Wiese v. Riverton Mem'l Hosp., LLC
| Decision Date | 29 November 2022 |
| Docket Number | S-21-0215 |
| Citation | 520 P.3d 1133 |
| Parties | Rebecca A. WIESE and Tyler D. Wiese, individually and as the natural parents and natural guardians of RDW, a minor, Appellants (Plaintiffs), v. RIVERTON MEMORIAL HOSPITAL, LLC, a Delaware business entity, Appellee (Defendant). |
| Court | Wyoming Supreme Court |
Representing Appellants: Robert P. Schuster, Bradley L. Booke, Adelaide P. Myers of Robert P. Schuster, P.C., Jackson, Wyoming. Argument by Mr. Booke.
Representing Appellee: Patrick Murphy of Williams, Porter, Day & Neville, PC, Casper, Wyoming; LaMar F. Jost, Clarissa M. Collier of Wheeler Trigg O'Donnell LLP, Denver, Colorado. Argument by Ms. Collier.
Representing Amicus Curiae, Wyoming Trial Lawyers Association: Grant Lawson, Casper, Wyoming.
Before FOX, C.J., and KAUTZ, BOOMGAARDEN, GRAY, and FENN, JJ.
[¶1] Rebecca A. and Tyler D. Wiese (the Wieses) sued Riverton Memorial Hospital, LLC k/n/a SageWest Health Care-Riverton (Hospital) alleging it violated the (now-repealed) Wyoming Hospital Records and Information Act (Act), Wyo. Stat. Ann. §§ 35-2-605 to 35-2-617.1 Among other things, the Wieses claimed the Hospital failed to provide them the metadata (audit trail) associated with Ms. Wiese's Centricity Perinatal (Centricity) electronic medical record. The district court granted summary judgment to the Hospital and denied summary judgment to the Wieses. It implicitly held audit trails associated with electronic medical records are not medical records or health care information required to be disclosed under the Act. It also determined the Hospital complied with the Act by producing Ms. Wiese's medical records and informing them her Centricity electronic medical record, which was needed to generate the Centricity audit trail, did not exist and/or could not be found. The court denied the Wieses’ motion for additional discovery under Wyoming Rule of Civil Procedure (W.R.C.P.) 56(d) and denied as moot their motion to compel discovery and motion to conduct a joint inspection of the Hospital's Centricity data storage devices. Because we conclude audit trails qualify as "health care information" under the Act and a genuine issue of material fact exists as to whether the Hospital complied with the Act with respect to Ms. Wiese's Centricity electronic record and audit trail, we reverse and remand for further proceedings consistent with this opinion.
[¶2] The Wieses raise four issues, which we restate as three:
1. Did audit trails constitute "health care information" under the Wyoming Hospital Records and Information Act?
2. Did the district court err by concluding no genuine issues of material fact existed regarding whether the Hospital complied with the Act with respect to Ms. Wiese's Centricity electronic record and audit trail?
3. Did the district court err by failing to consider the Wieses’ outstanding motions before ruling on the parties’ summary judgment motions?
[¶3] On the evening of September 24, 2012, Ms. Wiese was admitted to the Hospital's labor and delivery unit for a planned induction of labor. She gave birth to RDW at 9:50 a.m. the next day. He had no respirations, tone, reflexes, or color. RDW was intubated and life-flighted to a hospital in Denver, Colorado, where he was diagnosed with cerebral palsy as a result of "severe hypoxic ischemic encephalopathy"—brain damage caused by lack of oxygen to critical brain structures. Ms. Wiese was discharged from the Hospital on September 26, 2012.
[¶4] At the time of RDW's birth, the Hospital's primary electronic patient medical record software system was Hospital Management System (HMS). The Hospital also collected patient medical data from its labor and delivery unit via Centricity, a proprietary software system developed and owned by General Electric Healthcare and/or General Electric Medical Systems (GE Healthcare). Centricity temporarily stored/saved patient medical data on a primary and a back-up server, both located on-site at the Hospital.
