Illinois Official Reports 

Appellate Court

Lindsey v. Butterfield Health Care II, Inc., 2017 IL App (2d) 160042

Appellate Court 

Caption

JANNIE LINDSEY, as Plenary Guardian of the Person and Estate of 

Laura Lindsey, a Disabled Person, Plaintiff-Appellee, v. 

BUTTERFIELD HEALTH CARE II, INC., d/b/a Meadowbrook 

Manor of Naperville; THE BUTTERFIELD HEALTH CARE

GROUP, INC., d/b/a Butterfield Health Care Group, Inc.; JIN RONG 

WANG; and VIVIAN SALVADOR, Defendants (Butterfield Health 

Care II, Inc., d/b/a Meadowbrook Manor of Naperville, DefendantAppellant).

District & No. Second District

Docket Nos. 2-16-0042, 2-16-0268 cons.

Filed February 9, 2017

Decision Under 

Review

Appeal from the Circuit Court of Du Page County, No. 15-L-222; the 

Hon. Kenneth L. Popejoy, Judge, presiding.

Judgment Affirmed in part and vacated in part.

Cause remanded.

Counsel on

Appeal

Clausen Miller P.C., of Chicago (Rodd E. Elges and Paul V. Esposito, 

of counsel), for appellant.

Susan Novosad and Nicole Schroeder, of Levin & Perconti, and Leslie 

J. Rosen, of Leslie J. Rosen Attorney at Law P.C., both of Chicago, for 

appellee.
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Panel JUSTICE SCHOSTOK delivered the judgment of the court, with 

opinion.

Presiding Justice Hudson and Justice Spence concurred in the 

judgment and opinion.

 OPINION 

¶ 1 In this consolidated appeal, the defendant Butterfield Health Care II, Inc., doing business 

as Meadowbrook Manor of Naperville (Meadowbrook), claims that certain of its documents 

are privileged and that the circuit court of Du Page County should not have ordered it to 

produce them during discovery in a lawsuit filed against it by plaintiff, Jannie Lindsey, as the 

guardian of Laura Lindsey. Meadowbrook insists that the Medical Studies Act (735 ILCS 

5/8-2101 et seq. (West 2014)) and the Long-Term Care Peer Review and Quality Assessment 

and Assurance Protection Act (Quality Assurance Act) (745 ILCS 55/1 et seq. (West 2014)) 

protect it against having to disclose those documents. We agree with the trial court that the 

documents at issue should be produced. 

¶ 2 BACKGROUND 

¶ 3 On April 29, 2012, 88-year-old Laura Lindsey was allegedly injured during a fall while she 

was in the care of Meadowbrook, a nursing home. On May 9, 2012, employees of 

Meadowbrook completed a report regarding Laura’s injury. On January 9, 2014, the plaintiff 

filed a complaint on Laura’s behalf against Meadowbrook, sounding in negligence. The 

plaintiff subsequently issued written discovery requests to Meadowbrook, seeking all 

investigation reports. Meadowbrook refused to disclose the May 9, 2012, report, asserting that 

it was privileged pursuant to the Quality Assurance Act and the Medical Studies Act because it 

was “prepared for the Facility’s Quality Assurance Committee.” 

¶ 4 On August 25, 2015, the plaintiff filed a motion to compel, arguing that the May 9, 2012, 

report was authored neither for the purpose of internal quality control nor by an internal quality 

control committee. Meadowbrook opposed the motion and gave the report to the trial court for 

its in camera review. In support of its objection, Meadowbrook filed an affidavit of Patricia 

Stambaugh, its administrator at the time of Laura’s fall. Stambaugh averred that, as 

Meadowbrook’s administrator, she was familiar with Meadowbrook’s quality assurance 

protocols. Meadowbrook’s quality assurance process required the completion of internal 

quality-assurance-investigation reports relating to incidents or accidents involving resident 

injuries. These reports were prepared for the purpose of being considered by Meadowbrook’s 

quality assurance committee and/or its fall committee. (The fall committee met to determine 

ways that the risk of resident falls might be reduced.) The quality assurance committee met on 

a quarterly basis, and the fall committee met on a weekly basis. 

¶ 5 On October 15, 2015, following a hearing and the trial court’s in camera review of the 

report, the trial court ordered Meadowbrook to disclose the report. The trial court found that 

the report was simply factual and that it did not contain recommendations for improvement. 

