Johnson v. Nyack Hosp.
| Decision Date | 10 September 1991 |
| Docket Number | No. 90 Civ. 0856 (RWS).,90 Civ. 0856 (RWS). |
| Citation | 773 F. Supp. 625 |
| Parties | Fletcher J. JOHNSON, M.D. and Benjay Realty Corp., Plaintiffs, v. NYACK HOSPITAL, Kenneth Steinglass, M.D., Daniel Berson, M.D., James Dawson and Rockland Thoracic Associates, P.C., Defendants. |
| Court | U.S. District Court — Southern District of New York |
Reed Smith Shaw & McClay, Washington, D.C. (George R. Clark, Kevin D. Jones, of counsel), Reed Smith Shawe & McClay, Pittsburgh, Pa. (Debra H. Dermody, of counsel), Stein, Zauderer, Ellenhorn, Frischer & Sharp, New York City (Sidney H. Stein, of counsel), for plaintiffs.
Garfunkel, Wild & Travis, P.C., Great Neck, N.Y. (Norton L. Travis, Leonard M. Rosenberg, David A. Zarett, Susan F. Scharf, of counsel), for defendants Nyack Hosp., Daniel Berson, M.D. and James Dawson.
Proskauer Rose Goetz & Mendelsohn, New York City (Jeffrey A. Mishkin, Francis D. Landrey, Lauren S. Albert, of counsel), for defendants Kenneth Steinglass, M.D. and Rockland Thoracic Associates, P.C.
Defendants Nyack Hospital ("Nyack"), Daniel Berson, M.D. ("Berson"), James Dawson ("Dawson"), Kenneth Steinglass, M.D. ("Steinglass"), and Rockland Thoracic Associates, P.C. ("Rockland") have moved pursuant to Rule 56, Fed.R.Civ.P. for summary judgment dismissing the complaint of plaintiffs Fletcher J. Johnson, M.D. ("Johnson"), and Benjay Realty Corporation ("Benjay"), as well as for attorneys' fees and costs. For the reasons set forth below, the summary judgment motions are granted. The motions for attorneys' fees are denied, but the motions for costs are granted.
Johnson, a New York resident, is a physician licensed to practice in the states of New York and New Jersey. In 1972, Johnson was granted privileges to perform vascular and thoracic surgery at Nyack, a voluntary not-for profit hospital located in Nyack, Rockland County, New York.
Benjay is a New York corporation with its principal place of business in Upper Nyack, New York. At all relevant times, Benjay was owned and controlled by Johnson.
Steinglass, a New York resident, is chief of thoracic and vascular surgery at Nyack. Berson was the director of the Department of Surgery during the period relevant to the complaint. Dawson served as Nyack's administrator during the relevant period.
Rockland is a New York professional corporation owned by Steinglass and Alfred Moscarella, M.D.
On February 8, 1990, Johnson and Benjay filed their complaint alleging violations of the federal antitrust laws and tortious interference with economic advantage. The complaint alleged that Steinglass and Dawson conspired to revoke Johnson's privileges to perform thoracic and vascular surgery at Nyack in order to eliminate Johnson as a competitor in the market for thoracic and vascular surgery services.
The complaint alleged Johnson competed in the relevant market with other doctors at Nyack and had privileges to perform this type of surgery at other hospitals in Rockland County as well as plans to establish a "medical mall" in the area. According to the complaint, Johnson in 1984 announced plans for the "medical mall" — a treatment center that was to provide in a single location services from various specialists.
On August 30, 1990, Steinglass and Rockland filed their summary judgment motions. On October 18, 1990, Nyack, Berson and Dawson filed their summary judgment motions. A series of adjournments agreed to by the parties postponed the return date of the motion until May 30, 1991, as of which date the motion was considered fully submitted.
On January 1, 1985, Steinglass began his first three year term of service as chief of the Section of Thoracic and Vascular Surgery at Nyack (the "Section").
Under Nyack's by-laws (the "By-Laws"), a section chief is "accountable for all professional ... activities within his department." By-Laws Art. V, § 3(1). Shortly after being named section chief, Steinglass met with Berson and Dawson to discuss quality of care in the Section and agreed to conduct a review of all cases performed by Section members. The review consisted of an examination of all 222 cases performed by the nine Section members over the period from December, 1984 through June 1985. The review analyzed each surgeon's technique, judgment and documentation skills.
Steinglass concluded from the review that Johnson's performance fell below minimally acceptable standards. Steinglass recommended to Berson the revocation of Johnson's medical staff privileges to perform thoracic and vascular surgery.
Before taking any further action, Nyack retained two independent experts in thoracic and vascular surgery — Dr. E.F. Conklin ("Conklin") and Dr. Graham W. Knox ("Knox") — to review Johnson's thoracic and vascular cases. The experts, in separate and independent reports, also found that Johnson provided substandard care.
On January 28, 1987, Berson informed Nyack's Credentials Committee that the Department of Surgery recommended that Johnson's thoracic and vascular surgery privileges not be renewed.
On February 10, 1987, Nyack's Credentials Committee held a special meeting to consider Berson's recommendation. At this meeting, Steinglass presented the conclusion reached in his report. The Steinglass, Knox, and Conklin reports were made available for the Credentials Committee members' review. The Credentials Committee recommended the revocation of Johnson's thoracic and vascular surgery privileges, based on the Surgery Department's recommendations, the reports of Steinglass and the two experts, and its own review.
