Roberts v. Saint Thomas Health Servs. (Summary)

HCQIA/NPDB

Roberts v. Saint Thomas Health Servs., No. M2012-01718-COA-R3-CV (Tenn. Ct. App. Oct. 17, 2013)

The Court of Appeals of Tennessee affirmed a lower court’s grant of summary judgment in favor of a hospital against a surgeon’s claims of injury to his reputation, breach of contract, defamation of character, and tortious interference with business relations, based on the Health Care Quality Improvement Act (“HCQIA”) and the state peer review statute. The hospital’s medical executive committee (“MEC”) had suspended the surgeon’s clinical privileges after finding that the surgeon failed to comply with the hospital’s standards of care. The MEC’s suspension was conveyed to the surgeon through a letter, which also explained his procedural rights under the hospital’s medical staff bylaws. Upon receiving the letter, the surgeon requested a fair hearing but the parties reached an agreement before the hearing, after which he waived his right to a fair hearing. The agreement was that the surgeon would complete counseling and enroll in ongoing outpatient therapy and the hospital would restore his clinical privileges. The hospital also reported these proceedings with the National Practitioner Data Bank (“NPDB”), because the surgeon was suspended for more than 30 days.

The court found that while the hospital did not provide notice and a hearing, as required by HCQIA for immunity to apply, the report to the NPDB was made after the surgeon waived his fair hearing rights. The NPDB Guidebook suggests that a fair hearing that negated the recommendations of the MEC would not have required a report to the NPDB. The court reasoned that the surgeon’s alleged reputational damage cannot be separated from his decision to waive his right to a fair hearing. The court concluded that the fair hearing was the place to challenge the procedures the surgeon now complains were insufficient and dispute any allegations against him.