Dookeran v. County of Cook
| Decision Date | 14 December 2009 |
| Docket Number | No. 1-08-1426.,1-08-1426. |
| Citation | 336 Ill. Dec. 424,920 N.E.2d 633 |
| Parties | Keith DOOKERAN, Plaintiff-Appellee and Cross-Appellant, v. The COUNTY OF COOK, Defendant-Appellant and Cross-Appellee. |
| Court | United States Appellate Court of Illinois |
Jabob Pomeranz, Esq., Cornfield and Feldman, Chicago, IL, for Plaintiff-Appellee and Cross-Appellant.
Patrick T. Driscoll, Jr., Chief, Civil Action Bureau, Arleen C. Anderson, Richard A. Devine, State's Attorney, Cook County, Chicago, IL, for Defendant-Appellant and Cross-Appellee.
This appeal and cross-appeal arise from Dr. Keith Dookeran's petition for review, through a common law writ of certiorari, of the Cook County Board's denial of his 2004 application for reappointment to the medical staff at John H. Stroger, Jr., Hospital of Cook County (Stroger). Dr. Dookeran was first hired by Stroger in 2000, subject to biennial reappointments. In his 2004 reappointment application, Dr. Dookeran revealed for the first time that he received a formal reprimand from his previous employer. Neither his initial 1999 application nor his 2002 reappointment application detailed the reprimand. Several administrative committees at Stroger conducted inquiries into the omission and discovered both the details of the previous reprimand and a series of allegations that Dr. Dookeran behaved unprofessionally toward students, staff, and colleagues at Stroger. Pursuant to Stroger's medical staff bylaws (bylaws), a hearing committee was formed and heard testimony concerning the allegations against Dr. Dookeran.
Based on its findings, the hearing committee recommended that Dr. Dookeran's reappointment application be denied. Although other administrative committees disagreed, the Cook County Board adopted the hearing committee's recommendation and denied Dr. Dookeran's reappointment application. Dr. Dookeran filed a petition for a writ of certiorari in the circuit court. Judge Kathleen M. Pantle reversed the Board's denial of Dr. Dookeran's reappointment in favor of the reprimand recommended by Stroger's executive medical staff (EMS) to suspend Dr. Dookeran's clinical privileges for 30 days.
Cook County appeals, arguing that Judge Pantle failed to give due deference to the facts set out in the administrative record supporting the Board's denial of Dr. Dookeran's reappointment.
Dr. Dookeran cross-appeals from the 30-day suspension.
Because the Board's decision to deny reappointment was not arbitrary or capricious, we affirm the Board's decision and reverse Judge Pantle's order.
In January 1997, Dr. Dookeran was hired at Mercy Hospital in Pittsburgh (Mercy) as a general surgeon and surgical oncologist. On November 18, 1998, Dr. Ronald Boron, chairman of the medical executive committee at Mercy, sent Dr. Dookeran a letter formally reprimanding him for "creat[ing] a hostile work environment." The letter requested that Dr. Dookeran "refrain from screaming and yelling at, berating, threatening and intimidating Mercy Hospital employees," and noted that "[f]urther outbursts and disruptive behavior of this type" would lead to "more serious action." In the letter, Mercy's medical executive committee recommended that Dr. Dookeran "seek help in the form of counseling to assist in the control of this behavior."
Also in November 1998, Dr. Dookeran received a letter from the Greater Pittsburgh Surgical Associates (Greater Pittsburgh), a group practice at Mercy, terminating his position as director of surgical research and associate program director of the general surgery residency program. According to the letter, the terminations were "a consequence of [Dr. Dookeran's] unprofessional conduct toward Mercy Hospital employees."
In 1999, Dr. Dookeran applied for a position in the surgery department at Stroger. In his application, Dr. Dookeran noted that his contract with the Greater Pittsburgh practice group was terminated in November 1998. Although the application form asked if Dr. Dookeran's clinical privileges had ever been revoked, it did not request information regarding formal reprimands; Dr. Dookeran's application did not disclose his reprimand letter from Mercy. Dr. Dookeran's application included a letter of recommendation from Dr. Howard Zaren, who supervised Dr. Dookeran at Mercy and in 1999 was chairman of Stroger's surgery department. Dr. Zaren would later testify before Stroger's hearing committee that he was aware of Dr. Dookeran's Mercy reprimand when he wrote the recommendation, but he believed the reprimand was "retaliation for a whistle blowing situation" wherein Dr. Dookeran allegedly discovered that doctors at the Mercy Cancer Institute forged their names on a grant application Dr. Dookeran prepared. In his recommendation, Dr. Zaren did not mention the reprimand letter and rated Dr. Dookeran's relationships with students, colleagues, and paramedical staff as exceptional. Based in part on Dr. Zaren's recommendation, Cook County appointed Dr. Dookeran to the Stroger medical staff as an attending physician with clinical privileges.
