Koelling v. Board of Trustees of Mary Frances Skiff Memorial Hospital

• Decision Date: 15 November 1966
• Docket Number: No. 52232,52232
• Citation: 146 N.W.2d 284,259 Iowa 1185
• Parties: Lloyd H. KOELLING, Appellant, v. The BOARD OF TRUSTEES OF the MARY FRANCES SKIFF MEMORIAL HOSPITAL, Murray B. Nelson, L. B. Robison, and Laro L. Peirce, as Members of said Board, Appellees.
• Court: Iowa Supreme Court

Page 284

146 N.W.2d 284

259 Iowa 1185

Lloyd H. KOELLING, Appellant, v. The BOARD OF TRUSTEES OF the MARY FRANCES SKIFF MEMORIAL HOSPITAL, Murray B. Nelson, L. B. Robison, and Laro L. Peirce, as Members of said Board, Appellees.

No. 52232.

Supreme Court of Iowa.

Nov. 15, 1966.

Rehearing Denied Jan. 10, 1967.

Korf, Diehl, Clayton & Cleverley, Newton, for appellant.

Hammer, Matthias, Tyler & Levin, Newton, for appellees.

Cross, Hamill, Selby & Updegraff, Newton, for appellee, Laro L. Peirce.

STUART, Justice.

Dr. Koelling, M.D., brought this action in certiorari against the Board of Trustees of the Mary Frances Skiff Memorial Hospital in Newton asserting defendants' action in indefinitely suspending plaintiff's staff privileges at the hospital was illegal and unconstitutional, exceeded the board's jurisdiction and that the findings and decision of the board were not supported by sufficient evidence. The Writ of Certiorari issued and defendants' decision was stayed until trial. After trial, the court annulled the writ and vacated the stay. Plaintiff has appealed from this final order.

Plaintiff is a licensed medical doctor. He has practiced in Newton as a member of the hospital medical staff for seventeen years. Early in the morning of June 30, 1965, he arranged for the hospital to admit Mrs. Sharon Vriezlaar. At that time she was in critical condition from the loss of blood due to a hemorrhage from the vaginal area. In the evening of June 30, the hospital administrator requested the patient to sign the standard abortion form which would relieve the attending physician and hospital from responsibility for an abortion. She refused to sign such statement claiming plaintiff had, in some way, been involved in an abortion operation performed on her. She then signed two forms. One exonerated the hospital from any responsibility. The other accused Dr. Koelling of knowingly performing 'an act which may have contributed to the induction of an abortion'.

This accusation precipitated an investigation by the medical staff credentials committee. The committee reported its findings and recommendations to the full medical staff. The medical staff recommended to the board of trustee that plaintiff's staff privileges be suspended and listed 11 charges against him. All charges dealt with the manner in which he handled the case of Sharon Vriezlaar, but made no mention of the alleged abortion or Mrs. Vriezlaar's accusation.

Dr. Koelling was notified of the charges by letter dated August 14 and was advised therein that the board of trustees would hold a hearing on the medical staff's recommendations August 26. After hearing, the board sustained most of the charges filed by the staff and suspended plaintiff's staff privileges indefinitely. The certiorari proceedings challenged this decision. The trial court held the board of trustees acted within its jurisdiction, and that the decision was not illegal or unconstitutional and was supported by substantial evidence. We agree.

I. Plaintiff contends the statutes under which defendants claim authority to make rules, hold hearings, and suspend plaintiff's right to practice as a member of the staff of the municipal hospital is an unconstitutional delegation of legislative power to an administrative agency in that the statutes fail to provide sufficient standards and guidelines. He relies primarily on Lewis Consolidated School District v. Johnston, 256 Iowa 236, 127 N.W.2d 118.

Cities have the power to establish and regulate hospitals, section 368.27, Code of Iowa. By ordinance they may provide for the election of hospital trustees. Section 380.1. 'Said board of trustees shall be vested with authority to provide for the management, control and government of such city or town hospital and shall provide all needed rules and regulations for the economic conduct thereof * * *. In the management of said hospital no discrimination shall be made against practitioners of any school of medicine recognized by the laws of the state.' Section 380.6.

The State Department of Health is given the power to license hospitals, chapter 135B, Code of Iowa, 'to provide for the development, establishment and enforcements of basic standards (1) for the care and treatment of individuals in hospitals and (2) for the construction, maintenance and operation of such hospitals, which in the light of existing knowledge, will promote safe and adequate treatment of such individuals in hospitals, in the interest of the health, welfare and safety of the public.' Section 135B.2. It is given the power to adopt, amend, promulgate and enforce rules designed to accomplish the above purposes. Section 135B.7.

