Doe v. Leavitt (Summary)

HEALTH CARE QUALITY IMPROVEMENT ACT

Doe v. Leavitt, 552 F.3d 75 (1st Cir. 2009)

The United States Court of Appeals for the First Circuit affirmed the decision of the district court and held that an "investigation" under the Health Care Quality Improvement Act, for purposes of the provision requiring hospitals to report physicians who surrender clinical privileges while under investigation for suspected incompetence or improper professional conduct, is ongoing until the hospital either takes final action or formally closes the probe.

The issue arose when a nurse filed a complaint against a physician alleging that the physician threatened her. The medical executive committee temporarily suspended the physician’s privileges, appointed an ad hoc investigating committee to look into the allegations, and the medical executive committee ultimately proposed that the physician be allowed to return to the hospital as long as he agreed to certain conditions. The physician rejected the proposal and resigned his clinical privileges, at which point the hospital reported him to the National Practitioner Data Bank (NPDB).

The physician argued that the investigation had ended when the ad hoc committee presented its report to the medical executive committee and, therefore, he had not resigned while under an investigation. The First Circuit disagreed, and, echoing the Secretary of Health and Human Services’ analysis of "investigation" in the underlying administrative proceeding, the court concluded that an "investigation" ends only when a health care entity’s decision-making authority either takes a final action or formally closes the investigation. Thus, the NPDB report was appropriately submitted.