Pinnacle Anesthesia Consultants v. Fisher (Full Text)


File: 071042F – From documents
transmitted: 06/25/2009
AFFIRMED;
Opinion issued June 25, 2009.





In The
Court of Appeals
Fifth
District of Texas at Dallas
……………………….
No. 05-07-01042-CV
……………………….
PINNACLE ANESTHESIA CONSULTANTS, P.A.,
Appellant

V.
DR. NEAL FISHER, Appellee
…………………………………………………….
On Appeal from the 193rd Judicial District
Court

Dallas County,
Texas
Trial Court Cause No.
04-12966-L
…………………………………………………….
OPINION
Before Justices
Moseley, FitzGerald, and Francis
Opinion By
Justice Moseley

        Dr. Neal Fisher’s
employment agreement with Pinnacle Anesthesia Consultants,
P.A. provided that he could be terminated for “cause,” which
was defined in the agreement as any of sixteen different reasons. Fisher sued
Pinnacle, alleging (among other things): breach of contract based on its
termination of the employment agreement without cause; slander; and conversion.
The principal dispute between the parties is whether Pinnacle terminated Fisher
without cause.
        The trial court granted
partial summary judgment for Fisher on his breach of
contract claim, deciding that he had conclusively negated thirteen of the
termination-for-cause grounds stated in the agreement. A jury found in favor of
Fisher on the other three termination-for-cause grounds; it also found for
Fisher on his slander and conversion claims. The trial court rendered a final
judgment in favor of Fisher. Pinnacle appeals, asserting the trial court erred
in granting partial summary judgment and complaining of certain trial rulings.
For the reasons below, we reject Pinnacle’s arguments, resolve its issues
against it, and affirm the trial court’s judgment.

I. FACTUAL AND
PROCEDURAL BACKGROUND


        Fisher is a
board-certified anesthesiologist. In 1990, he joined Dallas
Anesthesia Associates, a group of anesthesiologists that
provided obstetric anesthesia services at Presbyterian Hospital in Dallas. In
1999, the successor to Dallas Anesthesia Associates merged with Pinnacle, a
group of anesthesiologists practicing in North Texas. Pinnacle continued to
provide obstetric anesthesia services to Presbyterian. Fisher signed an
employment agreement with Pinnacle and thereby became its employee and a member
of its Dallas Division.
A.

The Employment
Agreement


        Pursuant to
the agreement, Fisher agreed to provide anesthesiology services
exclusively to Pinnacle’s patients on a full-time basis at
certain locations. His duties as a physician included performing both
anesthesiology services and administrative duties and following Pinnacle’s
professional standards of quality and its practice protocols and policies. The
agreement provided that it was automatically renewed for one-year terms “unless
terminated in accordance with the terms of this Agreement.” Section 4.2(a) of
the agreement, entitled “Termination For Cause,” provided that, upon an
affirmative vote of certain percentages of Pinnacle’s outstanding shareholders
and of Pinnacle’s directors in attendance at a meeting at which a quorum was
present, Pinnacle could terminate the agreement “immediately for cause.” Section
4.2(a) also contained fourteen subsections, which defined “cause” to mean any of
sixteen different reasons.  
See Footnote 1 
These subsections will be discussed in more detail herein.
        The agreement
also contained an article (Article VI) entitled
“Noncompetition”; section 7.1 of this article states “Left Intentionally
Blank.” The remainder of the article does not include a non- competition
agreement, and there is no dispute that Fisher was not subject to such an
agreement.
B.

The
Meeting


        On January 10, 2004,
Fisher was informed that a meeting of Pinnacle’s Dallas
Division would be held on January 22. Fisher was told he and his attorney
could attend the meeting, but he was not told the meeting’s subject. Some
portions of the meeting were “closed door” as to Fisher and his attorney;
however, Fisher recorded those portions of the meeting he was permitted to
attend, apparently with the knowledge of those participating. A transcript of
that recording was submitted as evidence during the summary judgment proceedings
and was also admitted into evidence at trial.
        Early portions of the
meeting, which were recorded and which included all
shareholders of the Dallas Division, its attorneys, and Fisher and his
attorney, involved allegations of several clinical and administrative incidents
concerning Fisher. Fisher defended himself, stating that the incidents had been
reviewed by the hospital, were untrue, or were just allegations with no
documentation. He stated his belief that he was being targeted for termination
by the Dallas Division’s management because he had questioned what he perceived
as Pinnacle’s business plan of billing as many procedures as possible
out-of-network in order to increase Pinnacle’s profits.
        Fisher was
asked to agree to submit to Pinnacle’s peer review process, which
would have included, among other things, a psychiatric
evaluation and a blood test for drugs. Fisher volunteered to take any type of
drug test (“a hair sample, urine, blood, everything . . .”), but refused to
submit voluntarily to Pinnacle’s peer review process, stating that he believed
such a peer review would be a “kangaroo court.”
        During a final portion of the
meeting (also recorded), Fisher was told he had to agree to five conditions to
remain in Pinnacle: (1) submit to Pinnacle’s peer review process for clinical
incidents; (2) agree to a two-year probation for administrative matters; (3)
sign a three-year non-compete agreement; (4) withdraw from another physician
group; and (5) agree to pay Pinnacle’s attorney’s fees and expenses in
connection with the January 22 meeting. These were described as “the tickets for
him to get back in and really integrate.” Fisher was told that if he chose not
to agree to the conditions, he must leave Pinnacle. He was given a deadline of
5:00 p.m. the following day to respond, but Fisher stated immediately that he
would not agree to the conditions. (No evidence was admitted at trial or
in connection with the earlier partial summary judgment hearing contradicting
these statements.)
        After the next day’s
deadline, Pinnacle wrote Fisher that it was proceeding to
terminate him for cause under the agreement. It also withheld
fees due to Fisher in order to reimburse itself for its attorney’s fees incurred
in connection with the January 22 meeting.
C.

