2014 Repl. Vol., 2015 Cum. Supp.), § 14-410 of the Health Occupations 
Article generally prohibits the admission, as evidence in a criminal or civil action, a consent 
order entered into between the Board of Physicians and a physician.  This prohibition is not 
limited to tort actions for medical malpractice.  The admission of any portion of such a consent 
order into evidence constitutes reversible error.  Under the circumstances, it is clear that defense 
counsel’s emphasis on the consent order and the disciplinary action underlying the consent 
order led the jury to consider legally inadmissible evidence, which prejudiced the plaintiff.  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IN THE COURT OF APPEALS 
 
OF MARYLAND 
 
No.  103 
 
September Term, 2015 
 
______________________________________ 
 
BRENDA SMITH  
 
 
 
v. 
 
DELAWARE NORTH COMPANIES, ET AL. 
 
 
Barbera, C.J. 
Greene 
Adkins 
McDonald 
Hotten 
Rodowsky, Lawrence F. (Retired, 
 Specially Assigned) 
Battaglia, Lynne A. (Retired, Specially 
Assigned), 
 
JJ. 
______________________________________ 
 
Opinion by Greene, J. 
______________________________________ 
 
Filed:  August 19, 2016 
 
Circuit Court for Baltimore City 
Case No. 24C-14-002519 
Argued: June 1, 2016 
  
 
In the instant case, we address whether Md. Code (1981, 2014 Repl. Vol., 2015 
Cum. Supp.), § 14-410 of the Health Occupations Article (“HO”) bars the admission of a 
Board of Physicians’ consent order as evidence in a civil or criminal proceeding.  Brenda 
Smith (“Smith”) filed a workers’ compensation claim seeking compensation benefits from 
Delaware North Companies and its insurer (collectively “Delaware North”) for a full knee 
replacement.  At issue was whether the injury Smith sustained at work caused her to need 
knee replacement surgery.  During a jury trial in the Circuit Court for Baltimore City, Smith 
presented the expert testimony of Dr. Kevin McGovern.  To impeach Dr. McGovern’s 
credibility, Delaware North sought to admit a consent order that Dr. McGovern entered 
into with the Maryland Board of Physicians (“the Board”).  Over a timely objection, the 
trial court admitted into evidence a portion of that consent order.  We conclude it was legal 
error to do so.  HO § 14-410 serves generally as a statutory bar to the admission of a Board 
of Physicians’ consent order into evidence in a civil or criminal action.        
FACTUAL AND PROCEDURAL BACKGROUND 
 
On September 7, 2012, Smith slipped on the floor in the course of her employment 
as a cook at Camden Yards.  She landed on her left knee when she fell.  A few weeks after 
the fall, Smith sought medical attention from Dr. Thomas Whitten.  An MRI of her left 
knee revealed that she had torn the posterior horn of the medial meniscus1 and that she had 
                                                          
 
1 The medial meniscus is the “crescentic intraarticular cartilage of the knee joint attached 
to the medial border of the upper articular surface of the tibia occupying the space 
surrounding the contacting surfaces of the femur and tibia.”  STEDMAN’S MEDICAL 
DICTIONARY 1184 (Thomas L. Stedman ed., 28th ed. 2006).   
2 
 
medial2 compartment arthritis.  Smith initially sought conservative treatment from Dr. 
Whitten in the form of cortisone shots.  Dr. Whitten also recommended that Smith undergo 
an arthroscopic procedure.  After Dr. Whitten’s retirement, Smith transferred her care to 
Dr. Kenneth Tepper.  Dr. Tepper recommended that Smith undergo unicompartmental knee 
arthroplasty.3  Next, Smith visited Dr. Mark Cohen at Maryland Orthropedics, P.A. on 
November 11, 2013.  Dr. McGovern, another practitioner at Maryland Orthropedics, P.A. 
saw Smith on February 18, 2014.  Both Dr. Cohen and Dr. McGovern recommended Smith 
undergo a full left knee replacement. 
On January 28, 2014, Smith filed a workers’ compensation claim requesting an 
authorization for a total left knee replacement.  The Workers’ Compensation Commission 
denied her claim after it held a hearing on April 4, 2014.  Smith filed a petition for judicial 
review of the Workers’ Compensation Commission’s denial of her claim in the Circuit 
Court for Baltimore City and requested a jury trial.  On November 24, 2014, Smith filed a 
“Motion In Limine to Exclude Certain Testimony from Kevin McGovern, M.D.” to prevent 
Delaware North from raising questions at trial about any professional disciplinary action 
taken against Dr. McGovern.4  Smith also sought to exclude portions of Dr. McGovern’s 
                                                          
 
2 STEDMAN’S MEDICAL DICTIONARY 1167 (Thomas L. Stedman ed., 28th ed. 2006) 
describes the term “medial” as “[r]elating to the middle or center; nearer to the median or 
midsagittal plane.”  
  
3 Unicompartmental refers to one compartment of the knee, rather than the full knee. 
 
4 The disciplinary action involved a consent order that Dr. McGovern entered into with the 
Board on July 2, 2012.  Upon the Board’s issuance of charges, a physician has the right to 
an evidentiary hearing before a hearing officer or to settle the charges without an 
evidentiary hearing by entering into a consent order.  See HO § 14-405 and HO § 14-401.1.  
3 
 
de bene esse deposition where defense counsel inquired into the disciplinary charges 
against Dr. McGovern.5  She argued in her motion that HO § 14-410 “expressly prohibits 
                                                          
 
A consent order is a “Final Order” of the Board.  See COMAR 10.32.02.02(B)(16).  As Dr. 
McGovern’s consent order notes, when a physician enters into a consent order with the 
Board, the physician waives his or her “right to appeal any adverse ruling of the Board” 
which a physician is generally entitled to after an evidentiary hearing.  Pursuant to HO § 
14-411.1, “[a] description of any disciplinary action taken by the Board or a disciplinary 
panel against a licensee within the most recent 10-year period that includes a copy of the 
public order” will be disclosed on the licensee’s public individual profile maintained by 
the Board.  Hence, any consent order is posted on a physician’s public profile for 10 years.     
   
5 During Dr. McGovern’s de bene esse deposition, defense counsel asked, “what’s the 
current status of your medical license in Maryland?”  Dr. McGovern responded, “I have no 
restrictions on my license.”  The following line of questioning followed: 
 
[Defense Counsel]: Well, aren’t you currently on probation? 
 
[Plaintiff’s Counsel]: Objection.  And I’ll object to any line of questioning 
that have (sic) to do with any type of probation or investigations. 
 
[Defense Counsel]: Okay. I understand.  But doctor, aren’t you currently on 
probation? 
 
[Dr. McGovern]: On the advice of my attorney I’m not allowed to answer 
that question. 
*** 
[Defense Counsel]: Well, you’re on probation in Maryland for the next two 
years, right? 
 
[Dr. McGovern]: Again, on the advice of my attorney I’m not allowed to 
answer that question. 
 
[Defense Counsel]: Doctor, isn’t it true that you were also fined ten thousand 
dollars by the Maryland Board of Physicians for failure to meet the standard 
of care? 
 
[Plaintiff’s Counsel]: I’m going to object to that question as not being 
relevant and also it being known that those questions are not permissible in 
this – type of setting and nothing to do with the case. 
 
[Defense Counsel]: I understand you have a continuing objection.  But 
Doctor, isn’t it true that you were also fined ten thousand dollars by the 
Maryland Board of Physicians for failure to meet [the] standard of care? 
4 
 
the introduction of such evidence in any collateral proceeding such as an appeal from a 
workers’ compensation commission claim.”6     
                                                          
 
 
[Dr. McGovern]: On the advice of my attorney I’m not allowed to answer 
that question. 
 
[Defense Counsel]: Okay. Could I have this marked, please? 
 
