Gashgai v. Maine Medical Ass'n
| Decision Date | 19 January 1976 |
| Citation | 350 A.2d 571 |
| Parties | Abdollah GASHGAI, M.D. v. MAINE MEDICAL ASSOCIATION et al. |
| Court | Maine Supreme Court |
Locke, Campbell & Chapman by Frank G. Chapman, Augusta, Skelton, Taintor & Abbott by Charles H. Abbott, Lewiston, for plaintiff.
Verrill Dana Philbrick Putnam & Williamson by Charles L. Cragin, III, John A. Mitchell, Portland, for defendants.
Before DUFRESNE, C. J., and WEATHERBEE, POMEROY, WERNICK, ARCHIBALD and DELAHANTY, JJ.
This is an appeal by the defendants, Maine Medical Association (a Maine corporation), the Ethics and Discipline Committee of the Maine Medical Association and Bruce Trembly, M.D., in his capacity as Chairman of said Committee, from a (Kennebec County) Superior Court judgment embodying a permanent injunction against defendants.
The judgment was entered in a civil action against defendants instituted on May 10, 1974 by plaintiff, Abdollah Gashgai, M.D., a medical doctor duly licensed to practice medicine in the State of Maine and a member of the defendant Maine Medical Association. The complaint alleged, inter alia, that the Ethics and Discipline Committee of the Maine Medical Association, over the signature of its Chairman, Dr. Trembly, had issued a report concerning plaintiff and distributed it to
'a variety of individuals, institutions, bureaus and offices, in violation of the bylaws and procedures of Defendant Association.'
and the actions of the Committee and its Chairman
'. . . are so arbitrary, capricious, discriminatory, willful, wanton and reckless as to cause irreparable loss and damage to Plaintiff.'
plaintiff sought preliminary and permanent injunction prohibiting '. . . further circulation of said report' and commanding the parties who had sent or delivered the report to other persons 'to retrieve all copies' sent or delivered.
After defendants had answered the complaint, the Justice presiding in the Superior Court held a hearing on June 12, 1974. On September 12, 1974, he filed findings of fact all of which are adequately supported by evidence and are, therefore, here controlling. These findings disclose the following factual situation.
On March 8, 1974 Mrs. Rayna B. Leibowitz, acting in her official capacity as a Medical Claims Consultant for the Department of Health and Welfare of the State of Maine, and in accordance with instructions given her by Dr. George Sullivan acting in his capacity as a consultant to said Department and a member of the Board of Registration in Medicine of the State of Maine, forwarded to defendant Trembly, by letter, a request on behalf of the Department for an investigation by the Maine Medical Association Ethics and Discipline Committee of certain aspects of Dr. Gashgai's medical practice and conduct in specific instances. On March 25, 1974 Mrs. Leibowitz sent another letter providing supplemental information and renewing the Department's request for investigatory assistance.
Shortly after March 8, 1974 Dr. Trembly, by telephone, and without indicating that charges had been lodged against Dr. Gashgai, requested that he appear on March 27, 1974 before a committee of the Maine Medical Association. At that time, Dr. Trembly did not further identify the committee. Subsequently, an undated letter was sent to Dr. Gashgai confirming the date and time of the meeting and informing Dr. Gashgai that a committee of the Maine Medical Association (still not more specifically identified) had been asked to look into the reasons for particular charges Dr. Gashgai had made to the Department of Health and Welfare.
At all times here relevant Dr. Gashgai has been a member of the Maine Medical Association which (although a corporation) is, basically, a voluntary association of individuals licensed to practice medicine in the State of Maine. A condition precedent to membership in the Maine Medical Association is membership in a County Medical Society which is a component of the Maine Medical Association. Dr. Gashgai is a member of the Kennebec County Medical Society, one such county component.
