DiTrolio v. Antiles
| Decision Date | 01 August 1995 |
| Parties | Joseph V. DITROLIO, M.D., Plaintiff-Respondent, v. Leonard ANTILES, M.D., Peter Boorjian, M.D., Domenick Falcone, M.D., Oleh Bachynsky, M.D., and the Montclair Urological Group, Defendants-Appellants, and Jane Doe, a fictitious defendant, John Doe, a fictitious defendant, and XYZ, P.A., a fictitious defendant, Defendants. |
| Court | New Jersey Supreme Court |
Glenn A. Clark, Morristown, for appellants Leonard Antiles, M.D., Peter Boorjian, M.D., Domenick Falcone, M.D., and Oleh Bachynsky, M.D. (Riker, Danzig, Scherer, Hyland & Perretti, attorneys; Mr. Clark and Edward A. Zunz, Jr., of counsel; Mr. Clark and Barbara J. Scheader, on the briefs).
David P. Weeks, Woodbridge, for appellant Montclair Urological Group (Mackenzie, Welt, Maher, North & Weeks, attorneys).
Frank R. Ciesla, Middletown, for respondent (Giordano, Halleran & Ciesla, attorneys; Mr. Ciesla, John F. Varley, III, and James L. Petsche, on the brief).
The opinion of the Court was delivered by
In this case, we again consider the scope of the entire controversy doctrine. The occasion is presented in an action by a doctor seeking monetary damages for a variety of tortious acts committed by four doctors and their professional medical group. Plaintiff claims that as a result of the actions of the doctors, who are on the medical staff of a hospital, he was wrongfully denied full promotional staff privileges at the hospital and suffered consequential damages. This action follows a previous law suit against the hospital and its board of trustees, in which plaintiff sought to obtain the privileges that he claimed were unfairly denied.
We must determine whether the entire controversy doctrine is applicable to bar the current action because the facts giving rise to the tort claims against the doctors and their medical group also gave rise to the claims against the hospital and its trustees in the earlier action. The issue is, basically, whether a sufficient commonality of facts undergirds each set of claims to constitute essentially a single controversy that should be the subject of only one litigation.
The trial court applied the entire controversy doctrine to bar the current action. The Appellate Division reversed. 276 N.J.Super. 234, 647 A.2d 1318 (1994). The appeal is before us as the result of a dissent in the Appellate Division. R. 2:2-1.
In 1984, plaintiff Joseph DiTrolio was admitted to the medical staff of Mountainside Hospital (Hospital) as a provisional staff member in the Department of Urology (Department), and as such, was subject to supervision and observation by active staff members. 276 N.J.Super. at 238, 647 A.2d 1318. The Hospital's bylaws provided that an appointment as a provisional staff member was for a two-year term, whereupon the individual could either be promoted to the position of active staff member in the rank of an associate attending physician, with no supervision, or reappointed for a single additional term, as a provisional staff member with supervision. Ibid.
At the time of plaintiff's appointment, the Department of Urology consisted of four voting members: Drs. Leonard Antiles, Peter Boorjian, Dominic Falcone and Oleh Bachynsky. Dr. Antiles was the director of the Department. Three of the voting members, Drs. Antiles, Boorjian and Falcone, were shareholders in the Montclair Urological Group. Ibid.
Plaintiff maintains that from the beginning of his affiliation with the Hospital in 1984, the doctors engaged in conduct "for the sole purpose of interfering with his ability to treat patients there." Specifically, plaintiff points to numerous scheduling problems. The doctors, who supervised plaintiff during surgery, would often cancel at the last minute. Consequently, plaintiff claims that he was "forced to limit his hospital admissions to only a handful of patients each year."
After two years as provisional staff, plaintiff became eligible for appointment to the active medical staff of the Hospital. The bylaws required the Department to make a recommendation concerning plaintiff's medical competency. In September 1986, the Department submitted its recommendation to the Medical Staff Membership and Credentials Committee (M & C Committee). The same four doctors who comprised the Urology Department also at that time comprised the entire M & C Committee. The Urology Department recommended against plaintiff's appointment as an active staff member and for reappointment as a provisional staff member under continued supervision and observation. Id. at 238-39, 647 A.2d 1318. In their review of plaintiff's record, the members of the Department determined Id. at 239, 647 A.2d 1318. The Department, however, also recommended that plaintiff be permitted to perform four specified procedures without supervision or observation. Ibid. The M & C Committee accepted these recommendations. Ibid.
