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The Peer Review Protection Act does not shield credentialing materials, the Pennsylvania Superior Court has ruled, relying on the state Supreme Court's decision from last year in Reginelli v. Boggs.

In Reginelli, the justices ruled that documents are only covered under the PRPA if they are generated by “peer review committees” of organizations that are regulated by the state to operate in the health care industry.

In Estate of Leonard P. Krappa v. Lyons, the Superior Court ruled in a May 7 unpublished memorandum to uphold a Lackawanna County trial judge's decision that credentialing materials generated by defendant Community Medical Center were not privileged because they did not deal with the quality or efficiency of doctors' patient care and because the hospital's credentialing committee did not qualify as a “review committee” under Reginelli.

The plaintiffs had sued the hospital and Dr. Frank Piro, among other defendants, alleging that a delayed cancer diagnosis ultimately resulted in the death of decedent Leonard Krappa. The trial judge, Margaret Bisignani Moyle, had granted the plaintiffs' emergency motion to compel discovery of Community Medical's unredacted credentialing materials for two of its doctors, including Piro.

The hospital had argued that the credentialing records “were generated for quality improvement purposes and maintained exclusively by the committee” and were therefore protected under the PRPA

But Moyle and, subsequently, a three-judge panel of the Superior Court disagreed.

The panel, consisting of Judges Carolyn Nichols and Paula Francisco Ott, as well as Senior Judge Dan Pellegrini, pointed to Reginelli's holding that, under the PRPA, a “review organization” and a “review committee” are two different things.

The PRPA defines a “review organization” as a “hospital board, committee or individual” involved in reviewing ”the professional qualifications or activities of its medical staff or applicants thereto,” known as credentialing review. A ”review committee,” on the other hand, is “any committee” that engages in “peer review,” which the PRPA defines as an assessment of the “quality and efficiency of services ordered or performed” by a professional health care provider.

The appellate panel, led by Nichols, also cited a paragraph from the Reginelli ruling that said, “review of a physician's credentials for purposes of membership (or continued membership) on a hospital's medical staff is markedly different from reviewing the 'quality and efficiency of service ordered or performed' by a physician when treating patients. Accordingly, although 'individuals reviewing the professional qualifications or activities of its medical staff or applicants for admission thereto,' … are defined as a type of 'review organization,' such individuals are not 'review committees' entitled to claim the PRPA's evidentiary privilege in its Section 425.4.”

“Therefore, the Reginelli court indicated that the PRPA does not extend its grant of an evidentiary privilege to materials that are generated and maintained by entities reviewing the professional qualifications or activities of medical staff 'i.e., credentials review,'” Nichols said. “Additionally, 'the performance file [in Reginelli] was not generated or maintained by [the defendant hospital's] peer review committee,' and the PRPA's evidentiary privilege did not apply.”

Nichols noted that both Moyle and the appellate panel conducted in camera reviews of the documents requested in the Krappa case and both determined that consisted entirely of credentialing materials.

“Regarding the applicability of the PRPA, the materials in the doctors' personnel files are generated and maintained by appellant's credentialing committee,” Nichols said.”The PRPA's protections do not extend to the credentialing committee's materials, because this entity does not qualify as a 'review committee.'”

Community Medical's attorney, Bruce Coyer of O'Malley, Harris, Durkin & Perry in Scranton, could not be reached for comment.

Counsel for Piro, Gary Samms of Obermayer Rebmann Maxwell & Hippel in Philadelphia, said he and his client were “disappointed” by the ruling.

“However, we believe there will be more cases defining this issue in the future,” he added.

Counsel for the plaintiffs, Rosalind Kaplan of Jarve Kaplan Granato Starr in Marlton, New Jersey, said Reginelli was decided just before the Krappa case was set to go to trial last year, giving rise to the discovery dispute.

“Once the law changes when you have a pending case, that law then applies,” she said, adding, “Here, the Superior Court said what Reginelli said: privilege is applied narrowly.”