Court Opinion

ID: 9402475
Source: CourtListenerOpinion
Date Created: 2023-06-15 19:12:07.479748+00
Date Added: 2024-06-11T17:20:00.077038
License: Public Domain

IN THE SUPREME COURT OF APPEALS OF WEST VIRGINIA
                                January 2023 Term                         FILED
                                    _______________                    June 15, 2023
                                                                          released at 3:00 p.m.
                                                                      EDYTHE NASH GAISER, CLERK
                                   No. 21-0830                        SUPREME COURT OF APPEALS
                                 _______________                           OF WEST VIRGINIA

                               ROBERT D. TOLER,
                             Plaintiff Below, Petitioner,

                                         V.

              CORNERSTONE HOSPITAL OF HUNTINGTON, LLC,
                      Defendant Below, Respondent.

               _____________________________________________

                   Appeal from the Circuit Court of Cabell County
                     The Honorable Gregory L. Howard, Judge
                             Civil Action No. 19-C-196

                                AFFIRMED
               _____________________________________________

                            Submitted: March 21, 2023
                               Filed: June 15, 2023

Steven S. Wolfe, Esq.                         Richard D. Jones, Esq.
Wolfe, White & Associates                     Amy Humphreys, Esq.
Logan, West Virginia                          Jason A. Proctor, Esq.
Attorney for Petitioner                       Flaherty Sensabaugh Bonasso PLLC
                                              Charleston, West Virginia
                                              Attorneys for Respondent

JUSTICE BUNN delivered the Opinion of the Court.

CHIEF JUSTICE WALKER AND JUSTICE WOOTON dissent and reserve the right to
file dissenting opinions.
                             SYLLABUS BY THE COURT

              1.     “The party seeking the protections of the peer review privilege bears

the burden of establishing its applicability by more than a mere assertion of privilege.”

Syllabus point 3, State ex rel. Wheeling Hospital, Inc. v. Wilson, 236 W. Va. 560, 782

S.E.2d 622 (2016).

              2.     “To determine whether a particular document is protected by the peer

review privilege codified at W. Va. Code § 30-3C-3 (1980) (Repl. Vol. 2015), a reviewing

court must ascertain both the exact origin and the specific use of the document in question.

Documents that have been created exclusively by or for a review organization, or that

originate therein, and that are used solely by that entity in the peer review process are

privileged. However, documents that either (1) are not created exclusively by or for a

review organization, (2) originate outside the peer review process, or (3) are used outside

the peer review process are not privileged.” Syllabus point 1, State ex rel. Wheeling

Hospital, Inc. v. Wilson, 236 W. Va. 560, 782 S.E.2d 622 (2016).

              3.     “The curative admissibility rule allows a party to present otherwise

inadmissible evidence on an evidentiary point where an opponent has ‘opened the door’ by

introducing similarly inadmissible evidence on the same point. Under this rule, in order to

be entitled as a matter of right to present rebutting evidence on an evidentiary fact: (a) The

original evidence must be inadmissible and prejudicial, (b) the rebuttal evidence must be

                                              i
similarly inadmissible, and (c) the rebuttal evidence must be limited to the same

evidentiary fact as the original inadmissible evidence.” Syllabus point 10, State v. Guthrie,

194 W. Va. 657, 461 S.E.2d 163 (1995).

                                              ii
BUNN, Justice:

              Petitioner Robert D. Toler appeals from orders entered September 15, 2021,

and March 20, 2020, by the Circuit Court of Cabell County. In the 2021 order, the circuit

court entered judgment on a jury verdict in favor of the Respondent, Cornerstone Hospital

of Huntington, LLC (“Cornerstone”). The verdict was rendered in Mr. Toler’s lawsuit

seeking damages for injuries he sustained while visiting a patient at Cornerstone. The

circuit court’s 2020 order protected from discovery an incident report in which a

Cornerstone employee allegedly described the condition of the patient’s room immediately

following Mr. Toler’s injury. In that order, the circuit court applied the protections afforded

by the peer review privilege to the incident report. This ruling also precluded the parties

from disclosing the incident report during the trial of this case.

              On appeal to this Court, Mr. Toler argues that the circuit court erred by

finding that Cornerstone’s incident report is protected by the peer review privilege set forth

in West Virginia Code §§ 30-3C-1 to -5. Cornerstone contends that its incident report is

protected by the peer review privilege because its employee prepared the report exclusively

for its own use in its internal quality assurance and facility maintenance review process.

              We conclude that the circuit court did not err in ruling that the peer review

privilege protects Cornerstone’s incident report from discovery. Further, the circuit court

did not err by entering judgment on the jury’s verdict in favor of Cornerstone because Mr.

