Romero v. KPH Consolidation, Inc.

166 S.W.3d 212, 48 Tex. Sup. Ct. J. 752, 2005 Tex. LEXIS 427, 2005 WL 1252748
CourtTexas Supreme Court
DecidedMay 27, 2005
Docket03-0497
StatusPublished
Cited by395 cases

This text of 166 S.W.3d 212 (Romero v. KPH Consolidation, Inc.) is published on Counsel Stack Legal Research, covering Texas Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Romero v. KPH Consolidation, Inc., 166 S.W.3d 212, 48 Tex. Sup. Ct. J. 752, 2005 Tex. LEXIS 427, 2005 WL 1252748 (Tex. 2005).

Opinions

Justice HECHT

delivered the opinion of the Court, in which

Chief Justice JEFFERSON, Justice OWEN, Justice O’NEILL, Justice WAINWRIGHT, Justice MEDINA, and Justice GREEN joined.

This is an action against a hospital for negligently delaying a blood transfusion for the plaintiff while he was in surgery, and for malicious credentialing of the surgeon. The trial court rendered judgment on a verdict for the plaintiff on both claims. As the case comes to us, it raises two principal issues, each requiring a bit of explanation at the outset.

The first issue is whether there is any clear and convincing evidence that the hospital acted with malice in credentialing the surgeon — that is, in initially- granting him privileges to practice in the hospital, and then allowing him to retain them. In Texas, by statute, a hospital is not liable for improperly credentialing a physician through its peer review process unless the hospital acts with malice,1 defined (for the time period involved in this case) as actual awareness of, yet conscious indifference to, an extreme risk.2 Proof of malice is made more difficult in this setting because peer review communications and proceedings are generally confidential and privileged [215]*215from disclosure.3 Since the Rules of Evidence prohibit drawing any inference from a claim of privilege in a civil case,4 a phintiff must prove that a hospital acted Thaciously without access to evidence of whathappened, or did not happen, in the eredenialing process. The jury in this case was instructed, at the plaintiffs’ request, that they could find malice only from clear md convincing evidence, and they did so. But the court of appeals determined that there was no evidence of malice.5 We ecnc^ucie that there was no clear and convfr'P^g evidence of malice.

T- a question tliPfr becomes whether judgment can rest on thd jury’s negligence funding. The answer turns on the second issue: whether it was reversible error to allo>w the jury, in apportioning responsibility 'fiar Abe plaintiff’s injuries among the hospital, two pihysiciaas, and a nurse, to consider the hospiifefs alleged malicious credentialing, of which we conclude there was no evidence, along with the hospital’s negligent delivery of blood to the operating room, for which the hospital does not challenge liability here. The jury could logically have thought the hospital responsible to a lesser degree had they been permitted to consider only the hospital’s negligence. The apportionment question, was submitted to the jury in broad form, as required by Rule 277 of the Texas Rules of Civil Procedure “whenever feasible”.6 But broad-form submission cannot be used to put before the jury issues that have no basis in the law or the evidence.7 The significant benefits of broad-form submission neither necessitate nor justify misleading the jury with legally or factually invalid claims. We agree with the court of appeals that the submission of the apportionment question was error, that it probably caused the rendition of an improper judgment, and that complaint of the error was preserved for appeal.8

The court of appeals reversed the judgment of the trial court and remanded the case for a new trial on the negligence claim against the hospital. We affirm.

I

Dr. Merrimon Baker applied to Columbia Kingwood Medical Center in February [216]*2161993 for privileges to practice there as an orthopedic surgeon. Columbia (the business name used by respondent KPH Consolidation, Inc.) is an acute care facility in Kingwood, on the northeast side of Houston, with 155 beds and 360 doctors on staff. Baker had been practicing nearby, at what is now the Cleveland Regional Hospital, just north of Kingwood, where he had been recruited to come from South Carolina in 1989, several months after he had completed his residency and entered private practice. Besides being licensed in Texas and South Carolina, Baker was also licensed in Mississippi, although his application there had initially been denied because he had forged his partner’s and office manager’s names to it.

Baker’s application was considered by Columbia’s peer review committee, the Medical Executive Committee, comprised of doctors on Columbia’s staff whose responsibility it was to determine the qualifications and review the performance of all physicians permitted to practice there. As already noted, Texas law provides that with certain exceptions, the proceedings and records of a peer review committee are confidential and communication's to it are privileged from disclosure.9 The exceptions, insofar as they concern us here, allow peer review committees to share information with each other and with appropriate state and federal agencies, national accreditation bodies, the Texas State Board of Medical Examiners, and other states’ licensing boards.10 Columbia has asserted that privilege in this case". Thus, the record is silent concerning what information the Committee did or did not obtain regarding Baker, and any deliberations it may or may not have had, not only in connection with his original applkWon, but over the more than four years †⅜ he remained at Columbia. From this dui-co, the rules of evidence permit nojiferenee whatever to be drawn.11 Wo do know, however, that the Committee ,yas charged with thoroughly and carefully¡11Véstigating each physician who appE for privileges at Columbia. This invu ~e'i obtaining extensive information from ⅞ v physician contacting licensing age¿leij; health facilities, and o&er physicians w.vo ¾⅞1⅛ have information about tlm applicant, . well as the National Wactitiower Date Bank, to wfeh information regarding the professional eompr ’-neo and/ conduct of physicians ⅛ retired by federal regulation to béReprp ⅛-d,12 and law enforcement agencies, including the federal Drug Enforcement Agency. We also know that after a physician was admitted to practice at Columbia, the Committee was responsible for constantly monitoring and reviewing his or her practice.

If the Committee’s initial investigation of Baker was thorough, it should have revealed that from 1988 to 1993 he had been sued ten times for malpractice. The Committee should have inquired how these suits were resolved, and specifically, whether resolution involved a payment of money. Our record does not reflect how each case was resolved, although it does indicate that’ some cases were resolved favorably to Baker. One lawsuit alleged that in 1990 at Cleveland he had operated [217]*217on the wrong hip of a patient. That suit was settled and dismissed six months after it was filed.

Columbia granted Baker’s application in February 1994. As with all doctors accepted at Columbia, Baker’s privileges were initially provisional and subject to further review. Baker continued to work at Cleveland, where most of his practice was centered. He also had privileges at two other hospitals in the vicinity.

In November 1994, Baker’s office manager, Janet Pickett, told the physician with whom Baker was then associated, Dr. Dan Parkinson, that she suspected Baker was abusing a prescription drug, hydrocodone, marketed as Lortab and Vicodin.

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Cite This Page — Counsel Stack

Bluebook (online)
166 S.W.3d 212, 48 Tex. Sup. Ct. J. 752, 2005 Tex. LEXIS 427, 2005 WL 1252748, Counsel Stack Legal Research, https://law.counselstack.com/opinion/romero-v-kph-consolidation-inc-tex-2005.