KAREN SALEBA, CT, AND THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, INC. V. EXECUTRIX OF THE ESTATE OF NORMA LUANN SOARD AND JOSEPH SOARD; INDIVIDUALLY AND AS NEXT FRIEND AND GUARDIAN OF AMBER HATTER, AMANDA HATTER, AND AUSTIN HAMMONDS
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*UyrrMr (~Vurf
of
KAREN SALEBA, CT,
AND
THE GOOD SAMARITAN HOSPITAL
OF CINCINNATI, OHIO, INC.
V.
ON APPEAL FROM COURT OF APPEALS
CASE NO. 2008-CA-001200
BOONE CIRCUIT COURT NO. 06-CI-00338
HONORABLE JAMES R. SCHRAND,
JUDGE, BOONE CIRCUIT COURT
APPELLEES
AND
BARBARA YVETTE FISER, AS
EXECUTRIX OF THE ESTATE OF
NORMA LUANN SOARD AND
JOSEPH SOARD ;
INDIVIDUALLY AND AS NEXT
FRIEND AND GUARDIAN OF
AMBER HATTER, AMANDA HATTER,
AND AUSTIN HAMMONDS
OPINION OF THE COURT BY JUSTICE ABRAMSON
AFFIRMING
Karen Saleba and The Good Samaritan Hospital of Cincinnati, Ohio
(hereinafter Saleba), petitioned the Kentucky Court of Appeals for a writ
prohibiting Judge James Schrand of the Boone Circuit Court from requiring
them to disclose various peer review documents relating to Saleb~i's
interpretation of certai
pap smear specimen and Saleba's proficiency Gas a.
cytotechnologist . The Court of Appeals denied the writ, finding that Saleba had
failed to demonstrate that the trial court was acting outside of :its jurisdiction
or about to act erroneously . Arguing primarily that the trial court erred in
applying Kentucky law as opposed to (Ohio law to determine whether the peer
review documents were privileged, Salebea now appeals to this Court as a
matter of right. Kentucky Const. § 1. 10(2)(a) ; CR 76.36(7)(ay Because the trial
court did not act erroneously in applying Kentucky law or in ordering the GTood
Samaritan Hospital to produce the relevant peer review documents, the Court
of Appeals properly denied Saleba's petition for a writ . Therefore, tt
Court of
Appeals decision is affirmed and Saleba's request for a writ is denied .
RELEVANT FACTS
In this medical malpractice case, Barbara Yvette Fiser, as the Executrix
of the Estate of Norma Luann Soard, filed suit against several treating
physicians, technologists, hospitals, and healthcare organizations on February
21, 2006, claiming that the defendants collectively failed to properly diagnose
and treat Soard for cervical cancer, resulting in her untimely death . The
particular facts underlying this appeal involve the interpretation of Soard's pap
smear, which, Fiser contended, would have revealed Soard's cervical cancer if it
had been read properly. On June 8, 2000, Dr. Hooshang Silanee, an
obstetrician-gynecologist licensed to practice medicine in Kentucky, performed
a pap smear on Soard in his Kentucky office . After Dr. Silance couriered
Soard's pap smear specimens to K lborne Medical Laboratories, Inc ., located in
Covington, Kentucky, Kilborne then sent the specimens to the Good Samaritan
Hospital in Cincinnati, Ohio . On or about ,June 20, 2000, Karen Saleba, a
cytotechnologist employed by Good Samaritan, interpreted Soard's specimens
as negative for cervical cancer. Five years later, Soard was diagnosed with
cervical cancer and died soon thereafter . As one basis for this medical
malpractice action, Fiser claims that Saleba misinterpreted Soard's June 8,
2000 pap smear specimens.
On January 9, 2008, Fiser served Saleba with a formal discovery request.
Saleba objected to four of the requests, Numbers 1., 2,
and 17 . These
requests read as follows :
1 . Please produce copies of any and all documents
concerning or related to any and all slides which
were misinterpreted by Karen Saleba . (See
Deposition of Karen P . Saleba, CT, at page 23) .
2 . Please produce copies of any and all documents
regarding Quality Assurance Reviews of Karen
Saleba (Id . at page 25)
3 . Please produce copies of any and all documents
regarding Ms. Saleba's monthly proficiency tests
(MIME) and the results for tests administered by
DHL, CAP, ASC, and/or any other entity, during
her employment with Good Samaritan /TriHealth
(Id . at page 34-35) .
