Cooper v. Delaware Valley Medical Center

CourtUnited States State Supreme Court of Pennsylvania
Citation539 Pa. 620,654 A.2d 547
PartiesHarry A. COOPER, D.O., Appellees, v. DELAWARE VALLEY MEDICAL CENTER, Harry Glass, D.O., Bart Butta, D.O., Angelo Zappala, D.O., Sal Cerniglia, D.O., Peter Molle, D.O., Leonard Davidson, D.O., Steven Ficci, D.O., Andrew Friedman, D.O., Seymour Kessler, D.O., Leonard Limongelli, D.O., Louis Pearlstein, D.O., Robert Brehouse, D.O., James C. Rossi, D.O., Martin Schetchter, D.O., Walter Snyder, D.O., Keith W. Harvie, D.O., Henry Dubiel, D.O., Anthony Mangiracina, D.O., Harold Feiler, D.O., Roderick Cannatella, D.O., Frank Rizzo, D.O., Joseph Flynn, D.O., Morris Rossman, D.O., James Rae, D.O., Frank Perrone, D.O., I. Joel Berman, D.O., Lester Ruppersberger, D.O., Jeffrey Selk, D.O. and Annette Catino, Appellants.
Decision Date15 February 1995

Richard K. Masterson, Norristown, for B. Amster, D.O.

David L. Pennington, Philadelphia, for H. Cooper, D.O.

Before NIX, C.J., and FLAHERTY, ZAPPALA, PAPADAKOS, CAPPY, CASTILLE and MONTEMURO, JJ.

OPINION

MONTEMURO, Justice.

This case is about the degree to which our courts have the authority to review matters that arise within the context of peer review. We granted allocatur to resolve any conflicts in the lower courts as to the proper scope of judicial review of hospital staffing decisions. Moreover, we agreed to determine, as it is a matter of first impression, whether a hospital enjoys immunity for good faith peer review under 63 Pa.S. § 425.3. Because the Superior Court correctly decided these issues, we affirm.

This matter has a long and involved procedural and factual history which will be set out at length to facilitate understanding.

In 1979, appellee, Harry Cooper, started a four-year residency in orthopedic surgery at Delaware Valley Medical Center (DVMC). Appellee's residency was performed under the training of Bernard Amster, D.O. It was appellee'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 at DVMC. For each year of his residency, appellee executed a resident-hospital contract. The contracts lacked any reference to guaranteeing Cooper the privilege of treating emergency room patients upon the successful completion of residency.

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

During Dr. Cooper's final year of residency, the new Board, under the guidance of Dr Amster, adopted new rules and regulations for the division of orthopedic surgery on July 30, 1982. The critical impact of the new rules was that DVMC established written eligibility criteria for orthopedists wishing to treat unassigned emergency room patients. Specifically, the new rules 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) certification in orthopedic surgery by the American Osteopathic Academy of Orthopedics; (c) be an active staff physician for at least three years; and (d) he must admit at least fifty (50) patients per year to the orthopedic service from his practice.

On June 30, 1983, appellee successfully completed his residency at DVMC and received certification from Dr. Amster. Two weeks earlier, the DVMC Credentials Committee had recommended Dr. Cooper for active staff privileges on a six month probationary basis.

Dr. Cooper submitted a formal, written request to Dr. Amster to treat unassigned emergency room patients at DVMC on October 2, 1984. Dr. Amster did not respond to appellee's request. Consequently, Dr. Amster remained the only orthopedic surgeon eligible to receive unassigned emergency room patients at DVMC. In February of 1985, appellee 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, Dr. Cooper reaffirmed 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 appellee's request to treat unassigned emergency room patients because he failed to meet the new criteria.

This chain of events led appellee to file a federal lawsuit in 1985, alleging anti-trust violations on the part of Dr. Amster and DVMC. The federal suit was dismissed when the Honorable J. William Ditter, Jr., determined that the matter was not ripe for adjudication, because appellant had not exhausted his remedies within the DVMC administrative appeal process. Cooper v. Amster, 645 F.Supp. 46 (E.D.Pa.1986). The Third Circuit Court of Appeals affirmed in an unreported Memorandum Opinion.

In February 1986, appellee filed a saving action in the Bucks County Court of Common Pleas 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 focused on the refusal to grant appellant emergency room privileges at DVMC. Preliminary objections were filed and the trial court granted appellee leave to amend his complaint. The amended complaint named only Dr. Amster and DVMC as defendants.

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

Dr. Cooper proceeded to exhaust all of DVMC's internal administrative appeals. However, the decision of the Credentials Committee remained unchanged. As a result, on March 18, 1988, Dr. Cooper instituted a civil action in the Court of Common Pleas of Philadelphia County against Dr. Amster, DVMC, and thirty-six individual defendants. This second state court action alleged: 1) federal and state due process and equal protection violations; 2) a violation of state anti-trust laws; 3) tortious interference with business relationships; 4) intentional infliction of mental and emotional distress; 5) libel and slander; 6) breach of contract; and 7) a violation of the Health Care Facilities Act, 35 Pa.S. § 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 1986 Bucks County action.

In November 1991, DVMC and Dr. Amster filed separate Motions for Summary Judgment. In a single order, the trial court granted the motion of DVMC and the thirty individual defendants 1 as to all causes of action in both of appellee's complaints. Judge Biester concluded that it was precluded from engaging in a substantive review of the hospital's staffing decisions by reason of the Superior Court's holding in Rosenberg v. Holy Redeemer Hospital, 351 Pa.Super. 399, 506 A.2d 408 (1986), allocature denied, 514 Pa. 643, 523 A.2d 1132 (1986). Moreover, 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 Pa.S. § 425. Dr. Amster's motion was granted with respect to the claims under the Fourteenth Amendment; for intentional infliction of emotional distress; and for defamation. With respect to all other claims, Dr. Amster's motion was denied.

As a result of the trial court's order, Dr. Cooper appealed to the Superior Court. The Superior Court reviewed the issues raised, and consolidated them into two primary areas of concern. First, Dr. Cooper disputed the interpretation and application of Rosenberg v. Holy Redeemer Hospital. Cooper v. Delaware Valley Medical Center, 428 Pa.Super. 1, 630 A.2d 1 (1993). Second, Dr. Cooper questioned the interpretation and application of the immunity provisions of the Peer Review Protection Act. Id.

The Superior Court found that the trial court had interpreted Rosenberg too broadly and distinguished the instant matter from Rosenberg. Moreover, the Superior Court found that the immunity provisions of the Peer Review Protection Act do not extend to hospitals, but are limited to individuals. After establishing that the DVMC was not immune and that Dr. Cooper's action was not completely prohibited by Rosenberg, the court went on to discuss the correctness of the trial court's order of summary judgment. The Superior Court held that there were issues of fact as to whether some individuals were motivated by malice so as not to be immune under the Peer Review Protection Act. Accordingly, the Superior Court found that the trial court's grant of summary...

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