Romney v. Franciscan Med. Grp. (Summary)

EMPLOYMENT AGREEMENT

Romney v. Franciscan Med. Grp., No. 71625-5-I (Wash. Ct. App. Feb. 17, 2015)

The Court of Appeals of Washington upheld an arbitration provision in an employment contract between a defendant medical group and its former employees.

The medical group entered into employment contracts with three individuals, which included an agreement to arbitrate all employment-related disputes between the parties. The employees brought claims of wage violations on behalf of themselves and a class of physicians, medical assistants and nurse practitioners, and at the same time requested that the court find the arbitration provision unconscionable. The medical group moved to compel arbitration, but the trial court found that the contract was unconscionable and invalid.

The appellate court reversed and remanded the trial court’s opinion, determining that the arbitration provision should be upheld even if other specific provisions of the employment agreement are found to be unconscionable. The court found that while other unconscionable provisions may be severed from an employment contract, those provisions should not affect the underlying arbitration provision. Also, the arbitration provision itself was found not to be procedurally or substantively unconscionable, because the terms were not one-sided. The court further determined that in a class action suit such as this, the arbitration provisions can be imposed on class members who did not sign the agreement.

Ducharme v. Nova Cas. Co. (Summary)

DISCOVERY/PEER REVIEW

Ducharme v. Nova Cas. Co., Civil Action No. 6:13-3108 (W.D. La. Feb. 10, 2015)

The United States District Court for the Western District of Louisiana quashed an insurance company’s subpoena against a hospital, holding that the information sought was protected by the peer review privilege.

Plaintiff was hit by a car insured by the defendant, an insurance company. The insurance company subpoenaed the hospital inquiring about the plaintiff’s treating physician’s disciplinary record. The hospital objected to the subpoena and moved to quash it.

The court held that the disciplinary record of the physician was protected by the peer review privilege because the information requested was within the ambit of the hospital’s personnel committee, had nothing to do with plaintiff’s personal injury claims and the insurance company was only seeking this information so it could impeach the treating physician if he testified at trial.

Quinones v. Univ. of Puerto Rico (Summary)

AMERICANS WITH DISABILITIES ACT

Quinones v. Univ. of Puerto Rico, Civil No. 14-1331 (JAG) (D. P.R. Feb. 13, 2015)

The U.S. District Court for the District of Puerto Rico granted in part and reversed in part a medical school’s motion to dismiss claims brought by a resident who was terminated from its residency program due to her addiction to and illegal use of prescription drugs.

The resident was released from an alcohol rehabilitation program shortly before her enrollment in the residency program. However, after enrollment, the resident began abusing the prescription drugs Soma, Ambien, and Adderall which caused her to have problems complying with the program’s requirements. The resident met with the program committee several times to discuss her addiction and performance, and after being terminated from the program, she was granted a hearing, after which her request for permanent reinstatement was rejected. The resident then filed complaints of retaliation and disability discrimination under the Americans with Disabilities Act (“ADA”) and the Federal Rehabilitation Act (“Rehabilitation Act”).

The court held that the resident did not qualify as disabled under the ADA because she was currently engaged in the illegal use of drugs. Although the ADA offers protection for those who are in recovery for a significant period of time, the court determined that being drug-free for three months is not enough time to be classified as a rehabilitated drug user. The court also stated that the resident could not be disabled under the ADA because she was still using the drugs illegally at the time of her termination. Further, the court held that, even if the resident were to qualify as a disabled individual, she still would not meet the requirements for protection under the ADA because her drug use would have rendered her unqualified to perform the functions of her job as a resident. Finally, the court held that since the resident failed to qualify under the ADA, her claim under the Rehabilitation Act also failed.

On the retaliation claim, the court found that the resident had alleged sufficient facts to support the claim that the medical school retaliated against her by denying her reinstatement into the program and permanently terminating her. The court found the proximity between her conduct and the adverse employment action to be “sufficient to establish a causal link at this preliminary stage.”

Willis v. UPMC Children’s Hosp. of Pittsburgh (Summary)

AGE DISCRIMINATION

Willis v. UPMC Children’s Hosp. of Pittsburgh, Civil Action No. 13-131 (W.D. Pa. Feb. 10, 2015)

The United States District Court for the Western District of Pennsylvania dismissed a nurse’s claim under the Age Discrimination in Employment Act (“ADEA”) against a hospital holding that the nurse failed to establish that she was the victim of intentional discrimination.

Plaintiff, a 61-year-old nurse, was employed at defendant hospital and within a five-month period was written up three times for cursing around a patient and his family, confronting the leadership staff, and leaving a shift without completing a patient’s history and physical. The nurse was terminated after the last incident and brought a claim under the ADEA.

The court stated that the nurse proved that she was at least 40 years old, suffered an adverse employment decision and was qualified for the position, thus satisfying three of the four elements for a case of prima facie discrimination. Therefore, the sole dispute was whether she satisfied the forth element – can an inference of discrimination be made because younger employees replaced the nurse.

