California courts have been active concerning peer review issues, ruling on three major decisions in the month of August. The Court of Appeals of California and the Federal District Court for the Northern District of California issued opinions further clarifying peer review processes in the state. These decisions not only affect practitioners within California, but also will influence courts across the country faced with the similar issues.

On August 28, 2007, the Federal District Court held that a doctor who assented to restrictions on his right to practice could not proceed with an action against the hospital without first submitting his peer review claims to the administrative board. The hospital and physician agreed to limit his privileges in lieu of a full suspension. California law requires an exhaustion of internal remedies afforded by the hospital before initiation of litigation. The court ruled that this "waiver" does not circumvent the need to seek an internal hearing before turning to the courts. After dismissing all of the peer review claims, the court opined that had the decision to suspend been unilateral, the physician could rightfully avoid the internal proceedings because the administrative remedies would have been futile.

Ennix v. Stanton, No. C 07-02486 WHA 2007 U.S. Dist. LEXIS 66032 (N.D. Cal. Aug. 28, 2007).

A day earlier, a California Court of Appeals ruled a peer review hearing officer was without authority to terminate a peer review hearing effectually terminating the physician’s privileges.   During the pre-hearing process, the hospital and physician had requested the exchange of documents relevant to the proceeding. The physician had yet to hand over one of the documents. In response, the hearing officer terminated the hearing based on the physician’s alleged refusals to produce the document. The California court ruled that the hearing officer lacked authority to terminate a hearing, which in effect, operated as a decision on the merits of the case. Only the peer review body, the true trier of fact, had authority to decide on the merits of the case.

Mileikowsky v. WestHillsHospital, 154 Cal. App. 4th 752, (2d. Dist. Aug. 27, 2007).

Another state appeals court affirmed a prior decision that a physician, banned from the hospital because of his disruptive behavior, was not entitled to a court hearing. The physician was barred from further litigating his claim against the employer. Although the hospital did not follow peer review procedures, the court found that because the hospital did not claim the physician posed a danger medically, the entire matter was outside the peer review scope. The physician was dismissed for his disruptive behavior and constant criticisms of facilities and staff.  The court did note that the hospital still must follow common law standards of fair procedure even when outside the peer review scope.

Blau v. NorthridgeHospitalMedicalCenter, et al., No. A111845, 2007 Cal. Ct. App. LEXIS 6809 (1st Dist. Aug. 22, 2007).

The full court opinions can be found at the links below: