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matter","paragraphs":["para_1","para_2","para_3","para_4","para_5","para_6","para_7","para_8","para_9","para_10","para_11","para_12","para_13","para_14","para_15","para_16","para_17","para_18","para_19","para_20","para_21","para_22","para_23","para_24","para_25","para_26","para_27","para_28","para_29","para_30","para_31","para_32","para_33","para_34","para_35","para_36","para_37","para_38","para_39","para_40","para_41","para_42","para_43","para_44","para_45","para_46","para_47","para_48","para_49","para_50","para_51","para_52","para_53","para_54","para_55","para_56","para_57","para_58","para_59","para_60","para_61","para_62","para_63","para_64","para_65","para_66","para_67","para_68","para_69","para_70","para_71","para_72","para_73","para_74","para_75","para_76","para_77","para_78","para_79","para_80","para_81","para_82","para_83","para_84","para_85","para_86","para_87","para_88","para_89","para_90","para_91","para_92","para_93","para_94","para_95","para_96","para_97","para_98","para_99","para_100","para_101","para_102","para_103","para_104","para_105","para_106","para_107","para_108","para_109","para_110","para_111","para_112","para_113","para_114","para_115","para_116","para_117","para_118","para_119","para_120","para_121","para_122","para_123","para_124","para_125","para_126","para_127","para_128","para_129","para_130","para_131","para_132","para_133","para_134","para_135","para_136","para_137","para_138","para_139","para_140","para_141","para_142","para_143","para_144","para_145","para_146","para_147","para_148","para_149","para_150","para_151","para_152","para_153","para_154","para_155","para_156","para_157","para_158","para_159","para_160","para_161","para_162","para_163","para_164","para_165","para_166","para_167","para_168","para_169","para_170","para_171","para_172","para_173","para_174","para_175","para_176","para_177","para_178","para_179","para_180","para_181","para_182","para_183","para_184","para_185","para_186","para_187","para_188","para_189","para_190","para_191","para_192","para_193","para_194","para_195","para_196","para_197","para_198","para_199","para_200","para_201","para_202","para_203","para_204","para_205","para_206","para_207","para_208","para_209","para_210","para_211","para_212","para_213","para_214","para_215","para_216","para_217","para_218","para_219","para_220","para_221","para_222","para_223","para_224","para_225","para_226","para_227","para_228","para_229","para_230","para_231","para_232","para_233","para_234","para_235","para_236","para_237","para_238","para_239","para_240","para_241","para_242","para_243","para_244","para_245","para_246","para_247","para_248","para_249","para_250","para_251","para_252","para_253","para_254","para_255","para_256","para_257","para_258","para_259","para_260","para_261","para_262","para_263","para_264","para_265","para_266","para_267","para_268","para_269","para_270","para_271","para_272","para_273","para_274","para_275","para_276","para_277","para_278","para_279","para_280","para_281","para_282","para_283","para_284","para_285","para_286","para_287","para_288","para_289","para_290","para_291","para_292","para_293","para_294","para_295","para_296","para_297","para_298","para_299","para_300","para_301","para_302","para_303","para_304","para_305","para_306","para_307","para_308","para_309","para_310","para_311","para_312","para_313","para_314","para_315","para_316","para_317","para_318","para_319","para_320","para_321","para_322","para_323","para_324","para_325","para_326","para_327","para_328","para_329","para_330","para_331","para_332","para_333","para_334","para_335","para_336","para_337","para_338","para_339","para_340","para_341","para_342","para_343","para_344","para_345","para_346","para_347","para_348","para_349","para_350","para_351","para_352","para_353"],"kind":"front_matter"}],"paragraphs":[{"text":"IN THE COURT OF APPEALS OF NORTH CAROLINA","paragraph_id":"para_1"},{"text":"No. COA25-589","paragraph_id":"para_2"},{"text":"Filed 4 March 2026","paragraph_id":"para_3"},{"text":"Harnett County, No. 23CV002578-420","paragraph_id":"para_4"},{"text":"PAULA M. MCGEHEE, Executrix of the ESTATE OF TONY MILLER MCGEHEE,","paragraph_id":"para_5"},{"text":"Plaintiff,","paragraph_id":"para_6"},{"text":"v.","paragraph_id":"para_7"},{"text":"MARK ADAM FARBER, M.D., Individually; FERNANDO MOTTA, M.D.,","paragraph_id":"para_8"},{"text":"Individually; and PAUL BRIAN TESSMANN, M.D., Individually, Defendants.","paragraph_id":"para_9"},{"text":"Appeal by Defendants Mark Adam Farber, M.D.; Fernando Motta, M.D.; and","paragraph_id":"para_10"},{"text":"Paul Brian Tessmann, M.D.; and Non-Parties UNC Health; Melina R. Kibbe, M.D.;","paragraph_id":"para_11"},{"text":"Harvey L. Lineberry II, Ph.D.; David Gerber, M.D.; Ron Falk, M.D.; Elise","paragraph_id":"para_12"},{"text":"Maggioncalda, M.D.; Austin