Traina v. OSF Healthcare Sys., Inc. (Summary)

CLINICAL PRIVILEGES

Traina v. OSF Healthcare Sys., Inc., No. 3-12-0548 (Ill. App. Ct. July 15, 2013)

The Appellate Court of Illinois ruled in favor of a private hospital’s motion to dismiss multiple counts in an orthopedic surgeon’s amended complaint alleging a violation of the hospital’s bylaws and also that the proceedings reviewing the hospital’s decision to restrict his surgical privileges were fundamentally unfair. After a departmental study showed that the surgeon’s revision rates were significantly higher than other doctors in the department and the national average, the hospital requested that he take remedial action or the hospital would institute formal corrective action against him. The surgeon requested that the revision cases be reviewed by an outside source. Upon completion of the outside review, the surgeon was informed that he must “voluntarily resign” his privileges or complete an approved remediation program or fellowship or else face further “corrective action.” Ultimately, the physician took neither option and later requested a hearing after a recommendation was made to restrict his clinical privileges. The physician brought a lawsuit claiming violations of the bylaws and unfair procedure after the  Board affirmed the recommendation.  The trial court dismissed these claims and the physician appealed.

The appellate court worked from the premise that, as a general rule, the internal staffing decisions of a private hospital are not subject to judicial review, except when the decision in question involves a revocation, suspension, or reduction of a physician’s existing staff privileges, which could seriously affect the physician’s ability to practice medicine. With regard to the surgeon’s complaint that there was a violation of the bylaws, which prohibits any person from serving on the hearing committee if they have previously been “actively” involved in the investigation, the court found that the lower court properly dismissed the counts because the doctors on the hearing committee were neither “active participants” in, nor did they “initiate[ ] or investigate[ ]” the underlying matter. The court also found that the surgeon’s complaint failed to allege he suffered any actual prejudice as a result of the doctors’ presence on the review hearing committee. Further, the complaint did not allege any person on the hearing committee actually acted with prejudice, malice, or unfair bias. As a private hospital setting lacks state action, a physician facing disciplinary measures by the hospital is entitled to certain “basic protections,” including notice and a fair hearing. As the surgeon had adequate notice of the concerns subject to the disciplinary action and the hearing committee allowed him to cross-examine witnesses and present evidence in his own defense, the court concluded that the pleadings and supporting documents refuted the surgeon’s claim that the hospital deprived him of a fundamentally fair proceeding.