The court referred a woman to a medical center for psychiatric evaluation. While a patient at the medical center, the woman was under the care of a psychiatrist. The psychiatrist treated the woman for major depressive disorder, psychotic disorder, and bipolar disorder.
On the fifth day of her inpatient treatment, the psychiatrist wrote her a prescription for Lamictal (25 mg twice per day), as well as Zoloft, Seroquel, Flagyl, and Buspar. One of the known complications that can result from taking Lamictal are severe rashes that present as Stevens Johnson Syndrome (“SJS”), and toxic epidermal necrolysis (“TEN”), among other conditions. The manufacturer's recommended initial dose of Lamictal is 25 mg per day. However, the psychiatrist prescribed 25 mg twice per day. Additionally, the psychiatrist prescribed Zoloft, which in conjunction with Lamictal, is known to increase the likelihood of having adverse reactions. Two weeks after she was admitted, the woman was released from the medical center and transported to the city jail, where over the course of several days her condition deteriorated.
After six days at the jail she was transported back to the medical center for emergency care. After multiple days of treatment for a severe rash, immense pain, and high temperatures, among others things, the woman was diagnosed with SJS and TEN, secondary to Lamictal use.
The woman sued the doctor and the medical center. The complaint alleged that the psychiatrist negligently and/or wantonly breached the standard of care owed to her including failure to warn, failure to obtain informed consent, and failure to monitor, among others. Throughout the complaint, the woman asserted that the psychiatrist proximately caused her physical and psychological injury along with causing her excruciating pain and suffering, mental anguish, permanent injury, loss of enjoyment of life, and consequential and incidental damages, and post-traumatic stress disorder that were expected to continue in the future. The complaint alleged that the medical center negligent hired, trained, supervised, and retained the doctor.
The woman filed a motion to compel the production of the doctor’s personnel file. She sought the file for the purpose of determining if any investigation was conducted or disciplinary action was taken due to his treatment of her; if there were records of the doctor attending any training or continuing education courses related to Lamictal, SJS, or TEN; and the basis of his separation from the medical center. The motion also requested the court compel the deposition of a corporate representative of the medical center.
The United States District Court for the Middle District of Alabama, Southern Division, denied the woman’s motion to compel the production of the doctor’s personnel file and motion to compel the deposition of a corporate representative. The court held that the information contained in the doctor’s personnel file was either not discoverable or the need for discovery was not compelling because the information sought was otherwise readily obtainable and requiring the medical center to produce corporate representatives would be unduly burdensome.
Information contained in the doctor's personnel file that related to any investigation or disciplinary action was not discoverable. Under both Alabama and federal law, such information is protected. Alabama Code § 6–5–333 and 42 U.S.C.A. 11101 make records and proceedings of any peer review or a utilization and quality control committee, professional standards review committee, or a similar committee not available for discovery proceedings.
The need for information contained in the doctor's personnel file that related to training or continuing education courses or the basis for his separation from the medical center was not compelling because the information sought was otherwise readily obtainable. The court found that information on any training or continuing education courses the doctor may have taken related to Lamictal, SJS, or TEN was discoverable by less invasive means. The woman could have requested the information through interrogatories or requests for production. The court noted that previously she had propounded interrogatories and requests for production seeking the names of all studies, papers, treatises, text books, articles, etc., upon which the doctor relied for his knowledge on Lamictal. The court also noted that the woman deposed the doctor, which provided a second opportunity for her to seek this information. The court found that the basis for the doctor’s separation from the medical center was also discoverable by less invasive means, and in fact, was discussed in the doctor's deposition. The court concluded that the woman received a full and fair answer to her deposition questions regarding the doctor’s separation from the medical center. The court went on to state that the woman’s dislike of the information provided did not provide justification to compel the doctor's personnel file and the woman failed to offer any evidence that the doctor's answers on the subject were in any way untruthful or untrustworthy.
Requiring the medical center to produce corporate representatives for deposition would be duplicative and unduly burdensome. The corporate representative depositions would be duplicative because the woman had already conducted extensive discovery regarding the medical center. Specifically, the court noted that the medical center had tendered eight employees for deposition (four emergency room nurses, a physician's assistant, two Behavioral Medical Unit nurses, and a hospitalist/physician), as well as the three physicians who were named defendants for deposition. Additionally, the medical center responded to multiple sets of interrogatories and requests for production. A substantial percentage of the topics attached to the notice of deposition were covered at length in the eleven prior depositions and discovery requests. The corporate representative depositions would be unduly burdensome because the notice of deposition implicated multiple units of the hospital. The woman was admitted to the medical center five different times by different departments. She also placed telephone calls into the call center. All of these contacts are implicated in the woman’s notice of deposition. To comply with the request, the medical center would have to proffer approximately five corporate representatives from various departments, and none would have any further information to offer than what has already been received through past discovery.
The United States District Court for the Middle District of Alabama, Southern Division, denied the woman’s motion to compel the production of the doctor’s personnel file and motion to compel the deposition of a corporate representative.
See: McBride v. Houston County Health Care Authority, 2014 WL 4599020 (M.D.Ala., September 15, 2014) and McBride v. Houston County Health Care Authority, 2014 WL 707166 (M.D.Ala. Feb 24, 2014) (not designated for publication).
See also Medical Law Perspectives, May 2013 Report: Drugs, Dosage, and Damage: Physician Liability for Prescribing or Administering Medication
See also Medical Law Perspectives, March 2012 Report: Off-Label Use of Prescriptions: When is this Medical Malpractice? Is the Pharmaceutical Company Liable for Overpromotion?