Maryland Board of Physicians v. Geier

Hotten, J. We consider whether a party asserting the absolute quasi-judicial privilege and the deliberative process (executive) privilege may properly appeal three orders from the circuit court prior to a final judgment, and whether those privileges prevent the admissibility of certain discovery. Respondents, Dr. Mark Geier (“Dr. Geier”), David Geier (“Mr. Geier”) and Anne Geier (“Ms. Geier”), 1 filed a complaint against Petitioners 2 ”), in the Circuit Court for Montgomery County, alleging that Petitioners invaded their privacy by publicizing their private medical information in a cease and desist order that was issued during disciplinary proceedings brought by Petitioners against Dr. Geier and Mr. Geier. During discovery, the circuit court entered three separate orders that: (1) granted Respondents’ sixth motion for sanctions against Petitioners regarding the disclosure of audio ⁵³⁴ tapes of Petitioners’ deliberations; (2) denied Petitioners’ motion for reconsideration of a default order on liability for a series of discovery failures; and (3) denied Petitioners’ motion for a protective order from Respondents’ sixth motion to compel documents, which required Petitioners to disclose their personal financial information to Respondents. Petitioners appealed all three interlocutory orders, and this Court granted certiorari.

For the reasons that follow, we grant Respondents’ motion to dismiss as it relates to the orders denying Petitioners’ motions for reconsideration and for a protective order; deny Respondents’ motion to dismiss as it relates to the order granting Respondents’ sixth motion for sanctions; reverse and vacate the order granting Respondents’ sixth motion for sanctions; and remand the case to the circuit court for further proceedings consistent with this opinion. FACTUAL AND PROCEDURAL BACKGROUND I. Board’s Administrative Proceedings Against Respondents Mark R. Geier and David Geier a. Mark Geier On October 3, 2006, the Board notified Dr. Geier that it had received a complaint against him regarding his use of the drug Lupron 3 to treat autistic children. The complaint alleged that Dr. Geier was: (1) practicing outside of the scope of his expertise and the prevailing standard of care for autism; (2) experimenting on children without a rational scientific theory or the supervision of a qualified review board; and (3) failing ⁵³⁵ to provide appropriate informed consent regarding the potential side effects of Lupron and similar drugs.

On April 27, 2011, the Board summarily suspended Dr. Geier’s right to practice medicine, asserting that the “public health, safety or welfare imperatively required emergency action” due to certain medical practices engaged in by Dr. Geier. 4 On May 16, 2011, the Board formally charged Dr. Geier with violations of the Medical Practice Act, Md. Code (Repl. Vol. 2014), §§ 14-401 et seq. of the Health Occupations Article (“Health Oce.”). On September 15, 2011 the Board issued amended charges against Dr. Geier for prescribing medicine to family members while his license was suspended. After amending its complaint, the Board charged Dr. Geier with: (1) unprofessional conduct in the practice of medicine; (2) willfully making or filing a false report or record in the practice of medicine; (3) willfully failing to file or record any medical record as required under law; (4) practicing medicine with an unauthorized person or aiding an unauthorized person in the practice of medicine; (5) gross overutilization of health care services; (6) failing to meet standards, as determined by peer review, for the delivery of quality medical care; and (7) failing to keep adequate medical records.

On September 26, 2011, after six days of hearings, 5 an Administrative Law Judge (“ALJ”) issued a proposed decision upholding the summary suspension of Dr. Geier’s license. On ⁵³⁶ March 13, 2012, following an additional five days of hearings, the ALJ issued a 126-page proposed decision, recommending that the charges against Dr. Geier be upheld, 6 and that his license be revoked. Dr. Geier took exception to the ALJ’s findings, but on August 22, 2012, the Board issued a final decision revoking his license. Dr. Geier petitioned for judicial review, and the Circuit Court for Montgomery County affirmed the Board’s revocation on April 9, 2014.

Dr. Geier moved to alter or amend the court’s ruling, but the motion was denied. Dr. Geier then noted an appeal to the Court of Special Appeals, and that Court, in a reported opinion, affirmed the Board’s decision. See Geier v. Md. State Bd. of Physicians, 223 Md.App. 404 , 116 A.3d 1026 (2016). b. David Geier On May 16, 2011, the Board also charged Dr. Geier’s son, Mr. Geier, for practicing medicine without a license in violation of Health Occ. § 14-601. 7 On March 7, 2012, an ALJ recommended that the charges against Mr. Geier be dismissed.

On July 30, 2012, however, the Board rejected the ALJ’s recommendation and many of the judge’s findings, concluding that Mr. Geier had practiced medicine without a license because he diagnosed a patient, determined which blood tests the patient required, and ordered those tests. The Board imposed a $10,000 fine. Mr. Geier petitioned the Circuit Court for Montgomery County for judicial review of the Board’s findings, and the circuit court affirmed the Board’s decision on April 25, 2014. Mr. Geier then appealed to the Court of Special Appeals, and that Court, in an unreported opinion dated July 31, 2015, also affirmed the Board. ⁵³⁷ c.

