Virginia: Patient Falls – a Lawyer’s Discovery

On April 21, 2015, Newport News Circuit Court decided 7 matters in Peck v. Riverside Hospital, Inc., et al., No. CL1400873V-04, another hospital in-patient fall case. Defendants, Riverside Hospital, Inc. and Nurse Sunny Freeman, already had filed Stipulations that they had breached the applicable standard of care and that they thereby had caused harm to their victim, Plaintiff patient.

The Judge in the Peck medical malpractice lawsuit denied Defendant Sunny Freeman, R.N.’s Demurrer to Allegations of Willful and Wanton Negligence, Recklessness, and Gross Negligence, finding that there was sufficient foundation for punitive damages supported by facts in the Amended Complaint. The Judge in Peck also denied the Pleas in Bar of Defendants, Nurse Practitioner Un C. “Connie” Kim, Registered Nurse Mallory (Rusk) Campbell, and Riverside Healthcare Association, Inc., though the latter with leave to refile after discovery.

Additionally, the Judge in the Peck patient fall suit granted Plaintiff’s Motion for Lift of Protective Order re Riverside’s 8/2/13 Risk Management Worksheet (a/k/a “Quality Care Control Report”), Riverside’s 8/26/13 Root Cause Analysis Report, Riverside’s 8/23/13 Apparent Cause Analysis Report, and Riverside’s 8/2/13 Causes and Coding Worksheet, since they actually are individual’s comments and conclusions, not of the peer review committee as represented by Defendants’ counsel at hearing on June 23, 2014. Peck further lifted the Protective Order re all other Plaintiff patient’s medical record referenced in the 6/23/14 “Privilege” Hearing Order.

Re Plaintiff’s (First) Motion to Compel Discovery against Defendants, Peck ordered as follows:

1. Interrogatory [“I”] and Request for Production [“RP”] 1: Defendants shall answer and respond re the Requests for Admission information and materials sought, except without respect to “and/or future”;

2. I&RP 2: Defendants shall answer and respond re the patient health care and other information and materials sought, except for “home address”;

3. I&RP 3: Defendants shall answer and respond re the billing/payment/write-off/write-down information and materials sought, except for “home address”;

4. I&RP 4: [There was no Objection.]

5. I&RP 5: Defendants shall answer and respond re the expert publications information and materials sought, according to court rules;

6. I&RP 6: Defendants shall answer and respond re the knowledgeable individuals information and materials sought, with “case-related” deleted;

7. I&RP 7: Defendants shall answer and respond re the observers/treaters/carers/charters/data-enterers information and materials sought, with “and/or otherwise recorded” deleted (but with leave to Plaintiff to return to Court re the aforesaid deletion);

8. I&RP 8: Defendants shall answer and respond re the information and materials sought about patient/family hospital/personnel communications information and materials known to Defendants;

9. I&RP 9: Defendants shall answer and respond re the patient assignment number/acuity census information and materials sought, without identifying other patients by name;

10. I&RP 10: Defendants shall answer and respond re the personnel license/certification/ privilege/practice denial/revocation/suspension/restriction and/or discipline/reprimand/remediation/ censure information and materials sought “under seal” to the Court for in camera review, except the Written Warnings information and materials re Registered Nurse and Unit Clerk referenced in Riverside’s 8/26/13 Root Cause Analysis shall be produced directly to Plaintiff;

11. I&RP 11: Defendant shall answer and respond re the witness testimony and expert reports/disclosure information and materials sought, only for nurses, nurse practitioners, nurse assistants, and nurse aides who attended Plaintiff’s patient;

12. I&RP 12: Defendants shall answer and respond re the portable bed alarm information and materials sought on a hospital-wide basis and re the fixed/built-in alarm information and materials sought only for the Plaintiff’s actual bed or, alternatively, for a substantially similar exemplar bed;

13. I&RP 13: Defendant shall answer and respond re the computer database and other hospital records/papers information and materials sought, by supplementing their prior production of unredacted 8/2/13 Risk Management Worksheet a/k/a “Quality Care Control Report”, 8/26/13 Root Cause Analysis Report, 8/23/13 Apparent Cause Analysis Report, and 8/2/13 Causes and Coding Worksheet;

14. I&RP 14: Defendants shall answer and respond re the then-current hospital/nursing/ physician/other standards/criteria/guidelines/directives/policies/procedures/ protocols sought for the enumerated “fall risk”/falls topics re Plaintiff;

15. I&RP 15: Defendants shall answer and respond fully re the enumerated 8/2/10-8/2/13 presenters/“fall risk”/falls grand rounds, orientation, preceptorship, in-service, skills fair, staff development instruction, computer-based learning modules, nursing schools, and other clinical teaching information and materials sought;

16. I&RP 16: Defendant shall answer and respond re the enumerated JCAHO accreditation/ standards/criteria/requirements/preparers/approvers/custodian repository/ preparations/submissions/displays/productions information and materials sought;

17. I&RP 17: Defendant shall answer and respond fully re the then-current Riverside School of Professional Nursing and the Riverside School of Practical Nursing instructors/ “fall risk”/falls information and materials sought;

18. I&RP 18: Defendant shall answer and respond fully re the various “fall risk”/falls educational completion information and materials sought, only for the nurses, nurse practitioners, nurse assistants and/or nurse aides who attended Plaintiff’s patient;

19. I&RP 19: Defendant shall answer and respond re the 8/2/10-8/2/13 bed alarms/rails/sitter/ restraints/other “fall risk”/falls interventions/problems/complaints/remediation information and materials sought;

20. I&RP 20: Defendant shall answer and respond re the 8/2/10-8/2/13 bed alarms/rails/sitter/ restraints/other “fall risk”/falls interventions/injuries/claims/demands/suits/ proceedings information and materials sought; and

32. I&RP 32(A-J) and Requests for Inspection 1(A-J): Defendants shall respond by producing and/or making available for on-site inspection and photographing at Riverside Regional Medical Center, at Riverside School of Professional Nursing, and at Riverside School of Practical Nursing all beds, alarms, and armbands/stickers/ magnets/placards/forms materials sought.

Finally, re Plaintiff’s Second Motion to Compel against Defendants, Peck ordered as follows:

1. I 21: Defendants shall answer fully re the Unit Clerk identification/employment/education/ training/certification/licensure information sought to Plaintiff;

2. RP 21(A): Defendants shall respond fully re the Unit Clerk license/resume/CV/education/ training/certification/licensure materials sought to Plaintiff, but obfuscate the license number; and

3. RP 21(B): Defendants shall respond fully re the counseling/remediation/discipline materials sought to the Court “under seal” for in camera review, except the Written Warnings information and materials re Registered Nurse and Unit Clerk referenced in Riverside’s 8/26/13 Root Cause Analysis shall be produced directly to Plaintiff.