The memorable lesson of Sternberg v. Nanticoke Memorial Hospital is that the Delaware Supreme Court upheld a grant of summary judgment to the hospital on the basis of immunity under the Health Care Quality Improvement Act (HCQIA), despite:

·         The physician was admittedly a competent orthopaedic surgeon; and

·         There had been no evidence of any adverse outcomes.

Dr. Sternberg’s position was that a crucial element of HCQIA immunity, i.e. the reasonable belief that the action was taken in the furtherance of quality health care, could not be possible because, without any evidence of adverse outcomes, there was no reasonable basis to form that belief. However, the Court found as follows:

·         “The problem with Sternberg’s argument is that it does not take into account his long history of disruptive behavior, and the circumstances leading up to the suspension.”

·         “These facts, without more, may not provide a reasonable basis to conclude that anyone was at risk of harm during that operation, but it is entirely reasonable to conclude that the doctor (a) with a long history of outbursts and uncontrolled anger; (b) who flouts the hospital’s rules in an operating setting; (c) knowing that he is under a zero tolerance directive is engaging in self-destructive behavior.”

·         “Warner and the MEC did not have to wait until that self-destructive behavior resulted in actual harm.”