Pierson v. Orlando Health (Summary)

BREACH OF CONTRACT/HCQIA IMMUNITY

Pierson v. Orlando Health, No. 6:08-cv-466-Orl-28GJK (M.D. Fla. Oct. 27, 2010)

The United States District Court for the Middle District of Florida granted a hospital’s motion for summary judgment on breach of contract and declaratory relief claims brought by a physician after he was removed from the hospital’s trauma and emergency call rotation. The physician was clinically privileged at the defendant’s hospitals when concerns arose about his performance with trauma and emergency call. An investigation began and during the investigation the physician was removed from trauma and emergency call pending completion of the investigation. The physician was still allowed to treat and admit patients in the hospital. After the investigation committee made its report and recommendation to the credentialing committee and the medical executive committee (MEC), the MEC made a recommendation to which the physician requested and received a hearing.

The physician claimed the hospital breached their contract by violating provisions of the bylaws. While the court recognized that bylaws constitute a binding contract, it found “there [wa]s no genuine issue of material fact as to any of the alleged breaches of the Bylaws.” The court held that while “there may have been some technical violations of the time deadlines,” the physician “ha[d] not presented evidence of how any such violation was material” which entitled the hospital to summary judgment on the breach of contract claim.

The hospital claimed and was held to have immunity under the Health Care Quality Improvement Act (HCQIA) and Florida law. The court said that the hospital met the four elements of HCQIA immunity because the hospital’s action against the physician was in furtherance of quality health care, the effort to obtain facts was far beyond a reasonable effort, the physician was afforded adequate procedures, and the hospital’s actions were warranted by the facts. The court also found immunity under Florida law because the physician “ha[d] not identified any evidence of intentional fraud” and “ha[d] not made a specific response” to the hospital’s claim of immunity under Florida law.

The physician’s claim for declaratory relief sought to have the hospital rescind, correct, and expunge the reports to any third parties. The physician claimed that if the trauma and emergency call was not a clinical privilege it should not have been reported to the National Practitioner Data Bank (NPDB). The court held, however, that under HCQIA the physician’s actions were included in the definition of clinical privileges. “There is no inconsistency between a statute employing one definition of a term and a hospital delineating the scope of that same term in a different, narrower way in an arrangement with a physician.”