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
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
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
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
Oct. 21, 2005).