Board of Trustees of Memorial Hospital of Sheridan County v. Pratt

• Decision Date: 27 October 1953
• Docket Number: No. 2595,2595
• Citation: 262 P.2d 682,72 Wyo. 120
• Parties: BOARD OF TRUSTEES OF MEMORIAL HOSPITAL OF SHERIDAN COUNTY, v. PRATT.
• Court: Wyoming Supreme Court

Page 682

262 P.2d 682

72 Wyo. 120

BOARD OF TRUSTEES OF MEMORIAL HOSPITAL OF SHERIDAN COUNTY, v. PRATT.

No. 2595.

Supreme Court of Wyoming.

Oct. 27, 1953.

John F. Raper, R. G. Diefenderfer, Sheridan, for appellant.

H. Glenn Kinsley, Robert E. Holstedt, Sheridan, for respondent.

BLUME, Chief Justice.

This is an action brought by the Board of Trustees of the Memorial Hospital of Sheridan County against John R. Pratt a duly licensed physician and surgeon in this state. The question involved herein is as to whether or not the defendant shall be permitted to take his patients to the hospital and treat them therein if he fails and refuses to comply with the regulations made by the Board of Trustees of the hospital. The particular regulations involved herein will be mentioned later. The facts which we deem to be the pertinent facts herein are as follows: Sections 26-701 to 26-707, W.C.S.1945, provide for the organization and management of a memorial hospital. The statute provides that under certain circumstances, as set forth in the statute, it shall be the duty of the board of county commissioners to appoint a non-partisan board of trustees, none of which board shall be a medical doctor or a practitioner of the healing art, and which board shall consist of five competent and responsible citizens of the county, which board shall be organized and shall have control of the hospital and of its properties. It is provided that they shall file a certificate with the county clerk of the county and with the secretary of state. Upon the filing of such certificate said board of trustees shall automatically become a body corporate, with power to sue and be sued. The statute further provides that the board of county commissioners shall annually levy sufficient tax on all the taxable property in the county to provide for the maintenance of the hospital and the board of trustees shall expend that funds received from taxation in the careful maintenance of said hospital which shall be erected and maintained on lands, the title of which shall be in the county. Every county memorial hospital established and maintained under the provisions of this statute shall be kept and maintained as a public county hospital. The board of trustees shall have the right to charge persons able to pay for the services and for use of its facilities and shall furnish free medical hospitalization to such persons who have no means to pay for the same. It is made the duty of the board of trustees to keep a careful record of all of its doings and of all its expenditures and furnish same to the board of county commissioners and make a complete report of its doings each year.

The plaintiff in this case is the duly constituted Board of Trustees of the Memorial Hospital of Sheridan County as above mentioned. It adopted rules and regulations in connection with the management of the hospital. The board appoints a medical staff upon application of the respective physicians. All appointments to the medical staff are made for one calendar year and renewable from year to year. As a matter of practice, all physicians in Sheridan County, except those belonging to the courtesy division, belong to the medical staff and have the right to use the facilities of the Memorial Hospital. The converse also appears to be substantially true, namely that all physicians who have the right to use the facilities of the hospital are members of the medical staff, except those who use the hospital by courtesy only. By the rules of the board, the medical staff is directed to adopt by-laws and rules subject to the approval of the board of trustees. The board may suspend the privileges of a member of the medical staff for violating the rules and regulations in reference thereto. But a credentials committee of the medical staff shall first make a report to the board and thereafter an opportunity is afforded the member of the medical staff to be heard as to whether or not he should be suspended.

On August 12, 1949, the medical staff adopted rules approved by the board of trustees which are in controversy herein as follows:

'7. The Attending Physician Shall be Held Responsible for the Preparation of a Complete Medical Record for Each Patient. This record shall include identification; that complaint; personal history; family history; history of present illness; physical examination; special reports such as consultation, clinical laboratory, x-ray, and others; provisional diagnosis; medical or surgical treatment; pathological findings; propress notes, final diagnosis, condition on discharge; follow-up; and autopsy report when available. The operative record shall be completed within twenty-four hours after operation. No medical record ahll be filed until it is complete, except on order of the Medical Records Committee.

