Court Opinion

ID: 9927102
Source: CourtListenerOpinion
Date Created: 2024-01-26 06:05:18.605235+00
Date Added: 2024-06-11T09:23:48.384955
License: Public Domain

If this opinion indicates that it is “FOR PUBLICATION,” it is subject to
                 revision until final publication in the Michigan Appeals Reports.

                          STATE OF MICHIGAN

                             COURT OF APPEALS

ESTATE OF RICHARD CHANDLER, by its                                  UNPUBLISHED
Personal Representative, DENISE CHANDLER,                           January 25, 2024

               Plaintiff-Appellee,

v                                                                   No. 360684
                                                                    Wayne Circuit Court
VHS SINAI-GRACE HOSPITAL, INC., doing                               LC No. 21-006189-NH
business as SINAI-GRACE HOSPITAL MEDICAL
CENTER EMERGENCY SERVICES,

               Defendant-Appellant,
and

ACADEMIC INTERNAL MEDICINE
SPECIALISTS, PLLC, KHAN RIZWAN, PLLC,
LAUREN GANDOLFO, D.O., STEFANIE WISE,
M.D., RIZWAN KHAN, M.D., and MEDICAL
CENTER EMERGENCY SERVICES,

               Defendants.

Before: CAVANAGH, P.J., and RICK and PATEL, JJ.

PER CURIAM.

       In this interlocutory appeal, defendant, VHS Sinai-Grace Hospital, LLC, doing business as
Sinai-Grace Hospital Medical Emergency Services (hereinafter referred to as VHS), appeals by
leave granted1 an order of the trial court granting a motion to compel discovery made by plaintiff,

1
 Estate of Richard Chandler v VHS Sinai-Grace Hospital, LLC, unpublished order of the Court
of Appeals, entered March 25, 2022 (Docket No. 360684).

                                                -1-
Denise Chandler, as personal representative of the Estate of Richard Chandler. We affirm in part,
reverse in part, and remand for further proceedings.

                                 I. FACTUAL BACKGROUND

       This action arises out of the death of the decedent, Richard Chandler, in March 2020.
Richard presented at the hospital on March 28, 2020, and was experiencing shortness of breath
and chest pain. Richard was evaluated in the emergency department by Dr. Lauren Gandolfo,
D.O., and her resident, Dr. Ryan King, D.O. Richard reported that in the days leading up to his
hospital visit, he had been tested for COVID-19, but had not yet received the results. At that point,
Dr. Gandolfo and Dr. King “arrived at a differential diagnosis of asthma exacerbation, pneumonia
and viral syndrome.” They ordered a chest x-ray and electrocardiogram (EKG), and placed
Richard on oral steroids and an albuterol inhaler. The EKG indicated that Richard was suffering
from a slightly elevated heart rate, and the chest x-ray found “bilateral patchy multifocal
pneumonia likely due to viral infection.”

        While he was in the emergency room, Richard began experiencing lightheadedness. His
heart rate dropped from 120 to 60 beats per minute for about 30 seconds before returning to 120
beats per minute. He was thereafter admitted to the hospital. Richard was then diagnosed with
“[a]cute hypoxic respiratory failure requiring supplemental oxygen, suspect secondary to
coronavirus infection[.]” He was given supplemental oxygen.

        Richard briefly began to improve, and progress notes indicated that he would be discharged
if his troponin2 levels were normal and he did not need to go back on supplemental oxygen.
However, Richard’s troponin levels increased and he was placed back on supplemental oxygen
later that afternoon. At around 4:30 p.m. on March 29, 2020, staff heard Richard fall to the floor.
A doctor’s note explained:

               The patient was in his room in the [Emergency Department] when he was
       suddenly heard to fall from his bed onto the floor. Initially he was propped up on
       his elbows and attempting to get up, but then rapidly became unresponsive. He did
       continue to have spontaneous respiratory effort. Staff lifted the patient back to the
       stretcher and immediately moved him to resuscitation for rapid evaluation.

               Upon arrival to the resuscitation room, we attempted to obtain vitals but
       noted that he did not have palpable peripheral pulses. However, he was initially
       verbal and complaining of difficulty breathing. Decision was made to intubate the
       patient. However, prior to intubation, decision was also made to administer push
       dose phenylephrine secondary to his profound hypertension.

