EXHAUSTION OF ADMINISTRATIVE REMEDIES CONFIRMED AGAIN

A Colorado Federal District Court has confirmed the applicability of the doctrine of exhaustion administrative remedies regarding credentialing disputes. In Catholic Health Initiatives, Colorado v. Gross, Dr. Gross terminated the hospital peer review process by resigning during the early stages of an investigation. The facts of the case indicate that a quality issue regarding Dr. Gross’ performance arose at the hospital. The hospital notified Dr. Gross of its evaluation and indicated that he should either voluntarily withdraw his privileges to perform certain surgical cases or that he continues to perform the procedures only with the assistance of a proctor under specified conditions. Rather than comply, Dr. Gross resigned. When Dr. Gross attempted to withdraw his resignation, the hospital took the position that the resignation was final and that Dr. Gross’ only recourse was to reapply for medical staff membership and clinical privileges.

Dr. Gross filed suit in District Court alleging breach of a duty of good faith, denial due process and tortious interference with contractual relationships. The District Court granted the hospital’s motion for summary judgment on the due process and breach of contract issues, but split its decision on two tortious interference claims. One claim based upon a Data Bank Report was dismissed based upon HCQIA immunity. The second, based upon the hospital’s non-peer review conduct, was not dismissed.

The Federal District Court followed the recent holding of the Colorado Supreme Court in Crow v. Penrose-St. Francis Healthcare System, which required that a physician must exhaust all peer review committee administrative remedies before seeking relief in court. This decision was featured in a Med Law Blog post on October 29, 2007.

A copy of the full opinion is available at the following link:

http://op.bna.com/hl.nsf/id/mapi-79zptc/$File/catholic.pdf