'8. A complete history and physical examination shall in all cases be written within twenty-four hours after admission of the patient.

'17. Patients shall be discharged only on written order of the attending physician. At the time of discharge the attending physician shall see that the record is complete, state his final diagnosis, and sign the record. Records Must be Completed Within One Week After the Dismissal of the Patient.'

The records to be kept, the blank forms of which are in the record before us, are:

1. Record of Personal History and Physical Examination

2. Record of Operation and Anesthesia

3. Requisition and Report in Connection with X-ray

4. Progress Notes

5. Physician's Order Sheet

6. Pregnancy and Labor Record.

As to whether or not the records are properly made is, according to the testimony of Charlotte Sell, registered medical record librarian, determined as follows: 'Q. Who is the final judge of the completeness of the records? A. I'd have to answer that in two parts because if the record comes to me and, as I stated before, that if the diagnosis and the history and physical and all the other pertinent things have been put in and it seems as though it is complete, it is not turned back; I simply keep it in the file. If there is any question whatsoever then I turn it back to the attending physician and if I receive it the same way as I gave it to him then I turn it over to the Record Room Committee.' The record room committee seems to be a committee of the physicians who examine as to whether or not records have been made according to requirements and regulations.

It appears herein that during the year 1951 a very large number of reports which were to be made by Dr. Pratt were not properly made. In January 1952, sixty-five of these reports were delinquent, which number, however, was cut down to thirteen in March 1952. On December 15, 1951, the chairman of the credentials committee recommended to the board of trustees, plaintiff herein, that Dr. Pratt not be reappointed as a member of the medical staff unless he brought his records up to date to the satisfaction of the records committee. The board of trustees accordingly in January 1952, did not reappoint the defendant as a member of the medical staff for the year 1952, but gave him an opportunity to be heard, serving notice upon him to appear before the board. That hearing was finally held on March 1, 1952, at which the defendant and his counsel were present. In view of the fact that the defendant had not then complied with the rules and regulations in accordance with making the reports, the board reaffirmed its action of January 1952, and refused to make him a member of the staff. But instead of enforcing its orders, it brought the present action herewith which was filed on March 6, 1952, in which the facts of delinquency of the defendant with reference to his reports were set out and wherein the plaintiff prayed for declaratory judgment and decree to the effect that the rules and regulations adopted by the board of trustees and the medical staff are reasonable rules and regulations in so far as they applied to the defendant in this case, and that the defendant, in case he continued to refuse to comply with these rules and regulations, should be declared to forfeit his right to continue to make use of the facilities of the hospital and be permanently enjoined from making use of such facilities in case of continued refusal to comply with these regulations.

The court entered its judgment and decree in this case on October 6, 1952, wherein the court found the fact that the defendant was delinquent in filling out his reports in connection with his patients; that the board has power to make reasonable rules and regulations and that the rules hereinbefore set out (rules 7, 8 and 17) are reasonable rules; and the court in part decreed as follows '(3) That upon the Defendant's failure and refusal to comply with the said rules and regulations and to prepare and complete medical records for patients admitted to said Hospital under his name as attending physician, as established by the evidence in this case, the Plaintiff Board had and has the authority to deny to the Defendant, appointment to the medical staff of the Hospital and to deny him the privileges of a Staff member and to deny to him, the use of the facilities of said Hospital for treatment of patients admitted thereto under his name as attending physician.

'(4) That the Defendant be and is hereby granted additional time to and including November 15, 1952, within which to prepare and complete the medical records for patients heretofore admitted to said Hospital for care and treatment under his name as attending physician and for those patients hereafter so admitted, including the month of October, 1952, insofar as such records are due and required by said Rules and Regulations.

'(5) That in case of the failure or refusal of the Defendant to comply with said Rules and Regulations and to prepare and complete medical records for the patients admitted to said Hospital under his name as attending physician, as required by said Rules and...