              As the patient was given phenylephrine, he suddenly had decrease of his
       heart rate from the 150s to an irregular bradycardic rhythm and became

2
  Troponin is a type of protein found in the muscles of the heart. “High levels of troponin in the
blood may mean you are having or recently had a heart attack.” https://medlineplus.gov/lab-
tests/troponin-test/ (accessed December 12, 2023).

                                                -2-
       unresponsive. He was immediately given a push of epinephrine and atropine.
       Under my direct supervision, the resident physician performed endotracheal
       intubation with glide scope visualization. He was immediately placed on the
       ventilator. [Nasogastric] tube was placed.

              Staff did consider risks but opted to perform chest compressions. Patient
       received 2 doses of epinephrine. He then had return of spontaneous circulation.

                                               * * *

               Bedside ultrasound by the resident physician noted [right ventricular]
       dilation that is very concerning for acute [pulmonary embolism (PE)]. [computed
       tomography (CT) scan] was ordered. Patient’s blood pressure is 110/64 at this time.

              Patient did go for CT scan. By my interpretation, demonstrates bilateral
       patchy groundglass opacities,[3] also demonstrating by radiology is interpretation
       massive pulmonary emboli. Heparin has already been ordered.

             [Arterial blood gas analysis] demonstrates severe acidosis with pH 6.795,
       PCO2 79, P02 168. Lactate is 16.

               Soon after return to the [transitional care unit], imaging, patient with
       recurrent cardiac arrest. This is a point at which the CT images were reviewed,
       noting his massive PE as well as the bilateral groundglass changes. This is
       consistent with COVID-19. Given his prior cardiac arrest, massive PE[,] previous
       downtime and severity of illness, further efforts were deemed futile. Patient was
       pronounced deceased at 1806. Patient’s wife was notified.

As noted, Richard passed away on March 29, 2020. The doctors’ final impressions regarding
cause of death included “[a]cute massive pulmonary emboli,” “acute cardiopulmonary arrest,” and
“[a]cute suspected COVID-19.” On April 1, 2020, Richard’s COVID-19 test results were released,
and showed that he was positive for the virus when the specimen was collected on March 19, 2020.

        Denise (hereinafter referred to as plaintiff), as Richard’s personal representative, filed the
instant suit, alleging medical malpractice (Count I) and gross negligence (Count II) against all of
the named defendants. Generally, plaintiff alleged that defendants were grossly negligent for
having failed to timely diagnose his pulmonary embolism. The complaint alleged that had the
pulmonary embolism been discovered sooner, Richard could have undergone surgery and would
have survived.

3
  Groundglass opacities are gray areas that appear on CT scans of the lungs, and can be the result
of a number of different conditions, “including infection, chronic interstitial disease and acute
alveolar       disease.”             Radiopaedia,        Ground-Glass       Opacification       <
https://radiopaedia.org/articles/ground-glass-opacification-3?lang=us> (accessed December 14,
2023).

                                                 -3-
        In lieu of filing an answer, defendants moved for summary disposition. They argued that
they were immune from suit under the Pandemic Health Care Immunity Act (PHCIA),
MCL 691.1471 et seq., which was created by 2020 PA 240 (effective October 22, 2020). They
noted that “the Act provides that the ‘liability protection provided by this act applies retroactively,
and applies on or after March 29, 2020 and before July 14, 2020.’ MCL 691.1477.” Defendants
contended that the PHCIA applied because when Richard died, they were providing health services
in support of the state’s response to COVID-19, and none of their acts could be deemed grossly
negligent. According to defendants, the allegations in the complaint did not rise to the level of
gross negligence, and at most could be considered medical malpractice. For these reasons,
defendants argued that they were immune from suit and entitled to summary disposition under
MCR 2.116(C)(7) (claim barred by operation of law) and (C)(10) (no genuine issue of material
fact), with respect to all claims.

        In response, plaintiff argued that defendants could not claim immunity for any negligent
acts that occurred on March 28, 2020, as the plain language of the PHCIA stated that the immunity
granted by the statute applies only on or after March 29, 2020. She also argued that defendants
could not rely on the PHCIA where they merely thought Richard had COVID-19, but had not
actually diagnosed him with the virus. Plaintiff argued that this was so because defendants had
not demonstrated that their care was “in support of this state’s response to the COVID-19
pandemic,” per MCL 691.1475. Finally, even if the PHCIA applied, plaintiff argued that there
was a question of fact on the issue of gross negligence, and that summary disposition would
therefore be premature. Relevant to this appeal, plaintiff submitted an affidavit from Jeffrey
Eichenlaub, RN, a nurse who was present when Richard passed away. The affidavit states as
follows:

              VII. That although the necessary staff and personnel were present to
       provide resuscitative measures, the staff was instructed not to attempt resuscitation
       on Richard Chandler.

