Court Opinion

ID: 9913987
Source: CourtListenerOpinion
Date Created: 2023-12-29 13:02:19.249629+00
Date Added: 2024-06-11T13:09:46.693552
License: Public Domain

DISTRICT COURT OF APPEAL OF FLORIDA
                        SECOND DISTRICT

                      JOSEPH CASTELLANO, M.D.,

                                 Petitioner,

                                     v.

   DAVID HALPERN, M.D. and WEST FLORIDA-MHT, LLC d/b/a HCA
               FLORIDA SOUTH TAMPA HOSPITAL,

                               Respondents.

              Nos. 2D22-3154, 2D22-4155, and 2D22-4156
                           CONSOLIDATED

                            December 29, 2023

Petition for Writ of Certiorari to the Circuit Court for Hillsborough
County; Melissa M. Polo and James M. Barton, II, Judges.

Stuart Jay Levine of Walters Levine & Degrave, Tampa, for Petitioner.

Martin B. Goldberg; Jennifer Christianson; Jonathan E. Siegelaub; and
Ashley P. Singrossi of Lash & Goldberg, LLP, Miami, for Respondent
David Halpern, M.D.

Walter J. Tache and Magda C. Rodriguez of Tache, Bronis and Descalzo,
P.A., Miami, Florida, for Respondent West Florida-MHT, LLC d/b/a HCA
Florida South Tampa Hospital.

KELLY, Judge.
     In these consolidated petitions for writ of certiorari, petitioner
Joseph Castellano, M.D., asks us to quash the order of the trial court
sustaining respondent David Halpern, M.D.'s objections to discovery
propounded by Castellano in his lawsuit against Halpern for intentional
interference with a business relationship and defamation per se. He also
asks us to quash the protective order entered in favor of respondent West
Florida-MHT, LLC d/b/a HCA Florida South Tampa Hospital (HCA), a
non-party below. Halpern and HCA argued, and the trial court agreed,
that all discovery sought by Castellano was privileged and confidential
under sections 395.0191(8), 395.0193(8), and 766.101(5),1 Florida
Statutes (2021), provisions which afford confidentiality in connection
with applications for hospital staff membership and clinical privileges,
hospital peer review and disciplinary proceedings, and hospital medical
review committee proceedings respectively.2 We conclude that the trial

     1 We note that constitutional challenges to these statutes have been

raised on the basis of article X, section 25, of the Florida Constitution
("[P]atients have a right to have access to any records made or received in
the course of business by a health care facility or provider relating to any
adverse medical incident."); Edwards v. Thomas, 229 So. 3d 277, 287
(Fla. 2017) (holding that article X, section 25 "eliminat[ed] all discovery
restrictions on 'any records . . . relating to any adverse medical incident'
") (omission in original). However, the constitutional exception to the
privilege is not at issue in this case. See, e.g., Tarpon Springs Hosp.
Found., Inc. v. White, 286 So. 3d 879, 882-83 (Fla. 2d DCA 2019) (holding
that the constitutional exception to the privilege protecting records of a
hospital board from discovery in any civil action against a provider of
professional health services did not apply because the action did not
involve an "established adverse medical incident").
     2 These statutes also contain provisions providing immunity to

participants in those processes for actions "arising out of or related to
carrying out the provisions" of the various statutes. See § 395.0191(7);
see also § 766.101(8). In Halpern v. Castellano, 339 So. 3d 343 (Fla. 2d
DCA 2022), we denied Halpern's petition for certiorari asking us to quash
the order of the trial court denying his motion to dismiss Castellano's
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court's determination that the discovery Castellano seeks is protected
departs from the plain language of the statutes under which Halpern and
HCA claim privilege, and that precluding the requested discovery will
destroy Castellano's ability to prove his claim at trial. Accordingly, we
grant the petitions and quash the trial court's orders.
     I. Facts
     Castellano is a board-certified general surgeon who performs
cosmetic surgery. Halpern is a board-certified plastic surgeon. The two
doctors are competitors. In the past, Castellano, who had general
surgery privileges at HCA, unsuccessfully sought to obtain permission to
perform certain cosmetic surgery procedures at the hospital. At that
time, only board-certified plastic surgeons were permitted to perform
those procedures. Faced with this reality, Castellano approached a
member of HCA's Medical Executive Committee (MEC) and proposed that
HCA add a new clinical practice area in cosmetic surgery to its existing
practice areas so that general surgeons could apply for clinical privileges
to perform procedures currently limited to plastic surgeons. The MEC
thought the idea was worth exploring and, per the hospital's bylaws,
referred the matter to the Credentialing Committee for study. As part of
its investigation into whether HCA should add a cosmetic surgery
practice, the Credentialing Committee interviewed Halpern to get his
views on the subject. He strongly opposed the proposal. Nevertheless,
the Committee ultimately suggested to the MEC that it recommend the
idea to HCA's Board of Trustees.
     When Halpern learned that the MEC voted in favor of adding the
new practice area and that it was going to recommend it to the Board, he

