Martinez v. Porta
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IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF TEXAS
FORT WORTH DIVISION
NICOLAS LEANDRO MARTINEZ,
INDIVIDUALLY, and AS
INDEPENDENT ADMINISTRATOR
OF THE ESTATE OF MARGARET
GLORIA MARTINEZ, DECEASED;
CHRISTINA MARIE ORTIZ;
CARMEN RACHEL ORTIZ; and
MIGUEL ANTONIO ORTIZ
Plaintiff,
V.
CESAR H. PORTA, M.D.;
RAMASAMY SELVARAJ, M.D.;
SHIRAM SUDARSHAN, M.D.;
SCOTT WILLIAMSON, M.D.;
and UNITED REGIONAL HEALTH
CARE SYSTEM, INC., d/b/a UNITED
REGIONAL HEALTH CARE SYSTEM
Defendants.
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CIVIL ACTION NO. 4:03-CV-915-Y
ORDER OVERRULING OBJECTIONS TO
MAGISTRATE JUDGE’S DISCOVERY ORDERS
Pending before the Court are Objections to Magistrate Judge’s Discovery Orders [doc. #
141], filed by defendant United Regional Health Care System, Inc. (“the Hospital”) on July 11,
2006. After consideration of the objections, the response, and the reply, the Court OVERRULES
the objections.
This case involves claims brought under the Emergency Medical Treatment and Active
Labor Act (“the EMTALA”). See 42 U.S.C.A. § 1395dd (West Supp. 2006). Margaret Gloria
Martinez was admitted to the Hospital’s emergency department on November 18, 2001, complaining
of radiating chest pain and numbness in her right arm. She was discharged from the emergency
Case 4:03-cv-00915 Document 156 Filed 11/01/2006 Page 2 of 5
department once, but returned 45 minutes later and was admitted to the Hospital later that day. In
the early morning hours of November 19, Martinez suffered a heart attack and died. Her husband
and children brought suit against the Hospital and the doctors involved in her care.
Plaintiffs served a request for production on the Hospital, requesting medical records from
each person who was a patient in the emergency department between November 1, 1996, through
December 1, 2002, and presented with symptoms similar to Martinez’s or received cardiac-type
treatment. After the Hospital objected to this request and Plaintiffs filed a motion to compel, this
Court referred the matter to United States Magistrate Judge Charles Bleil. See 28 U.S.C.A. §
636(b)(1)(A) (West 2006). The magistrate judge overruled some of the Hospital’s objections to this
request, but sustained some of the Hospital’s objections based on assertions of attorney-client and
work-product privileges. He further reduced to 1999 and 2001 the years for which the Hospital was
obligated to produce such records and deleted five categories that Plaintiffs had listed that would
qualify a patient’s file as subject to production. The Hospital was ordered to redact names, social-
security numbers, billing information, and personal contact information from the records before
production.
The Hospital’s motion to reconsider this ruling was also referred to the magistrate judge
because the Hospital presented new evidence in the motion. The magistrate judge granted the
motion to reconsider. Plaintiffs were given 60 days to inspect all responsive records and select 400
for the Hospital to redact and copy, at the Hospital’s expense. Plaintiffs were ordered not to record
any information from the records “other than that necessary to clearly make known or identify those
charts selected from production.” The magistrate judge further entered a protective order governing
the inspection, production, and use of protected health information that might be disclosed:
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(1) No party shall use or disclose the protected health information contained in the patient
charts to be inspected for any purpose other than the litigation for which such information
was requested. See 45 C.F.R. [§] 164.512(e)(1)(v)(A).
(2) At the end of the litigation, Plaintiffs shall return to [the Hospital] any and all protected
health information (including copies thereof). See 45 C.F.R. [§] 164.512(e)(1)(v)(B).
(3) Counsel for the parties shall give notice of this Order and its terms to each person to
whom protected health information is disclosed by them, and each such person shall be
required to comply with the provisions of this Order. (June 30 Qualified Protective Order
at 2.)
The Hospital now objects to this determination. See FED. R. CIV. P. 72(a).