The
Lawsuit


        Fisher sued Pinnacle,
alleging breach of contract (for terminating without
cause), slander (for statements made about Fisher during and after the
meeting), conversion (for withholding fees from Fisher), and other causes of
action.
        Pertinent to his breach
of contract claim, Fisher contended that: (1) the
employment agreement overcame the presumption that he was an at-will
employee; (2) he could only be terminated for “cause” as defined in the
agreement; (3) nothing in the agreement required him to accept any of Pinnacle’s
five demands for continuing his employment; and thus (4) Pinnacle breached the
agreement by constructively terminating him without cause at the meeting. There
appears to be no dispute as to Fisher’s first two contentions; however, Pinnacle
disputed the latter two contentions. Specifically, Pinnacle claimed that
Fisher’s actions before and during the meeting constituted “cause” to terminate
him under the agreement, and that it thereafter terminated Fisher for cause
pursuant to the agreement after Fisher refused Pinnacle’s
demands.
        The trial court granted
Fisher’s traditional motion for partial summary judgment
in part and denied it in part. The exact text of the trial
court’s order will be reviewed in more detail herein, but by way of summary the
trial court held that Fisher proved as a matter of law he was not terminated for
cause based on any of the “for cause” provisions in the agreement, save three.
Those three provisions, set forth in subsection (iv)[1] and subsection (viii)[1]
and [2], defined “cause” as:
        (iv)

Physician’s [1] failure
to perform the duties required hereunder . . .;

        
        (viii)

Physician’s engaging in
behavior or activities which [1] result in damage to the Association’s
reputation and/or [2] disrupt, undermine or
threaten to disrupt or undermine the operations or cohesiveness of the
Association or the Physician’s Division . . . .

(Brackets
added.)  
See
Footnote
 2 
The trial court also granted Pinnacle’s motion for
summary judgment on all of Fisher’s causes of action against it except
breach of contract, conversion, and slander.
        The case then proceeded
to jury trial.  
See
Footnote
 3 
As to Fisher’s
breach of contract claim, the
jury found that Pinnacle did not terminate Fisher for cause under the three remaining “for cause” grounds under the
contract.  
See
Footnote
 4 
The jury also found Fisher did not repudiate the employment agreement. Based on
these answers, the jury awarded Fisher damages of $900,000 in past lost earnings
and $5 million in future lost earnings on his breach of contract claim. The jury
also found in Fisher’s favor on his claims for conversion and slander and
awarded damages of $36,000 and $200,000 (respectively) for these
claims.
        Based on the jury’s
findings, the trial court signed a judgment in favor of Fisher
and against Pinnacle in the amount of $8,597,508.27,
including attorney’s fees and prejudgment interest. Pinnacle appealed, asserting
three issues. None of these issues relate to the computation of the damage
amounts.

II. BREACH OF
CONTRACT


        A breach of contract
occurs when a party fails to perform an act that it has
expressly or impliedly promised to perform. Case Corp. v. Hi-Class
Bus. Sys. of Am., Inc
. 184 S.W.3d 760, 769, 770 (Tex. App.-Dallas 2005, pet.
denied). A defendant’s improper termination of a contract is a breach of the
contract as a matter of law. Gunter Hotel of San Antonio Inc. v. Buck,
775 S.W.2d 689, 697 (Tex. App.-San Antonio 1989, writ denied); Incorporated
Carriers, Ltd. v. Crocker
, 639 S.W.2d 338, 340 (Tex. App.-Texarkana 1982, no
writ); Howell v. Kelly, 534 S.W.2d 737, 740 (Tex. Civ. App.-Houston [1st
Dist.] 1976, no writ). When an employment agreement requires cause to terminate
an employee, the burden of proof for establishing cause rests upon the employer.
Cushman & Wakefield, Inc. v. Fletcher, 915 S.W.2d 538, 543 (Tex.
App.-Dallas 1995, writ denied).
        As described above, the trial
court granted partial summary judgment for Fisher, concluding as a matter of law
that Pinnacle did not have cause to terminate Fisher based on thirteen of the
sixteen “for cause” grounds set forth in the contract. The jury also held in
favor of Fisher, finding as a matter of fact that Pinnacle did not terminate
Fisher for cause based on the remaining three “for cause” grounds. The trial
court’s partial summary judgment as to the thirteen “for cause” grounds, and the
manner in which the court tried the three remaining “for cause” grounds, give
rise (respectively) to Pinnacle’s first and second issues on
appeal.
A.

Partial
Summary Judgment


        In its first
issue, Pinnacle contends the trial court erred in granting partial
summary judgment.
        1.

