Health Care Lawyer Blog

A recent federal court case serves as an important reminder for every physician facing or undergoing a suspension that hospitals are required to take certain steps under the law in connection with suspensions, and physicians should remain vigilant to ensure that these steps are followed.

In the case, a federal court in New Mexico held that a hospital that suspended a physician’s privileges without making a reasonable effort to obtain the facts of the cases underlying the suspension was not immune from the physician's claim for damages and injunctive relief.

In Osuagwu v. Gila Regional Medical Center, plaintiff Chinonyerem Osuagwu was an OBGYN on the medical staff at Defendant Gila Regional hospital. Following two laparoscopic procedures performed by plaintiff where the patients suffered complications, the hospital’s Medical Executive Committee (“MEC”) held a special meeting – unbeknownst to plaintiff – and summarily suspended plaintiff’s privileges for 14 days. Importantly, the notice of suspension did not specify exactly which procedures were in question, nor did the MEC ever interview Plaintiff regarding the charges against him or the cases it was considering.

Following the summary suspension, the MEC asked the hospital's internal Peer Review Committee (PRC) to review the two cases and provide recommendations. None of the physicians on the PRC were gynecologists. In addition to looking at the two cases, the PRC randomly pulled 34 of plaintiff’s charts and divided them up amongst several “unidentified physicians” for review. Plaintiff was never interviewed in connection with the review or asked to provide evidence or an explanation during the process. Following the review, in which the physicians held that plaintiff’s performance “fell below the standard of care”, the MEC held an emergency meeting and voted to suspend plaintiff’s privileges indefinitely.

Continue reading "Court Holds Physician's Rights Violated in Suspension Proceedings" »

A Washington state appellate court recently held that a hospital that failed to make a reasonable effort to obtain the facts underlying a physician’s suspension or give reasonable notice of the same lost its statutory immunity under the Health Care Quality Improvement Act (HCQIA). The decision is notable because even though the plaintiff physician’s suspension lasted for a very short time, the court still held that the hospital’s hasty actions were enough to deprive it of protection from the physician’s lawsuit.

In Smigaj v. Yakima Valley Memorial Hospital Association, Dr. Diana Smigaj was an obstetrician/gynecologist (obgyn) who was on the medical staff of Yakima Valley Memorial Hospital (the “Hospital”). After concerns arose regarding the quality of care provided by Smigaj, a peer review committee at the Hospital recommended the suspension of her medical staff privileges. The medical chief of staff agreed and notified Dr. Smigaj of the suspension; however, the Hospital’s Medical Executive Committee (“MEC”) reinstated her privileges 11 days later. The reinstatement was not retroactive.

Accordingly, Smigaj sued the Hospital and several physicians/administrators, claiming that the suspension was arbitrary and capricious, motivated by gender discrimination and anticompetitive bias, a breach of the hospital’s bylaws, and a breach of contract and fiduciary duty.

The trial court granted the Hospital’s motion to dismiss, finding that it was entitled to immunity under HCQIA. However, the appellate court reversed.

HCQIA generally affords hospitals immunity for “professional review actions” so long as the following conditions are met:
1) The professional review action was taken in the reasonable belief that it was in furtherance of quality healthcare;
2) The professional review decision was made after a reasonable effort to obtain the facts;
3) The physician received adequate notice and procedures that are fair under the circumstances;
4) The action was taken in the reasonable belief that, under the facts known, a suspension was warranted.

After the jump - why HCQIA did not apply

Continue reading "Appeals Court Holds Wa. Hospital Not Entitled to HCQIA Immunity in Physician Suspension Suit" »