Cohn v. Bond

953 F.2d 154
CourtCourt of Appeals for the Fourth Circuit
DecidedDecember 31, 1991
DocketNo. 91-2502
StatusPublished
Cited by23 cases

This text of 953 F.2d 154 (Cohn v. Bond) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fourth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cohn v. Bond, 953 F.2d 154 (4th Cir. 1991).

Opinion

OPINION

HAMILTON, Circuit Judge:

R. Ernest Cohn, a chiropractor, filed this case complaining that Wilkes General Hospital and its medical staff improperly denied his request for staff privileges in violation of Section 16 of the Clayton Act, 15 U.S.C. § 26 (1973); Sections 1 and 2 of the Sherman Antitrust Act, 15 U.S.C. §§ 1, 2 (1973); and in violation of a North Carolina statute concerning access to public hospitals by chiropractors. N.C.Gen.Stat. § 90-153 (1991). Dr. Cohn appeals from an order of the United States District Court for the Western District of North Carolina granting summary judgment to John L. Bond and other members of the medical staff of Wilkes General Hospital, and dismissing Dr. Cohn’s state law claim. 767 F.Supp. 111. We find that the defendants’ actions are shielded by operation of the Local Government Antitrust Act (LGAA), the State Action Doctrine and intracorpo-rate immunity. The decision of the district court is hereby affirmed.

I.

Dr. Cohn practices in Wilkesboro, North Carolina. Wilkes Hospital is a municipally owned and operated hospital under the City of Wilkesboro. Dr. John Bond is the named defendant of the medical staff of Wilkes Hospital. Other members of the medical staff are also defendants in this action.

In 1984, Dr. Cohn applied for privileges at Wilkes Hospital. In accordance with Wilkes Hospital’s bylaws, the request was referred to the Medical Staff Credentials Committee for review. The Committee recommended to the Board of Trustees of Wilkes Hospital (the “Board”) that Dr. Cohn’s application be denied. Their expressed reasons for denial were that the medical doctors would be unable to supervise care given by a chiropractor, and that granting hospital privileges to a chiropractor may not be permitted by law in North Carolina. Dr. Cohn appealed this decision to the Medical Executive Committee. The Executive Committee noted that chiropractors were permitted to practice in public hospitals, but that a hospital is not required to admit them. The Executive Committee otherwise affirmed the decision of the Credentials Committee. Dr. Cohn appealed this decision to the Board. On May 28, 1985, the Board met and heard testimony from Dr. Cohn. Thereafter, the Board went into closed executive session and decided to deny Dr. Cohn’s request for privileges. The Board cited as grounds for its decision: (1) concerns over the ability of medical staff to supervise Dr. Cohn, (2) a lack of requests for chiropractic care at Wilkes Hospital, (3) insurance concerns, (4) the absence of reasons why such services need to be administered in a hospital, (5) the lack of similar privileges to a chiropractor in other hospitals, and (6) a lack of knowledge necessary to monitor fees by chiropractors. After a subsequent request from Dr. Cohn for limited privileges, and a request for reconsideration of his initial [157]*157application, the Board affirmed its earlier denial on July 22, 1986, and again on October 27, 1987.

Dr. Cohn’s suit originally named Wilkes Hospital, members of the Board, and members of Wilkes Hospital’s medical staff. The only parties remaining at the summary judgment stage were the Board and the medical staff members. Dr. Cohn dropped Wilkes Hospital as a party in his third amended complaint. (Complaint, J.A. at 173-182). Dr. Cohn appeals only the granting of summary judgment with respect to his causes of action against the medical staff. Dr. Cohn specifically notes in his brief that the Trustees (Board) are not involved in this appeal. (Appellant’s Brief at 3, n. 1).

The district court granted summary judgment on the grounds that the conduct challenged was immunized under the Local Government Antitrust Act, 15 U.S.C. § 34 (Supp. I 1984), and under the State Action Doctrine. The district court also exercised its discretion to dismiss Dr. Cohn’s pendent state claim, and denied Dr. Cohn’s motion to reconsider the district court’s earlier denial of a motion to compel discovery of certain Board meetings. The district court held that such meetings were privileged and not subject to discovery.

Dr. Cohn appeals, claiming that the district court erred in extending LGAA and State Action Doctrine immunity to the staff members who recommended that he be denied privileges at Wilkes Hospital. Dr. Cohn also appeals the district court’s denial of discovery of the Board’s proceedings in executive session. Lastly, he claims that the district court erred in that the state claim it dismissed was one he had already dropped, and that the district court never dismissed the actual state claim he was asserting.

II.

The appropriate standard of review for the granting of summary judgment is de novo. A decision of the trial court refusing to continue discovery is upheld absent an abuse of discretion. Sandcrest Outpatient Services v. Cumberland County Hospital System, Inc., 853 F.2d 1139, 1148 (4th Cir.1988).

III.

The LGAA provides immunity to any local government, official or employee acting in an official capacity from money damages in an antitrust case. 15 U.S.C. § 36. The appellant does not appeal the determination by the district court that Wilkes Hospital is a local governmental unit covered by the LGAA. The LGAA also provides immunity to a person who is not an employee or official if that person is “engaged in ‘official action directed by a government or official or employee thereof.’ ” Sandcrest, 853 F.2d at 1143 (quoting, 15 U.S.C. § 36(a)).

The facts in Sandcrest are similar to the facts in this case. In Sandcrest, the administrator declined to extend the emergency room service contract of Sandcrest Services. Sandcrest Services brought an antitrust action on the grounds that it was improperly excluded from providing services by the hospital, its board of trustees, the administration, and the medical staff. This court upheld the district court findings that the hospital, the administrator, and the medical staff committee were immune from such suits under the LGAA. This court held that the actions of the medical staff were “directed by” officials of the governmental entity, as contemplated by the LGAA. Whether actions are “directed by” an official, as contemplated by the LGAA, is determined by borrowing and applying the State Action Doctrine two prong test. Sandcrest, 853 F.2d at 1143, citing H.R.Conf.Rep. No. 1158, 98th Cong., 2d Sess. 3, reprinted in 1984 U.S.Code Cong. & Admin.News, 4602, 4627.

In Sandcrest, the members of the medical staff were found to be immunized by the LGAA because their actions were “directed by officials.” In light of our recent decision in Oksanen v. Page Memorial Hospital, 945 F.2d 696 (4th Cir.1991), the medical staff’s conduct in this ease is more directly immune. Oksanen holds that when members of the medical staff recom[158]

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953 F.2d 154, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cohn-v-bond-ca4-1991.