The Disclosure of the Respondents Personal Medical Information On January 25, 2012, during the pendency of both disciplinary proceedings, the Board issued a cease and desist order against Dr. Geier, accusing him of practicing medicine while his license had been summarily suspended. The order, posted to the Board’s website and viewable by the public, specifically alleged that Dr. Geier had written prescriptions for all three Respondents. The order also detailed the Respondents’ confidential medical information, identified the specific medications that Dr. Geier allegedly prescribed to each person, and described the medical conditions that each medication treated. 8 Petitioners promptly removed the confidential information from the cease and desist order in response to Respondents’ protest. Petitioners also issued an amended cease and desist order that deleted the references to the patients and the medications that Dr. Geier allegedly prescribed for them.

In the interim between the initial publication and the Petitioners’ remedial actions, other persons viewed and commented about the Respondents’ confidential medical information, and those comments are still accessible on the internet. Ultimately, an ALJ rejected the charge that Dr. Geier had written any prescriptions in violation of the summary suspension order issued by Petitioners.

II

Respondents’ Civil Action Against Petitioners a. The Complaint On December 12, 2012, while Dr. Geier and Mr. Geier were pursuing judicial review of the Board’s adverse rulings, Respondents filed a three-count complaint in the Circuit Court for Montgomery County against Petitioners. The complaint alleged that by publicizing the January 25th cease and desist ⁵³⁸ order that contained the Respondents’ confidential medical information, Petitioners deprived them of their constitutional right to privacy; violated the Maryland Confidentiality of Medical Records Act, Md. Code (1982, 2009 Repl. Vol.), §§ 4-301 et seq. of the Health General Article; and invaded their privacy by giving unreasonable publicity to private facts.

The complaint also alleged that Petitioners “acted with ill will and with the intent to injure [Respondents] by exposing Dr. Geier’s personal medical information and that of his wife and son.” Respondents requested compensatory damages, as well as three million dollars in punitive damages. Petitioners moved to dismiss the complaint for failure to state a claim upon which relief could be granted, asserting they had absolute quasi-judicial immunity from suit under Ostrzenski v. Seigel, 177 F.3d 245 (4th Cir, 1999). Following a hearing on July 10, 2013, the circuit court dismissed the Confidentiality of Medical Records Act claim, finding that the statute did not create a private cause of action. The circuit court allowed the constitutional and invasion of privacy claims to proceed, finding that the record was inadequate to evaluate the applicability of any immunities at such an early stage of the proceedings. b.

Discovery Following the circuit court’s ruling that allowed two of Respondents’ claims to proceed, Respondents sought extensive discovery, attempting to uncover evidence demonstrating Petitioners acted out of animosity in publishing the cease and desist letter. Respondents sought information regarding the specific circumstances immediately surrounding the Petitioners’ disclosure of their confidential medical information, as well as documents and testimony that revealed Petitioners’ decisional process in the administrative proceedings against them. Respondents also sought communications between Petitioners and their counsel that related to these proceedings. Following an unsatisfactory response to discovery requests, Respondents filed multiple motions to compel and motions for discovery sanctions against Petitioners between the months of ⁵³⁹ November 2013 and February 2016, which led to numerous hearings in the circuit court, and concurrent interlocutory appeals by Petitioners.

Of import to the issues before this Court are the events that occurred during and after Petitioners’ filed their first interlocutory appeal from the circuit court’s June 17, 2014 discovery order. 9 On August 15, 2014, 10 Respondents filed their fifth motion for sanctions seeking a default judgment as to liability, alleging primarily that Petitioners failed to produce an adequately prepared organizational representative noted as a prepared designee for a 167-topic deposition. Respondents subsequently requested a hearing regarding the fifth motion for sanctions. Also on August 15th, the Court of Special Appeals issued an order staying all discovery in the circuit court pending the outcome of the first interlocutory appeal. In opposition to Respondents’ fifth motion for sanctions, Petitioners alleged that most of the deposition topics covered information in Respondents’ possession or were not discoverable because they involved issues pending on appeal.

Petitioners also noted they appealed the circuit court’s June 17th discovery order denying Petitioners assertions of various privileges, and that Petitioners “should not be sanctioned for ⁵⁴⁰ declining to allow these protections and privileges to be eviscerated in other discovery proceedings” and allowing Respondents to “frustrate the appellate court’s ability to provide meaningful relief in its resolution” of the issues before it. Following a hearing on November 13, 2014, the circuit court granted Respondents’ fifth motion for sanctions. On December 16, 2014, the circuit court issued a memorandum opinion that detailed Petitioners’ culpable conduct during discovery, and thereafter, entered a default judgment of liability against Petitioners. The circuit court noted that a trial on damages would be scheduled after Petitioners’ first interlocutory appeal had been resolved.