                                               1
Toler failed to rebut Cornerstone’s assertion of the peer review privilege. Therefore, we

affirm the circuit court’s March 20, 2020 and September 15, 2021 orders.

                                              I.

                     FACTUAL AND PROCEDURAL HISTORY

              On January 7, 2019, Mr. Toler was visiting his girlfriend, who was a patient

at Cornerstone. Mr. Toler spent the night in a recliner chair in her room to help take care

of her. While getting up from the chair in her room, Mr. Toler fell and broke his femur.1

When various medical personnel, both at Cornerstone and the emergency room at St.

Mary’s Medical Center where Mr. Toler was transported for treatment, asked him what

had caused the fall, Mr. Toler claimed that his leg gave way and that he thought it was a

charley horse. Two Cornerstone nurses heard Mr. Toler fall and, after checking on him,

one of the nurses reported the incident to the house supervisor, Nurse Jeff Hall.

              Nurse Hall went to the patient’s room to check on Mr. Toler and then

prepared an incident report documenting his fall. Mr. Toler seems to believe that the

incident report supports his later description of the circumstances of his fall as being caused

by a roll of tape left on the floor of the patient’s room and that Nurse Hall may have reported

              1
               Although Mr. Toler appears to have broken his femur, which is a leg bone,
the record also indicates that Mr. Toler broke his hip, which, it appears, could refer to a
break of the top of his femur. See Femur, Mosby’s Medical Dictionary (9th ed. 2013)
(defining “femur” as “the thigh bone, which extends from the pelvis to the knee”).

                                               2
finding a roll of tape on the floor while investigating Mr. Toler’s fall.2 While Mr. Toler

subsequently testified at trial that he stepped on a roll of tape and that the roll of tape had

caused him to fall and break his femur, none of the medical professionals who treated Mr.

Toler immediately following his fall reported in their notes of Mr. Toler’s examinations

anything about a roll of tape. Rather, the contemporaneous medical records all indicate that

Mr. Toler reported that his leg had given out and caused him to fall. The Cornerstone nurses

who responded to the patient’s room immediately after Mr. Toler’s fall also stated that Mr.

Toler claimed that his leg had given out, that he thought he had a charley horse, and that

he did not mention a roll of tape in describing the circumstances of his fall.

              Mr. Toler then sued Cornerstone3 and sought discovery of the incident report,

which Cornerstone claimed is protected by the peer review privilege. See generally W. Va.

Code §§ 30-3C-1 to -5. Mr. Toler filed a motion to compel disclosure of the incident report,

and the circuit court held a hearing on the motion. By order entered March 20, 2020, the

circuit court agreed with Cornerstone’s claim of peer review privilege and precluded

disclosure of the document to Mr. Toler.

              2
                 The record is unclear as to how Mr. Toler deduced the alleged contents of
Cornerstone’s incident report because Cornerstone claims that this document is privileged,
was prepared exclusively for its own internal use, and has not been disclosed to anyone
outside of its peer review process. While Cornerstone provided a copy of its incident report
under seal for our consideration on appeal, and the circuit court reviewed this document in
camera, it does not appear that Mr. Toler has been permitted to view the incident report.
              3
                  Mr. Toler’s complaint is not part of the Appendix Record in this case.

                                               3
              During the trial of Mr. Toler’s case against Cornerstone, the court permitted

Nurse Hall, who had prepared the incident report, to testify about his personal knowledge

of the circumstances surrounding Mr. Toler’s fall, as the original source of the contents of

the incident report. Nurse Hall’s trial testimony did not reference a roll of tape on the floor.

Mr. Toler testified that he fell when his leg went out from under him, and he stepped “on

a piece of tape.” However, no other testimony or evidence adduced at trial mentioned the

roll of tape that Mr. Toler alleges caused him to fall and break his femur in the course of

treatment for his injuries. The jury, on its verdict form, answered the first question as

follows:

                     1.    Do you find by a preponderance of the evidence
              that Robert Toler stepped on a roll of tape causing him to fall
              on the morning of January 7, 2019?

                           Yes _____                     No __X__

The circuit court entered a final order of judgment on the jury’s verdict in favor of

Cornerstone on September 15, 2021. Mr. Toler then appealed to this Court.

                                              II.

                                STANDARD OF REVIEW

              The issue before the Court is whether the circuit court properly excluded

Cornerstone’s incident report based on its rulings that the report is protected by the peer

review privilege and that the report was not subject to disclosure at trial. In assessing the

circuit court’s rulings, we must consider both of the circuit court’s orders from which Mr.