17 . Please produce a copy of the incident report(s)
related to Ms. Saleba's interpretation of Norma
Luann Soard's pap smear of June 2000, possibly by
Dr. Farnum (Id . at page 175) .
Saleba conten.ded that those documents were protected by Ohio's Peer Review
Statute, R.C . § 2305.252, which states that peer review documents "shall not
be subject to discovery or introduction in evidence in any civil action against a
health care entity or health care provider . . . ." Fiser disagreed that Ohio-law
applied, and on March 3, 2008, filed a motion to compel Saleba to produce the
requested documents . Saleba opposed this motion to compel and requested a
protective order from the trial court.
On April 22, 2008, the trial court held a hearing on these motions . On
May 22, 2008, the trial court entered its order holding that Kentucky law, not
Ohio law, applied to this case . The trial court concluded that Kentucky's Peer
Review Statute, KRS 311. .377, permits the discovery of peer review documents
in medical malpractice suits and that Saleba was required to comply with
Fiser's discovery requests. Specifically, the trial court ordered Saleba to
produce a
(1)
(2)
(3)
(4)
(5)
copy of documents concerning or related to
slides misinterpreted by Saleba;
copy of documents regarding Quality Assurance
Reviews of Saleba;
copy of documents regarding Saleba's monthly
proficiency tests (MIME) and the results for tests
administered by DHL, CAP, ASCP and/or any
other entity during her employment with Good
Samaritan Hospital/ TriHealth;
copy of items in Saleba's personnel file from
TriHealth and Good Samaritan Hospital
regarding her interpretations of pap smear
specimens for the diagnosis and/or treatment of
patients with cervical dysplasia and/or cervical
cancer; and
copy of the incident report(s) related to Saleba's
interpretation of Norma Soard's pap smear of
June 2000, if such report exists .
The court's order provided for the redaction Wany personal itiforrnation in the
produced material, including but not limited to name, address, date of birth,
social security number or other information which could be used to identify
individuals . . . ." The trial court also ordered that all of Saleba's peer review
records would be kept confidential .
Following the entry of this order, Saleba sought a writ of prohibition from
the Kentucky Court of Appeals in order to prevent the production of these
documents . On December 29, 2008, the Court of Appeals denied this writ,
finding that Saleba had failed to show that the trial court was acting outside its
jurisdiction or about to act erroneously . On appeal to this Court, Saleba
argues that the trial court acted erroneously by applying Kentucky law to this
medical malpractice case; that Ohio law, which prohibits the discovery of peer
review documents, should have been applied; and that even if the trial court
correctly applied Kentucky law, this Court should overrule Sisters of Charity
Health Systems, Inc v . Raikes, 984 S .W .2d 464 (Ky. 1998), which holds that
Kentucky's peer review privilege does not extend to medical malpractice suits .
Agreeing with the Court of Appeals that the trial court correctly applied
Kentucky law and properly ordered Saleba to produce the peer review
documents, we affirm .
ANALYSIS
Whether to grant or deny a writ of prohibition is within the sound
discretion of the court with which the petition is filed . Haight v. Williamson,
833 S .W-2d 821, 823 (Ky . 1992) . Thus, an appellate court ultimately reviews
that decision for an abuse of discreti on . Newell Enter rises, Inc v. Bowliljg,
158 S .W .3d 750, 754 (Ky. 200,5) . In Hoskins v . Maricle, 150 S .W .3d 1, 10 (Ky .
2004), this Court explained that
.[a] writ of prohibition may be granted upon a showing
that (1) the lower court is proceeding or is about to
proceed outside of its jurisdiction and there is no
remedy through an application to an intermediate
court; or (2) that the lower court is acting or is about
to act erroneously, although within its jurisdiction,
and there exists no adequate remedy by appeal or
otherwise and great injustice and irreparable i11jury
will result if the petition is not granted .
Saleba argues that her case falls into the second class of writs, contending that
the trial court acted erroneously by applying Ohio law, that she has no
adequate remedy by appeal, and that she will suffer an irreparable injury
without a writ. Although Saleba is correct that "there will rarely be an
adequate remedy on appeal if the alleged error is an order that allows
discovery," Sowders v. Lewis, 241 S .W.3d 319, 323 (Ky. 2007), she has
nonetheless failed to prove that the trial court acted erroneously by applying
Kentucky law.