On December 24, 2014, Petitioners noted a second interlocutory appeal based on the circuit court’s default judgment, which the Court of Special Appeals consolidated with Petitioners’ initial appeal filed on June 26. See Md. Bd. Of Physicians v. Geier, 225 Md.App. 114, 123 A.3d 601 (2015). c. The Court of Special Appeals’ Decision The Court of Special Appeals first held that neither order appealed by Petitioners constituted a final judgment.

The Court concluded that the collateral order doctrine applied to the June 17th discovery order, allowing the Court to hear Petitioners’ claims regarding that discovery order. See Geier, 225 Md.App. at 129-38, 123 A.3d at 610-16 . The collateral order doctrine did not apply to the December 16th order of default on liability, corresponding to Respondents’ fifth motion for sanctions, because the Court concluded that the issues that order addressed were not “collateral” to the merits of the case. Id. at 139-43 , 123 A.3d at 616-19 .

In considering the merits of Petitioners’ claims regarding the June 17th order, the Court held that under Health Occ. § 14-410 11 Dr. John L. Young’s (“Dr. Young”) 12 disciplinary ⁵⁴¹ files were not discoverable by Respondents. The Court noted that, under Health Occ. § 14-410, both the Board and Dr. Young had to expressly consent to the discoverability of Dr. Young’s proceedings as parties to the action. Because the Board objected to releasing Dr. Young’s proceedings, they were not discoverable by Respondents in the present action. Id. at 144-47, 123 A.3d at 619-21 .

The Court also concluded that the circuit court erred in rejecting Petitioners’ claim of executive privilege, because it failed to expressly balance Petitioners’ need for confidentiality against Respondents’ need for disclosure, and the impact of nondisclosure on a fair administration of justice. Id. at 147-52 , 123 A.3d at 621-24 . Finally, the Court considered the merits of Petitioners’ claims regarding the allegedly privileged communications between the Board and Joshua Shafer, an investigator for the Board. Although the Court noted that generally an appellate court does not have jurisdiction to consider an interlocutory appeal from a discovery ruling that rejects a claim of attorney-client privilege, the Court still considered the merits because it formed a part of a ruling that the Court had jurisdiction to review.

Id. at 153 , 123 A.3d at 624 (citing Kurstin v. Bromberg Rosenthal LLP, 420 Md. 466, 480 , 24 A.3d 88, 96 (2011)). The Court noted that the Guidelines for Administrative Adjudicatory Proceedings (“Guidelines”) have no effect on the confidentiality of communications between Board employees, like Shaffer, and the Board’s attorneys. Id. at 154, 123 A.3d at 625 . The Court concluded that the circuit court erred in rejecting Petitioners’ claim of privilege on the ground that the Guidelines rendered Shafer a “stranger” to the attorney-client rela ⁵⁴² tionship between the Board and its attorneys.

Id. at 154 , 123 A.3d at 625 . The Court remanded the case back to the Circuit Court for Montgomery County for further proceedings consistent with its opinion. d. The Post-Remand Proceeding in the Circuit Court On remand, Respondents sought a hearing on their sixth motion for sanctions filed on August 8, 2014, 13 involving Petitioners’ audio recordings on internal deliberations regarding Dr. Geier’s and Mr. Geier’s disciplinary proceedings. On November 5, 2014, Respondents served their sixth request for production of documents, seeking a variety of financial information from Petitioners, which prompted Petitioners to pursue a protective order, based in substantial part, on their claim of absolute quasi-judicial immunity from suit.

On December 28, 2015, Petitioners also filed a motion for reconsideration of the default liability order and for summary judgment in Petitioners’ favor. Petitioners asserted that in the order of default on liability, the circuit court found the Board, but not the individual Petitioners, had engaged in discovery violations. Petitioners also argued that the Court of Special Appeals narrowed the scope of what discovery should be permitted. Respondents disagreed, and on February 10, 2016, filed a seventh motion for sanctions alleging that Petitioners’ motion for a protective order raising the immunity defense was in bad faith.

On March 24, 2016, the circuit court held a hearing on the parties’ respective motions, and subsequently denied Petitioners’ motion for summary judgment, motion for reconsideration on the default judgment of liability, and motion for a protective order from Respondents’ sixth request for documents. The circuit court found that the General Assembly had enacted a detailed statutory scheme addressing Petitioners’ immu ⁵⁴³ nity from suit in 1976 that has not been repealed. 14 The circuit court concluded that because the statutory scheme remains in effect, Petitioners’ claim of a common law absolute quasi-judicial immunity claim did not apply. On that basis, the circuit court denied Petitioners’ motion for summary judgment. The circuit court also denied Petitioners’ motion for reconsideration because the circuit court found that, even under the Court of Special Appeals’ mandate, Petitioners failed to provide specific evidence that their deponent was responsive, sufficient for the circuit court to reverse its order.