The court held that the nurse did not satisfy the fourth element because there was no evidence in the record regarding the ages of the new employees, or whether the employees assumed the duties of the nurse. The court also found that the fourth element was not satisfied because requiring her to prove that she was replaced by a younger employee “eliminates no common, lawful reasons for her discharge and is not necessarily inconsistent with [her] ultimate burden of showing she suffered intentional discrimination because of her age.” Thus, the court concluded that the nurse did not put forth evidence that would permit an inference of intentional discrimination.

Also, the court stated that even if the nurse did establish a prima facie case of age discrimination, the hospital terminated her for legitimate nondiscriminatory reasons, and there was no indication that these reasons were pretextural. Therefore, although the nurse mentioned that she intended to retire at 65, the court stated that it was not an unusual employment practice to ask an employee how long he or she intends to work, and that it might be prudent for future staffing needs, given the large turnover experienced by the nursing staff at the hospital.

Jackson v. Mercy Behavioral Health (Summary)

HIPAA – NO PRIVATE RIGHT OF ACTION

Jackson v. Mercy Behavioral Health, Civil No. 14-1000 (W.D. Pa. Jan. 28, 2015)

The U.S. District Court for the Western District of Pennsylvania granted a hospital’s motion to dismiss a patient’s claims that her civil rights were violated under HIPAA.

A patient was receiving treatment at a hospital and was placed into a 30-day residential diversion program. During that time, the patient’s medical records were sent to her dentist without her consent. A hospital employee then told the patient to sign an after-the-fact consent for the release of records, saying that failure to do so would result in early discharge from the residential program. The patient refused to sign the release, and was discharged from the program three days early. She then alleged that the hospital violated HIPAA and engaged in unlawful retaliation when she did not sign the after-the-fact consent.

The court dismissed the patient’s claims, finding that the court lacked subject matter jurisdiction over the action because HIPAA violations are within the jurisdiction of the Department of Health and Human Services and the Department of Justice’s Office of Civil Rights. Additionally, the court held that the patient did not have a claim upon which a relief could be granted, as HIPAA does not provide a private cause of action on individuals.

Belnap v. Iasis Healthcare Corp. (Summary)

INJUNCTION, EXHAUSTION OF REMEDIES, MEDICAL STAFF HEARING

Belnap v. Iasis Healthcare Corp., No. 2:14-cv-00086-DN (D. Utah Jan. 28, 2015)

The U.S. District Court for the District of Utah granted in part and denied in part a health care system’s motion to compel arbitration in a suit alleging that the health care system attempted to eliminate a physician from the market.

The health care system signed an agreement with the physician to develop an abdominal treatment center. In the agreement was an arbitration clause that dictated that the parties were to resolve disputes through mediation or arbitration.

A short time later, the physician was alleged to have sexually harassed a female employee, and the health care system suspended his clinical privileges. He then requested a fair hearing, where it was determined that the action of the Medical Executive Committee was unwarranted and the physician’s suspension was vacated. The health care system never actually established the abdominal treatment center.

The physician sued based on seven causes of action. The court granted the health care system’s motion to compel arbitration for the physician’s claim that the health care system imposed a restraint on trade by attempting to eliminate him from the market. The physician alleged that the health care system conspired to restrain trade by failing to establish the abdominal treatment center. The court found that this claim fell under the scope of the physician’s contract and should therefore be held to the arbitration requirement in the agreement.

However, the physician’s other claims, including violation of bylaws, breach of the implied covenant of good faith and fair dealing, false representation, and intentional infliction of emotional distress, were all held to be outside the scope of the agreement. Therefore, these claims could not be barred by the arbitration clause.

The physician then requested a preliminary injunction to stop the health care system’s conduct toward him and to delay another fair hearing that was scheduled to challenge the Medical Executive Committee’s adverse recommendation for reappointment. (Belnap v. Iasis Healthcare Corp., No. 2:14-cv-00086 (D. Utah Feb. 4, 2015).) The physician requested that this fair hearing be postponed “until such time as the case can be fully and fairly litigated.” The court denied this request, finding that the physician’s injunction relied on facts that were not present in his original complaint. Additionally, the physician failed to exhaust all administrative remedies available before resorting to legal action.

Knapik v. Mary Hitchcock Mem’l Hosp. (Summary)

RESIDENT DISCIPLINE

Knapik v. Mary Hitchcock Mem’l Hosp., No. 5:12-cv-175 (D. Vt. Feb. 3, 2015)

The U.S. District Court for the District of Vermont granted summary judgment to a hospital to resolve claims that the hospital wrongfully terminated a resident after she shared a colleague’s reprimand letter with a medical fellowship program.

The resident practiced at the Vermont hospital through the course of her residency. During this time, she befriended a resident colleague, though their relationship cooled after a series of disputes. At one time during her residency, the colleague received a letter from the Vermont hospital administration, reprimanding her and instructing her to change her behavior. When the colleague eventually applied for a fellowship position at a Kentucky hospital, she failed to disclose the contents of this letter. The resident, who had been shown this letter, anonymously sent the Kentucky hospital a copy of the letter. When the Vermont hospital was made aware of this, it traced computer inquiries to determine that the resident had sent the letter. After determining that her behavior was in violation of its ethical conduct standard, the Vermont hospital dismissed the resident from the residency program. The resident filed for wrongful termination, breach of contract, and breach of implied covenant of good faith and fair dealing.

