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U.S. Court In Michigan Finds Peer Review Documents Not Relevant To EMTALA Claim


HLD, v. 33, n. 12 (December 2005)

U.S. Court In Michigan Finds Peer Review Documents Not Relevant To EMTALA Claim


A federal court in Michigan found that a medical malpractice plaintiff could not circumvent a state statute barring discovery of peer review documents because he failed to show the documents were relevant to his Emergency Medical Treatment and Labor Act (EMTALA) claim.


Alfred Stringfellow visited the emergency room at Oakwood Hospital (hospital) after having chest pains and other problems. It was discovered that Stringfellow drank and took cocaine, so after being counseled on substance abuse and given Ativan for anxiety, Stringfellow was released. Stringfellow died the next day.


Plaintiff, Stringfellow's personal representative, sued the hospital alleging violations of EMTALA and asserting state negligence and medical malpractice claims against the hospital and treating physician.


During discovery, plaintiff sought the hospital's Emergency Department policies and procedures, any "quality improvement plan for the Emergency Department," the hospital's Medicare provider agreement, and certain peer review documents. The hospital objected and plaintiff filed a motion to compel.


The U.S. District Court for the Eastern District of Michigan granted the motion in part and denied it in part. The court first held that the emergency department policies and procedures were relevant and likely to lead to admissible evidence and therefore were discoverable. The court found next that plaintiff's request for a quality improvement plan was "ambiguous and irrelevant" and therefore was not discoverable. The court similarly found the hospital's Medicare provider agreement to be irrelevant and not discoverable.


Turning to the issue of the peer review materials, the court found that discovery of the materials was barred by Michigan's Public Health Code and Peer Review privilege. Plaintiff argued that, even though the state law barred discovery of the peer review materials, the materials sought were relevant to the EMTALA claim and therefore federal law should govern the discovery request. But the court was not persuaded that the peer review materials were relevant to the EMTALA claim.


The sole issue in the instant EMTALA claim, the court noted, was whether Stringfellow was diagnosed with an emergency condition, a fact that should be contained in the medical records. A hospital's duty under EMTALA does not arise until an emergency medical condition is diagnosed--here the court noted that plaintiff's own expert submitted an affidavit that stated that the hospital did not diagnose any emergency medical condition and therefore was guilty of negligence.


"The hospital's failure to diagnose any underlying cause of decedent's symptoms or to detect an emergency condition cannot serve as the basis for a violation of EMTALA's stabilization requirements," the court held. Accordingly, the court held the peer review documents were not discoverable.


Stringfellow v. Oakwood Hosp. and Med. Ctr., NO. 03 CV 75188 DT (E.D. Mich. Oct. 21, 2005).


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