The trial court further noted that there was no indication that the report had been reviewed by 

any committee. 
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¶ 6 On December 17, 2015, after Meadowbrook continued to refuse to disclose the report, the 

trial court found Meadowbrook in contempt. Meadowbrook appealed from that order. That 

appeal was docketed in this court as appeal No. 2-16-0042.

¶ 7 Thereafter, while updating discovery, Meadowbrook discovered six written witness 

statements that were prepared during the course of its internal investigation. It provided the 

plaintiff with a supplemental privilege log that included the statements, and it then filed a 

motion for a protective order. In support of its motion, Meadowbrook attached an affidavit of 

Stambaugh. She stated that the statements were prepared pursuant to Meadowbrook’s quality 

assurance practices. On April 6, 2016, the trial court denied Meadowbrook’s motion and ruled 

that the statements were not privileged. After Meadowbrook indicated that it would refuse to 

comply with the trial court’s order, the trial court held Meadowbrook in contempt. 

Meadowbrook appealed from that order. That appeal was docketed in this court as appeal No. 

2-16-0268. On May 5, 2016, this court consolidated Meadowbrook’s two appeals for review.

¶ 8 ANALYSIS 

¶ 9 On appeal, Meadowbrook argues that the trial court erred in ordering disclosure of the May 

9, 2012, report and the six witness statements. Meadowbrook argues that the report and the 

statements were privileged under both the Medical Studies Act and the Quality Assurance Act. 

¶ 10 The burden of establishing a privilege is on the party seeking to invoke it. Roach v. 

Springfield Clinic, 157 Ill. 2d 29, 41 (1993). The standard of review depends on the question 

that was answered in the trial court. Chicago Trust Co. v. Cook County Hospital, 298 Ill. App. 

3d 396, 401 (1998). “Where, as here, the defendant challenges an order compelling discovery 

of information that the defendant believes to be subject to a statutory discovery privilege, the 

question is one of statutory construction, which is purely a question of law.” Klaine v. Southern 

Illinois Hospital Services, 2016 IL 118217, ¶ 13. Thus, our review is de novo. Id. 

¶ 11 This case is governed by the Quality Assurance Act (745 ILCS 55/1 et seq. (West 2014)). 

The Quality Assurance Act provides that proceedings and communications of a peer-review or 

a quality-assessment-and-assurance committee at a long-term care facility shall be privileged 

and confidential. 745 ILCS 55/4 (West 2014). No Illinois appellate court opinion has yet 

interpreted the Quality Assurance Act. We note, however, that the Quality Assurance Act 

contains language similar to that in the Medical Studies Act and covers a similar subject. 

Whereas the Quality Assurance Act pertains to quality assurance committees at long-term care 

facilities, the Medical Studies Act pertains to quality assurance committees at medical 

facilities such as hospitals. Under the in pari materia doctrine, statutes covering the same 

subject should be interpreted harmoniously. Holly v. Montes, 231 Ill. 2d 153, 161-62 (2008). 

Accordingly, we believe that it is appropriate to construe the Quality Assurance Act the same 

way that our courts have construed the Medical Studies Act. 

¶ 12 The purpose of the Medical Studies Act is to encourage candid and voluntary studies and 

programs used to improve hospital conditions and patient care or to reduce the rates of death 

and disease. Niven v. Siqueira, 109 Ill. 2d 357, 366 (1985). The Medical Studies Act is 

premised on the belief that, absent the statutory peer-review privilege, physicians would be 

reluctant to sit on peer-review committees and engage in frank evaluations of their colleagues. 

Richter v. Diamond, 108 Ill. 2d 265, 269 (1985). Documents generated specifically for the use 

of a peer-review committee receive protection under the Medical Studies Act. Toth v. Jensen, 

272 Ill. App. 3d 382, 385 (1995). However, the Medical Studies Act does not protect against 
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disclosure of information generated before the peer-review process began. Chicago Trust, 298 

Ill. App. 3d at 403. 

¶ 13 This case is controlled by our supreme court’s decision in Roach and the First District’s 

decision in Chicago Trust. In Roach, the parents of a child with birth defects brought a medical 

malpractice claim against the hospital where the child was born and against the mother’s 

obstetricians. The child’s birth defects allegedly resulted from problems with the mother’s 

anesthesia. After the child’s birth, the hospital’s chief of anesthesiology spoke with a nurse and 

a nurse anesthetist about the cause of the defects. These conversations occurred well before the 

monthly meeting of the hospital’s peer-review committee. The parents sought to compel the 

chief of anesthesiology to disclose the content of these conversations. The hospital objected, 

citing the Medical Studies Act. The hospital asserted that, because the chief of anesthesiology 

was on the peer-review committee, his communications were privileged. The supreme court 

rejected the hospital’s argument, holding that where the committee is composed of the 

hospital’s medical staff, the committee must be involved in the peer-review process before the 

privilege will attach. Roach, 157 Ill. 2d at 40. The supreme court explained: 

“If the simple act of furnishing a committee with earlier-acquired information were 

sufficient to cloak that information with the statutory privilege, a hospital could 

effectively insulate from disclosure virtually all adverse facts known to its medical 

staff, with the exception of those matters actually contained in a patient’s records.” Id.

at 41. 

