Cooper v. Delaware Valley Medical Center

Decision Date10 September 1993
Citation630 A.2d 1,428 Pa.Super. 1
PartiesHarry A. COOPER, D.O., Appellant, v. DELAWARE VALLEY MEDICAL CENTER, Bernard Amster.
CourtPennsylvania Superior Court

David L. Pennington, Philadelphia, for appellant.

Brian M. Peters, Philadelphia, for Delaware Valley, appellee.



This is an appeal from the January 3, 1992 order of the Court of Common Pleas of Bucks County, granting the motions for summary judgment of the several defendants, with the exception of the motion of Dr. Bernard J. Amster. We reverse.

The long history giving rise to this appeal must be fully recounted to facilitate a detailed and complete resolution of the issues presently before this court. In faithful adherence to our standard of evidentiary review, we must examine the record in a light favorable to appellant, who is entitled to the benefit of all reasonable inferences.

In 1979, appellant, Harry Cooper, began a four-year residency in orthopedic surgery at Delaware Valley Medical Center (hereinafter "DVMC"). Appellant's residency was performed under the training of Bernard Amster, D.O. It was appellant's testimony that he accepted the residency with the understanding that at its completion, he would join Dr. Amster in his practice and be permitted to treat unassigned emergency room patients. For each year of his residency, appellant executed a contract. However, none of the contracts contain any reference that appellant was guaranteed the privilege of treating emergency room patients upon the completion of residency.

During the third year of appellant's residency, internal problems developed among DVMC's board of directors. A lawsuit was filed by half of the members of the board against Drs. Amster, Berman, and Glass alleging that they had created conflicts to prevent expansion of the hospital and admission to the staff of physicians who would compete in the same practice areas. Drs. Amster, Berman, and Glass consequently filed a countersuit. Both suits were marked settled, and eventually Dr. Amster's faction gained control of the board.

As appellant entered his final year of residency, the new board, under the guidance of Dr. Amster, adopted new Rules and Regulations for the Division of Orthopedic Surgery. The major impact of the new rules was that, for the first time, DVMC established written eligibility criteria for orthopedists wishing to treat unassigned emergency room patients. Specifically, the new Rules and Regulations for the Division of Orthopedic Surgery, adopted July 30, 1982, established the following four requirements for a doctor seeking to treat unassigned emergency room patients:

(a) An AOA approved internship and an AOA residency;

(b) Be certified in orthopedic surgery by the American Osteopathic Academy of Orthopedics;

(c) Be an active staff physician for at least three years;

(d) He/she must admit to the orthopedic service at least fifty patients [per] year from his/her practice.

On June 30, 1983, appellant successfully completed his residency at DVMC. The completion of appellant's residency was certified by Dr. Amster. Two weeks prior to completing his residency, the DVMC Credentials Committee had recommended appellant for active staff privileges on a six-month probationary basis.

On October 2, 1984, appellant submitted a formal, written request to Dr. Amster to treat unassigned patients in the DVMC emergency room. Dr. Amster failed to respond to appellant's request and thus remained the only orthopedic surgeon eligible to receive unassigned emergency room patients. In February of 1985, appellant sent a letter to the DVMC Medical Executive Committee requesting privileges to treat unassigned emergency room patients. In his letter to the Medical Executive Committee, appellant reaffirmed his position that he was told at the beginning of his residency he would have such privileges if he chose to practice at DVMC. The Medical Executive Committee held a hearing on this matter on March 28, 1985, and subsequently denied appellant's request to treat unassigned emergency room patients because he failed to meet the new criteria.

This series of events led appellant to file a federal lawsuit in 1985 alleging antitrust violations on the part of Dr. Amster and DVMC. The federal suit was ultimately dismissed when the Honorable J. William Ditter, Jr., determined the matter was not yet ripe for adjudication since appellant had not exhausted all his remedies within the DVMC appellate process. The Third Circuit Court of Appeals affirmed the dismissal of the federal action.

In February 1986, appellant also filed a saving action in state court against DVMC, Dr. Amster, Dr. Newman, Dr. Stepanuk, and Metropolitan Hospital-Parkview Division. The complaint was based on theories of tortious interference with prospective contractual relations, promissory estoppel, fraud, misrepresentation, and breach of implied contract. The state court action, like the federal action, centered around the refusal to grant appellant emergency room privileges at DVMC. After preliminary objections were filed, the trial court granted appellant leave to amend his complaint. The amended complaint named only Dr. Amster and DVMC as defendants.

