Mena v. Idaho State Bd. of Med. — Mar. 2016 (Summary)

PHYSICIAN LICENSE

Mena v. Idaho State Bd. of Med.
No. 43125-2015 (Idaho Mar. 23, 2016)

The Supreme Court of Idaho reversed the Idaho State Board of Medicine’s (the “Board”) decision to impose sanctions on a physician’s license to practice medicine under the Disabled Physician Act.  The physician had reports filed against him alleging that he was abusing drugs or alcohol, as well as complaints about his record keeping, late dictations, and possible inadequate medical care.  The Board began an investigation regarding the physician’s ability to perform certain medical procedures.  Based on the state Disabled Physician Act, the Board determined that some level of impairment existed and ordered 11 sanctions to the physician’s license to practice medicine.

The physician appealed the Board’s decision to the state courts, which upheld the Board’s action.  However, that decision was reversed by the Idaho Supreme Court.  Under the Disabled Physician Act, the Board needed to prove, through expert testimony, that the physician had a mental illness and that the mental illness made the physician unable to practice medicine with reasonable skill or safety.  However, the Board failed to provide the required expert testimony on these issues.  The Idaho Supreme Court reasoned that the Board’s own evaluation of the evidence demonstrated that there was insufficient evidence to support its order.  The supreme court vacated the lower court’s ruling and ordered the lower court to remand the matter back to the Board which was to reconsider the action in light of the Idaho Supreme Court’s opinion.

Griffith v. Aultman Hosp. — Mar. 2016 (Summary)

DISCOVERY OF MEDICAL RECORDS

Griffith v. Aultman Hosp.
No. 2014-1055 (Ohio Mar. 23, 2016)

The Supreme Court of Ohio held that the physical location of patient data is not relevant to the determination of whether that data qualifies as a “medical record” under the statute setting forth procedures by which a patient may obtain a copy of his or her medical record.  This litigation arose as a result of a son’s request for a copy of his father’s complete medical record, after the father died in the intensive care unit of the hospital.  The initial medical record given to the son did not contain cardiac-monitoring data, which was not kept in the medical records department.  The hospital argued that because the data was not kept within the medical records department it did not fall under the statutory definition of a medical record.  The court disagreed, reasoning that the Ohio legislature did not limit the definition of medical record in the statute to data held in the medical records department.  As such, the physical location of the data was not relevant.  Instead, the court ruled that the definition of what qualifies as a medical record focused on “whether a healthcare provider made a decision to keep data that was generated in the process of the patient’s health care treatment and that pertained to the patient’s medical history, diagnosis, prognosis or medical condition.”  The court then reversed the lower court’s ruling in favor of the hospital and remanded the case back to the trial court for further proceedings consistent with the court’s opinion.

Reid v. KentuckyOne Health, Inc. — Mar. 2016 (Summary)

HCQIA IMMUNITY

Reid v. KentuckyOne Health, Inc.
No. 2015-CA-000092-MR (Ky. Ct. App. Mar. 18, 2016)

A surgeon received a letter from the hospital’s Surgery Quality Assurance and Investigation Committee that all of his cases would be subject to a focused review.  Two months later, the surgeon was told by the Medical Executive Committee that he could no longer perform any further surgical procedures at the hospital unless he was accompanied by an actively practicing and board certified general surgeon or endoscopist.  The physician did not exercise his clinical privileges under the conditions imposed and did not renew his medical staff appointment.  However, he then sued the hospital claiming that the conditions imposed by the MEC constituted a breach of contract, intentional infliction of emotional distress, and tortious interference.  The trial court concluded that the hospital was entitled to immunity under the Health Care Quality Improvement Act (“HCQIA”), because it had conducted “professional review activities.”

The Kentucky Court of Appeals reversed the trial court’s finding that the hospital’s actions constituted a “professional review action” not “professional review activities.”  The court ruled that the conditions that were imposed on the surgeon so severely restricted his clinical privileges at the Hospital that they constituted a “professional review action.”  The appellate court then questioned whether the hospital was entitled to HCQIA immunity because the hospital did not appear to meet all of the standards required by HCQIA, including a hearing.  Therefore, the appellate court remanded the case back to the trial court for further consideration of the pertinent provisions of HCQIA.

Brown v. Rush Univ. Med. Ctr. — Mar. 2016 (Summary)

BREACH OF CONTRACT

Brown v. Rush Univ. Med. Ctr.
No. 1-15-0192 (Ill. App. Ct. Mar. 18, 2016)

Two physicians brought claims against their former employer, a medical center, a physician’s association, and the former chair of the medical center’s dermatology department.  The physicians alleged breach of contract and quantum meruit claims against the medical center.  Additionally, the physicians claimed intentional interference with prospective economic advantage and violation of the Illinois Consumer Fraud Act against the medical center and the former dermatology chair.

The physicians claimed that when they left and started their own practice their former employer did not share the location or information regarding their new practice to their patients from the medical center.  The trial court accepted the chair’s reasoning that he did not share the information because the practice was not up and running at the time the information was given to him.  Furthermore, he did not share the information immediately after the opening of the new practice because he was not made aware once it had begun operating.  The trial court agreed with the defendants that this was not intentional interference with the plaintiffs’ business.  Following the bench trial, the physicians appealed the rulings by the trial court, including the trial court’s decision to not allow certain evidence to be used in the case, including tax returns and other financial evidence.  Additionally, the physicians wanted to file a third complaint and were denied.  The appellate court affirmed the decision.

