On December 13, 2012, a newborn was delivered via C-section by a physician at the Scranton Quincy Hospital Company LLC. Despite the surgical means of delivery, the child suffered an acute hypoxic ischemic brain injury (P91.60) that ultimately resulted in permanent disability. The parents of the child decided to take legal action against the obstetrician and hospital, alleging that the provider failed to diagnose and treat a placental abruption. Prior to the birth, the plaintiffs claim that there were warning signs preluding the need for an emergency C-section which were ignored by hospital staff.

This case catalyzed a contemporary discussion regarding the use and accessibility of physician records/materials used in medical malpractice cases under the Peer Review Protection Act (PRPA). 63 P.S. §§425.1 – 425.4.

Brett C. Shear, Associate at Marshall, Dennehey, Warner Coleman, & Goggin describes PRPA as:

“The Peer Review Protection Act is an important Pennsylvania statute that aims to provide an incentive for health care providers, practice groups and hospitals to police themselves by seeking peer review when something goes wrong. The statute provides that the proceedings and records of a review committee shall not be subject to discovery or introduction into evidence in any civil action against the health care provider, practice group or hospital. It further provides that no person who was in attendance at a peer review committee meeting shall be permitted or required to testify in any civil action as to the proceedings of the committee or as to any findings, recommendations, evaluations, opinions or other actions of the committee.”

This act protects records submitted for peer review with an umbrella of confidentiality, so that the information cannot be used against physicians in litigation proceedings. Over the course of its 40-year lifespan, the Act’s protections have been narrowing steadily. Such is the case in the conflict described earlier in this post, Vaccaro v. Scranton Quincy Hospital Company, LLC. Plaintiffs are seeking documents from the defendant’s credentials file. Of course, the defendant declares protection under the PRPA – a move that was ultimately appealed.

Honorable Judge Nealon was given the responsibility of determining the validity and admissibility of each party’s claims. Through comparing preceding cases, Nealon determined that while physician performance reviews are protected under the PRPA; the defendant physician’s medical claims history records and medical charting warning letters must be disclosed in the court of law. The defendants were instructed to produce the aforementioned records, but were granted discretion in providing evaluation reports as they remained protected under the Act.

What does this mean for the future of PRPA? It may be safe to assume that the scope of the protection act will continue to narrow, limiting physician protection where peer reviewed documents are concerned.