De Leon v. Saint Joseph Hosp., Inc.
| Decision Date | 06 April 1989 |
| Docket Number | No. 88-1018,88-1018 |
| Citation | 871 F.2d 1229 |
| Parties | Jose S. DE LEON, M.D.; Maria G. De Leon, his wife, Plaintiffs-Appellants, v. SAINT JOSEPH HOSPITAL, INC.; William L. Macon, IV, M.D., Defendants-Appellees. |
| Court | U.S. Court of Appeals — Fourth Circuit |
Howard J. Schulman, Baltimore, Md., for plaintiffs-appellants.
Catherine Angela Potthast (John G. Prendergast, Jr., Barry Bach, Smith, Somerville & Case, Baltimore, Md., on brief), for defendants-appellees.
Before WIDENER, MURNAGHAN and CHAPMAN, Circuit Judges.
Once again this court must consider a medical doctor's attempt by an action for defamation to counter a hospital's denial of staff privileges. See Sibley v. Lutheran Hospital, 871 F.2d 479 (4th Cir.1989). Once again we find the effort futile.
Jose S. De Leon, M.D., a surgeon, completed his residency at St. Joseph's Hospital in Baltimore, Maryland and was subsequently employed by it on a contractual basis as a "house surgeon." De Leon applied for admitting privileges at the hospital, but was rejected. He then filed suit against the hospital and Dr. William Macon, its Chief of Surgery, in the United States District Court for the District of Maryland, alleging breach of contract, defamation, tortious interference with prospective advantage and loss of consortium. On March 3, 1988, Judge Alexander Harvey, II entered summary judgment for the defendants on all claims. De Leon has appealed the grant of summary judgment on the defamation claim.
De Leon, a Filipino national, received his medical degree from the University of the Philippines in 1970. He performed a general surgical residency at the Philippines General Hospital Medical Center from 1970 until 1975. In 1976 he emigrated to the United States. De Leon underwent a one-year fellowship at the Texas Heart Institute and an internship and residency at the Brooklyn-Cumberland Medical Center from 1977 to 1979. De Leon then transferred to the Pennsylvania College of Medicine for his second year of residency. Due to poor performance, he was not reappointed to a third year residency and was forced to apply elsewhere.
Although De Leon submitted numerous applications, St. Joseph Hospital (the Hospital) was the only institution willing to accept him at a third year level (the others required him to repeat his second year). De Leon completed his third, fourth and fifth (final) years of residency at St. Joseph. He was then hired by St. Joseph on a contractual basis as a "house surgeon" for the period of July 1, 1983 to June 30, 1984. A "house surgeon" could not admit patients to the hospital and was required to treat patients only under the supervision of another physician. 1
In January of 1984 De Leon applied for medical privileges that would allow him to admit patients to the Hospital. As part of the application, De Leon signed a release absolving the Hospital, its agents and others, including those providing information to the hospital, from civil liability connected with the application process.
Pursuant to the Hospital's Bylaws, De Leon's application was forwarded to the Credentials Committee, consisting of seven appointed and elected members. Appraisal forms were sent out to De Leon's references and his previous employers. Macon, the head of surgery, was required to assess De Leon's qualifications. Macon supervised the house surgeons and was in a position to evaluate De Leon's medical skills.
Macon submitted a letter concerning De Leon's qualifications to the Credentials Committee. Macon concluded De Leon's qualifications were unsatisfactory and recommended that his application be denied. 2 The district court summarized De Leon's credentials as follows:
Dr. Macon had received numerous complaints concerning Dr. de Leon's failures to show up for his required duties, concerning his refusals to see patients when requested to and concerning his unavailability on numerous occasions when he was "on call."
Dr. de Leon's abilities as a surgeon were also questionable. One doctor who had supervised him during his residency had commented on his extreme hesitancy and nervousness during surgery. Another doctor who had supervised Dr. de Leon had, in fact, voted against permitting de Leon even to continue his residency because of doubts about his competency. These subjective impressions were confirmed by Dr. de Leon's performance on objective tests. During his residency at the Brooklyn-Cumberland Medical Center, he scored in the 21st percentile 1 on the In-Training Examination. During his residency at the Hospital, he scored in the 11th percentile in a similar test. Moreover, he failed the American Board of Surgery's examination for board certification in 1983, scoring in the 17.6 percentile. 2
On July 16, 1984, the Credentials Committee met and considered De Leon's application. The Committee found De Leon's credentials to be unsatisfactory. Pursuant to the Hospital Bylaws, the negative recommendation was forwarded to the Hospital's Medical Executive Committee, to the Board of Trustees Medical Staff Privileging Committee and finally to the full Board of Trustees of St. Joseph Hospital (the Board). Each body reviewed the record and independently determined De Leon's credentials were unsatisfactory. On September 27, 1984, the Board voted to deny De Leon's application.