                                               4
Toler has appealed. We first review the circuit court’s March 20, 2020 order that denied

Mr. Toler’s motion to compel discovery responses by Cornerstone and found that the peer

review privilege applies to Cornerstone’s incident report. Our prior cases recognize that a

circuit court’s rulings regarding the application of the peer review privilege involve

multiple standards of review. We review the circuit court’s interpretation and application

of the peer review privilege statutes de novo as that determination requires the resolution

of a question of law:

              [A]t issue in the case sub judice is the correctness of the circuit
              court’s interpretation and application of the applicable
              statutory law concerning privileges relating to health care peer
              review proceedings. As this contention involves a question of
              law, we apply a plenary review to the circuit court’s decision
              in this regard. “Interpreting a statute or an administrative rule
              or regulation presents a purely legal question subject to de novo
              review.” Syl. pt. 1, Appalachian Power Co. v. State Tax Dep’t
              of West Virginia, 195 W. Va. 573, 466 S.E.2d 424 (1995).

State ex rel. Charles Town Gen. Hosp. v. Sanders, 210 W. Va. 118, 123, 556 S.E.2d 85, 90

(2001). We then consider whether the circuit court abused its discretion when determining

if the privilege applies to a particular document because that ruling involves a question of

fact: “The determination of which materials are privileged under W. Va. Code, 30-3C-1 . . .

et seq. is essentially a factual question and the party asserting the privilege has the burden

of demonstrating that the privilege applies.” Syl. pt. 2, in part, State ex rel. Shroades v.

Henry, 187 W. Va. 723, 421 S.E.2d 264 (1992).

              Next, we review the circuit court’s September 15, 2021 order that entered

judgment on the jury’s verdict in favor of Cornerstone, which includes the court’s pre-trial

                                               5
rulings on Cornerstone’s motions in limine to exclude reference to and testimony about its

incident report at trial as well as the court’s rulings on the admissibility of evidence during

trial. As to a circuit court’s evidentiary rulings, we have held that

                     [t]he West Virginia Rules of Evidence and the West
              Virginia Rules of Civil Procedure allocate significant
              discretion to the trial court in making evidentiary and
              procedural rulings. Thus, rulings on the admissibility of
              evidence . . . are committed to the discretion of the trial court.
              Absent a few exceptions, this Court will review evidentiary
              and procedural rulings of the circuit court under an abuse of
              discretion standard.

Syl. pt. 1, in part, McDougal v. McCammon, 193 W. Va. 229, 455 S.E.2d 788 (1995).

Accord State v. Marple, 197 W. Va. 47, 51, 475 S.E.2d 47, 51 (1996) (“The evidentiary

rulings of a circuit court . . . are reviewed under an abuse of discretion standard.”). We will

consider Mr. Toler’s assignments of error in accordance with these standards.

                                             III.

                                       DISCUSSION

              On appeal, Mr. Toler asserts two assignments of error: the circuit court erred

(1) by ruling that Cornerstone’s incident report is protected by the peer review privilege

and (2) by continuing to exclude the report when, according to Mr. Toler, Cornerstone

opened the door to the document’s disclosure during the trial of this case. We consider both

assigned errors in turn.

                                               6
                                  A. Peer Review Privilege

               To determine whether the peer review privilege applies, it is necessary to

consider the scope of the privilege. We previously have recognized that, “[t]hrough the

enactment of West Virginia Code § 30-3C-3 in 1980,[4] the Legislature imposed

confidentiality on all information, documents, and records subjected to review by a medical

peer review organization.” Young v. Saldanha, 189 W. Va. 330, 332, 431 S.E.2d 669, 671

(1993). The Legislature’s enactment of this statutory privilege also “clearly evinces a

public policy encouraging health care professionals to monitor the competency and

professional conduct of their peers in order to safeguard and improve the quality of patient

care.” Syl. pt. 2, in part, id.

               In establishing the parameters of the privilege, the Legislature has defined

the terms “peer review” and “review organization.”

                      “Peer review” means the procedure for evaluation by
               health care professionals of the quality and efficiency of
               services ordered or performed by other health care
               professionals, including practice analysis, inpatient hospital
               and extended care facility utilization review, medical audit,

               4
                 We note that, during the course of the events giving rise to this appeal, the
Legislature amended the peer review privilege statutes, which revised some previously
enacted provisions and adopted other new provisions. See generally W. Va. Code § 30-3C-
1 (eff. Apr. 29, 2019) (revising existing section); W. Va. Code § 30-3C-3 (eff. Apr. 29,
2019) (revising existing section); W. Va. Code § 30-3C-5 (eff. Apr. 29, 2019) (adopting
new provision establishing criteria for waiver of peer review privilege). Our consideration
of this case is guided by the version of the peer review privilege that was in effect at the
time of Mr. Toler’s fall in January 2019, and we will refer to those statutory provisions that
were effective at that time throughout this opinion.

                                              7
                 ambulatory care review, claims review and patient safety
                 review.

