McDaniel v. Loyola Univ. Med. Ctr.
McDaniel v. Loyola Univ. Med. Ctr.
2016 WL 11734770 (N.D. Ill. 2016)
October 4, 2016

Mason, Michael T.,  United States Magistrate Judge

Medical Records
Failure to Produce
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Summary
The court denied the plaintiff's motion to compel the production of 800 operative notes from the defendants. The court found that the motion was untimely and that the documents sought were not responsive to the requests to produce. The court also noted that the 2012 Epic audit was created to assist with verifying any attendance issues and was properly produced in response to discovery requests, and that Clarity receives a data feed from Epic and is not directly accessed by users in the course of patient care.
Additional Decisions
MARK D. MCDANIEL, M.D. Plaintiff,
v.
LOYOLA UNIVERSITY MEDICAL CENTER, et al. Defendants
No. 13 CV 6500
United States District Court, N.D. Illinois, Eastern Division
Filed October 04, 2016

Counsel

Cynthia H. Hyndman, Robert Lawrence Margolis, Laura R. Feldman, Robinson Curley P.C., Chicago, IL, for Plaintiff.
Brian Wegg Bulger, Jacob Maxwell Rubinstein, Julie Lynn Trester, Cozen O'Connor, Chicago, IL, for Defendants Loyola University Medical Center, CHE Trinity, Inc., Loyola University of Chicago, William J. Hopkinson, MD, Terry Light, MD, William Cannon, MD, Dane Salazar, MD, Alexander Ghanayem, MD.
Douglas Raymond Carlson, Douglas Carlson LLC, Chicago, IL, for Defendant Accreditation Council for Graduate Medical Education.
Mason, Michael T., United States Magistrate Judge

Opinion

*1 Written Opinion by Magistrate Judge Michael T. Mason: For the reasons set forth below, plaintiff's motion to compel discovery responses [269] (also listed as docket entries 270 and 271) is denied. Status hearing remains scheduled for October 13, 2016 at 10:00 a.m.
 
BACKGROUND
The background of this matter has been discussed in previous Court orders and party motions. In brief, plaintiff Mark McDaniel, M.D. (“plaintiff”) brought this action alleging that he was wrongfully terminated from Loyola University Medical Center's (“LUMC”) orthopaedic residency program and exposed to a hostile work environment. Defendants LUMC, CHE Trinity, Inc., Loyola University of Chicago, Dr. William Hopkinson, Dr. Terry Light, Dr. William Cannon, Dr. Dane Salazar, and Dr. Alexander Ghanayem (collectively referred to as “defendants”) contend that misrepresentations in plaintiff's surgical case logs, his poor attendance, and his lack of professionalism were the factors that led to his termination.
 
Written discovery closed on October 30, 2015. (Dkt. 167). Oral fact discovery was set to close on March 30, 2016. Id. On March 28, 2016, this Court granted the parties' agreed motion to extend discovery, ordering oral discovery to close on July 29, 2016. (Dkt. 230). On July 28, 2016, plaintiff filed a motion to compel discovery responses [269][1]. In his motion, plaintiff seeks the production of certain medical records created and entered by plaintiff in “Epic,” the electronic medical records database at LUMC. Plaintiff alleges that the documents are responsive to his second request to produce to LUMC Nos. 7 and 22, second request to produce to Dr. Hopkinson Nos. 6 and 13, second request to produce to Dr. Cannon No. 7, second request to produce to Dr. Light No. 7, and his third request to produce to LUMC No. 5. In brief, the requests to produce seek documents concerning the decision to terminate plaintiff, including the decision to terminate him prior to his probation hearing; documents concerning plaintiff's attendance, including dates plaintiff was allegedly absent without permission; and all documents concerning resident attendance for clinical responsibilities.[2] (Motion at 10-11).
 
According to plaintiff, the Epic medical records supplement an allegedly incomplete Epic audit trail that was created in 2012. Specifically, in September 2012, Dr. Cannon requested a review of plaintiff's Epic activity in order to help ascertain plaintiff's attendance on certain dates. As a result, an Epic audit trail (hereinafter “Epic audit”) containing data for January 1, 2009 through September 13, 2012 was created. It was produced during the course of written discovery. During the April 18, 2016 deposition of Ms. Gina Ordonez, Department Administrator for the Orthopaedic Surgery Department at LUMC, plaintiff's counsel asked the deponent to compare medical records authored by plaintiff with the Epic audit. The comparison demonstrated that certain medical records were not included in the Epic audit. Consequently, Ms. Ordonez acknowledged that because of this discrepancy the audit trail appeared to be incomplete. (Motion at Ex. D, page 210-11). Parties subsequently met and conferred regarding the allegedly incomplete audit trail.
 
