Egan v. Athol Memorial Hospital

971 F. Supp. 37, 1997 U.S. Dist. LEXIS 10023, 1997 WL 395740
CourtDistrict Court, D. Massachusetts
DecidedMarch 28, 1997
DocketCivil Action 94-40158-NMG
StatusPublished
Cited by24 cases

This text of 971 F. Supp. 37 (Egan v. Athol Memorial Hospital) is published on Counsel Stack Legal Research, covering District Court, D. Massachusetts primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Egan v. Athol Memorial Hospital, 971 F. Supp. 37, 1997 U.S. Dist. LEXIS 10023, 1997 WL 395740 (D. Mass. 1997).

Opinion

MEMORANDUM AND ORDER

GORTON, District Judge.

The plaintiff, Ronald E. Egan, M.D. (“Egan”) has sued Athol Memorial Hospital (“Athol”), its president and ten doctors due to their participation in a medical peer review process which in 1994 resulted in termination of Egan’s medical staff membership and privileges at Athol. Plaintiff seeks damages and injunctive relief under Sections 1 and 2 of the Sherman Antitrust Act, Sections 4 and 5 of the Massachusetts Antitrust Act and Sections 2 and 11 of the Massachusetts Consumer Protection Act. In addition, plaintiff seeks damages for bad faith and unreasonableness. The defendants have filed a Joint Motion for Summary Judgment which is opposed by plaintiff.

I. Facts

The following relevant facts are 1) agreed upon by the parties, 2) not specifically contradicted by the plaintiff, or 3)assumed from letters, minutes of meetings and depositions submitted in support of and opposition to the motion. The facts are viewed in the light most favorable to the plaintiff. See O’Connor v. Steeves, 994 F.2d 905, 907 (1st Cir.1993).

*40 A. Background

In November of 1981, Egan applied for appointment to the attending medical staff of the hospital and requested surgical privileges. On March 2, 1982, Egan was appointed to the active medical staff of Athol, and his request for surgical privileges was approved later that month.

On July 28, 1986, the first recorded Incident Report was issued against Egan. Later that year, a letter was sent to Dr. Charles Pierson, a member of the Executive Committee, from the members of Athol’s Maximum Care Unit Committee in which they noted three Maximum Care Unit (“MCU”) cases which were viewed as having been inadequately managed by Egan. The MCU Committee issued a recommendation and suggested that Egan be invited to discuss the three cases and the recommendation with the MCU Committee or the Executive Committee. As a consequence, Athol’s Ad Hoc Committee on Professional Conduct met with Egan on February 13, 1987. Egan agreed with the recommendations of the MCU Committee that 1) he be required to consult an appropriate internal medicine specialist or sub-specialist for each of his admissions to the MCU whether they be medical or surgical in nature, 2) his future admissions were to be monitored, and 3) if he did not follow the Committee’s recommendations, further action could be taken.

On February 4, 1988, Mr. DiFederico, President of Athol, submitted a report to the Massachusetts Board of Registration in Medicine informing it that, based upon a review by Athol’s Tissue Committee, Egan was required to be supervised by a senior surgeon for his next ten dilation and curettage procedures, and that Egan was required to have medical and surgical consults on all of his MCU admissions.

In December, 1988, three nurses wrote letters about a contemporaneous incident in which Egan had been called in to assist with a patient. The nurses alleged that Egan was acting inappropriately and suspected that he was intoxicated. He was informed in writing of the complaint, denied that he was intoxicated and complained that the unprofessional way in which the surgical call had been executed influenced his behavior on the evening in question.

From October to December, 1989, Egan was often cited for incomplete and late medical charts. During the same period, Athol’s Utilization Review Committee conducted a study of Egan’s discharge plans and concluded that those plans accounted for up to 50% of Athol’s total readmissions.

In 1990 and thereafter, defendants continued to receive complaints from nurses, staff and other physicians about Egan’s clinical competence and professional behavior. The defendants conducted an investigation into each of the complaints, and several cases were identified as being of particular concern with regard to the appropriateness of care rendered by Egan. He was asked to respond, both orally and in writing, to the peer review committees’ concerns, which he did on numerous occasions. In the meantime, his application for reappointment dated September 21, 1991 was taken under consideration.

At about the same time, Egan filed complaints about alleged substandard treatment provided by several Athol physicians. For instance, in November, 1991, Egan wrote two variance reports complaining of one doctor’s performance and one variance report complaining of a second doctor’s performance. In April of that year, he made written complaints against two other doctors.

B. Six of Egan’s Cases Scrutinized

In November 1992, after reviewing additional information provided by Egan, the Executive Committee of the Medical Staff retained an independent medical reviewer to review six of Egan’s cases. The reviewer concluded that four of the cases indicated significant inadequacies in Egan’s medical care.

Plaintiff retained his own experts to evaluate and render opinions on the quality of the care he provided. Several expert reports were written before the disputed disciplinary action was taken by Athol, and additional letters were submitted after litigation ensued. Those letters addressed some of the cases that later served as the basis for the disputed disciplinary action (“course require *41 ments”) as well as other cases, and the opinions rendered therein ranged from finding that Egan was somewhat at fault to declaring that he was not incompetent.

Patient # 1 was one of the six patients who was of particular concern to the MCU Committee, and one of the four patients whose care by Egan had been found to be inadequate by the independent medical reviewer. Egan contended in an affidavit, however, that a fellow physician was either wrong or purposefully misstated facts about the care of patient # 1 and that the same physician, who blamed an alleged delay in diagnosis on Egan, was really at fault himself for failing to respond.

C. The Professional Review Resulting in the Disciplinary Action at Issue

The decision that Egan’s reappointment to the medical staff at Athol would be conditioned upon his taking additional required courses within six months was arrived at between June and October, 1993 through a series of meetings, written communications and phone conversations between the defendants and Egan or his former attorney. Specifically, the Medical Staff Executive Committee (the “Committee”) addressed the matter at three separate meetings, the last being a general meeting of the staff in September, 1993. Minutes of meetings of both the Committee and the staff show that the decision on Egan was unanimously approved. During the September, 1993 staff meeting, a written recommendation was distributed indicating that a review had been made of the opinions of Egan’s experts. Egan declined the opportunity to provide additional information.

After the Committee first recommended that Egan be required to complete course requirements, Egan made it clear that he would refuse to fulfill those requirements and requested both that he be afforded a hearing and that the Committee comply with the Medical Staff By-laws in any decision it made.

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Bluebook (online)
971 F. Supp. 37, 1997 U.S. Dist. LEXIS 10023, 1997 WL 395740, Counsel Stack Legal Research, https://law.counselstack.com/opinion/egan-v-athol-memorial-hospital-mad-1997.