Patient care information shared by physicians for the purpose of improving health care quality and safety could lose its protected status in a case that could be heard before the Supreme Court of the United States.
What’s at stake
Where physicians now freely share patient safety information without fear of liability in support of higher quality health care, the Kentucky-based case Tibbs v. Bunnell could allow this data to be released for use in lawsuits.
Health care professionals now are asking the highest court in the land to overturn a Kentucky Supreme Court ruling that would lift confidentiality protections in place under the federal Patient Safety and Quality Improvement Act of 2005 (PSQIA) for data that is collected in patient safety systems.
PSQIA gives physicians and other health care providers a confidential way to share information related to patient safety events through a patient safety organization (PSO). Information submitted to a PSO is meant to be used for improving care quality and safety without threat that the information will be used against the physicians involved.
If upheld, the Kentucky court’s decision “will stifle the collection and use of ‘patient safety work product,’ and frustrate one of the fundamental purposes of the act—to provide a nationwide repository where adverse health care outcomes can be studied and corrected,” physicians said in a friend-of-the-court brief filed by the Litigation Center of the AMA and State Medical Societies.
The case’s origins
The issue began when a patient died while being treated for a medical condition at a University of Kentucky hospital, and the patient’s estate brought a medical liability suit against the hospital. The hospital submitted an incident report to a PSO so the incident could be analyzed and added to the database, but the patient’s estate asked for production of the incident report as part of litigation discovery.
The hospital argued that the incident report was privileged under the PSQIA, but a trial court ruled that it wasn’t. The case wound its way up to the Kentucky Supreme Court, which reasoned that the PSQIA didn’t protect this information because records of this sort are required to be created under state law, even if they aren’t actually submitted to a state regulatory agency. The hospital now is asking the U.S. Supreme Court to take up the case.
Not the only threat
Tibbs v. Bunnell isn’t the only case that seeks to release data at the heart of patient safety efforts. A similar case now is making its way through the Florida court system.
In Southern Baptist Hospital of Florida, Inc. v. Charles, a Florida court ordered a hospital to produce patient safety work product documents as part of litigation discovery. The hospital has appealed this ruling.
This past week, the Michigan Supreme Court upheld hospitals’ privilege in another similar case, Krusac v. Covenant Medical Center. The case dealt with protecting confidential incident reports from discovery, in this case prepared in conjunction with peer review processes.
Visit the AMA Litigation Center Web page to learn more about these cases and others related to patient safety.