*2 The defendants attempted to resolve any disparities, however, due to limitations in the technology they were allegedly unable to produce a replica of the 2012 Epic audit trail with all of the missing dates. Accordingly, in an effort to supplement the Epic audit, they produced additional audit trails. Specifically, defendants produced an audit trail generated in Clarity[3] for the time period of December 17, 2010 through September 17, 2012. It was subsequently learned that for data management and capacity reasons, the data contained in Clarity was eventually moved into another system called Access Log. Consequently, an Access Log audit trail was produced for the period June 1, 2009 through December 16, 2010. Plaintiff contends that the Access Log audit trail contains less data than the other productions. Defendants respond that the Access Log software does not store all of the same fields of data contained in Epic and Clarity, but they maintain that all of the data for the relevant time periods has been produced.
 
On July 1, 2016, plaintiff provided defense counsel with a list of over 1,900 operative notes for approximately 400 patients that were allegedly still missing from the produced audit trails. In his reply [283], plaintiff clarifies that he seeks approximately 800 Epic records associated with the 400 patients. (Reply at 1). On July 8, 2016, defendants produced Epic audit trails for certain patients that contained activity for plaintiff, Dr. Hegarty, and Ms. Ordonez. Defendants objected to producing the medical records identified by plaintiff because the documents were not responsive to prior discovery requests, were untimely sought, and were unduly burdensome. Plaintiff's motion followed.
 
In his motion, plaintiff seeks to compel the production of the operative notes for certain patients that are allegedly not included in the Epic audit. According to plaintiff, “Loyola relied on the McDaniel Audit Trail to make determinations about Dr. McDaniel's attendance and performance in connection with the decision to terminate Dr. McDaniel.” (Motion at 4). Plaintiff asserts that the Epic audit is incomplete and unreliable, specifically because it is missing various notes authored by plaintiff. Therefore, he maintains that he should receive supplemental information necessary to further assess his attendance. In his reply, plaintiff argues that the Epic records are responsive to discovery requests because they comprise information relevant to the Epic audit that was reviewed in 2012. Moreover, plaintiff states that the motion is timely because defendants' reliance on the audit trail was not established until Ms. Ordonez's deposition. It is also plaintiff's position that the request is not burdensome because the records are easily accessible.
 
Defendants respond [277] that plaintiff's motion is untimely and does not seek documents responsive to the requests to produce. According to defendants, plaintiff had ample time to request the medical records prior to the close of written discovery. Further, defendants' emphasize that no discovery request ever sought Epic data beyond that which was used to determine whether to terminate plaintiff. While plaintiff previously requested specific patient notes to compare with his case logs, he made no further requests for any additional patient records. Defendants explain that they did not review operative notes in determining whether to terminate plaintiff, therefore plaintiff's motion does not sufficiently relate to his discovery requests. Moreover, defendants assert that whether or not the Epic audit was incomplete is irrelevant because the only issue is whether they relied on the audit trail in good faith when making the decision to terminate plaintiff. Defendants further emphasize that Epic is not a tool for tracking attendance and that all audit trails available for the time period covered by the 2012 Epic audit have been produced. Additionally, defendants' argue that the medical records are irrelevant and unlikely to lead to the discovery of admissible evidence, that the request would create an undue burden, and that it would require the production of protected health information.
 
*3 The Court agrees that plaintiff's request is untimely and does not seek documents responsive to the specific requests to produce.
 
LEGAL STANDARD
Rule 26(b)(1) of the Federal Rules of Civil Procedure allows the parties to obtain discovery regarding “any nonprivileged matter that is relevant to any party's claim or defense and proportional to the needs of the case.” “In ruling on motions to compel discovery, courts have consistently adopted a liberal interpretation of the discovery rules.” Kodish v. Oakbrook Terrace Fire Prot. Dist., 235 F.R.D. 447, 450 (N.D. Ill. 2006) (citation omitted); see Cannon v. Burge, No. 05 C 2192, 2010 WL 3714991, at *1 (N.D. Ill. Sept. 14, 2010) (“The federal discovery rules are liberal in order to assist in trial preparation and settlement.”). “Courts commonly look unfavorably upon significant restrictions placed upon the discovery process,” and the “burden rests upon the objecting party to show why a particular discovery request is improper.” Kodish, 235 F.R.D. at 450.
 