Burden of
Proof

        A party seeking to
recover upon a claim may move for summary judgment in
his favor upon all or any part thereof. Tex. R. Civ. P. 166a(a). When the
plaintiff moves for summary judgment on a claim for relief, he must
affirmatively demonstrate by summary judgment evidence that there is no genuine
issue of material fact concerning each element of his claim, including the
existence of damages or loss. See Rhone-Poulenc, Inc. v. Steel, 997
S.W.2d 217, 223 (Tex. 1999); Green v. Unauthorized Practice of Law Comm.,
883 S.W.2d 293, 297 (Tex. App.-Dallas 1994, no writ). See also Tex. R.
Civ. P. 166a(a) (summary judgment may be rendered on issue of liability alone,
although there is genuine issue as to amount of damages). The plaintiff meets
this burden if he produces evidence that would be sufficient to support an
instructed verdict at trial. See Ortega- Carter v. Am. Int’l Adjustment
Co.
, 834 S.W.2d 439, 441 (Tex. App.-Dallas 1992, writ
denied).
        Once the movant with the
burden of proof has established the right to summary
judgment on the issues presented, the nonmovant’s response should present
to the trial court a genuine issue of material fact that would preclude summary
judgment. See Abdel-Fattah v. Pepsico, Inc., 948 S.W.2d 381, 383 (Tex.
App.-Houston [14th Dist.] 1997, no writ). If a case is not fully adjudicated on
a motion for summary judgment, the trial court is authorized to render partial
summary judgment, making “an order specifying the facts that are established as
a matter of law, and directing such further proceedings in the action as are
just.” See Tex. R. Civ. P. 166a(e).
        2.

Standard of
Review

        We review a traditional
summary judgment de novo. Roehrs v. FSI Holdings,
Inc., 246 S.W.3d 796, 805 (Tex. App.-Dallas 2008, pet.
denied). We consider the evidence in the light most favorable to the nonmovant
and resolve all doubts in the nonmovant’s favor. W. Invs., Inc. v. Urena,
162 S.W.3d 547, 550 (Tex. 2005). Issues not expressly presented to the trial
court by written motion, answer, or other response shall not be considered on
appeal as grounds for reversal. See Tex. R. Civ. P. 166a(c); City of
Houston v. Clear Creek Basin Auth.
, 589 S.W.2d 671, 677 (Tex.
1979).
        3.

Analysis

        Pinnacle makes several
arguments under its first issue. It argues: (a) Fisher’s
motion did not address each of the “for cause” grounds for
termination set forth in the agreement; (b) the text of the trial court’s order
shows that the trial court erred because it treated Fisher’s traditional motion
for partial summary judgment as a “no evidence” motion attacking each ground for
termination “for cause” under the agreement; (c) because the trial court ruled
against Fisher with respect to several of the “for cause”grounds for
termination, it should have denied Fisher’s motion in its entirety and thus it
erred in “ruling on specific grounds piecemeal”; and (d) the trial court erred
in granting summary judgment because Pinnacle raised a fact issue regarding
termination for cause on several grounds.
                (a)

Scope of Fisher’s
Motion

        Pinnacle argues that
Fisher’s motion did not address each of the “for cause”
grounds for termination set forth in the agreement. We disagree. In his
motion, Fisher asserted that the fourteen subsections set out “separate actions
that would constitute ’cause’ for terminating” and asserted that “[n]one of the
grounds could be relied upon to terminate [him] under the agreement . . . .” He
asserted that, under the terms of the employment agreement, his refusal to
submit to Pinnacle’s five conditions was not “cause” for termination. He
asserted that eight of the “for cause” grounds “were not even alleged” by
Pinnacle against him. He argued that the remaining grounds could not be
triggered by mere allegations, and they all required that he be found to have committed some act that would trigger
termination for cause.  
See
Footnote
 5 
As evidence, Fisher’s motion relied, in part, on: the transcription of the
recording of the January 22 meeting; a copy of the agreement, containing all
fourteen subsections stating all sixteen grounds for termination for cause; and
an affidavit of Fisher stating that he made an audio recording of the January 22
meeting, it truly and accurately recorded the events at the meeting, and the
transcription attached to the motion as Exhibit A was a “true and accurate transcript of the audio recording.”  
See Footnote 6 
We thus conclude Fisher’s motion addressed all sixteen bases for termination
“for cause” under the agreement.
                (b)        Nature
of Fisher’s Motion and Trial Court’s
Order
        Pinnacle also argues that
the text of the trial court’s order shows it treated
Fisher’s traditional motion for partial summary judgment as a “no
evidence” motion attacking each ground for termination “for cause” under the
agreement, and thus erred by in effect requiring Pinnacle to marshal its proof
of cause for each of the contractual grounds for termination. The basis for
Pinnacle’s argument is the trial court’s use of the phrase “no evidence” in the
second and third numbered paragraphs of the order, which we quote below. The
order states that the trial court is granting the motion in part and denying it
in part “as follows:”

        1. [Fisher’s]
motion for summary judgment that [Pinnacle] breached the
[employment agreement] is GRANTED IN PART in so far that
there is conclusive summary judgment evidence establishing a prima facie
case of breach by [Pinnacle] subject to the rulings in paragraphs 2-5
below.



        2. [Fisher’s] motion for
summary judgment that there is no evidence that
[Fisher] breached Section 4.2(a)(xii) or was terminated for cause
pursuant to Section 4.2(a)(xii) of the [employment agreement] is GRANTED and the
Court also finds as a matter of law there was no recommendation made pursuant to
this provision of the Agreement to terminate [Fisher’s] employment pursuant to
Section 4.2(a)(xii).



        3. [Fisher’s]
motion for summary judgment that there is no evidence that
[Fisher] breached Section 4.2(a)(iv) of the [employment
agreement] that reads physician’s “failure or refusal to comply with the
policies, standards and regulations of the Association with from time to time
may be established, as determined in the Board of Directors’ sole discretion”
and there is no evidence that [Fisher] was terminated for cause pursuant
to Section 4.2(a)(iv) of the [employment agreement] that reads physician’s
“failure or refusal to comply with the policies, standards and regulations of
the Association with from time to time may be established, as determined in the
Board of Directors’ sole discretion” is GRANTED.



