Scenario 4.1 During a school field trip to a local orchard, 13-year-old Johnny Chapman fell out of a tree while picking apples. That evening, his parents took him to the emergency room at Woodville Hospital, where he was diagnosed with a fractured ulna. He was admitted and surgery was necessary. Johnny was discharged after a two-day stay. Johnny's parents subsequently sued the school system and two of the three parent chaperones who had volunteered for failing to safeguard Johnny during the field trip and failing to seek emergency medical care. Three months later, the health information department director at Woodville Hospital, Jay Forshall, was subpoenaed with directions to bring Johnny's record to a deposition the following day. The deposition was being held in Columbia City, which was 125 miles away. Jay complied with the subpoena by preparing Johnny's medical record. Woodville Hospital's health record was hybrid, so Jay printed out the electronic components from the hospital's EHR system and collected the remaining components that existed on paper. Jay drove to Columbia City the following morning. During the deposition, legal counsel for the Chapmans proceeded to ask Jay about Johnny's medical record. Jay was asked to verify that the record was Johnny's and that it was prepared in the usual course of business. He was then asked about the contents of the record. One question posed to him was whether Tylenol, which had been administered to Johnny at the hospital, was given to lessen Johnny's pain. Jay stated that he presumed legal counsel's statement was true, as that is a common reason for Tylenol to be given. Jay was also asked to read an otherwise illegible note that the physician, Dr. Fogle, had written on the discharge instruction sheet. Dr. Fogle was a visiting physician, and Jay was not familiar with her handwriting. Nonetheless, he tried his best to assist legal counsel in deciphering the note. Jay was not involved in the case any further following the deposition. However, he was aware that the hospital's peer review committee minutes (where Johnny's case had been discussed) had also been subpoenaed. Several months later, he read in the newspaper that the case had gone to trial. One of the parent chaperones who was initially sued never responded to the complaint and did not participate in any of the proceedings, including the trial. A jury rendered a verdict against the school system and the three parent chaperones, with all being required to pay money damages. 1. A verdict was rendered against three parent chaperones. How was the third parent included in the case? 2. Based on the facts, was Jay Forshall required to provide Johnny's records in response to the subpoena? Why or why not? What factors did you take into consideration? 3. Were all of the questions asked of Jay Forshall during the deposition appropriate? If your answer is no, what questions were inappropriate? Why? 4. Identify other legal procedural issues associated with this case. 5. Presume that Jay Forshall later realized that an authorization signed by Johnny's parents had not accompanied the subpoena. Did he wrongfully respond to the subpoena? 6. Presume that, while acting on the subpoena, Jay Forshall discovered that the electronic component of the record had sections deleted. A review of audit trails determined that a hospital staff member was responsible for the deletions. Under what legal concept could the hospital be liable for the deletions? What should have been done to protect the record? 7. Do you believe that all the evidence that was discoverable during the deposition was admissible at trial? On what do you base your conclusion? 8. Do you believe the peer review committee minutes were discoverable? On which legal principle(s) do you base your conclusion? 83