San Angelo Community Medical Center, LLC Regional Employee Assistance Program, Inc. D/B/A Community Medical Associates And Michael S. Blanc, M.D. v. Miltiadis Leon, M.D., and Cardiology Associates of West Texas, P.A.

CourtCourt of Appeals of Texas
DecidedApril 29, 2021
Docket03-19-00229-CV
StatusPublished

This text of San Angelo Community Medical Center, LLC Regional Employee Assistance Program, Inc. D/B/A Community Medical Associates And Michael S. Blanc, M.D. v. Miltiadis Leon, M.D., and Cardiology Associates of West Texas, P.A. (San Angelo Community Medical Center, LLC Regional Employee Assistance Program, Inc. D/B/A Community Medical Associates And Michael S. Blanc, M.D. v. Miltiadis Leon, M.D., and Cardiology Associates of West Texas, P.A.) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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San Angelo Community Medical Center, LLC Regional Employee Assistance Program, Inc. D/B/A Community Medical Associates And Michael S. Blanc, M.D. v. Miltiadis Leon, M.D., and Cardiology Associates of West Texas, P.A., (Tex. Ct. App. 2021).

Opinion

TEXAS COURT OF APPEALS, THIRD DISTRICT, AT AUSTIN

NO. 03-19-00229-CV

San Angelo Community Medical Center, LLC; Regional Employee Assistance Program, Inc. d/b/a Community Medical Associates; and Michael S. Blanc, M.D., Appellants

v.

Miltiadis Leon, M.D.; and Cardiology Associates of West Texas, P.A., Appellees

FROM THE 51ST DISTRICT COURT OF TOM GREEN COUNTY NO. A160176C, THE HONORABLE CHARLES CHAPMAN, JUDGE PRESIDING

MEMORANDUM OPINION

San Angelo Community Medical Center, LLC (SACMC); Regional Employee

Assistance Program, Inc. d/b/a Community Medical Associates (CMA); and Michael S. Blanc,

M.D. appeal from the trial court’s order that partially denied their motion to dismiss under the

Texas Citizens Participation Act (TCPA). See Tex. Civ. Prac. & Rem. Code §§ 27.001–.011.1

For the following reasons, we affirm in part and reverse and remand in part.

Background

Miltiadis Leon, M.D., practices interventional cardiology, and Cardiology

Associates of West Texas, P.A. (CAWT) is Dr. Leon’s professional association. Dr. Leon has

1 References to the TCPA in this opinion are to its provisions as they existed prior to the 2019 amendments. See Act of May 17, 2019, 86th Leg., R.S., ch. 378, §§ 11, 12, 2019 Tex. Gen. Laws 684, 687 (stating that amendments to TCPA apply “only to action filed on or after” September 1, 2019). medical staff privileges at SACMC, an acute care hospital. Dr. Blanc is employed by CMA and

provides interventional cardiology services at SACMC.

Dr. Leon and CAWT sued appellants in May 2016, asserting causes of action

based on theories of restraint of trade, tortious interference with existing contracts, tortious

interference with prospective relations, fraud, promissory estoppel, unjust enrichment, and

piercing the corporate veil. They sought to recover damages and declaratory judgment based on

appellants’ “unlawful, tortious, and anticompetitive conduct” which sought “to severely

diminish, restrain, or completely eliminate Dr. Leon’s independent medical practice from the

pool of competing interventional cardiologists in the San Angelo, Tom Green County, Texas

market.” Dr. Leon’s and CAWT’s factual allegations concerned cross-coverage practices at

SACMC,2 physicians who were hired by Dr. Leon and assisted covering his patients at SACMC

when he was unavailable, and the peer-review process at SACMC and how it had been applied to

the physicians whom Dr. Leon had hired.

As to their request for declaratory relief, Dr. Leon and CAWT sought a

declaration concerning Section 5(a) of SACMC’s rules and regulations that, under that provision,

appellants “have a duty to provide coverage to Plaintiffs’ practice if other non-CMA physicians

associated with Plaintiffs’ practice are excluded by [appellants] under the medical peer review or

credentialing process.” Dr. Leon and CAWT attached to their petition: SACMC medical staff

rules and regulations and bylaws, employment agreements between CAWT and physicians,

letters, and emails.