In accordance with procedures required under the By-Laws, Nyack's Medical Executive Committee met on February 10, 1987 to consider the matter. Under the By-Laws, the Medical Executive Committee consists of the directors of each department; the President, past President, and Secretary-Treasurer of the medical staff; and three active members of the medical staff elected by the medical staff. Twentyfour members of the Nyack medical staff attended this meeting as members of the Medical Executive Committee. Of that group — which represented the full range of specialties at Nyack — all but two voted in favor of rescinding Johnson's thoracic and vascular surgery privileges.
According to the minutes of the meeting, Steinglass again presented his report, the chairman of the Credentials Committee sent a letter setting forth its decision, and Berson summarized the expert opinions from Conklin and Knox. The Medical Ethics Committee members also received copies of the expert reports.
The minutes further report that:
Upon motion, after lengthy discussion, the recommendations that Dr. Fletcher Johnson's privileges in thoracic/vascular surgery be rescinded be approved. There was 1 opposed and 1 abstention. This will become effective immediately. A letter will be sent to Dr. Johnson informing him of this and advising him of what options are now available to him.
By letter of February 10, 1987, the chairman of the Medical Ethics Committee informed Johnson of the Medical Executive Committee's action. In that letter, he stated that the revocation of Johnson's privileges to practice thoracic and vascular surgery at Nyack would take effect the next day. The letter further stated that the Medical Executive Committee's action had been referred to the Peer Review and Ethics Committee for an investigation to commence within ten days and that Johnson would be contacted about receiving, pursuant to the By-Laws, a formal interview in front of that committee.
On February 24, 1987, Nyack's Peer Review and Ethics Committee reviewed and voted to uphold the Medical Ethics Committee's decision to revoke Johnson's privileges. Johnson was present at the February 24 meeting.
At the meeting, Steinglass made an oral presentation of his findings and of the reports of Knox and Conklin. Johnson raised claims of bias and incomplete records with regard to the previous proceedings. The decision to revoke Johnson's privileges was effective immediately.
Johnson subsequently commenced an action in New York State Supreme Court for Rockland County seeking a preliminary and permanent injunction reinstating his thoracic and vascular surgery privileges.
The Supreme Court dismissed Johnson's complaint for failure to exhaust administrative remedies, i.e., the intra-hospital due process hearing — to which he was entitled under the By-Laws — and the statutorily required proceeding before the New York State Public Health Counsel, an agency specifically charged with ruling on physicians' staff privilege grievances.
Pursuant to the By-Laws, Johnson requested a review of the Peer Review and Ethics Committee's decision before an independent hearing officer. Under Article III § 8(2) of the By-Laws, Nyack appointed Dr. Julius Jacobson ("Jacobson"), a practicing surgeon at Mt. Sinai Hospital and a professor of surgery at Mt. Sinai Medical School as the independent hearing officer.
When informed of Nyack's selection of Jacobson, Johnson's counsel objected on the grounds that Jacobson had some prior familiarity with the case. Nyack responded that the appointment of a hearing officer is "within the province of the Hospital."
The hearing was held on December 17, 1987, from 8:00 a.m. until 3:30 p.m. Before the hearing, Nyack supplied Johnson and his counsel with copies of Steinglass' report, copies of the reports by Conklin and Knox, as well as medical records relating to the thoracic and vascular surgery cases to be reviewed at the hearing.
Under the procedures set forth in the By-Laws, Johnson was represented by counsel at the hearing. Pursuant to his rights under the By-Laws, he presented expert testimony on his behalf and he was given the opportunity to cross examine Nyack's witnesses.
Testimony proceeded on a case-by-case basis: Steinglass...
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Johnson v. Nyack Hosp., 94 Civ. 7464 (LAK).
...Dr. Johnson's complaint was within the primary jurisdiction of the New York State Public Health Council ("PHC"). Johnson v. Nyack Hospital, 773 F.Supp. 625 (S.D.N.Y.1991), aff'd on other grounds, 964 F.2d 116 (2d Cir.1992) ("Johnson I"). Inasmuch as the details of the proceedings that prece......
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Johnson v. Nyack Hosp.
...(2d Cir. 1996), aff'g 891 F.Supp. 155 (S.D.N.Y.1995) ("Johnson II"); Johnson v. Nyack Hospital, 964 F.2d 116 (2d Cir.1992), aff'g 773 F.Supp. 625 (S.D.N.Y.1991); Johnson v. Nyack Hospital, 169 F.R.D. 550 (S.D.N.Y.1996). 3. Plaintiff has dropped Rockland Thoracic Associates, P.C. from the se......
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Johnson v. Nyack Hosp.
...judgment, dismissing the complaint without prejudice because plaintiffs failed to exhaust administrative remedies. Johnson v. Nyack Hosp., 773 F.Supp. 625, 631 (S.D.N.Y.1991), aff'd on other grounds, 964 F.2d 116 (2d Cir.1992) ("Johnson I "). This Court affirmed on May 11, 1992, relying not......
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Johnson v. Nyack Hosp.
...District Judge ), dismissing his complaint, with costs, for failure to exhaust administrative remedies. See Johnson v. Nyack Hosp., 773 F.Supp. 625 (S.D.N.Y.1991) ["Johnson I "]. Defendants cross-appeal from the district court's order denying their motion for attorney's fees. Id. For the re......