Harris v. Bradley Mem'l Hosp. & Health Ctr., Inc.

• Decision Date: 16 May 2012
• Docket Number: SC 18944
• Court: Connecticut Supreme Court
• Parties: STEPHEN HARRIS v. BRADLEY MEMORIAL HOSPITAL AND HEALTH CENTER, INC.

STEPHEN HARRIS v. BRADLEY MEMORIAL HOSPITAL AND HEALTH CENTER, INC.

SC 18944

Supreme Court of Connecticut

Argued May 16

officially released September 4, 2012

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Michael G. Rigg, with whom was Steven V. Manning, for the appellant (defendant).

P. Jo Anne Burgh, with whom was Mary Alice Moore Leonhardt, for the appellee (plaintiff).

Opinion

HARPER, J. This case, involving the summary suspension of the medical privileges of the plaintiff, Stephen Harris, by the defendant, Bradley Memorial Hospital and Health Center, Inc., comes to this court for the second time. In the plaintiff's appeal; Harris v. Bradley Memorial Hospital & Health Center, Inc., 296 Conn. 315, 319-20, 994 A.2d 153 (2010); this court determined that the trial court improperly had granted the defendant's motion for judgment notwithstanding the verdict on claims of breach of contract, breach of the implied covenant of good faith and fair dealing, and tortious interference with business expectancies¹ due to the plaintiff's failure to prove that the underlying administrative proceedings ultimately had terminated in his favor and improperly had denied the plaintiff's motion for punitive damages. Accordingly, we reversed the judgment as to the grant of the motion for judgment notwithstanding the verdict and as to the denial of the motion for punitive damages and remanded the case for further proceedings. Id., 351-52.

The present appeal arises from the proceedings on remand that resulted in the plaintiff being awarded punitive damages and offer of judgment interest pursuant to General Statutes § 52-192a. The defendant now appeals from the trial court's judgment,² claiming that: (1) it was entitled to immunity as a matter of law under the federal Health Care Quality Improvement Act of 1986 (federal act), 42 U.S.C. § 11101 et seq., from damages arising from its summary suspension of the plaintiff's privileges; (2) the trial court improperly instructed the jury regarding the standard for determining immunity under the federal act; (3) the award of common-law punitive damages violated the defendant's constitutional right to due process; (4) the award of common-law punitive damages violated the defendant's right to immunity under the federal act and the common law; and (5) the offer of judgment interest violated the defendant's right to due process. The plaintiff contends that the defendant is precluded from raising the first two claims due to its failure to properly raise them in the previous appeal in which the jury verdict was at issue and that we should reject the remaining claims relating to punitive damages and offer of judgment interest on the merits. We conclude that the defendant is not precluded from raising its immunity claims and that it is entitled to immunity from money damages under the federal act as a matter of law. Accordingly, we reverse the judgment.

In the first appeal, we set forth in substantial detail the underlying facts that the jury reasonably could have found. Harris v. Bradley Memorial Hospital & Health Center, Inc., supra, 296 Conn. 320-25. We summarize those facts, and the pertinent procedural history reflected in the record, that are necessary to an under-standing of the issues presently before us. In 1993, the plaintiff, a general surgeon, was admitted to the defendant's medical staff and granted privileges, which the defendant periodically renewed. In 1999, following the renewal of the plaintiff's privileges earlier that year, a patient sustained an injury during a surgical procedure performed by the plaintiff. After a review of that procedure at the department of surgery's monthly morbidity and mortality meeting, the plaintiff agreed to a six month period of observation, after which time the plaintiff's privileges were fully restored.

In late 2000, members of the defendant's administration informed the plaintiff that, because of concerns about his clinical capabilities, an outside entity would be contacted to perform a review and analyze his cases. In fact, the proposed external review already had been conducted, based on a nonrandom sample of only those surgical cases of the plaintiff that previously had been subject to review at the morbidity and mortality meetings due to some complication or error that had occurred. Shortly thereafter, the plaintiff was informed that the external review had been completed and that, because the report was unfavorable, the defendant's medical executive committee had decided to form a peer review panel for the purpose of conducting further review of the plaintiff's cases. An additional nonrandom sample of the plaintiff's cases in which issues had arisen was submitted to the peer review panel.

In early 2001, the plaintiff was summoned to appear before the peer review panel, with no prior notice of the meeting date or the cases on which he would be questioned. Following that meeting, the peer review panel prepared a report in which it questioned the plaintiff's ability to safely function independently as a general surgeon in light of the panel's conclusions that the surgical care provided by the plaintiff during the period of time reviewed evidenced global deficits and did not meet the standard of care expected of a board certified general surgeon. Shortly thereafter, the reports of both the peer review panel and the external review were presented at the monthly meeting of the medical executive committee. The committee summarily suspended the plaintiff's surgical privileges effective immediately and limited his privileges to assisting in the operating room.

Pursuant to the defendant's medical staff bylaws, the plaintiff then sought review of the medical executive committee's action. On review, the hearing panel found that the plaintiff had not met his burden of proving that the decision suspending his privileges was not sustained by the evidence, unreasonable or otherwise unfounded. On the basis of its findings, the hearing panel recommended that the summary suspension be continued. The defendant's board of directors subsequently rejected the plaintiff's appeal from the decision of thehearing panel, in which the plaintiff had claimed that the suspension was unwarranted, motivated by the bad faith of a competing surgeon who had assumed the position of chairman of the department of surgery in September, 2000, and impeded by the lack of due process.

Thereafter, the plaintiff commenced the present action, alleging in a four count complaint: (1) breach of contract; (2) breach of the covenant of good faith and fair dealing; (3) tortious interference with business expectancies; and (4) a violation of the Connecticut Unfair Trade Practices Act (CUTPA), General Statutes § 42-110a et seq. The plaintiff sought damages and a permanent injunction requiring the defendant to cease and desist from terminating the plaintiff's privileges and interfering with his patient relationships. In response, the defendant asserted a special defense that it was immune from liability under the federal act, which covers professional peer review actions by health care providers such as hospitals.³

Prior to trial, the defendant filed a motion for summary judgment, claiming that the plaintiff was unable to rebut the statutory presumption of immunity under the federal act. The trial court, Burke, J., granted the motion in part and denied it in part. The court first determined that the federal act applies an objectively reasonable standard for examining a ''professional review action''; see footnote 14 of this opinion; to which the presumption of immunity applies under the federal act, and thus, the plaintiff's allegations of bad faith were irrelevant. The court further determined that there had been more than one professional review action and that the plaintiff had demonstrated the existence of a material question of fact as to whether at least one of them, the proceedings culminating in the summary suspension of the plaintiff's privileges by the medical executive committee, satisfied the statutory criteria for immunity. Specifically, the court determined that the plaintiff had presented sufficient evidence to raise a question as to whether he had rebutted the presumption that the defendant had met two of the conditions for immunity to apply—that the defendant had made reasonable efforts to obtain the facts and had provided the plaintiff with adequate notice and the opportunity to be heard. 42 U.S.C. § 11112 (a) (2) and (3); see footnote 13 of this opinion for the text of that statute. The court rejected the defendant's claim...