        4. [Fisher’s] motion for
summary judgment that Fisher did not breach
Section 4.2(a)(iv) of the [employment agreement] for the “failure to
perform the duties required hereunder” and was not terminated for cause pursuant
to Section 4.2(a)(iv) of the [employment agreement] that reads physician’s
“failure to perform the duties required hereunder” is DENIED.



        5. [Fisher’s] motion for
summary judgment that [Fisher] did not breach
Section 4.2(a)(viii) and was not terminated for cause pursuant to Section
4.2(a)(viii) is DENIED.



        All other
relief not expressly granted herein is DENIED. . . .

(Emphasis added in
italics.)
         We agree Fisher’s motion
for partial summary judgment was a traditional
motion as to Pinnacle’s liability for breach of the agreement; thus,
Fisher had the burden of proving he was entitled to summary judgment with
respect to each of the “for cause” grounds for termination set forth in the
agreement.
        Although the language of
the trial court’s order is not a model of clarity, we
conclude that paragraph 1 of the order, by granting Fisher’s motion
“subject to the rulings in paragraphs 2-5 below,” is effective to grant Fisher a
traditional summary judgment negating all sixteen grounds for termination for
cause, “subject to” the additional specified rulings. Two of those rulings, in
paragraphs 4 and 5 of the order, deny Fisher summary judgment as to three of the
termination-for- cause grounds (namely, subsections (iv)[1] and (viii)[1] and
[2]); thus, they necessarily contravene paragraph 1 and are effective to exclude
from paragraph 1’s grant of traditional summary judgment the issues of whether
Fisher was terminated pursuant to those subsections.
        That brings us to the
meaning of paragraphs 2 and 3, which purport to grant a
“no evidence” summary judgment with respect to the “for cause” grounds
set forth in subsections (xii) and (iv)[2] (respectively). Unlike paragraphs 4
and 5 of the order, however, the holdings in paragraphs 2 and 3 do not
contravene paragraph 1’s grant of traditional summary judgment; i.e., they do
not remove issues relating to termination under subsections (xii) and (iv)[2]
from the scope of the traditional summary judgment granted in paragraph 1. As
worded by the trial court, paragraphs 2 and 3 constitute additional-albeit
erroneous-“no evidence” summary judgment rulings as to whether Fisher was
terminated pursuant to subsections (xii) and (iv)[2]. Unless the trial court
erred in granting a traditional summary judgment on those subsections in
paragraph 1 of the order, we cannot conclude that the additional holdings in
paragraphs 2 and 3 resulted in the entry of an improper judgment. See
Tex. R. App. P. 44.1(a) (error is reversible if it probably caused rendition of
improper judgment or probably prevented appellant from properly presenting case
to court of appeals).
        In addition, Pinnacle
argues the trial court’s order “creates ambiguity” as to
which grounds for cause the order covers. Fisher disagrees,
arguing among other things that Pinnacle waived this complaint by approving the
order as to form. Assuming without deciding that Pinnacle has not waived this
complaint, we still disagree. As noted above, paragraph 1 effectively granted
Fisher a traditional summary judgment negating the all “for cause” grounds for
termination, subject to the rulings in paragraphs 2 through 5. Paragraphs 4 and
5 negate and limit that traditional summary judgment to exclude the issues of
whether Fisher was terminated for cause pursuant to subsections (iv)[1] and
(viii)[1] and [2], and those issues were thereafter tried to a jury. Further,
although paragraphs 2 and 3 erroneously reference a no-evidence motion, they do
not negate or limit the effect of paragraph 1. We conclude no ambiguity exists
such as would require reversal.
                (c)

“Piecemeal” Nature of
Rulings

        Pinnacle argues that,
because the trial court found a fact issue existed as to
whether Pinnacle terminated Fisher for cause based on three
of the sixteen grounds for termination set forth in the agreement (subsections
(iv)[1] and (viii)[1] and [2]), the trial court should have denied Fisher’s
motion in toto, and thus it erred in “ruling on specific grounds piecemeal.”
Again, Fisher replies that Pinnacle waived this complaint by approving the order
as to form.
        Assuming Pinnacle did not
waive this complaint, we conclude rule of civil
procedure 166a(e) is dispositive-it permits partial summary judgment,
directing the trial court to make “an order specifying the facts that are
established as a matter of law, and directing such further proceedings in the
action as are just.” See Tex. R. Civ. P. 166a(e). Thus, we conclude the
trial court did not err by granting partial summary judgment on some of the
grounds for termination, reserving others for trial.
                (d)

Issue of Fact as to Other
“For Cause” Grounds

         As noted
above, Fisher’s summary judgment motion asserted that he was not
terminated “for cause” as defined in the employment
agreement. He asserted that nothing in the agreement required him to accept any
of the conditions for continued employment presented to him at the January 22
meeting, and his refusal to accept those conditions did not fit within any of
the enumerated termination-for-cause grounds. In its response, Pinnacle
contended that Fisher’s failure to agree to undergo Pinnacle’s peer review
process justified his termination under subsection (iv)[1] and [2], subsection
(viii)[1] and [2], and subsection (xii). The trial court granted partial summary
judgment, finding that Fisher proved as a matter of law he was not terminated
for cause under any of the provisions of the agreement except for three
(subsection (iv)[1] and subsection (viii)[1] and [2]), which were later tried by
a jury. On appeal, Pinnacle asserts the trial court erred in granting summary
judgment disposing of the issue of termination because it raised a fact issue
under six for- cause provisions.
        First, we consider
Pinnacle’s assertion that it raised a fact issue as to Fisher’s
termination under subsection (iv)[2]-permitting termination
for “failure or refusal to comply with the policies, standards and regulations
of the Association which from time to time may be established, as determined in
the Board of Directors’ sole discretion”-and, therefore, the trial court erred
in granting summary judgment disposing of the issue of termination under that
subsection. In support of this assertion, Pinnacle makes several
arguments.
        Pinnacle argues Fisher’s
refusal to agree to undergo peer review constituted
evidence of a violation of Pinnacle’s policies, standards, or
regulations. However, no provision of the employment agreement requires a
Pinnacle physician to agree to submit to Pinnacle’s peer review process upon
request. Neither did Pinnacle point to evidence that Pinnacle’s directors had
established a policy, standard, or regulation imposing such a requirement.
Further, there was evidence that a peer review referral could be made without a
physician’s agreement. Specifically, Hank Duffy, Pinnacle’s manager who began
the January 22 meeting, stated there that:

The Dallas physician shareholders are
being asked to refer to the Pinnacle quality
improvement in Peer Review Committee certain allegations made regarding
Dr. Fisher’s clinical practice. Should the Dallas Division shareholders believe
that there is reason to be concerned about any clinical practice, there is a
professional obligation to address the behavior from the peer review process. It
is the shareholder’s primary obligation. . . . It is the question of [sic] is
there a sense among the shareholders that the allegations are sufficient that
they be sent to the peer review process because it is protected. . .
.

Later,
Duffy read specific allegations regarding clinical practices and
stated:

Those are the six clinical allegations and they fall into uh, what we’re
calling the Peer
Review group. If your
colleagues hypothetically believe that those allegations probably aren’t true,
but there are enough of them that they should be cautious, we are telling them
that they should refer this to the peer review process to protect everybody
including yourself.

In a deposition, Fisher stated he heard one of the Pinnacle
doctors “was going around
soliciting votes from
the doctors to put me in peer review . . . .” Accordingly, we reject Pinnacle’s
argument that Fisher’s refusal to agree to undergo peer review constituted
evidence of a violation of Pinnacle’s policies, standards, or
regulations.
        Pinnacle also directs our
attention to its “Quality Management Policies and
Procedures” which concern “Handling Suspected Impaired Practitioners.”
This document provides that a suspected impaired physician should be reported to
the chairperson of Pinnacle’s Quality Improvement Committee, who then names a
Physician Health Committee to investigate the report and make a recommendation
as to disciplinary action to the Board of Directors. This document was attached
as an exhibit to Fisher’s reply to Pinnacles’s response. However, in its
response, Pinnacle did not bring this document to the trial court’s attention,
although it pointed to an allegation of “using alcohol while on Obstetrics
service.” But Pinnacle made no argument that Fisher was an impaired physician or
that anyone had invoked the procedures provided by the “Quality Management
Policies and Procedures” with respect to Fisher, or that Fisher violated the
terms of those policies, standards, or requirements by refusing to agree to
submit to peer review. Because this argument was not made in Pinnacle’s response
as an issue expressly precluding summary judgment, Pinnacle cannot raise it on
appeal as a reason to reverse the summary judgment. See City of Houston,
589 S.W.2d at 677.
        Pinnacle also argues at
least one Dallas Division doctor had been required to
undergo peer review and this was some evidence of an informal policy
requiring Pinnacle physicians to submit to peer review upon request. However,
this argument was not made in Pinnacle’s response as an issue expressly
precluding summary judgment. Thus, Pinnacle cannot raise it on appeal as a
reason to reverse the summary judgment. See id.
        Pinnacle also
makes the following argument:

The question before the court on
summary judgment was not whether Fisher’s
noncompliance with Pinnacle’s policies, standards, or regulations had
been established, or even whether there was a fact issue concerning whether it
had been established, but whether there was a fact issue that it could have been
established in the sole discretion of the Pinnacle board, which had not yet
acted at the time of the January 22, 2004, meeting.