Flick, M.D.; Justin Myers, D.O.; and Abhi Mehrotra,","paragraph_id":"para_13"},{"text":"M.D. from order entered 28 February 2025 by Judge Thomas H. Lock in Harnett","paragraph_id":"para_14"},{"text":"County Superior Court. Heard in the Court of Appeals 13 January 2026.","paragraph_id":"para_15"},{"text":"Robinson, Bradshaw & Hinson, P.A., by Matthew W. Sawchak, Erik R.","paragraph_id":"para_16"},{"text":"Zimmerman, and Clara Nieman, for all Appellants.","paragraph_id":"para_17"},{"text":"Cranfill Sumner, LLP, by Ryan Shuirman and Kelley M. Petcavich, for","paragraph_id":"para_18"},{"text":"Non-Parties UNC Health; Melina R. Kibbe, M.D.; Harvey L. Lineberry, II,","paragraph_id":"para_19"},{"text":"Ph.D.; David Gerber, M.D.; Ron Falk, M.D.; Elise Maggioncalda, M.D.; Austin","paragraph_id":"para_20"},{"text":"Flick, M.D.; Justin Myers, D.O.; and Abhi Mehrotra, M.D.","paragraph_id":"para_21"},{"text":"Walker Allen, LLP, by Barry Cobb, for Defendants-Appellants Mark Adam","paragraph_id":"para_22"},{"text":"Farber, M.D.; and Fernando Motta, M.D.","paragraph_id":"para_23"},{"text":"Ellis & Winters, LLP, by Alex J. Hagan, for Defendant-Appellant Paul Brian","paragraph_id":"para_24"},{"text":"Tessmann, M.D.","paragraph_id":"para_25"},{"text":"MCGEHEE V. FARBER","paragraph_id":"para_26"},{"text":"Opinion of the Court","paragraph_id":"para_27"},{"text":"- 2 -","paragraph_id":"para_28"},{"text":"The Melvin Law Firm, P.A., by R. Bailey Melvin, for Plaintiff-Appellee Paula","paragraph_id":"para_29"},{"text":"M. McGehee, Executrix of the Estate of Tony Miller McGehee.","paragraph_id":"para_30"},{"text":"COLLINS, Judge.","paragraph_id":"para_31"},{"text":"This appeal arises from a discovery dispute in a medical malpractice action","paragraph_id":"para_32"},{"text":"and involves three privileges: The Patient Safety and Quality Improvement Act, the","paragraph_id":"para_33"},{"text":"medical review-committee privilege, and the physician-patient privilege. Appellants","paragraph_id":"para_34"},{"text":"are three UNC Health physicians, Defendants Mark Adam Farber, M.D.; Fernando","paragraph_id":"para_35"},{"text":"Motta, M.D.; and Paul Brian Tessmann, M.D.; non-party UNC Health; and eight","paragraph_id":"para_36"},{"text":"non-party UNC physicians, Melina R. Kibbe, M.D.; Harvey L. Lineberry II, Ph.D.;","paragraph_id":"para_37"},{"text":"David Gerber, M.D.; Ron Falk, M.D.; Elise Maggioncalda, M.D.; Austin Flick, M.D.;","paragraph_id":"para_38"},{"text":"Justin Myers, D.O.; and Abhi Mehrotra, M.D. Appellee is Plaintiff Paula M. McGehee","paragraph_id":"para_39"},{"text":"in her capacity as Executrix of her deceased husband’s estate.","paragraph_id":"para_40"},{"text":"Appellants appeal from an order entered 28 February 2025 directing UNC","paragraph_id":"para_41"},{"text":"Health to produce certain documents subject to a protective order and allowing","paragraph_id":"para_42"},{"text":"Plaintiff to depose the subpoenaed non-party physicians regarding past incidents","paragraph_id":"para_43"},{"text":"involving Dr. Farber. For the reasons discussed herein, we affirm in part, vacate in","paragraph_id":"para_44"},{"text":"part, and remand to the trial court.","paragraph_id":"para_45"},{"text":"I. FACTUAL AND PROCEDURAL BACKGROUND","paragraph_id":"para_46"},{"text":"Decedent Tony Miller McGehee was seen on 8 August 2021 at UNC Medical","paragraph_id":"para_47"},{"text":"Center for right flank pain that radiated to his groin. Decedent had been transferred","paragraph_id":"para_48"},{"text":"MCGEHEE V. FARBER","paragraph_id":"para_49"},{"text":"Opinion of the Court","paragraph_id":"para_50"},{"text":"- 3 -","paragraph_id":"para_51"},{"text":"to UNC Medical Center from the Central Carolina Hospital Emergency Department","paragraph_id":"para_52"},{"text":"after a CT scan of his abdomen and pelvis was concerning for aortic dissection, and a","paragraph_id":"para_53"},{"text":"subsequent CT scan of his chest revealed findings consistent with a Stanford Type B","paragraph_id":"para_54"},{"text":"aortic dissection.","paragraph_id":"para_55"},{"text":"Upon his arrival at UNC Medical Center, a UNC radiologist interpreted the","paragraph_id":"para_56"},{"text":"CT scan from Central Carolina Hospital and reported findings consistent with a","paragraph_id":"para_57"},{"text":"Stanford Type A aortic dissection. Dr. Motta ordered a CT scan of Decedent’s chest,","paragraph_id":"para_58"},{"text":"abdomen, and pelvis. A UNC radiologist interpreted the scan and reported findings","paragraph_id":"para_59"},{"text":"consistent with a Stanford Type A aortic dissection.","paragraph_id":"para_60"},{"text":"Dr. Tessmann admitted Decedent to the ICU to perform a cardiac-gated CT","paragraph_id":"para_61"},{"text":"scan to evaluate for a retrograde intramural hematoma. Cardiac-gated CT scans","paragraph_id":"para_62"},{"text":"were