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Duffy v. Lawrence Memorial Hospital

United States District Court, D. Kansas

March 31, 2017

MEGEN DUFFY, Relator/Plaintiff,
v.
LAWRENCE MEMORIAL HOSPITAL, Defendant.

          MEMORANDUM AND ORDER

          Teresa J. James U.S. Magistrate Judge

         This matter is before the Court on Defendant/Counterclaimant Lawrence Memorial Hospital's Motion to Modify Discovery Order (Doc. 133) Directing Defendant/Counterclaimant Lawrence Memorial Hospital to Respond to Document Request Nos. 40, 41, 43 and 58 and for Protective Order, or, in the Alternative, Motion for Extension of Time to Respond (ECF No. 142). Pursuant to Federal Rule of Civil Procedure 26(c), Defendant asks the Court to enter a protective order directing it to produce a random sampling of 252 patient records, along with five spares, in order to respond to Plaintiff's Document Requests Nos. 40, 41, 43 and 58. Plaintiff opposes the motion. As set forth below, Defendant's motion is granted.

         I. Relevant Background

         In its order dated February 7, 2017, this Court ordered Defendant to produce within 14 days documents responsive to certain of Plaintiff's requests in her Second Request for Production of Documents.[1] Plaintiff acknowledges Defendant produced the documents in question with the exception of those which are the subject of the instant motion, i.e. those responsive to RFP No. 40, 41, 43 and 58. The relevant requests are as follows:

REQUEST 40: All records for LMH Emergency Department patients 18 years and older, presenting with complaints of chest pain or acute myocardial infarction from October 1, 2010 to the present, which reflect or indicate the time such patients first had contact with Emergency Department personnel during such visits.
REQUEST 41: All electrocardiogram (ECG or EKG) printouts, strips, and other paper or electronically stored records, for patients 18 years and older presenting in the LMH Emergency Department between October 1, 2010 and the present with complaints of chest pain or acute myocardial infarction, reflecting or indicating the time an electrocardiogram was performed.
REQUEST 43: All nurse notes, cheat sheets, time stamps, and other electronically stored or paper notes or records used by Emergency Department employees to note the time any patient, 18 years or older and presenting to the Emergency Department with complaints of chest pain or acute myocardial infarction, first had contact with Emergency Department personnel during such visits.
REQUEST 58: All Emergency Department logs or other documentation of transfers (as required to be kept by the Emergency Medical Treatment & Labor Act), to or from any other medical facility, of patients presenting to LMH with chest pain or acute myocardial infarction.[2]

         As Defendant conducted searches for documents responsive to these requests, it determined that 15, 574 unique patient records would have to be located and gathered.[3] The process would require an individual or individuals to go into Defendant's electronic records system and review every one of the patient charts in those records to respond to the discovery order. As Defendant explains, the hospital rolls its patients' Emergency Department visit records into their inpatient or observation visits, making it impossible to electronically segregate the Emergency Department portion from the hospital-based portion of any visit. According to Defendant, during 2016 it released 13, 848 patient records (or nearly 2, 000 fewer than this production would require) with a staff of three individuals working five days a week. Mr.

         Williams voices a concern that processing and logging 15, 574 patient records in relatively short order would cause significant strain on Defendant's access to and use of its electronic production database, slowing the system and potentially impacting patient care. As a result, Mr. Williams recommends that the search for and production of these patient records be performed outside the hours of 7:00 AM to 5:00 PM Monday through Friday.

         In an effort to calculate the time necessary to locate and produce the relevant patient records, Defendant's Medical Records department obtained a sample of ten patient records. They reported that it took up to 20 minutes to process and log a single patient's records to respond to the four requests at issue, and an additional ten minutes to determine if a record contained information relating to a transfer to or from other medical facilities as requested in RFP No. 58. At 30 minutes per record, Defendant estimates it would take 7, 787 worker hours to locate and produce responsive information for 15, 574 patient records. If Defendant had ten employees working on the task, they would spend more than ninety-seven days working eight hours a day, at an estimated cost to Defendant of $196, 933.23.[4]

         After aggregating the information, Defendant asserts it would need to redact patients' personal confidential information. According to an affidavit of the Director of Litigation Support at defense counsel's law firm, redaction would take ten reviewers fourteen days at a cost of $37, 259.50. The process would include a quality control attorney reviewer who would spend two hours a day, and reviewers who would review 15 documents per hour for eight hours a day.

         In sum, Mr. Williams and Mr. Cole estimate that producing the information relevant to RFP Nos. 40, 41, 43, and 58 would take 8, 982 hours of work and cost in excess of $230, 000 if done by contract staff.

         II. Summary of the ...


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