The circuit court also noted that, even after adhering to the Court of Special Appeals’ mandate, Petitioners’ conduct remained “abysmal, abominable, [and] sanctionable.” Finally, the circuit court granted Respondents’ sixth motion for sanctions. The circuit court found that Petitioners did not assert any privilege in their initial responses to Respondents’ requests for the audiotapes, and the tapes were not included on Petitioners’ privilege logs, so the assertion of privilege was waived. The circuit court also ordered that all of Respondents’ outstanding discovery requests were due by April 22, 2016. On April 1, 2016, Petitioners noted an interlocutory appeal to the Court of Special Appeals, seeking review of the circuit court’s March 24th orders denying their motions for reconsideration and request for a protective order, and granting Respondents’ sixth motion for sanctions.

This Court, sua sponte, granted certiorari, and on April 22, 2016 ordered a stay of the proceedings pending further review. Additional facts shall be provided, infra, to the extent they prove relevant in addressing the issues presented. STANDARD OF REVIEW With respect to discovery rules, it is long settled that circuit court judges “are vested with a reasonable, sound ⁵⁴⁴ discretion in applying them, which discretion will not be disturbed in the absence of a showing of its abuse.” Ehrlich v. Grove, 396 Md. 560, 560 , 914 A.2d 783, 790 (2007) (quoting E.I. du Pont de Nemours & Co. v. Forma-Pack, Inc., 351 Md. 396, 405 , 718 A.2d 1129, 1133-34 (1998)). Thus, the resolution of discovery disputes and the imposition of discovery sanctions are within the circuit court’s sound discretion, and reviewed by this Court only for abuse of discretion.

See id. An abuse of discretion occurs “where no reasonable person would take the view adopted by the [trial] court” or when the court acts “without reference to any guiding principles or rules[,]” or when the ruling under consideration is “clearly against the logic and effect of facts and inferences before the court[ ]” or when the ruling is “violative of fact and logic.” Gallagher Evelius & Jones, LLP v. Joppa Drive-Thru, Inc., 195 Md.App. 583, 597 , 7 A.3d 160, 168 (2010) (quoting Wilson v. John Crane, Inc., 385 Md. 185, 198-99 , 867 A.2d 1077 (2005)). “Generally, the standard is that absent a showing that a court acted in a harsh, unjust, capricious and arbitrary way, [this Court] will not find an abuse of discretion.” Ehrlich, 396 Md. at 561 , 914 A.2d at 790 (quoting Dashiell v. Meeks, 396 Md. 149, 178 , 913 A.2d 10, 26 (2006)). DISCUSSION I. Respondents Motion to Dismiss In conjunction with filing their brief in this Court, Respondents’ also filed a motion to dismiss this appeal for lack of appellate jurisdiction arguing that none of the three orders before this Court are immediately appealable. We conclude that the orders denying Petitioners’ respective motions for reconsideration and for a protective order are not properly appealable, and therefore, grant Respondents’ motion to dismiss as it relates to those orders.

Because we conclude, however, the order granting Respondents’ sixth motion for sanction is immediately reviewable by this Court under the collateral order doctrine, we deny Respondents’ motion to dismiss as it relates to that order. ⁵⁴⁵ a. Final Judgment None of the appealed circuit court’s orders qualify as a final judgment that would grant this Court automatic review of the circuit court’s decisions. Section 12—101(f) of the Courts and Judicial Proceedings Article defines a final judgment as a “judgment, decree, sentence, order, determination, decision or other action by a court ... from which an appeal, application for leave to appeal, or petition for certiorari may be taken.” To constitute a final judgment, a trial court’s ruling “must either decide and conclude the rights of the parties involved or deny a party the means to prosecute or defend rights and interests in the subject matter of the proceeding.” Harris v. State, 420 Md. 300, 312 , 22 A.3d 886, 893 (2011) (quoting Schuele v. Case Handyman, 412 Md. 555, 565 , 989 A.2d 210, 216 (2010)). Additionally, for a judgment to be final, the ruling must also contain the following three attributes: “(1) it must be intended by the court as an unqualified, final disposition of the matter in controversy!!;] (2) unless the court acts pursuant to Maryland Rule 2-602(b) to direct the entry of a final judgment as to less than all the claims or all the parties, it must adjudicate or complete the adjudication of all claims against all parties; [and] (3) it must be set forth and recorded in accordance with [Maryland] Rule 2-601.” Metro Maint.

Sys. S., Inc. v. Milburn, 442 Md. 289, 298 , 112 A.3d 429, 436 (2015) (citing Rohrbeck v. Rohrbeck, 318 Md. 28, 41 , 566 A.2d 767, 773 (1989). The record reflects that the circuit court did not intend for any of its orders to be considered a “final disposition of the matter in controversy[.]” See Metro Maint. Sys.