In addition to the foregoing, the operation of a city hospital is circumscribed by the statutory provisions with regard to construction requirements, inspections, public health and the practice acts appearing in the Iowa code. While these acts do not apply directly to our immediate problem, they do limit the power of the board of trustees to manage, control and operate the hospital as they please. They could not by rule or regulation employ persons as nurses who did not qualify as provided by the code, nor could they permit unlicensed persons to practice medicine or surgery. The facilities must meet statutory standards. We conclude the code sections and rules provide adequate standards for the guidance of the board of trustees in the operation of the hospital.

Authorities have long made a distinction between statutes which give a state administrative agency the power to legislate on matters to be applied statewide and those which give a local governing body power to legislate on matters of local application. We distinguish this case from Lewis Consolidated School District v. Johnston, supra, on this basis as well as on the wording of the particular statutes and those in pari materia.

'It is a well settled rule, supported with practical unanimity by the authorities that the general doctrine prohibiting the delegation of legislative authority has no application to the vesting in political subdivisions of powers to govern matters which are local in scope. For a great variety of purposes and governmental functions the legislature may delegate a part of its power over local subjects to municipal corporations, county boards, and other public bodies within the legislative classification of departments. In addition to the most frequent exercise of this power, in the case of municipalities, this principle has been employed to sustain a delegation of powers ordinarily exercisable only by the legislature to such subdivisions as county committees, park commissioners, school districts and counties or county boards.' 16 Am.Jur.2d 500--501, Constitutional Law, § 250. The above quotation is cited with approval in Peterson v. Cook, 175 Neb. 296, 121 N.W.2d 399, 403. See: 16 C.J.S. Constitutional Law § 140 pp. 650--651; City of Milwaukee v. Sewerage Commission, 268 Wis. 342, 67 N.W.2d 624, 631.

Cities have statutory authorization to enact ordinances transferring the responsibility for operation of a city hospital to the board of trustees. The board then becomes the local body charged with the responsibility of legislating on this local issue.

The Wyoming Supreme Court in Board of Trustees of Memorial Hospital v. Pratt, (1953) 72 Wyo. 120, 262 P.2d 682, faced the same constitutional argument when the trustees of a memorial hospital sought to deprive a physician of staff privileges for failure to abide by the rules and regulations relating to medical records. As this opinion clearly states the reasons for such position and refers to appropriate authorities, we quote:

'In Findlay v. Board of Sup'rs of County of Mohave, 72 Ariz. 58, 230 P.2d 526, 24 A.L.R.2d 841, it is stated in the minority opinion that all the members of the court considered the regulation to exclude a physician from a public hospital as having been adopted in a legislative capacity. And we are inclined to believe that the is probably true in the case at bar. That, however, is not determinative of the question before us. It is true that, generally speaking, the legislature cannot delegate its legislative authority. 16 C.J.S. Constitutional Law § 133, p. 337. However, the constitutional provision relied upon by counsel for the appellant is not operative in all cases. If it were, municipal corporations would not be able to adopt any ordinances which are clearly legislative in character. In Cooley's Constitutional Limitations, 8th Ed. Vol. 1, p. 235, the author states that municipal corporations are exempted from the constitutional provision above mentioned by reason of the immemorial practice of municipal corporations to adopt ordinances of various kinds. And there are exceptions other than that relating to municipal corporations. Thus it is stated in 16 C.J.S., Constitutional Law, § 140, p. 399, as follows: 'The general doctrine prohibiting the delegation of legislative powers has no application to the vesting of such powers in political subdivisions created for the purpose of local government. In the absence of constitutional inhibitions, the legislature may delegate to appropriate local governmental agencies authority to legislate with regard to local affairs, to frame and enforce such by-laws, ordinances, and regulations, as are incident to local self-government, and to carry out certain functions which, although limited in their scope, are, in their performance, an exercise of sovereignty.' In 11 Am.Jur. 934, § 223, it is stated: 'For a great variety of purposes and governmental functions the legislature may delegate a part of its power over local subjects to municipal corporations, county boards, and other public bodies within the legislative classification of departments.' In Maricopa County Municipal Water Conservation Dist. No. 1 v. LaPrade, 45 Ariz. 61, 40 P.2d 94, 99, the court stated: 'The next objection is that the act contains a number of...