Dr. Gashgai honored the request of Dr. Trembly and appeared on the evening of March 27, 1974 at the Holiday Inn in Augusta where he met informally with Dr. Trembly and other doctors who were members of the Ethics and Discipline Committee of the Maine Medical Association. It soon became apparent to Dr. Gashgai that the meeting had lost its original 'conversational' tone and had become accusatory of him. It then dawned on Dr. Gashgai that Dr. Trembly and the others were actively engaged in investigating charges against him which were serious.
During a questioning of Dr. Gashgai lasting approximately two hours Dr. Trembly and the others on the Committee made references to invoices and other documents which had been provided to them by the Department of Health and Welfare. They also utilized information contained in confidential documents supplied to the Committee, without Dr. Gashgai's prior knowledge or consent, by Dr. Henry J. Wheel-wright, Medical Director of the Augusta General Hospital. These same documents ultimately formed the basis of the conclusions reached by the Committee.
On March 27, 1974, without having undertaken any investigation additional to that constituted by the questioning of Dr. Gashgai on that date, the Committee issued a report containing the conclusions that the invoices submitted by Dr. Gashgai to the State Department of Health and Welfare showed gross overutilization, malpractice and unethical practice by Dr. Gashgai. The report also recommended that Dr. Gashgai be severely reprimanded.
The Committee sent the report to Dr. Gashgai and also to the Maine Medical Association, the Board of Registration in Medicine of the State of Maine, the Department of Health and Welfare of the State of Maine and the Medical Director of the Augusta General Hospital. As the result of having received the report, the Department of Health and Welfare placed Dr. Gashgai on a 'constant surveillance' list, thereby requiring that all invoices henceforth submitted by Dr Gashgai be carefully reviewed to evaluate the propriety of his charges.
The presiding Justice supported the permanent injunction issued by him 1 with the following conclusions: (1) the activities of Dr. Trembly and the other persons who had acted with him as members of the Committee on Ethics and Discipline of the Maine Medical Association were in violation of various of the Association's bylaws; (2) said activities contravened procedural due process requirements of the Constitutions of the United States and the State of Maine as applicable by virtue of the special relationship here existing between a governmental agency of the State of Maine and the Maine Medical Association and its Committee-a relationship sufficient to transform the Committee's activities into governmental action subject to constitutional due process mandates.
Defendant maintain on appeal that the findings of the presiding Justice of violations of the Association's by-laws and his references to the legal consequences flowing therefrom were not intended to be independently separate grounds of decision but were offered only as ancillary support for his constitutional due process condlusions. Defendant contend, therefore, that the only issue to be decided in this appeal is the correctness of the presiding Justice's holding that defendants' actions here in question are subject to the due process mandates of the United States and Maine Constitutions.
We disagree with defendants. Our study of the record convinces us that plaintiff had maintained before the presiding Justice that the violations of the Association's by-laws were discrete grounds entitling him to the injunctive relief sought by him independently of his additional claim of constitutional due process violations. The presiding Justice addressed each of these separate claims and concluded that each was a sufficient, independent ground justifying the injunctive relief he ordered.
We agree with the presiding Justice that the Committee actions of which Dr. Gashgai complains were in violation of particular by-laws of the Maine Medical Association and involved actual, and imminently threatened, injury to Dr Gashgai-injury which was irreparable because it tended to impair Dr. Gashgai's opportunity to earn a livelihood through the practice of his chosen profession and, therefore, required the injunctive relief ordered. We sustain the judgment of the Superior Court Justice on this ground and do not reach the constitutional due process question.
The presiding Justice found that the Ethics and Discipline Committee of the Maine Medical Association had violated the Association's by-laws in three critical respects. 2 The presiding Justice then reached the conclusion of law that said 'actions . . . were a nullity under the Defendant Maine Medical Association's own internal rules.'
The presiding Justice's findings as to the factual occurrences held to be violations of by-laws were adequately supported by evidence and are, therefore, here conclusive. The Justice's interpretation of the meaning of the by-laws, as applicable to the factual occurrences, was correct. Also correct was the presiding Justice's conclusion of law regarding the nullity of defendants' actions as a basis for judicial intervention to grant the injunctive relief here ordered.
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