Bhanusali v. Orange Reg’l Med. Ctr. (Summary)

ANTITRUST/DISCRIMINATION

Bhanusali v. Orange Reg’l Med. Ctr., No. 13-3426-cv (2d Cir. July 16, 2014)

The U.S. Court of Appeals for the Second Circuit upheld the dismissal of a physician’s antitrust claim against a hospital but reinstated his discrimination claim. Previously, in Bhanusali v. Orange Reg’l Med. Ctr., No. 10-CV-6694 (CS) (S.D. N.Y. Aug. 12, 2013), the U.S. District Court for the Southern District of New York dismissed claims of retaliation and antitrust violation brought by an orthopedic surgeon against a medical center.

The 62-year-old Indian orthopedic surgeon was the subject of a peer review, which led to the suspension and restriction of his privileges. The surgeon alleged that the Sham Peer Review was conspired as a means of intentional discrimination due to his race, national origin, and age, in violation of Title VII. The court originally found insufficient facts to show intentional discrimination, and gave the surgeon leave to amend his complaint with the instruction to add more clarity and specificity of the discrimination. In the surgeon’s amended complaint, he listed his cases that were examined on peer review, highlighting the fact that none of the reviewed surgeries resulted in an unsatisfactory outcome or patient complaint. The amended complaint then alleged numerous situations in which younger or white physicians were not investigated or punished for actions with serious complications. Additionally, the complaint gives examples of other Indian doctors who have allegedly experienced similar discrimination by the hospital. The surgeon also alleged that this conspired Sham Review Process was an antitrust violation, as it rendered it economically and professionally impossible for him to act as an orthopedic surgeon.

The district court dismissed all claims, finding that the surgeon failed to fix deficiencies from the previous pleading. The information provided to show intentional discrimination was deemed insufficient. The six incidents that led to the surgeon’s discipline were not explained in detail, making the court’s analysis impossible. Additionally, the surgeon’s allegation that similarly-situated doctors have not been disciplined was impossible to compare. The complaint did not elaborate on the experience of the similarly-situated doctors, so the court was unable to determine if they were actually comparator-doctors relative to the surgeon, as he claimed. Also, the allegations made regarding the disparaging treatment of the other Indian doctors were not deemed helpful to bolster the surgeon’s claims. Because the information presented in the complaint was insufficient to show that the surgeon was treated unfairly specifically due to his race, age, and national origin, the court dismissed this claim. In the absence of the discrimination claim, the court also had to dismiss the surgeon’s claim of conspiracy.

The district court also dismissed the antitrust claim, finding that the complaint failed to allege that the actions taken by the hospital resulted in antitrust injury because there were no factual connections made to link the alleged discrimination and the alleged market effects. The court declined to grant the surgeon a fourth chance to amend the complaint, holding that he had already been given ample opportunity to fix any deficiencies with the claims.

On appeal, the Second Circuit agreed with the district court that the surgeon did not properly support his antitrust claims that a hospital conspiracy to restrict his privileges resulted in harm to the marketplace. The appellate court did find, however, that the district court erred in dismissing the surgeon’s discrimination claims. Drawing reasonable inferences, the court concluded that the surgeon’s amended complaint was sufficient to plausibly support an inference of discrimination, and therefore should not have been dismissed.