I. Kentucky Law Applies to Determine the Admissibility of the Allegedly
Privileged Communications .
In ordering Saleba to comply with Fiser's discovery requests, the trial
court in this instance held that because "there are significant contacts to
warrant the application of Kentucky law and because Kentucky has made the
policy decision that such [peer review] records should be discoverable" in
medical malpractice cases, Kentucky law, and not Ohio law, should apply. On
appeal to this Court, Saleba argues that the trial court erred because in
Kentucky, the appropriate conflict of laws test. i s not- whether there are m-ly
sufficient, contacts with the forum state, but rather, which state has the most
significant contacts with. the communication, an approach Saleba rcpreselits is
set forth in the Restatement (Second) of Conflict of Laws (1.971) . Although Fiser
argues that Kentucky has only applied the Restatement approach in con tract
disputes, Sa.leba contends that Kentucky has never limited the "most
significant relationship" test articulated in the Restatement to contract disputes
and that it should be applicable to decide the conflict of laws issue in this case.
First and foremost, Kentucky has consistently applied § 188 of the
Restatement (Second) of Conflict of Laws to resolve choice of law issues that
arise in contract disputes. Section 188(l) of the Restatement, which is found in
Chapter Eight, entitled, "Contracts," and in Topic One, entitled "Validity of
Contracts and Rights Created Thereby," states in its entirety: "The rights and
duties of the parties with respect to an issue in contract are determined by the
local law of the state which., with respect to that issue, has the most significant
relationship to the transaction and the parties under the principles stated in §
6 ." Restatement (Second) Conflict of Laws § 188(l) (1971) (emphasis added) Kentucky has ample case law explaining that the "any significant contacts" test
applies to tort actions, whereas the Restatement's "most significant contacts"
test applies to contract disputes. Foster v. Leggett, 484 S .W .2d 827, 829 (Ky .
1972) (holding that in tort cases, "significant contacts-not necessarily the
most significant contacts" permit the application of Kentucky law) ; Breeding v.
Massachusetts Indemnity and Life Ins. Co ., 633 S.W .2d 717, 719 (Ky. 1982)
(holding that in disputes involving the "validity of
contract . . . It1he modern
test is which state has the most significant relationship to the transaction and
the parties") ; BonnIander v . Leader Nat. Ins . Co ., 949 S .W .2d 618, 620 (Ky .
App. 1996) (explaining that in tort actions, "any .significant. contact, with
Kentucky [i]s sufficient to allow Kentucky law to be applied," whereas in
contract actions, "the law of the state with the greatest interest in the OLACOrne
of the litigation should be applied") ;
Brewster xn Colgate-Palmolive Co ., 279
S .W .3d 142, 145, n . 8 (Ky. 2009) (applying Kentucky law in an asbestos
exposure case because of "significant contacts" with Kentucky even though the
plaintiff was exposed when he worked at the defendant's Indiana plant) .
Although Kentucky case law indicates that different choice of law rules
apply to tort actions versus contract disputes, these different tests are not
significant here because the underlying dispute in this specific appeal is
neither a tort nor a contract issue. Fiser's medical malpractice claim is most
assuredly a tort action, but the more specific issue in this writ action is the
discoverability of allegedly privileged communications . This Court recently
engaged in a. choice of law analysis involving privileged communications in
Major v. Commonwealth, 275 S.W.3d 706, 714-715 (Ky . 2009) . In Mayor, this
Court applied § 139(2) from the Restatement (Second) of Conflict of Laws
(1971) ' to resolve the issue of admissibility of a taped phone conversation
between the defendant from his home in Massachusetts and his father from his
Although the comment portion of § 139 was revised in 1988, the language of the
section as set forth in the 1971 Restatement (Second) was not changed by the 1988
revision .
home in Nova Scotia, Canada . Id. at 71.3 . The conversation would have been
privileged in Massachusetts but not in Kentucky, 2 where the defendant was,
being tried . A Although this Court ultimately held that the trial court did not
err in admitting the phone call because of the law of the case doctrine, we
explained that even without that doctrine, the trial court properly applied
Kentucky law. Id . In reaching this conclusion, this Court. relied on § 139(2) of
the Restatement (Second) of Conflict of Laws (1971), which. states:
Evidence that is privileged under the local law of the
state which has the most significant relationship with
the communication but which is not privileged under
the local law of the forum will be admitted unless there
is some special reason why the forum policy favoring
admission should not be given effect .