S., Inc., 442 Md. at 298 , 112 A.3d at 435 . The circuit court, after denying Petitioners’ motion for a protective order, ordered that Petitioners had until April 1, 2016 to provide an updated privilege log, and until April 22, 2016 to respond to all of Respondents’ outstanding discovery requests. The circuit court’s scheduling of additional discovery matters clearly indicates that there was no “unqualified, final disposition of the matter in controversy IT Id. ⁵⁴⁶ In the absence of a final judgment, appellate review is limited to three exceptions: (1) appeals from interlocutory orders specifically allowed by statute; (2) immediate appeals permitted under Maryland Rule 2-602; and (3) appeals from interlocutory rulings allowed under the common law collateral order doctrine. See Salvagno v. Frew, 388 Md. 605, 615 , 881 A.2d 660, 666 (2005).

The first two exceptions are not implicated in this case. b. Common Law Collateral Order Doctrine The common law collateral order doctrine is a well-established but narrow exception to the general rule that appellate review must ordinarily await the entry of a final judgment disposing of all claims against the parties. See Dawkins v. Balt. City Police Dep’t., 376 Md. 53, 58 , 827 A.2d 115, 118 (2003).

The doctrine is “based upon a judicially created fiction, under which, certain interlocutory orders are considered to be final judgments, even though such orders are clearly not final judgments.” Id. at 64 , 827 A.2d at 121 . For the doctrine to apply, the interlocutory order must satisfy the following four requirements: (1) the order must conclusively determine the disputed question; (2) the order must resolve an important issue; (3) the order must resolve an issue that is completely separate from the merits of the action; and (4) the issue would be effectively unreviewable if the appeal had to await the entry of a final judgment. Id. at 58 , 827 A.2d at 118 . These four requirements are strictly applied, and appeals under the doctrine may be entertained only in extraordinary circumstances.

Id. at 59 , 827 A.2d at 118 . In Dawkins this Court made clear that, as “a general rule, interlocutory [ ] orders rejecting defenses of common law sovereign immunity, governmental immunity, public official immunity, statutory immunity, or any other type of immunity are not appealable under the [ ] collateral order doctrine.” Id. at 65 , 827 A.2d at 122 . Specifically, we held, [wjhether, and under what circumstances, interlocutory orders overruling immunity defenses asserted by the Governor, Lieutenant Governor, Comptroller, Treasurer, Attorney ⁵⁴⁷ General, Speaker of the House, President of the Senate, or judges as defined in Article IV, § 2, of the Maryland Constitution, are immediately appealable under the collateral order doctrine will have to be determined in any future cases that might arise. Interlocutory trial court orders overruling immunity claims by other government officials, employees, departments, agencies, entities, units, or subdivisions, or by private persons or entities, are not appealable under this doctrine.

Id. (citations omitted). After Dawkins , this Court and the Court of Special Appeals clarified that interlocutory orders denying absolute judicial immunity and interlocutory orders denying executive privilege to “high level decision makers” are immediately appealable under the collateral order doctrine. See, e.g., Ehrlich, 396 Md. at 572 , 914 A.2d at 797 (concluding that an interlocutory appeal was appropriate under the “extraordinary circumstances involving discovery orders directed to a high government official.”); State v. Keller-Bee, 224 Md.App. 1, 6 , 119 A.3d 80, 83 (2015), aff'd, 448 Md. 300 , 138 A.3d 1253 (2016) (concluding that, under Dawkins, the trial court’s denial of the State’s motion to dismiss was immediately appealable under the collateral order doctrine because Article IV judges, and their clerks, are entitled to immediate appellate review of the denial of their judicial immunity). 1.

Order Granting Respondents’ Sixth Motion for Sanctions We hold that the circuit court’s order granting Respondents’ sixth motion for sanctions is properly appealable because it satisfies the narrow exception allowing discovery orders denying “high level decision makers” their executive privilege to be immediately appealable under the collateral order doctrine. i. Order Granting Motion for Discovery Sanctions is a “Discovery Order” An order granting discovery sanctions qualifies as a “discovery order” for the purposes of determining the appeala- ⁵⁴⁸ bility of an order denying executive privilege under the collateral order doctrine. Maryland Rule 2-433 governs a trial judge’s ability to enter orders when there are failures of discovery by one or both of the parties. Specifically, Maryland Rule 2-433(a)(3) authorizes a trial judge to enter “a judgment by default that includes a determination as to liability and all relief sought by the moving party against the failing party if the court is satisfied that it has personal jurisdiction over that party.” Respondents argue that “courts have consistently held that orders granting discovery sanctions against a party are not immediately appealable under the collateral order doctrine.” Respondents rely solely on Newman v. Reilly, a case that did not address sanctions within the discovery context. 314 Md. 364 , 550 A.2d 959 (1988).

Rather, the Newman court considered sanctions authorized by Cts. & Jud. Proc. § 3-2A-07(a) and Maryland Rule 1-341. See id. at 376-82, 550 A.2d at 965-68 . 15 In Newman , this Court held that “a sanctions order against a party to the underlying litigation is not immediately appealable, in advance of final judgment on the merits of the underlying action, under the collateral order doctrine.” Newman, 314 Md. at 385 , 550 A.2d at 969 (citing Yamaner v. Orkin, 310 Md. 321, 326 , 529 A.2d 361, 364 (1987)). This Court determined that the third prong for the collateral order doctrine test was not satisfied because “an application for sanctions” is not “a claim so distinct from the underlying lawsuit that the parties would be realigned depending on who is ⁵⁴⁹ claiming, and who is defending against, sanctions.” Id.

