DeKalb Medical Center, Inc. v. Obekpa

728 S.E.2d 265, 315 Ga. App. 739
CourtCourt of Appeals of Georgia
DecidedMay 2, 2012
DocketA12A0160
StatusPublished
Cited by4 cases

This text of 728 S.E.2d 265 (DeKalb Medical Center, Inc. v. Obekpa) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
DeKalb Medical Center, Inc. v. Obekpa, 728 S.E.2d 265, 315 Ga. App. 739 (Ga. Ct. App. 2012).

Opinion

Ellington, Chief Judge.

DeKalb Medical Center, Inc. (“the hospital”) appeals from an order of the Superior Court of DeKalb County that enjoined the hospital from reporting to the National Practitioner Data Bank (“the data bank”) a final, adverse decision of the hospital’s Board of Directors (“the board”) to deny the application of Dr. Adah E. Obekpa for renewal of his clinical privileges while Obekpa’s claims against the hospital remained pending. The hospital also appeals the court’s order denying its motion to dismiss Obekpa’s complaint for equitable relief, a complaint that seeks to set aside the board’s final decision and to reinstate a previous recommendation of the hospital’s hearing panel. For the following reasons, we reverse.

1. The hospital contends that the superior court erred in denying its motion to dismiss Obekpa’s complaint, which was converted to a motion for summary judgment when the court took evidence outside the pleadings with the consent of the parties,1 because the hospital is entitled to immunity pursuant to Georgia’s peer review statute, OCGA§ 31-7-132 (a). We agree.

[740]*740Obekpa did not file a complaint for damages, which would have been governed by the federal Health Care Quality Immunity Act of 1986 (“HCQIA”).2 Rather, he sought equitable relief. In his complaint and the amendments thereto, Obekpa asked the superior court (1) to declare the final decision of the board void because it was motivated by malice and because the hospital failed to abide by the credentialing and corrective action policy of its medical staff bylaws, and (2) to enjoin the hospital from reporting its decision to deny his application for reappointment to the hospital staff to the data bank.3

Georgia’s peer review immunity statute provides that no professional health care provider “shall be held, by reason of the performance of peer review activities,... to be civilly liable under any law unless [the provider] was motivated by malice toward any person affected by such activity.” OCGA § 31-7-132 (a). Unlike the HCQIA, this Code section provides immunity from all civil liability, not just from monetary damages.4 “Consequently, Georgia’s peer review statute [covers] claims for equitable relief.” Taylor v. Kennestone Hosp., Inc., 266 Ga. App. at 21-22 (4) (a). We review the superior court’s decision de novo and in the light most favorable to Obekpa. Id. So viewed, the record reveals the following undisputed facts.

Obekpa was appointed to the hospital staff in September 2008, with clinical privileges in internal medicine. A few weeks after his appointment, the hospital personnel began noticing that Obekpa was [741]*741not properly documenting the treatment of his patients. The hospital’s Chief of the Department of Medicine spoke with Obekpa and expressed his concerns. Documentation problems persisted, however, and, over the next five months, the hospital received complaints that Obekpa was not appropriately attentive to or responsive to his patients and that he was not properly using hospital resources. These initial complaints prompted efforts by the medical staff to engage Obekpa in “collegial intervention.” Obekpa was informed that the hospital would be monitoring him by reviewing his progress notes and assessing the level of patient and staff complaints.

Despite these informal efforts, Obekpa’s professional conduct remained unchanged. On May 8, Obekpa was informed that “the medical staff ha[d] reached the point of making a decision on initiating an investigation[.]” He was advised of the peer review and investigation process, the bylaws, and the fact that he could resign, if he chose, prior to an investigation being initiated and that, if he did so, no report would be made to the data bank. On July 7, the hospital’s Medical Executive Committee (‘MEC”) voted to conduct an investigation into Obekpa’s professional conduct. The MEC appointed an investigatory credentials committee of nine doctors (none of whom were members of the MEC) to review 25 of Obekpa’s patient charts and to notify Obekpa of the investigation. Obekpa was advised that the investigation would focus on his documentation of patient treatment, his responsiveness to patients and their families, his responsiveness to hospital staff, and his use of hospital resources. The investigatory process was explained to Obekpa, and he was advised of his right to participate and to respond.

Over the next month and a half, the credentials committee reviewed 25 of Obekpa’s cases and discovered significant problems with nine of them. For example, concerning a patient who was admitted with pneumonia on April 27, Obekpa’s progress notes were “pre-written with no changes at all.” He failed to mention the patient’s lung sounds or oxygenation, to note that the patient had been restrained, to note any discussion of a treatment plan with the nursing staff, or to timely request a pulmonary consultation, which delayed the patient’s length of stay for almost a week.

On August 31, the credentials committee met with Obekpa to discuss their findings. After the meeting, the committee voted to recommend limiting the number of Obekpa’s patients for a period of six months, monitoring his compliance with the committee’s recommendations, and having him attend additional training in medical records documentation, developing treatment plans, and the appropriate use of hospital facilities. The credentials committee sent its recommendation to the MEC, which reviewed the report prior to [742]*742making its final decision on September 1. On September 2, the hospital’s president and CEO notified Obekpa of the MEC’s decision to adopt the credentials committee’s recommendation and advised him of his right to appeal to a hearing panel. On September 28, Obekpa requested a hearing.

A panel of medical professionals (none of whom served on the MEC or the investigatory credentials committee) conducted a three-day hearing that concluded on January 21, 2010. Obekpa was represented by counsel. Obekpa admitted during the hearing that, even after the credentials committee investigation, he had received ten more peer review referrals concerning his performance, and that he had failed to respond to them in writing. The panel admitted into the record all previous letters, reports, charts, and other documents made during the course of the peer review process. It also accepted the final written statements of both the MEC and Obekpa. The panel issued its final report on March 3. In its report, the panel found that the MEC had met its evidentiary burden in support of its recommendation. The panel found that Obekpa had not shown, by a preponderance of the evidence, that the MEC’s adverse recommendation was either arbitrary, capricious, or not supported by credible evidence. Although the panel unanimously adopted the MEC’s conclusions, it recommended less severe corrective action in the desire to avoid negatively affecting Obekpa’s career. Specifically, the panel recommended that Obekpa receive additional training, attend case review conferences, and meet daily with the hospital’s risk management staff to ensure compliance with hospital policies. However, Obekpa’s patient referrals would not be limited, and no report of the adverse decision would be sent to the data bank.

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Bluebook (online)
728 S.E.2d 265, 315 Ga. App. 739, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dekalb-medical-center-inc-v-obekpa-gactapp-2012.