¶ 14 In Chicago Trust, a hospital patient’s ventilator accidently became disconnected. He then 

lapsed into a coma and suffered brain damage. The plaintiff filed a malpractice action against 

the hospital and sought discovery of certain incident and situation reports that hospital staff 

members created shortly after the ventilator accident. The hospital refused to disclose the 

reports. The hospital asserted that the reports were prepared at the request of the “Hospital 

Oversight Committee” and were an integral part of the quality assurance process. Chicago 

Trust, 298 Ill. App. 3d at 400. The trial court ordered that the reports be disclosed. After the 

hospital still refused to produce the reports, the trial court held the hospital in contempt. Id. at 

398-401. 

¶ 15 On appeal, the reviewing court held that the trial court properly ruled that the reports at 

issue should be disclosed. Id. at 406. The court explained that documents initiated, created, 

prepared, or generated by a peer-review committee are privileged under the Medical Studies 

Act; conversely, documents that are created in the ordinary course of the hospital’s medical 

business or for later corrective action by the hospital staff are not. Id. at 402-03. The court 

specifically rejected the hospital’s suggestion that its oversight committee could invoke the 

Medical Studies Act’s protection by declaring in advance that all incident documents prepared 

by the hospital staff were part of the peer-review process. Id. at 406. The court explained: 

“The Hospital’s position goes too far. Such a policy, if effective, would swallow the 

rule. The [Medical Studies] Act would not create exceptions to disclosure. It would 

make everything confidential, except for the patient’s own medical records.” Id.

¶ 16 Here, Meadowbrook raises the same argument as did the hospital in Chicago Trust. 

Meadowbrook argues that the report and the witness statements made following the incident 

should be privileged because the report and the statements were eventually reviewed by the 

quality assurance committee. As Meadowbrook’s argument is clearly without merit under the 
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Medical Studies Act (Roach, 157 Ill. 2d at 41; Chicago Trust, 298 Ill. App. 3d at 404), it is also 

without merit under the Quality Assurance Act. 

¶ 17 Meadowbrook insists that the report and the statements at issue were created only so that 

they could be reviewed by its quality assurance committee. Meadowbrook maintains that, if 

not for the existence of the quality assurance committee, the documents at issue would have 

never been created. As such, it contends, the documents should be privileged. Meadowbrook’s 

argument is unpersuasive. These documents are the same type of documents that the courts 

ordered disclosed in Roach and Chicago Trust. To adopt Meadowbrook’s argument would 

circumvent the holdings in Roach and Chicago Trust and allow Meadowbrook to keep 

everything privileged except a resident’s own medical records. That, we decline to do.

¶ 18 Meadowbrook further contends that, as the plaintiff did not submit any counteraffidavits, 

the affidavits it presented must be accepted as true. Although there is support for 

Meadowbrook’s legal proposition (Flannery v. Lin, 176 Ill. App. 3d 652, 657-58 (1988)), it 

does not advance Meadowbrook’s argument. In her affidavits, Stambaugh made clear that the 

report and the statements at issue were made prior to any peer-review committee meeting. 

¶ 19 Finally, we note that “a contempt citation is an appropriate method for testing the propriety 

of a discovery order.” Id. at 655. Here, the record reveals that Meadowbrook was not 

contemptuous of the trial court’s authority. Rather, its refusal was made in good faith, as it 

merely sought appellate review of its unsuccessful assertions of privilege. Accordingly, we 

vacate the trial court’s findings of contempt. See People ex rel. Birkett v. City of Chicago, 292 

Ill. App. 3d 745, 756 (1997). 

¶ 20 CONCLUSION 

¶ 21 The trial court correctly overruled Meadowbrook’s objections to producing the disputed 

report and witness statements. The contempt orders are vacated. We remand the cause to the 

trial court for proceedings consistent with this opinion. 

¶ 22 Affirmed in part and vacated in part. 

¶ 23 Cause remanded.