In the context of discovery sanctions, the issues the circuit court determines in deciding whether sanctions are appropriate are sufficiently separate from the merits of the underlying action. We conclude therefore, that Newman is not controlling in this case, and that an order for discovery sanctions is considered a “discovery order” for the purposes of denying a “high level decision maker” his or her executive privilege. ii. Order Granting Respondents’ Sixth Motion for Sanctions is Immediately Appealable This Court has consistently held that discovery orders, ordinarily, are not appealable prior to a final judgment terminating the case in the trial court. Montgomery County v. Stevens, 337 Md. 471, 477 , 654 A.2d 877, 880 (1995) (citing Dep’t of Soc.

Serv. v. Stein, 328 Md. 1, 7, 18 , 612 A.2d 880, 883, 888 (1992); Pub. Serv. Comm’n v. Patuxent Valley, 300 Md. 200, 207 , 477 A.2d 759, 763 (1984)). A narrow exception exists when a “high level decision maker” appeals a discovery order that denies their assertion of executive privilege.

See Stevens, 337 Md. at 477 , 654 A.2d at 880 ; see also Patuxent Valley, 300 Md. at 210 , 477 A.2d at 764 (“[Discovery orders, directed at other than high level government decision makers, are ordinarily not appealable .... ”). In both Stevens and Patuxent Valley , we determined that the discovery orders compelling a state actor to appear for a deposition were immediately ap-pealable. In both cases, the four-part collateral order doctrine test was satisfied because: (1) the orders conclusively required the appellant to take a deposition; (2) the orders resolved an important issue because they dealt with the potentially great harm to the public by the “disruption of the governmental process” that can be caused by discovery into the decision making processes of a high level government official; (3) the issue as to whether the depositions were appropriate was distinct from the merits of the action for judicial review; and (4) the issue would become effectively unreviewable later because the harm would occur when the depositions were taken, and there would be no effective reme ⁵⁵⁰ dy available thereafter. Stevens, 337 Md. at 479-80 , 654 A.2d at 881 ; Patuxent Valley, 300 Md. at 206-07 , 477 A.2d at 762-73 .

Additionally, despite the narrowing language contained in Dawkins, swpra, this Court, relying on our decisions in Stevens and Patuxent Valley , continues to recognize that discovery orders may be immediately appealed under the collateral order doctrine when those orders seek to probe the individual thought processes of a high level government official acting in an administrative or investigatory decisional capacity. See Hudson v. Hous. Auth. of Balt. City, 402 Md. 18, 25 , 935 A.2d 395, 399 (2007); see also Ehrlich, 396 Md. at 572 , 914 A.2d at 797 (recognizing that an interlocutory appeal was appropriate under the “extraordinary circumstances involving discovery orders directed to a high government official.”).

While the Hudson Court ultimately concluded that the collateral order doctrine did not apply under the facts presented, we acknowledged that if the four requirements for the collateral order doctrine are satisfied, then a discovery order that seeks to probe a high level government official’s mental processes acting in his or her administrative or decisional capacity, is immediately appealable. Hudson, 402 Md. at 24-27 , 935 A.2d at 398-400 . We conclude that Petitioners are considered “high level decision makers” and the denial of their assertion of executive privilege through the circuit court’s grant of Respondents’ sixth motion for sanctions is immediately reviewable by this Court. In considering what constitutes a “high level decision maker” for the appealability of orders denying executive privilege, this Court has held that executive decision making bodies have the ability to appeal orders denying their executive privilege.

See Stevens, 337 Md. at 479-80 , 654 A,2d at 881 (holding that a discovery order requiring the Chief of Police for Montgomery County to be deposed was immediately ap-pealable under the collateral order doctrine because the Chief was a “high level government decision-maker.”); Patuxent Valley, 300 Md. at 206-07 , 477 A.2d at 762-63 (determining ⁵⁵¹ that a discovery order requiring individual commissioners at the Public Service Commission to be deposed satisfied the collateral order doctrine because the members were “high level government decision-makers.”); Stein, 328 Md. at 23 , 612 A.2d at 891 (1992) (concluding that “[a]lthough the director of the Baltimore City Department of Social Services is not so high an official as the President of the United States, he or she is nevertheless on a par with the individual Public Service Commissioners” who were the Petitioners in Patuxent Valley). Petitioners fall within this category of high level executive decision makers because members of the Board are appointed by the Governor, with the advice of the Secretary of the Department of Health and Mental Hygiene (“DHMH”), and the advice and consent of the Senate, similarly to commissioners in the Public Service Commission. Cf Health Occ. § 14-202(a)(1), with Public Utilities Article § 2-102(a) (“The [Public Service] Commission consists of five commissioners, appointed by the Governor with the advice and consent of the Senate.”). The General Assembly has also delegated to the Board a variety of powers that make it the functional equivalent of a high level executive body.