performed on 11 August 2021 and 13 August 2021; both revealed findings","paragraph_id":"para_63"},{"text":"consistent with a Stanford Type A aortic dissection. Defendants discharged Decedent","paragraph_id":"para_64"},{"text":"from UNC Medical Center on 13 August 2021 with instructions to follow up in a","paragraph_id":"para_65"},{"text":"month. The next morning, Decedent went into cardiac arrest and was transferred to","paragraph_id":"para_66"},{"text":"Cape Fear Valley Medical Center where he died of an aortic aneurysm and aortic","paragraph_id":"para_67"},{"text":"dissection.","paragraph_id":"para_68"},{"text":"Decedent’s wife, as Executrix of his estate, filed suit against Defendants","paragraph_id":"para_69"},{"text":"alleging, in relevant part, that Defendants were negligent in treating Decedent.","paragraph_id":"para_70"},{"text":"Defendants answered Plaintiff’s complaint, denying the substantive allegations.","paragraph_id":"para_71"},{"text":"Plaintiff subpoenaed Drs. Kibbe, Lineberry, Gerber, and Falk to appear and","paragraph_id":"para_72"},{"text":"MCGEHEE V. FARBER","paragraph_id":"para_73"},{"text":"Opinion of the Court","paragraph_id":"para_74"},{"text":"- 4 -","paragraph_id":"para_75"},{"text":"testify at a deposition and to produce:","paragraph_id":"para_76"},{"text":"1. Any incident reports filed that is in any way related to","paragraph_id":"para_77"},{"text":"the care given to [Decedent]","paragraph_id":"para_78"},{"text":". . . .","paragraph_id":"para_79"},{"text":"3. Any complaints filed against Dr. Mark Adam Farber by","paragraph_id":"para_80"},{"text":"residents, staff, other UNC employees or patients","paragraph_id":"para_81"},{"text":"4. Any and all documents regarding any training,","paragraph_id":"para_82"},{"text":"punishment or discipline Dr. Mark Adam Farber has","paragraph_id":"para_83"},{"text":"received while employed by UNC.","paragraph_id":"para_84"},{"text":"Plaintiff also subpoenaed Drs. Maggioncalda, Flick, and Myers to appear and testify","paragraph_id":"para_85"},{"text":"at a deposition. All subpoenaed physicians filed motions to quash or, in the","paragraph_id":"para_86"},{"text":"alternative, for a protective order on the grounds that the subpoenas seek privileged","paragraph_id":"para_87"},{"text":"peer review information and documents that constitute patient safety work product","paragraph_id":"para_88"},{"text":"protected by the Patient Safety and Quality Improvement Act of 2005 (“Patient Safety","paragraph_id":"para_89"},{"text":"Act”).","paragraph_id":"para_90"},{"text":"Plaintiff also subpoenaed UNC Health to produce these same documents. UNC","paragraph_id":"para_91"},{"text":"Health filed a motion to quash or, in the alternative, for a protective order on the","paragraph_id":"para_92"},{"text":"grounds that the subpoena seeks privileged peer review information, documents that","paragraph_id":"para_93"},{"text":"constitute patient safety work product protected by the Patient Safety Act, and","paragraph_id":"para_94"},{"text":"documents that implicate the Protected Health Information (“PHI”) of non-party","paragraph_id":"para_95"},{"text":"patients under the Health Insurance Portability and Accountability Act (“HIPAA”)","paragraph_id":"para_96"},{"text":"and North Carolina law. In support of its motion, UNC Health submitted as exhibits","paragraph_id":"para_97"},{"text":"copies of its procedures for creating hospital peer review committees, the bylaws of","paragraph_id":"para_98"},{"text":"its medical staff and accompanying medical staff organization manual, a membership","paragraph_id":"para_99"},{"text":"MCGEHEE V. FARBER","paragraph_id":"para_100"},{"text":"Opinion of the Court","paragraph_id":"para_101"},{"text":"- 5 -","paragraph_id":"para_102"},{"text":"agreement with The Quality Center Patient Safety Organization (“Patient Safety","paragraph_id":"para_103"},{"text":"Organization”), its Patient Safety Event Reporting policy, a privilege log containing","paragraph_id":"para_104"},{"text":"an entry for a Safety Awareness for Everyone (“SAFE”) report regarding Decedent’s","paragraph_id":"para_105"},{"text":"care, and an affidavit of Dr. David Zvara, Chief Medical Officer of UNC Hospitals.","paragraph_id":"para_106"},{"text":"After a hearing on 21 January 2025, the trial court entered an order denying","paragraph_id":"para_107"},{"text":"UNC Health’s motion to quash and allowing its motion for a protective order, ordering","paragraph_id":"para_108"},{"text":"it to produce the subpoenaed documents and ruling that Plaintiff’s counsel may","paragraph_id":"para_109"},{"text":"question the subpoenaed physicians about “any manner related to the care given to","paragraph_id":"para_110"},{"text":"[Decedent] and their knowledge of any other incidents involving Dr. Farber where his","paragraph_id":"para_111"},{"text":"care