Freilich v. Bd. of Dir. of Upper Chesapeake Health
| Citation | 142 F.Supp.2d 679 |
| Decision Date | 14 May 2001 |
| Docket Number | No. CIV.A. S00-3605.,CIV.A. S00-3605. |
| Parties | Linda FREILICH, M.D. and Linda Freilich, M.D., P.A., Plaintiffs, v. THE BOARD OF DIRECTORS OF UPPER CHESAPEAKE HEALTH, INC., formerly Harford Mem. Hospital, et. al. Defendants |
| Court | U.S. District Court — District of Maryland |
Jennifer Mary Valinski, Law Office of Paul S. Blumenthal, Annapolis, MD, Paul S. Blementhal, Annapolis, MD, for Linda Freilich, M.D., P.A., plaintiffs.
Ward B Coe, III, Whiteford Taylor and Preston, Baltimore, MD, Brian M Peters, Jonathan B Sprague, Mitchell Allen Cohen, Post and Schell PC, Philadelphia, PA, for Upper Chesapeake Health, Inc., Board of Directors of Upper Chesapeake Health, Inc., Cecilio T. Camacho, M.D. Joan P. Edwards, Scott S. haswell, M.D., Shirley S. klein, James Lambdin, Anthony J. Meoli, Lyle E. Sheldon, Kenneth W. DeFontes, jr., David F. Gonano, Sherif H. Osman, M.D., Roger E. Schneider, M.D., Diane K. Ford, H. William Acker, Randall Worthington, SR., defendants.
Wendy A Kronmiller, J Joseph Curran, Jr., Office of the Attorney General, Baltimore, MD, for Secretary, Maryland Department of Health and Mental Hygiene, defendant.
The plaintiff, Dr. Linda Freilich, filed a 14-count, 76-page Complaint, against Upper Chesapeake Health (UCH), formerly Harford Memorial Hospital (HMH), fourteen individuals who were involved in her peer review, the State of Maryland, and the United States of America, alleging constitutional, statutory, and common law claims in connection with the hospital's termination of her medical staff privileges. Specifically, she alleges that the Health Care Quality Improvement Act (HCQIA), 42 U.S.C. § 11101 et seq., which provides immunity from damages to those who participate in physician peer review, and the Maryland statute (Section 19-319(e) of the Health-General Article of the Maryland Code) and regulation (Section 10.07.01.24(E) of the Code of Maryland Regulations), which govern physician credentialing, are all unconstitutional. She also brings a § 1983 claim against the hospital and individual defendants claiming that these parties violated her constitutional rights in making the decision to terminate her staff privileges. Finally, she alleges violations of the Americans with Disabilities Act and the Federal Rehabilitation Act based on her association and care of dialysis patients at the hospital, and a host of state law claims related to her loss of staff privileges. The State of Maryland and the United States government have moved to dismiss all claims that the plaintiff has asserted against them, and the hospital defendants have filed motions to dismiss all of the federal claims and several of the state law claims.1 There is no complete diversity of citizenship, so this Court's original jurisdiction is invoked only under 28 U.S.C. § 1331.
The Court notes at the outset that, on top of filing an unbelievably lengthy and complex complaint in this case, the plaintiff's briefs have improperly strayed far off point, injecting arguments and additional claims that are themselves legally insufficient. The Court will disregard all of these matters, confining its analysis to what was asserted in the plaintiff's complaint. For the following reasons, all of the defendants' motions to dismiss will be GRANTED, as to all federal claims, and the Court will exercise its discretion to dismiss the remaining state law claims without prejudice pursuant to 28 U.S.C. § 1367(c)(3).
Dr. Linda Freilich is a Board Certified Internist and Nephrologist who has practiced in Harford County, Maryland, and has had medical privileges at HMH for the past eighteen years.2 On April 11, 2000, the hospital defendants, Harford Memorial Hospital (HMH), now operating as part of Upper Chesapeake Health, Inc. (UCH),3 and a group of Dr. Freilich's peers at the hospital, denied Dr. Freilich's application for reappointment at the hospital. Dr. Freilich alleges that the defendants' failure to reappoint her was based on her "protected patient advocacy." Compl. at ¶ 21. Specifically, Dr. Freilich alleges that she advocated on behalf of certain patients at the hospital by making complaints about what she believed to be substandard care provided to certain groups of patients, including nursing home, dialysis, and indigent patients. She alleges that as a result of this advocacy, HMH and its Board of Directors participated in "a predetermined and a deliberate scheme and systematic program designed to force her out of [the hospital] in violation of [her] Constitutional Rights and in violation of Maryland's Health Code, COMAR Regulations and Maryland Law and Public Policy." Compl. at ¶ 81.