complaint based on his claim that he was entitled to immunity under
these statutes.
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sent a letter to HCA's chief of staff, who was also a member of the MEC,
with copies to the hospital's chief executive officer, its chief medical
officer, and the chair of HCA's Board stating his objection. It is this letter
that is at the heart of Castellano's complaint against Halpern for
defamation and intentional interference with a business relationship.
      The letter in its entirety states:
      It has come to my attention that certain cosmetic surgery
      privileges are being put forth to the Board of Governors
      meeting without my knowledge or input from you. Not for a
      lack of my availability or interest in this issue which you are
      keenly aware of. As you represent the entire staff of Memorial
      Hospital at this meeting I find this very disturbing and frankly
      a backhanded move on the part of the MEC. I formally
      request to be allowed to present my concerns (as well as every
      other Board Certified Plastic Surgeon on Staff and possibly
      every Board Certified Physician on Staff) to the Board in
      person since you have willfully excluded me from this
      process. Please reply in writing your response to this request
      or call me before the meeting. If you deny me this privilege, I
      will petition the Board itself but feel it is best to stay within
      the framework of the medical staff to do so.

      I am rather dismayed that you and the MEC would continue
      to consider this issue as I thought it was resolved and had its
      due process. Obviously not. I think that the Medical
      executive committee does not realize the seriousness of this
      proposal and the ramifications for the staff, the community[,]
      and the hospital itself. I am sure that the Board of Governors
      WILL want to hear both sides of the story and finally resolve
      this issue which ALL privileging is based upon. It is not
      about petty competitiveness but of patient safety in our
      community and within the hospital itself. IF you cannot see
      this or fully comprehend this then I am sorry for you and all
      the other misguided members of the MEC. I must protect the
      patients in our community and our beloved hospital which
      you will put at great risk, with little or no reward, with this
      irresponsible and unnecessary request.
                                       4
The Board ultimately voted against the proposal to add a practice area in
cosmetic surgery. Castellano's lawsuit followed.
      The amended complaint's basic allegations are that Halpern knew
it was Castellano who had advocated for the cosmetic surgery proposal,
and that he knew Castellano intended to apply for cosmetic surgery
privileges should HCA approve the idea. The amended complaint alleges
Halpern's letter contains false statements of fact about the ability of
cosmetic surgeons to safely practice cosmetic surgery, and that Halpern
intentionally and willfully made the false and defamatory statements for
malicious and anti-competitive purposes and that as a result Castellano
was damaged. All the discovery requests at issue here seek information
related to the contents of the letter.
      II. Analysis
      "[C]ertiorari is appropriate when a discovery order departs from the
essential requirements of law, causing material injury to a petitioner
throughout the remainder of the proceedings below and effectively
leaving no adequate remedy on appeal." Allstate Ins. Co. v. Langston, 655
So. 2d 91, 94 (Fla. 1995). In Giacalone v. Helen Ellis Memorial Hospital
Foundation, Inc., 8 So. 3d 1232, 1234 (Fla. 2d DCA 2009), this court
explained that "[c]ertiorari is rarely available to review orders denying
discovery because in most cases the harm can be corrected on appeal."
      However, when the requested discovery is relevant or is
      reasonably calculated to lead to the discovery of admissible
      evidence and the order denying that discovery effectively
      eviscerates a party's claim, defense, or counterclaim, relief by
      writ of certiorari is appropriate. The harm in such cases is
      not remediable on appeal because there is no practical way to
      determine after judgment how the requested discovery would
      have affected the outcome of the proceedings.

