In this medical malpractice litigation, plaintiff, individually and as executrix of her late husband's estate, moved to compel defendants to permit her expert to conduct an onsite inspection of decedent's electronic medical record (EMR). Plaintiff contended that pursuant to Rule 4:18-1, she had the right to inspect and examine the "metadata" associated with the EMR, which exceeded more than 2,000 pages and had already been produced in PDF format by defendants. Plaintiff agreed that defendants would control the log in to the computer system and the mouse guiding the expert's review. Plaintiff also agreed not to access the system through the use of thumb drives or discs to copy any information. Plaintiff also sought production of an "audit trail" of the EMR for nearly a full year after decedent's discharge.
Defendants objected, arguing the discovery request was unduly burdensome and posed security risks and the risk of exposing other patient's EMR. They argued that plaintiff should identify specific entries in the record for which she sought metadata, and they would produce it, subject to assertions of confidentiality or privilege. Defendants also objected to producing the audit trail, claiming it, too, was unduly burdensome and irrelevant.
The Law Division judge granted plaintiff's motion, and the court granted defendants leave to appeal.
The court concluded that plaintiff was entitled to access metadata in decedent's EMR pursuant to Rules 4:10-2(f) and 4:18-1, and that defendants bore the burden of demonstrating the discovery request was unduly burdensome. The court agreed with the motion judge's conclusion that defendants failed to do so, and the proposed inspection was reasonable. The court affirmed that portion of the judge's order granting the inspection as modified by reasonable restrictions, including a time limit for the inspection of four hours.
The court, however, reversed that portion of the judge's order requiring defendants to produce a post-discharge audit trail that extended beyond the date of the last entries made to decedent's EMR, finding plaintiff failed to demonstrate the potential for relevant information from such a broad request.