One of the fundamental issues in credentialing disputes is whether the Medical Staff Bylaws constitute contracts between the Hospital and the individual physicians. If the Medical Staff Bylaws do constitute a contract, then the due process provisions contained in the Bylaws are guaranteed to the physician, regardless of the Health Care Quality Immunity Act (HCQIA).
California Decision Allows Physician to Challenge Sham Peer Review as Whistleblower Retaliation
By Michael Cassidy on
Posted in Credentialing and Peer Review
In Fahlen v. Sutter Central Valley Hospitals, the California Supreme Court found:
- A physician is not required to first exhaust his administrative remedies through the medical staff appeals process in order to challenge sham peer review as whistleblower retaliation; and
- Dr. Fahlen qualified as a whistleblower for purposes of the California Whistleblower Act.
The…
Louisiana Becomes Medical Staff Bylaws Equal Contract State
By Michael Cassidy on
Posted in Credentialing and Peer Review
In Granger v. Christus Health Central Louisiana d/b/a Christus St. Francis Cabrini, the Louisiana Supreme Court ruled that medical staff bylaws are a contract between the hospital and a the medical staff member. The court ruled:
“In promulgating the Bylaws and in accepting the applications of the physicians who sought medical staff membership in
…
Court Allows Complaint Alleging Wrongful Data Bank Report as Intentional Infliction of Distress
By Michael Cassidy on
Posted in Credentialing and Peer Review
Sheikh v. Grant Regional Health Center is another case in a growing body of evidence that courts are granting less leeway and protection to hospitals which abuse the HCQIA immunity and reporting protections.
This is not a final decision awarding damages! It is only a decision by a Wisconsin federal district court rejecting the hospital’s motion…
Washington Court Denies HCQIA Immunity for Inadequate Investigation
By Michael Cassidy on
Posted in Credentialing and Peer Review
The cases where hospitals are denied HCQIA immunity are few and far between, especially when that denial is predicated upon the due process requirement of HCQIA, because of the due process exception condoning procedures that are fair under the circumstances.
In Smigaj v. Yakima Valley Memorial Hospital Association, the Washington Court of Appeals reversed…
Physician Avoids HCQIA Presumption of Immunity
By Michael Cassidy on
Posted in Credentialing and Peer Review
The presumption of immunity granted by the Health Care Quality Improvement Act (HCQIA) in peer review disputes is always a significant hurdle for physicians. In Zawislak v. Memorial Hermann Hospital System (which some readers may recognize from the excess benefit and physician recruitment IRS issues involving the hospital in the late 1990s), the hospital suspended Dr.
US DC of Massachusetts Orders Production of Performance Evaluations to Medical Resident
By Michael Cassidy on
Posted in Credentialing and Peer Review
In Gargiulo v. Baystate Health, Inc., Dr. Debra Gargiulo alleged that she was discriminated against on the basis of her age and disability by Baystate Health in violation of both federal and state law. As part of her claim, the plaintiff sought production of numerous documents relating to her records, evaluations and reports, as well…
Lack of Adverse Final Outcome Not Necessarily a Valid Peer Review Defense
By Michael Cassidy on
Posted in Credentialing and Peer Review
In Georgopoulos v. Humility of Mary Health Partners Inc., Dr. Georgopoulos was placed upon a six month surgical proctoring requirement because of extended operating times and excessive use of blood products. In addition to many procedural defenses, Dr. Georgopoulos’s primary substantive defense is that his patient survival and freedom from major cardiac events…
Physician’s Clinical Privileges Suspended for Long History of Disruptive Conduct
By Michael Cassidy on
Posted in Credentialing and Peer Review
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…
Medical Staff and Employment Issues Collide Again
By Michael Cassidy on
Posted in Credentialing and Peer Review
The Mississippi State Appeals Court affirmed a summary judgment decision by a Mississippi State Court in the case of C. Jake Lambert, Jr. M.D. v. Baptist Memorial Hospital-North Mississippi, Inc. and Baptist Memorial Health Services, Inc. Dr. Lambert was a medical staff member of Baptist Memorial Hospital (Hospital) and an employee of Baptist Memorial…