The New Jersey Supreme Court recently decided the case of Brugaletta v. Garcia in favor of patient safety in hospitals, concluding once again that a patient cannot obtain a hospital’s internal self-review that is done to comply with the Patient Safety Act. Brugaletta follows the law. This decision also benefits both New Jersey hospitals and patients by encouraging hospital self-improvements in a non-punitive environment. It should be applauded by all.
In Brugaletta, a patient filed a medical negligence lawsuit against Chilton Memorial Hospital, theorizing that she did not receive antibiotics frequently enough during her hospital stay. Although this patient had her hospital medical records that documented when she received the antibiotics, she asked the trial court nevertheless to compel production of the hospital’s internal self-critical analysis of her care. Why did her lawyers do this? If you are suing a hospital, there is no better evidence than a hospital’s own documents, especially those that recommend system improvements. This phenomenon is precisely the problem that the New Jersey legislature sought to avoid with a strong non-disclosure privilege. But in Brugaletta, the trial court ignored this. Despite strong statutory language deeming all documents from Patient Safety Act reviews to be privileged, the trial court ordered partial disclosure. The New Jersey Supreme Court deemed this improper. In a 6-1 decision, the New Jersey Supreme Court explained that the Patient Safety Act was designed to minimize adverse events caused by system failures in a hospital. To accomplish this goal, the Patient Safety Act encourages hospitals through administrative fines and state oversight to self-report to the Department of Health with corrective plans when serious preventable adverse events occur. At the same time, the Patient Safety Act shields these reports from disclosure in lawsuits. The trial court’s decision in Brugaletta, then, greatly disrupted this carefully crafted legislation. The statutory and regulatory language shielding discovery in lawsuits also could not be clearer. Thus, when a patient seeks information in litigation that was created “exclusively” during a hospital’s Patient Safety Act review, the court must prohibit disclosure to fulfill the legislature’s mandate.
Brugaletta is a victory for statutory law and patient safety, to be sure. But hospital administrations must continue to create and preserve evidence of compliance with the Patient Safety Act and its implementing regulations that govern the internal review process. For example, to fend off litigation challenges, hospitals and their counsel have to be ready to present proofs that (1) the hospital created a patient safety committee chaired by an individual selected by the facility’s chief executive officer or administrator, (2) individual committee members have appropriate professional experience, (3) the committee meets at least quarterly, and (4) there is a written safety plan that is periodically reviewed, among other requirements. These requirements are listed within N.J.A.C. 8:43E-10.4(c) and should be carefully consulted. In addition, all patient safety committee documents should be labeled as such to avoid any confusion as to their origin.
The content of this post is for informational purposes only and should not be construed as legal advice or legal opinion. You should consult a lawyer concerning your specific situation and any specific legal question you may have.