This argument presents nothing new,
absent some evidence that, on January 22, 2004, Pinnacle
had an existing policy, standard, or regulation
requiring Pinnacle physicians to submit voluntarily to peer review. And there is
no such evidence here.
        Pinnacle also argues
that, apart from Fisher’s refusal to submit to peer review,
many of the administrative allegations related specifically
to Fisher’s failure to comply with Pinnacle’s policies, procedures, and
directives, such as being on time for cases and filling out charts. In the
factual background of its response to Fisher’s motion for summary judgment,
Pinnacle outlined administrative complaints regarding Fisher’s failure to adhere
to its policies, procedures, and directives. However, Pinnacle made no argument
in its response that Fisher was terminated for failing to comply with policies,
procedures, and directives governing these administrative allegations. Because
this argument was not made in Pinnacle’s response as an issue expressly
precluding summary judgment, Pinnacle cannot raise it on appeal as a reason to
reverse the summary judgment. See id.
        Next, Pinnacle asserts
the trial court erred in granting summary judgment
disposing of the issue of termination under subsection (viii)[1] and
[2]-permitting termination for “engaging in behavior or activities which [1]
result in damage to the Association’s reputation and/or [2] disrupt, undermine
or threaten to disrupt or undermine the operations or cohesiveness of the
Association or the Physician’s Division”-because it raised a fact issue
regarding termination for cause under these subsections. But the trial court
denied Fisher’s motion for summary judgment on subsection (viii)[1] and [2], as
noted above. We need not address these specific arguments in the context of
summary judgment because the denial of Fisher’s motion for summary judgment for
cause under subsection (viii)[1] and [2] did not result in reversible error.
See Tex. R. App. P. 44.1. See also Reese v. Duncan, 80 S.W.3d 650,
665 (Tex. App.-Dallas 2002, pet. denied) (“If the trial court denies a motion
for summary judgment and the case is tried on its merits, the order denying the
summary judgment is not reviewable on appeal.”).
        We reach the same
conclusion as to Pinnacle’s argument that the trial court
erred in granting summary judgment disposing of the issue of
termination under subsection (iv)[1], which permits termination for a
physician’s “failure to perform the duties required” under the employment
agreement, because it raised a fact issue regarding termination for cause under
this subsection. The trial court denied Fisher’s motion for summary judgment on
subsection (iv)[1], as noted above. We need not address this specific argument
in the context of summary judgment because the denial of Fisher’s motion for
summary judgment for cause under subsection (iv)[1] did not result in reversible
error. See Tex. R. App. P. 44.1. See also Reese, 80 S.W.3d at
665.
        Lastly, we consider
Pinnacle’s argument that the trial court erred in granting
summary judgment disposing of the issue of termination
because evidence of Fisher’s derogatory statements made to outsiders raised a
fact issue of termination for cause under section (ix), which provides for
termination-for-cause for a physician’s “breach of any material fiduciary duty
to the Association.” This argument was not made in Pinnacle’s response to the
motion for summary judgment as an issue expressly precluding summary judgment.
Thus, Pinnacle cannot raise it on appeal as reasons to reverse the summary
judgment. See City of Houston, 589 S.W.2d at 677.
        We reach the
same conclusion regarding Pinnacle’s argument that the trial court
erred in granting summary judgment disposing of the issue of
termination because it raised an issue of fact pursuant to subsection (vii),
which provides termination-for-cause when a physician “materially breaches” the
employment agreement. Pinnacle argues specifically that Fisher breached section
2.1(c), (d), and (f) of the employment agreement, which required Fisher to
promote Pinnacle’s professional practice, attend to Pinnacle’s administrative
duties, and follow professional standards of quality. However, this argument was
not made in Pinnacle’s response to the motion for summary judgment as an issue
expressly precluding summary judgment. Thus, Pinnacle cannot raise it on appeal
as reasons to reverse the summary judgment. See id.
        Having
rejected Pinnacle’s arguments directed to the propriety of the summary
judgment, we resolve Pinnacle’s first issue
against it.
B.

Jury
Trial


        The jury was asked to
consider three grounds for termination for cause:
Fisher’s failure to perform the duties required under the employment
agreement (subsection (iv)[1]), or his engaging in behavior or activities which
resulted in damage to Pinnacle’ reputation (subsection (viii)[1]) or disrupted,
undermined, or threatened to disrupt or undermine Pinnacle’s or the Dallas
Division’s operation or cohesiveness (subsection (viii)[2]). The jury found
against Pinnacle. In its second issue, Pinnacle argues the trial court erred at
trial by “precluding in its entirety Pinnacle’s defense that Fisher’s refusal to
submit to peer review constituted cause for termination under the grounds
submitted to the jury.” Pinnacle asserts the trial court erred by: (1) limiting
its proof and argument on this issue; (2) granting motion for directed verdict
for Fisher on this point; and (3) instructing the jury that, as a matter of law,
Fisher’s “mere failure to voluntarily submit to [Pinnacle]’s peer review process
is not ‘Cause’ under the terms of their Employment Agreement.”
        
        1.        Limiting
Proof
        We review a trial court’s
evidentiary rulings for abuse of discretion.
Horizon/CMS Healthcare Corp. v. Auld, 34 S.W.3d 887, 906 (Tex.
2000). Unless the trial court’s erroneous evidentiary ruling probably caused the
rendition of an improper judgment, we will not reverse the ruling.
Id.
        After the jury returned
its verdict, Pinnacle argued that it “was prohibited at
trial from introducing evidence and arguing to the jury that Fisher’s
failure to submit to Pinnacle’s peer review process was a basis for his
termination and/or constituted termination for cause.” Pinnacle argued that
Fisher agreed Pinnacle could offer this evidence “later,” and Fisher did not
object. Pinnacle then described the testimony of six witnesses as an offer of
proof. However, it was undisputed that Fisher was not terminated solely because
he refused to submit to Pinnacle’s peer review. First, Dr. Michael Hicks,
Pinnacle’s president, was asked, “Was Dr. Fisher terminated solely because of a
refusal or statement that he would not participate in peer review?” Hicks
replied, “No, not at all.” Dr. Alan Frankfurt, a Pinnacle shareholder who
attended the January 22 meeting, was asked, “Did you terminate Neal Fisher’s
employment from Pinnacle solely because he refused to go to peer review?”
Frankfurt replied, “No. He had to abide by the other parameters as well.” None
of the testimony in the offer of proof related to the actual reason Fisher was
terminated, only that he could have been terminated for such failure. Because
such testimony was irrelevant to the issue of termination for cause, any error
in excluding this testimony did not result in reversible error. See Tex.
R. App. P. 44.1; Horizon/CMS Healthcare Corp., 34 S.W.3d at
906.
        2.

