Advocacy Update

June 28, 2018: Judicial Advocacy Update


If a trial court ruling that instructed a hospital to turn over "patient safety work product" is not overturned on appeal, hospitals in Illinois would be less likely to produce voluntarily reports that help patient safety organizations (PSOs) analyze adverse events and look for ways for hospitals to make patients safer.

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The question of what is discoverable to plaintiffs in medical malpractice cases in Illinois stems from a 2013 incident where Rosalie Jones, who was admitted to Ingalls Memorial Hospital in Chicago's south suburbs for renal failure, died from injuries after prolonged hypoglycemia.

Staff at the hospital were responsible for monitoring Jones' blood glucose levels. When her level was 203, she received insulin. Later, nurses drew blood for a comprehensive test that showed a blood glucose level of 16, but Jones' treatment team was not told about the test result and she was later found unresponsive and suffered irreversible brain damage, court records show.

Ingalls staff members submitted incident reports from Jones' case to Clarity Patient Safety Organization, a federally and state-certified PSO that collects reports from numerous hospitals to identify what changes can be made to improve patient safety and quality of care.

After Terri Daley—the independent administrator of Jones' estate—sued the hospital for medical malpractice, an Illinois trial court ruled that as part of the discovery process, Ingalls had to turn over the report sent to the Clarity PSO.

The hospital has appealed that ruling to the Illinois Appellate Court, First District, saying the federal Patient Safety and Quality Improvement Act (PSQIA) protects the report because it is a "patient safety work product." Attorneys for the hospital argue that the trial court improperly relied on state law—the Illinois Medical Studies Act—when it ruled the materials must be turned over.

The Litigation Center of the American Medical Association and State Medical Societies, along with the Illinois Health and Hospital Association, the Illinois State Medical Society and others, filed an amicus brief (PDF) in the case (PDF), Daley v. Teruel and Ingalls Memorial Hospital, supporting the hospital's position. The friend-of-the-court brief notes that Congress created a safeguarded patient safety process under the PSQIA to encourage hospitals to submit patient safety outcomes without "fear of increased liability risk." Read more at AMA Wire.

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