Dr. Freilich applied for reappointment at HMH in July 1998, pursuant to HMH bylaws and the Maryland state regulations, COMAR, 10.07.01.24(E)(2), which require that medical staff members apply for reappointment at least every two years. Dr. Freilich's application was forwarded to the Credentials Committee, which recommended in October 1998 that she be reappointed for one year through November 1999. This decision was approved by the Medical Executive Committee ("MEC"). However, in December 1998, the Board of HMH did not accept the MEC's recommendation for a one-year appointment, deciding instead to extend Dr. Freilich's privileges until the next board meeting scheduled for April 1999, for the purpose of allowing the MEC to conduct further review of Dr. Freilich's application. On April 14, 1999, after further review, the MEC recommended that Dr. Freilich's reappointment application be denied. Because of this adverse recommendation, Dr. Freilich requested, and received, a hearing before the Ad Hoc Hearing Committee. In January 2000, the Hearing Committee recommended that Dr. Freilich be reappointed retroactively for one year. The MEC requested appellate review of the Hearing Committee's recommendation, and at the Board's April 2000 meeting, the Appellate Review Committee proposed that Dr. Freilich's reappointment be denied. On April 11, 2000, the HMH Board voted to deny Dr. Freilich's application for reappointment to the medical staff, and to terminate her medical privileges. The basis for the Board's decision, as set forth in a letter notifying Dr. Freilich of the decision, was Dr. Freilich's "fail[ure] to demonstrate ethics and behavior in the hospital, cooperation with hospital personnel as it relates to patient care and the orderly operation of the hospital and proper general demeanor and attitude with respect to the hospital, its patients and its personnel." Compl., Ex. 2. The Board acted pursuant to a Medical Staff Bylaw which requires the Board to base its appointment recommendation upon certain criteria, including "[e]thics and behavior in the Hospital, cooperation with Hospital personnel as it relates to patient care or the orderly operation of the Hospital, and general demeanor and attitude with respect to the Hospital, its patients and its personnel." Bylaws, Appendix II § 3.1(g); Compl., Ex. 3. The Code of Maryland Regulations provides a standard for physician reappointment, which requires a hospital to collect and review certain information regarding the "physician's pattern of performance" including, among other factors, "[a]ttitudes, cooperation, and ability to work with others." COMAR § 10.07.01.24(E)(3)(b)(vii).
Under Federal Rule of Civil Procedure 12(b)(6), dismissal of a complaint for failure to state a claim is not appropriate "unless it appears beyond doubt that the plaintiff can prove no set of facts in support of his claim which would entitle him to relief." Conley v. Gibson, 355 U.S. 41, 45-46, 78 S.Ct. 99, 2 L.Ed.2d 80 (1957). When ruling on a motion to dismiss under 12(b)(6), a court must accept the allegations contained in the complaint as true. See DeBauche v. Trani, 191 F.3d 499, 505 (4th Cir.1999). The court is not, however, "bound by the plaintiffs legal conclusions, since the purpose of Rule 12(b)(6) is to test the legal sufficiency of the complaint." Randall v. United States, 30 F.3d 518, 522 (4th Cir.1994). Because it appears beyond doubt that Dr. Freilich can prove no set of facts sufficient to support any of her federal claims, the Court will grant defendants' motions to dismiss them all.
Dr. Freilich alleges in Count I that Md. Ann.Code, Health-General § 19-319(e) and Section 10.07.01.24(E)(3)(b)(vii) of the Code of Maryland Regulations are unconstitutional on their face and as applied to her.4 The HMH bylaw cited as the basis for the denial of Dr. Freilich's reappointment incorporates Section 10.07.01.24(E)(3)(b)(vii), which requires hospitals to consider "[a]ttitude, cooperation and ability to work with others" when making credentialing decisions. Dr. Freilich alleges that this regulation is unconstitutionally vague, and that, as applied to her through the hospital's bylaws, it violates her free speech and due process rights. She argues that these criteria are vague, ambiguous, and subjective, and are unrelated to patient care. She also alleges that the regulation violates her right to equal protection, arguing that such vague criteria are incapable of uniform application. Specifically, she states that "the State of Maryland authorizes, mandates, directs, encourages and facilitates hospitals to utilize prejudice, interpersonal animosities, arbitrary and capricious actions, and discriminatory conduct as the basis for reappointment decisions...." Compl. at ¶ 106.
In this case, Dr. Freilich brings both an action challenging the constitutionality of the state regulation under the Fourteenth Amendment (Count I) and a Section 1983 action (Count IV), based on the alleged...
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