Altman v. New York City Health & Hospitals Corp.

100 F.3d 1054
CourtCourt of Appeals for the Second Circuit
DecidedNovember 21, 1996
DocketNo. 1402, Docket 95-9053
StatusPublished
Cited by1 cases

This text of 100 F.3d 1054 (Altman v. New York City Health & Hospitals Corp.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Second Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Altman v. New York City Health & Hospitals Corp., 100 F.3d 1054 (2d Cir. 1996).

Opinion

VAN GRAAFEILAND, Circuit Judge:

On September 30, 1992, the Medical Director of Metropolitan Hospital Center entered a clinic at the Hospital and found a drunken doctor treating a patient. The doctor was Kurt Altman, Chief of the Hospital’s Department of Internal Medicine. The incident led to the disclosure of a history of bizarrely favored treatment for Altman, an admitted alcoholic, and to his subsequent termination as Chief of the Internal Medicine Department. This is an appeal from the summary judgment of the United States District Court for the Southern District of New York (Martin, J.) dismissing Altman’s action under the Americans with Disabilities Act (“ADA”), 42 U.S.C. §§ 12101 et seq., and New York Executive Law § 296 seeking reinstatement, back pay, damages for mental distress, anguish, pain and suffering, punitive and exemplary damages, attorneys’ fees, costs, disbursements and interest. For the reasons that follow, we affirm.

New York City Health and Hospitals Corporation (“HHC”) is a public benefit corporation which operates sixteen municipal hospitals in the City of New York. It is the primary provider of medical services to the City’s poor. Metropolitan Hospital is a member institution of HHC and serves the population of East Harlem, which is not the silk-stocking area of the City. Metropolitan contains approximately 550 beds and is divided into departments, each with its own staff and chief of staff. Internal Medicine is the largest department, comprising up to 160 beds, and as many as 70 patients in the Hospital’s intensive care unit.

New York Medical College, one of the largest private medical schools in the United States, provides medical personnel to a number of HHC hospitals, including .Metropolitan, pursuant to a contract with HHC. During their tenure, the doctors in question usually hold positions in both the College and the Hospital. However, appointment and removal of the hospital physicians is the sole prerogative of the President of HHC.

Atman, a native of Austria, began drinking as a medical student in Europe at the age of 25. He drank heavily, and this continued when he came to the United States. Atman began his association with Metropolitan in 1958 and became its Chief of Internal Medicine in 1991. Unknown to HHC officials, he was an alcoholic during this entire period. This was evidenced by periodic binges and drinking sprees, which occurred mainly during weekends and vacation periods. On at least three occasions, he required treatment for his alcoholism. One such lapse occurred in the early 1980’s. At that time, Atman was observed taking long lunch hours and had alcohol on his breath when he returned to work. He acted in a bizarre manner, and his speech was slurred. When Dr. Karl Adler, Atman’s friend and predecessor, was asked whether he discussed the situation with Atman, he replied:

I think I had the normal response that a chief would have to one of his colleagues but also who’s responsible — I felt that this activity couldn’t continue and that there needed to be — we needed to take some immediate steps to, one, protect the patients, and, two, to make sure that Dr. Atman underwent' some type of appropriate counseling therapy to deal with the issues. ■

With the help of Dr. Maryann Cohen, a psychiatrist at Metropolitan, Adler was able to secure the services of an outside psychiatrist who placed Atman under a program of counseled therapy. Adler and Cohen did “everything possible” to keep knowledge of the situation from other physicians at the Hospital and the Hospital Administrator. Adler kept no records of this episode, stating that he and- Cohen “acted mostly as a referral” and “what we saw as our role was getting him out of the hospital environment and into appropriate, therapy.”

Atman’s recovery, such as it was, was short-lived. On February 27, 1986, he was admitted to St. Luke’s/Roosevelt Hospital suffering from alcohol and barbiturate dependence. He was hospitalized for seven days and then underwent therapy treatment at Smithers Acoholism Treatment and Training Center, which was associated with the Hospital, discontinuing treatment after four months so that he could go to Europe. The Hospital record contains the following [1056]*1056note: “Is very concerned regarding his colleagues finding out that he’s being detoxed.”

The fact of the matter is that Adler knew about it and said not a word to either Dr. J. Emilio Carrillo, then President of HHC, or Dennis Gowie, Metropolitan’s Executive Director. Indeed, Adler hid this information from both Carrillo and Gowie when he subsequently recommended that Carrillo appoint Altman Chief of the Department of Internal Medicine. Adler’s explanation for this failure leaves much to be desired. He says that he considered the information to be privileged, but he doesn’t say why. It is questionable whether the typical relationship of doctor-patient existed as between Altman and Adler. Moreover, assuming the existence of such a relationship, when the patient becomes a danger to himself or others, under New York law the privilege must give way. MacDonald v. Clinger, 84 A.D.2d 482, 487,. 446 N.Y.S.2d 801 (1982). “‘The protective privilege ends where the public peril begins.’” Id. (quoting Tarasoff v. Regents of Univ. of Cal., 17 Cal.Sd 425, 442, 131 Cal.Rptr. 14, 551 P.2d 334 (1976)).

Adler’s argument that Altman himself was not legally bound to furnish this information is a glaring misstatement of the professional and legal obligations of a doctor seeking an important medical position. Neither Adler nor Altman could have been unaware of the fact that it is professional misconduct to practice medicine while the ability to practice is impaired by alcohol or being habitually drunk. See, e.g., N.Y. Educ. Law § 6509(3) & (4). In any event, Adler was not simply a silent bystander to Altman’s misdeeds. He was an active participant in securing for Altman the appointment of Chief of Internal Medicine that otherwise Altman quite obviously would not have received.

The final note at Smithers, which followed four months of group therapy, reads: “Patient did not recontact the service after the trip to Europe. Overconfident about' his ability to abstain. Prognosis Guarded.”

The irony in all of the foregoing is that when Altman yielded once again to the lure of alcohol, he did so at a reception honoring his appointment as Chief of the Department of Internal Medicine. This was followed by another vacation trip to Europe during which his drinking went completely out of control. It did not improve when he returned. He drank about a pint of vodka and a six pack of beer every day. Altman admits that he drank on the evening before the above-described September 30, 1992 incident, that he had a few more drinks in the morning before going to work, and that he drank three martinis during his luncheon recess. It is not surprising that he was discovered to be so drunk that he had difficulty in picking up his otoscope and returning it to its case. Neither is it surprising that he reentered St. Luke’s the following day at the insistence of Dr. Adler and his confidant, Dr. Richard Stone. A note in the hospital record dated October 4, 1992 reads: “[s]tiH quite distressed at being coerced into a Rehab by his job — -wants to blame us.”

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