See, e.g., Health Occ. § 14-205(a)(l) (granting the Board the power to “[e]nforce [Title 14] and Title 15 in [the Health Occupations Article.]”); Health Occ. § 14-205(a)(5) (The Board “[o]versee[s:] (i) [t]he licensing requirements for physicians and the allied health professionals; and (ii) [t]he issuance and renewal of licenses[.]”); and Health Occ. § 14-205(a)(8) (“[d]evelop[ing] and implement[ing] methods to: (i) [a]ssess and improve licensee practices; and (ii) [e]nsure the ongoing competence of licensees[.]”). This case is closely analogous to the facts in both Stevens and Patuxent Valley . Respondents are seeking to obtain discovery that delves into the Board’s decision making process. As in both Stevens and Patuxent Valley , we conclude that this case also satisfies the requirements of the collateral order doctrine.

First, the circuit court’s order conclusively determined that Petitioners must disclose their pre-decisional deliberations by submitting the audiotapes to Respondents by April ⁵⁵² 22, 2016. Second, like in Stevens and Patuxent Valley , this issue is important because of the “potentially great harm to the public by the ‘disruption of the governmental process’ that can be caused by discovery into the decision making process[ ]” of a high level executive decision maker. Stevens, 337 Md. at 479 , 654 A.2d at 881 ; Patuxent Valley, 300 Md. at 206-07 , 477 A.2d at 762 . Third, the issue in this case concerning Petitioners’ deliberative process (executive) privilege is distinct from the merits of Respondents’ action seeking damages for an alleged invasion of their privacy.

See, e.g., Ehrlich, 396 Md. at 572 , 914 A.2d at 797 (concluding that “the propriety of a potential intrusion on [executive] privilege[ ] has nothing to do with the merits of [the plaintiffs] wrongful termination claim.”). Fourth, the discovery order will be effectively unre-viewable on an appeal from a final judgment because the privilege’s protection would be irretrievably lost once Respondents’ gain access to the individual decisional thought processes of the Petitioners. See Patuxent Valley, 300 Md. at 207 , 477 A.2d at 763 . Additionally, as this Court noted in Patuxent Valley , “[r]egardless of the outcome of the trial, the disruption to the administrative process, caused by placing the officials under pretrial scrutiny, is incurred at the first instance. ... [I]t would be impossible to cure the harm done” to Petitioners once the audiotapes are given to Respondents.

Id. The order granting Respondents’ sixth motion for sanctions is a discovery order denying a high level executive decision maker their executive privilege. Accordingly, this Court has the authority to consider the merits of Petitioners’ assertion of executive privilege as applied to the audiotapes of their pre-decisional process. 2. Orders Denying Petitioners’ Motion for Reconsideration as to Default Liability and Motion for Protective Order The circuit court’s order denying Petitioners’ motions for reconsideration and for a protective order are not immediately appealable to this Court.

While we may have jurisdiction over one interlocutory order under the collateral order doc ⁵⁵³ trine, it does not give us the authority to consider other interlocutory orders that are not independently appealable. Petitioners conceded before the Court of Special Appeals that a party cannot immediately appeal from an order of default on liability. See Geier, 225 Md.App. at 140, 123 A.3d at 616 . Petitioners advance the same argument to this Court— that because we have standing to hear their appeal regarding the denial of their executive privilege, this Court has supplementary standing to consider their claims regarding the denial of their quasi-judicial immunity in the orders denying their motions for reconsideration and for a protective order.

As the Court of Special Appeals noted, Maryland Rule 8-131(d) states that “[o]n appeal from a final judgment, an interlocutory order previously entered in the action is open to review by the Court unless an appeal has previously been taken from that order and decided on the merits by the Court.” (emphasis added). As Judge Charles E. Moylan, Jr. observed in Banashak v. Wittstadt, “[t]here is scant authority on the question of appellate piggybacking[.]” 167 Md.App. 627, 670 , 893 A.2d 1236, 1261 (2006). We have not precisely addressed the issue of whether an order that is appealable as a final judgment allows other orders, otherwise not appealable, to be heard by an appellate court. As Judge Moylan noted, the Court of Special Appeals has repeatedly held that “the appeal-ability of each separate issue must be analyzed in a vacuum and that there are no two-for-the-price-of-one bargains on the appellate docket.” Id. at 671 , 893 A.2d at 1261 ; see also Williams v. State, 17 Md.App. 110 , 299 A.2d 878 (1973), overruled on other grounds by Stewart v. State, 282 Md. 657 , 386 A.2d 1206 (1978) (holding that an order denying a challenge to an array cannot be converted into an appealable order simply because it is joined with an appeal of an interlocutory order that is appealable).

