In Pierson v. Orlando Health, the U.S. District Court for the Middle District of Florida granted a motion for summary judgment for the hospital on the basis that the hospital was immune from any liability from damages under the immunity provisions of the Health Care Quality Improvement Act (HCQIA). 

Dr. Pierson had argued that the absence of any adverse outcomes precluded the hospital from taking the position that its actions had been taken in the furtherance of quality healthcare, and therefore the four elements of HCQIA immunity could not be satisfied.

In this case, the physician was removed from call responsibilities in 1996 following a lengthy investigation, an investigative committee issued a report in 1999 concluding that the physician experienced excessive surgical length, inappropriate scheduling, delayed dictating operative notes and performed elective cases as emergencies. Although there had been no adverse outcome, this course of conduct did jeopardize patient safety in quality health care. 

The physician initiated the full due process proceedings provided by the medical staff bylaws, ending in 2004 with the decision upholding the investigative committee’s report. The physician sued.  The hospital moved for summary judgment. The court found that no reasonable jury could conclude that the professional review action was taken for any reason other than an objectively reasonable belief that it would further quality health care. Although none of the physician’s patients experienced any adverse outcomes, there was evidence that the physician’s practice of performing surgery late at night and early in the morning while on call strained hospital resources and patients, both his own and others, at risk.