Lohrmann v. Iredell Memorial Hospital Inc.

620 S.E.2d 258, 174 N.C. App. 63, 2005 N.C. App. LEXIS 2287
CourtCourt of Appeals of North Carolina
DecidedOctober 18, 2005
DocketCOA04-1373
StatusPublished
Cited by16 cases

This text of 620 S.E.2d 258 (Lohrmann v. Iredell Memorial Hospital Inc.) 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
Lohrmann v. Iredell Memorial Hospital Inc., 620 S.E.2d 258, 174 N.C. App. 63, 2005 N.C. App. LEXIS 2287 (N.C. Ct. App. 2005).

Opinion

McGEE, Judge.

Wolfgang Lohrmann, M.D. (Dr. Lohrmann) filed suit against Iredell Memorial Hospital, Incorporated (Memorial Hospital) when Memorial Hospital’s governing body suspended Dr. Lohrmann’s medical staff privileges in early 2003. Dr. Lohrmann alleged breach of contract, failure to comply with N.C. Gen. Stat. § 131E-85, and violation of his rights to substantive and procedural due process of law.

Dr. Lohrmann was a medical doctor practicing in Iredell County in the speciality of nephrology, dealing with diseases of the kidney. Memorial Hospital was a nonprofit organization located in Statesville, *66 North Carolina, licensed to conduct business as a hospital for the general public. Dr. Lohrmann was a member of the medical staff at Memorial Hospital and exercised medical staff privileges in nephrol-ogy. Memorial Hospital’s corporate bylaws and medical staff bylaws permitted Memorial Hospital to take corrective action against members of its medical staff. The bylaws stated that corrective action could include suspension of medical staff privileges.

In February and March 2002, Dr. Lohrmann provided care and treatment to Ms. S and Mr. W, two Memorial Hospital patients. Ms. S was an eighty-year-old patient admitted to Memorial Hospital on 14 February 2002, with a diagnosis of gangrene of the left foot. Mr. W was a seventy-five-year-old patient who was admitted through Memorial Hospital’s emergency room on 16 March 2002, with shortness of breath and low blood pressure. Both patients later died while being treated at Memorial Hospital.

At a meeting of Memorial Hospital’s Medical Executive Committee (Executive Committee) on 22 April 2002, Arnold Nunnery, Chief Executive Officer (CEO) of Memorial Hospital, presented handwritten complaints by Nurse Traci Jenkins and Nurse Gail Roberts regarding Dr. Lohrmann’s care of Ms. S and Mr. W. Nurse Jenkins, who was also the granddaughter of Ms. S, reported that Dr. Lohrmann made arrangements for a surgical consultation to amputate Ms. S’s leg, despite Ms. S’s living will and despite discussion with family members that Ms. S’s leg should not be amputated. Nurse Jenkins also reported that Dr. Lohrmann was unwilling to speak with Ms. S and confirm Ms. S’s consent to the amputation in the presence of Nurse Jenkins.

Nurse Roberts reported concerns about Dr. Lohrmann’s changes to Mr. W’s code status, the set of instructions for medical personnel should Mr. W. experience cardiac arrest or respiratory failure. Nurse Roberts reported that Dr. Lohrmann changed Mr. W’s code status twice without discussing the changes with Mr. W’s primary physician and that Dr. Lohrmann’s instructions were too confusing for the nurses to follow.

After reviewing the written complaints of Nurse Jenkins and Nurse Roberts, the Executive Committee authorized a review of both cases by an outside physician. The two cases were reviewed by Dr. Ronald Falk (Dr. Falk), Chief of the Division of Nephrology & Hypertension at the UNC School of Medicine. Dr. Falk submitted his report to the CEO of Memorial Hospital in a letter dated 5 July 2002. The Executive Committee reviewed Dr. Falk’s report on 26 August *67 2002 and, in accordance with the medical staff bylaws, decided that the Chair of the Department of Medicine at Memorial Hospital would discuss voluntary suspension with Dr. Lohrmann. Dr. Lohrmann refused the Chair’s suggested thirty-one-day suspension. Thereafter, in accordance with the medical staff bylaws, a departmental ad hoc investigating committee (the investigating committee) was appointed to consider the accusations against Dr. Lohrmann. Memorial Hospital’s CEO informed Dr. Lohrmann of the appointment of the investigating committee in a letter dated 28 August 2002.

The CEO and Byron E. Dunaway, M.D., president of the medical staff of Memorial Hospital, provided Dr. Lohrmann with a statement of the charges against Dr. Lohrmann in a letter dated 18 September 2002. The letter stated that the Executive Committee had reviewed Dr. Falk’s report and had concluded that Dr. Lohrmann’s performance in treating Ms. S and Mr. W was “lower than the standards of [Memorial Hospital’s] Medical Staff[.]” The letter detailed the following specific conduct that the Executive Committee stated failed to meet medical staff standards: (1) violation of Ms. S’s rights “by not honoring [her] wishes as discussed in her Living Will and as per her family’s wishes”; and (2) violation of Mr. W’s rights “in relation to whether or not he should be resuscitated as provided by physician’s order . . . [which] was written on the basis of prior discussion with [Mr. W] and [his] family.”

The investigating committee interviewed a number of individuals, including Dr. Lohrmann, between 20 and 23 September 2002. The written summary of the investigating committee indicated the issues concerning Dr. Lohrmann were patient rights, as well as “communication with the patient/family/nursing/consulting physician attending.” The investigating committee made the following pertinent findings: (1) there was poor communication and handling of disagreements with family members; and (2) it was not clear from the record that Mr. W’s code status had been discussed with the attending physician prior to the change made by Dr. Lohrmann.

The Executive Committee met on 23 September 2002 to review the investigating committee’s summary. Pursuant to medical staff bylaws, Dr. Lohrmann and his attorney were present for the meeting of the Executive Committee and were permitted to make statements and answer questions. After the Executive Committee met with Dr. Lohrmann and considered the investigating committee’s summary, the Executive Committee voted to suspend Dr. Lohrmann *68 for seven days and to require him to complete a patient-oriented medical ethics course.

Pursuant to Article VII, Section 2 of the medical staff bylaws, the CEO notified Dr. Lohrmann of the Executive Committee’s recommendation in a letter dated 24 September 2002. The letter stated:

The reason for the adverse recommendation by [the Executive Committee] is that your actions taken in managing the professional services for the patients [Ms. S and Mr. W] were below the acceptable standards for members of the Medical Staff. Your determination that [Ms. S] was capable of consenting for the amputation of a limb was inconsistent with her medical condition and her Living Will; also it required close coordination with involved family members and physicians, which did not effectively occur. Your alteration of the DNR status of [Mr. W] without first obtaining the concurrence of the primary physician was inappropriate, and you entered an inappropriate order to effect the change.

Pursuant to Article VI, Section 1(f) of the medical staff bylaws, the Executive Committee’s recommendation for suspension entitled Dr. Lohrmann to exercise procedural rights to a hearing before a panel of medical staff members appointed by the president of the medical staff. Dr. Lohrmann made a timely request for a hearing before a panel (the panel) which was granted. At the panel’s hearing on 13 and 14 January 2003, Dr. Lohrmann was present and represented by counsel who called, examined, and cross-examined witnesses. The panel prepared a written report dated 18 February 2003 in which it concluded that a corrective action by the Executive Committee was an appropriate response to Dr.

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Cite This Page — Counsel Stack

Bluebook (online)
620 S.E.2d 258, 174 N.C. App. 63, 2005 N.C. App. LEXIS 2287, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lohrmann-v-iredell-memorial-hospital-inc-ncctapp-2005.