                VIII. When it was asked why we could not help Richard Chandler this
       second time, nursing staff was advised that as a result of a meeting of senior
       leadership, Administration and/or Department Heads of Sinai-Grace Hospital, a
       guideline and/or mandate had been put in place around March 2020 prohibiting
       staff from performing CPR on patients with a suspected COVID-19 infection.

               IX. That it is my understanding that as of the time of his presentation,
       [cardiac] arrests and death, Richard Chandler had not been diagnosed with COVID-
       19.

              X. That as a result of the instructions from Sinai-Grace Hospital physicians
       to not resuscitate Richard Chandler, he did not receive advanced life-saving
       measures including chest compressions . . . .

       Defendants filed a reply, arguing that under MCL 691.1475, the key question was when
the death occurred. They pointed out that the injury plaintiff was suing for was Richard’s death,
and argued that since his death actually occurred on March 29, 2020, the PHCIA applied.
According to defendants, it was irrelevant that some of the underlying acts or omissions that

                                                 -4-
plaintiff alleged caused Richard’s death occurred on March 28, 2020. Defendants then argued that
the medical records showed that Richard was being treated for complications related to COVID-
19, and that said treatment thus fell under the umbrella of health services provided in response to
the COVID-19 pandemic. Defendants noted that a known complication of COVID-19 infection
is an increased risk of venous thromboembolism, including pulmonary embolism, which was the
ultimate cause of Richard’s death. Defendants argued that the fact that they were unable to confirm
that Richard was positive for COVID-19 before he died was immaterial. Defendants further
argued that more discovery would be unnecessary in this case.

        The trial court ultimately denied the motion for summary disposition. At a hearing on the
matter, the court explained:

       Based on all these affidavits, the motion filed, I am denying defendant’s motion
       based on the failure of discovery having to have taken place [sic], based on the
       interpretation of the pandemic act, I don’t think shields somebody from negligence
       or gross negligence that may have occurred on March 28th; that can be a jury
       question. And whether the failure to order a simple CT scan for this presentation
       of illnesses amount to gross negligence or not is a jury question.

On October 11, 2021, the court entered an order denying the motion. Defendants appealed, and
this Court denied leave “for failure to persuade the Court of the need for immediate appellate
review.” Estate of Richard Chandler v VHS Sinai-Grace Hospital, Inc., unpublished order of the
Court of Appeals, entered February 17, 2022 (Docket No. 359114).

        The current matter arises out of a motion to compel discovery filed by plaintiff on
January 20, 2022. In the motion, plaintiff explained that she served an initial set of interrogatories
and requests for the production of documents, in which she “sought a full and complete copy of
the medical records regarding Plaintiff[’]s Decedent, including electronically stored information
such as metadata, audit trails and audit logs.” She stated that defendants responded to the request,
but failed to produce the requested material. Plaintiff further stated that she served a second set of
interrogatories and requests for the production of documents, but that defendants’ “responses were
almost entirely non-responsive, evasive and contained multiple boilerplate objections.”

        In one such interrogatory, plaintiff asked defendants to produce any “documents . . . and/or
written communications . . . provided to members of Defendant Hospital’s nursing staff and/or
physicians pertaining to what resuscitative efforts should/should not be made for suspected
COVID 19 positive patients prior to Richard Chandler’s death.” In response, defendants stated
“that based upon the information available to date, there was no blanket decision ‘not to resuscitate
suspected Covid-19 positive patients.’ ” In the motion, plaintiff also asked the trial court to compel
the production of “the ESI/metadata from Mr. Chandler’s chart and provide supplemental
responses to her ‘Second Interrogatories, Request for Production of Documents and Requests for
Admissions[.]’ ”

        Defendants responded to the motion to compel on February 7, 2022. They disputed
plaintiff’s allegation that there was some sort of blanket “do not resuscitate,” or “DNR” policy in
place at the hospital. Defendants referred to an e-mail that plaintiff obtained as part of the
discovery process, in which a recommendation not to resuscitate COVID-19 patients was

                                                 -5-
mentioned. A copy of the e-mail was included in the record submitted to this Court. It indicates
that patients who “code,” i.e., patients whose heart or breathing has stopped, should not be
resuscitated because “[t]he risk versus benefit for the patient weighed against Health Care
Professionals [sic] exposure was felt to be too great. Almost 100 percent of the coding . . . patients
will expire.” However, defendants insisted that no actual mandate had been put in place regarding
the resuscitation of COVID-19 patients. Defendants otherwise argued that plaintiff had not
addressed any of their objections to the discovery, including the relevance of the items she was
requesting, applicable privileges, and other rules that might preclude discovery. Instead,
defendants said that plaintiff was “asking this Court to require Defendants[] to produce information
that is non-existent, non-discoverable, or not yet known or available to these Defendants.”