or his interactions with patients, staff and employees may have been called into","paragraph_id":"para_112"},{"text":"question.” Defendants and the Non-Parties appealed.","paragraph_id":"para_113"},{"text":"II. DISCUSSION","paragraph_id":"para_114"},{"text":"A. Appellate Jurisdiction","paragraph_id":"para_115"},{"text":"As a threshold issue, we must determine whether we have jurisdiction to","paragraph_id":"para_116"},{"text":"review this appeal from an interlocutory discovery order.","paragraph_id":"para_117"},{"text":"“An interlocutory order is one made during the pendency of an action, which","paragraph_id":"para_118"},{"text":"does not dispose of the case, but leaves it for further action by the trial court in order","paragraph_id":"para_119"},{"text":"to settle and determine the entire controversy.” Veazey v. Durham, 231 N.C. 357, 362","paragraph_id":"para_120"},{"text":"(1950) (citation omitted). Immediate appeal from an interlocutory order may be","paragraph_id":"para_121"},{"text":"allowed in several instances, including where “the trial court’s decision deprives the","paragraph_id":"para_122"},{"text":"appellant of a substantial right” that will be lost absent immediate review pursuant","paragraph_id":"para_123"},{"text":"MCGEHEE V. FARBER","paragraph_id":"para_124"},{"text":"Opinion of the Court","paragraph_id":"para_125"},{"text":"- 6 -","paragraph_id":"para_126"},{"text":"to N.C. Gen. Stat. §§ 1-277(a) and 7A-27(b)(3)(a). Woody v. Vickrey, 276 N.C. App.","paragraph_id":"para_127"},{"text":"427, 433 (2021) (citation omitted).","paragraph_id":"para_128"},{"text":"“An interlocutory order affects a substantial right if the order deprives the","paragraph_id":"para_129"},{"text":"appealing party of a substantial right which will be lost if the order is not reviewed","paragraph_id":"para_130"},{"text":"before a final judgment is entered.” Cape Homeowners Ass’n, Inc. v. S. Destiny, LLC,","paragraph_id":"para_131"},{"text":"292 N.C. App. 374, 378 (2024) (quotation marks and citation omitted). When “a party","paragraph_id":"para_132"},{"text":"asserts a statutory privilege which directly relates to the matter to be disclosed under","paragraph_id":"para_133"},{"text":"an interlocutory discovery order, and the assertion of such privilege is not otherwise","paragraph_id":"para_134"},{"text":"frivolous or insubstantial, the challenged order affects a substantial right . . . .”","paragraph_id":"para_135"},{"text":"Sharpe v. Worland, 351 N.C. 159, 166 (1999).","paragraph_id":"para_136"},{"text":"Here, Appellants argue that the trial court’s order affects a substantial right","paragraph_id":"para_137"},{"text":"because UNC Health asserted “the federal privilege under the Safety Act” for the","paragraph_id":"para_138"},{"text":"SAFE report regarding Decedent’s care; “North Carolina’s privilege for the","paragraph_id":"para_139"},{"text":"proceedings of medical-review committees” under N.C. Gen. Stat. § 131E-95(b); and","paragraph_id":"para_140"},{"text":"“the doctor-patient privilege in N.C. Gen. Stat. § 8-53.” As the assertion of these","paragraph_id":"para_141"},{"text":"privileges is not otherwise frivolous or insubstantial, we hold that the challenged","paragraph_id":"para_142"},{"text":"order affects a substantial right. Id. Accordingly, we have jurisdiction to review this","paragraph_id":"para_143"},{"text":"appeal.","paragraph_id":"para_144"},{"text":"B. Standard of Review","paragraph_id":"para_145"},{"text":"Although discovery orders are ordinarily reviewed for abuse of discretion,","paragraph_id":"para_146"},{"text":"Midgett v. Crystal Dawn Corp., 58 N.C. App. 734, 737 (1982), an order compelling the","paragraph_id":"para_147"},{"text":"MCGEHEE V. FARBER","paragraph_id":"para_148"},{"text":"Opinion of the Court","paragraph_id":"para_149"},{"text":"- 7 -","paragraph_id":"para_150"},{"text":"disclosure of information claimed to be statutorily privileged presents a legal","paragraph_id":"para_151"},{"text":"question, and our review is therefore de novo. See Hammond v. Saini, 367 N.C. 607,","paragraph_id":"para_152"},{"text":"609-10 (2014).","paragraph_id":"para_153"},{"text":"A party asserting a statutory privilege must demonstrate that the privilege","paragraph_id":"para_154"},{"text":"applies and may not rely on “mere conclusory assertions.” Id. at 610. Instead, the","paragraph_id":"para_155"},{"text":"party must provide sufficient evidence establishing that the disputed material falls","paragraph_id":"para_156"},{"text":"within the scope of the privilege as defined by statute. Brown v. Am. Partners Fed.","paragraph_id":"para_157"},{"text":"Credit Union, 183 N.C. App. 529, 534 (2007). A party may attempt to meet this","paragraph_id":"para_158"},{"text":"burden by submitting affidavits setting forth facts sufficient to establish the","paragraph_id":"para_159"},{"text":"applicability