John T. Carpenter, Jr. v. The University of Alabama Health Services Foundation PC

Court of Appeals for the Eleventh Circuit·Decided May 10, 2019·No. 18-11433·Unpublished

Opinion

[DO NOT PUBLISH]

IN THE UNITED STATES COURT OF APPEALS

FOR THE ELEVENTH CIRCUIT

No. 18-11433

Non-Argument Calendar

D.C. Docket No. 2:15-cv-01812-RDP

JOHN T. CARPENTER, JR., Plaintiff-Appellant,

versus

THE UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION PC, a domestic professional non-profit corporation,

Defendant-Appellee.

Appeal from the United States District Court for the Northern District of Alabama

(May 10, 2019)

Before JILL PRYOR, BRANCH and JULIE CARNES, Circuit Judges. PER CURIAM:

Dr. John Carpenter, Jr., a physician who previously held a staff position with the University of Alabama Health Services Foundation (“UAHSF”) and a tenured faculty position at University of Alabama at Birmingham’s (“UAB”) School of Medicine, brought a § 1983 claim against UAHSF, alleging a violation of his property interest in continued employment in both positions when he was wrongfully discharged without a pre-termination hearing. The district court granted summary judgment to UAHSF, concluding that Carpenter failed to create a genuine issue of material fact regarding whether he voluntarily resigned from his position. We agree because, even viewing the evidence in the light most favorable to Carpenter, his resignation was voluntary. He thus was not deprived of any protected interest in his employment within the meaning of the Due Process Clause. We affirm the district court.

I. FACTUAL BACKGROUND Carpenter worked as a professor at the UAB School of Medicine for approximately 40 years. For most of this time, he was a tenured faculty member. Besides serving as a UAB faculty member, he practiced medicine as an employee of UAHSF.1 He worked as an oncologist specializing in breast cancer.

1 UAHSF is a non-profit corporation through which all UAB medical care is provided.

UAB faculty members, like Carpenter, also have employment contracts with UAHSF to provide health care services at UAB-affiliated hospitals and clinics.

This case arises out of Carpenter’s treatment of a patient with breast cancer.

Carpenter treated the patient with hormone therapy for approximately two years before the patient began chemotherapy. According to Carpenter, he delayed treating the patient with chemotherapy because she was depressed and did not want to begin that treatment. While the patient continued on hormone therapy, Carpenter also prescribed her an antidepressant drug. When the patient told Carpenter she was ready, he had her begin chemotherapy.

After the patient began chemotherapy, she was seen by Dr. Jennifer De Los Santos, a UAB radiation oncologist. De Los Santos was concerned that Carpenter had treated the patient with only hormone therapy for such a long period while her breast cancer was progressing. De Los Santos reported Carpenter to UAHSF’s risk management committee for inappropriate care of a patient. De Los Santos also called Dr. Boris Pasche, Carpenter’s supervisor, with her concerns. De Los Santos told Pasche that Carpenter’s treatment of the patient was “egregious,” “outside of guideline[s], and “high risk.” Doc. 40-5 at 9. 2 Pasche relayed De Los Santos’s concerns to Dr. Robert Bourge, the vice chair of clinical affairs in UAB’s Department of Medicine. Bourge also discussed Carpenter’s treatment of the patient with the risk management committee and with Dr. Seth Landefeld, the chair of UAB’s Department of Medicine.

2 Citations in the form “Doc. #” refer to numbered entries on the district court’s docket.

Later that day, Pasche’s secretary told Carpenter that once he finished seeing patients, he needed to go see Pasche. Carpenter had no advance warning about the purpose of the meeting. When Carpenter arrived to see Pasche, Pasche escorted him to Landefeld’s office. Carpenter then met with Bourge, Pasche, and other department administrative personnel. Pasche told Carpenter about De Los Santos’s complaint. Pasche indicated that he had discussed the matter with the risk management committee and determined that the patient had been treated too long with preoperative treatment and that the case had not been managed according to guidelines set forth in current medical research. Pasche said he had told the committee that he thought Carpenter “had no clinical judgment, and that if anybody came to see [Carpenter] on a given day, that . . . there was absolutely no way to predict what advice [Carpenter] might give them.” Doc. 40-4 at 16. Pasche then told Carpenter that the risk management committee had concluded that such a doctor could not practice at UAB. Pasche told Carpenter that he would have to resign. During the meeting, Carpenter had no opportunity to respond to the accusations.

After Pasche stated that Carpenter should resign, Bourge explained to Carpenter that there was an alternative to resigning, which was that he could have a hearing. Bourge provided no information about the procedures for the hearing, but Carpenter understood that the hearing would review the appropriateness of the

patient’s treatment. Bourge warned Carpenter that the outcome of the hearing would be reported to the National Practitioner Database and that Bourge had prevailed in every hearing in which he had participated.

At the meeting, Carpenter was not asked to decide whether he would resign.

He also was not given a deadline when he had to make his decision. Carpenter was told that his patients would be reassigned to other physicians, although he would be permitted to complete his patient notes. Carpenter felt overwhelmed and intimidated during the meeting.

After the meeting ended, Pasche and Carpenter talked for a few more minutes. Pasche told Carpenter that “he felt it would not be possible to get the [risk management] committee to reconsider its decision” and that it would not be possible for Carpenter to continue to practice at UAB given the information Pasche had told the risk management committee. Doc. 40-4 at 19. Pasche suggested that Carpenter potentially could continue teaching and research in a voluntary, unpaid faculty position.

After the meeting, Carpenter believed that even if he pursued a formal hearing, he would not be reinstated. He also understood that if there was an adverse result at the hearing, it would be reported to the National Practitioner Database. Carpenter knew that if a termination was reported to the National

Practitioner Database, it would become public knowledge and would make it more difficult for him to be hired in the future.

Carpenter then returned to the clinic and told his nurse that he was going to have to resign. He went home and reported to his wife that he was going to have to resign because, based on what he had been told at the meeting, there was no chance that he could prevail at the hearing. The next day Carpenter weighed his options of resigning or pursuing a hearing. He discussed the situation with one or two friends but did not consult an attorney or speak with anyone at UAB. Carpenter also did not review the UAB faculty handbook, which set forth the procedures that would have governed the hearing.

The following day—two days after the initial meeting—Carpenter and Pasche met for about 20 minutes. Pasche again told Carpenter “he thought there was no possibility of reconsideration or reversal of the committee’s decision and that he thought there was zero chance that [Carpenter] could ever practice again at UAB no matter what.” Doc. 40-4 at 23. Pasche then provided Carpenter with a pre-prepared resignation later, which Carpenter signed.

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John T. Carpenter, Jr. v. The University of Alabama Health Services Foundation PC, (11th Cir. 2019).

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