In reviewing a magistrate judge’s order on a nondispositive matter, such as discovery, this
Court may modify or set aside any portion of the order only if the objecting party shows that it is
clearly erroneous or contrary to law. See 28 U.S.C.A. § 636(b)(1)(A); FED. R. CIV. P. 72(a). A
finding is clearly erroneous when, although there may be evidence to support it, this Court is left
with the definite and firm conviction that a mistake has been made; a determination is contrary to
law if the magistrate judge misinterpreted or misapplied applicable law. See Marks v. Struble, 347
F. Supp. 2d 136, 149 (D. N.J. 2004). In other words, this Court may not disturb a magistrate judge’s
determination on a nondispositive matter merely because it could have been decided differently.
See Easley v. Cromartie, 532 U.S. 234, 259 (2001).
Under the EMTALA, a hospital must provide “appropriate” medical screening. See 42
U.S.C.A. § 1395dd(a). Appropriateness is judged by whether the screening at issue was performed
equitably in comparison to other patients with similar symptoms. See Marshall v. E. Carroll. Parish
Hosp., 134 F.3d 319, 322-24 (5th Cir. 1998). The Hospital argues that Plaintiffs’ request is irrelevant
because: (1) the categories of records requests for patients who received cardiac-type treatment do
not allow comparison to patients with similar symptoms; (2) records for years before 2001 do not
apply to Martinez’s care. The Hospital also asserts that the magistrate judge’s order is overly
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burdensome to the Hospital, does not protect “confidential healthcare information of innocent
uninvolved third parties,” and forces it to create new documents in response to the production
request.
Regarding the categories of information that they seek, Plaintiffs are correct that this
evidence reasonably could lead to evidence bearing on appropriateness and is, thus, relevant. See
Coughlin v. Lee, 946 F.2d 1152, 1158 (5th Cir. 1991). For example, a patient’s chart could show a
non-specific cardiac symptom, e.g., nausea, when, in fact, the presenting symptoms were similar to
Martinez’s. If such a patient was treated with cardiac methods, Plaintiffs’ request would uncover
the chart, but would be shielded under the Hospital’s rigid, symptom-presented criteria.
The Hospital did not raise its relevance argument attacking the categories until it filed its
motion to reconsider the magistrate judge’s first order. Regarding its complaints that records from
1999 are too far removed from Martinez’s death to be relevant, the Hospital admits that there is no
case law to definitively indicate the time frame over which medical records would be relevant.
(Hosp.’s Br. at 14.) But Plaintiffs ably argued exactly why the 1999 records are relevant before the
magistrate judge. (Hosp. R. to Objs. at 121, 584-586.)
The Hospital’s burdensomeness objection is also meritless. As pointed out by Plaintiffs in
their response, the Hospital has wholly failed to show undue burdensomeness. See generally FED.
R. CIV. P. 26(b)(2). By law, the Hospital is required to maintain its records in such a way that would
allow them to be easily retrieved. (Hosp.’s R. to Objs. at 121-24.) The Hospital’s evidence of
burdensomeness does not refer to or take into account these record-keeping requirements.
The Hospital asserts that the magistrate judge’s order fails to protect patient privacy. This
Court concludes, however, that the magistrate judge took adequate steps to protect patient privacy.
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Although the order did not go as far as the Hospital wanted, there is no showing that the order was
erroneous or contrary to the law.
The Hospital’s argument that the magistrate judge’s order requires it to create new
documents is puzzling. On the one hand, the Hospital asserts that patient privacy must be taken into
account; however, it further asserts that it cannot be asked to create new documents even in the
interest of patient privacy. The order for the Hospital to compile a list of charts available is
reasonable and protects Plaintiffs from a possible data dump by the Hospital. See generally FED.
R. CIV. P. 26(c). Further, and as noted by Plaintiffs, the suggestion to compile a list of responsive
records was originally raised by the Hospital in response to Plaintiffs’ motion to compel. (Hosp. R.
to Objs. at 16.)
The Hospital has not shown that the magistrate judge’s order was clearly erroneous or
contrary to law. Thus, its objections are overruled.
SIGNED November 1, 2006.
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