Bhan v. Battle Creek Health Sys.
| Decision Date | 08 September 2014 |
| Docket Number | No. 13-1682,13-1682 |
| Parties | RAAKESH C. BHAN, M.D., Plaintiff-Appellant, v. BATTLE CREEK HEALTH SYSTEMS, ET AL., Defendants-Appellees. |
| Court | U.S. Court of Appeals — Sixth Circuit |
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File Name: 14a0704n.06
ON APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF MICHIGAN
Before: BOGGS and MOORE, Circuit Judges; BARRETT, District Judge.*
BARRETT, District Judge. At issue in this appeal are claims stemming from Raakesh Bhan, M.D.'s loss of clinical-staff privileges at the Michigan hospitals of Borgess Medical Center ("Borgess") and Battle Creek Health Systems ("BCHS"). Bhan contends that in depriving him of clinical-staff privileges, Borgess, BCHS, and/or their respective executive officers tortiously interfered in his business relationships, defamed him, and breached their contractual relationships with him. All of those claims were dismissed by the district court pursuant to Fed. R. Civ. P. 12(b)(6), except the defamation claim against Borgess and its employees which was dismissed pursuant to Fed. R. Civ. P. 56. For the reasons given below, we affirm the dismissal of those claims.
The two hospitals involved in this case - Borgess and BCHS - provide hospital services in Michigan. Borgess's executive officers include President and Chief Executive Paul Spaude, Chief Medical Officer Terry Baxter, M.D., and Chief Quality Officer Robert Brush, M.D. BCHS's executive officers include President and Chief Executive Officer Denise Brooks-Williams, former Chief Executive Officer Patrick Garrett, and former Chief Medical Officer Jeffrey Mitchell, M.D.1
Bhan was a critical-care doctor (also called an "intensivist") of Indian descent who provided critical-care medical services in Kalamazoo, Michigan and Calhoun, Michigan. He initially received clinical-staff privileges to provide such medical services at BCHS in 1986 and at Borgess in 1991. As a practitioner with staff privileges, Bhan was subject to the Medical Staff Bylaws of the hospitals. The Medical Staff Bylaws are the mechanism through which the Board of Trustees delegates to the Medical Staff the responsibility of monitoring medical care to assure quality of care and to make recommendations to the Board of Trustees regarding the evaluation and monitoring of clinical performance. Included among those numerous bylaws are the procedures for applying for reappointment, for summary suspension, and for hearings and appeals. Also included among those bylaws are provisions for immunity and release of liability.
On February 27, 2007, Bhan suffered a stroke. He alleges that the stroke was caused by the Borgess Bedside Policy implemented by Baxter and Brush in January 2007 under which apractitioner was required to be at the bedside of a patient in the Intensive Care Unit within five minutes of being paged. According to Bhan, he had to sleep at the hospital to comply with the Bedside Policy because Baxter and Brush interfered with his attempts to obtain assistance from others in meeting this policy. Baxter is alleged to have interfered because of Bhan's race and because Baxter's wife was a member of a competing intensivist practice at Borgess at that time. Brush is alleged to have interfered because he received a financial benefit from being a former member of the competing intensivist practice at Borgess from which he had received a payout upon his departure.
After more than six months of stroke rehabilitation, Bhan resumed his duties at Borgess to some extent. According to Bhan, he had fully recovered in so far as his abilities to perform at the highest level as a critical-care practitioner.
After his return, Bhan' s qualifications for clinical-staff privileges came under scrutiny. On or about April 14, 2009, Borgess summarily suspended Bhan's clinical-staff privileges. Bhan alleges the summary suspension was issued based upon inadequate facts and improper procedures. The Medical Executive Committee purportedly recommended setting aside the summary suspension initially, but later approved it as a result of actions taken by Baxter, Brush, and Spaude. Although Bhan subsequently received a "fair hearing," he contends that the hearing was not conducted in accordance with the procedures set forth in the Medical Staff Bylaws. Bhan's clinical-staff privileges at Borgess ultimately were revoked.
Bhan alleges that on or about January 26, 2010, BCHS suspended his clinical privileges for primary responsibility of patient care in the Intensive Care Unit based on inadequate factsand improper procedures. Subsequently, Brooks-Williams and BCHS provided a report to the National Practitioner's Data Bank concerning that suspension. According to Bhan, those actions were taken even after multiple tests requested by Garrett, Mitchell, and Brooks-Williams confirmed that he could practice as a critical-care intensivist. Although Bhan received a "fair hearing," he contends that the hearing was not conducted in accordance with the procedures set forth in the Medical Staff Bylaws.
