In an August 14, 2006 ruling on a motion in a federal case in Alabama, the district judge allowed the admission of an investigation report created by the Centers for Medicare and Medicaid Services (“CMS”) in an EMTALA action. The lawsuit was brought by a lady who, at 38 weeks of pregnancy, had been involved in an automobile accident. She presented to the hospital emergency department and advised the clerk she was pregnant and was having contractions. She was told that she must wait for the obstetrician on call to decide whether to see her. The patient left the hospital. She filed an EMTALA complaint. CMS investigated the matter and concluded that the hospital had violated federal regulations. The patient also sued the hospital in federal court.

In attempting to defeat the hospital’s motion for summary judgment, the patient offered the report by CMS of its investigation of the complaint the patient had made. The court, over the objections of the hospital, ruled the report, minus any legal conclusions it contained, was admissible, finding that the evidence met the admissibility rules of Federal Rule of Evidence 803(8)(C) (records of public agencies as exception to hearsay rule). The court also reasoned that because the patient had made the complaint and had received a copy of the report, she could authenticate it.

Interestingly, the hospital also tried to argue that the information contained in the report was quality assurance information barred by the Alabama Code of Evidence (privileged peer review evidence). The judge refused to accept this argument. He noted that federal courts often have declined to apply state peer review privileges in federal question cases, such as ADA, Title VII, Sherman Act and at least two (2) other EMTALA cases. Health care providers should be aware that, at least according to the Alabama court’s decision, a majority of federal courts have declined to apply state peer review privileges in a wide variety of federal actions. The federal court case citation is Henderson v. Medical Ctr. Enter., No. 1:05-CV-823-MEF (M.D. Ala. Aug. 14, 2006).