Fabian v. Hosp. of Cent. Conn. — Mar. 2016 (Summary)

TITLE VII

Fabian v. Hosp. of Cent. Conn.
No. 3:12-CV-1154 (SRU) (D. Conn. Mar. 18, 2016)

The United States District Court for the District of Connecticut denied a hospital’s motion for summary judgment on Title VII discrimination claims made by an orthopedic surgeon. The surgeon was a transgender woman who alleged that the hospital declined to hire her because she disclosed her identity as a transgender woman.  The court was faced with the question of whether the surgeon was an employee and subject to the protections of Title VII, and if Title VII applied to transgender identity.

The court denied summary judgment to the hospital on the basis of the surgeon not being an employee.  The court ruled that the hospital had not shown, as a matter of law, that the surgeon was not an employee.

The court also concluded that Title VII applies to transgender identity because it is equivalent to discrimination “because of sex.” The court went on to conclude that whether the hospital discriminated against the surgeon on the basis of her gender identity is a question for a jury.

Cent. Kan. Med. Ctr. v. Hatesohl — Mar. 2016 (Summary)

CORPORATE PRACTICE OF MEDICINE

Cent. Kan. Med. Ctr. v. Hatesohl
Nos. 113,675, 113,834 (Kan. Ct. App. Mar. 18, 2016)

A family practitioner entered into an employment agreement with a medical center that was operating as an Ambulatory and Surgical Center.  The physician resigned his position and the medical center filed a suit for breach of the non-compete agreement that was part of the employment agreement.  Additionally, the former employer/medical center filed suit against the physician’s new employer for breach of the non-compete agreement.

The district court held in favor of the physician and his new employer on the grounds that the employment agreement between the physician and the medical center was unenforceable because the center was not licensed properly to allow a family practitioner to practice at the facility.  The appellate court reversed, finding that the district court misunderstood the corporate structure of the medical center and the licensing of the medical center and thus the court’s conclusion that the employment agreement was unenforceable was erroneous.

Arapahoe Surgery Ctr., LLC v. Cigna Healthcare, Inc. — Mar. 2016 (Summary)

ANTITRUST

Arapahoe Surgery Ctr., LLC v. Cigna Healthcare, Inc.
Civil Action No. 13-CV-3422-WJM-CBS (D. Colo. Mar. 21, 2016)

The United States District Court for the District of Colorado granted in part and denied in part an insurance company’s motion for summary judgment on claims made by a second insurance company under antitrust law and the Employee Retirement Income Security Act (“ERISA”). This litigation arose from disputes over the handling of billing, payment, and fee-forgiving procedures for patients with no in-network responsibility. The court reasoned that because of a lack of evidence of an antitrust injury there was no way a reasonable jury could find in the second insurance company’s favor on its antitrust claims. The court also reasoned that the second insurance company’s ERISA claims were barred for failure to exhaust administrative remedies as to any claim for benefits that was not appealed through both administrative levels under the plans in dispute.

Med. Ctr. at Elizabeth Place, LLC v. Atrium Health Sys. — Mar. 2016 (Summary)

ANTITRUST

Med. Ctr. at Elizabeth Place, LLC v. Atrium Health Sys.
No. 14-4166 (6th Cir. Mar. 22, 2016)

The United States Court of Appeals for the Sixth Circuit reversed the holding of the district court, which had held that a hospital network was a single entity, and dismissed an antitrust case on summary judgment without adjudicating the question of whether the behavior of the network of hospitals constituted impermissible anticompetitive conduct.  The court of appeals found instead that a reasonable juror could determine that four hospitals that participated in a joint operating agreement were a “combination” for purposes of the antitrust laws, rather than a single entity that could not conspire with itself.

The court of appeals found that the complaint contained information that supported the plaintiff’s assertions that the defendant hospitals colluded to keep the plaintiff from competing in the local market.  The evidence included e-mails, letters, direct statements, and the fact that the defendants did not have any shared assets.  The court of appeals held that because the plaintiff presented the evidence above of conduct and business operations that raise the possibility of concerted action among the defendant hospitals, the question remains upon remand whether hospitals that had previously pursued their own interests separately and that continue to seem to compete, combined illegally in restraint of competition.  Thus, the court of appeals reversed the judgment of the district court and remanded the case.

Baptist Health Sys. v. Rutledge — Mar. 2016 (Summary)

PEER REVIEW

Baptist Health Sys. v. Rutledge
No. CV-15-616 (Ark. Mar. 17, 2016)

The Supreme Court of Arkansas ruled that a hospital’s challenge to a state law governing peer review was not capable of being reviewed by the courts because there was no “justiciable controversy.”  Because there was no “actual, present controversy” between the parties, the supreme court dismissed the appeal.

Offor v. Mercy Med. Ctr. — Mar. 2016 (Summary)

EMPLOYMENT DISCRIMINATION

Offor v. Mercy Med. Ctr.
No. 15-CV-2219 (ADS)(SIL) (E.D.N.Y. Mar. 10, 2016)

The United States District Court for the Eastern District of New York granted a medical center’s motion to dismiss claims of national origin and race discrimination, retaliation, libel, slander, and intentional infliction of emotional distress made by a physician. The physician was an African American woman born in Nigeria. Among other things, the physician was denied moonlighting hours, not invited to a training class, denied vacation time, and demoted due to low volume.  Eventually, she was terminated due to unprofessional behavior and improper advice given to parents of a patient. In assessing the claims made by the physician, the court ruled that some of the medical center’s actions did not rise to the level of an “adverse action.”  Also, the physician relied solely on conclusory allegations without providing any sufficient factual allegations from which a jury could plausibly conclude that the medical center’s actions were based on her status as an African American.