(McGovern Exhibit 1 [the consent order] was marked for purposes of 
identification.) 
 
[Defense Counsel]: Doctor, I’m handing you what has been marked for 
identification purposes as Defense 1.  Do you recognize that? 
 
[Dr. McGovern]: On the advice of my attorney I’m not allowed to answer 
that question. 
 
[Defense Counsel]: I understand that your attorney doesn’t want you to 
answer any substantive questions regarding the status of your license or your 
probation, but could you just identify what this document is. 
 
[Plaintiff’s Counsel]: I’m going to object to your request for him to identify 
what the object is . . . . because it’s not relevant to the case at hand and will 
not be submittable (sic) in any way and will be a motion subject (sic) in 
limine.   
 
[Defense Counsel]: I understand.  But we could allow the judge to make that 
ruling. 
 
[Plaintiffs’s Counsel]: I’m going to object to any questions regarding this 
consent order, any further questions regarding it.   
 
[Defense Counsel]: Understood.  Doctor, do you know what this document 
is? 
 
[Dr. McGovern]: On the advice of my attorney I’m not allowed to answer 
questions. 
 
In response to defense counsel’s continued questioning regarding the consent order and 
the consent order’s substantive contents, Dr. McGovern continued to respond that he 
was not allowed to answer the question on the advice of his attorney. 
 
6 HO § 14-410 provides in pertinent part: 
5 
 
On December 11, 2014, a jury trial was held in the Circuit Court for Baltimore City 
to answer the question of whether Smith’s knee replacement surgery was causally related 
to the accidental injury she suffered on September 7, 2012.  Prior to jury selection, the trial 
judge heard the parties’ arguments regarding Smith’s “Motion In Limine to Exclude 
Certain Testimony from Kevin McGovern, M.D.”  Smith argued that the admission of the 
consent order would violate HO § 14-410(a).  The trial judge disagreed and stated, “I do 
agree with [d]efense counsel that the stating (sic) of the consent order in effect is a 
stipulation of the parties that it’s okay to be used.”7  She explained, “it’s an exception to 
the medical review committee privilege8 as we’re referring to it.”   
Once the trial judge determined that the consent order was admissible, she provided 
Smith with an opportunity to argue whether the admission of the consent order was “more 
substantially prejudicial than probative of the issue of whether Dr. McGovern is telling us 
                                                          
 
(a) Except by the express stipulation and consent of all parties to a proceeding 
before the Board, a disciplinary panel, or any of its other investigatory 
bodies, in a civil or criminal action: 
(1) The proceedings, records, or files of the Board, a disciplinary panel, or 
any of its other investigatory bodies are not discoverable and are not 
admissible in evidence; and 
(2) Any order passed by the Board or disciplinary panel is not admissible in 
evidence. 
 
7 Smith’s brief explains that the trial court concluded that Dr. McGovern signing the 
consent order was an “express stipulation and consent” to the consent order being used in 
a civil or criminal proceeding.  HO § 14-410(a).    
 
8 It appears that the trial judge was referring to the privilege applicable to the Board’s 
“proceedings, records, or files” and “[a]ny order passed by the Board” under HO § 14-
410(a) rather than the medical review committee privilege that arises under HO § 1-401(d).   
 
6 
 
facts that are relevant to Ms. Smith’s case.”9  Smith noted that even though Dr. McGovern 
was on probation pursuant to the consent order, his license to practice medicine was still 
in good standing and that Dr. McGovern was still qualified to treat patients and offer expert 
testimony.  Smith then argued that questioning on the disciplinary action would confuse 
and mislead the jury about the merits of the case, which involved the narrow issue of 
whether Smith’s workplace injury caused her need for knee replacement surgery.  
Therefore, Smith contended that the probative value of the consent order and disciplinary 
action was substantially outweighed by their prejudicial effect.  
The trial judge ruled that 
[i]t appears to this [c]ourt that the probative value of going into the 
disciplinary action against Dr. McGovern is outweighed by the prejudicial 
effect of the possible confusion of the jury.  However, there’s no question in 
my mind that the question about the status of his license, that should be asked.   
 
Now, how far that question is allowed to go will depend on the answers Dr. 
McGovern gives.  If I understand from the written submissions, Dr. 
McGovern’s license is authorized only in the case that he obey the terms of 
the consent order.   
 
Thus, the trial judge granted, in part, Smith’s “Motion In Limine to Exclude Certain 
Testimony from Kevin McGovern, M.D.” and excluded the portions of Dr. McGovern’s 
de bene esse deposition that referenced the disciplinary charges against him.  She, however, 
allowed “the Defense to introduce the consent order showing that there are restrictions on 
[Dr. McGovern’s] license.”  In response, Smith asked that the admission of the consent 
                                                          
 
9 Md. Rule 5-403 provides: “Although relevant, evidence may be excluded if its probative 
value is substantially outweighed by the danger of unfair prejudice, confusion of the issues, 
or misleading the jury, or by considerations of undue delay, waste of time, or needless 
presentation of cumulative evidence.” 
7 
 
order “be limited to the conclusions of law and the order that sets forth the conditions in 
[Dr. McGovern’s] probation” rather than the whole consent order which details the facts 
of each disciplinary charge against Dr. McGovern.  The trial judge agreed with Smith and 
limited the submission of the consent order to the last six pages, excluding the first 
seventeen pages of the order.  The last six pages of the consent order begin with the Board’s 
“Conclusions of Law,” which state:  
Based on the foregoing Findings of Fact, the Board concludes as a matter of 
law that [Dr. McGovern’s] actions and inactions, as set forth above, 
constitute a failure to meet the appropriate standards for the delivery of 
quality medical care, in violation of H.O. § 14-404(a)(22); and a failure to 
keep adequate medical records, in violation of H.O. § 14-404(a)(40).  The 
charges under H.O. § 14-404(a)(23), of willfully submitting false statements 
to collect fees for which services are not provided, and H.O. § 14-404(a)(19), 
of grossly overutilizing health care services, are dismissed. 
 
These pages of the consent order also set forth the conditions of Dr. McGovern’s two year 
probation10 and disclosed that the consent order “is considered a PUBLIC 
DOCUMENT[.]”  The page that contains Dr. McGovern’s signature is entitled, 
“CONSENT” and states: 
I, Kevin McGovern, M.D., acknowledge that I am represented by counsel 
and have consulted with counsel before entering into this Consent Order.  By 
this Consent and for the purpose of resolving the issues raised by the Board, 
                                                          
 
10 During his period of probation, Dr. McGovern was required to: (1) “pay a civil fine of 
$10,000[;]” (2) complete a “Board approved one-on-one tutorial in medical ethics[;]” (3) 
complete a “3,000-word paper regarding the therapeutic use of sciatic nerve blocks[;]” (4)  
complete a “Board-approved course or one-on-one tutorial in medical recordkeeping[;]” 
(5) complete a “Board-approved billing course[;]” (6) complete a “comprehensive Board-
approved course or one-on-one tutorial of significant duration in conservative orthopedic 
pain management treatment[;]” and (7) meet with a Board-approved mentor at least two 
times for comprehensive peer reviews upon successful completion of the above-referenced 
courses.   
8 
 
I agree and accept to be bound by the foregoing Consent Order and its 
conditions. 
 
I acknowledge the validity of this Consent Order as if entered into after the 
conclusion of a formal evidentiary hearing in which I would have had the 
right to counsel, to confront witnesses, to give testimony, to call witnesses 
on my own behalf, and to all other substantive and procedural protections 
provided by law.  I agree to forego my opportunity to challenge these 
allegations.  I acknowledge the legal authority and jurisdiction of the Board 
to initiate these proceedings and to issue and enforce this Consent Order.  I 
affirm that I am waiving my right to appeal any adverse ruling of the Board 
that I might have filed after any such hearing. 
 
