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“Original Source” Exception Overcome by Focus on Documents’ Purpose in Peer Review Protection Act Analysis

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An opinion from the Allegheny County Court of Common Pleas helped further shape the Peer Review Protection Act ("the Act") analysis by focusing on hospitals' efforts to improve the care they provide in ways that may not involve a traditional committee. 

In the underlying matter, the plaintiffs alleged that the patient sustained a deep tissue injury during a hospital admission.  After receiving a copy of the incident report, a registered nurse created a chronology of the patient's treatment based on his medical records and the discussions she had with the physicians involved.  Then, with the help of another nurse, she created a re-education plan.  The plaintiffs sought both the chronology and the reeducation plan.  The defendants, however, contended they were protected because they were created in order to improve care.  Judge R. Stanton Wettick, Jr. agreed.

Judge Wettick began with addressing the Act's purpose of protecting candid evaluations of health care providers, which requires confidentiality to allow for a comprehensive, honest assessment.  Documents that contain information that can be found from original sources, such as medical records, are not given the same protections.  Original sources are documents prepared solely in connection with the recording events of a patient's treatment.

Here, however, the original source exception did not apply because the registered nurse testified that it was assumed that she would review any event on her unit, regardless of whether a supervisor directed her to do so.  Judge Wettick noted that each document, "was generated for the purpose of evaluating the conduct of the medical staff and, if necessary, re-educating the staff regarding future procedures."  The fact the documents contained some information from original sources did not mean they were discoverable.  Moreover, although the Act does not define the term "review organization," Judge Wettick pointed to the Superior Court's interchangeable use of the terms "committee" and "individual."  Accordingly, an individual may constitute a review committee on her own.  Therefore, Judge Wettick found that both documents fell within the Act's confidentiality provision based on the nurses' desire to self-assess and re-educate.

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