Specifically, the Department was concerned about plaintiff's medical care in two cases that had been the subject of Department Quality Assurance presentations. The Department viewed these cases as involving "substandard" medical care and informed plaintiff at a September 11, 1986 meeting that if "the quality of his work does not improve significantly ... the Department will not recommend the appointment to the Staff at the end of the provisional period."
The following year, on August 20, 1987, plaintiff once again requested promotion from provisional to associate attending status. Ibid. Because the Hospital's medical bylaws provide that a candidate can be reappointed to the provisional staff only once, the only options available to the doctors at this time were to recommend that plaintiff either be appointed as a full-fledged active staff member or to reject his appointment completely.
Once again, the Department recommended against the promotion, citing seven cases that "typified Dr. DiTrolio's inability to perform up to the standards of the Mountainside Urology Department." Ibid. The M & C Committee on February 16, 1988, accepted the Department's recommendation that plaintiff "not be reappointed to the [Hospital] medical staff because of his inability to maintain adequacy of medical care in the [Department]." Ibid. The Committee further recommended that plaintiff "however continue with his current privileges until due process is completed." Ibid.
In a letter dated February 17, 1988, plaintiff's attorney requested a hearing pursuant to the Hospital bylaws regarding plaintiff's "application for promotion to associate attending status ... and removal of all departmental observation and supervision," asserting "that the Membership and Credentials Committee has failed to submit to the Medical Board a recommendation regarding Dr. DiTrolio's application for promotion from provisional to associate status." Ibid. Based on this request, an ad hoc committee of the Hospital's medical staff (Ad Hoc Committee) was constituted. Ibid. It conducted hearings on nine non-consecutive days between May 18 and July 5, 1988. Ibid. Plaintiff was represented by counsel throughout the ad hoc hearing. The Department doctors testified, as well as the Chairman of the M & C Committee and the Director of Medical Records. Plaintiff testified on his own behalf, and additionally presented two independent expert witnesses who testified that plaintiff did not violate accepted standards of medical care in the seven cases. Plaintiff also called the Hospital's Medical Staff President, the Hospital's Chief Executive Officer, and another doctor as witnesses. The hearing generated 1100 pages of transcripts.
In September 1988, The Ad Hoc Committee concluded that plaintiff should be promoted and that his medical care was satisfactory. In its review of the seven cases presented, the Ad Hoc Committee determined that plaintiff's overall management of the seven cases "was generally acceptable and does not justify a recommendation for non-reappointment." Id. at 240, 647 A.2d 1318. The Ad Hoc Committee also recommended that because plaintiff had not had an opportunity to demonstrate competence at the Hospital in three areas of complex urological surgery, that before unsupervised surgical privileges be granted with respect to radical nephrectomy, open uretal procedures, and cystectomy, plaintiff
present evidence, such as two or three cases in each category, done at another hospital for review of adequacy by an Ad Hoc Committee. This Committee should include at least one urological consultant from another hospital. In the event that this material is not available, an outside urologist should be hired by the hospital to supervise these cases done at Mountainside Hospital. This consultant should report directly to the Medical Staff President.
[Ibid.]
Additionally, the Ad Hoc Committee expressed concern about "the procedures followed by the Department of Urology and the Membership and Credential Committee in this case," but noted that it "cannot conclude that there was intentional wrongdoing." Ibid. The specific concerns were:
1. Department of Urology meetings were held in the Chairman's office, rather than in the hospital. Because departmental meetings are official hospital business, they should be conducted on the hospital premises.
2. Assigning supervision has apparently been at the sole discretion of the Chairman. A specific procedure for assigning supervision should be included in the Department rules, and all active members of the Department should be included to provide broadened assessment of competence.
3. The Committee is concerned that Dr. DiTrolio was not adequately informed and properly counseled at the time criticisms of his work apparently arose. It is extremely important that if alleged deficiencies exist, th...
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