Maric v. St. Agnes Hospital Corp.

65 F.3d 310
CourtCourt of Appeals for the Second Circuit
DecidedSeptember 13, 1995
DocketNo. 763, Docket 94-7569
StatusPublished
Cited by1 cases

This text of 65 F.3d 310 (Maric v. St. Agnes Hospital Corp.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Second Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Maric v. St. Agnes Hospital Corp., 65 F.3d 310 (2d Cir. 1995).

Opinion

WALKER, Circuit Judge:

Plaintiff Dr. Radoslav Marie, a licensed obstetrician and gynecologist, filed this suit alleging, among other claims, that defendants conspired to deny him hospital privileges in order to prevent him from opening a birthing center that would compete with their practices. He contended that this conduct constituted a violation of the antitrust laws, namely the Sherman Act, 15 U.S.C. § 1, and was thus actionable under the Clayton Act, 15 U.S.C. §§ 15, 26. The United States District Court for the Southern District of New York (Challes L. Brieant, District Judge) granted summary judgment in favor of defendants on the antitrust claim and dismissed the remaining state law claims without prejudice. We affirm.

BACKGROUND

On July 1, 1989, Dr. Marie joined the Northeast Permanente Medical Group, P.C. (“NPMG”), a professional corporation that provides physician services to a health maintenance organization, Kaiser Foundation Health Plan of New York (“Kaiser”). As NPMG and Kaiser required, Marie soon after obtained staff privileges at St. Agnes Hospital (“St. Agnes”).

After several months at St. Agnes, Dr. Marie told the President of St. Agnes, defendant Dr. Robert J. Stanley, that he wanted to open a birthing center that would feature a method of childbirth in which delivery occurred under water, an idea that he had entertained for the better part of ten years. According to Dr. Marie’s complaint, Dr. Stanley promised his cooperation and signed a non-disclosure agreement on behalf of the hospital.

On November 26, 1989, Lori Cherry, a Kaiser subscriber, entered St. Agnes complaining of abdominal pain. She was five months pregnant. After Ms. Cherry lost consciousness, stopped breathing, and had no pulse, Dr. Marie and an internist were summoned. Dr. Marie arrived at the hospital at 11:30 p.m. and examined Ms. Cherry. By that time, she had spontaneously started breathing again and regained blood pressure but remained in a semieomatose state. Dr. Marie concluded that her condition was not related to her pregnancy and, after discussing the case with the internist, left the hospital at approximately 1:00 a.m. Unfortunately, Dr. Marie’s conclusion was wrong. His patient died a few hours later from a rap-toed ectopic tubal pregnancy.

As New York law required, the hospital reported Ms. Cherry’s death to the New York State Department of Health (“DOH”), which initiated an investigation into the incident. In addition, the case was taken up at a number of meetings of various hospital committees at St. Agnes, including the Executive Committee, the Emergency Department, the Morbidity and Mortality Committee, the Medical Board, the Board of Trustees Quality Assurance Committee, and the Medical Peer Review Committee. On December 20, 1989, the Medical Peer Review Committee referred the matter to the Obstetrics and Gynecology Department, which held a peer review meeting on February 13, 1990. The Department concluded that Dr. Marie’s management of the case was deficient principally because he failed to order certain tests, neglected to obtain a surgical consultation, and left the patient before a diagnosis was reached.

On March 22, 1990, Dr. du Vigneaud, the Director of the Department of Obstetrics and Gynecology and a defendant, presented the peer review’s findings to the Board of Trustees Quality Assurance Committee. He recommended that Dr. Marie be informed that his cases would be monitored by the Obstetrics and Gynecology Department until further notice. The Quality Assurance Committee, concerned that these corrective measures might be inadequate in light of the seriousness of the case, ordered further review of the matter before recommending corrective action to the Board of Trustees.

In early April, 1990, while the foregoing review was underway, Dr. Marie informed Dr. du Vigneaud that he intended to purchase an existing obstetrics and gynecology practice to use as his birthing center. Under New York law, such a center must have [312]*312procedures to transfer a patient to a hospital no more than twenty minutes away in case of complications. 10 NYCRR § 754.2(e). New York law also requires the director of such a center to have either obstetrical privileges at the hospital or a formal agreement with the hospital for the provision of necessary care. 10 NYCRR § 754.5(a)(l)-(2).

Meanwhile, following meetings on April 11 and 19 at which Ms. Cherry’s death was discussed, the Quality Assurance Committee recommended that the hospital monitor Dr. Marie’s and the internist’s cases for a period of six months, and on April 24 the hospital sent Dr. Marie a letter to that effect. On May 4, less than two weeks later, another incident occurred that called plaintiffs professional judgment into question. A woman who was approximately twelve weeks pregnant was admitted to the hospital exhibiting signs of a possible miscarriage. Although both the duty nurse and the patient’s husband called Dr. Marie repeatedly, he refused to come to the hospital. He claimed that he had been summoned by the woman earlier and had waited at the hospital for her but she had not shown up, and that in any event he was not needed.

On May 10, the State Department of Health cited St. Agnes for its treatment of Ms. Cherry. The deficiencies included Dr. Marie’s failure to order certain tests and his decision to leave the hospital despite the patient’s rapidly deteriorating condition. Faced with this assessment of the earlier incident and Dr. Marie’s behavior on May 4, the Board of Trustees summarily suspended plaintiffs hospital privileges on May 17,1990. NPMG then terminated him for failure to maintain staff privileges at St. Agnes.

Thereafter, Dr. Marie requested, pursuant to the hospital’s by-laws, that an ad hoc committee be formed to review his suspension. The committee, comprised of Drs. du Vigneaud, Donald Cohen, and Michael Pa-nio — all defendants in this action — interviewed Dr. Marie and examined the facts of the case before reaching an independent conclusion that summary suspension was appropriate. Dr. Marie then asked for and was given permission to present his case at an upcoming Medical Board meeting. The Board, after hearing Dr. Marie, recommended that the suspension be rescinded and that he instead be put on probation for one year, conduct all work under strict supervision, and receive a letter of reprimand. The Board of Trustees accepted this recommendation.

Dr. Marie filed suit in December of 1993. He alleged that the restrictions placed on him by the hospital forced him to abandon his plans for a birthing center, and that the hospital, its administrators, and the various doctors serving in its departments and on its committees had conspired to restrict his staff privileges, thus constituting a group boycott in violation of the Sherman Act and actionable under the Clayton Act. He also pressed a state law claim for intentional interference with contract and prospective contractual relations. On May 11, 1994, the district court granted the defendants summary judgment on plaintiffs antitrust claims and dismissed the state law claim without prejudice. Plaintiff appeals.

DISCUSSION

As the foregoing recitation of facts makes clear, the hospital, faced with what was at the least questionable conduct on the part of Dr.

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Maric v. St. Agnes Hospital Corp.
65 F.3d 310 (Second Circuit, 1995)

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