2
In Ma- or, supra, this Court began its conflict of laws discussion with the following
statement: "in mold-state matters, Kentucky traditionally follows the Restatement
(Second) of Conflict of Laws (1988) ." We cited to State Farm Mutual Auto . Ins. Co.
v. Marley, 151 S .W .3d 33, 42 (Ky. 2004) for this proposition . Saleba argues that
this statement in Major, supra, indicates that the entire Restatement-and thus,
the most significant relationship test-has been adopted by Kentucky and is
applicable in all conflict of laws cases . As explained above, however, the approach
adopted by Kentucky and articulated in § 188 of the Restatement only applies to
contract disputes . There is no Kentucky case law indicating that Kentucky has ever
adopted or applied § 145(l) of the Restatement, which states that "[t]he rights and
liabilities of the parties with respect to an issue in tort are determined by the local
law of the state which . . . has the most significant relationship to the occurrence
and the parties . . . ... Restatement (Second) of Conflict of Laws § 145 (1971) .
Further, the case of State Farm Mutual Auto . Ins. Co . v. Marley, supra, relied on by
Major, supra, was a contract dispute that specifically cited only § 188 from the
Restatement . In that case, Justice Cooper explained in his dissent that although
the traditional rule in Kentucky "has been that the validity of a contract is to be
determined by the laws of the state in which it was made . . . ltjhe modern test is
`which state has the most significant relationship to the transaction and the
parties."' Marlev , 151 S .W.3d at 41-42 (Cooper, dissenting) quoting Restatement of
Conflict of Laws 2d, § 188 (1971) . Although this Court's blanket statement in
Major, supra, may be overbroad in the sense that only certain sections of the
Restatement (Second) of Conflict of Laws have actually been adopted in Kentucky,
when read in context with prior case law and Marley, supra, it does not alter the
precedent that in tort actions, Kentucky law will apply if Kentucky has any
significant contacts with the action .
This Court explained that even if N/lassachusetin had the most significant
relationship with the phone conversation, there still "must be some special
reason for Kentucky to forgo its acknowledged policy favoring admission" of
.this type of taped phone conversation . Id . at 714 . Concluding that, 11o ',',,PC ciaI
reason existed to ignore Kentucky's policy favoring admission of the disputed
communication, this Court held that the trial court properly applied Kentucky
law and admitted the phone conversation . Id . a t 713-16.
Curiously, Sa.leba argues that this Court should apply § 139 of the
Restatement (Second) of Conflict of Laws to the case at hand, but contends that
"this approach. requires weighing the significance of each state's interests."
Although Saleba is correct that § 1-39 of the Restatement initially instructs
courts to determine which state has the most significant relationship with a
communication, the rule goes on to explain that if the communication is not
privileged under the local law of the forum-in this case, Kentucky--the
communication "will be admitted unless there is some special reason why the
forum policy favoring admission should not be given effect." Restatement
(Second) of Conflict ofLaws § 139(2) (1971) . Applying this rule to the case at
hand, we again conclude that there is no special reason to warrant ignoring
Kentucky's policy of permitting peer review documents to be discoverable in
medical malpractice suits .
Although Soard-a Kentucky resident who saw a Kentucky physician
and who had no control over her lab results being sent by a Kentucky
laboratory to an Ohio hospital-arguably has a significant interest in the peer
review communications, Ohio does appear to liave the ic~re significant
relationship with the peer review documents : an Ohio healthcare provider was
the subject of the documents, and they were generated in Ohio by an Ohio
hospital . However, as the Restatement explains, even if Ohio had, die
ore
significant relationship, a special reason must still exist before a Kentucky
court will apply another state's law excluding evidence when Kentucky law
plainly favors admission. No such reason exists in this case . Moreover, due to
Kentucky's long-standing precedent deeming peer review documents to be
discoverable in medical malpractice actions, the trial court was clearly _justified
in applying Kentucky law . Because the trial court did not act erroneously in
applying Kentucky law or in requiring Saleba to comply with Fiser's discovery
requests, the Court of Appeals did not abuse its discretion in denying Saleba's
petition .
II. Kentucky Continues to Recognize the Discoverability of Peer Review
Materials in Medical Malpractice Actions.