W. Va. Code § 30-3C-1 (eff. 2004). “Review organization” is defined, in pertinent part, as

                 any committee or organization engaging in peer review,
                 including a hospital utilization review committee, . . . a
                 medical audit committee, . . . a physicians’ advisory
                 committee, . . . any entity established pursuant to state or
                 federal law for peer review purposes, and any committee
                 established by one or more state or local professional societies
                 or institutes, to gather and review information relating to the
                 care and treatment of patients for the purposes of:
                 (i) Evaluating and improving the quality of health care
                 rendered; (ii) reducing morbidity or mortality; or
                 (iii) establishing and enforcing guidelines designed to keep
                 within reasonable bounds the cost of health care. It shall also
                 mean any hospital board committee or organization reviewing
                 the professional qualifications or activities of its medical staff
                 . . ., and any professional standards review organizations
                 established or required under state or federal statutes or
                 regulations.

Id.

                 The peer review privilege itself is set forth in West Virginia Code § 30-3C-

3 (eff. 1980):

                        W. Va. Code, 30-3C-3 [1980] provides that “[t]he
                 proceedings and records of a review organization shall be
                 confidential . . . Provided, That information, documents or
                 records otherwise available from original sources are not to be
                 construed as immune from discovery or use in any civil action
                 merely because they were presented during proceedings of
                 such [a review] organization. . . .” The language of the statute
                 grants a privilege to all the records and proceedings of a review
                 organization, but no privilege attaches to information,
                 documents or records considered by a review organization if
                 the material is “otherwise available from original sources.”

                                                 8
Syl. pt. 3, Shroades, 187 W. Va. 723, 421 S.E.2d 264. See generally W. Va. Code § 30-

3C-3 (eff. 1980). Furthermore,

                     [p]ursuant to the plain language of W. Va. Code § 30-
              3C-3 (1980) (Repl. Vol. 1998), information, documents, and
              records ordinarily protected by the peer review privilege lose
              their specter of confidentiality and may be accessed by third
              parties when (1) said materials are “otherwise available from
              original sources” or (2) “an individual [has] execute[d] a valid
              waiver authorizing the release of the contents of his file
              pertaining to his own acts or omissions.”

Syl. pt. 4, State ex rel. Brooks v. Zakaib, 214 W. Va. 253, 588 S.E.2d 418 (2003).5

              To protect a document from disclosure based upon the protections afforded

by the peer review privilege, the party seeking the privilege’s protections must request

recognition of the privilege and demonstrate its applicability to the document for which

protection is sought. “The party seeking the protections of the peer review privilege bears

the burden of establishing its applicability by more than a mere assertion of privilege.” Syl.

pt. 3, State ex rel. Wheeling Hosp., Inc. v. Wilson, 236 W. Va. 560, 782 S.E.2d 622 (2016).

                    A party wishing to establish the applicability of the peer
              review privilege, set forth at W. Va. Code § 30-3C-3 (1980)

              5
                 Accord Syl. pt. 2, State ex rel. Wheeling Hosp., Inc. v. Wilson, 236 W. Va.
560, 782 S.E.2d 622 (2016) (“Where documents sought to be discovered are used in the
peer review process but either the document, itself, or the information contained therein, is
available from an original source extraneous to the peer review process, such material is
discoverable from the original source, itself, but not from the review organization that has
used it in its deliberations.” (emphasis added)); Syl. pt. 3, Young v. Saldanha, 189 W. Va.
330, 431 S.E.2d 669 (1993) (“To effect a waiver of the privilege of confidentiality which
attends information and records properly the subject of health care peer review under West
Virginia Code §§ 30-3C-1 to -3 (1993), the Legislature has required that an individual must
formally indicate his intent to waive this confidentiality by executing a valid waiver.”
(emphasis added)).

                                              9
              (Repl. Vol. 2015), should submit a privilege log which
              identifies each document for which the privilege is claimed by
              name, date, and custodian. The privilege log also should
              contain specific information regarding (1) the origin of each
              document, and whether it was created solely for or by a review
              committee, and (2) the use of each document, with disclosures
              as to whether or not the document was used exclusively by
              such committee. Finally, the privilege log should provide a
              description of each document and a recitation of the law
              supporting the claim of privilege.

Syl. pt. 4, Wheeling Hosp., 236 W. Va. 560, 782 S.E.2d 622.

              Once the party seeking the protections of the peer review privilege has

requested its application and submitted the requisite privilege log, the circuit court is then

tasked with determining whether the privilege should be applied to preclude disclosure of

the document at issue.

                      To determine whether a particular document is
              protected by the peer review privilege codified at W. Va. Code
              § 30-3C-3 (1980) (Repl. Vol. 2015), a reviewing court must
              ascertain both the exact origin and the specific use of the
              document in question. Documents that have been created
              exclusively by or for a review organization, or that originate
              therein, and that are used solely by that entity in the peer review
              process are privileged. However, documents that either (1) are
              not created exclusively by or for a review organization,
              (2) originate outside the peer review process, or (3) are used
              outside the peer review process are not privileged.