ANALYSIS
Timeliness
Written discovery closed on October 30, 2015. (Dkt. 167). According to defendants, and undisputed by plaintiff, responses to the discovery requests at issue were served on May 29, 2015. (Resp. at 7). Plaintiff claims that he had no reason to suspect that the Epic audit was inaccurate and the “source of much of the material supporting the termination” (reply at 4) until Ms. Ordonez's deposition. The deposition transcripts included in the motion, however, do not demonstrate that the deposition provided information previously unavailable to plaintiff. Specifically, the record before the Court fails to establish that plaintiff had no prior notice of the use or the accuracy of the Epic audit. With respect to plaintiff's assertion that he had no reason to suspect that the Epic audit was inaccurate until Ms. Ordonez's deposition, plaintiff, in fact, provided the documents that showed gaps in the Epic audit. Based on the comparison plaintiff asked her to do, Ms. Ordonez noted that there did appear to be inaccuracies in the Epic audit. While her testimony may be the first time someone testified that there were inaccuracies, it cannot be said to be the first time plaintiff was put on notice of the discrepancies. Plaintiff presumably learned of the discrepancies whenever his counsel decided to compare the documents used in the deposition with the Epic audit. Therefore, plaintiff is unable to maintain that he had no knowledge of the inaccuracies until the deposition.
 
Plaintiff further appears to rely on the assertion that Ms. Ordonez's deposition was the first time he learned of the defendants' reliance on the allegedly incomplete Epic audit in making a decision regarding his termination. Again, however, this argument fails. In addition to the production of the Epic audit, defendants produced a number of memoranda that Ms. Ordonez prepared based on her review of certain documents. The memoranda break down certain attendance concerns and identify the sources from which Ms. Ordonez gathered her information. In each memorandum, Ms. Ordonez references the Epic audit and the information gathered from it, as well as the other sources used. (Resp. at Exs. 2(A-F)). For example, a September 17, 2012 memorandum from Ms. Ordonez to Dr. Hopkinson references her review of the Epic audit, plaintiff's case log, Epic scheduling, and surgical billing records in addition to conversations with attending physicians, for her assessment of plaintiff's attendance. (Resp. at Ex. 2(A)). She makes specific references to instances where there is no recorded Epic activity. These memoranda were produced during the course of written discovery. Plaintiff, in fact, used one of the September 26 memoranda in Ms. Ordonez's deposition. (Motion at Ex. C). Accordingly, Ms. Ordonez's use of and reliance on the Epic audit was made known to plaintiff when the documents were produced, not when she was deposed.
 
*4 Plaintiff's claim that he had no way of determining whether the flaws in the Epic audit had been identified by defendants is without merit. The memoranda discuss the review of the audit and where alleged gaps in attendance were found. Any concerns over the use of the audit or its accuracy could have been brought at an earlier time. Plaintiff had ample time to address these attendance matters, yet he waited until almost six months after the close of written discovery to seek additional documents. Accordingly, there is no evidence that the deposition put plaintiff on notice of anything that was not previously available.
 
Plaintiff's ability to attempt to receive the medical records at an earlier date is further evidenced by the fact that on December 7, 2015, plaintiff brought a motion to compel particular medical records when he wanted to dispute arguments over his case log entries. (Dkt. 187). In his reply to the December 7 motion, plaintiff argued that the medical records were relevant to establish that he performed cases that were not accurately reflected in his case log, which was one of the reasons given for his termination. (Dkt. 205 at 8). This Court granted plaintiff's motion in part because it related to a disparity between procedures plaintiff claimed to have performed and what was reflected in the case logs.[4] (Dkt. 207 at 7).
 
Notably, the December 7 motion was filed just over a month after written discovery closed. This present motion was filed almost eight months after written discovery closed. Just as plaintiff identified disparities with the case logs and his attendance, he could have identified the disparities with the audit trail and his attendance at an earlier date. As discussed above, the attendance issues were discussed in multiple memoranda previously produced, and Ms. Ordonez's deposition did not put plaintiff on notice of anything not previously available to plaintiff.
 