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Id. at 1234-35.
     Because it goes to our jurisdiction, our first task is to examine
whether the trial court's discovery orders cause "material injury" that
cannot be remedied on appeal. See Gonzalez v. State, 15 So. 3d 37, 39
(Fla. 2d DCA 2009) (explaining that "material and irreparable harm" is a
jurisdictional requirement for certiorari relief). Halpern concedes that
the discovery orders eviscerate Castellano's case.3 He contends,
however, that this circumstance is not what results in irreparable harm.
Rather, Halpern argues the harm results from the uncertainty regarding
how the prohibition on discovery affected the outcome of the case. Here,
he contends there is no uncertainty—the trial court's determination that
the requested discovery is privileged will "entirely dispose of the action"
for two related reasons. First, it will make it impossible for Castellano to
make the evidentiary showing to prove his claims and second, it amounts
to a finding that Halpern is immune from suit under the immunity
provisions in the statutes and consequently, the court will eventually
have to enter judgment in his favor. Thus, Halpern argues, Castellano
cannot demonstrate irreparable harm because he "will be free to
challenge the immunity rulings in an appeal from the judgment."
     We believe this argument overlooks the fact that if Castellano is
precluded from conducting the requested discovery not only can he not
prove his claims, on direct appeal he "would have the nearly impossible
task of proving that the trial court committed reversible, harmful error";
he could not even make a proffer of what the evidence would have shown
had discovery been allowed. Anderson v. Duggan, 56 So. 3d 830, 832-33
(Fla. 2d DCA 2011) (finding irreparable harm where a party was

     3 HCA's response is silent on this matter.

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precluded from obtaining documents needed to prove his claim thus
preventing him from meeting his burden of proof and further making it
"nearly impossible" to establish on appeal that the trial court erred).
Accordingly, we conclude that under these circumstances, Castellano
has established irreparable harm for the purposes of certiorari review.
     Next, we must determine whether Castellano has shown that the
trial court departed from clearly established law.
      "[C]learly established law" can derive from a variety of
      legal sources, including recent controlling case law,
      rules of court, statutes, and constitutional law. Thus,
      in addition to case law dealing with the same issue of
      law, an interpretation or application of a statute, a
      procedural rule, or a constitutional provision may be
      the basis for granting certiorari review.

Allstate Ins. Co. v. Kaklamanos, 843 So. 2d 885, 890 (Fla. 2003). A
departure from clearly established law can be shown by the
misapplication of the plain language in a statute. Gonzalez, 15 So. 3d at
39. Accordingly, we must review the statutory provisions upon which
Halpern and HCA base their claims of privilege to determine if the trial
court's finding of privilege is supported by the plain language of those
statutes.
     The statutes at issue regulate hospital procedures governing the
granting of staff membership and clinical privileges, physician discipline,
and quality evaluation and improvement. See Holly v. Auld, 450 So. 2d
217, 220 (Fla. 1984) (stating that the legislature "deemed it wise to
encourage a degree of self-regulation by the medical profession through
peer review and evaluation"), abrogated on other grounds by Conage v.
United States, 346 So. 3d 594, 598 (Fla. 2022). Section 395.0191, titled
"Staff membership and clinical privileges," directs the manner in which a

                                     7
licensed facility, such as a hospital, is to consider applications for staff
membership or clinical privileges. Section 395.0191(8) prohibits the
discovery of "investigations, proceedings, and records" of a hospital board
"in any civil action against a provider of professional health services
arising out of matters which are the subject of evaluation and review by
such board." Similarly, sections 395.0193(8) and 766.101(5) contain the
same prohibition for the "investigations, proceedings, and records" of a
hospital's peer review panel or medical review committee. Section
395.0193 pertains to the "process of investigating and disciplining
physicians pursuant to the state-mandated peer review process."
§ 395.0193(1). Section 766.101 provides for the establishment of a
committee
      to evaluate and improve the quality of health care rendered by
      providers of health service, to determine that health services
      rendered were professionally indicated or were performed in
      compliance with the applicable standard of care, or that the
      cost of health care rendered was considered reasonable by the
      providers of professional health services in the area.

