Evans v. Cowan

510 S.E.2d 170, 132 N.C. App. 1, 14 I.E.R. Cas. (BNA) 1261, 1999 N.C. App. LEXIS 1
CourtCourt of Appeals of North Carolina
DecidedJanuary 5, 1999
DocketCOA97-781
StatusPublished
Cited by33 cases

This text of 510 S.E.2d 170 (Evans v. Cowan) is published on Counsel Stack Legal Research, covering Court of Appeals of North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Evans v. Cowan, 510 S.E.2d 170, 132 N.C. App. 1, 14 I.E.R. Cas. (BNA) 1261, 1999 N.C. App. LEXIS 1 (N.C. Ct. App. 1999).

Opinion

JOHN, Judge.

Plaintiff appeals the trial court’s grant of summary judgment in favor of defendants. We affirm the trial court.

Pertinent factual and procedural information includes the following: Defendant Jane Hogan (Dr. Hogan) was awarded a Ph.D. degree in health care administration in 1991 by the University of Pennsylvania. In 1990, she served as a volunteer consultant at the University of North Carolina at Chapel Hill (UNC-CH) Student Health Services (SHS). In that capacity, Dr. Hogan contacted plaintiff and suggested employment at SHS to plaintiff. The latter had under consideration a tenure track faculty position at the University of South Carolina School of Nursing, but instead agreed 9 April 1990 to become Associate Director of the AfterHours Program (AfterHours) at SHS. AfterHours provided health services to UNC-CH students during evenings, weekends and holidays.

Plaintiff joined a task force comprised of defendant Dr. Bruce Vokoson (Dr. Vokoson), Director of AfterHours; Dr. Hogan; defendant Dr. Judith Cowan (Dr. Cowan), Director of SHS; and Jaclyn Jones (Jones), Acting Director of Nursing. The task force was seeking methods of improving the efficiency of SHS. In addition, plaintiffs duties included clinical responsibilities and the task of recruiting and supervising physician extenders, i.e., physician assistants attached to a physician’s medical license, employed in AfterHours.

The AfterHours task force met regularly for several months. In December 1990, plaintiff suggested that SHS change its practice of paying “moonlighting” physicians to provide AfterHours medical care. In plaintiff’s opinion, that service could be more efficiently and *3 economically furnished by full-time nurse practitioners. According to plaintiff, this suggestion made Dr. Vukoson “visibly angry.”

In task force meetings, plaintiff also sought implementation of a comprehensive alcohol policy for SHS, noting “most of our patients’ problems [are] alcohol-related.” At one meeting, plaintiff also expressed concern that Dr. Hogan had acted as the second R.N. covering a SHS night shift. Plaintiff noted Dr. Hogan was a non-employee acting in a medical capacity at a state institution.

In April 1991, Dr. Cowan informed plaintiff that her job responsibilities would be strictly clinical as of 1 July 1991. Shortly thereafter, plaintiff developed pleural pericarditis, an inflammation of the lung tissue and heart covering. Plaintiff informed Jones, her supervisor, that she expected to return to work the week of 5 May 1991. However, because her sick leave was exhausted, plaintiff actually resumed her duties 29 April 1991. On 30 April 1991, Dr. Vukoson telephoned plaintiff’s cardiologist to ascertain if plaintiff was working contrary to her physician’s instructions.

Plaintiff subsequently received a letter dated 6 May 1991, signed by Jones and Drs. Vukoson and Cowan, described therein as a “Final Written Warning for personal conduct.” Noting plaintiff’s earlier than anticipated return to work, the correspondence asserted plaintiff’s “inconsistent communications” had resulted in 1) the waste of administrative time expended in procuring coverage for her shifts, 2) inconvenience to staff who had agreed to provide coverage, and 3) dimin-ishment in supervisory and employee relations as a result of the confusion. In addition, plaintiff was relieved of responsibility for the AfterHours schedule. According to plaintiff, the warning communicated by the letter was rescinded 30 August 1991.

In May 1991, plaintiff learned at a nursing staff meeting that SHS planned to use “Fellows,” physicians who were current recipients of a fellowship in a graduate medical education program, as back-up supervision for nurse practitioners in AfterHours. To be approved to practice in North Carolina, nurse practitioners must work continuously under the supervision of a primary supervising physician (PSP). Believing this new policy would directly conflict with 21 N.C.A.C. 32M.0009(5)(a), plaintiff approached Jones and Dr. Cowan with her concerns. Dr. Cowan contacted the Board of Medical Examiners (the Board) to request clarification of the regulation and obtain advice regarding the proposed practice. Dr. Cowan was informed the physicians in question could properly serve as back-up supervisors. This *4 response was consistent with information Dr. Hogan had sought and received from the Board.

Plaintiff’s re-certification with the Board as a nurse practitioner came due in June 1991. Dr. Vukoson, as plaintiffs PSP, was required to sign her application for reapproval to practice, and despite some reluctance, he did so. However, by copy of a letter to the Board dated 18 October 1991, Dr. Vukoson advised plaintiff he intended to withdraw as her PSP effective 1 January 1992. Dr. Vukoson indicated this decision was based on his increasing lack of trust in plaintiff and what he perceived as her lack of respect for his medical license.

In her deposition, Dr. Cowan related that Dr. Vukoson had communicated to her two instances of plaintiffs failure to follow established protocol in treating students. The first concerned a student with a history of suicide, and the second involved a prescription to a student of a drug not in the treatment protocol and allowing that student to leave SHS while “complaining of what could have been a serious reaction with the [drug].” Dr. Cowan also indicated she was aware of a “profound communication difficulty, such a profound difference in perceptions” between plaintiff and Dr. Vukoson.

On 14 November 1991, the UNC-CH Medical Staff (the Staff) passed a resolution (the resolution) under which only physicians serving as full-time employees of the Staff and working in the same section as a physician extender were permitted to serve as the latter’s PSP. This rule in effect prevented any physician other than Dr. Vukoson from acting as plaintiff’s PSP.

As a result of the resolution, plaintiff was unable to maintain the necessary medical credentials for her position and was notified she would be discharged as of 6 May 1992. Plaintiff received a pre-termination hearing 24 April 1992 and appealed through the highest available grievance procedure levels. Ultimately, UNC-CH Chancellor Paul Hardin upheld plaintiffs discharge for failure to maintain credentials.

On 16 November 1993, plaintiff filed the instant action in Orange County Superior Court, alleging slander, violation of her federal constitutional rights and violation of her rights under Article I, §§ 1, 12, 14 and 19 of the North Carolina Constitution. Following removal of the case , by defendants to the United States District Court for the Middle District of North Carolina, defendants moved for summary judgment. In an order filed 6 January 1995, the federal court granted *5 summary judgment on the federal constitutional and slander claims and remanded the state constitutional claims brought against defendants in their official capacities to Orange County Superior Court.

On 14 February 1995, defendants sought summary judgment from the trial court on plaintiffs state constitutional claims, arguing each was barred by res judicata as being “identical in all respects to the federal constitutional claims already adjudicated.” Defendants’ motion was allowed, and plaintiff filed timely notice of appeal.

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Cite This Page — Counsel Stack

Bluebook (online)
510 S.E.2d 170, 132 N.C. App. 1, 14 I.E.R. Cas. (BNA) 1261, 1999 N.C. App. LEXIS 1, Counsel Stack Legal Research, https://law.counselstack.com/opinion/evans-v-cowan-ncctapp-1999.