Syl. pt. 1, Wheeling Hosp., 236 W. Va. 560, 782 S.E.2d 622.

              Mr. Toler contends on appeal that the circuit court erred by ruling that the

peer review privilege applies to shield Cornerstone’s incident report from disclosure. He

                                               10
does not contend that Cornerstone failed to properly request the peer review privilege

protection or that Cornerstone’s privilege log listing the incident report and describing why

it should be protected was inadequate. Neither does Mr. Toler claim, under his first

assignment of error, that Cornerstone waived the privilege. Rather, Mr. Toler contends that

the circuit court erred in applying the peer review privilege to the facts of this case, which

he contends is in the nature of a premises liability case to which the privilege should not

apply.

              We disagree with Mr. Toler’s assertion that the peer review privilege should

not apply to this case because of the nature of his claims against Cornerstone, i.e., premises

liability claims by a non-patient.6 The statutes setting forth the peer review privilege do not

limit its application to any particular type of case. Neither do the statutes limit the

application of the privilege based upon the identity of the person seeking a purportedly

protected document’s discovery. Rather, the limits of the peer review privilege pertain to

the document sought to be protected by its provisions, the manner in which that document

has been prepared, and the way in which that document has been used. “Documents that

have been created exclusively by or for a review organization, or that originate therein, and

that are used solely by that entity in the peer review process are privileged.” Syl. pt. 1, in

part, Wheeling Hosp., 236 W. Va. 560, 782 S.E.2d 622.

              6
               Again, Mr. Toler’s complaint is not included in the appellate record. See
supra note 3. However, the nature of Mr. Toler’s claims do not appear to be in dispute.

                                               11
              Upon Cornerstone’s invocation of the peer review privilege and submission

of a privilege log detailing why the privilege should apply to its incident report, the circuit

court was charged with considering the applicability of the peer review privilege statutes

and vested with the discretion to determine whether the privilege should apply to the

incident report at issue in this case. See Charles Town Gen. Hosp., 210 W. Va. at 123, 556

S.E.2d at 90; Syl. pt. 2, in part, Shroades, 187 W. Va. 723, 421 S.E.2d 264. In its order

denying Mr. Toler’s motion to compel disclosure of Cornerstone’s incident report, the

circuit court reached the following conclusions of law in support of its ruling:

                     In the instant case, the [c]ourt agrees with the
              Defendant’s       [Cornerstone’s]    assertion     that     the
              Occurrence/Incident Report which was prepared by a nurse
              and reviewed by the Director of Quality Management falls
              squarely within the statutory requirements [of the peer review
              privilege statutes] enumerated above.

                     The [c]ourt finds that the Occurrence/Incident Report at
              issue was prepared to report a non-routine event that had some
              potential for injury to a patient or visitor and was intended to
              help ensure that quality health care is rendered at the hospital
              by identifying and correcting any problems related to non-
              routine occurrences.

                     The [c]ourt also finds that the Plaintiff’s [Mr. Toler’s]
              status of a non-patient is irrelevant with regard to the
              applicability of the peer review privilege in this instance.
              Therefore, based upon the evidence presented in this matter,
              and applying the above [peer review privilege] statutes, the
              [c]ourt finds that the Occurrence/Incident Report in question is
              not subject to subpoena or discovery proceedings and is
              precluded from admissibility in evidence pursuant to the Peer
              Review [Privilege] Statute.

                                               12
               All of these findings are consistent with the Legislature’s recognition of a

peer review privilege in West Virginia Code § 30-3C-3 and this Court’s further

clarification of the scope of that privilege. See, e.g., Syl. pt. 1, Wheeling Hosp., 236 W. Va.

560, 782 S.E.2d 622; Syl. pt. 3, Shroades, 187 W. Va. 723, 421 S.E.2d 264. We do not find

that the circuit court erred or abused its discretion in finding that the peer review privilege

applies to protect Cornerstone’s incident report from disclosure. The circuit court properly

ruled that the peer review privilege does not except certain types of cases from its

application. The court further found that the incident report had been prepared exclusively

for Cornerstone’s internal review process and that the report had been used solely in that

review process and not disclosed or disseminated outside of Cornerstone’s internal review.