I sign this Consent Order after having an opportunity to consult with counsel, 
voluntarily and without reservation, and I fully understand and comprehend 
the language, meaning and terms of the Consent Order.  
 
 
After the court addressed the parties’ motions, a jury was selected and trial began.  
Smith was the first witness to testify.  She testified on her own behalf as to the injuries she 
suffered and the recommendations of her doctors.  Next, Smith presented expert witness 
testimony by playing a redacted version of Dr. McGovern’s video deposition for the jury.11  
Dr. McGovern testified as follows: 
[Plaintiff’s Counsel]: Now, you said you reviewed Dr. Cohen’s notes prior 
to your examination of Ms. Smith; is that correct? 
 
[Dr. McGovern]: Yes. 
 
[Plaintiff’s Counsel]: Did you also look at his impression and his diagnosis 
of what her injury was? 
 
[Dr. McGovern]: Of course. 
 
[Plaintiff’s Counsel]: And what was his diagnosis of her injury? 
 
[Dr. McGovern]: Aggravation of pre-existing medial compartment arthritis 
of her left knee related to the injury of September 7th, 2012. 
                                                          
 
11 The video deposition was redacted to reflect the trial court’s pre-trial ruling to exclude 
defense counsel’s questioning of Dr. McGovern regarding the disciplinary charges against 
him.  
9 
 
*** 
[Plaintiff’s Counsel]: And what were the – what was shown by the x-rays? 
 
[Dr. McGovern]: That she had degenerative arthritis, severe in her left knee 
and moderate in her right knee.   
 
[Plaintiff’s Counsel]: And what were the results of the – when you reviewed 
the MRI, what were the results of Ms. Smith’s MRI? 
 
[Dr. McGovern]: Again, it showed degenerative changes and it showed a tear 
of her medial meniscus in her left knee . . . . The menisci, the medial and 
lateral meniscus, the medial is on the inner part of the joint, the lateral is on 
the outer part of the joint.  The medial part is the part of your knee that would 
touch your other knee if you put your knees together . . . . In this case[,] 
there’s a tear in the back portion of the meniscus, the posterior horn of the 
meniscus, which is the most common place for menisci to tear when they 
tear.  The medial is the most common place for it to tear.  The lateral 
meniscus on the outside of the knee doesn’t tear nearly as frequently as does 
the one on the inner aspect of the knee.  And most meniscal tears are caused 
by some sort of twisting injury to the knee.   
 
[Plaintiff’s Counsel]: And Ms. Brenda Smith, she would – had both of those 
positive showings on the MRI as far as her left knee is concerned? 
 
[Dr. McGovern]: It showed that she had a tear of the posterior horn of her 
medial meniscus as well as arthritis in her knee. 
 
[Plaintiff’s Counsel]: And as far as the arthritis is concerned, the MRI 
classified that as – how did the MRI classify that arthritis in the findings? 
Would it be correct to say that they said mild degenerative arthritic changes? 
 
[Dr. McGovern]: Well, it says in the lateral meniscus – meniscus it shows 
mild degenerative change without definite tear.  And then in the medial 
meniscus it shows mild degeneration of the meniscus.  That is a little bit 
different than the arthritis itself.  Again that’s what they’re talking about in 
the menisci being mildly degenerated.  We know from the x-ray that she has 
fairly significant arthritis in her knee.   
*** 
[Plaintiff’s Counsel]: Can someone have arthritis and not need a knee 
replacement? 
 
[Dr. McGovern]: Oh absolutely.  You’re looking at one right now, I have 
arthritis in one of my knees and I don’t need a knee replacement.  
 
10 
 
[Plaintiff’s Counsel]: And can arthritis in someone’s knee, can that be 
aggravated by a trauma? 
 
[Dr. McGovern]: Absolutely. 
 
[Plaintiff’s Counsel]: And can you just explain to the ladies and gentlemen 
of the jury how a trauma could aggravate pre-existing arthritis?   
 
[Dr. McGovern]: Well, in a simplistic way, it’s possible that that could just 
be the straw that breaks the camel’s back.  At some point something happens 
that makes a joint become painful and symptomatic.  In this particular case 
the mostly (sic) likely scenario is that she had arthritis in her knee.  She had 
mild degeneration of her menisci, but when she had the fall she ended up 
tearing her medial meniscus [as] the result of the fall.  That tear then 
aggravates and inflames the joint and causes the knee to become 
symptomatic, the arthritis to become symptomatic.  In a young healthy 
person with no arthritis you could go in there with the arthroscope and repair 
or remove the damaged meniscus, and the symptoms would go away.  But 
unfortunately once the knee is arthritic, such as this one, then taking care of 
the meniscus, fixing it or removing it doesn’t solve the problem.  Because 
the arthritis, once it becomes inflamed and symptomatic, stays symptomatic.  
So she would need something more significant than an arthroscopy for a torn 
meniscus, she would need a knee replacement to make her symptoms go 
away.         
*** 
[Plaintiff’s Counsel]: And what is your diagnosis as to after, you know, 
reviewing the history, reviewing the MRIs, looking at your notes, Dr. 
Cohen’s notes, the x-rays, what is your diagnosis of what the cause of her 
current condition is and what’s the cause of the need for the left knee 
replacement? 
 
[Dr. McGovern]: Well, it’s my belief that she had arthritis in her knee that 
wasn’t symptomatic before this injury.  That this injury caused her to tear her 
medial meniscus which caused an aggravation of her arthritis and has caused 
her to remain symptomatic as a result of that.  The only solution for her 
problem as a result of this injury of September 7th, 2012 now is to have the 
knee replacement.  Nothing less than that will work.  She’s already had 
conservative treatment.  She’s had Cortisone shots and gel injections into her 
knee of lubricants, called viscosupplementation, none of which have solved 
her problem and none of which probably would.  And at this point a knee 
replacement is the only thing that would resolve her symptoms she now has 
as a result of her injury of September 2012.  
11 
 
 
[Plaintiff’s Counsel]:  And that opinion is – diagnosis is based within a 
reasonable degree of medical probability? 
 
[Dr. McGovern]: Yes or I would haven’t (sic) said it.   
 
[Plaintiff’s Counsel]: Did you have the opportunity to review a letter from 
Dr. Cohen dated January 21st, 2014? 
 
[Dr. McGovern]: Yes. 
 
[Plaintiff’s Counsel]: In that letter did Dr. Cohen detail his opinion of Ms. 
Smith’s left knee condition in that letter? 
 
[Dr. McGovern]: It did. 
 
[Plaintiff’s Counsel]: And what was his opinion? 
 
[Dr. McGovern]: The same as mine. 
*** 
[Plaintiff’s Counsel]: Now, Ms. Smith was also diagnosed or I should say 
seen by a Dr. Becker; are you familiar with Dr. Becker?12 
 
[Dr. McGovern]: I know who Dr. Becker is, yes. 
 
[Plaintiff’s Counsel]: And have you had a chance to look at his report and his 
addendum to his report? 
 
[Dr. McGovern]: I have. 
 
[Plaintiff’s Counsel]: And what is your understanding of Dr. Becker’s role 
in this case? 
 
[Dr. McGovern]: He performed an independent medical evaluation for the 
defense. 
 
[Plaintiff’s Counsel]: And in reviewing his report is there anything 
significant that you disagree with? 
 
[Plaintiff’s Counsel]: I think we disagree on the fact that she needs a knee 
replacement as a result of her injury.  We agree that she has arthritis that was 
aggravated by the accident.   
 
