Burton v. University of Iowa Hospitals & Clinics

566 N.W.2d 182, 1997 Iowa Sup. LEXIS 199, 1997 WL 330965
CourtSupreme Court of Iowa
DecidedJune 18, 1997
Docket96-1535
StatusPublished
Cited by28 cases

This text of 566 N.W.2d 182 (Burton v. University of Iowa Hospitals & Clinics) is published on Counsel Stack Legal Research, covering Supreme Court of Iowa primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Burton v. University of Iowa Hospitals & Clinics, 566 N.W.2d 182, 1997 Iowa Sup. LEXIS 199, 1997 WL 330965 (iowa 1997).

Opinion

LAVORATO, Justice.

At issue in this appeal is whether Iowa Code section 135.41 (1993) gives an in-hospital staff committee of a state hospital discretion to deny public inspection of records regarding summaries of nosocomial infections (infections that a person contracts while a patient at the hospital). Assuming the statute does give such discretion, we are then faced with the question whether such hospital must allow public inspection of the summaries pursuant to Iowa Code chapter 22, Iowa’s open records law. Contrary to the district court’s decision, we hold that the statute does indeed grant the in-hospital staff committee discretion to deny public inspection of the summaries. We further hold that chapter 22 does not supersede such discretion notwithstanding that the summaries are public records.

We therefore reverse the district court’s grant of summary judgment to the party seeking inspection of the summaries. We remand for entry of summary judgment in favor of the hospital’s motion and for an order dismissing the petition of the party seeking inspection.

The University of Iowa Hospitals and Clinics (UIHC) collects data on nosocomial infections that arise at the hospital. As mentioned, nosocomial infections are those that a person contracts while a patient at the hospital. Nosocomial infections can be caused in many ways, including lack of adequate hand washing, improper sterilization of medical instruments and devices, improper treatment of water, use of invasive procedures, or utilization of new medical devices and instruments. The Infection Control Subcommittee (ICS) at the hospital monitors and controls access to the nosocomial infection data.

On June 19, 1994, Karen Burton wrote to Dr. Richard Wenzel, who was then Chair of the ICS. In her letter Burton requested “immediate access to all records of rates of nosocomial infections at UIHC from 1990 through the most recent period for which records exist.” The letter further stated: “This request is made under Iowa Code chapter 22 and excludes only those records identified as confidential in section 22.7, paragraph 2.”

The same day Burton wrote to University of Iowa Vice-President Ann Rhodes, mentioning earlier conversations with hospital officials. The letter stated:

On June 17, when I asked William Hesson on what basis UIHC refused to release infection rate information to the public, he cited Iowa Code sections 135.40-135.42. I have enclosed a copy of those sections for your review.
Far from restricting public access to public records, the sections cited by Hes-son are permissive; they allow the release of otherwise confidential records to a nar *184 rowly defined population for narrowly defined purposes. As such, sections 135.40-135.42 have no relevance to my request under Iowa Code chapter 22, Examination of Public Records.

The ICS’s senior assistant director, William W. Hesson, denied Burton’s June 19 request made to Wenzel. Hesson’s letter of denial to Burton, dated June 23, stated:

Dr. Wenzel has forwarded to me your recent letter requesting release of records of rates of nosocomial infections. As I informed you during our conversation earlier this month, it is the position of the UIHC that these records, consisting of information provided to an in-hospital staff committee to be used in the course of studies for the purpose of reducing morbidity and mortality, are strictly confidential pursuant to §§ 135.40-.42, Code of Iowa (1993).
I have also forwarded your request to the Office of the Attorney General for further review of your request and our position.

Hesson was also, at all relevant times, assistant director of legal services for the UIHC. On July 8 Burton called assistant attorney general Maureen McGuire. On July 28 McGuire wrote Hesson:

Your letters to Karen Burton regarding her request for access to the records on the rates of nosocomial infections have been forwarded to me for response.
I agree with you that under Iowa Code section 135.41 information that has been obtained for the purpose of studies to reduce morbidity and mortality is available only for medical research and education. However, Iowa Code section 135.41 does provide that “a summary of such studies may be released by any such group for general publication.” Such studies shall not include the identity of any person included in the study. In view of that provision, the hospital can make available to Ms. Burton a summary of any such studies.
The determination whether to prepare and make public a summary is within the discretion of the hospital. The statute does not require that a summary be prepared or that it be released to the public. Certainly, there are policy issues that you will want to take into account in making the determination.

After speaking with McGuire, Burton researched the exact types of data the UIHC had on nosocomial infections. Burton then renewed her request via a September 15 letter:

I request access to all statistical summaries, in the custody of the UIHC, of data on nosocomial infections, collected by the program of hospital epidemiology pursuant to the UIHC Infection Control Policy No. 107. This request is made under the authority of Chapter 22, Examination of Public Records, Iowa Code (1993) and should not be construed to include any request for access to any patient records or identities designated as confidential in Code section 22.7(2) or section 135.41.
This request includes but is not limited to access to all monthly, quarterly, and yearly summaries distributed by the program of hospital epidemiology pursuant to Policy No. 107 and which present nosoco-mial infection incidence densities by site and/or organism for each hospital unit surveyed.

In a September 30 letter to Burton, Hes-son denied her latest request, again citing the data’s alleged confidentiality pursuant to Iowa Code sections 135.40-.42. The letter cites the UIHC’s reasons for keeping the data confidential:

The success of [the UIHC Program of Hospital Epidemiology] is highly dependent on the cooperation and support of the physicians, nurses and other caregivers whose care is subject to surveillance by the program. In turn, this support is dependent on our ability to provide assurances that the information obtained by the program will be kept confidential. I am unwilling to jeopardize the program, and thus the safety of patients, by authorizing the release of the information you have requested. The General Assembly has recognized this important link between confidentiality and patient safety and enacted sections 135.40-.42.

*185 Several months later, Burton filed this suit requesting an injunction, pursuant to Iowa Code section 22.10, ordering the UIHC to comply with Iowa’s Open Records Act (Iowa Code chapter 22). She later amended her petition to include requests for cost, damages, and attorney fees.

The UIHC answered, admitting refusal of disclosure, but denying a violation of chapter 22.

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Bluebook (online)
566 N.W.2d 182, 1997 Iowa Sup. LEXIS 199, 1997 WL 330965, Counsel Stack Legal Research, https://law.counselstack.com/opinion/burton-v-university-of-iowa-hospitals-clinics-iowa-1997.