Matchett v. Superior Court

• Decision Date: 11 July 1974
• Citation: 40 Cal.App.3d 623,115 Cal.Rptr. 317
• Court: California Court of Appeals Court of Appeals
• Parties: Laurence E. MATCHETT, Petitioner, v. SUPERIOR COURT of the State of California FOR the COUNTY OF YUBA, Respondent; Malcolm L. PETWAY et al., Real Parties in Interest. Civ. 14362.

Page 317

115 Cal.Rptr. 317

40 Cal.App.3d 623

Laurence E. MATCHETT, Petitioner, v. SUPERIOR COURT of the State of California FOR the COUNTY OF YUBA, Respondent Malcolm L. PETWAY et al., Real Parties in Interest.

Civ. 14362.

Court of Appeal, Third District, California.

July 11, 1974.

As Amended July 25, 1974.

Freitas, Allen, McCarthy, Bettini & MacMahon by Richard V. Bettini, San Rafael, for petitioner.

Hassard, Bonnington, Rogers & Huber, San Francisco, Leonard & Lyde, Oroville, Albert B. Norris, Stockton, Terence J. Keeley, Yuba City, Bledsoe, Smith, Cathcart, Johnson & Rogers, San Francisco, Lawrence Handelman, Burlingame, argued, for real parties in interest.

FRIEDMAN, Acting Presiding Justice.

Petitioner Matchett is plaintiff in a medical malpractice action. Two of the defendants are Dr. Malcolm L. Petway and the Rideout Memorial Hospital. The complaint alleges that Matchett, a patient in the hospital, suffered injuries resulting from negligent treatment by the doctor and from the hospital's negligence in admitting and retaining the doctor on its staff without adequate inquiry into or controls over his competence.

Matchett sought pretrial discovery of hospital and staff records pertaining to Dr. Petway's selection and retention, as follows: the hospital's 'personnel and/or staff file,' the files of the credentials committee of the hospital staff, its executive committee, its tissue committee and its records committee. Assigning Evidence Code section 1157 as authority, the superior court denied the discovery request in its entirety ¹. Matchett seeks a writ of mandate directing the superior court to order discovery.

According to current judicial policy, reviewing courts will entertain applications for prerogative writs to control discovery, but only sparingly and to review questions of first impression and general importance. (Rudnick v. Superior Court (1974), 11 Cal.3d 924, 114 Cal.Rptr. 603, 523 P.2d 643, filed July 5, 1974.) We issued an order to show cause because Evidence Code section 1157 had not been construed in any reported decision. (See, however, American Mutual Liability Ins. Co. v. Superior Court (1974), 38 Cal.App.3d 579, 597, 113 Cal.Rptr. 561.)

Section 1157 specifies that the records of a medical staff committee are immune from discovery when the committee has 'the responsibility of evaluation and improvement of the quality of care rendered in the hospital . . ..' In passing upon the claim of immunity, a court must have before it facts which allow it to match the staff committee's mission and function against the specifications of the statute. The trial court record in the present case is seriously flawed. The burden of establishing entitlement to nondisclosure rested with the party resisting discovery, not the party seeking it. (Sierra Vista Hosp. v. Superior Court (1967), 248 Cal.App.2d 359, 365, 56 Cal.Rptr. 387.) Thus the moving papers of Matchett, the plaintiff, supplied only a cursory description of the medical staff committees whose records he wanted to see. In resisting discovery, defendant Petway presented no facts at all. He filed only an argumentative memorandum declaring: 'The documents sought are clearly not subject to discovery and are privileged pursuant to Evidence Code section 1157.'

In the present proceeding defendant Petway, as real party in interest, rests his case upon the sparse facts revealed by his opponents' papers. Courts should be reluctant to lighten the burden of the party claiming nondisclosure, since he has superior access to the facts surrounding his claim of exemption. Nevertheless, we are not disposed to pivot our decision on inadequate draftsmanship. It is more vital that the statute be fulfilled. We avail ourselves of Evidence Code section 452, subdivision (h), to take judicial notice of nationwide, generally accepted standards describing the organization and functions of medical staffs and medical staff committees in accredited hospitals. ²

I

It is at once apparent that the trial court's order was too sweeping. The medical staff immunity described in section 1157 extends to, first, the proceedings, and second, the records of the described staff committees. It does not embrace the files of the hospital administration (as distinguished from staff). The trial court should have inquired into the existence of a hospital administration file concerning the doctor and, if such a file existed, should have permitted its inspection, excluding any portions which reflected the proceedings of staff committees conforming to the specifications of the immunity statute.

