More Tales of Peer Review!
Note these are
not all CPRJ cases, but used as examples of the pervasiveness of
sham peer review... many of our clients have requested privacy
They are used for case precedents
v Methodist Children's Hosp
Tex. Ct. App.
A surgeon had
his privileges suspended at two hospitals. he sued under various state
claims. the court ruled that the suspensions had fair hearings and under
HCQIA, there could be no damages. He lost not so much under the HCQIA but
equally under the specific Texas statutes.
v Upper Chesapeake Health
unrestricted at Harford Hospital for 18 years. When she applied for
reappointment the hospital Board refused to reappoint her citing the ethics
and behavior language in the medical staff bylaws. The doctor had been
critical in the past of hospital quality of care. Plaintiff sued 14
individuals and the hospital for denying her reappointment due to her
patient rights advocacy. She stated that HCQIA was unconstitutional. All
claims were dismissed by the district court and she appealed. The 4th
Circuit ruled that this was a straight physician hospital dispute and that
her due process and equal protection challenges to HCQIA were not valid.
She stated that since HCQIA allows hearsay during the hearing procedure and
the denial of privileges without a finding of incompetent behavior would
require the court to rewrite a statute that passes the rational review
phase. She attempted to state the reasonableness standard of the HCQIA were
vague and this was also tossed since it is the peer review panel and not the
physician that must meet the reasonableness standard. The claims against
the hospital were thrown out for lack of standing of the physician to
advocate for her dialysis patients.
basically throws out any further attacks on HCQIA and its ability to utilize
the reasonableness approach. It also allows, at least in Maryland, the
ability of the hospital to not allow physicians who criticize the methods or
patient care to be on the staff. I believe the most important thing this
shows is that the medical staff must review their bylaws and
change those which are written by the hospital paid attorney to ones that
are done by neutral attorneys. Remember, "If not for the grace of God, go
From: lawrence huntoon
To: Center Peer Review Justice Inc
Sent: Thursday, June 26, 2003 10:08 AM
A truly outrageous miscarriage of justice.
Patients are the real losers when hospitals have the ability to purge
stand up and speak out in favor of improving quality of care.
Publicity of what these hospitals are doing is the key.
Goad v Virginia Bd.
Va. Ct. App.
The Board placed Goad's
license in indefinite suspension due to potentially sexually inappropriate
behavior. Goad sued and the lower court agreed with the Board. The
Appellate court overturned the decision since the Board used the statute
stating the AMA and APA standards of Ethics were to be used as the
standard. In fact these are merely guidelines and may not be used as a
standard. The Board had no other standard to compare the action and
therefore the Board was compelled to dismiss.
Ghanem v Pres.
CA Ct. App.
The physician was conditionally reappointed to the
private hospital. The conditions were to attend CME courses and not
engage in specific disruptive behaviors. The physician did not comply
and was removed from the staff following a full hearing. He sued and
lost in both the lower and the appeals court. He claimed that he did
not get a fair hearing and that hearsay was used against him. The
court stated the hearing was fair and the evidence was allowed under both
the hospital bylaws and government code.
Chadha v Charlotte
Conn. Ct. App.
Chadha had his
license revoked. He sued four members of the medical staff for filing false
reports to the department of public health. The case was tossed in both the
lower and court of appeals due to absolute immunity under the state's common
law. Here there was an overlap between common law absolute immunity and
statute partial immunity. The upper court ruled absolute immunity applied
in this case.
Smith v Ashland
Ky. Ct. App.
A medical Center was in
its rights to forcibly remove a Honorary member of the medical staff from a
MEC meeting and then remove his staff membership. No fair hearing was
offered. The court stated that there were no violations of the bylaws.
It sounds like this radiologist needed the well being committee.
Jeung v McKrow
The doctor was
removed from the staff and sued under racial discrimination. He lost like
most of these since the hospital was able to show legitimate cause for
termination of privileges. In this case there were patient complaints and
malpractice suits. The hospital would not allow the physician to call
witnesses at the hearing. what happened was the patient's expert refused to
leave the hearing when asked by the hearing officer. This cost the hospital
the potential for attorney's fees and costs.
Patton v St. Francis Hosp.
Ga. Ct. App.
Patton had his privileges revoked by the MEC after a full peer review
hearing. He sued for damages and injunctive relief. The hospital was granted
summary judgment under HCQIA. Patton appealed and lost. The Court stated
there was immunity under both the federal and state laws. The Court used the
four prongs of the HCQIA and stated that a death made the act in furtherance
of health care, they had a year long peer review which showed a reasonable
effort to obtain the facts, the notice and hearing procedures were adequate
and that Patton did not show enough evidence to overcome the presumption
that the hospital believed its actions were reasonable. This last one is an
Conner v Salina Health Ctr.
Conner was denied reappointment to Salina
following a peer review panel recommended against the reappointment. Conner
filed suit that he was due federal due process even though the hospital was
private. The district court said it was private and there were no federal
grounds and the hospital was not a state officer. The 10th Circuit agreed
that the plaintiff was deprived of no federal rights. The court also found
that traditionally peer review was not regulated by the state.
Tales of bad faith or "sham" peer review: It seems to be an epidemic!
And if you can't figure out from these biographies how to go about ruining someone through peer review or peer
review-like actions, then here's a concise primer
to let you know how!