Vishal Nemarugommula, M.D. v. VHS San Antonio Partners, LLC, Baptist Medical Center, Sowjanya Mohan, M.D., Dimple Butler, M.D., Kimberly Mallery, M.D., and Physician Services, LLC

CourtTexas Court of Appeals, 4th District (San Antonio)
DecidedMarch 18, 2026
Docket04-25-00534-CV
StatusPublished

This text of Vishal Nemarugommula, M.D. v. VHS San Antonio Partners, LLC, Baptist Medical Center, Sowjanya Mohan, M.D., Dimple Butler, M.D., Kimberly Mallery, M.D., and Physician Services, LLC (Vishal Nemarugommula, M.D. v. VHS San Antonio Partners, LLC, Baptist Medical Center, Sowjanya Mohan, M.D., Dimple Butler, M.D., Kimberly Mallery, M.D., and Physician Services, LLC) is published on Counsel Stack Legal Research, covering Texas Court of Appeals, 4th District (San Antonio) primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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Vishal Nemarugommula, M.D. v. VHS San Antonio Partners, LLC, Baptist Medical Center, Sowjanya Mohan, M.D., Dimple Butler, M.D., Kimberly Mallery, M.D., and Physician Services, LLC, (Tex. Ct. App. 2026).

Opinion

Fourth Court of Appeals San Antonio, Texas MEMORANDUM OPINION

No. 04-25-00534-CV

Vishal NEMARUGOMMULA, M.D., Appellant

v.

VHS SAN ANTONIO PARTNERS, LLC, Baptist Medical Center, Sowjanya Mohan, M.D., Dimple Butler, M.D., Kimberly Mallery, M.D., and Physician Services, LLC, Appellees

From the 73rd Judicial District Court, Bexar County, Texas Trial Court No. 2025-CI-15896 Honorable Antonia Arteaga, Judge Presiding

Opinion by: Lori Massey Brissette, Justice

Sitting: Irene Rios, Justice Lori Massey Brissette, Justice H. Todd McCray, Justice

Delivered and Filed: March 18, 2026

AFFIRMED

In this appeal, appellant, Vishal Nemarugommula, M.D. (“Dr. Vishal”), challenges the trial

court’s failure to grant him a temporary injunction, during his pending lawsuit, that would enjoin

appellee VHS San Antonio Partners, LLC d/b/a/ Baptist Medical Center (“Baptist”) from reporting

its suspension of his privileges for forty-five days to the Texas Medical Board (“TMB”) and the

National Practitioner Data Bank (“NPDB”). Dr. Vishal argues the trial court abused its discretion 04-25-00534-CV

in denying his injunction because: (1) Baptist is not immune from suit or injunctive relief; (2) he

demonstrated he had a probable, imminent, and irreparable injury; (3) he put forth some evidence

tending to sustain his causes of action; and (4) his claims are not barred by the statute of limitations.

Based upon our review of the law and the record, we affirm the trial court’s judgment.

BACKGROUND

This lawsuit stems from a peer review of Dr. Vishal that resulted in his hospitalist privileges

being revoked by Baptist. Dr. Vishal, a physician, owned and managed Alamo Physician Services,

PLLC—a hospitalist group. He alleges hospitalists affiliated with Alamo’s alleged competitor,

Envision Physician Services, LLC (“Envision”), mistakenly believed he was poaching their

patients, and used the peer-review process to eliminate him as a competitor.

Baptist’s Medical Executive Board (“MEB”) conducted the peer review of Dr. Vishal over

the course of two years. Dr. Vishal alleges the MEB’s peer review was a sham “orchestrated” by

Baptist’s Chief Medical Officer—a hospitalist and former director at Envision—along with two

other members of the MEB—who he alleges were also employees and directors at Envision—who

initially voted to summarily suspend and then permanently revoke his privileges. On June 15,

2023, the MEB summarily suspended Dr. Vishal’s privileges due to its purported concerns

surrounding appropriate consultation and assignment of patients, comprehensive documentation,

and quality of patient care.

On June 27, 2023, the MEB reviewed Dr. Vishal’s conduct, relying on Midas reports 1 and

a prior Methodist Hospital NPDB report, among other things. The following day, the MEB

1 Midas is an event reporting system that plays an important role in maintaining quality patient care at Baptist by helping hospitals track, analyze, and mitigate clinical events, medication errors, and operational performance to ensure regulatory compliance.

