Axcess Med. Clinic, Inc. v. S. Randall Easterling
| Decision Date | 24 September 2015 |
| Docket Number | CIVIL ACTION NO. 3:14CV112 DPJ-FKB |
| Court | U.S. District Court — Southern District of Mississippi |
| Parties | AXCESS MEDICAL CLINIC, INC.; KENNETH CHARLES KNIGHT; AND FITZHUGH LEE NEAL, JR., M.D. PLAINTIFFS v. S. RANDALL EASTERLING, M.D.; VIRGINIA CRAWFORD, M.D.; LARRY B. AYCOCK, M.D.; AND H. VANN CRAIG, M.D. DEFENDANTS |
This § 1983 action is before the Court on Defendants' motion for summary judgment [50] pursuant to Federal Rule of Civil Procedure 56. Defendants Dr. S. Randall Easterling, Dr. Virginia Crawford, and Dr. Larry B. Aycock are three members of the nine-member Executive Board of the Mississippi State Board of Medical Licensure; Defendant Dr. H. Vann Craig serves as the Executive Director. Plaintiffs Axcess Medical Clinic, Inc. and its owners, Kenneth Charles Knight and Dr. Fitzhugh Lee Neal, Jr., sued each Defendant in his or her individual capacity under § 1983. Plaintiffs contend that Defendants' conduct at a May 15, 2013 hearing regarding Axcess's recertification as a pain-management clinic deprived Knight and Dr. Neal of their constitutional rights.
In their motion, Defendants seek summary judgment as to all of Plaintiffs' claims based on qualified immunity. Plaintiffs have responded in opposition [53] and filed an alternative motion for leave to conduct discovery under Rule 56(d) [54]. The Court, having considered the memoranda and submissions of the parties, finds that Plaintiffs' motion for discovery pursuant to Rule 56(d) should be denied and Defendants' motion should be granted in part but otherwise denied without prejudice.
The dispute between these parties began in January 2012, when the Mississippi State Board of Medical Licensure ("Board") passed a rule stating that pain-management clinics must be owned by a licensed physician. Previously, Plaintiff Kenneth C. Knight, who is not a physician, owned Axcess clinic. In order to comply, he sold a majority ownership in the clinic to Plaintiff Dr. Fitzhugh Lee Neal, Jr., a licensed physician, in February 2012. Under this set-up, the Board certified Axcess as a pain-management clinic on February 28, 2012. Am. Compl. [41] ¶ 24. Axcess's certification as a pain-management clinic was to expire on June 30, 2012. Id. At that time, the regulations did not require any specific medical training, only a license to practice medicine in Mississippi which Dr. Neal possessed. Neal Aff. [53-1] at 2.
On June 18, 2012, Dr. Neal submitted an application for renewal of the clinic registration. Id. On August 3, 2012, the Board requested additional information related to Dr. Neal's training and IRS tax forms indicating "proof of ownership." Letter [53-4]. Counsel for Axcess provided all available information in support of ownership, but explained that 2012 tax forms would not be available until after December 31, 2012. Letter [53-6]. Dr. Neal also provided the Board with proof of his medical training, including his satisfaction of continuing medical education ("CME") requirements that met the rules in effect as of June 18, 2012. Am. Compl. [41] ¶¶ 27, 28. His training remained unchanged from the time the initial application was approved in February 2012. Id. ¶ 39.
On October 11, 2012, the Board notified Dr. Neal that it had denied his application because his training did not meet the Board's qualification requirements:
Letter [53-7] (emphasis in original).
Within one week, Dr. Neal emailed Defendant Easterling explaining his experience and qualifications. Email [53-8]. In addition, counsel for Axcess wrote to Defendant Craig asking for clarification of the alleged deficiencies. Letter [53-9]. When no response followed, Dr. Neal's counsel sent a second letter on December 20, 2012, providing twenty pages of documentation detailing Dr. Neal's qualifications, training, and experience in the field of pain management. Letter [53-10]. Again, no response immediately followed.
Six months later, Dr. Neal received a letter dated April 24, 2013, in which the Board ordered him to appear before the executive committee on May 15, 2013, to "show cause" why the Board should not deny his renewal application. The Board cited Dr. Neal's "failure to provide necessary documentation or submit a new application for reconsideration as requested by letter dated August 3, 2012" and asserted that his CME documentation "does not indicate emphasis in the area of pain management." Letter [41-6].
