• Montana Supreme Court Affirms Injunction against Hospital Suspension of Physician Who Denied It Access to His Family’s Private Medical Records
  • December 11, 2009
  • Law Firm: Holland & Hart LLP - Denver Office
  • The Montana Supreme Court affirmed the issuance of a preliminary injunction restraining Community Medical Center, a hospital in Missoula, Montana for suspending the medical staff privileges of a hospitalist whose only offense was to refuse to grant unrestricted access to his family’s medical records to a hospital subcommittee. The physician designated as “Dr. Doe,” in the case of John Doe, M.D. v. Community Medical Center, Inc., DA08-0397, decided on November 24, 2009, asserted that that Community Medical Center  (“CMC”) breached the terms of its contract with him embodied in CMC’s medical staff bylaws and policies by summarily suspending his privileges with no demonstration of “ a substantial likelihood of imminent impairment of the health or safety of any patient, perspective patient, employee or other person present in the medical center” -the sole designated basis for summary suspension at CMC.

    Dr. Doe’s children had been diagnosed earlier with a rare, life threatening condition involving panhypotuitarism. During 2007 and 2008, Dr. Doe ordered numerous outpatient laboratory tests and imaging studies for himself, his wife and his children. CMC confronted Dr. Doe expressing concern that such testing may constitute unethical medical treatment of his family members. The Chief of the Medical Staff of CMC, Dr. Hiller, asked for an investigation by the Medical/Allied Health Staff Assistance Committee, a committee organized primarily for dealing with serious behavioral  issues like drug or alcohol addiction and was not a designated “peer review” committee.

    The Committee obtained outpatient medical records of Dr. Doe and family from CMC and from another hospital, St. Patrick’s Hospital, without Dr. Doe’s knowledge or consent. The committee asked Dr. Doe to disclose the names of all physicians treating each member of his family and to authorize direct access to them by the committee. When Dr. Doe refused to comply at a committee meeting, Dr. Hiller suspended him because;

    [H]is demeanor and refusal or inability to coherently answer routine and legitimate questions regarding the volume and nature of the tests caused me to have serious and legitimate concerns regarding his mental health and ability to exercise good judgment.

    “Good judgment” being in the eye of the superior beholder, the Supreme Court sided with the trial court in favor of Dr. Doe.

    The very crux of Dr. Doe’s complaint in the District Court was the complete absence of any evidence or even suggestion by the MEC that Dr. Doe’s conduct had placed the health or safety of any patient or other person in the Medical Center in jeopardy; therefore he alleged that there were no facts justifying nor was there a legal basis for summarily suspending his privileges. This being so, the suspension and ensuing proposed peer review were outside the parameters of the Bylaws, and as such constituted a breach of contract . . . .

    The court rejected CMC’s arguments that Dr. Doe was required to first exhaust his administrative remedies before going to court, that the state law was implicitly pre-empted by the Healthcare Quality Improvement Act of 1986 and that the injunction was an unwarranted interference with the police powers and duties of the Montana Board of Medical Examiners. It also rejected CMC’s argument that any harm to Dr. Doe’s reputation from CMC’s federally required report of any suspension lasting more than 30 days to the National Practitioner Data Bank could be dispelled by a later filing of a voiding report in the event Dr. Doe does prevail in a post suspension hearing (“[T]he fact is that a ringing bell cannot be unrung.”].

    The court noted that there was credible testimony in the transcript that Dr. Doe is an “excellent physician,” who exhibited no behavior that would suggest that he was incapable, incompetent, or not qualified” to practices as a hospitalist at CMC and that CMC demonstrated no specific behavioral issue other than his refusal to provide private medical information regarding his children and his refusal to sign a blanket waiver of confidentiality. While acknowledging the value and importance of the peer review process, the court refused to preclude a physician from access to the courts of the state where the process goes awry.

    Notwithstanding the validity and propriety of peer review as a process whereby a physician who endangers patients or other persons within the Medical Center can be immediately reviewed by his peers, we cannot preclude a physician from seining access to the courts to remedy an ostensible breach of contract.

    It appears after all that even doctors and their families have protection at law to support their right to medical privacy, where it does not directly impinge upon the legitimate interests of hospitals, medical staffs and their patients.