On March 27, 2018, the the Supreme Court of Pennsylvania sent every emergency medicine contracting group scrambling to ensure their peer-review processes were comporting with the laws in their respective states. Taking a very strict interpretation of the Pennsylvania Peer Review Protection Act (PRPA), the court held that the emergency medicine contracting group, UPMC Emergency Medicine, Inc. (ERMI), did not qualify as a “professional health care provider” under the PRPA and was thus not given the evidentiary privilege afforded by the state’s peer-review statute.
The court ruling stems from the medical malpractice action of Reginelli v Boggs. The clinical story is a seemingly familiar one in emergency medicine, whereby a patient presents to the emergency department with epigastric discomfort, returning later with a misdiagnosed myocardial infarction. The issues soon turned from the basic elements of a negligence claim to the discoverability of peer-review material. During a deposition, it became apparent that Brenda Walther, MD, the ED director, maintained a “performance file” on the physicians in the group, including the defendant, Marcellus Boggs, MD. The plaintiffs filed a motion to compel production of the performance file, which was allowed by virtue that “ERMI, as an independent contractor, is not an entity enumerated in the PRPA as being protected by peer review privilege.”
The PRPA articulates that “peer review” is undertaken and protected by “professional health care providers,” which are defined as those “individuals or organizations who are approved, licensed, or otherwise regulated to practice or operate in the health care field under the laws of the Commonwealth.”1 Among the 12 protected individuals or organizations listed in the act, two are “a physician and a corporation or other organization operating as a hospital.”1