Feyz v. Mercy Memorial Hosp.
| Decision Date | 24 June 2006 |
| Docket Number | No. 128059.,128059. |
| Citation | 475 Mich. 663,719 N.W.2d 1 |
| Parties | Bruce B. FEYZ, M.D., Plaintiff-Appellee, v. MERCY MEMORIAL HOSPITAL; Medical Staff of Mercy Memorial Hospital; Richard Hiltz, James Miller, D.O.; John Kalenkiewicz, M.D.; J. Marshall Newbern, D.O.; and Anthony Songco, M.D., Defendants-Appellants. |
| Court | Michigan Supreme Court |
Jeffrey L. Herron, Ann Arbor, for the plaintiff.
Kitch Drutchas Wagner Valitutti & Sherbrook (by Susan Healy Zitterman and Karen B. Berkery), Detroit, for the defendants.
Clark Hill, P.L.C. (by Robert L. Weyhing and Paul C. Smith), Detroit, for Michigan Osteopathic Association, amicus curiae.
Kerr, Russell and Weber, P.L.C. (by Joanne Geha Swanson and Daniel J. Schulte), Detroit, for Michigan State Medical Society, amicus curiae.
Michael A. Cox, Attorney General, Thomas L. Casey, Solicitor General, and Ron D. Robinson, Assistant Attorney General, Detroit, for the Michigan Civil Rights Commission and the Michigan Department of Civil Rights, amici curiae.
Hall, Render, Killian, Heath & Lyman, P.L.L.C. (by Michael J. Philbrick), Troy, for Michigan Health & Hospital Association, amicus curiae.
Plaintiff is a physician with staff privileges at defendant Mercy Memorial Hospital. This lawsuit arises from an internecine dispute over nursing orders for patient intake at the defendant hospital. Plaintiff's insistence on requiring the nursing staff to use his special standing orders instead of defendant hospital's standing orders eventually led to a conflict with defendant hospital and a peer review of plaintiff's professional practices as well as disciplinary action.
Plaintiff's challenge of the peer review conducted by some of the defendants and the resulting disciplinary action taken against him requires that we consider the scope of immunity provided for peer review. In order to promote effective patient care in hospitals, the Legislature enacted MCL 331.531, commonly referred to as Michigan's peer review immunity statute. The purpose of statutory peer review immunity is to foster the free exchange of information in investigations of hospital practices and practitioners, and thereby reduce patient mortality and improve patient care within hospitals. The Legislature obviously intended to protect peer review participants from liability for participation in this communicative and evaluative process. In order to create an environment in which such candid explorations of the quality of hospital patient care can occur, among other protections, the Legislature prohibited the discovery of communications made within the peer review process and granted immunity from liability to all who participate in peer review without "malice."
The primary question posed in this appeal is the scope of judicial review of peer review permitted under MCL 331.531. A secondary question is whether the judicially created "doctrine of nonintervention"—a doctrine suggesting that staffing decisions of private hospitals are generally beyond the scope of judicial review—is compatible with the peer review immunity statute. Finally, we must also construe the undefined peer review statutory term "malice."
Because the peer review immunity statute establishes qualified immunity from liability for peer review communication and participants who provide such communications, we conclude that there is no justification for recognizing the nonintervention doctrine that the lower courts in this state have applied in considering claims arising from peer review. We therefore hold that this doctrine cannot supplement or supplant the statutory immunity granted by our Legislature. Furthermore, there is no basis, statutory or otherwise, to justify the application of a nonintervention doctrine to general staffing decisions of a private hospital. We also hold that, consistent with the objects of the peer review immunity statute, malice should be defined as set forth by the Court of Appeals in Veldhuis v. Allan.1 Thus, we hold that malice can be established when a 2
Accordingly, we vacate the judgment of the Court of Appeals and remand this case to the Monroe Circuit Court for further proceedings consistent with this opinion.