                                                          
 
12 Dr. Larry Becker was defense counsel’s expert witness.   
12 
 
On cross-examination, defense counsel asked, “can you state to a reasonable degree of 
professional certainty whether or not Ms. Smith would have needed a knee replacement 
even if she hadn’t slipped at work?”  Dr. McGovern responded: 
No, I can’t say a hundred percent whether she would or wouldn’t have.  
Again, she wasn’t symptomatic before this injury.  There’s no way of 
knowing at what point she would or wouldn’t become symptomatic in the 
future.  There’s a possibility she would have needed a knee replacement in 
the future with or without this injury, but I can’t say when it would be or for 
sure it would be. 
 
After Dr. McGovern’s deposition was played, the trial judge admitted into evidence Dr. 
McGovern’s curriculum vitae.  The defense presented the testimony of its expert witness, 
Dr. Larry Becker, via video deposition.  Next, the court admitted into evidence Dr. 
Becker’s curriculum vitae and the Workers’ Compensation Commission’s Order resulting 
from the administrative proceeding.  The trial judge also granted, over Smith’s objection, 
defense counsel’s request to move into evidence the last six pages of the Board’s consent 
order against Dr. McGovern.   
 
The parties rested and the trial judge gave the jury a series of instructions on the 
law.  After the jury instructions were given, the parties gave closing arguments.  Defense 
counsel repeatedly mentioned the consent order in his closing argument: 
Bringing up this whole aggravation argument is what’s meant to confuse you, 
because they have to come up with something different than their expert . . . . 
[Smith’s Counsel] would indicate that there’s a piece of evidence [the 
consent order] that you’ll review in conjunction with their expert from Dr. 
McGovern.  Please read that document and decide whether you believe 
anything that individual told you today, because when he was asked about 
his medical license, he said everything was just fine.  He wasn’t truthful.  
He’s on probation currently for ethical problems involved in workers’ 
compensation claims and he’s who they hired . . . . Dr. McGovern’s 
disciplinary action, being on probation, I mean, look at the fine that was 
13 
 
levied against him for unethical practices in workers’ compensation claims, 
but yet you should believe him?  His entire testimony should be disregarded 
. . . . Was Dr. McGovern’s testimony consistent?  Nope.  The consent order 
shows the inconsistencies in his testimony about the status of his medical 
license.  Whether the witness’ testimony was contradicted by evidence.  Once 
again, the order that you’re going to read from the Maryland Board of 
Physicians completely contradicts and puts into question his truthfulness, his 
honesty, his integrity, his ethics.  And they want you to believe this 
gentleman . . . . But just think in your own mind, would you or would you 
(sic) have a loved one go to a doctor for treatment that’s been disciplined by 
the Maryland Board of Physicians, that’s on probation for ethical problems, 
would you ever in your wildest dreams send your loved one to that provider?  
But yet they want you to rely upon him in this claim.  It’s insulting to this 
entire system.  
 
And for that reason I would ask on behalf of my client that you affirm the 
decision of the Commission, [and] check the box “No.”   
 
During rebuttal, Smith’s counsel attempted to respond to the statements made by defense 
counsel during his closing argument: 
Now, I realize that defense counsel has submitted into evidence a disciplinary 
action against Dr. McGovern and it’s - - he is on probation . . . . So you think 
to yourself, you say, all right, Dr. McGovern got disciplined, he must have 
done something wrong, he is on probation.  Well, when people are on 
probation, when they are being disciplined . . . . You make sure you tow the 
line, you make sure you don’t get in trouble, because if you do, you’re going 
to have to - - have the consequences, and Dr. McGovern is in that exact 
situation right now.  So he’s not making any mistakes.  He’s following the 
book, he’s following the rules, because he is on probation and that’s 
something to take into consideration when you weigh his credibility.   
 
After jury deliberations, the jury returned and responded “no” to the question: “‘Is Brenda 
Smith’s knee replacement surgery causally related to the accidental injury suffered on 
September 7, 2012,’ yes or no?”  Based on this jury verdict, the trial judge affirmed the 
decision of the Workers’ Compensation Commission. 
14 
 
 
On December 23, 2014, Smith filed a “Motion for a New Trial.”  Initially, on April 
1, 2015, another trial judge granted Smith’s “Motion for a New Trial” but subsequently 
denied Smith’s motion in an “Order Correcting and Replacing the Court’s Prior Order” on 
June 24, 2015.  The court explained that HO § 14-410(a) “only applies to civil trials 
involving tort actions for medical malpractice and thus is inapplicable to this case.”   
Smith noted an appeal to the Court of Special Appeals on July 9, 2015.  Pending the 
appeal and prior to any proceedings in that court, we granted certiorari, Smith v. Delaware 
North Companies, 446 Md. 290, 132 A.3d 193 (2016), to answer the following questions:      
1. Does the privilege set forth under § 14-410 of the Health Occupations 
Article (“H.O.”) bar the admission of evidence of a Board of Physicians 
[c]onsent [o]rder to impeach a physician who is offering testimony as an 
expert witness? 
 
2. Was the privilege set forth under § 14-410 intended to be strictly limited 
to medical malpractice actions? 
 
For the reasons stated below, we shall answer the first question in the affirmative and the 
second question in the negative.   
STANDARD OF REVIEW 
 
The issues before this Court arise out of the trial court’s admission as evidence at trial 
of the consent order and its subsequent denial of Smith’s motion for new trial.  The trial 
court based both of these rulings on its interpretation of HO § 14-410.  Questions of 
statutory interpretation are purely legal inquires, which we review de novo.  Reier v. State 
Dep’t of Assessments & Taxation, 397 Md. 2, 26, 915 A.2d 970, 984 (2007). 
“The cardinal rule of statutory interpretation is to give effect to the legislative 
purpose or policy.”  State Dep’t of Assessments & Taxation v. Md.-Nat’l Capital Park & 
15 
 
Planning Comm’n, 348 Md. 2, 13, 702 A.2d 690, 696 (1997).  In ascertaining legislative 
intent, “we look first to the language of the statute, giving it its natural and ordinary 
meaning.”  Scriber v. State, 437 Md. 399, 410, 86 A.3d 1260, 1266 (2014).  Where the plain 
language of the statute is unambiguous, we end our inquiry as to legislative intent and 
“apply the statute as written, without resort to other rules of construction.”  Griffin v. 
Lindsey, 444 Md. 278, 287, 119 A.3d 753, 758 (2015).  We have also stated that: 
We neither add nor delete language so as to reflect an intent not evidenced in 
the plain and unambiguous language of the statute, and we do not construe a 
statute with forced or subtle interpretations that limit or extend its 
application. 
 
We [] do not read statutory language in a vacuum, nor do we confine strictly 
our interpretation of a statute’s plain language to the isolated section alone. 
Rather, the plain language must be viewed within the context of the statutory 
scheme to which it belongs, considering the purpose, aim, or policy of the 
Legislature in enacting the statute.  We presume that the Legislature intends 
its enactments to operate together as a consistent and harmonious body of 
law, and, thus, we seek to reconcile and harmonize the parts of a statute, to 
the extent possible consistent with the statute’s object and scope.  
 
Merchant v. State, 448 Md. 75, 94–95, 136 A.3d 843, 855 (2016).  Additionally, we 
presume that “‘the Legislature intends its enactments to operate . . . such that no part 
of the statute is rendered meaningless or nugatory.’”  Fisher v. Eastern Corr. Inst., 
425 Md. 699, 707, 43 A.3d 338, 343 (2012) (quoting Smack v. Dep’t of Health and 
Mental Hygiene, 378 Md. 298, 306, 835 A.2d 1175, 1179 (2003)).   
DISCUSSION 
 
HO § 14-410 governs the issue of whether the Board of Physician’s consent order 
entered into by Dr. McGovern was admissible as evidence in the instant case.  The parties, 
16 
 
however, offer competing interpretations of this statute.  HO § 14-410 provides in pertinent 
part: 
(a) Except by the express stipulation and consent of all parties to a proceeding 
before the Board, a disciplinary panel, or any of its other investigatory bodies, 
in a civil or criminal action: 
(1) The proceedings, records, or files of the Board, a disciplinary panel, or any 
of its other investigatory bodies are not discoverable and are not admissible in 
evidence; and 
(2) Any order passed by the Board or disciplinary panel is not admissible in 
evidence.  
(b) This section does not apply to a civil action brought by a party to a 
proceeding before the Board or a disciplinary panel who claims to be aggrieved 
by the decision of the Board or the disciplinary panel. 
 