Therefore, we affirm the circuit court’s March 20, 2020 order ruling that the peer review

privilege precludes the disclosure of Cornerstone’s incident report.7

               7
                 This result is also consistent with the amendments to West Virginia Code
§ 30-3C-3 that were enacted shortly after the incident at issue in this case. In West Virginia
Code § 30-3C-3(a)(1) (eff. 2019), the Legislature adopted a narrow exception to allow the
disclosure of “[n]ursing home . . . incident or event reports . . . pertaining to the plaintiff of
that civil action, or reports of same or similar incidents within a reasonable time frame of
the events at issue in the civil action[.]” Nursing home incident reports, in general, remain
subject to the peer review privilege except as directed by § 30-3C-3(a)(1), and there is no
other exception to permit the disclosure of other types of incident reports that otherwise
would be protected by the peer review privilege. If we were to adopt Mr. Toler’s position
regarding the peer review privilege’s inapplicability to Cornerstone’s incident report in this
case because he is a non-patient asserting a premises liability claim, we would effectively
be allowing the disclosure of an incident report that otherwise would be protected by the
peer review privilege without a statutory exception that permits its disclosure. This result
would essentially require that we read into the peer review privilege legislation additional
terms that the Legislature did not include. We cannot rewrite legislation to include
provisions that the Legislature chose not to adopt. See Syl. pt. 11, Brooke B. v. Ray C., 230
W. Va. 355, 738 S.E.2d 21 (2013) (“It is not for this Court arbitrarily to read into a statute

                                                13
                     B. Effect of Cornerstone Witness Testimony on
                     Continued Assertion of Peer Review Privilege

              In his second assignment of error, Mr. Toler argues that the circuit court erred

by allowing two Cornerstone employees to testify at trial and that, by virtue of their

testimony, the incident report should have been disclosed to Mr. Toler for his use during

the trial. Cornerstone denies that the witnesses it called defeated its assertion of the peer

review privilege protection for the incident report.

              After the circuit court entered its order in 2020 ruling that Cornerstone’s

incident report is protected by the peer review privilege, the court considered Cornerstone’s

motions in limine prior to the jury trial. By order entered August 24, 2021, the circuit court

ruled that privileged material, which would include Cornerstone’s incident report, could

not be referenced during the trial, and Mr. Toler did not object to this ruling:

                MOTION IN LIMINE TO EXCLUDE TESTIMONY
                AND REFERENCES TO PRIVILEGED MATERIAL

                     As to Defendant’s [Cornerstone’s] “Motion In Limine to
              Exclude Testimony And References To Privileged Material,”
              Plaintiff [Mr. Toler] did not object to this Motion. This [c]ourt
              FINDS the motion well taken, and, for the reasons set forth in
              the Motion, it is hereby GRANTED.

that which it does not say. Just as courts are not to eliminate through judicial interpretation
words that were purposely included, we are obliged not to add to statutes something the
Legislature purposely omitted.”).

                                               14
By virtue of Mr. Toler’s failure to object to the exclusion of testimony about and references

to privileged material, including Cornerstone’s incident report, from the trial, Mr. Toler

has waived his objection to the circuit court’s exclusion of testimony about and references

to the incident report at trial. See Syl. pt. 2, State ex rel. Cooper v. Caperton, 196 W. Va.

208, 470 S.E.2d 162 (1996) (“To preserve an issue for appellate review, a party must

articulate it with such sufficient distinctiveness to alert a circuit court to the nature of the

claimed defect.”).

              Mr. Toler further contends that, because Nurse Hall was permitted to testify

at trial, the contents of Cornerstone’s incident report should have been disclosed at trial as

Nurse Hall’s contemporaneous notes of his conversation with Mr. Toler. However, the peer

review privilege permits the disclosure of original source information without defeating

the assertion of the privilege. See generally W. Va. Code § 30-3C-3; Syl. pt. 2, Wheeling

Hosp., 236 W. Va. 560, 782 S.E.2d 622; Syl. pt. 4, Brooks, 214 W. Va. 253, 588 S.E.2d

418; Syl. pt. 3, Shroades, 187 W. Va. 723, 421 S.E.2d 264. Here, Nurse Hall testified

regarding the original source of the incident report he prepared: his conversation with Mr.

Toler about the circumstances of the fall and his observations about the patient’s room in

which Mr. Toler’s fall occurred. During his testimony, Nurse Hall did not reference the

incident report he prepared for Cornerstone. Nurse Hall’s testimony was consistent with

the original source exception to the peer review privilege and the circuit court’s rulings

finding that the incident report is protected by the peer review privilege and excluding any

                                               15
references to or testimony about privileged materials at trial. Therefore, Mr. Toler is not

entitled to relief on this basis.

               Mr. Toler additionally contends that the testimony of Cornerstone’s

corporate representative, Nurse Brandon Gagnon, chief nursing officer, “opened the door”

to the incident report’s admissibility at trial. Nurse Gagnon testified as a witness called by

Mr. Toler. During Nurse Gagnon’s direct testimony, counsel for Mr. Toler proposed a

hypothetical situation of water causing a fall and asked the following question, which

Nurse Gagnon answered:

                      Q. [by Mr. Toler’s counsel]: . . . Where would you
               document that the fall had occurred due to water or some other
               obstruction on the floor?

