Reid v. KentuckyOne Health, Inc. — Mar. 2016 (Summary)

HCQIA IMMUNITY

Reid v. KentuckyOne Health, Inc.
No. 2015-CA-000092-MR (Ky. Ct. App. Mar. 18, 2016)

A surgeon received a letter from the hospital’s Surgery Quality Assurance and Investigation Committee that all of his cases would be subject to a focused review.  Two months later, the surgeon was told by the Medical Executive Committee that he could no longer perform any further surgical procedures at the hospital unless he was accompanied by an actively practicing and board certified general surgeon or endoscopist.  The physician did not exercise his clinical privileges under the conditions imposed and did not renew his medical staff appointment.  However, he then sued the hospital claiming that the conditions imposed by the MEC constituted a breach of contract, intentional infliction of emotional distress, and tortious interference.  The trial court concluded that the hospital was entitled to immunity under the Health Care Quality Improvement Act (“HCQIA”), because it had conducted “professional review activities.”

The Kentucky Court of Appeals reversed the trial court’s finding that the hospital’s actions constituted a “professional review action” not “professional review activities.”  The court ruled that the conditions that were imposed on the surgeon so severely restricted his clinical privileges at the Hospital that they constituted a “professional review action.”  The appellate court then questioned whether the hospital was entitled to HCQIA immunity because the hospital did not appear to meet all of the standards required by HCQIA, including a hearing.  Therefore, the appellate court remanded the case back to the trial court for further consideration of the pertinent provisions of HCQIA.