        A hearing on the matter was held, and the parties largely argued consistent with their briefs.
Relevant to this appeal, the court addressed the interrogatories and requests for production
pertaining to the alleged DNR policy, as well as another interrogatory regarding the number of CT
scans performed during Richard’s hospitalization. Regarding the DNR policy, the trial court
opined that “part of [the] allegation is there was basically a directive not to bother with patients
with COVID. So this is relevant to [her] discovery.” Regarding the number of machines available
in the hospital, the court noted that the question “goes to whether the hospital was too overwhelmed
to give this alleged simplest test to this gentleman therefore causing his death and as a result it’s
also relevant.” Finally, regarding the number of CT scans performed, the court stated that it did
not believe the request was overly broad and would allow it. Accordingly, the trial court granted
the motion to compel and ordered defendants to produce the requested documents within 14 days.
On February 18, 2022, the court subsequently entered an order granting the motion to compel in
part and denying it in part.4 As is relevant to this appeal, the order specifically directed defendants
to produce the following:

          [A] full and complete list (with the redaction of all patients’ names and protected
          health information) of all CT scans and/or ultrasounds performed on patients in the
          radiology department and/or emergency department of Defendant Hospital between
          5 pm on March 28, 2020 to the time of Richard Chandler’s death at approximately
          6:06 pm on March 29, 2020. (Plaintiff[’]s Second Interrogatories, Request for
          Production of Documents and Requests for Admissions - Request for Production
          #4);

                  Subject to a Protective Order that is to be drafted and provided by Defendant
          Hospital to Plaintiff on or before March 23, 2022, Defendant Hospital must produce
          on or before March 28, 2022 any written documents, emails, text messages,
          bulletins, memorandums, internal communications, alerts, mandates, and/ or
          written communications in any form that were disseminated, distributed, and/or
          provided to members of Defendant Hospital’s nursing staff and/or physicians
          pertaining to what resuscitative efforts should/should not be made for suspected
          COVID 19 positive patients prior to Richard Chandler’s death. (Plaintiff[’]s

4
    It is unclear from the record which interrogatory requests were denied by the court.

                                                  -6-
          Second Interrogatories, Request for Production of Documents and Requests for
          Admissions - Request for Production #7).

       Defendant VHS5 filed an application for leave to appeal on March 18, 2023. On March 25,
2023, this Court entered an order granting the application for leave to appeal. Estate of Richard
Chandler v VHS Sinai-Grace Hospital, LLC, unpublished order of the Court of Appeals, entered
March 25, 2022 (Docket No. 360684).

                                           II. ANALYSIS

        VHS argues that the trial court abused its discretion by ordering the production of
documents pertaining to the hospital’s recommended procedures for dealing with COVID-19
patients requiring resuscitation, as well as a list of every CT scan and ultrasound performed in the
radiology and emergency departments during Richard’s hospitalization. We agree in part.

        A trial court’s discovery-related decisions are reviewed for an abuse of discretion. Cabrera
v Ekema, 265 Mich App 402, 406; 695 NW2d 78 (2005). Michigan’s “court rules implement an
open, broad discovery policy.” Id. at 406-407 (quotation marks, ellipses, and citation omitted).
“Parties are permitted to obtain discovery regarding any matter, not privileged, that is relevant to
the subject matter of the lawsuit, whether it relates to the claim or defense of the party seeking
discovery or to the claim or defense of another party. MCR 2.302(B)(1).” Cabrera, 265 Mich
App at 407. But a trial court “should also protect the interests of the party opposing discovery so
as not to subject that party to excessive, abusive, or irrelevant discovery requests.” Id.

