A California court has held that one hospital cannot take adverse peer review actions against a physician based solely on adverse peer review actions at another hospital; there must be an independent investigation of the medical issues.

In Smith vs. Selma Community Hospital, a copy of the opinion is attached below, the California appellate court affirmed a California trial court decision reinstating Dr. Smith’s political privileges. Selma Community Hospital had terminated Dr. Smith’s clinical privileges based upon adverse peer review actions at two other related hospitals, identified as the Hanford Hospitals. Interestingly, the Hanford Hospitals’ peer review actions appear to be part of a long history of litigation between Dr. Smith and the Hanford Hospitals involving both an attempt to acquire Dr. Smith’s practice and the peer review issues.

The medical staff proceedings at Selma Community Hospital had proceeded as follows:

1. The Medical Executive Committee had recommended termination of Dr. Smith’s clinical privileges;

2. Dr. Smith requested a medical staff hearing, which essentially found that the Hospital had not demonstrated via preponderance of the evidence that termination was reasonable and warranted based on the facts, as required by the Medical Staff Bylaws;

3. The Hospital appealed the Medical Staff Hearing Panel decision and the Governing Board reversed that decision;

4. Dr. Smith filed an action for mandamus with the California trial court, which reversed the Board’s decision; and

5. The Hospital appealed the trial court decision to the California superior court, which affirmed the trial court’s decision.

You should note in this lengthy opinion that the peer review issues are decided under California law, which was enacted in January 1990, and California is one of the few states to opt-out of the protections of the Heath Care Quality Immunity Act provisions by establishing its own basic procedural requirements. The California courts essentially decided that the Selma Community Hospital Board decision was incorrect because it treated the Hanford Hospitals’ decisions as binding administrative decisions, which it was bound to follow pursuant to the Doctrine of Collateral Estoppel and that the Medical Staff Hearing Panel had not made separate findings of fact. The California appellate court rejected both of those arguments, declaring that the Hanford Hospital decisions were not binding under the Rules of Collateral Estoppel and that Selma Hospital Medical Staff Hearing Panel had specifically found that Selma Community Hospital had not made an independent investigation in separate findings of fact.


www.medlawblog.com/Smith v. Selma(2).pdf