Directing a
Verdict

        A directed verdict is
proper under rule of civil procedure 268, in part, when the
evidence conclusively proves a fact that establishes a
party’s right to judgment as a matter of law. Tex. R. Civ. P. 268. See
Coastal Transp. Co. v. Crown Cent. Petroleum Corp.
, 136 S.W.3d 227, 233
(Tex. 2004). In reviewing the granting of a directed verdict, we must determine
if there is more than a scintilla of evidence to raise a fact issue on the
material question presented. See Coastal Transp. Co., 136 S.W.3d at 233.
We consider all of the evidence in a light most favorable to the party against
whom the verdict was instructed and disregard all contrary evidence and
inferences; we give the losing party the benefit of all reasonable inferences
created by the evidence. Id. at 234. If the evidence supporting a finding
on the issue “rises to a level that would enable reasonable and fair-minded
people to differ in their conclusions,” it constitutes more than a scintilla of
evidence and the case must be reversed and remanded for a jury determination.
See id. (citation omitted).
        We consider Pinnacle’s
arguments in light of the trial court’s directed verdict on
the issue that the failure to agree to submit voluntarily to
peer review was not just cause for termination.
        Section 1.1 of the
employment agreement defines “Anesthesiology Services”
required of Pinnacle physicians as “the services of a specialist in the
practice of anesthesiology” and lists six specific services clearly related to
delivering medical care to patients. Following that list, the employment
agreement states, “Physician shall render Anesthesiology Services in accordance
with the Association’s policies and procedures and shall perform any other
services that are assigned or requested from time to time by the Association and
the Physician’s Division
.” (Emphasis added.) Referring to subsection
(iv)[1], Pinnacle argues on appeal that submission to peer review comes within
the “non-anesthesiological services” referred to in the italicized language and
that “the refusal [to submit to peer review] could have been construed by a
reasonable juror as a failure by Fisher to perform the duties required of him
under the Agreement.” However, even if this were true, the evidence was
undisputed that Fisher was not fired solely because he refused to submit to peer
review-he was fired for refusing to submit to all five
conditions.  
See
Footnote
 7 
        Pinnacle’s
arguments as to subsection (viii)[1] and [2] rest on speculation as to
Fisher’s motive for such refusal, the possible
reaction of other doctors to such refusal, and the possible future “effect” of
such refusal, including “whether it was safe to schedule Fisher for
anesthesiological procedures.” Pinnacle argues, “These lingering questions could
not help but disrupt and undermine operations and cohesiveness.” There was no
evidence presented as to whether such “lingering questions” had any factual
basis. The only record references in Pinnacle’s brief are to the fact of
Fisher’s refusal at the meeting. Such speculation and surmise do not constitute
more than a scintilla of evidence. See Coastal Transp. Co., 136 S.W.3d at
233-34. Because there is no evidence raising a fact issue on the question of
whether Fisher’s failure to agree to submit voluntarily to peer review was just
cause for termination under subsections (iv)[1] or (viii)[1] and [2], we
conclude the trial court did not err in granting a directed verdict on this
issue. See id.
        Having rejected
Pinnacle’s arguments, we conclude the trial court did not err in
directing a verdict on the issue that the failure to agree to
submit voluntarily to peer review was not just cause for termination. See
id.

        3.

Instructing the
Jury

        The trial court is
required to “submit such instructions and definitions as shall
be proper to enable the jury to render a verdict.”
Sterling Trust Co. v. Adderley, 168 S.W.3d 835, 842-43 (Tex. 2005)
(quoting Tex. R. Civ. P. 277). We review the trial courts submission of
instructions and jury questions under an abuse of discretion standard.
Barnett v. Coppell N. Tex. Court, Ltd., 123 S.W.3d 804, 824 (Tex.
App.-Dallas 2003, pet. denied). To determine whether an alleged error in the
jury charge is reversible, we must consider the pleadings of the parties, the
evidence presented at trial, and the charge in its entirety. Id.
        At the charge conference,
although Pinnacle initially objected to submission of the instruction, it then
agreed to include “mere” in the instruction. By such agreement Pinnacle
abandoned its objection and waived its argument on appeal. See Tex. R.
App. P. 33.1(a). Even if Pinnacle had not abandoned this objection, as noted
above, two Pinnacle witnesses testified that Fisher was not terminated solely
because he refused to participate in peer review. Because the instruction
enabled the jury to render a verdict, we discern no abuse of discretion in the
submission of this jury instruction. See Sterling Trust Co., 168 S.W.3d
at 842-43; Barnett, 123 S.W.3d at 824.
        4.

Conclusion

        Having
rejected Pinnacle’s arguments as to the trial rulings, we resolve
Pinnacle’s second issue against it.

III.
CONVERSION


        In its third issue,
Pinnacle contends Fisher had no conversion claim because
that claim was based on Pinnacle’s deducting its attorney’s
fees from his final salary payment, but such money was not “a specific tangible
asset” required to prove a tort for conversion of money. The record shows that
Pinnacle’s only objection to the originally proposed submission of Question 4
was the inclusion of the word “wrongfully” in the question. In response to
Pinnacle’s objection, the trial court deleted the word “wrongfully,” thus
effectively sustaining Pinnacle’s sole objection. Pinnacle had no other
objection to Question 4, which asked the jury, “Did [Pinnacle] convert Neal
Fisher’s property?” and listed the elements of a conversion claim. We conclude
Pinnacle’s argument on appeal was not made in the trial court. See Tex.
R. App. P. 33.1.
        In addition, in closing
argument, Pinnacle’s counsel said,

I’m going to tell you, we are not
going to fuss about [the conversion award]. If you think
Dr. Fisher deserves that money write “Yes” in there and we’ll
write that check before they get out of the courtroom. . . . You decide. That’s
not a biggie. If you think he deserves that, give it to him.