        The Michigan court rules establish “ ‘an open, broad discovery policy....’ ” Id. at 406
(citation omitted). MCR 2.302(B)(1) defines the scope of permissible discovery as follows:

          Parties may obtain discovery regarding any non-privileged matter that is relevant
          to any party’s claims or defenses and proportional to the needs of the case, taking
          into account all pertinent factors, including whether the burden or expense of the
          proposed discovery outweighs its likely benefit, the complexity of the case, the
          importance of the issues at stake in the action, the amount in controversy, and the
          parties’ resources and access to relevant information. Information within the scope
          of discovery need not be admissible in evidence to be discoverable.

Here, we are dealing with two separate discovery requests—one pertaining to the hospital’s alleged
DNR policy, the other pertaining to diagnostic records. We will address each request in turn.

                                    A. COVID-19 DNR POLICY

       VHS first argues that the trial court abused its discretion by ordering the production of
documents pertaining to the hospital’s recommended course of action in cases where an individual
with COVID-19 or suspected COVID-19 might require resuscitation. In general, such information
would be relevant to determining why VHS staff decided not to try to resuscitate Richard a second

5
    VHS is the only defendant participating in this appeal.

                                                  -7-
time. Although VHS argues that this can be explained based on the fact that Richard was simply
experiencing cardiac symptoms too severe to warrant resuscitation, VHS overlooks the fact that
plaintiff will likely need this information to overcome the requirements set forth in the PHCIA.
Under the PHCIA,

               A health care provider or health care facility that provides health care
       services in support of this state’s response to the COVID-19 pandemic is not liable
       for an injury, including death, sustained by an individual by reason of those
       services, regardless of how, under what circumstances, or by what cause those
       injuries are sustained, unless it is established that the provision of the services
       constituted willful misconduct, gross negligence, intentional and willful criminal
       misconduct, or intentional infliction of harm by the health care provider or health
       care facility. [MCL 691.1475.]

Thus, according to the statute, plaintiff must establish gross negligence, not ordinary negligence,
in order for her claim to succeed. The PHCIA went into effect on March 28, 2020, and would
certainly apply to any actions taken on March 29, 2020, the date of Richard’s death. Taking that
into consideration, information about any recommendations or policies regarding COVID-19
patients would be relevant and necessary to plaintiff’s claim in this case.

        However, VHS says that any documents pertaining to COVID-19 policies and procedures
are not discoverable because they fall under the peer-review privilege, MCL 333.21515. Notably,
VHS does not actually admit that any of these documents exist, stating on appeal that “the Hospital
has not to date discovered any of the items referenced in the trial court’s order[.]” However, as
plaintiff points out, there is at least one e-mail in the record pertaining to recommendations for
resuscitating COVID-19 patients. Thus, it would appear that there could be discoverable
documents available.

        But even if such documents exist, VHS contends that they are privileged. MCL 333.21515
states that “[t]he records, data, and knowledge collected for or by individuals or committees
assigned a review function described in this article are confidential and shall be used only for the
purposes provided in this article, shall not be public records, and shall not be available for court
subpoena.” Under MCL 333.21513(d), hospitals must organize their staff in such a way as to
effectuate “review of the professional practices in the hospital for the purpose of reducing
morbidity and mortality and improving the care provided in the hospital for patients . . . .
includ[ing] the quality and necessity of the care provided and the preventability of complications
and deaths occurring in the hospital.” VHS contends that the documents, if they exist, would be
covered because they were created “for the purpose of reducing morbidity and mortality and
improving the care provided” to patients. MCL 333.21513(d).

        Policies pertaining to so-called DNR orders for COVID-19 patients would certainly affect
“morbidity and mortality” under the statute. However, VHS does not explain whether any of the
alleged documents are actually “peer-reviewed” under MCL 333.21515. The peer-review process
necessitates that the documents were “collected for or by individuals or committees assigned a
review function . . . .” MCL 333.21515 (emphasis added). VHS has not proven that this is the
case. Indeed, since VHS argues that no such documents have even been found, it is somewhat
impossible to logically argue that all of the documents would fall under the peer-review privilege.

                                                -8-
Instead, VHS is merely arguing that if these documents exist, they should hypothetically be
covered by the peer-review privilege under MCL 333.21515. Under the circumstances, this Court
cannot reasonably conclude that the trial court abused its discretion in ordering the discovery of
documents pertaining to a potential COVID-19 DNR policy. Further, we are not convinced that
any of the documents would be covered by the peer-review privilege. As it stands now, VHS’s
argument that the documents are privileged is at most premature.

