Al-Jurf v. Iowa Bd. of Med — July 2013 (Summary)

State Licensing Board

Al-Jurf v. Iowa Bd. of Med.
No. 12-0293 (Iowa Ct. App. July 24, 2013)

The Court of Appeals of Iowa affirmed a lower court’s denial of a physician’s petition for judicial review, finding no merit in the physician’s claims on appeal and supporting the medical board’s finding that the physician’s interactions with his colleagues constituted unethical conduct. The court applied the medical board’s rules and reasoned that the physician created a hostile educational environment, failing to make the benefits of his knowledge and attainments available to the residents under his training. The court further found that by threatening, demeaning, bullying, and interfering with the abilities of others to do their work, the physician’s actions failed to uphold dignity and honor in the medical profession. The court also agreed with the lower court in finding that the physician failed to meet his burden of showing that the medical board abused its discretion by issuing a press release regarding the disciplinary proceedings, as nothing in the release was inaccurate.

Prime Healthcare Servs. v. Serv. Emps. Int’l Union (Summary)

Antitrust

Prime Healthcare Servs. v. Serv. Emps. Int’l Union, Civil Action No. 11-cv-2652-GPC-RBB (S.D. Cal. July 25, 2013)

The United States District Court for the Southern District of California granted a motion to dismiss a hospital management company’s claims against a health plan and an unincorporated labor association for violations of Sections 1 and 2 of the Sherman Act.  The hospital management company claimed that the defendants unlawfully entered into labor partnership agreements in a market domination strategy to eliminate the hospital management company from the market.  The court found that the written agreements between the defendants clearly indicated that they had no intention of attempting to dominate the market and push competitors out of business. The court also found that the hospital management company failed to prove market power or injury to competition.

Feygina v. Hallmark Health Sys. (Summary)

PHYSICIAN CONTRACT

Feygina v. Hallmark Health Sys., No. MICV2011-03449 (Mass. Super. Ct. July 12, 2013)

The Superior Court of Massachusetts held that a physician who was attempting to recover unpaid wages was entitled to treble damages but refused to award additional compensation for prejudgment interest or increased income tax liability. The court stated that the corporation still owed the physician additional managed care payments. These damages were trebled in accordance with the state wage act. The court explained that trebling the amount is compensatory, not punitive in nature. The court rejected the corporation’s claim that it was protected by a statutory hospital exception because the corporation only had affiliations with hospitals; it was not a hospital itself. Based on this trebled award, the court stated that it would be “double counting” to allow the physician to receive additional compensation based on increased income tax liability.

Traina v. OSF Healthcare Sys., Inc. (Summary)

CLINICAL PRIVILEGES

Traina v. OSF Healthcare Sys., Inc., No. 3-12-0548 (Ill. App. Ct. July 15, 2013)

The Appellate Court of Illinois ruled in favor of a private hospital’s motion to dismiss multiple counts in an orthopedic surgeon’s amended complaint alleging a violation of the hospital’s bylaws and also that the proceedings reviewing the hospital’s decision to restrict his surgical privileges were fundamentally unfair. After a departmental study showed that the surgeon’s revision rates were significantly higher than other doctors in the department and the national average, the hospital requested that he take remedial action or the hospital would institute formal corrective action against him. The surgeon requested that the revision cases be reviewed by an outside source. Upon completion of the outside review, the surgeon was informed that he must “voluntarily resign” his privileges or complete an approved remediation program or fellowship or else face further “corrective action.” Ultimately, the physician took neither option and later requested a hearing after a recommendation was made to restrict his clinical privileges. The physician brought a lawsuit claiming violations of the bylaws and unfair procedure after the  Board affirmed the recommendation.  The trial court dismissed these claims and the physician appealed.

The appellate court worked from the premise that, as a general rule, the internal staffing decisions of a private hospital are not subject to judicial review, except when the decision in question involves a revocation, suspension, or reduction of a physician’s existing staff privileges, which could seriously affect the physician’s ability to practice medicine. With regard to the surgeon’s complaint that there was a violation of the bylaws, which prohibits any person from serving on the hearing committee if they have previously been “actively” involved in the investigation, the court found that the lower court properly dismissed the counts because the doctors on the hearing committee were neither “active participants” in, nor did they “initiate[ ] or investigate[ ]” the underlying matter. The court also found that the surgeon’s complaint failed to allege he suffered any actual prejudice as a result of the doctors’ presence on the review hearing committee. Further, the complaint did not allege any person on the hearing committee actually acted with prejudice, malice, or unfair bias. As a private hospital setting lacks state action, a physician facing disciplinary measures by the hospital is entitled to certain “basic protections,” including notice and a fair hearing. As the surgeon had adequate notice of the concerns subject to the disciplinary action and the hearing committee allowed him to cross-examine witnesses and present evidence in his own defense, the court concluded that the pleadings and supporting documents refuted the surgeon’s claim that the hospital deprived him of a fundamentally fair proceeding.

Mathai v. Bd. of Sup’rs of Louisiana State Univ. (Summary)

SOVEREIGN IMMUNITY

Mathai v. Bd. of Sup’rs of Louisiana State Univ., No. 12-2778 (E.D. La. July 17, 2013)

The United States District Court for the Eastern District of Louisiana dismissed a suit against the board of a medical school and its dean by a former student who brought claims under §1983 and for breach of contract.  The student, who had a history of drug use that resulted in her entering into a continuation of enrollment contract with the school’s campus assistance program, was dismissed from the medical school after she refused to attend a three-month inpatient treatment program. The district court found the board, as an arm of the state, was immune from liability for the breach of contract and §1983 claims.  Similarly, the student’s claims for money damages against the dean were barred, as the court found he was acting in his official capacity as dean and was therefore protected by qualified immunity.  The student’s claims for injunctive relief against the dean were not barred by immunity, but the district court dismissed them nonetheless, finding that the student was not denied due process.