        Based on Pinnacle’s lack
of further objection before the trial court and its
argument before the jury, we conclude Pinnacle did not preserve for
review its conversion argument. See Pirtle v. Gregory, 629 S.W.2d 919,
920 (Tex. 1982) (per curiam) (“The reason for the requirement that a litigant
preserve a trial predicate for complaint on appeal is that one should not be
permitted to waive, consent to, or neglect to complain about an error at trial
and then surprise his opponent on appeal by stating his complaint for the first
time.”). We resolve Pinnacle’s third issue against it.

IV. CONCLUSION

        Having resolved
Pinnacle’s three issues against it, we affirm the trial court’s
judgment.


                                                
         
                                                
         JIM
MOSELEY
                                                
         JUSTICE

071042F.P05




Footnote
1
Unless specified, all references to “subsections” refer to subsections of
section
4.2(a). These subsections defining
“cause” are numbered (i) through (xiv); the agreement refers to them as
“subsections,” as do we. However, our discussion acknowledges that subsections
(iv) and (viii) each contains two separate grounds for termination. For clarity,
our discussion of subsections (iv) and (viii) include bracketed numbers
delineating the two separate grounds for termination set forth in each of those
subsections.



Footnote
2
See supra note 1.



Footnote
3
Because of the nature of Pinnacle’s complaints on appeal, we need not recount in
detail the evidence relating to Pinnacle’s
liability (except with respect to whether it terminated Fisher without cause) or
the evidence relating to Fisher’s damages.



Footnote
4
Specifically, the jury answered “no” to the following question:


Do you find, by a preponderance of the evidence, that
[Pinnacle] terminated [Fisher] for
“Cause” under
the terms of their Employment Agreement?



        “Cause” under the terms
of their employment contract means:

        a.)

A failure to perform the
duties required under the Employment Agreement and/or

        b.)

Engaging in behavior or
activities which resulted in damage to [Pinnacle’s] reputation and/or
disrupted, undermined or threatened to disrupt
or undermine the operations or cohesiveness of [Pinnacle] or the Dallas Division
of [Pinnacle].



        You are instructed that,
as a matter of law, [Fisher’s] mere failure to
voluntarily submit to [Pinnacle’s] peer review process is not “Cause”
under the terms of the Employment Agreement.



Footnote
5
The only subsection not expressly referenced by number in the motion is
subsection (x), which defined “cause” to include
the physician’s “ engaging in fraud or embezzlement.” See infra
note 6. However, this subsection was encompassed within both of the two
categories discussed above: it was not alleged by Pinnacle, and it required
Fisher be found to have committed (not just accused of committing) some act of
fraud or embezzlement. Thus, we conclude Fisher’s motion also addressed and
encompassed termination under subsection (x).



Footnote
6
The subsections specifying cause for termination are quoted
below:

        (i)

The suspension,
revocation, surrender, or cancellation of Physician’s right to practice
medicine in Texas or to prescribe controlled
substances;
        

        (ii)

Absent a prior agreement
between the parties, the revocation, reduction or surrender of
Physician’s membership on the medical staff of any location
listed on Exhibit A or any adverse action taken against Physician’s clinical
privileges at any such location or the failure of Physician to attain the
necessary clinical privileges to provide Anesthesiology Services at any such
location within a reasonable time of applying for such clinical
privileges;
        

        (iii)

The imposition of any
restrictions or limitations by any governmental authority having
jurisdiction over Physician to such an extent that he cannot
engage in the professional practice on the basis for which he was
employed;

        (iv)

Physician’s [1] failure
to perform the duties required hereunder or [2] failure or refusal to
comply with the policies, standards and
regulations of the Association which from time to time may be established, as
determined in the Board of Directors’ sole discretion;

        (v)

Physician is found guilty
of unprofessional or unethical conduct by any board, institution,
organization or professional society having any privilege or
right to pass on the conduct of Physician;

        
        (vi)

Physician’s conviction in
a court of competent jurisdiction of any felony offense or any
misdemeanor offense involving moral
turpitude;
        
        (vii)

Physician materially
breaches this Agreement;
        

        (viii)

Physician’s engaging in
behavior or activities which [1] result in damage to the Association’s
reputation and/or [2] disrupt, undermine or
threaten to disrupt or undermine the operations or cohesiveness of the
Association or the Physician’s Division;
        

        (ix)

Physician’s breach of any
material fiduciary duty to the Association;
        

        (x)

Physician’s engaging in
fraud or embezzlement;
        

        (xi)

Physician’s loss of
malpractice insurance as a result of any action or inaction of Physician
which cannot be timely replaced through diligent
efforts;
        

        (xii)

A recommendation by the
Quality Assurance and Peer Review Committee (or the Board
of Directors, if such committee has not been created) to
terminate Physician’s employment with the Association is made after an
investigation regarding the quality of patient care rendered by Physician is
concluded;
        

        (xiii)

Physician’s employment
status with the Association is modified by the Board of Directors
of the Association and Physician does not, if required by the
Board of Directors, transfer to Association the required portion of his shares
in accordance with the Buy-Sell Agreement; or
        

        (xiv)

Physician’s failure to
pay his pro-rata portion of indemnification amounts to any proper
indemnitee pursuant to Article XIV of that certain Asset
Exchange Agreement and Plan of Reorganization between the Association, DFW
Anesthesia Associates, P.A. (“DFW”) and North Texas Anesthesia Consultants, P.A.
(“NTAC”).

(Brackets added.)



Footnote
7
Moreover, we decline to hold that, in the context of section 1.1 of the
employment agreement, the provision requiring
Fisher to provide “any other services” could reasonably be construed to include
agreeing to submit to peer review.



File Date[06/25/2009]
File Name[071042F]
File
Locator[06/25/2009-071042F]