Hayes v. Mercy Health Corp.

• Decision Date: 01 October 1999
• Citation: 739 A.2d 114,559 Pa. 21
• Parties: Timothy J. HAYES, M.D., Appellee, v. MERCY HEALTH CORPORATION, t/a Mercy Catholic Medical Center a/k/a Fitzgerald Mercy Hospital, Appellant.
• Court: Pennsylvania Supreme Court

739 A.2d 114

559 Pa. 21

Timothy J. HAYES, M.D., Appellee, v. MERCY HEALTH CORPORATION, t/a Mercy Catholic Medical Center a/k/a Fitzgerald Mercy Hospital, Appellant.

Supreme Court of Pennsylvania.

Argued April 28, 1999.

Decided October 1, 1999.

Brian M. Peters, Jonathan B. Sprague, Philadelphia, for Mercy Health Corp.

Richard A. Sprague, Geoffrey R. Johnson, Joseph R. Podraza, Jr., Philadelphia, for Timothy Hayes, M.D.

Before FLAHERTY, C.J., and ZAPPALA, CAPPY, CASTILLE, NIGRO, NEWMAN and SAYLOR, JJ.

OPINION

SAYLOR, Justice.

The issue before us is whether the confidentiality provision of the Peer Review Protection Act ("the Act"), 63 P.S. §§ 425.1-425.4, applies to an internal hospital proceeding in which a physician challenges his own peer review process. We conclude that it does not, and therefore affirm the trial court.

In October of 1995, Appellant Mercy Catholic Medical Center ("the Hospital") summarily suspended the clinical privileges of Appellee Timothy J. Hayes, M.D. ("Dr. Hayes"), a general surgeon. The apparent basis of the Hospital's action was, in its words, "a serious issue involving patient care" that resulted in a medical malpractice action. Dr. Hayes requested a hearing before a peer review panel, as was his right under the Hospital's bylaws. Numerous procedural complications ensued, leading both parties to seek relief from the trial court. In July of 1997, after hearings had been held, the peer review panel unanimously recommended that the suspension be terminated "because the facts [of the underlying case] do not support suspension."

Pursuant to the bylaws, the panel forwarded its recommendation to the Hospital's Medical Board. At a meeting that was held in September of 1997, and recorded on audiotape, the Medical Board approved the panel's recommendation with one change: instead of stating that the facts "do not support suspension," the Medical Board stated that the facts "[do] not support continued suspension" (emphasis added). The Medical Board sent its recommendation to the Hospital's Board of Directors for final action at its next meeting, scheduled for September 25, 1997.

Dr. Hayes sought to challenge the Medical Board's recommendation because he feared that the Board, by advising against "continued" suspension, was implying that the initial suspension had been appropriate. In addition, a confidential source had allegedly informed him that some members of the Medical Board had acted in bad faith in making such recommendation. Wishing to learn what had transpired at the Medical Board's meeting, Dr. Hayes asked the trial court to enjoin the Hospital from destroying the tape recording of the meeting and to order the Hospital to furnish a copy of the tape to him. The Hospital agreed to preserve the tape, but refused to provide a copy to Dr. Hayes. When the trial court ordered it to do so, the Hospital filed a notice of appeal with the Commonwealth Court, along with an emergency application for a stay of the trial court's order.

On September 25, 1997, the Commonwealth Court granted a temporary stay. That same day, the Hospital's Board of Directors voted to accept the recommendation of the Medical Board and reinstate Dr. Hayes' clinical privileges. In an unreported opinion filed July 14, 1998, the Commonwealth Court quashed the Hospital's appeal as moot, noting that Dr. Hayes had obtained the reinstatement of his privileges and that the Board of Directors' decision to that effect was not subject to further hearing or review. The Hospital filed a petition for allowance of appeal, Dr. Hayes joined in that request, and allowance of appeal was granted.¹

Preliminarily, we observe that the Commonwealth Court erred in concluding that the present appeal is moot. Although Dr. Hayes' clinical privileges have been restored, his record continues to reflect a lengthy suspension of those privileges. Pursuant to the federal Health Care Quality Improvement Act of 1986 ("HCQIA"), 42 U.S.C. §§ 11101-11152, the Hospital is required to supply information concerning Dr. Hayes' suspension to a national data bank, and any hospital at which Dr. Hayes may seek employment or clinical privileges in the future will be required to review the information contained in the data bank.² See 42 U.S.C. §§ 11133(a), 11135(a); see generally Susan L. Horner, The Health Care Quality Improvement Act of 1986: Its History, Provisions, Applications and Implications, 16 AM. J.L. & MED. 455 (1990). Thus, the failure of the Hospital's Board of Directors to state that Dr. Hayes' initial suspension, not merely his "continued" suspension, was unwarranted may, if left unchallenged, continue to have a deleterious effect on Dr. Hayes' medical career. See Cooper v. Delaware Valley Med. Ctr., 539 Pa. 620, 628-29, 654 A.2d 547, 551 (1995)