II

Petitioner points to that portion of section 1157 (fn. 1, supra) which declares: 'The prohibition relating to discovery or testimony shall not apply . . . to any person requesting hospital staff privileges . . ..' He views this exception as a limitation which makes the immunity inoperative in a lawsuit charging the hospital with negligent selection or retention of 'any person requesting hospital staff privileges.'

The contention rests upon an interpretation which is inconsistent with the statute's objective. In an accredited hospital, the organized medical staff is responsible to the hospital governing body for the quality of in-hospital medical care; it evaluates the qualifications of applicants and holders of staff privileges; it recommends appointment, reappointment, curtailment and exclusion from staff privileges; it provides peer group methods for reviewing basic medical, surgical and obstetrical functions. (Accreditation Manual: Governing Body and Management, p. 6; Medical Staff, pp. 5--7; Medical Record Services, p. 3.) When medical staff committees bear delegated responsibility for the competence of staff practitioners, the quality of in-hospital medical care depends heavily upon the committee members' frankness in evaluating their associates' medical skills and and their objectivity in regulating staff privileges. Although composed of velunteer professionals, these committees are affected with a strong element of public interest.

California law recognizes this public interest by endowing the practitioner-members of hospital staff committees with a measure of immunity from damage claims arising from committee activities. (Civ.Code, § 43.7; Ascherman v. San Francisco Medical Society (1974), 39 Cal.App.3d 623, 114 Cal.Rptr. 681.) Evidence Code section 1157 expresses a legislative judgment that the public interest in medical staff candor extends beyond damage immunity and requires a degree of confidentiality. It was enacted in 1968 in apparent response to this court's decision in Kenney v. Superior Court (1967), 255 Cal.App.2d 106, 63 Cal.Rptr. 84. There we sustained a malpractice plaintiff's claim to discovery of hospital staff records which might reveal information bearing upon the competence of the defendant doctor. In Kenney only the doctor was a defendant, not the hospital. Nevertheless, a public policy question was raised by malpractice plaintiffs' access to medical files revealing committee investigations and appraisals of their peers. Section 1157 was enacted upon the theory that external access to peer investigations conducted by staff committees stifles candor and inhibits objectivity. ³ It evinces a legislative judgment that the quality of in-hospital medical practice will be elevated by armoring staff inquiries with a measure of confidentiality.

This confidentiality exacts a social cost. Because it impairs malpractice plaintiffs' access to evidence. In a damage suit for in-hospital malpractice against doctor or hospital ⁴ or both, unavailability of recorded evidence of incompetence might seriously jeopardize or even prevent the plaintiff's recovery. Section 1157 represents a legislative choice between competing public concerns. It embraces the goal of medical staff candor at the cost of impairing plaintiffs' access to evidence.

The statute, then, is aimed directly at malpractice actions in which a present or former hospital staff doctor is a defendant. The statutory exception for 'any person requesting hospital staff privileges' cannot be construed as plaintiff contends. To all appearances the exception was designed to set the immunity to one side and to permit discovery in suits by doctors claiming wrongful or arbitrary exclusion from hospital staff privileges. (See, e.g., Willis v. Santa Ana etc. Hosp. Assn. (1962), 58 Cal.2d 806, 26 Cal.Rptr. 640, 376 P.2d 568; Ascherman v. San Francisco Medical Society, supra, 39 Cal.App.3d 623, 114 Cal.Rptr. 681; 17 Stan.L.Rev. 900.)

IV

We examine each of the affected staff committees to ascertain whether it fits the statutory description: '. . . having the responsibility of evaluation and improvement of the quality of care rendered in the hospital . . ..'

CREDENTIALS COMMITTEE: According to petitioner's supporting declaration, the credentials committee screens applicants for staff privilege, collects information concerning the applicants' competence and submits its recommendations to the staff executive committee and the hospital board of directors. The Joint Commission's description goes beyond petitioner's. The credentials committee has the additional task of periodic appraisal of all information regarding the competence of incumbent staff members and of making recommendations for reappointment and assignment to various departments and clinical services. (Accreditation Manual, Medical Staff, p. 6; Guidelines, pp. 38--39.) Thus the credentials committee's inquiries and records reflect not only the applicant's training and activity before he served in the hospital, but also incumbent staff members' experience within the hospital.

RECORDS COMMITTEE: Petitioner's declaration and the Joint Commission's published standards contain compatible descriptions of the records committee. All significant clinical information must be incorporated in each patient's medical record, which then becomes a basic...