Opinion ID: 2402231
Heading Depth: 1
Heading Rank: 4

Heading: Peer-Review Privilege

Text: Before reaching this issue, we must set forth the current state of the law on the peer-review privilege in this jurisdiction. Rule 26(b)(1) of the Superior Court Rules of Civil Procedure provides the outer bound of the scope of discovery: Parties may obtain discovery regarding any matter, not privileged, which is relevant to the subject matter involved in the pending action   . Etymologically, the word privilege is derived from a combination of two Latin words meaning private law. Jaffee v. Redmond, 518 U.S. 1, 32 n. 4, 116 S.Ct. 1923, 135 L.Ed.2d 337 (1996) (Scalia, J., dissenting). Some of the more common privileges are between attorney and client, husband and wife, priest and penitent. Robert B. Kent et al., Rhode Island Civil Procedure § 26:7, V-21 (West 2006). A determination of the proper scope of a privilege demands a delicate balancing: The privileges    are designed to protect weighty and legitimate competing interests.    [T]hese exceptions to the demand for every man's evidence are not lightly created nor expansively construed, for they are in derogation of the search for truth. United States v. Nixon, 418 U.S. 683, 709, 710, 94 S.Ct. 3090, 41 L.Ed.2d 1039 (1974). [5] Nevertheless, certain privileges are recognized because they are deemed to serve such a vitally important public good that `transcend[s] the normally predominant principle of utilizing all rational means for ascertaining truth.' Trammel v. United States, 445 U.S. 40, 50, 100 S.Ct. 906, 63 L.Ed.2d 186 (1980). In the specific context of the peer-review privilege, we have acknowledged the social importance of open discussions and candid self-analysis in peer-review meetings to ensure that medical care of high quality will be available to the public. Moretti v. Lowe, 592 A.2d 855, 857 (R.I.1991). Two similar yet distinct Rhode Island statutes afford providers of health care the peer-review privilege. Section 23-17-25(a) [6] and § 5-37.3-7(c) [7] create a privilege for the proceedings and records of peer-review boards, such that those documents shall not be subject to discovery or be admissible in evidence. [8] Section 5-37.3-7(c) further refines what is protected: No person who was in attendance at a meeting of [a peer-review] board shall be permitted or required to testify as to any matters presented during the proceedings of that board or as to any findings, recommendations, evaluations, opinions, or other actions of that board or any members of the board.    [A] witness cannot be questioned about his or her testimony or other proceedings before that medical peer review board or about opinions formed by him or her as a result of those proceedings. The following three sentences of § 23-17-25(a) serve to cabin the scope of that privilege: [(1) A]ny imposition or notice of a restriction of privileges or a requirement of supervision imposed on a physician for unprofessional conduct    shall be subject to discovery and be admissible in any proceeding against the physician for performing, or against any health care facility or health care provider which allows the physician to perform the medical procedures which are the subject of the restriction or supervision during the period of the restriction or supervision or subsequent to that period[; (2)] Nothing contained in this section shall apply to records made in the regular course of business by a hospital or other provider of health care information[; and (3)] Documents or records otherwise available from original sources are not to be construed as immune from discovery or used in any civil proceedings merely because they were presented during the proceedings of the committee. Section 5-37.3-7(c) includes a similar caveat concerning the discoverability and admissibility of information available from original sources. It is upon this statutory landscape that this Court has issued two opinions that interpret the precise nature of the peer-review privilege in this jurisdiction; those opinions have been scrutinized closely by the parties in this case. First, we held that the privilege did entitle a hospital to withhold all records and proceedings before the peer-review board, even those pertaining to the plaintiff in that case. Cofone v. The Westerly Hospital, 504 A.2d 998, 1000 (R.I.1986). In refuting the plaintiff's argument that a health-care provider could use the privilege as a shield against discovery and liability by simply providing its [peer-review board] with the medical records of plaintiff, we summarized § 23-17-25 as dictating that only the records and the proceedings which originate with the peer-review board are immune from discovery and inadmissible. Cofone, 504 A.2d at 1000. Next, we held that a doctor was obligated to answer interrogatories requesting the names of those who served on a peer-review board and whether a hospital ever had restricted, revoked, or curtailed the doctor's staff privileges. Moretti, 592 A.2d at 856, 858. In addition to providing a detailed summary of the peer-review privilege in other jurisdictions, we stated that the pertinent statute should be strictly construed because privileges, in general, are not favored in the law and this immunity from discovery is in derogation of both common-law and the general policy favoring discovery. Id. at 857. Furthermore, [t]he burden of establishing entitlement to nondisclosure rests on the party resisting discovery. Id. The public purpose of the peer-review privilege is not served when the privilege created in the peer-review statute is applied beyond what was intended and what is necessary to accomplish the public purpose. Id. The privilege must not be permitted to become a shield behind which a physician's incompetence, impairment, or institutional malfeasance resulting in medical malpractice can be hidden from parties who have suffered because of such incompetence, impairment, or malfeasance. Id. at 857-58. Read together, Cofone and Moretti reveal this Court's careful and informed deliberations on the challenging legal issue of where to draw the line between what is privileged and what is discoverable. We now proceed to the arguments raised by defendants. 1