§ 766.101(1)(a)1, l.
      It is undisputed that Castellano's lawsuit for defamation and
intentional interference with a business relationship does not arise from
the hospital's peer review or medical review processes, nor does it arise
from the hospital's consideration of an application by Castellano for staff
membership or clinical privileges. Perhaps recognizing the limited scope
of the grant of privilege contained in these statutes, the respondents urge
us to broadly interpret them arguing that we are obligated to honor the
obvious legislative intent and policy behind the statutes even where that

                                      8
intent requires an interpretation that exceeds the literal language of the
statutes.4 Our obligation is the opposite.
     As the supreme court explained in Ham v. Portfolio Recovery
Associates, LLC, 308 So. 3d 942, 946-47 (Fla. 2020),
     [i]n interpreting the statute, we follow the "supremacy-of-text
     principle"—namely, the principle that "[t]he words of a
     governing text are of paramount concern, and what they
     convey, in their context, is what the text means." Antonin
     Scalia & Bryan A. Garner, Reading Law: The Interpretation of
     Legal Texts 56 (2012). We also adhere to Justice Joseph
     Story's view that "every word employed in [a legal text] is to be
     expounded in its plain, obvious, and common sense, unless
     the context furnishes some ground to control, qualify, or
     enlarge it." Advisory Op. to Governor re Implementation of
     Amendment 4, the Voting Restoration Amendment, 288 So. 3d
     1070, 1078 (Fla. 2020) (quoting Joseph Story, Commentaries
     on the Constitution of the United States 157-58 (1833), quoted
     in Scalia & Garner, Reading Law at 69).

(Alteration in original). "[W]e are precluded from construing an
unambiguous statute in a way which would extend, modify or limit, its
express terms or its reasonable and obvious implications." Lawnwood
Med. Ctr., Inc. v. Sadow, 43 So. 3d 710, 721 (Fla. 4th DCA 2010) (quoting
Donato v. Am. Tel. & Tel. Co., 767 So. 2d 1146, 1150-51 (Fla. 2000).
     Respondents characterize these statutes as providing
"extraordinarily broad discovery immunity" provisions that protect from
discovery any disciplinary, credentialing, or quality review materials.
They make no real argument that what occurred here arose from the
hospital's peer review or medical review committees. Instead, the

     4 We reject respondents' contention that permitting the discovery

sought by Castellano in this case runs counter to the legislature's goal of
encouraging "self-regulation by the medical profession through peer
review and evaluation." See Holly, 450 So. 2d at 220.
                                     9
respondents focus on what they characterize as the credentialing
process.
      Reduced to its essence, the respondents' argument is that even
though the allegations in the petition do not arise from an application by
Castellano for staff or clinical privileges, the privilege extends to the
process by which the hospital sets the standards and procedures for
acting on an application for privileges. They contend that if the cosmetic
surgery proposal had been adopted, the hospital would then have had to
set standards for considering and acting upon applications for staff
membership or clinical privileges in that area; and therefore, the privilege
should extend to Castellano's discovery requests in this case.
      We cannot accept this expansive reading of the statute. The plain
language of section 395.0191(8) expressly limits the privilege to "any civil
action against a provider of professional health services arising out of
matters which are the subject of evaluation and review by such board,"
and the matters subject to evaluation and review by the board in the
context of section 395.0191 are applications for staff membership or
clinical privileges. The same analysis applies to sections 395.0193 (peer
review) and 766.101 (medical review). Because the trial court extended
the statutory privilege beyond what is provided for in the plain language
of the statute, we conclude it departed from the essential requirements of
law. We therefore grant Castellano's petitions for writ of certiorari and
quash the trial court's discovery orders.
      Petitions granted; orders quashed.

NORTHCUTT and LaROSE, JJ., Concur.

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Opinion subject to revision prior to official publication.

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