Angel Cancel v. the Medical Center of Central Georgia, Inc.

Court of Appeals of Georgia·Decided March 15, 2018·No. A17A1709·Published

Opinion

FIFTH DIVISION

MCFADDEN, P. J.,

BRANCH and BETHEL, JJ.

NOTICE: Motions for reconsideration must be physically received in our clerk’s office within ten days of the date of decision to be deemed timely filed.

http://www.gaappeals.us/rules

March 15, 2018

In the Court of Appeals of Georgia A17A1708, A17A1709. CANCEL et al. v. THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. et al. (two cases).

BRANCH, Judge.

This is the third appearance of this matter before this Court. In late 2002, Louis Goolsby, M.D., the chief executive officer of The Medical Center of Central Georgia, Inc. (“the Medical Center”), and Angel Cancel, M.D., the chief executive officer of Central Georgia Anesthesia Services, Inc. (“CGAS”) learned of apparent billing and medical irregularities by CGAS members working at the hospital. After an investigation and the voluntary dissolution of CGAS, the Medical Center declined to rehire four former CGAS members (including Dr. Cancel), all of whom later brought this action against three of their former colleagues (“the individual defendants”) as

well as the Medical Center, its president and chief executive officer A. Donald Faulk, and Dr. Goolsby (“the hospital defendants”).

In Cancel v. Sewell, 321 Ga. App. 523 (740 SE2d 870) (2013) (“Cancel I”), we affirmed the trial court’s grant of summary judgment as to Dr. Cancel’s claims. Id. at 530-536.1 In Sewell v. Cancel, 331 Ga. App. 687 (771 SE2d 388) (2015) (“Cancel II”), we reversed the denial of summary judgment to the individual defendants as to the remaining plaintiffs’ claims for breach of fiduciary duty and fraud. Id. at 689-695 (2), (3). In the same decision, we vacated the trial court’s denial of summary judgment and remanded with direction that the trial court “clarify” whether the hospital defendants were immune from prosecution because they had relied on a peer review panel in reaching their decision to terminate CGAS and not to rehire plaintiffs. Id. at 698 (4). On remand from Cancel II, the trial court held that the Medical Center had indeed relied on a peer review panel in reaching its decision to terminate CGAS and held the hospital defendants immune from plaintiffs’ claims. On appeal from that judgment in Case No. A17A1708, the remaining plaintiffs assert that the trial court

1 In Cancel I, we also dismissed the hospital defendants’ cross-appeals as to orders denying summary judgment that were filed after plaintiffs’ notice of appeal. 321 Ga. App. at 535-538. The Supreme Court of Georgia reversed this dismissal and remanded the case to this Court. Sewell v. Cancel, 295 Ga. 235, 238-240 (759 SE2d 485) (2014).

erred in this and other holdings. In Case A17A1709, plaintiffs argue that the trial court erred in denying their motion to supplement the record on appeal. We find no error and affirm in both cases.

To prevail at summary judgment under OCGA § 9-11-56, the moving party must demonstrate that there is no genuine issue of material fact and that the undisputed facts, viewed in the light most favorable to the nonmoving party, warrant judgment as a matter of law. OCGA § 9-11-56 (c). A defendant may do this by showing the court that the documents, affidavits, depositions and other evidence in the record reveal that there is no evidence sufficient to create a jury issue on at least one essential element of plaintiff’s case.

Lau’s Corp. v. Haskins, 261 Ga. 491 (405 SE2d 474) (1991).

Although we thus view the record in a light favorable to plaintiffs, the relevant facts are not in dispute. In 2000, CGAS entered into a contract to provide the Medical Center with all of its anesthesia services. In the fall of 2002, Dr. Cancel and Dr. Goolsby became aware of potentially fraudulent medical chart documentation by some CGAS members. See Cancel I, 321 Ga. App. at 524. Dr. Cancel also became aware of nurses’ complaints that anesthesiologists were sometimes absent from surgeries and other procedures for which those doctors were medically responsible. As a result of these allegations of billing and medical improprieties, CGAS sought an

evaluation by the American Society of Anesthesiologists (ASA), but Dr. Goolsby, then the Medical Center’s vice president for medical affairs, cancelled a scheduled ASA visit without notifying Dr. Cancel. See Cancel I, 321 Ga. App. at 525. The Medical Center then retained Ann Atkinson, a psychological consultant, who interviewed the hospital staff and the CGAS physicians by phone in “listening sessions” held in December 2002 and January 2003. The notes to these sessions, which were produced during discovery, show that Atkinson spoke with all 14 anesthesiologists in nearly 15 hours of conversation and with 41 of 43 nurses in over 11 hours of conversation. On the basis of these sessions, Atkinson concluded that CGAS was suffering from acute dysfunction, including power struggles, threats, “lack of trust,” and allegations of sexual misconduct.2 Shortly before a meeting with Atkinson in early 2003, Dr. Pravin Jain, another CGAS anesthesiologist, showed Dr. Goolsby examples of what Dr. Jain considered to be improper medical chart documentation. Over the next three months, Dr. Jain also uncovered billing irregularities by CGAS members. See Cancel I, 321 Ga. App. at 525-526. On April 25, 2003, after receiving Dr. Jain’s allegations, and without

2 According to Atkinson’s notes of the conversations, for example, some group members reported that one doctor was having an affair with one of the other doctors and that used condoms and pornographic materials had been found in his office.

further review of CGAS’s billing records, Faulk notified CGAS in writing that the group’s contract would be terminated “for cause” as of May 31, 2003, “unless CGAS can demonstrate by such date that it is in substantial compliance” with its contract with the Medical Center. Faulk’s letter also represented that the Medical Center “cannot guarantee that any current member of CGAS . . . will be offered a contract of employment within the restructured Department of Anesthesiology,” that applications for rehiring “will and must be evaluated carefully in light of the serious concerns that have arisen in regard to CGAS,” and that the Medical Center “commits to evaluate every application . . . fairly, objectively, and on its individual merits.” See Cancel I, 321 Ga. App. at 526.

In early May 2003, and after consultation with counsel, the officers of CGAS voted unanimously to terminate its contract with the Medical Center, with the termination effective on August 31, 2003, “so as to avoid earlier termination for cause,” with all physician contracts with CGAS to terminate at the same time. Cancel II, 331 Ga. App. at 691. Also in May 2003, the Medical Center formed a panel with members including Faulk, Dr. Goolsby, another senior CGAS anesthesiologist, Atkinson, and a nurse (“the Goolsby panel”), which was charged with evaluating the applications of any CGAS members seeking a position in the restructured department.

On June 2, 2003, after an audit conducted off-site and limited to “medical direction review,” the Medical Center notified CGAS that in light of the panel’s evaluation, eight CGAS members, including individual defendants Alvin Sewell, M.D., Sanjiwan Tarabadkar, M.D., and Miles McDonald, M.D., would be offered positions at the hospital.

In August 2005, the four physicians not re-hired by the Medical Center — Drs.

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