After his appointment, Dr. Dookeran was required by the bylaws to apply for reappointment biennially. In July 2002, Dr. Dookeran submitted an application for reappointment to his department chair, Dr. Zaren, who pursuant to the bylaws then submitted it to Stroger's credentials committee. On the form, Dr. Dookeran indicated that he had not been reprimanded by any health care organization over the prior four years, failing to note Mercy's reprimand three years and eight months earlier. Dr. Dookeran was reappointed.
In April 2004, Dr. Dookeran again applied for reappointment by submitting the same form to Dr. Zaren and the credentials committee. However, on the 2004 application Dr. Dookeran fully disclosed the details of his Mercy reprimand, which by this point dated back nearly seven years.
The credentials committee requested in writing that Dr. Dookeran explain his failure to disclose Mercy's reprimand in either his 1999 job application or his 2002 reappointment application. In response, Dr. Dookeran wrote to the committee that the 1999 application form did not request information on reprimands, and that in July 2002 he "perhaps believed that the reprimand had occurred almost four years previously and that there was no need for reporting." Dr. Dookeran added, "[i]n my 2004 reapplication, I did not need to report the reprimand since it occurred 7 years ago, however, I did so in error." Subsequently, the credentials committee interviewed Dr. Dookeran and several other members of Stroger's staff to determine whether his behavior at Stroger was similarly unprofessional as his conduct at Mercy.
Pursuant to the bylaws, the credentials committee submitted a recommendation to deny Dr. Dookeran's reappointment application to the executive medical staff (EMS). The bylaws provide that the EMS should review the credentials committee's recommendation and submit a recommendation of its own to the medical director and the joint conference committee, which advises the Cook County Board on its final decision. However, the bylaws permit an alternative path for review; any staff member can file a report with the peer review committee whenever the conduct of a practitioner threatens patient safety or falls below professional standards. Before making its recommendation to the medical director and joint conference committee, the EMS utilized this alternative and referred the matter to the peer review committee to investigate Dr. Dookeran's alleged misconduct at Stroger.1
The peer review committee reviewed the credentials committee's report, met with members of the credentials committee, and interviewed Dr. Dookeran, Dr. Zaren, and several other members of Stroger's staff. The peer review committee then issued a written recommendation to the EMS. In its recommendation, the peer review committee concluded that Dr. Dookeran "willfully falsified" his 2002 reappointment application by denying the existence of the Mercy reprimand letter, and that Dr. Dookeran "has a long history of inappropriate behavior with hospital personnel" which "consists of verbal abuse." The committee also found that Dr. Dookeran "has not shown the ability or willingness to change his behavior." However, the peer review committee recommended only a 29-day suspension of Dr. Dookeran's clinical privileges.
The EMS reviewed the peer review committee's recommendation and adopted it, but increased the length of the suggested suspension to 30 days. This would require Dr. Dookeran to report the suspension to the national physician data bank and adversely affect his future employment prospects. The bylaws provide that when the EMS makes such an adverse recommendation against a practitioner, it triggers that practitioner's right to a "hearing and appeal" challenging that unfavorable decision before it is submitted to the joint conference committee. The bylaws further provided that at such a hearing, the practitioner "shall have the burden of proving, by clear and convincing evidence, that the adverse action or recommendation lacks a factual basis or that the adverse action or recommendation is arbitrary, capricious or unreasonable." At Dr. Dookeran's request, a hearing committee composed of five attending members of the medical staff not previously involved in the case was appointed to hear his appeal.
The testimony before the hearing committee concerned Dr. Dookeran's reappointment applications and several allegations of unprofessional conduct by Dr. Dookeran at Stroger. Because the testimony was given at several different times based upon the availability of the relevant witnesses, we present it below according to its subject matter.
In his testimony...
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Dookeran v. Cnty. of Cook
...in fact he had received a formal reprimand for creating a hostile work environment at Mercy. See Dookeran v. County of Cook, 396 Ill.App.3d 800, 336 Ill.Dec. 424, 920 N.E.2d 633, 637 (2009). More particularly, Dookeran was removed as director of surgical research and associate director of t......
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Dookeran v. Cnty. of Cook
...of the circuit court and upheld the denial of the plaintiff's reappointment application. Dookeran v. County of Cook, 396 Ill.App.3d 800, 336 Ill.Dec. 424, 920 N.E.2d 633 (2009)( Dookeran I ). The Illinois Supreme Court denied the plaintiff's petition for leave to appeal. See Dookeran v. Cou......
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Dookeran v. Cnty. of Cook
...years, when in fact he had received a formal reprimand for creating a hostile work environment at Mercy. See Dookeran v. County of Cook, 920 N.E.2d 633, 637 (Ill. App. Ct. 2009). More particularly,Dookeran was removed as director of surgical research and associate director of the general su......