Garrison v. Board of Trustees of Memorial Hosp. of Laramie County, Wyo.

• Decision Date: 19 July 1990
• Docket Number: No. 89-200,89-200
• Citation: 795 P.2d 190
• Parties: Richard L. GARRISON, M.D., Appellant (Plaintiff), v. BOARD OF TRUSTEES OF MEMORIAL HOSPITAL OF LARAMIE COUNTY, WYOMING, Appellee (Defendant).
• Court: Wyoming Supreme Court

Page 190

795 P.2d 190

28 A.L.R.5th 801

Richard L. GARRISON, M.D., Appellant (Plaintiff), v. BOARD OF TRUSTEES OF MEMORIAL HOSPITAL OF LARAMIE COUNTY, WYOMING, Appellee (Defendant).

No. 89-200.

Supreme Court of Wyoming.

July 19, 1990.

Daniel E. White of Vines, Gusea & White, P.C., Cheyenne, for appellant.

Gregory C. Dyekman of Dray, Madison & Thomson, P.C., Cheyenne, for appellee.

Before CARDINE, C.J. ^* , and THOMAS, URBIGKIT, MACY and GOLDEN, JJ.

CARDINE, Chief Justice.

This appeal addresses the propriety of the appellee's, Board of Trustees of Memorial Hospital of Laramie County (Trustees), denial of appellant's, Richard L. Garrison, M.D., application for appointment to the medical staff at Memorial Hospital (Hospital). The Trustees denied Dr. Garrison's application on November 4, 1988. On December 5, 1988, Dr. Garrison filed a complaint in the district court seeking declaratory, monetary and injunctive relief. The district court upheld the decision of the Trustees and, on appeal, Dr. Garrison challenges that order.

We affirm.

ISSUES

Dr. Garrison states the issues to be:

"I. Whether the appellant was denied due process of law by virtue of appellee's consideration of his medical competency where the appellant was systematically precluded from developing a record on that issue.

"II. Whether the trial court erred in relying upon the fact that appellant has not held obstetrical privileges since 1985 as a justification for its finding that the appellee's conduct was not arbitrary or capricious."

The Trustees summarize the case in one issue:

"I. Whether the decision of the Board of Trustees of Memorial Hospital of Laramie County to deny appellant's application for appointment to the medical staff was arbitrary, capricious or without foundation in fact."

BACKGROUND

On May 26, 1988, Dr. Garrison submitted an application for appointment to the medical staff of the Hospital. He used a form supplied by the Hospital which provides:

"I hereby apply for appointment to the Medical Staff of Memorial Hospital of Laramie County. I understand and agree that I, as an applicant for Medical Staff membership, have the obligation to produce adequate information for proper evaluation of my professional competence, character, ethics, physical and mental health and other qualifications, and for resolving any doubts about such qualifications.

"I hereby authorize all hospitals, medical institutions or organizations, my references, personal physicians, employers, business and professional associates and governmental agencies to release to the Hospital and its Medical Staff information and records for evaluation of my professional, ethical and physical qualifications for membership on the Staff and practice in the Hospital.

"I hereby release from liability all representatives of the Hospital and its Medical Staff for their acts performed in good faith and without malice in connection with evaluating my application and my credentials and qualifications, and release from liability any and all individuals and organizations who provide information to the Hospital or its Medical Staff, in good faith and without malice, concerning my qualifications for staff appointment and clinical privileges. I hereby consent to the release of such information.

"I fully understand that any significant misstatements in or omissions from this application constitute good and sufficient cause for denial of appointment or cause for summary dismissal from the Medical Staff. All information submitted by me in this application is true to my best knowledge and belief.

"If I am granted membership on the Medical Staff, I agree to abide by its Bylaws, Rules and Regulations and those of the Governing Board of the Hospital. I understand that initial and continued Staff membership are dependent upon professional competence and ethical practice.

