In Badri v. Huron Hospital, which is part of the Cleveland Clinic Health System, the District Court for the Northern District of Ohio granted summary judgment to the defendant hospital in which Dr. Badri was alleging violations of the Americans with Disabilities Act, the Rehabilitation Act, and the typical emotional distress, tortuous interference, defamation and breach of contract causes of action arising out of the termination of his medical staff privileges.

Although the case reaches a fairly routine result, i.e. the dismissal of the claims on the basis of HCQIA immunity, it is notable in two respects. 

First, with respect to the discrimination and failure to accommodate counts, the analysis of the court points out the difficulties for physicians in making these assertions. Principally, the physicians must have admitted or alleged sometime during the pre-dispute time period that they actually had a disability and needed accommodations. After the fact allegations that they had been treated discriminatorily make it difficult to qualify for the protections of the Acts. In connection with this issue, the case also illustrates the difficult of trying to establish discriminatory treatment in peer review actions, because the peer review actions, investigations, accommodations, etc. regarding other physicians are typically confidential. In this case, Dr. Badri merely alleged that Huron Hospital had a long history of working with physicians with disabilities and made reference to an unnamed physician with an addiction problem, but provided no other evidence. The court concluded that Dr. Badri had failed to fulfill his burden of establishing that the peer review process had been used merely as a pretext for discriminatory treatment. 

Second, the case also deals with the issue of establishing whether a reasonable investigation had been conducted. The HCQIA Standards specifically state that the action must have been taken “after a reasonable effort to obtain the facts of the matter.” This issue arises frequently. One popular reference, although not cited in this case, is the Singh vs. Blue Cross case, in which the court concluded that the physician was not entitled to a “perfect” investigation. The court concluded in this case that an alleged problem, i.e. giving undo creditability to a mistaken report, was not enough to establish that the hospital had not otherwise conducted a reasonable investigation.