University Hospitals of Cleveland, Inc. v. Lynch

96 Ohio St. 3d 118
CourtOhio Supreme Court
DecidedAugust 7, 2002
DocketNo. 2001-0081
StatusPublished
Cited by60 cases

This text of 96 Ohio St. 3d 118 (University Hospitals of Cleveland, Inc. v. Lynch) is published on Counsel Stack Legal Research, covering Ohio Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
University Hospitals of Cleveland, Inc. v. Lynch, 96 Ohio St. 3d 118 (Ohio 2002).

Opinions

Moyer, C.J.

{¶ 1} This cause involves entities that are parts of an academic medical center at which medical students and physicians are trained, research is conducted, and patients are provided care. Appellee and cross-appellant University Hospitals of Cleveland, Inc. (“the hospital”), operates in conjunction with the Case Western Reserve University School of Medicine and numerous clinical practice plans to form the Academic Medical Center at Case Western Reserve (“the medical center”). Appellant and cross-appellee University Dermatologists, Inc. (“UDI”), was a medical practice operating in conjunction with the departments of dermatology of both the hospital and the medical school from 1979, the time of UDI’s incorporation, until 1998.

{¶ 2} The hospital and the director of its dermatology department, appellee and cross-appellant Kevin D. Cooper, M.D., initiated this action, contending that they are legally entitled to control and manage UDI under various theories, e.g., resulting trust, constructive trust, quantum meruit, and breach of contract. This case also presents the question whether the parties’ failure to serve appellee, Attorney General Betty D. Montgomery, with notice of the action rendered the trial court’s judgment voidable at the request of the Attorney General pursuant to R.C. 109.25.

I

Factual Background

A

The Original Action

{¶ 3} The term “practice plan” as used herein refers to an entity, sometimes incorporated, that is analogous to a private physician’s professional practice. At the medical center, each practice plan corresponds to an academic department of the medical school, e.g., urology, cardiology, etc. The medical school requires that its full-time faculty members treat patients solely through a designated practice plan. Patients, or their insurers, pay the practice plans rather than the individual treating physicians. The practice plans thereby generate significant revenues that are used to cover the expenses of the practice plan, e.g., salaries, rent, equipment, etc. A portion of the net income generated by each practice [120]*120plan is channeled to the hospital and medical school. The practice plans provide the medical school with comprehensive financial reporting on a regular basis. Moreover, the salaries of physician faculty members are set by the chair of the corresponding medical school department in consultation with the dean of the medical school, although the salaries are paid to the physicians by their practice plan.

{¶ 4} These practices are consistent with a document created in 1978 by the medical school entitled “Policies Governing Professional Practice Income of Full Time Faculty Members at Case Western Reserve University” (“policies statement”). The policies statement sets forth the responsibilities each department chair and all full-time faculty members have to the dean with respect to the operation of practice plans at the medical school.

{¶ 5} Historically, it was not uncommon for an individual to simultaneously hold the three positions of chair of a medical school department, director of the corresponding hospital department, and director of the corresponding practice plan. One witness described the relationship of the practice plans, the hospital, and the medical school as “almost symbiotic.” As a result, the same person often found it difficult to separate his actions according to these theoretically separate roles.

{¶ 6} In 1977, the medical school appointed David Bickers, M.D., to head its division of dermatology, which at that time was part of the medical school’s department of medicine. At Bickers’s urging, the division of dermatology was elevated to the status of department, and, in 1979, Bickers was appointed chair of the department of dermatology at the medical school. He thereafter concurrently served as director of the department of dermatology of the hospital.

{¶ 7} In August 1979, after conferring with legal counsel, Bickers formed UDI by incorporating it as a for-profit corporation, pursuant to R.C. Chapters 1785 and 1701. Ohio law requires that the stock of a corporation formed pursuant to R.C. Chapter 1785 be held only by a licensed professional, in the case of UDI, by a medical doctor. R.C. 1785.02, 1785.05, and 1785.07. Bickers obtained a personal bank loan of approximately $35,000 to equip and open UDI’s first clinic office.

{¶ 8} When he incorporated UDI, Bickers was aware that practice plans varied from medical center to medical center, as well as within medical centers. He knew of a university where faculty members functioned independently, in individual private practices, and provided only minimal financial support to the university.

{¶ 9} Bickers, in contrast, had a twofold purpose in incorporating UDI: he wanted to create a practice plan that would support the academic mission of the medical school, but he also wanted to “protect [him]self in terms of potential [121]*121future incursions on the practice organization by the institution,” and thereby afford himself “some degree of protection or fall back” should “some unforeseen events occur that would threaten [his] livelihood and [his] ability to practice.” In other words, he envisioned a for-profit corporation with himself as the sole shareholder so that he could leave the medical center and take the practice with him if the institution “decided that it wished to diminish or co-opt resources from” the practice plan.

{¶ 10} In May 1980, in order to implement his plan that UDI would financially benefit the medical school, Bickers submitted a draft agreement to the dean of the medical school, proposing a formula for calculating the portion of UDI income to be given to the medical school. Bickers subsequently met with Richard Behrman, M.D., who was to become dean in July 1980, to discuss the proposal.

{¶ 11} During the meeting, the two doctors discussed numerous issues concerning UDI’s relationship with the hospital and the medical school, including the ownership of UDI should Bickers end his employment with the medical school. Behrman proposed that in such a circumstance, Bickers would transfer the stock of UDI to the dean of the medical school, for ultimate transfer to Bickers’s successor to the chair of the department of dermatology. Behrman testified that Bickers never rejected this proposal, nor indicated that he would not transfer UDI stock to the medical school should he decide to leave. In fact, Behrman believed that Bickers orally agreed to this proposal at that meeting. On the other hand, Bickers recalled that he had specifically rejected the dean’s suggestion that the UDI shares should be transferred to the dean if Bickers left the medical school.

{¶ 12} After the meeting, Bickers and Behrman each prepared a draft agreement to govern that contingency, each with a different resolution of the issue. However, no written agreement was ever executed. Nevertheless, UDI began submitting payments to the medical school in accordance with the formula set forth in the original draft agreement submitted by Bickers in May 1980. UDI also began providing annual financial reports to the medical school. Over the years the hospital provided support to UDI, including supplying it with equipment, clinic space, loans, etc.

{¶ 13} In 1981, Bickers recruited appellant and cross-appellee William S. Lynch, M.D., to the medical school to develop the surgical practice within the dermatology department of the medical school.

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Cite This Page — Counsel Stack

Bluebook (online)
96 Ohio St. 3d 118, Counsel Stack Legal Research, https://law.counselstack.com/opinion/university-hospitals-of-cleveland-inc-v-lynch-ohio-2002.