Daley v. Teruel
107 N.E.3d 1028, 2018 IL App (1st) 170891 (2018)
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Rule of Law:
Documents created by a healthcare provider solely for the purpose of reporting to a federally certified Patient Safety Organization (PSO) are privileged 'patient safety work product' under the federal Patient Safety and Quality Improvement Act of 2005. This federal privilege expressly preempts state discovery rules that would otherwise compel the documents' disclosure in litigation.
Facts:
- On November 17 and 18, 2013, Rosalie Galmore Jones was a patient at Ingalls Memorial Hospital where she received treatment for her blood glucose levels.
- Ingalls Memorial Hospital had a contract with Clarity Patient Safety Organization (Clarity), a federally certified PSO, to conduct activities to improve patient safety.
- On December 4, 2013, Jones's daughter made an in-person complaint to an Ingalls employee regarding the care Jones received on November 18.
- Following the incident and complaint, Ingalls created several documents, including incident review No. 25472 (created Dec. 5, 2013) and complaint No. 5101 (created Dec. 11, 2013).
- These documents were assembled by Ingalls for the sole purpose of submission to Clarity through its 'Healthcare Safety Zone Portal' to improve patient safety and quality of care.
- The documents were reported to Clarity through this portal.
- Rosalie Galmore Jones died in October 2014.
Procedural Posture:
- Terri Daley, administrator of Jones's estate, sued Ingalls Memorial Hospital and two nurses in the Circuit Court of Cook County, Illinois, for medical malpractice.
- During discovery, Daley requested documents related to the incident, and Ingalls objected, asserting privilege under the federal Patient Safety Act.
- Daley filed a motion to compel production.
- The circuit court ordered Ingalls to produce the documents for an in camera review.
- After reviewing the documents, the circuit court granted Daley's motion in part, ordering Ingalls to produce redacted versions of three documents.
- Ingalls filed a motion for reconsideration, which the circuit court denied.
- To obtain appellate review, Ingalls refused to comply with the production order and requested a finding of 'friendly contempt.'
- The circuit court found Ingalls in contempt and imposed a $1 fine.
- Ingalls (Defendant-Contemnor-Appellant) appealed the contempt order to the Illinois Appellate Court, First District.
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Issue:
Does the federal Patient Safety and Quality Improvement Act of 2005 preempt a state court's discovery order and render documents privileged when they were created by a hospital solely for reporting to a Patient Safety Organization?
Opinions:
Majority - Presiding Justice Burke
Yes. The federal Patient Safety Act preempts the state court's discovery order because the documents at issue qualify as privileged 'patient safety work product.' To encourage voluntary reporting of medical errors, the Act creates a broad privilege for information assembled or developed by a provider for reporting to a Patient Safety Organization (PSO). Based on the unrebutted affidavit from Ingalls's counsel, the court found the documents were created 'solely' for submission to Clarity, a certified PSO, and were in fact reported. The documents are not original medical records, nor were they created to satisfy a separate, mandatory state reporting requirement, as Illinois's adverse event reporting law was not yet implemented. Because the documents meet the statutory definition of patient safety work product, the Act's express preemption clause, which states the privilege applies 'Notwithstanding any other provision of...State...law,' renders the state court's production order invalid.
Analysis:
This decision solidifies the robust protections of the federal Patient Safety Act in Illinois, creating a strong shield against discovery for a hospital's internal quality and safety analyses. It emphasizes that a provider's intent and process are paramount; by demonstrating that documents were created 'solely' for a patient safety evaluation system and reported to a PSO, providers can protect those documents from disclosure in malpractice litigation. While this furthers the Act's goal of encouraging candid self-assessment to improve healthcare quality, it also presents a significant hurdle for plaintiffs seeking to discover a hospital's internal investigation into an adverse event.
