Director of Health Affairs v. Foic

• Decision Date: 25 August 2009
• Docket Number: No. 18286.,18286.
• Citation: 977 A.2d 148,293 Conn. 164
• Parties: DIRECTOR OF HEALTH AFFAIRS POLICY PLANNING, University of Connecticut Health Center v. FREEDOM OF INFORMATION COMMISSION.
• Court: Connecticut Supreme Court

977 A.2d 148

293 Conn. 164

DIRECTOR OF HEALTH AFFAIRS POLICY PLANNING, University of Connecticut Health Center v. FREEDOM OF INFORMATION COMMISSION.

No. 18286.

Supreme Court of Connecticut.

Argued March 24, 2009.

Decided August 25, 2009.

Trade C. Brown, principal attorney, with whom, on the brief, were Victor Perpetua, principal attorney, and Colleen Murphy, general counsel, for the appellant (defendant).

Jane D. Comerford, assistant attorney general, with whom, on the brief, was Richard Blumenthal, attorney general, for the appellee (plaintiff).

NORCOTT, PALMER, VERTEFEUILLE, ZARELLA and McLACHLAN, Js.

McLACHLAN, J.

The dispositive issue in this appeal is whether certain records held by the plaintiff, the director of health affairs policy planning for the University of Connecticut Health Center,¹ are exempt from disclosure under the freedom of information act (act), General Statutes § 1-200 et seq., pursuant to General Statutes § 19a-17b(d), which protects peer review proceedings from discovery and introduction into evidence in a civil action.² The defendant, the freedom of information commission (commission), appeals from the judgment of the trial court sustaining the plaintiff's appeal from the final decision of the commission.³ On appeal, the commission claims that the trial court improperly concluded that the requested records were exempt from disclosure pursuant to § 19a-17b. The commission also claims that the trial court improperly concluded that four of the requested records were exempt from disclosure pursuant to § 60.13(a) of title 45 of the Code of Federal Regulations.⁴ Because we conclude that § 19a-17b is inapplicable to commission proceedings, and, therefore, that 45 C.F.R § 60.13 is also inapplicable, we reverse the judgment of the trial court.

The final decision of the commission sets forth the following relevant facts and procedure. The complainant, Louis J. Russo, a former patient of Jacob Zamstein, a physician, requested in writing records pertaining to the plaintiff's decision not to renew Zamstein's clinical privileges. In response, the plaintiff produced minutes of four meetings of the clinical affairs subcommittee of the University of Connecticut Health Center board of directors, but declined to produce the remainder of the requested records, which the plaintiff claimed comprised the credentialing file created by the clinical affairs subcommittee and the credentials committee. The complainant then filed a complaint with the commission seeking disclosure of the records pursuant to the act. Following a hearing on the matter, the commission concluded that the plaintiff is a public agency within the meaning of § 1-200(1)(A); the requested records are public records within the meaning of General Statutes §§ 1-210(a) and 1-212(a);⁵ the clinical affairs subcommittee and the credentials committee are medical review committees within the meaning of § 19a-17b(a)(4); and the requested records concern peer review.⁶ The commission also concluded, however, that § 19a-17b(d) is applicable only to "civil actions" and not to proceedings before the commission seeking disclosure pursuant to the act. Therefore, the commission concluded that § 19a-17b(d) does not provide an exemption to mandatory disclosure pursuant to §§ 1-210(a) and 1-212(a). The commission also rejected the plaintiff's claim that four of the requested records — labeled IC-2006-098-20 through IC-2006-098-23 and IC-2006-098-33 — were exempt from disclosure pursuant to 45 C.F.R. § 60.13(a). In rejecting the plaintiff's claim, the commission relied on the last sentence of 45 C.F.R. § 60.13(a), which provides: "Nothing in this paragraph shall prevent the disclosure of information by a party which is authorized under applicable [s]tate law to make such disclosure." Reasoning that the act authorized the plaintiff to make the disclosure, the commission concluded that 45 C.F.R. § 60.13(a) did not provide an exemption to the act.⁷ Accordingly, the commission ordered the plaintiff to provide the complainant with copies of the requested records, with the exception of three records that the commission had determined were exempt from disclosure under § 1-210(b)(10) because those records constituted requests for legal advice and responses thereto.