The Statutory Privilege Pursuant to HO § 14-410 
 
 
Smith argues that HO § 14-410(a) creates what she calls “the board proceedings 
privilege.”  The language of HO § 14-410 is clear and unambiguous.  As Smith argues, the 
plain language of HO § 14-410(a) prevents the admission or discovery of, “in a civil or 
criminal action[,] . . . [t]he proceedings, records, or files of the Board, a disciplinary panel, 
or any of its other investigatory bodies” and the discovery of “[a]ny order passed by the 
Board or disciplinary panel.”  Smith is also correct in her assertion that HO § 14-410 
provides only two exceptions to this privilege.  Pursuant to HO § 14-410(a): “The 
proceedings, records, or files of the Board, a disciplinary panel, or any of its other 
investigatory bodies” and the discovery of “[a]ny order passed by the Board or disciplinary 
panel” may be used “in a civil or criminal action” if all parties to the Board proceeding or 
disciplinary panel expressly stipulate and consent to its use.  HO § 14-410(b) provides a 
second exception: these privileged materials may also be used in “a civil action brought by 
a party to a proceeding before the Board or a disciplinary panel who claims to be aggrieved 
17 
 
by the decision of the Board or the disciplinary panel.”  The trial court’s determination that 
“the [signing] of the consent order in effect is a stipulation of the parties that it’s okay to 
be used” does not fall under either statutory exception.          
 
 Both Dr. McGovern and the Board signed the consent order and these signatures 
indicate the parties’ agreement to the terms of the order.  As the consent order notes, by 
agreeing to the terms of the order, a physician acknowledges that he freely agrees to be 
bound by the terms of the consent order and is aware that he waives certain rights by 
settling the charges against him without an evidentiary hearing.  Nowhere on the page 
entitled “CONSENT” or anywhere else in the consent order does it state that agreeing to 
the terms of the consent order also indicates consent to its admissibility or discoverability 
“in a civil or criminal action.”  HO § 14-410.  The plain language of HO § 14-410 requires 
“the express stipulation and consent of all parties to a proceeding” before any “proceedings, 
records or files of the Board” or “[a]ny order passed by the Board or disciplinary panel” 
can be admitted “in a civil or criminal action.”  It is clear that Dr. McGovern’s signature 
on the “CONSENT” page does not rise to the level of an “express stipulation and consent” 
to anything other than agreement to be bound by the terms of the consent order.  Thus, we 
conclude that the trial judge erred in ruling that the signing of the consent order constituted 
an exception to the privilege provided under HO § 14-410. 
 
As noted above, there are only two exceptions to the privilege set forth under HO § 
14-410.  Contrary to Delaware North’s characterization of the consent order as permissible 
impeachment evidence, HO § 14-410 does not contain an exception for the use of 
“proceedings, records or files of the Board” or “[a]ny order passed by the Board or 
18 
 
disciplinary panel” to be used to impeach the credibility of a witness.  To read in an 
impeachment exception would impermissibly “reflect an intent not evidenced in the plain 
and unambiguous language of the statute” and “construe the statute with forced or subtle  
interpretations that . . . extend its application.”  Kushell v. Dep’t of Nat. Res., 385 Md. 563, 
576–77, 870 A.2d 186, 193 (2005) (quoting Price v. State, 378 Md. 378, 387, 835 A.2d 
1221, 1226 (2003)).  Therefore, we hold that the plain language of HO § 14-410 bars the 
admission of the consent order to impeach the credibility of a physician who is offering 
testimony as an expert witness. 13   
The Public Nature of the Consent Order 
 
Delaware North’s contention that the consent order’s classification as a public 
document removes it from the ambit of HO § 14-410 is also without merit.  As previously 
discussed, HO § 14-410 provides two statutory exceptions.  Neither of these exceptions 
allows parties to a disciplinary proceeding of the Board to waive the protections provided 
under HO § 14-410 by signing a document containing a public document disclosure.  
Although HO § 14-410(a) allows privileged materials to be used if all parties to the Board 
proceeding or disciplinary panel expressly stipulate and consent to its use, contrary to 
                                                          
 
13 Even where the plain meaning of the statute is clear, “the resort to legislative history is 
a confirmatory process.”  Smith v. State, 399 Md. 565, 578, 924 A.2d 1175, 1182 (2007). 
Our interpretation of HO § 14-410 is consistent with the statute’s legislative purpose.  See 
Certain Underwriters at Lloyd’s, London v. Cohen, 785 F.3d 886, 894 (4th Cir. 2015) 
(“Barring the admission of Board disciplinary orders in later civil and criminal actions 
encourages physicians to cooperate during Board proceedings.  Such cooperation 
strengthens the Board’s ability to conduct proceedings that are thorough and fair, and 
thereby advances the Board’s efforts to protect the health and safety of the public.”).      
 
19 
 
Delaware North’s belief, agreeing that a consent order is a public document does not 
amount to an express stipulation and consent as to the order’s use at trial.  To adopt 
Delaware North’s view would invite a “forced or subtle interpretation” of the exception 
provided in HO § 14-410(a).  Fangman v. Genuine Title, LLC, 447 Md. 681, 691, 136 A.3d 
772, 778 (2016). 
 
In Certain Underwriters at Lloyd’s, London v. Cohen, the Fourth Circuit addressed 
the same argument that Delaware North puts forth: agreeing to enter into a consent order 
which is a public document14 renders the order and the underlying circumstances of the 
                                                          
 
14 HO § 14-411.1 provides:  
(a) In this section, “health maintenance organization” has the meaning stated 
in § 19-701 of the Health-General Article. 
 
 (b) The Board shall create and maintain a public individual profile on each 
licensee that includes the following information: 
(1) A summary of charges filed against the licensee, including a copy of the 
charging document, until a disciplinary panel has taken action under § 14-
404 of this subtitle based on the charges or has rescinded the charges. 
(2) A description of any disciplinary action taken by the Board or a 
disciplinary panel against the licensee within the most recent 10-year period 
that includes a copy of the public order; 
(3) A description in summary form of any final disciplinary action taken by 
a licensing board in any other state or jurisdiction against the licensee within 
the most recent 10-year period; 
(4) The number of medical malpractice final court judgments and arbitration 
awards against the licensee within the most recent 10-year period for which 
all appeals have been exhausted as reported to the Board; 
(5) A description of a conviction or entry of a plea of guilty or nolo 
contendere by the licensee for a crime involving moral turpitude reported to 
the Board under § 14-416 of this subtitle; and 
(6) Medical education and practice information about the licensee including: 
(i) The name of any medical school that the licensee attended and the 
date on which the licensee graduated from the school; 
(ii) A description of any internship and residency training; 
20 
 
                                                          
 
(iii) A description of any specialty board certification by a recognized 
board of the American Board of Medical Specialties or the American 
Osteopathic Association; 
(iv) The name of any hospital where the licensee has medical 
privileges as reported to the Board under § 14-413 of this subtitle; 
(v) The location of the licensee’s primary practice setting; and 
(vi) Whether the licensee participates in the Maryland Medical 
Assistance Program. 
 