of the privilege to the particular documents being withheld or by","paragraph_id":"para_160"},{"text":"submitting the allegedly privileged materials for an in camera review. Id. at 534-35.","paragraph_id":"para_161"},{"text":"C. Patient Safety Act","paragraph_id":"para_162"},{"text":"Appellants first argue that the trial court erred by ordering UNC Health to","paragraph_id":"para_163"},{"text":"disclose the SAFE report because it is privileged patient safety work product under","paragraph_id":"para_164"},{"text":"the Patient Safety Act.","paragraph_id":"para_165"},{"text":"The Patient Safety Act, 42 U.S.C. §§ 299b-21 et seq., establishes a federal","paragraph_id":"para_166"},{"text":"privilege and confidentiality provisions for patient safety work product, subject to","paragraph_id":"para_167"},{"text":"statutory exceptions. 42 U.S.C. §§ 299b-22(a)-(c). Patient safety work product is","paragraph_id":"para_168"},{"text":"defined in three ways: (1) “data, reports, records, memoranda, analysis . . . or written","paragraph_id":"para_169"},{"text":"or oral statements . . . assembled or developed by a provider for reporting to a patient","paragraph_id":"para_170"},{"text":"safety organization and are reported to a patient safety organization,” id.","paragraph_id":"para_171"},{"text":"MCGEHEE V. FARBER","paragraph_id":"para_172"},{"text":"Opinion of the Court","paragraph_id":"para_173"},{"text":"- 8 -","paragraph_id":"para_174"},{"text":"§ 299b-21(7)(A)(i)(I); (2) such things developed by a patient safety organization, id.","paragraph_id":"para_175"},{"text":"§ 299b-21(7)(A)(i)(II); and (3) such things that “identify or constitute the deliberations","paragraph_id":"para_176"},{"text":"or analysis of, or identify the fact of reporting pursuant to, a patient safety evaluation","paragraph_id":"para_177"},{"text":"system,” id. § 299b-21(7)(A)(ii). The definition of patient safety work product excludes","paragraph_id":"para_178"},{"text":"“information that is collected, maintained, or developed separately, or exists","paragraph_id":"para_179"},{"text":"separately, from a patient safety evaluation system[,]” and such “separate","paragraph_id":"para_180"},{"text":"information or a copy thereof reported to a patient safety organization shall not by","paragraph_id":"para_181"},{"text":"reason of its reporting be considered patient safety work product.” Id.","paragraph_id":"para_182"},{"text":"§ 299b-21(7)(B).","paragraph_id":"para_183"},{"text":"The first definition protects documents that “are assembled or developed by a","paragraph_id":"para_184"},{"text":"provider for reporting to a patient safety organization and are reported to a patient","paragraph_id":"para_185"},{"text":"safety organization[.]” Id. § 299b-21(7)(A)(i)(I) (emphasis added). The critical inquiry","paragraph_id":"para_186"},{"text":"is the purpose for creating the information; thus, “the information will only be","paragraph_id":"para_187"},{"text":"considering patient safety work product if it is created ‘for the purpose of reporting’","paragraph_id":"para_188"},{"text":"to a patient safety organization.” Daley v. Teruel, 107 N.E.3d 1028, 1037 (Ill. App. Ct.","paragraph_id":"para_189"},{"text":"2018) (citation omitted).","paragraph_id":"para_190"},{"text":"Here, UNC Health has not met its burden of demonstrating that the SAFE","paragraph_id":"para_191"},{"text":"report is protected by the Patient Safety Act. The UNC Health Patient Safety Event","paragraph_id":"para_192"},{"text":"Reporting policy governing SAFE reports indicates that UNC Health uses SAFE","paragraph_id":"para_193"},{"text":"reports for multiple internal purposes, including routine quality improvement","paragraph_id":"para_194"},{"text":"purposes and operational review: “Within a culture of safety, there is continuous","paragraph_id":"para_195"},{"text":"MCGEHEE V. FARBER","paragraph_id":"para_196"},{"text":"Opinion of the Court","paragraph_id":"para_197"},{"text":"- 9 -","paragraph_id":"para_198"},{"text":"reporting of patient safety concerns or events in order for these occurrences to be","paragraph_id":"para_199"},{"text":"analyzed and processes changed or systems improvements made.” Dr. Zvara","paragraph_id":"para_200"},{"text":"acknowledged these additional uses in his affidavit:","paragraph_id":"para_201"},{"text":"11. UNC Hospitals’ Patient Safety Evaluation System","paragraph_id":"para_202"},{"text":"(PSES) exists anywhere UNC Hospitals conduct patient","paragraph_id":"para_203"},{"text":"safety activity and extends anywhere the use of Patient","paragraph_id":"para_204"},{"text":"Safety Work Product (“PSWP”) may result in quality","paragraph_id":"para_205"},{"text":"improvement. PSWP is considered “collected” when the","paragraph_id":"para_206"},{"text":"information is entered into the SAFE event reporting","paragraph_id":"para_207"},{"text":"system. Submission