Bhan filed his initial Complaint in the Western District of Michigan on February 26, 2010. Thereafter, the district court entered an order staying the case, which was lifted in June 2011 after Bhan exhausted his administrative remedies.
On August 10, 2011, Bhan filed his eighteen-count Second Amended Complaint. All of the defendants moved to dismiss pursuant to Fed. R. Civ. P. 12(b)(6). The district court granted the motions as to the claims for tortious interference, defamation against BCHS and its executives, due-process violations under 42 U.S.C. § 1985, breach of contract, conspiracy, and injunctive relief. The only remaining claims alleged violations of Michigan's Elliot-Larsen Civil Rights Act, violations of the Americans with Disabilities Act, and defamation against Borgess and its executives. All of those remaining claims were later dismissed pursuant to Fed. R. Civ. P. 56.
The district court had federal-question jurisdiction over this case pursuant to 28 U.S.C. § 1331. The district court had supplemental jurisdiction over the remaining claims pursuant to 28 U.S.C. § 1367. This court now has jurisdiction because Bhan has appealed from a finaljudgment of a federal district court that disposed of all of his remaining claims. 42 U.S.C. § 1291.
All of the issues raised in this appeal are reviewed de novo. Casias v. Wal-Mart Stores, Inc., 695 F.3d 428 (6th Cir. 2012) (Rule 12(b)(6) dismissal); Donald v. Sybra, 667 F.3d 757, 760 (6th Cir. 2012) (Rule 56 dismissal).
In reviewing the claims pursuant to Fed. R. Civ. P. 12(b)(6), the court must "construe the complaint in the light most favorable to the plaintiff, accept its allegations as true, and draw all reasonable inferences in favor of the plaintiff." Bassett v. Nat'l Collegiate Athletics Ass'n, 528 F.3d 426, 430 (6th Cir. 2008). "[T]o survive a motion to dismiss[,] a complaint must contain 1) 'enough facts to state a claim to relief that is plausible,' 2) more than 'a formulaic recitation of a cause of action's elements,' and 3) allegations that suggest a 'right to relief above a speculative level.'" Tackett v. M&G Polymers, USA, LLC, 561 F.3d 478, 488 (6th Cir. 2009) (quoting Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 555, 570 (2007)). A claim has facial plausibility when the pleaded factual content allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged. Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009); see also In re Sofamor Danek Grp., 123 F.3d 394, 400 (6th Cir. 1997) (). Although the plausibility standard is not equivalent to a "'probability requirement,' . . . it asks for more than a sheer possibility that a defendant has acted unlawfully." Iqbal, 556 U.S. at 678 (quoting Twombly, 550 U.S. at 556).
Under Fed. R. Civ. P. 56, summary judgment is appropriate "if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as amatter of law." Fed. R. Civ. P. 56(a). A court must view the evidence and draw all reasonable inferences in favor of the nonmoving party. Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986).
The BCHS Appellees argue that they are entitled to statutory immunity under the Health Care Quality Improvement Act, 42 U.S.C. § 11101 et seq. BCHS Br., pp. 19-20. Under the Act, members of a professional-review body "shall not be liable in damages under any law of the United States or of any State . . . with respect to the action" if the professional-review action was taken:
(3) after adequate notice and hearing procedures are afforded to the physician involved or after such other procedures as are fair to the physician under the circumstances, and
(4) in the reasonable belief that the action was warranted by the facts known after such reasonable effort to obtain facts and after meeting the requirement of paragraph (3).
42 U.S.C. §§ 11111(a)(1), 11112(a). A professional review is presumed to satisfy these standards, unless the presumption is rebutted by a preponderance of the evidence. 42 U.S.C. §§ 11112(a).
We agree with the district court that Bhan pleaded sufficient facts to avoid a Rule 12(b)(6) dismissal based upon statutory immunity, including facts that the BCHS Appellees relied upon an inadequate set of criticisms and did not afford him adequate notice and hearingprocedures under the circumstances. Whether and to what extent any of the BCHS Appellees took part in the peer-review process also is not clear at the initial stage of litigation. Given that the statute...
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