In re "K"

561 A.2d 1063, 132 N.H. 4, 1989 N.H. LEXIS 62
CourtSupreme Court of New Hampshire
DecidedJuly 14, 1989
DocketNo. 88-086
StatusPublished
Cited by27 cases

This text of 561 A.2d 1063 (In re "K") is published on Counsel Stack Legal Research, covering Supreme Court of New Hampshire primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In re "K", 561 A.2d 1063, 132 N.H. 4, 1989 N.H. LEXIS 62 (N.H. 1989).

Opinions

Souter, J.

The Dartmouth-Hitchcock Medical Center appeals an order of the Superior Court (Morrill, J.) requiring Mary Hitchcock Memorial Hospital to provide a former patient with two documents, a report of the hospital’s nurse epidemiologist and minutes of the hospital’s Infections Committee, each addressing the possibility that the patient contracted herpes while in the hospital. We hold the report and minutes privileged against disclosure under RSA 151:13-a (Supp. 1988) and reverse.

The plaintiff, who has been designated by the letter "K” to preserve anonymity, was admitted to the maternity section of Mary Hitchcock Memorial Hospital in Hanover on August 2, 1986, and gave birth to a child the following day. On August 7, two days after her discharge, K experienced pain while urinating. Although a physician’s examination revealed no more than redness where an episiotomy had been performed, blisters appeared in the genital area over the course of the next three days, and a second physician who examined K on August 12 said the blisters appeared to be [6]*6symptoms of herpes. A culture was then taken, as was another on August 14, after which the herpes infection was confirmed. K had not been so diagnosed previously.

K’s husband happened to be employed by the hospital at the time and was sufficiently familiar with its organization to know that its nurse epidemiologist, Nancy Watkins, customarily made enquiries into the origins of infections that might arguably have been communicated within the hospital. Accordingly, on August 15, he met with Mrs. Watkins, told her about the diagnosis, and described three unsanitary conditions observed during K’s hospital stay that he thought might be, or indicate, the source of her infection: a container of another patient’s urine had been left in the lavatory K shared; insects had been found floating in a bath in which K had soaked to mitigate her labor pains; and ice packs used during the episiotomy had not, he suspected, been adequately cleaned. He later testified, subject to Mrs. Watkin’s denial, that he asked whether another maternity patient during K’s admission had been infected with herpes, K having told him about the suspiciously bandaged leg of a woman in a nearby room where K had attended a group discussion. K’s husband also claimed, and Mrs. Watkins also denied, that he asked her to incorporate the results of her enquiry into the record of K’s medical treatment.

Mrs. Watkins proceeded to conduct an investigation that included a test of K’s blood, interviews with K’s two treating physicians and the head of the maternity nursing unit, and an examination of K’s medical record. In the meantime, one of K’s treating physicians prescribed medication for the infection.

Although Mrs. Watkins testified that she had probably told K’s husband that she would report back to him in some fashion, it was not her practice to make reports to patients and she decided against doing so in this case. She planned, instead, to advise one of K’s treating physicians of anything that might appropriately be communicated to K, and otherwise to report only to the hospital’s Infections Committee, as in the normal course. On August 29, 1986, however, K herself called Mrs. Watkins to ask what she had learned. K testified that Mrs. Watkins told her the hospital had admitted a patient with herpes during K’s stay, but that the patient’s symptomatic leg had been wrapped. Mrs. Watkins denied this and testified that, as a matter of courtesy, she told K she had determined that none of the three conditions mentioned by K’s husband indicated a probable source of infection, and told her nothing else about the investigation. In any event, Mrs. Watkins thereafter reported her findings to the Infections Committee at its [7]*7September 1986 meeting, as reflected in its minutes, and prepared a written report, now retained in files kept in her own office.

In 1987, K’s lawyer requested the hospital, through Mrs. Watkins, to release the results of the investigation. When the hospital claimed a privilege under RSA 151:13-a (Supp. 1988) and refused, K brought the instant petition in the superior court seeking a disclosure order. The superior court found the statute ambiguous and expressive of no clear legislative intent to create a privilege for the records of any hospital committee except one established to promote “quality assurance.” Having found that the hospital had a quality assurance committee separate from the Infections Committee, the trial court held the privilege inapplicable and ordered disclosure of Mrs. Watkin’s written report and the relevant portion of the minutes of the Infections Committee’s September 1986 meeting. The hospital appealed.

The principal issue being the applicability of the statutory privilege to the documents in question, our first concern is with the words of the statute:

“151:13-a Proceedings of Hospital Committees; Confidentiality.
“I. As used in this section ‘records’ means records of interviews and all reports, statements, minutes, memoranda, charts, statistics, and other documentation generated during the activities of a quality assurance committee. Records shall not mean original hospital medical records or other records kept relative to any patient in the course of the business of operating a hospital.
“II. Records of a hospital committee organized to evaluate matters relating to the care and treatment of patients or to reduce morbidity and mortality and testimony by hospital trustees, medical staff, employees, or other committee attendees relating to activities of the quality assurance committee shall be confidential and privileged and shall be protected from direct or indirect means of discovery, subpoena, or admission into evidence in any judicial or administrative proceeding, except that in the case of a legal action brought by a quality assurance committee to revoke or restrict a physician’s license or hospital staff privileges, or in a proceeding alleging repetitive malicious action and personal injury brought against a physician, a committee’s records shall be discoverable.
[8]*8“HI. A hospital board of directors or trustees may waive its privilege under this section and release information or present committee records by discovery, subpoena, or admission into evidence in any judicial or administrative proceeding.
“IV. No hospital, trustees, medical staff, employees, or other committee attendees shall be held liable in any action for damages or other relief arising from the providing of information to a hospital committee or in any judicial or administrative proceeding.”

Thus, subject to exceptions not relevant here, the provisions of paragraphs I and II create a privilege against disclosure of records “generated during the activities” of a hospital committee “organized to evaluate matters relating to the care and treatment of patients or to reduce morbidity and mortality,” and paragraph II provides further for a privilege against evidentiary admissibility of the testimony, as such, of “committee attendees relating to activities of the quality assurance committee.”

Although the statute’s drafting is imprecise, we do not perceive any ambiguity as between the references to a “quality assurance committee” and a “hospital committee organized to evaluate . . . care . . . and reduce” risk.

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Cite This Page — Counsel Stack

Bluebook (online)
561 A.2d 1063, 132 N.H. 4, 1989 N.H. LEXIS 62, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-k-nh-1989.