of PSWP into the PSES is performed","paragraph_id":"para_208"},{"text":"with the intention of ultimately reporting PSWP to the","paragraph_id":"para_209"},{"text":"[Patient Safety Organization]. PSWP that is derived from","paragraph_id":"para_210"},{"text":"analysis and deliberations shall be marked “PSWP –","paragraph_id":"para_211"},{"text":"Analysis within the PSES” or “Confidential.”","paragraph_id":"para_212"},{"text":"(emphasis added). Although UNC Health ultimately submitted the SAFE report to","paragraph_id":"para_213"},{"text":"the Patient Safety Organization, UNC Health may not shield otherwise discoverable","paragraph_id":"para_214"},{"text":"internal documents from disclosure merely by routing them through their patient","paragraph_id":"para_215"},{"text":"safety evaluation system. UNC Health has not met its burden of demonstrating that","paragraph_id":"para_216"},{"text":"the SAFE report was created for reporting to a patient safety organization. The court","paragraph_id":"para_217"},{"text":"thus did not err by concluding that Appellants failed to show that the SAFE report","paragraph_id":"para_218"},{"text":"was created for reporting to a patient safety organization within the meaning of 42","paragraph_id":"para_219"},{"text":"U.S.C. § 299b-21(7)(A)(i)(I).","paragraph_id":"para_220"},{"text":"Appellants cite In re BayCare Med. Grp., Inc., for the proposition that the","paragraph_id":"para_221"},{"text":"Patient Safety Act may protect from disclosure documents created, used, or","paragraph_id":"para_222"},{"text":"maintained for multiple purposes under the first definition, so long as the documents","paragraph_id":"para_223"},{"text":"constitute patient safety work product under the statute. 101 F.4th 1287, 1291 (11th","paragraph_id":"para_224"},{"text":"MCGEHEE V. FARBER","paragraph_id":"para_225"},{"text":"Opinion of the Court","paragraph_id":"para_226"},{"text":"- 10 -","paragraph_id":"para_227"},{"text":"Cir. 2024). But BayCare is neither binding nor persuasive, as it addressed the third","paragraph_id":"para_228"},{"text":"definition of patient safety work product, not the first.","paragraph_id":"para_229"},{"text":"The SAFE report likewise does not “identify or constitute the deliberations or","paragraph_id":"para_230"},{"text":"analysis of . . . a patient safety evaluation system” because, as UNC Health concedes,","paragraph_id":"para_231"},{"text":"it created the SAFE report which “analyzes Mr. McGehee’s condition and treatment.”","paragraph_id":"para_232"},{"text":"As the SAFE report does not include the deliberations or analysis of a patient safety","paragraph_id":"para_233"},{"text":"evaluation system, it does not satisfy the third definition of patient safety work","paragraph_id":"para_234"},{"text":"product under 42 U.S.C. § 299b-21(7)(A)(ii).","paragraph_id":"para_235"},{"text":"For the reasons stated above, the SAFE report does not constitute patient","paragraph_id":"para_236"},{"text":"safety work product, and the court did not err by ordering UNC Health to disclose the","paragraph_id":"para_237"},{"text":"report.","paragraph_id":"para_238"},{"text":"D. Medical Review Privilege","paragraph_id":"para_239"},{"text":"Appellants next argue that the trial court erred by ordering the subpoenaed","paragraph_id":"para_240"},{"text":"non-party physicians to testify in depositions about “privileged discussions of","paragraph_id":"para_241"},{"text":"medical-review committees.”","paragraph_id":"para_242"},{"text":"The medical review privilege, less commonly referred to as the medical","paragraph_id":"para_243"},{"text":"review-committee privilege, provides that “[t]he proceedings of a medical review","paragraph_id":"para_244"},{"text":"committee, the records and materials it produces[,] and the materials it considers”","paragraph_id":"para_245"},{"text":"are confidential and not considered public records. N.C. Gen. Stat. § 131E-95(b)","paragraph_id":"para_246"},{"text":"(2025). These records and materials are not discoverable or admissible in any civil","paragraph_id":"para_247"},{"text":"action against a hospital or a provider of professional health services “which results","paragraph_id":"para_248"},{"text":"MCGEHEE V. FARBER","paragraph_id":"para_249"},{"text":"Opinion of the Court","paragraph_id":"para_250"},{"text":"- 11 -","paragraph_id":"para_251"},{"text":"from matters which are the subject of evaluation and review by the committee.” Id.","paragraph_id":"para_252"},{"text":"No person who attends a medical review committee meeting “shall be required to","paragraph_id":"para_253"},{"text":"testify in any civil action as to any evidence or other matters produced or presented","paragraph_id":"para_254"},{"text":"during the proceedings of the committee or as to any findings, recommendations,","paragraph_id":"para_255"},{"text":"evaluations, opinions, or