2 Dr. Leon’s and CAWT’s pleadings allege “[c]ross-coverage is the standard practice whereby physicians agree to accept weekend and after-hour patient calls for each other on a rotating basis and to cover each other’s patients when on vacation or otherwise unavailable.” 2 Appellants filed an answer in June 2016. Dr. Leon and CAWT filed a first

amended petition in February 2017 and a supplemental petition on November 16, 2018. In their

first amended petition, Dr. Leon and CAWT alleged the same facts and asserted the same causes

of action as in their original petition, but they also alleged additional facts, including specific

details about their claims that: (i) appellants had tortiously interfered with contracts between

Dr. Leon and the physicians whom Dr. Leon had hired, (ii) appellants had refused to provide

Dr. Leon cross-coverage to eliminate or severely restrain his interventional cardiology services,

and (iii) appellants had tortiously interfered with prospective relationships “with an associate

interventional cardiologist as well as additional patients.”3 For example, as to their

tortious-interference claim, Dr. Leon and CAWT alleged that “Dr. Blanc continued to harass and

disparage” one of the physicians whom Dr. Leon had hired “until he finally announced his

resignation from Dr. Leon’s practice.” Dr. Leon and CAWT also added specifics about the

referral process from the SACMC emergency room and the requirement of “equal distribution of

patients from the emergency room” and alleged that appellants’ interference of existing and

prospective contracts had caused them “actual damages or loss in the form of lost profits (which

may include [appellants]’ profits resulting from their tortious interference), mental anguish,

and/or injury to reputation.”

In the supplemental petition, Dr. Leon and CAWT asserted the causes of action of

defamation per se and business disparagement and alleged additional facts concerning other

claims asserted in the first amended petition, including their tortious-interference claims. They

3 For example, Dr. Leon and CAWT alleged in the first amended petition that appellants “intentionally interfered with Plaintiffs’ business relationships with a new associate physician or newly acquired patients by subjecting associate physicians to an onerous and arbitrary peer review process and failing to provide Plaintiffs adequate coverage of their interventional cardiology practice.” 3 alleged that appellants’ conduct was interfering with past, current, and future patients and that

Dr. Blanc published a statement that Dr. Leon “brought in interventional cardiologists [who]

were not a competent interventional cardiologist [sic] to treat patients coming to the [SACMC]

emergency room” and conducted a “whisper campaign saying [Dr. Leon’s] associated physicians

should not be allowed to treat interventional cardiology patients at [SACMC].” Dr. Leon and

CAWT alleged additional facts of “abuse” concerning the process of referring patients from the

SACMC emergency room.

On January 15, 2019, appellants filed their motion to dismiss under the TCPA,

seeking dismissal of Dr. Leon’s and CAWT’s defamation and business-disparagement claims in

the supplemental petition and their claims in the first amended petition “that rely upon the new

factual allegations” in the supplemental petition. Appellants supported their motion with

attachments, including Dr. Blanc’s affidavit, copies of the SACMC medical staff bylaws and

rules and regulations, and correspondence, including a November 11, 2011, letter from Dr. Blanc

informing Dr. Leon that CMA cardiologists would no longer be able to provide coverage for the

CAWT practice because of “significant and growing concerns regarding [a CAWT physician]’s

practice patterns and professional integrity.”4

Dr. Leon and CAWT filed a response to the motion to dismiss. They argued that

appellants’ motion was not filed timely except as to Dr. Leon’s and CAWT’s defamation and

business-disparagement claims. See Tex. Civ. Prac. & Rem. Code § 27.003(b) (requiring motion

to dismiss to be filed not later than 60th day after date of service of “legal action”). Dr. Leon and

CAWT further argued that their other causes of action should not be dismissed because they

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San Angelo Community Medical Center, LLC Regional Employee Assistance Program, Inc. D/B/A Community Medical Associates And Michael S. Blanc, M.D. v. Miltiadis Leon, M.D., and Cardiology Associates of West Texas, P.A., Counsel Stack Legal Research, https://law.counselstack.com/opinion/san-angelo-community-medical-center-llc-regional-employee-assistance-texapp-2021.