Granger v. Christus Health Cent. La. (Summary)

HCQIA IMMUNITY DENIED

Granger v. Christus Health Cent. La., No. 2012-C-1892 (La. June 28, 2013)

The Supreme Court of Louisiana affirmed in part and reversed in part a lower court’s award in favor of a surgeon.  Peer review proceedings arose from the care of a heart patient.  The hospital was not entitled to HCQIA immunity or state law immunity, but the surgeon was not entitled to damages based on lost income. The court rejected the hospital’s argument that the peer review action was distinguishable from the peer review activity described in HCQIA. The peer review activities that eventually led to the revocation of the surgeon’s privileges required notice and hearing; the hospital’s failure to provide adequate notice and hearing following a summary suspension meant that they were not entitled to HCQIA immunity.

The court also held that the hospital breached its contractual obligations to the surgeon by failing to provide a post-suspension hearing. This breach of contract merited an award of general damages. Damages for lost income were vacated because the surgeon failed to submit an application for reappointment. The court saw this as the reason for his permanent loss of privileges and refused to uphold the award for the lost income damages.

Rao v. Wash. Township Health Care Dist. (Summary)

PEER REVIEW/REVOCATION

Rao v. Wash. Township Health Care Dist., No. A134623 (Cal. Ct. App. June 28, 2013)

The California Court of Appeal reversed and remanded a lower court’s decision, with instructions that a hospital provide a surgeon the opportunity to argue whether the peer review action was justified.  After an investigation and a hearing, the hospital board revoked his staff membership and privileges. The appellate court held that the board violated the surgeon’s due process right by revoking his privileges following a hearing panel’s recommendation for less severe discipline.  The court ruled that the surgeon was not provided proper notice or the opportunity to respond to the prospect of revocation.

U.S. ex rel. Soulias v. Nw. Univ. (Summary)

FALSE CLAIMS

U.S. ex rel. Soulias v. Nw. Univ., No. 10 C 7233 (N.D. Ill. June 27, 2013)

The United States District Court for the Northern District of Illinois granted a hospital’s motion to dismiss, ruling that to satisfy Rule 9(b) for a False Claims Act claim, a relator must plead at least some actual examples of false claims and not simply state a “plausible” fraud claim. Concluding that the relator neither identified any actual false claims submitted by the hospital nor stated that the hospital submitted the false claims knowingly, the court granted the hospital’s motion to dismiss while allowing the relator one last opportunity to adequately plead her claims.

Morgan v. Saint Luke’s Hosp. of Kan. City (Summary)

LIEN ON PATIENT TORT CLAIM

Morgan v. Saint Luke’s Hosp. of Kan. City, No. WD 75098 (Mo. Ct. App. June 28, 2013)

The Missouri Court of Appeals ruled that a patient’s debt had been extinguished because of the presence of a contract between the hospital and the patient’s health insurance provider, which works to compel the participation of the hospital in accepting discounted payments from the patient’s health insurance provider that serve to extinguish the underlying patient account – in this case, the patient’s debt. The court reasoned that a lien cannot exist in the absence of a debt; thus, the patient’s pleadings stated a cause of action so as to survive a motion for judgment on the pleadings.

Chudacoff v. Univ. Med. Ctr. (Summary)

ABSOLUTE IMMUNITY

Chudacoff v. Univ. Med. Ctr., No. 2:08-cv-00863-RCJ-GWF (D. Nev. June 21, 2013)

The United States District Court for the District of Nevada ruled that a county hospital and members of its medical staff were entitled to absolute immunity against claims for violations of constitutional rights brought under 42 U.S.C. §1983.  Although the physicians were not employed by the county hospital, they were considered “state actors” who could benefit from absolute immunity for Section 1983 purposes because their authority to deprive the plaintiff physician of his privileges flowed directly from the county hospital.

Kowalski v. St. Francis Hosp. and Health Ctrs. (Summary)

NEGLIGENCE

Kowalski v. St. Francis Hosp. and Health Ctrs., 2013 N.Y. Slip Op. 04756 (N.Y. June 26, 2013)

The Court of Appeals of New York ruled that a hospital and an emergency room physician did not have a duty to prevent an intoxicated patient from leaving the hospital.

The patient had come to the hospital voluntarily and requested entry into the hospital’s detoxification facility.  While the patient had expressed suicidal thoughts in a prior visit to the hospital, one month earlier, he did not express such thoughts when he asked to enter the detoxification unit.  The patient later left the hospital and was killed when he was struck by a car.

