Texarkana Memorial Hospital, Inc. v. Jones

• Decision Date: 20 April 1977
• Docket Number: No. B-6279,B-6279
• Citation: 551 S.W.2d 33
• Parties: TEXARKANA MEMORIAL HOSPITAL, INC. d/b/a Wadley Hospital, Relator, v. Honorable Guy JONES, Judge, et al., Respondents.
• Court: Texas Supreme Court

Page 33

551 S.W.2d 33

TEXARKANA MEMORIAL HOSPITAL, INC. d/b/a Wadley Hospital, Relator, v. Honorable Guy JONES, Judge, et al., Respondents.

No. B-6279.

Supreme Court of Texas.

April 20, 1977.

Rehearing Denied May 18, 1977.

Atchley, Russell, Waldrop & Hlavinka, Victor F. Hlavinka, Texarkana, for relator.

Bader, Wilson, Menaker, Cox & Branson, Frank L. Branson, Dallas, Kronzer, Abraham & Watkins, W. James Kronzer and James Edward Robinson, Houston, for respondents.

REAVLEY, Justice.

Texarkana Memorial Hospital seeks a writ of mandamus to compel Honorable Guy Jones, Judge of the 202nd Judicial District, to withdraw his discovery order which requires the Hospital to produce the minutes of meetings of various Hospital groups. The question presented is the applicability and scope of Article 4447d, section 3, Vernon's Ann.Civ.St. Hospital asserts that this statute precludes discovery of all of the meeting minutes which it has been ordered to produce. Elton Tracy Reppond et al The Repponds instituted suit against Hospital and two doctors of the Hospital staff for injuries suffered by Elton Wayne Reppond, their infant son. The infant was born several weeks premature and was taken to Hospital where he allegedly was rendered blind due to prolonged overdoses of oxygen. The Repponds, pursuant to Rule 167, Texas Rules of Civil Procedure, sought discovery of the following items:

plaintiffs in the suit where the discovery of the records has been ordered, argues that this statutory provision does not apply to documents relevant to the issues of a personal injury or wrongful death suit, or that if the statute is applicable, an exception provided in the statute permits discovery as ordered by the District Judge. We agree with the Hospital.

"I. The minutes of all Pediatric Section Meetings from;

(a) January 1, 1971 to August 10, 1973;

(b) August 10, 1973 to July 30, 1975;

(c) July 30, 1975 to present time.

"II. The minutes of any other section meeting in which discussions occurred relative to blindness caused by excessive oxygen, the blood gas machine, or pertaining to drawing blood from patients in the nursery.

"III. The minutes of any other Pediatric Section meetings in which discussion occurred relative to the events which transpired during the treatment of Elton Wayne Reppond.

"IV. The minutes from the meetings of the General Medical Staff from:

(a) January 1, 1971 to August 10, 1973;

(b) August 10, 1973 to July 30, 1975;

(c) July 30, 1975 to present time.

"V. The minutes of the Board of Directors meetings concerning the purchase of equipment and facilities in the nursery."

The trial court, after a hearing and in-camera inspection of the materials, found that the items were records made by the medical staff of Hospital in accordance with hospital policy and were records maintained in the regular course of business. The trial court also found that Art. 4447d § 3 did not make the items privileged so as to preclude discovery. In conclusion the trial court stated that it was of "the opinion that in the case at bar such items are not protected from discovery and that the need for the production of said items, documents and things is of sufficient gravity and concern so as to justify a determination by the appellate court as to their discoverability. . . ."

Article 4447d, § 3 [Acts 1969, 61 St.Leg., p. 1719, ch. 568] provides as follows:

Sec. 3. The records and proceedings of any hospital committee, medical organization committee or extended care facility committee established under state or federal law or regulations or under the bylaws, rules or regulations of such organization or institution shall be confidential and shall be used by such committee and the members thereof only in the exercise of the proper functions of the committee and shall not be public records and shall not be available for court subpoena; provided, however, that nothing herein shall apply to records made or maintained in the regular course of business by a hospital or extended care facility. No physician, hospital, organization, or institution furnishing information, data, reports, or records to any such committee with respect to any patient examined or treated by such physician or confined in such hospital or institution shall, by reason of furnishing such information, be liable in damages to any person. No member of such a committee shall be liable in damages to any person for any action taken or recommendation made within the scope of the functions of such committee if such committee member acts without malice and in the reasonable belief that such action or recommendation is warranted by the facts known to him.

