This article originally appeared in Goldberg Segalla’s Professional Liability Matters. Read the issue here.

Recent medical-malpractice suits have pitted plaintiffs who request their doctors’ personnel records against Pennsylvania’s Peer Review Protection Act, which seeks to keep those records confidential and unflinchingly honest, ensuring quality care.

The Pennsylvania legislature passed the Peer Review Protection Act in 1964 to protect from discovery in legal cases the work and findings of a medical facility’s peer-review committee. But in 2018 the Pennsylvania Supreme Court held in Reginelli v. Boggs that the law did not apply to a supervising professional’s performance file on an emergency-room doctor. And this year, on May 23, the Pennsylvania Superior Court followed Reginelli in the case of Est. of Krappa v. Lyons, D.O., holding that the underacted credentialing files of two treating physicians were fair game for inspection by the plaintiffs.

The Peer Review Protection Act does not shield credentialing materials, the Pennsylvania Superior Court ruled, because the credentialing committee did not qualify as a peer-review committee.

In Krappa, the estate of a patient sued a hospital, a doctor, and others alleging that a delayed cancer diagnosis led to the death of Leonard Krappa. The trial judge in that case granted the plaintiffs’ request for the complete and underacted credentialing files of the two treating physician, but the medical center refused to produce them, arguing that they were protected by the peer-review act.

Reginelli is a medical-malpractice suit brought by the estate of a woman whose family claimed she died because she was misdiagnosed. The dispute stemmed from a January 2011 incident in which Eleanor Reginelli was transported by ambulance to an emergency room for what she described as gastric discomfort. She died of a heart attack several days after the hospital treated and released her.

The justices in the Reginelli case ruled that documents sought by the plaintiffs were only covered under the PRPA if they are generated by “peer review committees” of organizations that are regulated by the state to operate in the health care industry.

The hospital had argued that the credentialing records “were generated for quality improvement purposes and maintained exclusively by the committee” and were therefore protected under the PRPA.

Notably, the Superior Court in Pennsylvania and the Supreme Court in Reginelli made factual determinations that the files at issue consisted of credentialing materials. Health care institutions conducting credentialing and peer review should work with outside counsel to ensure any components of credentialing files that derived from a peer review committee are not produced in discovery. Also somewhat notably, the courts addressing this issue seem to focus on the fact that there were distinct credentialing and peer review committees at the institutions involved. A way to protect credentialing files may be to have consistency between committees or combine them.

Professional Liability Magazine, a collaborative effort of Goldberg Segalla’s Management and Professional Liability Practice Group, examines the latest best practices, emerging developments, and influential court decisions impacting the defense of professional-service providers. Read our latest issue here.