De Leon appealed the Board's decision. 3 An Ad Hoc committee of the Board was formed to hear De Leon's appeal. A hearing was held on August 27, 1985, but the committee did not reach a decision. 4 The committee was reformed and additional hearings were held on December 16 and 19, 1985. At the hearings, the district judge found:
De Leon was accorded the full panoply of due process rights. His counsel was given De Leon's credentials file; the testimony of witnesses was presented, and his attorney cross-examined witnesses on de Leon's behalf. Following the hearings, the Ad Hoc committee allowed de Leon to submit supplemental written argument.
On February 12, 1986, the Ad Hoc committee issued an 11-page report recommending De Leon's application be denied. De Leon's counsel was permitted to submit written supplemental and rebuttal argument to the full Board. On May 22, 1986, the full Board met, considered De Leon's appeal, and voted to deny the application.
That day, De Leon filed suit in the United States District Court for the District of Maryland. De Leon sued the hospital for breach of contract, defamation and interference with economic advantage. De Leon also sued Macon for interference with economic relations and defamation. The complaint also contained a derivative claim for loss of consortium on behalf of De Leon's wife. De Leon sought injunctive relief, compensatory and punitive damages.
Ample discovery was conducted by both sides, including over twenty depositions. 5 Motions for summary judgment were filed on behalf of the defendants. Lengthy memoranda and numerous exhibits were submitted by both sides. Oral argument was heard on February 19, 1988. Thereafter, Judge Harvey granted summary judgment for the defendants on all counts. De Leon appealed. 6
De Leon contends that the trial court erred in granting summary judgment to the defendants St. Joseph Hospital and Macon on the defamation counts. An appellate court normally reviews a grant of summary judgment de novo, applying the same standard as the district court. Felty v. Graves-Humphreys Co., 818 F.2d 1126, 1128 (4th Cir.1987).
The defendants, in moving for summary judgment, have the burden of showing that no genuine issue of material fact exists and that they are entitled to judgment as a matter of law. Fed.R.Civ.P. 56(c); Barwick v. Celotex Corp., 736 F.2d 946, 958 (4th Cir.1984). As the district court correctly identified, this burden may be met by the use of "affidavits, exhibits, depositions and other discovery materials." Barwick, 736 F.2d at 958. Once a defendant has met this burden, the plaintiff must go forward and produce sufficient evidence to support his contentions. "A mere scintilla of evidence is not enough to support a fact issue; there must be evidence on which a jury might rely." Barwick, 736 F.2d at 958-59 (quoting Seago v. North Carolina Theatres, Inc., 42 F.R.D. 627, 640 (E.D.N.C.1966), aff'd, 388 F.2d 987 (4th Cir.1967), cert. denied, 390 U.S. 959, 88 S.Ct. 1039, 19 L.Ed.2d 1153 (1968)).
The standard for granting summary judgment is akin to that of granting a directed verdict:
[T]here is no issue for trial unless there is sufficient evidence favoring the non-moving party for a jury to return a verdict for that party. If the evidence is merely colorable or is not significantly probative, summary judgment may be granted.... [T]he judge must ask himself not whether he thinks the evidence unmistakably favors one side or the other but whether a fair-minded jury could return a verdict for the plaintiff on the evidence presented. The mere existence of a scintilla of evidence in support of the plaintiff's position will be insufficient; there must be evidence on which the jury could reasonably find for the plaintiff.
Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249-52, 106 S.Ct. 2505, 2511-12, 91 L.Ed.2d 202 (1986) (citations deleted).
The proper analysis, therefore, is not simply whether there were disputed issues of fact; clearly De Leon has met that simple burden. "Only disputes over facts that might affect the outcome of the suit under the governing laws will properly preclude the entry of summary judgment." Anderson, 477 U.S. at 248, 106 S.Ct. at 2510. Even after considering the record in the light most favorable to De Leon, we are unable to detect any issue of fact relevant to the disposition of the case that would preclude the defendants from judgment as a matter of law. 7
The district court based its grant of summary judgment on four major points:
(1) De Leon's claims were barred by a release executed by him at the time of his...
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