                      A. [by Nurse Gagnon]: It would be documented through
               an incident reporting process.

(Emphasis omitted). When Mr. Toler’s counsel then asked, “And was that done in this

case?,” Cornerstone’s counsel immediately objected based on the court’s earlier rulings

excluding references to or testimony about materials the court had ruled were privileged

and, thus, not subject to disclosure. The court sustained Cornerstone’s objection, and Nurse

Gagnon continued his testimony without referencing Cornerstone’s incident report that

Nurse Hall prepared after Mr. Toler’s fall. On appeal, Mr. Toler contends that the circuit

court’s continued exclusion of the incident report after Nurse Gagnon had alluded to

Cornerstone’s incident reporting process constituted error because, Mr. Toler avers, Nurse

Gagnon’s testimony “opened the door” to the incident report’s disclosure. This argument

                                              16
misconstrues the concept of “opening the door” to the admission of otherwise inadmissible

evidence.

              In support of his argument, Mr. Toler cites State v. Baker, 230 W. Va. 407,

738 S.E.2d 909 (2013), which discusses the “opening the door” doctrine in the context of

criminal cases. See id., 230 W. Va. at 412, 738 S.E.2d at 914 (“The opening the door

‘doctrine operates to prevent a defendant from successfully excluding from the

prosecution’s case-in-chief inadmissible evidence and then selectively introducing pieces

of this evidence for the defendant’s own advantage, without allowing the prosecution to

place the evidence in its proper context.’ State v. James, 144 N.J. 538[, 554], 677 A.2d 734,

742 (1996).”). We have also discussed this principle in the civil law context, and explained

its operation as follows:

              First, we note that the phrase “‘[o]pening the door’ is also
              referred to as the doctrine of ‘curative admissibility.’” United
              States v. Rucker, 188 Fed. Appx. 772, 778 (10th Cir. 2006). See
              also 1 Louis J. Palmer, Jr., Robin Jean Davis, and Franklin D.
              Cleckley, Handbook on Evidence for West Virginia Lawyers
              § 106.04 at 158 (6th ed. 2015) (“The phrase ‘opening the door’
              is used by most courts to refer to the curative admissibility
              rule.”).

Miller v. Allman, 240 W. Va. 438, 450, 813 S.E.2d 91, 103 (2018). We further have

explained how a party may invoke the curative admissibility rule:

                     The curative admissibility rule allows a party to present
              otherwise inadmissible evidence on an evidentiary point where
              an opponent has “opened the door” by introducing similarly
              inadmissible evidence on the same point. Under this rule, in
              order to be entitled as a matter of right to present rebutting
              evidence on an evidentiary fact: (a) The original evidence must

                                              17
              be inadmissible and prejudicial, (b) the rebuttal evidence must
              be similarly inadmissible, and (c) the rebuttal evidence must be
              limited to the same evidentiary fact as the original inadmissible
              evidence.

Syl. pt. 10, State v. Guthrie, 194 W. Va. 657, 461 S.E.2d 163 (1995). In other words, “[t]he

doctrine of opening the door allows a party to elicit otherwise inadmissible evidence when

the opposing party has made unfair prejudicial use of related evidence.” James, 677 A.2d

at 742.

              This explanation of “opening the door” makes clear that when a party’s

opponent introduces inadmissible, prejudicial evidence, the party aggrieved by the

admission of that evidence is permitted to introduce otherwise inadmissible evidence to

rebut the opponent’s improper evidence. Here, Mr. Toler’s opponent, Cornerstone, did not

elicit the reference to Cornerstone’s incident reporting process from Nurse Gagnon. Mr.

Toler elicited that information during his counsel’s direct examination of Nurse Gagnon.

As the party who prompted Nurse Gagnon’s disclosure of the incident reporting process,

Mr. Toler is not entitled to benefit from the purportedly improper reference to the incident

                                              18
report he occasioned.8 Therefore, we find that Mr. Toler is not entitled to relief on this

basis.9

              8
                 Rather, this scenario is more reminiscent of the “invited error” doctrine than
the “opening the door” doctrine upon which Mr. Toler relies. See State v. Crabtree, 198
W. Va. 620, 627, 482 S.E.2d 605, 612 (1996) (“‘Invited error’ is a cardinal rule of appellate
review applied to a wide range of conduct. It is a branch of the doctrine of waiver which
prevents a party from inducing an inappropriate or erroneous response and then later
seeking to profit from that error. The idea of invited error is not to make the evidence
admissible but to protect principles underlying notions of judicial economy and integrity
by allocating appropriate responsibility for the inducement of error. Having induced an
error, a party in a normal case may not at a later stage of the trial use the error to set aside
its immediate and adverse consequences.”). See also Syl. pt. 2, State v. Bowman, 155
W. Va. 562, 184 S.E.2d 314 (1971) (“An appellant or plaintiff in error will not be permitted
to complain of error in the admission of evidence which he offered or elicited, and this is
true even of a defendant in a criminal case.”).
              9
                 Though not assigned as error by Mr. Toler, we would be remiss if we did
not acknowledge that Nurse Hall, during his direct testimony by Cornerstone’s counsel,
also briefly referenced the incident reporting process.

