Washington Supreme Court Limits Public Access to Hospital Privileging, Peer Review Documents

Public hospital districts may not disclose certain records created during closed-door meetings about hospital privileging decisions, the Washington Supreme Court recently held in Cornu-Labat v. Hospital Dist. No. 2 Grant Cnty., No. 86842-5, --- P.3d ----, 2013 WL 1490590 (April 11, 2013) (en banc) . The decision also could lead to broader withholding of documents related to the “peer-review” committees that assess patient care.

The case stems from a terminated doctor’s attempts to obtain, under the state Public Records Act (PRA), documents related to his employment at Quincy Valley Medical Center. The hospital twice in 2009 investigated complaints about the doctor’s competency and behavior. Both times, investigators failed to uncover evidence to substantiate the complaints. Still, hospital leaders “remained concerned” about the doctor, and the hospital directed him to seek an evaluation of his fitness-to-practice from the Washington Physician’s Health Plan. After the doctor failed to follow up with that program, the hospital terminated him. The hospital later denied the doctor’s PRA requests for its investigative records about him, asserting that the records were exempt from disclosure under statutory exemptions for certain quality-assurance and peer-review processes.

Although the Washington Supreme Court agreed with the doctor that one of the PRA exceptions relied upon by the hospital did not apply, the court sent the case back to the trial court to reconsider whether other PRA exemptions from disclosure applied. The opinion discusses three provisions affecting disclosure of the underlying records:

The exemption for documents produced by hospital “peer review” committees, which conduct internal investigations. RCW 4.24.250. The PRA exempts from public disclosure records of committees “regularly constituted” to evaluate the quality of patient care or the competency or qualifications of professionals, except for documents related to actions taken in response to such committees’ recommendations. Cornu-Labat holds that this exemption applies even when such committees include “peers” who are not doctors.
A statute that exempts certain records of hospital quality assurance committees. RCW 70.41.200. The law requires hospitals maintain quality improvement committees, and directs that certain records produced or held by those committees are not subject to public disclosure laws. In Cornu-Labat, the court held that the exemption applies only to committees organized for that specific purpose under hospital law; it does not apply more broadly to other committees that might also consider or discuss quality.
A state law that requires public hospital districts to hold certain meetings in secret, exempting them from state open meetings laws. RCW 70.44.062. Generally, Washington law requires public agencies meet openly. But RCW 70.44.062 grants confidentiality to “meetings, proceedings and deliberations” regarding public hospital districts’ professional privileging decisions. In Cornu-Labat, the doctor maintained that this exception only allowed the meeting to be closed to the public, not records related to the meeting. However, the court held this exception also shields from disclosure related records. The court read the statutory term “proceedings” to include the “official record or account” of a meeting: “It would make little sense for the legislature to demand the unqualified confidentiality of these meetings but not the written accounts of what occurred therein.” The court also said that an exemption for public hospital districts was “logical” because private hospitals are not subject to the PRA. The court said that the exemption applied only to official records of formal meetings. The court sent the case back to the trial court to determine whether the hospital withheld any documents that were not official records of a formal meeting—and therefore not exempt from public disclosure.

The court rejected the hospital’s claim that the doctor lacked a PRA right to the documents because he had signed a contract agreeing they would be held confidential. The court found that for the purposes of the PRA request, the doctor is a citizen, not an employee. Under the PRA, the identity of the requester is generally irrelevant. The court also held individual citizens cannot contract away their PRA rights.