The court ruled that there was no statute or regulation that authorized the hospital to prevent the patient from leaving.  Thus, the hospital had no authority to restrain the patient.  The hospital had no duty to confine the patient for having suicidal thoughts a month prior to the event, nor did the physician involved have a duty to call the police.  If the hospital restrained the visitor, it may have been exposed to liability for false imprisonment.

O’Connor v. Jordan Hosp. (Summary)

EMTALA

O’Connor v. Jordan Hosp., No. 10-11416-MBB (D. Mass. June 17, 2013)

The United States District Court for the District of Massachusetts ruled that a jury should decide whether a hospital terminated a nurse in retaliation for reporting an EMTALA violation or, alternatively, because of concerns about her performance.  Accordingly, the court denied the hospital’s motion for summary judgment.

The nurse claimed that the hospital terminated her in retaliation for reporting EMTALA violations in her capacity as variance manager for the hospital.  The court found that the nurse “reported” an EMTALA violation to her supervisors by bringing a complaint from another hospital to her supervisors’ attention and by preparing a letter to be sent to CMS.  Further, the court noted that the nurse’s subsequent termination was an adverse employment action.  The court ruled that a jury should determine whether her termination was in retaliation for her “reporting” the EMTALA violation or, as the hospital claimed, was based on ongoing concerns with her performance.  Thus, the hospital’s motion for summary judgment was denied on the EMTALA claim.

The court used similar reasoning in deciding that a jury should decide if the hospital retaliated against the nurse in violation of the Massachusetts Healthcare Provider Whistleblower Statute.

Graves v. Kovacs (Summary)

TORTIOUS INTERFERENCE WITH CONTRACT

Graves v. Kovacs, No. 49A05-1301-PL-1 (Ind. Ct. App. June 18, 2013)

The Court of Appeals of Indiana ruled that a complaint filed by a cardiologist did not have to explicitly mention the words “tortious interference with a contract” in order to state a cause of action against two physicians who he claimed played a role in the revocation of his clinical privileges at a hospital. The allegations of the complaint were sufficient to state a cause of action, even if the cause of action was mislabeled.

Butt v. Iowa Bd. of Med. (Summary)

MEDICAL LICENSURE ACTIONS

Butt v. Iowa Bd. of Med., No. 12-1118 (Iowa Ct. App. June 12, 2013)

The Court of Appeals of Iowa affirmed in part and reversed in part a state medical board’s conclusion that a cardiologist engaged in unprofessional behavior by engaging in a pattern of sexual harassment, holding that the record supported the board’s findings.  The board had testimony from nurses and telephone records that supported the claims that the cardiologist had made numerous unwanted telephone calls to a nurse’s cell phone, made threatening comments to a second nurse, and made offensive comments in a joking manner to a third staff member.  However, the court held that the application of the rule prohibiting unprofessional and unethical conduct was unconstitutionally vague in connection with certain of the allegations against the physician.  The court noted that the medical board’s charge against the physician had been that he had made numerous “harassing” phone calls; however, at the end of his hearing, the board concluded that he had made numerous “unwanted” phone calls to the nurse.  According to the court, an unwanted telephone call was too subjective of a standard because it could only be “determined by the ears of the recipient,” and in this case, the physician claimed the calls were made to apologize to the nurse, not to threaten her.  The court could determine no reasonable interpretation of unwanted telephone call that would give a physician fair warning that such conduct was prohibited.  Other portions of the medical board’s holding were upheld and, as such, the case was remanded to the state medical board to determine a more appropriate disciplinary action.

Nathan v. Ohio State Univ. (Summary)

FEDERAL DISCRIMINATION/PROVISION OF DOCUMENTS

Nathan v. Ohio State Univ., No. 2:10-cv-872 (S.D. Ohio June 14, 2013)

The United States District Court for the Southern District of Ohio denied a university-affiliated hospital’s motion for reconsideration of an order to compel the provision of protected documents, finding that the university had continuously failed to produce all performance-related documents pertinent to an anesthesiologist’s termination after being compelled by the court to do so.  In the underlying case, a female anesthesiologist sued the university alleging that her termination was discriminatory.  The university disagreed, claiming it was legitimately based on a number of significant performance deficiencies involving her interpersonal relationships and disruption of hospital operations.  In order to show that her termination was pretextual, the anesthesiologist sought all performance-related documentation for the other anesthesiologists practicing at the hospital, which the court upheld with an order to compel.  Initially, the university refused to comply at all, arguing that the request was burdensome and overbroad, then the university only provided those documents in the possession of the department chair, that the chair had actually relied upon in his performance evaluations of other anesthesiologists.  In this third review of the order to compel, the court determined that the order needed no further clarification and that the university simply refused to construe the term “performance-related” in a commonsense manner and refused to complete a reasonable inquiry in locating the relevant documents.