We concluded, supra, that none of the orders appealed by Petitioners constitute a final order as defined in Cts. & Jud. Proc. § 12-101(f). Instead, we determined that the order granting Respondents’ sixth motion for sanctions is immediately appealable because it satisfied the four-part collateral ⁵⁵⁴ order doctrine test. An order that satisfies the collateral order doctrine is not a final judgment, but rather a legal fiction that, under narrow circumstances, allows this Court to consider orders that would otherwise not be appealable at the time they are entered.

See Ehrlich, 396 Md. at 662 , 914 A.2d at 791 (quoting Dawkins, 376 Md. at 63 , 827 A.2d at 121 ); see also Snowden v. Balt. Gas & Elec. Co., 300 Md. 555 , 560 n. 2, 479 A.2d 1329 , 1331 n. 2 (1984). The collateral order doctrine is only applicable in narrow and extraordinary circumstances.

See Ehrlich, 396 Md. at 562 , 914 A.2d at 791 (referring to collateral doctrine orders as a “narrow class of orders!,]” and as a doctrine that is applicable only “in a very few ... extraordinary situations”); see also Dawkins, 376 Md. at 68-59 , 827 A.2d at 118 (noting that the collateral order doctrine “is a very limited exception to the principle that only final judgments terminating the case in the trial court are appeal-able,” and that the requirements for the collateral order doctrine are “strictly applied” and “entertained only in extraordinary circumstances.”) (citations omitted); Stevens, 337 Md. at 477 , 654 A.2d at 880 (recognizing that the collateral order doctrine applies to “a narrow class of orders ... which are offshoots of the principal litigation in which they are issued and which are immediately appealable as ‘final judgments’ without regard to the posture of the case.”) (citations omitted). As the Court of Special Appeals explained, “in a permissible, interlocutory appeal under the collateral order doctrine, it would make no sense to allow the parties to contest every other order in the case as though there had been a conventional final judgment.” Geier, 225 Md.App. at 141 , 123 A.3d at 617 . Further, the Court concluded that it “would be absurd to say that, in an appeal that is permissible only if the subject matter is ‘completely separate from the merits of the action,’ the appellate court may proceed to consider and decide every interlocutory ruling pertaining to the merits of the case.” Id. We agree with the Court of Special Appeals’ assessment that due to the narrow purpose of the collateral order doctrine, orders that do not independently ⁵⁵⁵ satisfy the four-part test may not be appealed by “piggybacking” onto another interlocutory order that does satisfy the test.

Therefore, the two additional orders are not properly before this Court. i. Order denying Petitioners’ Motion for Reconsideration for Default as to Liability is Not Immediately Appealable It is well-established that an order of default is not an “unqualified, final disposition of the matter” because an assessment of damages is still required. Franklin Credit Mgmt. Corp. v. Nefflen, 436 Md. 300, 321 , 81 A.3d 441, 453 (2013) see also Curry v. Hillcrest Clinic, Inc., 337 Md. 412, 425-27 , 653 A.2d 934, 940-41 (1995) (holding this Court’s decision in Banegura v. Taylor, see infra, was dispositive in concluding that there is no final judgment in an order for default until damages have been assessed); Banegura v. Taylor, 312 Md. 609, 618 , 541 A.2d 969, 973 (1988) (holding that an entry of an order of default, leaving damages open for a future trial, was not a final judgment, and could not be immediately appealed); Adams v. Mallory, 308 Md. 453, 461 , 520 A.2d 371, 375 (1987) (concluding that an order entering a judgment default of liability that did not determine any relief was not a final judgment).

Additionally, this Court in Banegura concluded that the denial of the defendant’s motion to strike the default order was interlocutory and not appealable because it did not dispose of the entire claim. Banegura, 312 Md. at 618 , 541 A.2d at 973-74 , The order denying Petitioners’ motion for reconsideration for default liability is central to the merits of the action, and therefore, fails the third factor of the collateral order doctrine test. For the foregoing reasons, we decline to review the order because it is neither a final judgment nor does it satisfy the collateral order doctrine. ii. Order Denying Petitioners’ Motion for Protective Order is Not Immediately Appealable The circuit court’s denial of Petitioners’ motion for a protective order from Respondent’s sixth motion to compel ⁵⁵⁶ documents is not properly appealable under the collateral order doctrine.

After creating the general rule in Dawkins, see supra, we declined to determine “[w]hether, and under what circumstances, interlocutory orders overruling immunity defenses asserted by the Governor, Lieutenant Governor, Comptroller, Treasurer, Attorney General, Speaker of the House, President of the Senate, or judges as defined in Article IV § 2, of the Maryland Constitution, are immediately appealable under the collateral order doctrine....” Dawkins, 376 Md. at 65 , 827 A.2d at 122 (emphasis added). This Court purposefully left open the possibility that in cases where privilege is denied to one of the specified positions above, an appellate court may have the authority to consider the interlocutory order denying the privilege under the collateral order doctrine. As Dawkins made clear “[i]nterlocutory trial