Before the federal lawsuit had been dismissed, the time arose for appellant's 1986 annual reappointment review for general staff privileges. Dr. Amster informed DVMC's administration that he could not review appellant's credentials because appellant had named him as a party defendant in a federal lawsuit. Consequently, DVMC retained an independent orthopedist, Dr. Keith Harvie, to perform the review. 1 Dr. Harvie's review included interviews with Drs. Amster and Stepanuk, both of whom were defendants in appellant's lawsuits, and a full interview with appellant. On November 25, 1986, the DVMC Credentials Committee voted to limit appellant's general staff privileges, in accord with Dr. Harvie's September 22, 1986 report.

Appellant then proceeded to exhaust all of DVMC's internal administrative remedies. However, the decision of the Credentials Committee remained unchanged. Accordingly, on March 18, 1988, appellant instituted a civil action in the Court of Common Pleas of Philadelphia County against Dr. Amster, DVMC, and thirty-six others. This state court action alleged federal and state due process and equal protection violations, a violation of state anti-trust laws, tortious interference with business relationships, intentional infliction of mental and emotional distress, libel and slander, breach of contract, and a violation of the Health Care Facilities Act, 35 Pa.S.A. § 448. The counts alleging violations of state anti-trust laws and the Health Care Facilities Act were dismissed pursuant to an order sustaining DVMC's preliminary objections.

On July 2, 1990, the 1988 Philadelphia County action was transferred to Bucks County and coordinated with the previously filed 1986 state saving action. The new coordinated action was listed with a 1990 Bucks County docket number and captioned accordingly.

In November 1991, DVMC and Dr. Amster filed separate Motions for Summary Judgment. In a single order, the Honorable Edward G. Biester, Jr., granted the motion of DVMC and the thirty 2 individual defendants as to all causes of action in both of appellant's state court complaints. The trial court concluded that it was precluded from engaging in a substantive review of the hospital's staffing decisions by reason of this court's holding in Rosenberg v. Holy Redeemer Hospital, 351 Pa.Super. 399, 506 A.2d 408 (1986). Furthermore, the trial court found that the thirty individual defendants were immune from liability pursuant to the provisions of the Pennsylvania Peer Review Protection Act, 63 P.S. § 425. With respect to Dr. Amster's motion, the trial court granted summary judgment for Dr. Amster on appellant's claims under the Fourteenth Amendment; for intentional infliction of emotional distress; and for defamation. Dr. Amster's motion was denied with respect to all other claims. This timely appeal followed.

Appellant presently raises four issues for our consideration:

I. Whether the trial court erred in failing to recognize that the decision in Rosenberg v. Holy Redeemer Hospital is inconsistent with the intent of the Pennsylvania Legislature to preserve a private cause of action against those who abuse the Peer Review Process?

II. Whether Rosenberg v. Holy Redeemer Hospital precludes plaintiff from maintaining causes of action other than a violation of his due process and equal protection rights under the Fourteenth Amendment?

III. Whether the Pennsylvania Peer Review Protection Act protects parties from civil liability that act with malice and fail to exercise due care?

IV. Whether the facts, taken in the light most favorable to Dr. Cooper, support his causes of action and therefore should have precluded entry of summary judgment in favor of defendants?

Essentially, appellant's four issues focus upon two primary areas of concern; an interpretation and application of Rosenberg v. Holy Redeemer Hospital, supra, and an interpretation and application of the immunity provisions of the Peer Review Protection Act.


Initially, we will consider the Rosenberg case and the extent to which it is presently applicable. The trial court relied upon Rosenberg in deciding that summary judgment was appropriate as to DVMC. There is a great difference of opinion between the parties as to the extent of Rosenberg's applicability. Appellees, echoing the analysis offered by the trial court, maintain that Rosenberg absolutely prohibits judicial interference in a private hospital's staffing process regardless of the cause of action pursued. Conversely, appellant contends that the trial court erroneously interpreted Rosenberg too broadly....

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