other actions of the committee or its members.” Id.","paragraph_id":"para_256"},{"text":"Although a committee member or a person who testifies before the committee may","paragraph_id":"para_257"},{"text":"testify in a civil action, that individual cannot be questioned regarding testimony","paragraph_id":"para_258"},{"text":"given before the committee or any opinions formed as a result of the committee","paragraph_id":"para_259"},{"text":"hearings. Id. The medical review privilege does not, however, extend to “information,","paragraph_id":"para_260"},{"text":"documents, or records otherwise available[.]” Id.","paragraph_id":"para_261"},{"text":"The purpose of N.C. Gen. Stat. § 131E-95(b) is to promote medical staff candor","paragraph_id":"para_262"},{"text":"and medical review committee objectivity. Shelton v. Morehead Memorial Hospital,","paragraph_id":"para_263"},{"text":"318 N.C. 76, 83 (1986). The privilege does not extend to “information . . . available[]","paragraph_id":"para_264"},{"text":"from original sources other than the medical review committee . . . merely because it","paragraph_id":"para_265"},{"text":"was presented during medical review committee proceedings[,]” and the statute’s","paragraph_id":"para_266"},{"text":"purpose is not violated by allowing materials otherwise available to “be discovered","paragraph_id":"para_267"},{"text":"and used in evidence even though they were considered by [a] medical review","paragraph_id":"para_268"},{"text":"committee.” Id. at 83-84; see also Armstrong v. Barnes, 171 N.C. App. 287, 294 (2005)","paragraph_id":"para_269"},{"text":"(holding that a doctor was not shielded from answering deposition questions about","paragraph_id":"para_270"},{"text":"his drug abuse because he was “an original source . . . [of] the information sought","paragraph_id":"para_271"},{"text":"MCGEHEE V. FARBER","paragraph_id":"para_272"},{"text":"Opinion of the Court","paragraph_id":"para_273"},{"text":"- 12 -","paragraph_id":"para_274"},{"text":"because he created and kn[ew] the details of his drug abuse outside the privileged","paragraph_id":"para_275"},{"text":"proceedings of the [medical review] committee and the records it produced”).","paragraph_id":"para_276"},{"text":"Here, the court ruled that Plaintiff’s counsel may question the subpoenaed","paragraph_id":"para_277"},{"text":"non-party physicians “about any matter related to the care given to [Decedent] and","paragraph_id":"para_278"},{"text":"their knowledge of any other incidents involving Dr. Farber where his care or his","paragraph_id":"para_279"},{"text":"interactions with patients, staff[,] and employees may have been called into","paragraph_id":"para_280"},{"text":"question.” At oral argument, the parties did not dispute the applicable law and","paragraph_id":"para_281"},{"text":"essentially agreed that the court’s order on this issue was overbroad. Plaintiff","paragraph_id":"para_282"},{"text":"conceded that if a subpoenaed physician “solely learned” of information about Dr.","paragraph_id":"para_283"},{"text":"Farber “only in a medical review committee hearing, then they wouldn’t be required","paragraph_id":"para_284"},{"text":"to testify about that.”","paragraph_id":"para_285"},{"text":"The court correctly ordered that “Plaintiff’s Counsel can inquire of these","paragraph_id":"para_286"},{"text":"employees about any matter related to the care given to [Decedent] and their","paragraph_id":"para_287"},{"text":"knowledge of any other incidents involving Dr. Farber where his care or his","paragraph_id":"para_288"},{"text":"interactions with patients, staff[,] and employees may have been called into","paragraph_id":"para_289"},{"text":"question.” (emphasis added). We add, however, that the subpoenaed non-party","paragraph_id":"para_290"},{"text":"physicians may not be compelled to answer such inquiries where their testimony","paragraph_id":"para_291"},{"text":"would provide information gained solely through medical-review committee","paragraph_id":"para_292"},{"text":"proceedings that is protected by the medical review privilege under N.C. Gen. Stat.","paragraph_id":"para_293"},{"text":"§ 131E-95. We thus vacate this portion of the order and remand to the trial court for","paragraph_id":"para_294"},{"text":"clarification of this provision consistent with the law.","paragraph_id":"para_295"},{"text":"MCGEHEE V. FARBER","paragraph_id":"para_296"},{"text":"Opinion of the Court","paragraph_id":"para_297"},{"text":"- 13 -","paragraph_id":"para_298"},{"text":"E. Physician-Patient Privilege","paragraph_id":"para_299"},{"text":"Appellants finally argue that the trial court erred by ordering UNC Health to","paragraph_id":"para_300"},{"text":"produce a spreadsheet containing patient complaints that mention Dr. Farber","paragraph_id":"para_301"},{"text":"because the spreadsheet is protected by