                     Q. [by Cornerstone’s counsel]: Had Mr. Toler told you
              on the morning of January 7th that when he stood up that he
              stepped on a roll of tape and it caused him to fall, what would
              you have done?

                      A. [by Nurse Hall]: For one thing, I would have looked
              for a roll of tape. Right? I would obtain that object or whatever
              the tape – in this instance, I would have got that and I would
              have used it for a foundation to do a report and find out what
              ways we could better this process and prevent this from going
              on any further and happening to the next patient.

(Emphasis omitted). This inquiry posed a hypothetical question to Nurse Hall, much like
the hypothetical water question Mr. Toler’s counsel asked Nurse Gagnon, because Nurse
Hall had earlier testified that Mr. Toler had not mentioned a roll of tape as causing or
contributing to his fall when Nurse Hall spoke with Mr. Toler shortly after he fell.
Immediately after the quoted exchange, Cornerstone’s counsel concluded her direct
examination of Nurse Hall. Mr. Toler’s counsel replied, “No cross, your Honor”; then
asked Nurse Hall four questions, none of which pertained to the reporting process Nurse
Hall had mentioned in his testimony; and allowed Nurse Hall to be excused as a witness.

                                               19
               Finally, Mr. Toler suggests that the jury’s questions to the court during its

deliberations necessitated the disclosure of Cornerstone’s incident report. During the jury’s

deliberations, it sent the following questions to the circuit court: “Is there an initial incident

report? Was it filed? Who filed it? Can we have a copy of said incident report?” After

meeting with counsel in chambers, determining that the peer review privilege continued to

protect the incident report from disclosure, and that the granted motion in limine precluded

reference to the incident report, the circuit court gave this answer to the jury:

               I can simply tell you that everything that was admissible
               evidence in this case has been discussed prior to the jury ever
               being here. We’ve had legal arguments on things, and there are
               things that are allowed to be in front of the jury and things that
               are not. Everything that you-all have to deliberate on and
               consider has been entered into evidence, and so you’re not to
               speculate as to what other pieces of evidence might be out there
               or might not be out there. You’re only to consider things that
               have been put in front of you . . . . And we’ve made sure that
               you have all of the evidence that you’re supposed to have
               legally to make this decision and reach your verdict; so don’t
               speculate on any other things that may be missing at this point.
               You just work with what you have and reach your verdict based
               on that information.

We find that these questions from the jury clearly indicate that it was not aware that an

incident report had been prepared in this case given that the first question was whether the

For the same reason we find that Mr. Toler has waived any objection to the exclusion of
testimony about or reference to Cornerstone’s incident report because he failed to object to
the circuit court’s decision to grant Cornerstone’s motion in limine, we similarly find that
Mr. Toler has waived any objection he may have had to Nurse Hall’s hypothetical reference
to the incident reporting process because he failed to object to Nurse Hall’s reference to
Cornerstone’s reporting process or elicit further testimony regarding this procedure on
cross-examination of this witness. See Syl. pt. 2, State ex rel. Cooper v. Caperton, 196
W. Va. 208, 470 S.E.2d 162 (1996).

                                                20
incident report existed. The circuit court’s answers to the jury’s questions were consistent

with its prior rulings finding that the peer review privilege shielded Cornerstone’s incident

report from disclosure and that the parties were not permitted to reference or elicit

testimony about the incident report at trial, which we have found were proper. We likewise

find that the circuit court did not abuse its discretion in answering the jury’s questions in

this manner and continuing to apply the peer review privilege to protect Cornerstone’s

incident report. Accordingly, we affirm the circuit court’s September 15, 2021 order

entering judgment in favor of Cornerstone on the jury’s verdict.

                                            IV.

                                     CONCLUSION

              We conclude that the circuit court did not err by ruling that the peer review

privilege applies to preclude the disclosure of Cornerstone’s incident report. Therefore, we

affirm the circuit court’s March 20, 2020 order that ruled that the incident report is

protected by the peer review privilege and the court’s September 15, 2021 order entering

judgment on the jury’s verdict in favor of Cornerstone.

                                                                                  Affirmed.

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