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The Pennsylvania Superior Court has urged the state Supreme Court to clarify a key aspect of a 2018 decision in which the justices limited the scope of the Peer Review Protection Act.

A three-judge panel of the Superior Court in Leadbitter v. Keystone Anesthesia Consultants unanimously affirmed an Allegheny County trial court's order requiring defendant St. Clair Hospital to produce to plaintiffs in a medical malpractice case the unredacted credentialing file of defendant Dr. Carmen Petraglia.

The panel—consisting of Judges John Bender, Alice Beck Dubow and Kate Ford Elliott—said it was constrained to follow the Pennsylvania Supreme Court's 2018 ruling in Reginelli v. Boggs and the Superior Court's subsequent ruling in Estate of Leonard P. Krappa v. Lyons.

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.

The justices explained 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.

In Lyons, the Superior Court ruled 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.

In a published Feb. 12 opinion in Leadbitter, the Superior Court said the credentialing file at issue contained professional opinions relating to Petraglia's competence; a "Professional Peer Review Reference and Competency Evaluation," which was prepared by other doctors and contains evaluations of Petraglia's performance; an "Ongoing Professional Practice Evaluation of St. Clair Hospital Summary Report" containing performance-related data that St. Clair Hospital compiled; and responses to St. Clair's inquiries to the National Practitioner Data Bank.

The panel said the file's contents met the PRPA's definition of "peer review" documents because professional health care providers prepared the documents, which evaluated the "quality and efficiency of services ordered or performed" by Petraglia.

But the panel then turned to the issue of whether Petraglia's credentialing file was prepared by a review committee or a review organization, somewhat reluctantly concluding that it was the former and therefore rendering the PRPA's privilege inapplicable.

"Although the professional evaluations of Dr. Petraglia reviewed by the credentialing committee are different from the type of documents that the Supreme Court considered in Reginelli, the Supreme Court's analysis still requires us to focus on the type of organization that is reviewing the professional evaluations, not whether the documents meet the definition of 'peer review' documents," Dubow wrote for the panel, but added in a footnote, "In light of the fact that the Supreme Court assumed that documents in a credentialing file are not peer review documents and in this case, the documents at issue are peer review documents, it would be helpful for the Supreme Court to grant allocatur and address this issue directly."

Counsel for St. Clair, John Conti of Dickie, McCamey & Chilcote in Pittsburgh, said in an email, "The opinion makes it abundantly clear that Supreme Court review is necessary to properly consider the fact that credentialing committees perform an essential peer review function. This issue is a matter of great importance to health care providers and judges alike, as evidenced by the Court's explicit request that the decision be reviewed by way of allocatur."

Counsel for Petraglia and defendant South Hills Orthopaedic Surgery Associates, M. Brian O'Connor of Matis Baum O'Connor in Pittsburgh, could not be reached, nor could counsel for the plaintiffs, John A. Caputo of John A. Caputo & Associates in Pittsburgh.