Accordingly, the Court finds that plaintiff's delay in seeking documents is not justified. Plaintiff did not need the deposition of Ms. Ordonez to establish that the audit trail was incomplete since his counsel's own review apparently yielded the same information. Any alleged gaps in the Epic audit should have been addressed at an earlier time.
 
Responsiveness to Requests to Produce
In addition to the timeliness argument, defendants assert that plaintiff's motion does not seek documents responsive to his requests to produce. Plaintiff's requests to produce at issue here can be broken down into two categories: (1) documents concerning defendants' decision to terminate plaintiff[5]; and (2) documents concerning plaintiff's attendance, including absence without leave and attendance for clinical responsibilities[6]. Plaintiff's motion seeks additional documents in order to dispute the accuracy of the documents used to determine whether to terminate plaintiff and to potentially establish attendance on particular days.
 
With respect to the first category of requests, the 2012 Epic audit was created to assist with verifying any attendance issues, and it was properly produced in response to discovery requests. Because the records plaintiff currently seeks were not used by defendants when making a decision regarding plaintiff's probation and/or termination, the records cannot be said to be “documents concerning the decision to terminate [plaintiff].” (Motion at 10).
 
*5 Plaintiff's own discovery requests support this Court's finding. Specifically, plaintiff's third request to produce to LUMC number 12 requests particular patient notes. Plaintiff requested these records in order to dispute allegations that he falsified case log reports. The belief that plaintiff falsified case log reports was one of the explanations defendants used for plaintiff's termination, and it was plaintiff's assertion that the medical records would reveal that he did not falsify his case logs. Consequently, plaintiff issued a separate request for the specific medical records. He did not argue that they fell within the other requests for documents concerning the decision to terminate him. Similarly, any request for documents to dispute attendance discrepancies should have been made separately. Accordingly, the Court finds that the 800 operative notes do not fall within plaintiff's request for documents concerning defendants' decision to terminate plaintiff.
 
Further, although plaintiff argues that the requested medical records fall under the discovery requests because they help to address attendance issues by establishing that plaintiff was indeed present on certain days, the medical records cannot be said to be documents concerning plaintiff's attendance. It is too broad an assertion that any document containing an individual's name and date can be considered “a document concerning the individual's attendance” for production purposes. No evidence has been presented that a patient's medical record is maintained as a way to establish a physician's attendance. Defendants did request an audit trail from Epic to help assess attendance issues, but they did so in order to determine whether plaintiff “entered information into Epic reflecting active patient care activities.” (Motion at Ex. B). This method was only one of the ways in which they attempted to analyze plaintiff's attendance.
 
As previously stated, Ms. Ordonez's September 2012 memoranda also reference her review of surgery case logs, Epic scheduling, IDX surgical billing detail, and the didactic attendance sheets for the applicable time period. (Resp. at Exs. 2(A-F)). Had the Epic audit been considered an attendance tracker, defendants would not likely have needed to compare and contrast information from so many sources. Accordingly, while medical records may incidentally shed some light on a physician's presence on a given day, there is no indication that they are intended to be an assertion of a physician's attendance. Plaintiff's request for particular medical records is not responsive to the discovery requests for documents concerning his attendance.
 
Conclusion
Consequently, this Court finds that plaintiff failed to seek the medical records at issue in a timely manner. Further, even if this Court did find the request and motion to be timely, the request does not seek documents responsive to his requests to produce. Accordingly, plaintiff's motion to compel the production of the operative notes is denied.

Footnotes
Plaintiff's original motion was docket entry 254. Plaintiff subsequently filed the motion under seal twice (dkt. 269 and 271), along with a redacted version (dkt. 270). For purposes of this order, the motion will be referred to as docket entry 269.
Plaintiff did not provide copies of the requests to produce in his motion; however, defendants' response included copies as exhibits.
Clarity, as explained by defendants, receives a data feed from Epic and is not directly accessed by users in the course of patient care. Because Clarity extracts data from Epic and there can be issues with the data transfer, a Clarity audit is not an exact replica of the electronic medical record.
As discussed in further detail below, the motion was related to a request to produce specific medical records.
Second request to produce to LUMC No. 7; second request to produce to Dr. Light No. 7; second request to produce to Dr. Hopkinson No. 6; and second request to produce to Dr. Cannon No. 7.
Second request to product to LUMC No. 22; second request to produce to Dr. Hopkinson No. 13; and third request to produce to LUMC No. 5.