(c) In addition to the requirements of subsection (b) of this section, the Board 
shall: 
(1) Provide appropriate and accessible Internet links from the Board's 
Internet site: 
(i) To the extent available, to the appropriate portion of the Internet 
site of each health maintenance organization licensed in this State 
which will allow the public to ascertain the names of the physicians 
affiliated with the health maintenance organization; and 
(ii) To the appropriate portion of the Internet site of the American 
Medical Association; 
(2) Include a statement on each licensee’s profile of information to be taken 
into consideration by a consumer when viewing a licensee’s profile, 
including factors to consider when evaluating a licensee’s malpractice data, 
and a disclaimer stating that a charging document does not indicate a final 
finding of guilt by a disciplinary panel; and 
(3) Provide on the Board’s Internet site: 
(i) Notification that a person may contact the Board by telephone, 
electronic mail, or written request to find out whether the number of 
medical malpractice settlements involving a particular licensee totals 
three or more with a settlement amount of $150,000 or greater within 
the most recent 5-year period as reported to the Board; and 
(ii) A telephone number, electronic mail address, and physical address 
through which a person may contact the Board to request the 
information required to be provided under item (i) of this item. 
 
(d) The Board: 
(1) On receipt of a written request for a licensee’s profile from any person, 
shall forward a written copy of the profile to the person; 
(2) Shall maintain a Web site that serves as a single point of entry where all 
physician profile information is available to the public on the Internet; and 
(3) On receipt of a verbal, electronic, or written request in accordance with 
subsection (c)(3) of this section, shall provide the information within 2 
business days of the request. 
 
21 
 
order admissible in a court proceeding.15  785 F.3d at 893−94.  Certain Underwriters at 
Lloyd’s, London involved a physician who had entered into a consent order with the Board.  
285 F.3d at 888–89.  In the consent order, the physician agreed to a three-month suspension 
followed by a five-year period of probation.  Id.  The consent order also contained a 
provision providing that the consent order “shall be a public document.”  Certain 
Underwriters at Lloyd’s, London, 785 F.3d at 893.  The physician’s disability insurer then 
brought suit against the physician for misrepresentations he made on his insurance 
application regarding the disciplinary actions he faced.  The Fourth Circuit reversed the 
magistrate judge’s decision to admit the physician’s consent order at trial.  It explained that 
based on the plain language of HO § 14-410, “solely by the ‘express stipulation and consent 
of all parties to a proceeding before the Board’ can a Board order be admitted into evidence 
in a civil proceeding like this one.”  Id. 
                                                          
 
 (e) The Board shall provide a mechanism for the notification and prompt 
correction of any factual inaccuracies in a licensee’s profile. 
 
 (f) The Board shall include information relating to charges filed against a 
licensee by a disciplinary panel and any final disciplinary action taken by a 
disciplinary panel against a licensee in the licensee’s profile within 10 days 
after the charges are filed or the action becomes final. 
 
 (g) This section does not limit the Board’s authority to disclose information 
as required under § 14-411 of this subtitle. 
 
15 The Fourth Circuit had diversity jurisdiction over the case in Certain Underwriters at 
Lloyd’s, London.  In diversity cases, the Fourth Circuit considers the questions before it 
“as the state court would do if confronted with the same fact pattern.”  Certain 
Underwriters at Lloyd’s, London, 785 F.3d at 892 (citing Roe v. Doe, 28 F.3d 404, 407 
(4th Cir. 1994)).  
22 
 
 
It further concluded that the fact “[t]he Consent Order states on its face that it ‘shall 
be a public document’ under the Maryland Public Information Act” does not “somehow 
render it admissible in a judicial proceeding.”  Id.  The Fourth Circuit elaborated: 
[The Maryland Public Information Act] “allows generally for the inspection 
and receipt of copies of public records.”  Waterkeeper Alliance, Inc. v. Md. 
Dep’t of Agric., 439 Md. 262, [268,] 96 A.3d 105, 108 (2014).  Each 
disciplinary order is also publicly available on the Internet.  See Md. Code 
Ann., Health Occ. §§ 14–411.1(b)–(d)(2) (requiring the Board to “create and 
maintain a public individual profile” on each licensed physician, available to 
the public on the Internet, which includes “[a] description of any disciplinary 
action taken by the Board . . . within the most recent 10–year period” and 
“includes a copy of the public order”).  But nothing in either the Public 
Information Act or Title 14 of the Health Occupations Article requires that 
public documents be admissible in judicial proceedings. 
 
Certain Underwriters at Lloyd’s, London, 785 F.3d at 893−94 (footnote omitted).  This 
logic is similarly applicable to the case sub judice.  “That a document is public does not 
remove it from the purview of the rules of evidence, or a statute explicitly governing its 
admissibility.”  Certain Underwriters at Lloyd’s, London, 785 F.3d at 894.  Although 
Delaware North does not contend that the public nature of a document removes it “from 
the purview of the rules of evidence,” its argument ignores the fact that HO § 14-410 
explicitly governs the admissibility of Dr. McGovern’s consent order.   Id.      
 
Delaware North also argues that HO § 14-410 does not bar the admission of the 
consent order into evidence because HO § 14-411 permits the disclosure of a physician’s 
general licensure information.  It refers specifically to HO § 14-411(c), which states in 
pertinent part:   
Nothing in this section shall be construed to prevent or limit the disclosure 
of: (1) General licensure, certification, or registration information maintained 
23 
 
by the Board, if the request for release complies with the criteria of § 4-333 
of the General Provisions Article; . . .  
  
From this, Delaware North reasons that the trial court properly admitted the redacted 
consent order which it claims only disclosed the general licensure status of Dr. McGovern’s 
medical license.  Smith counters that HO § 14-411(c) is irrelevant and that HO § 14-411(c) 
does not override HO § 14-410.  Smith further asserts that Delaware North’s interpretation 
improperly makes the term “disclosure” synonymous with the term “admission.”  The 
Board’s disclosure of “[g]eneral licensure, certification, or registration information” does 
not equate to the “admission” of the consent order.  We agree with Smith that the issuance 
of the consent order itself does not constitute “[g]eneral licensure, certification, or 
registration information” but rather, “it is evidence of discipline.”  Delaware North’s 
interpretation renders HO § 14-410 nugatory.  Under Delaware North’s interpretation, 
consent orders would be admissible into evidence even though HO § 14-410(a)(2) plainly 
states: “Any order passed by the Board or disciplinary panel is not admissible in evidence.”  
(emphasis added). 
 
HO § 14-411(c)(1) provides: “Nothing in this section shall be construed to prevent or 
limit the disclosure of . . . [g]eneral licensure, certification, or registration information 
maintained by the Board.”  The request for the release of the “[g]eneral licensure, 
certification, or registration information maintained by the Board” must also “compl[y] 
with the criteria of § 4-333 of the General Provisions Article [(“GP”).]”  GP § 4-333 is a 
provision within the Maryland Public Information Act (“the MPIA”).  It sets forth the 
24 
 
information a custodian of a public record may or may not disclose with regard to “the 
licensing of an individual in an occupation or a profession.”  GP § 4-333.  
 
The ambiguity in the otherwise plain language of HO § 14-411(c) arises in the 
following language because it is unclear whether it governs only disclosure of records by 
the Board or disclosure of records by anyone who makes a proper request under the MPIA, 
including parties to a civil or criminal action: “[n]othing in this section shall be construed 
to prevent or limit the disclosure of . . . [g]eneral licensure, certification, or registration 
information maintained by the Board.”  When language is ambiguous “we must look to 
other indicia to ascertain the intent of the General Assembly, including the relevant 
statute’s legislative history, the context of the statute within the broader legislative scheme, 
and the relative rationality of competing constructions.”  Twigg v. State, 447 Md. 1, 24, 
133 A.3d 1125, 1139 (2016) (internal quotations omitted).   
 
