In re Christus Santa Rosa Health System

Justice Green (Opinion)

The Texas Supreme Court granted mandamus relief to Christus Santa Rosa Health System on the applicability of the medical peer-review committee privilege and ordered the trial court to perform an in camera inspection to determine whether an exception to the privilege applied. Section 160.007 of the Texas Occupations Code makes medical peer-review proceedings and records confidential in order to promote candid and open communications regarding a physician’s competency and improve the standard of medical care provided to patients. The Court held the trial court abused its discretion when it ordered Christus to produce the records without first adequately reviewing the documents in camera.

The parties, Christus and Dr. Franklin, did not dispute that the medical peer-review committee privilege applied to the records sought, but disagreed about whether disclosure was required under an exception to that privilege. Section 160.007(d) requires a written copy of the committee’s recommendation, final decision, and basis for the decision be disclosed to the physician if the committee “takes action that could result in censure, suspension, restriction, limitation, revocation, or denial” of the physician’s privileges at the hospital. The Court clarified the exception and held that, for the exception to apply, the peer-review committee must do more than simply convene to review the physician’s actions—they must take some action that could have resulted in discipline. Otherwise, the “take action” language in § 160.007(d) would be rendered meaningless. Disclosure would be required every time the committee conducted a review, regardless of the outcome, which undermines the very purpose of the medical peer-review committee privilege—confidentiality to encourage open discussion of a physician’s competency.

Based on the record before it, the Court could not determine whether Christus’s medical peer-review committee took action that could have resulted in some sort of discipline against Dr. Franklin. So the Court ordered the trial court to conduct an in camera review of the documents and the evidence to determine if the exception applied.