        VHS’s final argument on this point is that attempting to find every document pertaining to
COVID-19 policies constitutes an unduly burdensome discovery request, and that it is
disproportionate to the needs of the case. But given the evidence in the record, including an e-
mail evincing that a DNR policy might have existed regarding COVID-19 patients, and sworn
testimony from a nurse stating that Richard was not resuscitated as a result of the policy, the request
is certainly not disproportionate to the needs of the case, nor should it be unduly burdensome to
discover and present evidence pertaining specifically to the DNR policy. For all of these reasons,
VHS’s arguments lack merit.

                       B. CT SCAN AND ULTRASOUND DOCUMENTS

         VHS next argues that the portion of the order directing the production of any CT scan and
ultrasound results taken during Richard’s hospitalization is irrelevant to the case. To the contrary,
plaintiff argues that the information is relevant because it goes to show that VHS could have
ordered an earlier CT scan, which could have potentially saved Richard’s life. Plaintiff theorizes
that VHS may argue that ordering an earlier CT scan was impossible because the hospital was
overfilled with COVID-19 patients. However, VHS states on appeal that defendants have no
intention to argue this point at trial. Instead, VHS claims that a CT scan was not ordered for
Richard until one became medically necessary, and that the scan was completed soon after it was
ordered. Richard’s medical records support this claim. He spent 45 minutes in critical care
“exclusive of procedures,” and the CT scan was performed not long before he passed away. Given
that this was an emergency situation, as Richard had already been resuscitated once before the CT
scan was ordered and completed, one can presume that he was not waiting for care due to an
overabundance of patients. Instead, it is apparent from the record that the CT scan was ordered
when it became medically necessary, as VHS indicates. Plaintiff presents no other compelling
argument as to why this information is relevant to the case.

        VHS further contends that the information would also be protected by the physician-patient
privilege, MCL 600.2157. The statute states, in relevant part:

               Except as otherwise provided by law, a person duly authorized to practice
       medicine or surgery shall not disclose any information that the person has acquired
       in attending a patient in a professional character, if the information was necessary
       to enable the person to prescribe for the patient as a physician, or to do any act for
       the patient as a surgeon. If the patient brings an action against any defendant to
       recover for any personal injuries, or for any malpractice, and the patient produces
       a physician as a witness in the patient’s own behalf who has treated the patient for
       the injury or for any disease or condition for which the malpractice is alleged, the
       patient shall be considered to have waived the privilege provided in this section as

                                                 -9-
       to another physician who has treated the patient for the injuries, disease, or
       condition.

Only the patient at issue can waive the physician-patient privilege. Meier v Awaad, 299 Mich App
655, 666; 832 NW2d 251 (2013). Plaintiff attempts to circumvent this issue by noting that all
patient information would be redacted. However, this Court has previously found that logs of
patient information, including “the type of surgeries performed, as well as the time and the dates
of the surgeries,” was privileged and not subject to discovery, even where the personal information
of individual patients was redacted. Johnson, 291 Mich App at 169-170. Here, plaintiff seeks to
have VHS produce “a full and complete list . . . of all CT scans and/or ultrasounds performed on
patients in the radiology department and/or emergency department” during the relevant time
period. Under Johnson, redacting patient information is insufficient to overcome the physician-
patient privilege.

        Finally, VHS again argues that attempting to produce this information would be unduly
burdensome. Even if the physician-patient privilege did not preclude discovery of this
information, this request is extremely burdensome to VHS. Given that there could have been
hundreds or thousands of patients who obtained CT scans and ultrasounds during Richard’s
hospitalization on March 28 and 29, 2020, it would be difficult, if not impossible, for VHS to go
through every single medical record and redact all of the pertinent information. Combined with
the fact that plaintiff has failed to overcome the physician-patient privilege, and cannot show that
the information is sufficiently relevant, we conclude that the trial court abused its discretion by
ordering VHS to produce these documents.

                                       III. CONCLUSION

        The trial court abused its discretion by ordering the production of documents pertaining to
CT scans and ultrasounds conducted during Richard’s hospital stay on March 28 and 29, 2020. In
all other respects, the trial court’s ruling was supported by law and fact.

        Affirmed in part, reversed in part, and remanded for further proceedings consistent with
this opinion. We do not retain jurisdiction.

                                                             /s/ Mark J. Cavanagh
                                                             /s/ Michelle M. Rick
                                                             /s/ Sima G. Patel

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