Alternatively, Saleba argues that if this Court holds that Kentucky law
applies to this action, we should consider overruling Sisters of Charity Health
Systems, Inc v . Raikes , 984 S .W.2d 464 (Ky. 1998), and adopting the position
that peer review documents are privileged in malpractice suits against
healthcare providers. Sisters of Charity Health Systems , supra, squarely
addressed the issue of whether KRS 311 .377(2) extends the peer review
privilege to medical malpractice suits . Id . Finding that it does not, this Court
held "that the peer review privilege created by KRS 311 .377(2) is limited to
suits against peer review entities as referred to and protected against in
Subsection I of the statute ." Id . at 470. This Court explained that
the General Assembly's intent and purpose din
enacting KRS 311 .377(2)1 was riot to hinder are
aggrieved patient's search for the truth in a medical
malpractice suit against a negligent, physiciaii or
hospital . The Preamble to the 1990 Act plainly states
that it was enacted for the protection of peer review
participants . Appellants, in their capacity in the cases
at bar as party-defendants in a medical malpractice
suit, are not included in this class because they have
not been sued for any action. taken in the course of
performing a peer review. Simply put, the statute was
not enacted for the protection of defendants in a
medical malpractice suit.
Id . at 469 . This Court reiterated its holding that KRS 31 1 .377(2) does not
protect peer review records in medical malpractice suits in. McFall v. Peace-,
Inc., 15 S .W.3d 724, 726 (Ky. 2000) .
Despite this well-established precedent, Saleba contends that this Court
misinterpreted KRS 311 .377(2) in Sisters of Charity Health Systems, su ra,
and that "the time has come" for the Court to revisit that decision . We
disagree . Stare decisis requires this Court to follow precedent set by prior
cases, and this Court will only depart from such established principles when
"sound reasons to the contrary" exist. Hilen v. Ham, 673 S .W .2d 713, 717 (Ky.
1984) ; Gilbertw Barkes, 987 S.W .2d 772 (Ky. 1999) . Although Saleba,
contends that this Court's refusal to protect peer review documents in medical
malpractice cases frustrates the purpose of the privilege and undermines the
greater goal of improving healthcare, Saleba has not presented compelling
reasons to justify discarding over twenty- years of precedent regarding the
interpretation of KRS 311 .377(2) . Furthermore, if Kentucky's legislature found
that this Court's decision in Sisters of Charit
sterns , su era, truly
frustrated the purpose of KRS 311 .377(2), the legislature has
11" Id over ten
years to amend that statute to include a clear, unmistakaNc pro]-libition
against discovery of peer review documents in malpractice suits against,
healthcare providers . It has not, done so . Therefore, we rcitcrate that KRS
311 .377(2) does not extend the privilege fear peer review documents to medical
malpractice suits .
CONCLUSION
Saleba and The Good Samaritan Hospital are not entided to a writ
because the trial court did not act erroneously in applying Kentucky law and
then requiring the production of certain peer review documents . Even
assuming Ohio had the more significant relationship to the peer review
documents, no special reason existed in this case justifying applying Ohio law
and ignoring Kentucky's strong precedent allowing the discovery of peer review
documents in medical malpractice suits . Because the trial court correctly
applied Kentucky law and because Kentucky case law clearly does not extend.
the privilege in KRS 311 .377(2) to peer review documents sought in medical
malpractice actions, the trial court did not act erroneously in requiring
disclosure of the requested peer review records. Thus, we affirm the Court of
Appeals' denial of the petition for a writ of prohibition.
All sitting. All concur.
COUNSEL FOR APPELLANTS :
Thomas M . Evans
Arthur Edmund, Phelps, ,1r .
Vaseem S Y Hadi
Rendigs, Fry, Kiely &. Dennis, LLP
One West Fourth Street .
Suite 900
Cincinnati, OH 45202
APPELLEE:
Honorable James Roger ISchrand, 11
Boone County ,Ju.stice Center
6025 Rogers Lane
Suite 447
Burlington, KY 41005
COUNSEL FOR APPELLEES :
Paul A Fiser
Sweeney &, Fiser, PLLC
2519 Ritchie Avenue
Crescent Springs, KY 41017
COUNSEL FOR AMICUS CURIAE
THE ST LUKE HOSPITALS, INC.
Scott M . Powers
Lange, Quill &, Powers, PLC
4 West Fourth Street
Suite 400
Newport, KY 41071-1090
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