Alexander v. Superior Court

Decision Date14 October 1993
Docket NumberNo. S026431,S026431
Citation859 P.2d 96,23 Cal.Rptr.2d 397,5 Cal.4th 1218
CourtCalifornia Supreme Court
Parties, 859 P.2d 96, 62 USLW 2296 Shirley ALEXANDER et al., Petitioners, v. The SUPERIOR COURT of Los Angeles County, Respondent; Shaik M. SAHEB et al., Real Parties in Interest.

Louise A. Lewis, Pasadena, Donald E. Werner, Van Nuys, Girardi and Keese and James B. Kropff, Los Angeles, for petitioners.

No appearance for respondent.

Early, Maslach & Price, Los Angeles, Horvitz & Levy, David M. Axelrad and David S. Ettinger, Encino, for real parties in interest.

Catherine I. Hanson, Kimberly S. Davenport, Christine R. Hall, Wilbur F. Littlefield, Public Defender, Los Angeles, and John Hamilton Scott, Deputy Public Defender, as amicus curiae on behalf of real parties in interest.

LUCAS, Chief Justice.

Petitioners are plaintiffs in a medical malpractice action. Real parties in interest (defendants in the underlying action) are various physicians and the Granada Hills Community Hospital (Granada Hills or Hospital). Petitioners sought to discover from Hospital the physicians' applications and reapplications for staff privileges at Granada Hills. The trial court declined to order discovery, and petitioners sought writ relief in the Court of Appeal. That court--without affording real parties an opportunity for oral argument--filed a decision directing issuance of a peremptory writ of mandate in the first instance, and further directing respondent court to enter an order compelling Hospital to produce the requested documents.

We conclude the Court of Appeal erred by processing the writ application under the expedited procedure authorized in Code of Civil Procedure section 1088 (see Palma v. U.S. Industrial Fasteners, Inc. (1984) 36 Cal.3d 171, 203 Cal.Rptr. 626, 681 P.2d 893 [hereafter Palma ] ), instead of the usual alternative writ procedure. We also conclude Evidence Code section 1157--which protects from discovery the "records" of a hospital's medical staff committee--bars the discovery order. Accordingly, we reverse the judgment of the Court of Appeal.

I. Facts and Procedure

Petitioners Shirley Alexander and her husband, Morris Rubin, filed a complaint against real parties Dr. Shaik M. Saheb (and six other physicians) and Granada Hills. 1 They asserted Alexander was subjected to negligent medical treatment by Dr. Saheb and other physicians, and prayed for damages.

Petitioners sought discovery from Hospital consisting of, inter alia, "any and all applications" by Drs. Saheb and others for medical staff privileges at Granada Hills. 2 Hospital disclosed certain requested documents but declined to deliver the applications for staff privileges on the ground those documents are privileged under Evidence Code section 1157.

Petitioners unsuccessfully moved the superior court for an order directing Hospital to disclose the documents, and thereafter sought a writ of mandate in the Court of Appeal to direct the trial court to order discovery. The Court of Appeal requested opposition and advised the parties it would consider whether to grant the petition and direct that a peremptory writ of mandate issue in the first instance pursuant to Palma, supra, 36 Cal.3d 171, 203 Cal.Rptr. 626, 681 P.2d 893. Real parties opposed the petition on the merits, and further asserted they had a right to oral argument before the court could grant relief.

Without holding oral argument, the Court of Appeal issued a decision granting the writ in the first instance. Following the holding in Hinson v. Clairemont Community Hospital (1990) 218 Cal.App.3d 1110, 267 Cal.Rptr. 503 (hereafter Hinson ), the court concluded Evidence Code section 1157 protects only those documents generated by a medical staff committee, and does not protect documents submitted to a medical staff committee. The court also concluded there is no statutory or constitutional right to oral argument when a court is considering whether to issue a peremptory writ in the first instance. We granted review to address both issues.

II. Analysis
A. Whether the Court of Appeal properly processed the writ application under the expedited procedure authorized by Code of Civil Procedure section 1088

In Palma, supra, 36 Cal.3d 171, 203 Cal.Rptr. 626, 681 P.2d 893, we outlined the procedure under which a court may issue a peremptory writ in the first instance (Code Civ.Proc., § 1088) in lieu of the usual alternative writ procedure (id., § 1087). We noted that Code of Civil Procedure section 1088 "requires, at a minimum, that a peremptory writ of mandate or prohibition not issue in the first instance unless the parties adversely affected by the writ have received notice, from the petitioner or from the court, that the issuance of such a writ in the first instance is being sought or considered. In addition, an appellate court, absent exceptional circumstances, should not issue a peremptory writ in the first instance without having received, or solicited, opposition from the party or parties adversely affected." (36 Cal.3d at p. 180, 203 Cal.Rptr. 626, 681 P.2d 893.) We also made clear that a peremptory writ in the first instance should not issue unless "it appears that the petition and opposing papers on file adequately address the issues raised by the petition, that no factual dispute exists, and that the additional briefing that would follow issuance of an alternative writ is unnecessary to disposition of the petition." (Id., at p. 178, 203 Cal.Rptr. 626, 681 P.2d 893.)