The Repponds argue that this 1969 enactment of the Legislature should be given a construction limited by the purpose of the statute which it amended. Article 4447d is entitled "Providing State Department of Health with Data on Condition and Treatment of Persons." Sec. 1 of that statute authorizes the release of information on the condition and treatment of patients to the State Department and other medical organizations for use in the study of diseases or for identification of persons needing immunization. It protects those persons providing this information from common law liability for unauthorized disclosure of information pertaining to the patients. Sec. 2 of the statute requires the organizations receiving the information to publish it only for the purpose of advancing medical research or education, and the identity of any person whose condition or treatment has been studied is to be confidential except for the purpose of identifying those persons who may be in need of immunization. It follows, according to the argument of the Repponds, that the restriction of Sec. 3 was intended by the Legislature to serve only a very limited purpose: the Legislature intended to exempt medical organizations from liability to the individual patient about whom information is collected while those organizations are engaged in medical research and education. For purposes of research and education the medical organizations are free to use the information and may not be forced to disclose it in a manner that would be objectionable to the individual patient. The Repponds conclude that there is no prohibition in this statute against a patient discovering information from the staff and committee deliberations which might be relevant to his grievances against the medical facility or its staff.

We do not read the provisions of the 1969 amendment (Sec. 3) as being applicable only to the manner and purpose of dissemination of information among medical organizations. The purposes of medical research and education, and the improvement of medical treatment, in any particular hospital or medical care facility is served by the free and uninhibited discussion of all events and experiences within the hospital or facility. The Legislature by this amendment must have intended to protect and encourage open and thorough review and investigation by making the records and proceedings of any such committee confidential and by expressly providing that they "shall not be available for court subpoena."

The Repponds also contend that the documents sought to be discovered come within the exception of Sec. 3 which allows discovery of "records made or maintained in the regular course of business." It is undisputed that the minutes of standing committees, clinical sections, general staff, and Board of Directors of Hospital are kept by the custodian of Hospital's records in the same manner as all other records. This construction asserted by the Repponds would have the Legislature specifically forbidding discovery of committee proceedings and then allowing their discovery because these minutes are kept with other records of the Hospital. It is not necessary to construe the enactment of the Legislature to be self-defeating. The clinical charts and other records made or kept for the individual patient can be easily distinguished from the minutes of Hospital committees.

We see it to be our responsibility to apply this statute exactly as the Legislature has written it. If the "records and proceedings of any hospital committee" are confidential and beyond the reach of court subpoena, then the deliberations of every group of persons constituted by the rules and bylaws of the hospital in its service is placed behind the veil. This includes the clinical departments, the standing committees, the general medical staff, and the Board of Directors. The proviso which permits discovery of "records made or maintained in the regular course of business" applies to the records kept in connection with the treatment of the individual patients as well as the business and administrative files and papers apart from committee deliberations. Hood v. Phillips, 537 S.W.2d 291 (Tex.Civ.App.1976, writ granted); Karp v. Cooley, 493 F.2d 408 (5th Cir Nothing that is said in the statute or in this opinion would prevent the proof or discovery of matters otherwise permitted over the objection that such evidence has been previously presented to the Hospital committee. The presentation of evidence or opinion to a Hospital committee during its deliberations does not thereby make that evidence or opinion privileged if offered or proved by means apart from the record of the committee. The effect of the statute is simply to prevent the discovery and use of the records and proceedings of the committee.

1974); Hall, Hospital Committee Proceedings and Reports: Their Legal Status, 1 American Journal of Law and Medicine, 245, 274 (1975). The writing to the contrary in French v. Brodsky, 521 S.W.2d 670, 676 (Tex.Civ.App.1975, writ ref'd n. r. e.) is disapproved.

We therefore hold that the statute prevents discovery of all of the items within the order of the trial court. The order must therefore be withdrawn. No writ need be issued unless the trial court fails to comply with this order.

McGEE and JOHNSON dissent...