The legislative history of HO § 14-411 provides valuable insight into the legislative 
intent of HO § 14-411(c).  The predecessor statute to HO § 14-411(c)(1) was HO § 14-
510.1(c).  See 1991 Md. Laws, Chap. 55.  HO § 14-510.1(c) was enacted by Chapter 237 
of the Acts of 1990 via Senate Bill 138.  The Senate Economic and Environmental Affairs 
Committee Bill Analysis on Senate Bill 138 (1990) (“Bill Analysis”), indicates that the 
bill: 
Authorizes the Board to disclose certain licensing information as provided in 
the State Government Article, including the name, address, business 
telephone number, educational and occupational background, and 
professional qualifications of a licensee, any orders and findings resulting 
from formal disciplinary actions against a licensee, and any evidence of 
financial responsibility of a licensee. 
 
25 
 
(emphasis added).  The Bill Analysis further explains that “[d]uring the 1989 revision of 
the Board’s statute, a provision to permit the Board to release information in accordance 
with the State Government Article was inadvertently omitted.”  This reveals that the 
Legislature intended HO § 14-411(c) to apply to the Board’s disclosure of “[g]eneral 
licensure, certification, or registration information maintained by the board” when the 
Board receives a request pursuant to the MPIA.  HO § 14-411(c) does not, as Delaware 
North contends, apply to the disclosure of the items set forth in HO § 14-411(c) by parties 
in a civil or criminal action.  
   
That HO § 14-411(c) applies only to the Board’s disclosure of general licensure 
information comports with the principles of statutory construction because it allows HO § 
14-411(c) and HO § 14-410 to be “construed together and harmonized.”  State v. Roshchin, 
446 Md. 128, 141, 130 A.3d 453, 461 (2016).  HO § 14-411(c) allows the Board to disclose 
general licensure information in the interest of public policy.  See Fioretti v. Maryland 
State Bd. of Dental Examiners, 351 Md. 66, 76, 716 A.2d 258, 263 (1998) (explaining that 
the purpose of the MPIA is “to provide the public the right to inspect the records of the 
State government or of a political subdivision”).  Disclosure by the Board pursuant to HO 
§ 14-411 does not interfere or prevent compliance with HO § 14-410 which prohibits, with 
limited exceptions, the admission in any civil or criminal action, “[t]he proceedings, 
records, or files of the Board, [or] a disciplinary panel” and “[a]ny order passed by the 
Board or disciplinary panel” in the interest of “encourag[ing] physicians to cooperate 
during Board proceedings.”  HO § 14-410(a); Certain Underwriters at Lloyd’s, London, 
785 F.3d at 894.   
26 
 
The Applicability of HO § 14-410 to All Civil and Criminal Actions 
 
In the Circuit Court’s order denying Smith’s motion for a new trial, it concluded that 
HO § 14-410(a) “only applies to civil trials involving tort actions for medical malpractice 
and thus is inapplicable to this case.”  Similarly, Delaware North argues that the trial court 
properly admitted the consent order because HO § 14-410 is applicable only where the 
civil action arises out of matters addressed by the Board.  Delaware North cites Unnamed 
Physician v. Comm’n on Med. Discipline, 285 Md. 1, 400 A.2d 396 (1979), where this 
Court analyzed the predecessor statute to HO § 1-401, Art. 43, § 134A.  Delaware North 
claims that this Court’s conclusion regarding the legislative intent of HO § 1-401 in 
Unnamed Physician offers insight into the legislative intent of HO § 14-410.  In Unnamed 
Physician, the Commission on Medical Discipline16 issued subpoenas duces tecum to 
members of a hospital review committee in the course of its investigation into the medical 
practices of a physician.  In the context of HO § 1-401, this Court concluded that “it appears 
probable that the words ‘civil action’ were intended to mean a tort action for medical 
malpractice.”  Unnamed Physician, 285 Md. at 12, 400 A.2d at 402.   
 
Delaware North also cites St. Joseph Med. Ctr., Inc. v. Cardiac Surgery Assocs., P.A., 
392 Md. 75, 896 A.2d 304 (2006) to support its interpretation that HO § 14-410 only 
applies to certain types of civil actions.  It explains that St. Joseph Med. Ctr., Inc., which 
involved a dispute between physicians over the discovery of documents covered by the 
medical review committee privilege of HO § 1-401(d), stands for the proposition that the 
                                                          
 
16 The Commission on Medical Discipline was the predecessor agency to the Board of 
Physicians. 
27 
 
privilege of HO § 14-410 covers only “a civil action against the physician.” (emphasis in 
brief).         
 
Delaware North’s reliance on these cases is misplaced.  Rather, both Unnamed 
Physician and St. Joseph Med. Ctr., Inc. support Smith’s assertion that the privilege of HO 
§ 14-410 applies to her appeal of a Workers’ Compensation Commission decision.  In fact, 
this Court explicitly stated in Unnamed Physician that “judicial review of the decision of 
an administrative agency is a civil action.”  285 Md. at 9−10, 400 A.2d at 401.  The 
Workers’ Compensation Commission “is an adjudicatory administrative agency.”  W.R. 
Grace & Co. v. Swedo, 439 Md. 441, 452, 96 A.3d 210, 217 (2014).  Therefore, Smith’s 
case falls squarely within the plain meaning of “a civil action.”  Unnamed Physician, 285 
Md. at 9−10, 400 A.2d at 401. 
 
The Court of Special Appeals recently addressed the argument that HO § 14-410 “does 
not apply to civil actions in which a physician is testifying as an expert” in Pepsi Bottling 
Grp. v. Plummer, 226 Md. App. 460, 469, 130 A.3d 1047, 1053 (2016).  In Plummer, Derek 
Plummer designated Dr. Franchetti, his physician, as an expert witness in the jury trial of 
his workers’ compensation claim.  226 Md. App. at 465, 130 A.3d at 1050.  Dr. Franchetti 
was charged with violating HO §§ 14-404(a)(19), 14-404(a)(22), and 14-404(a)(40).  Id.  
To resolve these charges, he entered into a consent order with the Board.  Id.  In Dr. 
Franchetti’s de bene esse testimony, he asserted a claim of privilege pursuant to HO § 14-
410 and refused to answer any questions regarding the disciplinary proceedings against 
him or the consent order he entered into.  Plummer, 226 Md. App. at 46, 130 A.3d at 1051. 
28 
 
 
First, the Plummer court stated that this Court’s statement in Unnamed Physician —
“it appears probable that the words ‘civil action’ were intended to mean a tort action for 
medical malpractice” — does not limit the privilege of HO § 14-410 to malpractice actions.  
285 Md. at 12, 400 A.2d at 402; see Plummer, 226 Md. App. at 471, 130 A.3d at 1054.  It 
explained:   
For us to accept appellants’ argument, we would have to equate the word 
“includes” with the word “means.”  Neither case law nor the general 
provisions of the Maryland Code support that construction of “includes.”  In 
Tribbitt v. State, 403 Md. 638, 943 A.2d 1260 (2008), the Court of Appeals 
. . . held that, “when statutory drafters use the term ‘means,’ they intend the 
definition to be exhaustive,” but “when drafters use the term ‘includes,’ it is 
generally intended to be used as ‘illustration and not . . . limitation.’ ”  Id.  at 
647, 943 A.2d 1260 (citing Hackley v. State, 389 Md. 387, 393, 885 A.2d 
816 (2005)).  Accord Maryland Code (2014), General Provisions Article, § 
1–110, which provides: “‘Includes’ or ‘including’ means includes or 
including by way of illustration and not by way of limitation.” 
 
Plummer, 226 Md. App. at 471−72, 130 A.3d at 1054. 
 
 
Moreover, the Plummer court observed: 
Unnamed Physician was focused upon the interpretation of language contained 
in Art. 43, § 134A(d), the predecessor to the current HO § 1–401(d), and 
whether that statute precluded the Board’s right to discovery of a hospital’s 
medical review committee’s records and proceedings; the issue on appeal in 
Unnamed Physician was not the discoverability and admissibility of the 
Board’s proceedings, records, and orders.   
 