-2- 04-25-00534-CV

recommended the permanent revocation of Dr. Vishal’s clinical privileges and membership in

Baptist, effective immediately. 2 Two MEB members were Envision directors. 3

Dr. Vishal then demanded a “fair hearing” in accordance with the bylaws, and a hearing

was held in October 2024 before a fair-hearing panel. 4 During the interim period, Baptist allegedly

raised entirely new allegations of improper chart access under HIPAA through its outside counsel.

During the hearing, Dr. Vishal was required to prove MEB’s recommendations were not supported

by a preponderance of the evidence and were arbitrary, capricious, or in violation of Baptist’s

bylaws. The panel ultimately found the MEB’s recommendation unsupported and suspended Dr.

Vishal for forty-five days.

The panel’s findings of fact specifically provided, among other things:

• Dr. Vishal accessed multiple patient records with no evidence that access was appropriate.

• Baptist had no clear written policy addressing physician record access and failed to provide appropriate training to Dr. Vishal.

• The MEB did not consider improper record access prior to revoking Dr. Vishal’s privileges.

• Baptist had no clear written policy for patient referrals from the ER to hospitalists and failed to maintain a current accurate listing of primary care referral relationships.

• Baptist received multiple reports of Dr. Vishal failing to appropriately perform his patient rounds when requested by Baptist staff.

• Baptist had long-standing IT issues with physician communication with Dr. Vishal unresolved prior to his suspension, which contributed to his perceived lack of availability.

• There was “no evidence” to indicate “the presence of at least two direct competitors” on the MEB discussing the recommendation to suspend Dr. Vishal as having impacted his due

2 Dr. Vishal was unable to return to practice at Baptist until June 30, 2025. 3 Dr. Vishal also alleges the process was not anonymous because he was actually named in the documentation before the MEB, and there was enough detail about his business that it was not anonymous. 4 While awaiting a fair hearing, Alamo collapsed as a going concern, and Dr. Vishal returned to outpatient family medicine. He alleges he suffered reputational harm, mental anguish, loss of income of approximately $3.4 million per year, and significant financial strain.

-3- 04-25-00534-CV

process rights, but it was nevertheless “inappropriate and may have influenced” the MEB’s recommendation.

The panel also found: Dr. Vishal “met his burden of proof in showing revocation of his medical

privileges was not an appropriate remedy in this instance and is not supported by the weight of the

evidence.”

The fair-hearing panel recommended: (1) Dr. Vishal be returned to the medical staff;

(2) that a revision be filed with the NPDB reflecting that, following a fair hearing, his prior

privileges were reinstated noting that he was suspended from the medical staff for a period of forty-

five days; and (3) he be required to participate in additional education as approved by the medical

staff in the areas of HIPAA compliance and patient medical record privacy. The panel explained

suspension was “appropriate” because Dr. Vishal should have known accessing multiple medical

records when he was not the attending nor the consulting physician was “extremely problematic.”

As the panel explained: When Dr. Vishal accessed “medical records and delet[ed] his reason for

access, [he] revealed a lack of judgment and an indifference to patient privacy and the security of

medical records.” He “should have sought guidance from [Baptist’s] senior leadership and

received clear direction before accessing records in the volume he was accessing [them].” The

panel also noted, however, that (1) there was “no collegial intervention” with Dr. Vishal by anyone

at Baptist, (2) no evidence to show Baptist considered the access issue to be a breach “since it was

not reported,” (3) no opportunity for him to address the medical record access issues with the

MEB, and (4) Dr. Vishal may have had legitimate and legally appropriate reasons to access a large

number of the records.

The fair-hearing panel decision was affirmed by the governing board on June 30, 2025,

and the forty-five-day suspension thereafter became final and reportable to the NPDB and the

-4- 04-25-00534-CV

TMB.

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Vishal Nemarugommula, M.D. v. VHS San Antonio Partners, LLC, Baptist Medical Center, Sowjanya Mohan, M.D., Dimple Butler, M.D., Kimberly Mallery, M.D., and Physician Services, LLC, Counsel Stack Legal Research, https://law.counselstack.com/opinion/vishal-nemarugommula-md-v-vhs-san-antonio-partners-llc-baptist-txctapp4-2026.