Recently, in Ng v. Superior Court (1992) 4 Cal.4th 29, 13 Cal.Rptr.2d 856, 840 P.2d 961, we cautioned that the accelerated procedure authorized in Code of Civil Procedure section 1088, and described in Palma, supra, 36 Cal.3d 171, 203 Cal.Rptr. 626, 681 P.2d 893, "is the exception; it should not become routine. Generally, that procedure should be adopted only when petitioner's entitlement to relief is so obvious that no purpose could reasonably be served by plenary consideration of the issue--for example, when such entitlement is conceded or when there has been clear error under well-settled principles of law and undisputed facts--or where there is an unusual urgency requiring acceleration of the normal process. If there is no compelling temporal urgency, and if the law and facts mandating the relief sought are not entirely clear, the normal writ procedure, including issuance of an alternative writ (see Palma, supra, at pp. 177-178, 203 Cal.Rptr. 626, 681 P.2d 893), should be followed." (Ng, supra, 4 Cal.4th at p. 35, 13 Cal.Rptr.2d 856, 840 P.2d 961.)

Nothing in the record suggests any "unusual urgency" justifying expedited resolution of petitioners' writ application. And, as explained below (post, pp. 400-403 of 23 Cal.Rptr.2d, 99-102 of 859 P.2d), the Court of Appeal could not legitimately have concluded that petitioners' "entitlement to relief [was] so obvious that no purpose could reasonably be served by plenary consideration of the issue," or that the matter involved "conceded or ... clear error under well-settled principles of law...." (Ng v. Superior Court, supra, 4 Cal.4th at p. 35, 13 Cal.Rptr.2d 856, 840 P.2d 961.) In fact, we conclude petitioners are not entitled to relief, and that the Court of Appeal erred by entertaining petitioners' writ application under Code of Civil Procedure section 1088. 3

B. Evidence Code section 1157

Evidence Code, section 1157, subdivision (a) (hereafter section 1157(a)) states: "Neither the proceedings nor the records of organized committees of medical ... staffs in hospitals, or of a peer review body ... having the responsibility of evaluation and improvement of the quality of care rendered in the hospital, ... shall be subject to discovery." (Italics added.) 4

This provision raises the issue whether applications and reapplications for staff privileges are "records" of medical staff committees under section 1157(a). To answer this question, we briefly review the statutory and administrative scheme that governs the operation of hospitals in this state.

Hospitals have a dual structure. First, an administrative governing body (often comprised of persons other than health care professionals) takes ultimate responsibility for the quality and performance of the hospital. Second, an "organized medical staff" entity (composed of health care professionals) has responsibility for providing medical services, and is "responsible to the governing body for the adequacy and quality of the medical care rendered to patients in the hospital." (Cal.Code Regs., tit. 22, § 70703, subd. (a); see also id., § 70701(a)(1)(F); Bus. & Prof.Code, § 805.5.)

The medical staff entity is required to perform various functions (e.g., "executive review, credentialing, ... utilization review, infection control") through one or more committees. (Cal.Code Regs., tit. 22, § 70703, subd. (d).) State regulations require that medical staff committees have "formal procedures for the evaluation of staff applications and credentials, appointments, reappointments, [and] assignment of clinical privileges ..." (Id., tit. 22, § 70703, subd. (b)), and that applicants and reapplicants for hospital privileges must "demonstrate their ability to perform surgical and/or other procedures competently and to the satisfaction of an appropriate committee or committees of the staff, at the time of original application for appointment to the staff and at least every two years thereafter." (Id., tit. 22, § 70701, subd. (a)(7).)

Given the statutory and regulatory scheme, it is clear that applications for staff privileges are the province of the hospital's medical staff committee. (California Eye Institute v. Superior Court (1989) 215 Cal.App.3d 1477, 1482-1483, 264 Cal.Rptr. 83; Peer Review Confidentiality, supra, 24 Santa Clara L.Rev. 661, 670.) Although a hospital's administrative governing body makes the ultimate decision about whether to grant or deny staff privileges, it does so based on the...

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