Mares, M.D. v. Miami Valley Hospital

CourtDistrict Court, S.D. Ohio
DecidedMay 2, 2023
Docket3:20-cv-00453
StatusUnknown

This text of Mares, M.D. v. Miami Valley Hospital (Mares, M.D. v. Miami Valley Hospital) is published on Counsel Stack Legal Research, covering District Court, S.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mares, M.D. v. Miami Valley Hospital, (S.D. Ohio 2023).

Opinion

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF OHIO WESTERN DIVISION AT DAYTON

JACQUELYN MARES, M.D.,

Plaintiff, Case No. 3:20-cv-453

vs.

MIAMI VALLEY HOSPITAL, et al., District Judge Michael J. Newman

Defendants. ______________________________________________________________________________

ORDER: (1) GRANTING DEFENDANTS’ MOTIONS FOR SUMMARY JUDGMENT (Doc. Nos. 49, 57); AND (2) TERMINATING THIS CASE ON THE DOCKET ______________________________________________________________________________

This civil case, consisting of federal claims and state law claims between diverse parties, is before the Court on two motions for summary judgment filed by: (1) Defendants Albert F. Painter, Psy.D. (“Dr. Painter”); Theodore Talbot, M.D. (“Dr. Talbot”); Jerome L. Yaklic, M.D. (“Dr. Yaklic”); and Wright State University, d/b/a Boonshoft School of Medicine (“Wright State”) (collectively, “Wright State Defendants”; or, as to the individual doctors, “individual Wright State Defendants”); and (2) Miami Valley Hospital (“MVH”); and Premier Health Partners (“Premier Health”). Doc. Nos. 49, 57. Plaintiff Jacquelyn Mares, M.D. (“Dr. Mares”) filed a response in opposition. Doc. No. 66. The Wright State Defendants, MVH, and Premier Health replied. Doc. Nos. 67, 68. This matter is ripe for review. I. Undisputed Facts A. Wright State’s Residency Program Wright State runs a medical residency program through the Boonshoft School of Medicine (“Boonshoft”), where it educates aspiring obstetricians and gynecologists. See Doc. Nos. 52-9, 54-1. Wright State partners with MVH and Premier Health to employ the residents. Doc. No. 54- 1. Three documents govern a resident’s relationship with Boonshoft: (1) the Resident Program Manual; (2) the Graduate Medical Agreement, which is between Boonshoft and the resident and serves as the resident’s enrollment contract; and (3) an individualized Resident-Fellow Agreement, which serves as the resident’s employment contract with MVH and Premier Health. Doc. Nos.

54-1, 54-23. Boonshoft put together its manual to comply with the Accreditation Council for Graduate Medical Education’s (“Accreditation Council”) program requirements for Obstetrics and Gynecology programs nationwide. See Doc. No. 54-24 at PageID 2117. The Accreditation Council notes, “[g]raduate medical education transforms medical students” into practitioners, while mandating that residency programs follow its requirements to “serve as role models of excellence, compassion, professionalism, and scholarship.” Doc. No. 54-20 at PageID 1884. The Accreditation Council provides that residency “educational programs” should last 48 months and impose evaluations of a resident’s performance “at the end of each rotation[,]” while the residency program director reviews the evaluations “every six months.” Id. at 1914. For those residents who

struggle to meet the program’s requirements, the Accreditation Council advises institutions to develop an “individual remediation plan” to resolve a resident’s deficiencies. Id. When an institution deems it appropriate to dismiss a resident, the Accreditation Council warns that the program directors must “ensure the program’s compliance with the Sponsoring Institution’s policies and procedures for due process when action is taken to suspend or dismiss[.]” Id. Inculcating professionalism is an important part of a residency program, according to the Accreditation Council. See, e.g., id. at PageID 1927. Among other things, a resident “must demonstrate an understanding of their personal role in the . . . provision of patient[] and family- centered care[,]” and the “safety and welfare of the patients entrusted to their care, including the ability to report unsafe conditions and adverse events[.]” Id. at PageID 1928. “[A]ccurate reporting of clinical and educational work hours, patient outcomes, and clinical experience data” are also essential facets of any residency program. Id. Boonshoft’s manual provides several academic and professional standards that its residents

must follow. Doc. No. 54-23 at PageID 2056, 2077. Professionalism is a resident’s core competency, manifested through good behavior. Id. at PageID 2049. Boonshoft requires that “resident[s] must perform all responsibilities . . . competently, efficiently, and maturely.” Id. at PageID 2077. If a resident violates any standard of professionalism, Boonshoft warns that this “constitute[s] sufficient grounds for disciplinary suspension, disciplinary termination, or disciplinary non-renewal of the resident’s appointment.” Id. Wright State’s Resident-Fellow Agreement notes that it, too, requires residents to adhere to the Accreditation Council’s standards. Doc. No. 54-1 at PageID 1826. The Resident-Fellow Agreement is between Wright State (doing business as Boonshoft), the individual resident, and a sponsoring hospital—in this case, MVH. See id. The agreement permits MVH to remove a

resident from its employment if he or she “is terminated” from or “substantially fails to meet any of the general requirements” of his or her residency. Id. at PageID 1828. Additionally, the agreement notes that it “abide[s] by . . . Ohio law[] concerning employment at will[,]” and “either party may terminate this agreement by giving written notice to the other at any time . . . for any reason that does not contradict the . . . due process procedures . . . for residents.” Id. at PageID 1827 (internal quotation marks omitted). To monitor a resident’s progression through the program, Boonshoft faculty regularly provide feedback to residents in informal and formal meetings. Doc. No. 54-23 at PageID 2056. Boonshoft also has a “Clinical Competency Committee” (“Competency Committee”), made up of obstetrics and gynecology faculty members. Doc. No. 54 at PageID 1754, 1804. The Competency Committee meets every six months to evaluate whether a resident is meeting the Accreditation Council’s twenty-four resident education “milestones.” Id. at PageID 1755–56. The Competency Committee cannot dismiss a resident, but it may recommend dismissal to the program director if

the majority of the Competency Committee so recommends. Id. at PageID 1757. To officially dismiss a resident from the program, however, Boonshoft has procedures— which it dubs its “due process procedures” or “Item 504”—that it first must follow. Doc. No. 54- 23 at PageID 2078. Initially, if a resident is not meeting Boonshoft’s academic or professional standards, the program must submit a written notice of intent to take adverse action, like suspension or termination, against the resident no later than 120 days before the end of his or her contract. Id. Next, Item 504 requires the program abide by the following seven1 steps: 1. Five days after receiving the written notice, the resident can request review of Boonshoft’s anticipated action. Id.

2. Sixty days after receiving the resident’s request, Boonshoft must hold a hearing. Id.

3. Boonshoft must compose a review panel for the hearing consisting of three faculty members, “who are knowledgeable of the program’s academic content.” Id. The dean of Boonshoft and MVH’s CEO appoint the members jointly. Id. The resident nominates one member and may submit a list of nominees, from which the dean and MVH’s CEO pick one member. Id. The dean and MVH’s CEO pick the final member. Id.

4. The review’s stated purpose “is to determine if there is substantial evidence” to support the action. Id. The resident may have an attorney as an observer at the hearing, but the attorney may not represent the resident during the hearing. Id. Boonshoft—through its director—can call witnesses (after giving a 15-day advanced notice to the resident) and question the resident and his or her witnesses. Id.

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Mares, M.D. v. Miami Valley Hospital, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mares-md-v-miami-valley-hospital-ohsd-2023.