The court declined to grant the hospital summary judgment on its claim that the resident failed to exhaust all remedies, finding that the hospital failed to follow its own policy for pursuing grievances. According to the hospital policy, the resident was to be given five days’ notice and the opportunity to request a hearing. However, the court found that the dismissal of the resident was within the hospital’s discretionary judgment. The court granted the hospital’s motion for summary judgment in deference to the hospital’s academic decision, finding that the dismissal was not arbitrary, capricious, or unreasonable.

Freedman v. Fisher (Summary)

EMTALA

Freedman v. Fisher, No. 13-3145 (E.D. Pa. Feb. 2, 2015)

The U.S. District Court for the Eastern District of Pennsylvania partially affirmed and partially denied a hospital’s cross-motions for summary judgment in a patient suit alleging violation of EMTALA.

A patient presented to the hospital’s emergency room complaining of chest and abdominal pain. The emergency physician examined the patient, running multiple tests. The patient was transferred within the hospital for observation and to meet with an internal medicine specialist. His condition continued to deteriorate, and he died in the hospital following a pericardial hemorrhage.

The court rejected the hospital’s argument that the plaintiff’s amended EMTALA claim was barred by the statute of limitations. Because the amended claim arose out of the same incident as the original complaint, it was held to “relate back” to the timing of the original complaint. The plaintiff alleged that the hospital violated EMTALA by failing to have an established policy or protocol for the patient’s situation. The court found that material issues of fact still existed over the hospital protocol, as it found numerous conflicts of evidence within the medical record. The court determined that this issue should be resolved by a jury. Finally, the court rejected the plaintiff’s claim that the transfer of the patient within the hospital violated EMTALA. According to the court, transferring a patient into an observation unit does not qualify as a “discharge,” meaning that it fails to meet the requirements for an EMTALA claim.

Commonwealth v. Partners Healthcare Sys. Inc. (Summary)

ACQUISITION

Commonwealth v. Partners Healthcare Sys. Inc., No. SUCV2014-02033-BLS2 (Mass. Super. Ct. Jan. 30, 2015)

The Superior Court of Massachusetts enjoined a healthcare provider system from acquiring two smaller healthcare provider systems, holding that the acquisition was not in the public’s interest. Acquirer was the largest health care provider system in the state with ten hospitals, a homecare agency, a network of rehabilitation facilities, and annual revenues of approximately $9 billion. Acquirees were two of the acquirer’s biggest geographic competitors. The three parties agreed on acquisition terms and announced their deal. The state’s attorney general investigated the deal for anticompetitive practices and discovered multiple issues. The healthcare provider systems negotiated with the attorney general and created a proposed acquisition agreement. The parties sought the court’s approval of the agreement.

The court rejected the proposed acquisition agreement. The proposed acquisition agreement called for temporary price caps to protect consumers from anticompetitive conduct by the acquirer. The court rejected the price caps because they were limited in time, failed to address the monopolization of the market, and are easy to circumvent. Additionally, the proposed acquisition agreement contains ten different areas of potential disagreement that the parties can petition the court to resolve. The court explained that the healthcare industry is highly complex and currently changing, thus it is ill-suited to handle the parties’ ongoing technical issues.

Gore v. Provena Hosp. (Summary)

APPARENT AGENCY

Gore v. Provena Hosp., No. 3–13–0446 (Ill. App. Ct. Feb. 9, 2015)

The Third District Appellate Court of Illinois affirmed a lower court’s grant of summary judgment in favor of a hospital. The hospital was sued by the mother of a young patient, who claimed that her son had suffered serious and permanent injuries due to the negligent treatment provided by a physician.

A dispositive issue in the case centered on whether the physician was legally considered to be an agent of the hospital. The court explained that a hospital can be liable for the negligent acts of an independent contractor physician, but only if the hospital “holds out” the physician as an agent and if the patient does not know that the physician is an independent contractor. The hospital demonstrated that the patient’s mother had signed a consent form which specifically disclaimed any agency relationship between itself and the physician.

The patient’s mother acknowledged that she had signed the consent form but insisted that she was not aware that the physician was an independent contractor. She pointed out that the paramedics in the ambulance had insisted on taking her son to this particular hospital, even though she had requested they take him to a different facility that was somewhat further away. Consequently, the mother argued that the paramedics’ decision demonstrated that the hospital held itself out as a place that could care for her son. In addition, she claimed that they had already begun to treat her son before she ever signed the consent form.

The court disagreed, emphasizing that the terms of the consent form were clear and unambiguous. It also noted that the consent form stated that professional personnel were available to explain the terms of the contract upon request, and that the patient’s mother had never requested any assistance. Since the patient’s mother could not show that the hospital had held the physician out as an agent, the court affirmed the lower court’s decision to grant summary judgment in favor of the hospital.