Day on Torts
Statements made in a meeting between defendant hospital and decedent’s family were not privileged and did not fall under the QIC statute.
In Castillo v. Rex, No. E2022-00322-COA-R9-CV (Tenn. Ct App. Oct. 4, 2023), plaintiff filed an HCLA suit after the death of her husband. Her husband died shortly after he was discharged from defendant hospital’s emergency room. The hospital held a Quality Improvement Committee (“QIC”) proceeding to investigate the care decedent received. Sometime thereafter, representatives from defendant hospital met with members of decedent’s family at a CANDOR meeting, where “Plaintiff was advised that Decedent should not have been discharged because the CT scan revealed a bleed.”
During depositions in the HCLA case, defense counsel instructed a physician not to answer questions about statements made at the CANDOR meeting. When plaintiff requested documents used in preparation for the CANDOR meeting, defendant moved for a protective order “to prohibit further inquiry into the nature and contents of all statements made at the CANDOR meeting as direct or indirect discovery of the QIC proceeding itself.” The trial court denied the motion for a protective order, and on interlocutory appeal, that denial was affirmed.
Tenn. Code Ann. § 68-11-272(c) provides a privilege for records, statements, and testimony of a QIC proceeding. Because the “purpose of a QIC proceeding is to allow healthcare organizations and providers a forum in which the actions leading to an unfavorable outcome may be reviewed and analyzed to improve the quality of care provided in the future without fear of legal prosecution for actions already committed,” the legislature found this privilege necessary.
In this case, however, plaintiff was seeking discovery related to a CANDOR meeting, which is a meeting “held with patients or the families following an adverse healthcare event to provide information concerning the details of the care provided and to facilitate an optimal resolution.” While some states have extended privileges to CANDOR meetings, the Tennessee Legislature has specifically not done so. Moreover, plaintiff here was not presented with any kind of confidentiality agreement or notice that what was said would be privileged.
The Court reasoned that CANDOR meetings did not necessitate the privilege applied to QIC meetings, explaining:
The subject matter of the two proceedings is inherently different. QIC proceedings are held to allow healthcare organizations and providers a forum in which the actions leading to an unfavorable outcome may be reviewed and analyzed to improve the quality of care provided in the future without fear of legal prosecution for actions already committed. Neither patients nor families are involved in such proceedings. …Whereas, a CANDOR meeting is held with the patient or the family following an adverse healthcare event to provide information concerning the details of the care provided and to facilitate an optimal resolution. The healthcare facility or the provider holding the meeting determines what information to share.
Because the statements made at the CANDOR meeting were for a totally different purpose than those made at a QIC proceeding, the Court found that the QIC privilege “simply does not apply to statements made at the CANDOR meeting whether or not such statements were based upon information obtained from a QIC proceeding.”
Denial of the protective order was accordingly affirmed.
This opinion was released one year after oral arguments in this case.
Note: Chapter 55, Section 13 of Day on Torts: Leading Cases in Tennessee Tort Law has been updated to include this decision.
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