the physician-patient privilege under N.C.","paragraph_id":"para_302"},{"text":"Gen. Stat. § 8-53.","paragraph_id":"para_303"},{"text":"Under the physician-patient privilege, a physician may not be required to","paragraph_id":"para_304"},{"text":"disclose any information “acquired in attending a patient in a professional character,","paragraph_id":"para_305"},{"text":"and which information was necessary to enable him to prescribe for such patient as","paragraph_id":"para_306"},{"text":"a physician, or to do any act for him as a surgeon.” N.C. Gen. Stat. § 8-53 (2025).","paragraph_id":"para_307"},{"text":"Confidential information contained in medical records may be furnished only if","paragraph_id":"para_308"},{"text":"authorized by the patient, or if deceased, by certain representatives. Id. The","paragraph_id":"para_309"},{"text":"physician-patient privilege extends to oral communications and to information","paragraph_id":"para_310"},{"text":"obtained by a physician through observation or examination during treatment. Cates","paragraph_id":"para_311"},{"text":"v. Wilson, 321 N.C. 1, 14 (1987). “The physician-patient privilege is strictly construed","paragraph_id":"para_312"},{"text":"and the patient bears the burden of establishing the existence of the privilege and","paragraph_id":"para_313"},{"text":"objecting to the introduction of evidence covered by the privilege.” Mosteller v.","paragraph_id":"para_314"},{"text":"Stiltner, 221 N.C. App. 486, 487 (2012) (quotation marks and citations omitted).","paragraph_id":"para_315"},{"text":"Here, the spreadsheet contains complaints submitted to UNC Health’s","paragraph_id":"para_316"},{"text":"patient-relations department, not to treating physicians. Appellants offered no","paragraph_id":"para_317"},{"text":"evidence that the information was communicated to a physician for treatment or","paragraph_id":"para_318"},{"text":"derived from a physician’s examination. Dr. Zvara’s affidavit merely asserted that","paragraph_id":"para_319"},{"text":"MCGEHEE V. FARBER","paragraph_id":"para_320"},{"text":"Opinion of the Court","paragraph_id":"para_321"},{"text":"- 14 -","paragraph_id":"para_322"},{"text":"the spreadsheet “implicates the Protected Health Information (‘PHI’) of patients","paragraph_id":"para_323"},{"text":"other than the Plaintiff,” but HIPAA’s definition of PHI is broader than § 8-53 and","paragraph_id":"para_324"},{"text":"does not establish a physician-patient privilege. Compare 45 C.F.R. § 160.103","paragraph_id":"para_325"},{"text":"(defining protected health information broadly to include individually identifiable","paragraph_id":"para_326"},{"text":"health information transmitted or maintained in any form or medium) with N.C. Gen.","paragraph_id":"para_327"},{"text":"Stat. § 8-53 (limiting physician-patient privilege to information acquired in attending","paragraph_id":"para_328"},{"text":"a patient and necessary to enable medical treatment).","paragraph_id":"para_329"},{"text":"The court reviewed the spreadsheet in camera and found no basis to conclude","paragraph_id":"para_330"},{"text":"that it contained privileged information. Upon our review, we conclude the same.","paragraph_id":"para_331"},{"text":"Furthermore, the court ordered UNC Health to redact any protected health","paragraph_id":"para_332"},{"text":"information and to produce the spreadsheet subject to a protective order.","paragraph_id":"para_333"},{"text":"Because the spreadsheet does not contain privileged physician-patient","paragraph_id":"para_334"},{"text":"information under section 8-53, the court did not err by ordering UNC Health to","paragraph_id":"para_335"},{"text":"produce it.","paragraph_id":"para_336"},{"text":"III. CONCLUSION","paragraph_id":"para_337"},{"text":"In sum, the trial court did not err by ordering UNC Health to disclose the SAFE","paragraph_id":"para_338"},{"text":"report, as it does not constitute patient safety work product under 42 U.S.C.","paragraph_id":"para_339"},{"text":"§ 299b-21(7)(A)(i) or (ii) and is therefore not privileged. The court erred to the extent","paragraph_id":"para_340"},{"text":"it ordered UNC Health and its employees to produce documents or provide testimony","paragraph_id":"para_341"},{"text":"regarding information that is protected by the medical review privilege under N.C.","paragraph_id":"para_342"},{"text":"Gen. Stat. § 131E-95. The court did not err by ordering UNC Health to disclose","paragraph_id":"para_343"},{"text":"MCGEHEE V. FARBER","paragraph_id":"para_344"},{"text":"Opinion of the Court","paragraph_id":"para_345"},{"text":"- 15 -","paragraph_id":"para_346"},{"text":"redacted patient complaints against Dr. Farber because these are not protected by","paragraph_id":"para_347"},{"text":"the physician-patient privilege under N.C. Gen. Stat. § 8-53. 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