February 18, 2022

Court Grants, Among Others, Plaintiff’s Motion for Unredacted Versions of Documents Already Protected by a HIPAA Qualified Protective Order as well as Documents Showing Computer Queries Used by Defendants

by Alan Brooks

In McCRIMMON and DETTMANN v. CENTURION OF FLORIDA, No. 3:20-cv-36-BJD-LLL (M.D. Fla. Feb. 7, 2022) before the Court were several issues including discovery disputes regarding search terms, unredacted versions of documents covered by HIPAA, and computer queries conducted by Defendants.

Plaintiffs, co-administrators of decedent’s estate, proceeded on an amended complaint against Defendants and individual healthcare providers.  Plaintiffs’ claims arose out of medical care decedent received when he was an inmate at the Florida Department of Corrections. Decedent was housed at the Reception and Medical Center (RMC) for his serious medical needs. After receiving surgery at Memorial Hospital Jacksonville, he returned to RMC, and five days later Plaintiffs alleged his health began to deteriorate.

Plaintiffs alleged that despite decedent’s condition, doctors took no action to determine the cause and refused to send him to the hospital. He was found unresponsive shortly thereafter. Plaintiffs alleged that Defendant Centurion implemented policies or practices that were contributing factors to decedent’s death.

Among others, Plaintiffs sought an order compelling Defendant Centurion to “(1) conduct an ESI search of 19 terms related to Plaintiffs’ Monell claim; (2) expand the timeframe of its ESI searches; (3) search the personal ESI of the individual Centurion healthcare providers who are Defendants in this action; and (4) provide unredacted copies of certain records previously disclosed.”  Monell claims (based on Monell v. Dep’t of Soc. Servs. of City of New York, 436 U.S. 658 (1978)), require a showing of “a persistent and wide-spread practice of violative conduct.” 

Defendant Centurion contended that Plaintiffs’ 19 proposed search terms were not proportional to the needs to the case and were not relevant to the Plaintiff’s Monell claim. Defendant Centurion also argued that personal ESI was fruitless because the individual Defendants had no responsive information and that Centurion properly redacted some information from already disclosed documents to “protect the PHI and PII of non-parties.” Upon consideration, Plaintiffs’ motion to compel was granted in part and denied in part.

With respect to search terms, the Court found that the search terms Defendant had already searched with would not necessarily capture documents to Plaintiffs’ Monell claim, which alleged that Defendant “maintained policies and practices pursuant to which prisoners . . . with serious medical needs were routinely denied medical care and access to medical care.”

The Court noted that some of the additional 19 terms Plaintiff propose could lead to matter that could bear on Plaintiffs’ Monell claims. Defendant countered that some of the terms had already been searched, and the other terms could be too broad and produce too many results. However, as noted by the Court, Defendant refused to provide alternative search terms and Defendant’s suggestion that it satisfied its discovery obligation by disclosing its written policies was disingenuous given Plaintiff’s contention that Defendant was aware and disregarded the history of abuse.

As stated by the Court: “The Court is not best positioned to identify appropriate search terms for the parties, nor should the Court do the attorneys’ work. Accordingly, the Court will direct Centurion to propose a list of alternative terms related to Plaintiffs’ Monell claim. The parties are best positioned to reach a compromise on a reasonable list of additional search terms specifically targeted to Plaintiffs’ Monell claim and within the search capabilities of Centurion’s databases to yield relevant documents.”     

With respect to timeframe for searches, while the Court found that some of Defendant’s original timeframe searches were appropriate, searches beyond the original timeframe related to Plaintiff’s Monell claim was reasonable because people who cared for decedent might have communicated about his care after his death.

As to Plaintiff’s request to compel individual Defendants to conduct ESI searches of their personal email accounts, text messages, and social media, having provided sworn interrogatories from the individual defendants that stated they did not use those platforms to discuss matters relevant to the case, the motion was denied.

With respect to Plaintiffs’ request for unredacted versions of documents already disclosed, given that the parties were already bound by a HIPAA qualified protective order, Plaintiff’s request was found to be reasonable and Defendant ordered to produce unredacted versions of documents previously disclosed to Plaintiffs with third-party PHI redacted.

Also before the Court was Plaintiff’s RFP seeking documents showing the searches or queries used by Defendant’s employees in a computer program called “UpToDate” related to “c. diff.” (the infection that caused decedent’s death) as well as documents by any individual defendants in the same program but not limited to “c. diff.” 

With respect to searches in UpToDate by any defendant employee, that request was denied given that searches by employees who were not defendants in the case and not involved in treating decedent were not relevant to Plaintiff’s individual deliberate indifference claims. 

However, Defendant’s objections with respect to searches by the individual defendants were overruled. Given that there was evidence that Defendant’s medical providers consulted the UpToDate program to inform themselves of treatment protocols, Plaintiff’s request for the searches conducted by the individual Defendants during the time they treated decedent was relevant and proportional.

The Court also rejected Defendant’s claim that it already appropriately searched the program using just the term “c. diff.”  The Court recognized that Plaintiff’s request was not so limited and that the request for results of ANY searches or queries the individual Defendants conducted for the specific time frame was reasonable given that it was plausible that the providers responsible for decedent’s care would have consulted UpToDate to search symptoms decedent was presenting and that any such searches could have been conducted to inform treatment decisions.