The plaintiff appealed from the decision of the commission to the trial court, which sustained the appeal, concluding that § 19a-17b(d) constituted an exemption to disclosure under the act. In its analysis, the trial court relied heavily on the public policy reasons underlying the peer review privilege,⁸ namely, "to encourage frank, uninhibited discussion, debate and criticism by the peers of a health care provider" during peer review proceedings, and, by encouraging that level of candor, to improve the quality of patient care. Commissioner of Health Services v. Kadish, 17 Conn.App. 577, 582, 554 A.2d 1097 (O'Connell, J., dissenting), cert. denied, 212 Conn. 806, 563 A.2d 1355 (1989). That purpose, according to the trial court, would be undermined by the disclosure of the records to the complainant. The court also focused on the provision in § 19a-17b(d) that peer review material "`shall not be subject to discovery,'" and concluded that allowing discovery of such material in the context of the act would have a chilling effect on the peer review process. Finally, the court concluded that proceedings of the commission pursuant to the act constitute civil actions for purposes of § 19a-17b(d). The court based its conclusion on the fact that proceedings pursuant to the act are instituted by the filing of a complaint; the commission is authorized to conduct hearings and hear testimony; and the proceedings are governed by various "procedural formalities commonly associated with an action in court." The trial court also concluded that the four records determined by the commission to pertain to information from the national practitioner data bank (data bank) were exempt from disclosure. The trial court reasoned that the information from the data bank was provided solely for the purpose of peer review, and that disclosure to the complainant would violate the requirement of 45 C.F.R. § 60.13(a) that entities that receive information from the data bank must "use it solely with respect to the purpose for which it was provided." Accordingly, the court rendered judgment sustaining the plaintiff's appeal. This appeal followed.

The plaintiff claims that § 19a-17b(d) provides a statutory exemption to mandatory disclosure under the act. The commission contends that § 19a-17b(d) is inapplicable to the act because proceedings pursuant to the act do not constitute civil actions within the meaning of § 19a-17b(d). We agree with the commission.

Section 19a-17b(d) provides in relevant part: "The proceedings of a medical review committee conducting a peer review shall not be subject to discovery or introduction into evidence in any civil action for or against a health care provider arising out of the matters which are subject to evaluation and review by such committee, and no person who was in attendance at a meeting of such committee shall be permitted or required to testify in any such civil action as to the content of such proceedings...." In order to interpret this language to mean that the peer review privilege bars disclosure pursuant to the act, we would have to conclude that the legislature intended the phrase "shall not be subject to discovery ... in any civil action," to include in its meaning "shall not be subject to disclosure ... in any action before the commission." This presents two closely related questions: whether the legislature, in enacting § 19a-17b(d), intended for the term "discovery" to include disclosure pursuant to the act, and intended for the phrase "in any civil action" to include actions before the commission. Both of these are questions of statutory construction and therefore are subject to plenary review. Barton v. Bristol, 291 Conn. 84, 97, 967 A.2d 482 (2009). "General Statutes § 1-2z directs us first to consider the text of the statute itself and its relationship to other statutes. If, after examining such text and considering such relationship, the meaning of such text is plain and unambiguous and does not yield absurd or unworkable results, extratextual evidence of the meaning of the statute shall not be considered." (Internal quotation marks omitted.) Id., at 97-98, 967 A.2d 482. We interpret the words of the statute "according to their ordinary meaning unless their context dictates otherwise." (Internal quotation marks omitted.) State v. Mattioli, 210 Conn. 573, 576, 556 A.2d 584 (1989).

We address each of these questions of statutory interpretation in turn, beginning with the question of whether "discovery" properly may be understood to include disclosure under the act, and taking our starting point, as § 1-2z directs, with the text of the statute. In enacting § 19a-17b(d), the legislature defined its scope in terms of rendering the proceedings of a medical review committee "not ... subject to discovery or introduction into evidence...."⁹ The meaning of "discovery" must be understood as it is employed in the statute, as one of the two circumstances within a civil action in which the privilege comes into play — in other words, "discovery" is best understood in conjunction with the concept of "evidence." Reading these two terms together, the most reasonable understanding of their meaning is that "discovery" refers to the pretrial procedures by which parties attempt to gain access to information held by the opposing party,¹⁰ and "introduction into evidence" refers to the means by which the parties attempt to use the information that they have available to them at the time of trial. This understanding of discovery is consistent with its dictionary definition as including "[t]he pre-trial devices that can be used by one party to obtain facts and information about the case from the...