I have had some further thoughts about the memorandum
which you forwarded to me.

The issue was misstated.

The primary value to a plaintiff's attorney
of derogatory comments in e-mail messages is not
as *evidence* but as a *hypothesis* which can then
be substantiated by discovery of the medical records.

Hypothesis in this context is what commonly precipitates legal action.
What is of value to the plaintiff's attorney is an explanation
at which neither the patient nor the attorney could arrive 
unless it were suggested to them from within the medical community.

Describing the e-mail message as a quality assurance document
might protect it against discovery as evidence,
but would not preclude a lawyer who obtained knowledge of it
from exploiting the understanding he had acquired.

On the other hand, Massachusetts has very stringent laws,
among the most restrictive in the nation, about "eavesdropping,"
i.e. the secret interception and or recording of electronic messages,.
Naturally, any lawyer worth his salt who eavesdropped on the
lan would take care to cover his tracks.
More likely, some disaffected employee
from inside would convey damaging information cleaned from the lan
the patient or to the patient's lawyer.