(noting that "[f]inding gainful employment in the hospital setting after a poor review is unlikely as a result of the provisions of the [HCQIA]"). Because our resolution of the matter at issue will have a practical effect on Dr. Hayes' ability to challenge the Board of Directors' decision, and thus on Dr. Hayes' professional future, this appeal is not moot. See Sonder v. Sonder, 378 Pa.Super. 474, 521, 549 A.2d 155, 179 (1988) (en banc) (stating that case is moot when determination sought could not have any practical effect on existing controversy).³

At issue is the following provision of the Act:

The proceedings and records of a review committee shall be held in confidence and shall not be subject to discovery or introduction into evidence in any civil action against a professional health care provider arising out of the matters which are the subject of evaluation and review by such committee....

63 P.S. § 425.4 ("Section 4"). In the interpretation of a statute, our overriding concern is to ascertain and effectuate the legislature's intent in enacting the statute. 1 Pa.C.S. § 1921(a); Pennsylvania Financial Responsibility Assigned Claims Plan v. English, 541 Pa. 424, 430, 664 A.2d 84, 87 (1995); Cooper, 539 Pa. at 632, 654 A.2d at 553. When the words of a statute are clear and free from ambiguity, the drafters' intent is to be gleaned from those words. 1 Pa.C.S. § 1921(b); English, 541 Pa. at 430, 664 A.2d at 87. We may not disregard the letter of the statute under the pretext of pursuing its spirit. 1 Pa. C.S. § 1921(b); Cooper, 539 Pa. at 632, 654 A.2d at 553. Significantly, Section 4 precludes the disclosure of peer review proceedings and recordings in certain specified circumstances, namely, in "civil action[s] ... arising out of the matters which are the subject of evaluation and review by such committee." These are words of limitation; "had the legislature intended the privilege to be absolute, it could have simply left these words out of the statute." Sanderson v. Frank S. Bryan, M.D., Ltd., 361 Pa.Super. 491, 498, 522 A.2d 1138, 1142 (1987), appeal denied, 517 Pa. 624, 538 A.2d 877 (1988). Dr. Hayes contends that, as his internal challenge to the Medical Board's recommendation did not arise out of the matters which were the subject of evaluation and review by the peer review committee, Section 4 does not preclude him from obtaining a copy of the tape recording of the Medical Board's deliberations.⁴ We agree.

In the present case, the subject of the peer review proceeding was the quality of medical care provided by Dr. Hayes to a particular patient. If, as in fact happened, the patient in question were to sue Dr. Hayes and/or the Hospital to recover damages for Dr. Hayes' allegedly substandard care, the confidentiality provision of Section 4 would apply, as such a lawsuit would "arise out of" the matter—the quality of care rendered by Dr. Hayes—which was the subject of the peer review proceeding.⁵ See Sanderson, 361 Pa.Super. at 501, 522 A.2d at 1143 (holding that Section 4 precludes medical malpractice plaintiff from discovering peer review information related to his own and other patients' cases).

Dr. Hayes' challenge to the proceeding, however, did not arise out of that substantive issue of patient care. In his emergency petition seeking preservation of the tape, Dr. Hayes asserted the following:

It is believed and therefore averred that the revision in Dr. Hayes' recommendation [from the conclusion that the facts did not support suspension, to the conclusion that the facts did not support continued suspension] was unlawfully and improperly accomplished through coercion condoned and promoted by the Hospital. Moreover, it is believed and therefore averred that evidence of this coercion (and, hence, unmitigated subversion of Dr. Hayes' minimum due process rights) exists on the tape employed to record the Medical Board's meeting.

Dr. Hayes' counsel expanded on these allegations at the hearing on his request for the tape, where he maintained that "[unnamed persons] who were present at [the] Medical Board meeting ... have made it clear that there were some physicians there with ulterior motives, in fact, two physicians who are responsible for the summary suspension...." The ulterior motive of those physicians, according to Dr. Hayes' counsel, was "fabricating a record to protect themselves" against an eventual lawsuit alleging the destruction of Dr. Hayes' professional reputation.⁶ In short, Dr. Hayes' concern was not the underlying medical matter which led to his suspension, but rather the fairness and integrity of the Medical Board's review of that suspension.

As the Superior Court has pointed out, it was a similar concern on the part of the legislature which led it to reject a more comprehensive draft of Section 4. Sanderson, 361 Pa.Super. at 500, 522 A.2d at 1143. That draft provided as follows:

All data and information acquired by a review organization, in the exercise of its duties and functions, shall be held in confidence and shall not be disclosed to any person except to the extent that may be necessary to carry out the purposes of the review organization and shall not be

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