Plummer, 226 Md. App. at 472−73, 130 A.3d at 1055 (emphasis in original).  Like 
Plummer, the issue on appeal in the instant case is the “discoverability and admissibility of 
the Board’s proceedings, records, and orders,” which was not addressed in Unnamed 
Physician.  Id. 
29 
 
 
The Plummer court also focused on the language of the predecessor to HO § 1-
401(d), Art. 43, § 134A(d): 
The proceedings, records, and files of a medical review committee are neither 
discoverable nor admissible into evidence in any civil action arising out of 
matters which are being reviewed and evaluated by the committee.  This 
immunity does not apply to a civil action brought by a party to the 
proceedings of the review committee and claiming to be aggrieved by the 
decision of the committee.  Also, this immunity does not extend to any 
records or documents considered by the committee which would otherwise 
be subject to discovery and introduction into evidence in a civil action. 
 
Plummer, 226 Md. App. at 473, 130 A.3d at 1055 (emphasis in original).  The Plummer 
court reasoned that because the same “arising out of” language is not present in either HO 
§ 14-410 or its predecessor, Art. 43, § 130, HO § 14-410(a) is not limited to malpractice 
claims.  226 Md. App. at 474, 130 A.3d at 1055–56.           
The Plummer court added, “[a]ny doubt in that regard was removed when the Court 
of Appeals revisited the interpretation of ‘civil action’ in St. Joseph Medical Center, Inc. 
v. Cardiac Surgery Assocs., P.A., 392 Md. 75, 896 A.2d 304 (2006).”  226 Md. App. at 
474, 130 A.3d at 1056.  Like Unnamed Physician, St. Joseph Medical Center, Inc. 
implicated HO § 1-401(d)(1).  The Plummer court noted “that the privilege relative to 
medical review committee proceedings . . . had been amended in 1997, and the statute no 
longer included the words ‘arising out of matters that are being reviewed and evaluated[.]’”  
Id.  Based on this amendment, the Plummer court aptly quoted this Court’s conclusion in 
St. Joseph Medical Center, Inc. that “the 1997 change [] extended the privilege to ‘any 
civil action.’”  392 Md. at 98, 896 A.2d at 318; see Plummer, 226 Md. App. at 474, 130 
A.3d at 1056.  Thus, the Circuit Court erred in denying Smith’s motion for a new trial 
30 
 
because the privilege set forth under HO § 14-410 was not intended to be strictly limited 
to medical malpractice actions. 
Prejudicial Effect of Admitting Consent Order 
 
Pursuant to Maryland Rule 5-103(a), “[e]rror may not be predicated upon a ruling 
that admits . . . evidence unless the party is prejudiced by the ruling.”  “The focus of our 
inquiry is on the probability, not the possibility, of prejudice.”  Flores v. Bell, 398 Md. 27, 
33, 919 A.2d 716, 720 (2007).  Delaware North claims that even if the court erred in 
admitting the redacted consent order, the admission of the order did not impact the outcome 
of the trial or prejudice Smith.  To support this theory, Delaware North states that “the 
transcript shows that [the status of Dr. McGovern’s medical license] was not even a fact 
focused on by either counsel for [Delaware North] or counsel for [Smith].”  It claims further 
that there was ample evidence aside from the redacted consent order to support the jury’s 
verdict such as “the testimony of [Smith], the testimony of the physicians, and the 
evidentiary record.”  In response, Smith argues that the admission of the redacted consent 
order “badly impacted the jury’s consideration of Dr. McGovern’s expert testimony.”  We 
agree.     
Smith notes as an alternative argument that the entire consent order should have 
been excluded under Md. Rule 5-403 because its prejudicial value outweighed its probative 
value.  However, once the redacted consent order was admitted into evidence, defense 
counsel was free to comment on this evidence, and did, in fact, comment on this evidence 
at great length.  As previously discussed, HO § 14-410 serves as a statutory bar to the 
admission of a consent order into evidence in any civil or criminal action.  The trial court’s 
31 
 
admission of the consent order allowed the jury to consider evidence that the General 
Assembly explicitly precluded from consideration. 
Contrary to Delaware North’s contention that the consent order was not “even a fact 
focused on” at trial, Smith points to the transcript, which reveals at least four instances 
where defense counsel emphasized the consent order against Dr. McGovern as a reason for 
disregarding Smith’s theory of causation.  First, defense counsel tells the jury: 
Please read that document [the consent order] and decide whether you 
believe anything that individual told you today, because when he was asked 
about his medical license . . . . He wasn’t truthful.  He’s on probation 
currently for ethical problems involved in workers’ compensation claims and 
he’s who [Smith] hired. 
 
Moments later, defense counsel stated: “Dr. McGovern’s disciplinary action, being on 
probation, I mean, look at the fine that was levied against him for unethical practices in 
workers’ compensation claims, but yet you should believe him?  His entire testimony 
should be disregarded.”  The disciplinary charges against Dr. McGovern were rehashed 
when defense counsel told the jury:  
The consent order shows the inconsistencies in his testimony about the status 
of his medical license.  Whether the witness’ testimony was contradicted by 
evidence.  Once again, the order that you’re going to read from the Maryland 
Board of Physicians completely contradicts and puts into question his 
truthfulness, his honesty, his integrity, his ethics.      
 
Defense counsel concluded his closing argument by asking the jury:   
 
[W]ould you have a loved one go to a doctor for treatment that’s been 
disciplined by the Maryland Board of Physicians, that’s on probation for 
ethical problems, would you ever in your wildest dreams send your loved 
one to that provider?  But yet they want you to rely upon him in this claim.  
It’s insulting to this entire system.  
 
32 
 
And for that reason I would ask on behalf of my client that you affirm the 
decision of the Commission, check the box “No.” 
 
(emphasis added).     
    
 Defense counsel not only emphasized the consent order and the underlying 
disciplinary charges Dr. McGovern faced but asked the jury to affirm the decision of the 
Workers’ Compensation Commission for “that reason,” i.e., the fact that Dr. McGovern 
had been disciplined by the Board.  It is more than probable that the jury considered this 
inadmissible evidence as a result of defense counsel’s repeated mention of the consent 
order and urging of the jury to render a verdict based on the disciplinary action.  Because 
there is a high probability that the jury considered legally inadmissible evidence in 
rendering its verdict, we conclude that the admission of the consent order was prejudicial 
to Smith. 
CONCLUSION 
 
The plain language of HO § 14-410 generally prohibits the admission of, in any 
“civil or criminal action,” the “proceedings, records or files of the Board, a disciplinary 
panel, or any of its other investigatory bodies” and “[a]ny order passed by the Board of 
disciplinary panel.”  HO § 14-410(a).  A physician’s agreement to the terms of a consent 
order and the public nature of a consent order does not constitute “express stipulation and 
consent” to its use as evidence in a civil or criminal action.  Id.  The trial court erred as a 
matter of law in admitting a redacted version of the consent order when the order was 
subject to the statutory bar of HO § 14-410 and did not meet any of the exceptions provided 
therein.  Defense counsel’s repeated emphasis of the consent order and the underlying 
33 
 
disciplinary action against Dr. McGovern made it more than probable that the jury 
considered the inadmissible evidence, causing prejudice to Smith’s case.  As a result, we 
conclude that a new trial is warranted. 
JUDGMENT OF THE CIRCUIT COURT 
FOR BALTIMORE CITY REVERSED.  
CASE REMANDED TO THAT COURT 
FOR A NEW TRIAL CONSISTENT WITH 
THIS OPINION.  COSTS TO BE PAID BY 
APPELLEES.