Schmitt v. Meritcare Health Sys. (Summary)

DEFAMATION

Schmitt v. Meritcare Health Sys., No. 20130013 (N.D. July 22, 2013)

The Supreme Court of North Dakota affirmed a lower court’s grant of summary judgment in favor of a hospital, holding that the physician’s allegations that the hospital’s responses to a credentialing questionnaire were defamatory failed to state a claim. The court found that the hospital could not be held liable for the statements it made in the questionnaire, which the physician admitted were “technically true,” and did not fit within any of the defamatory meanings under state law. The court also rejected the physician’s claim that the hospital and an unrelated clinic conspired to prevent him from obtaining privileges at other hospitals.

Brough-Stevenson v. Cmty. Emergency Med. Assocs. (Summary)

DEFAMATION

Brough-Stevenson v. Cmty. Emergency Med. Assocs., F063875 (Cal. Ct. App. July 12, 2013)

The Court of Appeal for the Fifth District of California affirmed the lower court’s holding in favor of an emergency room physician agreeing that the statements made by hospital administrators to the physician’s employer, Emergency Medical Associates (“Group”), about the physician were not protected under California’s anti-SLAPP statute.  The hospital and the Group argued that the statements at issue were made in the exercise of the right of free speech in connection with an issue of public interest.  Specifically, they argued that the statements made about the physician related to her willingness and ability to effectively serve as an ED physician and that this affected the quality and accessibility of health care.  The court disagreed.

Instead, the court found that the statements were more in the nature of a private workplace dispute because the statements dealt primarily with the physician’s personality and profitability.  The court was not persuaded that concerns about the physician’s lack of efficiency, or that she was difficult to work with, were matters of public interest sufficient to trigger the protections of the anti-SLAPP statute.  In reaching this conclusion, the court focused on statements made by the hospital that the physician was competent and qualified.  The decision to deny the motion to strike the physician’s complaint was upheld.

Connors v. Dartmouth Hitchcock Med. Ctr. (Summary)

DISCRIMINATION

Connors v. Dartmouth Hitchcock Med. Ctr., Nos. 2:10-cv-94, 2:12-cv-51 (D. Vt. July 11, 2013)

The United States District Court for the District of Vermont denied, in part, a medical center’s motion for summary judgment, finding that a psychiatry resident had stated a claim under the Vermont Fair Employment Practices Act (“VFEPA”).

The resident had advised the medical center, at the time of her initial appointment, that she had Attention Deficit Hyperactivity Disorder (“ADHD”), and requested reasonable accommodations.  Although the medical center granted her request, the resident alleged that during one of her off-site rotations the accommodations were not actually provided and as a result her symptoms emerged.

The resident was placed on a leave.  She agreed to a remediation plan which she completed.  When the resident subsequently returned to the off-site rotation, it was alleged that the accommodations were not made available to her.  Concerns about the resident’s performance were raised again.  She was allowed to complete her current year of training, but her contract for the upcoming year was not extended.

The program director provided the resident with a favorable reference and she completed her training at another program.  Subsequently, she sued alleging disability discrimination and illegal retaliation under VFEPA, breach of contract, and breach of an implied covenant of good faith and fair dealing.

The court found that there was a triable issue of fact regarding whether the medical center terminated the resident’s employment because she suffered from ADHD.  “Whether [the medical center’s] reasons for terminating her residency were a pretext for discrimination on the basis of disability cannot be resolved at summary judgment.”  Similarly, the court found that there was at least minimal evidence of a causal connection between the program director’s desire to terminate the resident’s participation in the residency program and his hostility toward her claim of disability, so the claim for retaliation would have to be decided by a jury.

Med. Staff of Avera Marshall Reg’l. Med. Ctr. v. Avera Marshall (Summary)

BYLAWS/CONTRACT

Med. Staff of Avera Marshall Reg’l. Med. Ctr. v. Avera Marshall, No. A12-2117 (Minn. Ct. App. July 22, 2013)

The Minnesota Court of Appeals affirmed the trial court’s decision in favor of the medical center, finding that the medical staff was not a separate legal entity and therefore lacked the capacity to sue or be sued.  The appeals court also found that the medical staff bylaws did not create a contractual relationship between the medical staff and the medical center.

The medical staff brought an action seeking to have the court declare that a medical staff has standing and capacity to sue.  The appeals court, in agreement with the trial court, found that under Minnesota law unincorporated associations, like the medical staff, do not have the capacity to sue or be sued.  The medical staff also sought to enjoin the medical center from repealing the existing bylaws and imposing new bylaws, claiming that the bylaws constitute an enforceable contract.  However, the appeals court held that the medical center retained authority to unilaterally modify the bylaws and that the bylaws are not a contract.

Alexander v. Avera St. Luke’s Hosp. — July 2013 (Summary)

EMPLOYMENT DISCRIMINATION

Alexander v. Avera St. Luke’s Hosp.
No. CIV 12-1012 (D. S.D. July 2, 2013)

The United States District Court for the District of South Dakota ruled that a pathologist was an independent contractor, not an employee, and granted summary judgment to the hospital defendant on the pathologist’s claims that his employment was terminated in violation of the Americans with Disabilities Act, Age Discrimination in Employment Act and Family Medical Leave Act.