"Richard Garrison MD

Signature

05/26/88

Date"

Dr. Garrison completed the application form. In answer to the question: "D. Have your privileges at any hospital ever been suspended, diminished, revoked or not renewed," he answered "no." ¹ In response to a routine inquiry to former sites of medical practice, the Hospital received a letter from the medical director of Thomas Memorial Hospital, South Charleston, West Virginia. The letter contained the following passage:

"Concerns over his obstetrical practice prompted a summary suspension of his obstetrical privileges effective on September 16, 1985. Doctor Garrison then requested that obstetrical privileges be deleted from his clinical privileges. In view of this request, Doctor Garrison was notified by letter dated December 6, 1985, that the summary suspension had been lifted."

The record also contains a letter from Dr. Garrison to Thomas Memorial Hospital, dated December 13, 1985, in which he resigned from the medical staff of that hospital.

At the hearing before the Medical Staff Joint Hearing Committee of Memorial Hospital, Dr. Garrison explained at length his reasons for answering "no" to the question at issue. He explained that he felt any questions about his competence had been decided in his favor and that he understood that his settlement of the issue with Thomas Memorial Hospital included an agreement that the action against his privileges By letter dated August 23, 1988, the Executive Committee of the Hospital (as well as the Credentials Committee) informed Dr. Garrison that it would recommend to the Trustees that his application be denied because of his answer of "no" to item D, supra. Dr. Garrison was also informed of his right to a hearing before the Joint Hearing Committee. A hearing was conducted at Dr. Garrison's request on September 13, 1988. By letter dated September 23, 1988, Dr. Garrison was informed that the Joint Hearing Committee would recommend denial of Dr. Garrison's application to the Trustees. Dr. Garrison was given notice by letter dated October 18, 1988, that the Trustees would provide an appellate review of the Joint Hearing Committee's decision. That hearing was conducted on October 31, 1988, and by letter dated November 4, 1988, the Trustees informed Dr. Garrison that they affirmed the decision of the Joint Hearing Committee saying:

                had been totally nullified as though it had never happened.  The record also contains a letter to the Hospital from John W. Traubert, M.D., Associate Dean for Student and Curricular Affairs, School of Medicine, West Virginia University.  He had conducted a review, per request of Thomas Memorial Hospital, concerning the quality of obstetrical care rendered by Dr. Garrison.  Dr. Traubert concluded that Dr. Garrison's care "was above reproach in all respects."   Dr. Traubert went on to express his opinion that Dr. Garrison's problems at Thomas Memorial Hospital were precipitated by that hospital's aversion to indigent patients (Dr. Garrison had a "fair percentage" of such cases and was the only doctor in the county that would deliver indigent patients) and because of Dr. Garrison's involvement in "pro-life" political activities.  Dr. Traubert could not confirm that these were the motivations for Thomas Memorial Hospital's action against Dr. Garrison;  but, he concluded, "it was clear to me that honest scientific review of patient care was not the motive."
                

"The Board [of Trustees] has limited its consideration in this matter in the same way the Joint Hearing Committee, Executive Committee and Credentials Committee previously did. The Board does not believe that it can or should attempt to pass judgment upon the merits of the summary suspension you suffered in West Virginia. Regardless of merit or lack of merit of that action, the fact remains that a summary suspension did occur and that your privileges were not renewed at that hospital. Both of these events should have been reported on your Medical Staff Application to Memorial Hospital of Laramie County, but were not.

"The Board has determined that falsification of one or more answers on your Staff Membership Application raises legitimate concerns over your veracity and professional ethics.

"After reviewing the evidence, the Board has determined that a decision of the Joint Hearing Committee to deny your staff membership application on the basis of the falsification of one or more answers on your application is supported by sufficient evidence. You have been given ample opportunity to present evidence to the Joint Hearing Committee and to the Board. The Board believes that all procedures set forth in the Medical Staff By-Laws have been correctly followed with respect to the matter of your application for staff membership. The explanations and reasoning given by you for providing information on your Medical Staff Application which was factually false were insufficient to justify that false answer. Providing false information to the hospital with respect to important matters such as medical staff privileges is a sufficient basis for the denial of your medical staff application."

We note also that the record contains an application for medical staff privileges at Putnam General Hospital, Hurricane, West Virginia, which is dated July 22, 1987. In that application, Dr. Garrison answered a similar question "yes." At the hearing before the district court, Dr. Garrison explained that he had answered that way even though he had been advised by Putnam General Hospital personnel that he Dr. Garrison filed his civil action in the district court seeking declaratory,...