When he arrived at the hearing, Dr. Neal executed an "Agreement to Appeal Informally Before Executive Committee by Current Licensee," agreeing that he understood "no disciplinary action will be taken without my express written consent" due to the informal nature of themeeting. Id. [41-7] (Agreement). The agreement stated that Dr. Neal had the right to counsel and further indicated his desire to have counsel present. Id. But when his attorney was delayed, Dr. Neal claims Defendants forced him to go forward unrepresented. Neal Aff. [53-1] ¶ 18.
During the meeting, Dr. Neal confirmed that he had been operating the clinic without certification since June 30, 2012. Board Minutes [50-2] at 3. What transpired next, according to Dr. Neal, was as follows:
Dr. Easterling informed me that he and the other individual physicians named herein believed that I did not meet the training requirements and accused me of practicing pain management without the proper qualifications. Dr. Easterling demanded repeatedly that I admit to such conduct. I felt intimidated and harassed during the hearing through threat of revoking my license and refusal to certify Axcess. As shown by the minutes of the meeting, the other physicians present joined in and agreed with Dr. Easterling's accusations and instructed me to immediately reduce the percentage of my pain management patients.
The minutes confirm that Dr. Neal was "advised that he immediately reduce the percentage of pain management patients" to a level that would not qualify Axcess as a pain-management clinic. Minutes [50-2] at 3. But the minutes indicate that the demand was based on the undisputed fact that Dr. Neal had been operating without certification for approximately ten months. Id. The minutes do not expressly address questions regarding qualifications, but they were mentioned in the notice. Regardless, there is no dispute that Dr. Neal was qualified under the then-existing rules.
As for the ownership issue, the parties agree Dr. Neal announced during the hearing that he brought the requested tax records. Defendants claim, however, that he did not leave themwith the Board while Dr. Neal insists that he was not asked to do so. Compare Neal Aff. [53-1] ¶ 19 with Board Minutes [50-2] at 3.
The minutes conclude by stating that Dr. Neal "would be notified of the Board's decision," and a motion then passed to "send Dr. Neal a letter advising that he has not been issued a certificate to practice as pain management yet he continues to do so." Minutes [50-2] at 3. He was "to be reminded" to immediately reduce his pain-management patients. That letter, which Craig sent on May 20, 2013, stated:
During the meeting, you advised that you had your federal tax return for the clinic; however, you have failed to provide a copy to the Board. The Board found that you still have not provided all of the requested documentation to be issued a certificate to operate your practice as pain management, yet you continue to practice as such. You were instructed by the Executive Committee to immediately reduce the percentage of pain management patients that receive prescriptions for controlled medications to be below 50%. Your practice will be monitored for compliance until all of the necessary documentation has been provided and your application for you to operate a pain management practice is approved.
May 20, 2013 Letter [53-13] at 1.
Because 100 percent of the clinics' patients were pain-management patients, Plaintiffs assert that these actions forced Axcess to close its doors on May 15, "under threat from the Individual Defendants to revoke Dr. Neal's license." Id. But on May 31, 2013, Axcess submitted the requested tax forms, id. ¶ 32, and the clinic was recertified as a pain-management clinic on June 26, 2013. An internal document from the Board regarding the certification dated June 12, 2013, bears the comment "OK-since we have no training regs." Renewal [53-15].
Three months later, on September 24, 2013, the Board instituted amendments to its rules, including adding specific training requirements for physicians practicing pain management.These training requirements became effective July 1, 2014. Plaintiffs contend that this history shows the Board wrongfully imposed the yet-to-be-applicable requirements in 2012 and 2013 when it challenged Dr. Neal's training and qualifications.
Plaintiffs initially filed this suit in state court on January 3, 2014, bringing claims under state law and § 1983 against the Board generally related to Plaintiffs' opposition to the newly adopted rules. The Board removed the action to this Court on February 10, 2014. As outlined below, the procedural history that followed is relevant to the present motions.
On March 20, 2014, the Plaintiffs filed their First Amended Complaint [9], adding individual and official capacity claims against the Individual Defendants....
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