In Ramamurthy v. JFK Medical Center and Solaris Health System the Appellate Division of the Superior Court of New Jersey affirmed a summary judgment dismissing Dr. Ramamurthy’s Petition for Injunctive Relief, which sought a court order prohibiting a suspension imposed by the hospital. Dr. Ramamurthy had argued at the trial court level that the hospital had violated its bylaws, thereby providing grounds to invalidate the 90 day suspension.

Dr. Ramamurthy was suspended for 90 days by the hospital for improper conduct, as described in the opinion. At the time the issue arose, the president of the medical staff appointed a first ad hoc committee, to investigate Dr. Ramamurthy’s conduct. The president of the medical staff actually rejected the first committee’s findings for failure to conduct a proper investigation. The president of the medical staff appointed a second ad hoc committee. During the second committee’s investigation, only two of the five committee members interviewed Dr. Ramamurthy, but the committee report reflected consensus among the five members, recommending suspension. 

The medical executive committee received the second ad hoc committee’s report and invited Dr. Ramamurthy to a meeting to explain his position. Dr. Ramamurthy chose not to attend the first MEC meeting. At a second MEC meeting, the MEC issued a 90 day suspension.

Dr. Ramamurthy requested a fair hearing, as provided in the medical staff bylaws, to contest the recommendation for the 90 day suspension. A fair hearing was conducted and Dr. Ramamurthy was represented by counsel. The committee affirmed the recommendation of the MEC. Dr. Ramamurthy appealed the hearing panel’s decision to the hospital board pursuant to the appellate review procedures of the medical staff bylaws. The review panel affirmed the recommendation for suspension.

Dr. Ramamurthy then sought injunctive relief on the basis of the hospital’s violation of its bylaws, alleging four violations:

1.         The ad hoc committee was appointed by the president of the medical staff, rather than the chairman of the department;

2.         Only two members of the five person second ad hoc investigative committee interviewed Dr. Ramamurthy;

3.         No record was made of the first investigative committee’s interview; and

4.         Dr. Ramamurthy was not invited to attend the second MEC meeting.

The trial court concluded that none of these facts constituted violations of the medical staff bylaws, and granted the hospital’s Motion for Summary Judgment to dismiss the complaint. The appellate court essentially confirmed the decision of the New Jersey trial court. 

It is interesting to note that the appellate opinion neither mentions the issue of whether the medical staff bylaws constitute a contract in New Jersey, nor is there any discussion of Section § 11112(b) of the Health Care Quality Improvement Act (HCQIA), which provides that the due process procedures mandated by HCQIA are not specific requirements, but simply recommendations, and that immunity is available pursuant to HCQIA as long as the proceeds were fair under the circumstances. Perhaps the omission of the HCQIA argument is simply because it is now well recognized that HCQIA does not grant immunity from injunctive relief.