Plaintiff is a physician with staff privileges at defendant Mercy Memorial Hospital.4 Plaintiff was dissatisfied with defendant hospital's standard nursing policy requiring nurses to document patients' prescribed medications and dosages by either copying the label on their prescription containers or copying a list of medications carried by patients. As a consequence, plaintiff created his own specialized orders directing the nursing staff to obtain very specific information from plaintiff's incoming patients about their prescription drug use. Plaintiff's orders directed the nursing staff, as part of the admissions process for his patients, to assume a far more aggressive investigative role regarding patient medication.5
Defendants disapproved plaintiff's standing orders, and instructed the nursing staff to ignore them. In several cases where the nurses disregarded plaintiff's special orders and followed defendant hospital's nursing directives, plaintiff prepared "incident reports" referring such cases to peer review committees for investigation of "potential medical errors." Further, plaintiff began making notations in patient records that his disregarded orders were intended to "[p]revent serious medication errors in the past."
Defendants initiated peer review proceedings against plaintiff based on plaintiff's failure to complete medical records6 and his insistence that the nursing staff follow his standing orders rather than comply with hospital policy. An ad hoc investigatory committee reviewed plaintiff's conduct and released its findings to the executive committee of defendant medical staff.7 Relying on the ad hoc committee's report, the executive committee referred plaintiff to the Health Professionals Recovery Program (HPRP) for a psychiatric examination.8 Plaintiff was placed on temporary probation.
Plaintiff alleges that he ceased writing his standard orders because, in compromise, defendant hospital gave plaintiff use of the pharmacy consult service to implement plaintiff's special orders. It appears that plaintiff's orders regarding patient medication overburdened the staff of the pharmacy consult service, so the hospital eventually discontinued this arrangement. Thereafter, plaintiff resumed placing his specialized orders in patients' medical charts. As a consequence, defendants took further action and placed plaintiff on indefinite probation. Plaintiff continues to practice medicine and retains privileges at defendant hospital, but is restricted from using defendant hospital's pharmacy consult service or insisting on compliance with his special orders.
Plaintiff filed a complaint alleging violations of the Persons with Disabilities Civil Rights Act,9 the Americans with Disabilities Act,10 the Rehabilitation Act of 1973,11 and 42 USC 1983 and 1985; invasion of privacy; breach of fiduciary and public duties; and breach of contract. The trial court granted summary disposition to defendants, concluding that all of defendants' actions arose out of the peer review process and therefore defendants were immune from liability under MCL 331.531. The court, as an alternative basis for granting summary disposition, relied on the doctrine of judicial nonintervention, which provides that courts will not review private hospitals' staffing decisions.
The Court of Appeals, in a split decision, partially reversed the trial court's award of summary disposition in favor of defendants,12 concluding that peer review immunity did not apply to statutory civil rights claims. The majority concluded that an alleged civil rights violation was not within the scope of peer review and that an alleged civil rights violation was "a malicious act."13 Furthermore, the majority held that the nonintervention doctrine did not prevent plaintiff from pursuing his civil rights claims, nor did the doctrine generally preclude plaintiff's contract and tort claims. The majority held that the doctrine stands for the limited proposition that a private hospital's staffing decisions are not subject to constitutional due process challenges. The majority concluded that the nonintervention doctrine did not create any greater insulation from judicial scrutiny than that enjoyed by any other private entity. In other words, the majority held that a private hospital's staffing decisions are subject to the same level of judicial review as would apply to the actions of any other private entity.
The Court of Appeals dissent agreed that an unlawful act of discrimination constituted malice,14 but disagreed that an unlawful discriminatory act was per se outside the scope of a peer review committee.15 The dissent would have affirmed the trial court's dismissal of plaintiff's tort and contract counts. The dissent also concluded that the majority improperly limited the scope of the nonintervention doctrine. The dissent opined that the nonintervention doctrine precluded judicial review of contract and contract-related tort claims arising from hospital staffing decisions with regard to all defendants.
This Court granted defendants' application for leave to appeal.16
The trial court granted defendants' summary disposition under MCR 2.116(C)(8). A trial court's grant of summary disposition is reviewed de novo.17 A motion for summary disposition brought pursuant to MCR 2.116(C)(8) tests the legal...
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