[¶5] Due to data storage limitations on the servers, data on both the primary and backup servers was constantly being overwritten as new data entered the servers. To preserve the data before it was overwritten, Centricity automatically archived the data on each server to a compact disc (CD). When a CD reached its data storage limit and needed to be replaced, Centricity would send an electronic message (a "pop up" box) to the nurses in the labor and delivery unit, informing them the CD needed to be replaced with a new CD. When the nurse removed the CD from the server, he or she would handwrite on the face of the CD the date it was removed and a unique Centricity identification number (Centricity ID), which he or she obtained from GE Healthcare. The Centricity ID identified the day of the year and the year the CD was removed. Before placing a new CD into the server, the nurse would handwrite on its face the date the CD was placed into the server. As a result, each Centricity CD contained, handwritten on its face, the date the CD had been placed into the server, the date it was removed, and the Centricity ID. Each CD was also electronically embedded with the Centricity ID. The Hospital stored these CDs in a locked cabinet in its labor and delivery unit until 2015, when it closed that unit. The CDs are now locked in the Hospital's Information Systems Department.
[¶6] After a patient's labor and delivery, the Hospital would print the patient's Centricity electronic record and scan it into the patient's HMS electronic record. In this case, a nurse printed Ms. Wiese's Centricity electronic record on September 25, a few hours after RDW's birth, and the Hospital's Health Information Management Department scanned the printed Centricity electronic record into her HMS electronic record.
[¶7] In October 2015, about three years after RDW's birth, the Wieses sent medical releases to the Hospital and requested all medical and billing records relating to Ms. Wiese's stay at the Hospital from September 24-26, 2012. In November and December 2016, the Hospital responded by producing a hard copy of Ms. Wiese's HMS electronic record, which included a hard copy of Ms. Wiese's scanned-in Centricity electronic record.
[¶8] The hard copy records revealed that most of the nursing entries (entries made by nurses from their observations rather than entries made automatically by monitoring sensors) in Centricity were not created contemporaneously with the events but rather hours later. For example, the nursing entries appearing on the printed fetal monitoring strip for the period from 8:15 a.m. to 8:20 a.m. on September 25, 2012, were actually created by the nurses between 4:06 p.m. and 4:08 p.m. on September 25, 2012, over five hours after RDW's birth. The printed "Delivery Summary" from Centricity showed blood from the umbilical cord (cord blood) had been "[t]aken," but the Hospital had not produced any laboratory test records or results for the cord blood. The Wieses asked the Hospital whether any pathology slides or tissue samples, such as cord blood, existed. The Hospital informed the Wieses there were no pathology or slides "because the physician did not order any" and stated it had provided them "with the entire hospital chart and record in this ... matter."
[¶9] In February 2018, the Wieses wrote the Hospital claiming it had withheld "[s]ignificant records." They again requested the Hospital send them all medical records relating to Ms. Wiese's stay at the Hospital in September 2012, including the Centricity audit trail. Unlike a paper record, which only reveals the last information entered into the record, an audit trail records and stores information identifying all occasions on which an electronic medical record was accessed, who accessed it, from where, what part of the electronic medical record was viewed, and the content of all entries made in the electronic record, including whether any information was deleted or altered and what information was deleted or altered. Consequently, the information in an audit trail may show if and when the records were supplemented, edited, or deleted.
[¶10] In April 2018, the Hospital responded to the Wieses’ letter, alleging it had provided them copies of all the medical records to which they were legally entitled. With respect to the Wieses’ request for audit trails, the Hospital stated it was not legally obligated to produce them to patients but nevertheless agreed to produce the audit trail associated with Ms. Wieses’ HMS electronic record.2 It informed the Wieses that the HMS audit trail was the only audit trail relating to Ms. Wiese in its possession, custody, and control. It claimed it was unable to produce the audit trail associated with Ms. Wiese's Centricity electronic record (or any of the Centricity record in an electronic format). It explained it had
[¶11] In June 2018, the Wieses filed a complaint against the Hospital alleging it violated the Wyoming Hospital Records and Information Act by failing to provide them all "health care information" concerning Ms. Wiese's labor and delivery, including Ms. Wiese's Centricity audit trail. To the extent the Hospital claimed the electronic information had been deleted or was not accessible, the Wieses asked for a court order allowing them, through their experts, to have access to the Hospital's Centricity servers and other storage devices to attempt to retrieve the requested data. The Hospital answered the complaint, again alleging it had no legal obligation to produce the Centricity audit trail. It also...
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