The Connecticut Supreme Court issued an interesting decision in the case of Harris v. Bradley Memorial Hospital & Health Center Inc. in May of 2010, which was precipitated by the summary suspension of Dr. Harris. Not only did it overturn the trial court’s grant of judgment notwithstanding the verdict in favor of the hospital, after a jury found that Dr. Harris was entitled to damages on his breach of contract claim, the Court also impliedly separated the peer review investigation into two parts, and granted immunity for damages under the Health Care Quality Improvement Act (HCQIA) for the pre-summary suspension activities but denied immunity for the post-summary suspension activities.
Dr. Harris was summarily suspended in February 2001from the medical staff by the medical executive committee, sought and lost a medical staff hearing in which the recommendation supported the continuation of the suspension, and lost the appeal to the hospital board as well. Following the completion of the medical staff peer review process, Dr. Harris filed a complaint seeking damages, an injunction returning him to practice at the hospital, and damages for tortious interference with his contractual relationships and a violation of the Connecticut Unfair Trade Practices Act (CUTPA).
The hospital filed two summary judgments prior to trial, and the trial court found that the physician had presented no evidence challenging the hospital’s compliance with the statutory criteria of CUTPA in connection with all of the proceedings subsequent to the summary suspension on February 13, 2001, and therefore granted the defendant’s motion for summary judgment as to claims for damages, recognizing that HCQIA does not immunize against injunctive relief.
However, the court denied the motion with respect to damages sought in connection with events leading up to the summary suspension and denied the motion with respect to injunctive relief. Separating the investigation into two stages is unusual. Many physicians have utilized the strategy seeking to create a series of separate peer review actions and test all of those actions against the immunity conditions of HCQIA, and courts typically hold that the entire process is one aggregate peer review decision.
Consideration of the “favorable termination doctrine” presents an unusual aspect in this case. The hospital argued that since the board previously held that the suspension was justifiable, the jury could not award damages for breach of contract, i.e. there was a prior favorable termination of the issue. The decision analyzes the origin and public policy of the favorable termination doctrine, which is to prevent litigants from obtaining judgments for justifiable actions, even if technical violations existed in the process. The court concluded this should not apply to health care because the more important public policy was supporting the role of a hospital board in insuring quality, rather than being concerned about potential liability for its actions. Therefore, the court overturned the judgment not withstanding the verdict, almost 9 years after the actual suspension.
An additional interesting aspect in this case is the analysis of the HCQIA violations. The court concluded that an investigation lead by an economic competitor, an independent review of medical records in which the selected medical records were only the problem cases selected by the economic competitor, and the decision to impose summary suspension after months of investigation would have allowed the jury to conclude that the bylaws procedures had been violated and did not qualify for HCQIA immunity.