Long v. Quorum Health Res., LLC
| Decision Date | 05 May 2014 |
| Docket Number | Case No. 2:13-cv-189 |
| Court | U.S. District Court — District of Vermont |
| Parties | RAYMOND A. LONG, M.D., Plaintiff, v. QUORUM HEALTH RESOURCES, LLC, and NORTHWESTERN MEDICAL CENTER, INC., Defendants. |
Plaintiff Raymond A. Long, M.D. alleges that Defendants Quorum Health Resources, LLC ("QHR") and Northwestern Medical Center, Inc. ("NMC") are liable for statements made to the United States Department of Health and Human Services ("HHS") regarding his professional performance. Defendants now move to dismiss the First Amended Complaint ("FAC") pursuant to Fed. R. Civ. P. 12(b)(6), arguing res judicata and failure to state a claim.1 Defendants also oppose Dr. Long's motion for leave to file a Second Amended Complaint. For the reasons set forth below, Defendants' motion to dismiss is GRANTED, Dr. Long's motion for leave to amend is DENIED, and this case is DISMISSED.
In September 2001, Dr. Long was granted privileges topractice as a surgeon at NMC.2 He claims that in 2003, someone at NMC deliberately contaminated several of his surgeries with bacteria, thereby causing infections in his patients. NMC subsequently arranged for a peer review process, in part to investigate Dr. Long's allegations. As a result of this process, NMC issued an order prohibiting Dr. Long from performing any further surgeries until he had been evaluated by a psychiatrist. The order also advised him of his right to a hearing. Dr. Long resigned the following day, allegedly to avoid further "inexcusable danger to his patients." ECF 41 at 6, ¶ 38.
On April 30, 2004, NMC submitted an Adverse Action Report ("AAR") to the National Practitioner Data Bank ("NPDB"), stating that Dr. Long had voluntarily surrendered his clinical privileges at NMC "while under, or to avoid, investigation relating to professional competence or conduct." Id. at 7, ¶ 42. Pursuant to federal law, health care entities are required to report to the NPDB all surrenders of clinical privileges "[w]hile the physician or dentist is under investigation by the entity relating to possible incompetence or improper professional conduct." 42 U.S.C. § 11133(a)(1)(B)(i). The NPDB can be queried when a doctor seeks to obtain employment or privileges at a hospital or other health care entity. See 42 U.S.C. § 11137.
Dr. Long contends that the report to the NPDB was unjustified. He claims that instead of conducting an investigation for the purpose of furthering quality health care, NMC undertook the peer review process "to blame Plaintiff for the deliberately caused infections and to cast him as mentally unstable." ECF 41 at 7, ¶¶ 39-41. Accordingly, he argues, the process did not constitute an "investigation" as defined by the the Health Care Quality Improvement Act, and no report to the NPDB was required.
On August 29, 2011, Dr. Long wrote to NMC requesting that the AAR be "removed." ECF 1-2 at 2. When NMC declined, Dr. Long sought review by the Secretary of HHS (the "Secretary"). In a letter dated December 2, 2011, the Secretary acknowledged receipt of Dr. Long's request and notified him that it might require additional information either from him or "the entity that filed the report under review." The Secretary also explained that the scope of review was limited, as it would only determine "(1) if the report is legally required or permitted to be filed and (2) if the report accurately depicts the action taken and the reporter's basis for the action as reflected in the written record." The Secretary further informed Dr. Long that if he claimed "the reporting entity was wrong to take action," or "acted unfairly," those issues were outside the scope of review, and a statement would be added to the report noting theSecretary's limited jurisdiction, as well as its findings. Id. at 10-11. The December 2, 2011 letter also notified Dr. Long of his right to withdraw his request for review.
On December 20, 2011, the Secretary asked NMC to provide additional information. Specifically, NMC was asked to "share with us the sequence of events that led Northwestern to report Dr. Long to the NPDB, and provide copies of documentation to support your explanation." Id. at 13. On January 31, 2012, NMC Chief Executive Officer Jill Berry Bowen replied with a brief cover letter, a two-page chronology of events that occurred between March 8 and April 30, 2004, and supporting documentation from that same time period (the "Bowen Response"). The cover letter stated as follows:
Id. at 15. The chronology set forth the date and a brief description of events and attached documents. Those documents included correspondence within NMC, correspondence to Dr. Long, Dr. Long's resignation letter, and the AAR.
Dr. Long alleges that the Bowen Response "went far beyond the original submission to the NPDB." ECF 41 at 8, ¶ 48. The FAC contends that "a reasonable reader would reasonably understand" statements in the Bowen Report to be asserting: that the peer group review constituted an "investigation" as defined by the NPDB Guidebook and federal law; that the peer group itself was a "peer review committee" as defined by Vermont law and a "peer review organization" as defined by federal law; that Dr. Long was emotionally unstable because he contended that there was a criminal conspiracy against him that in fact did not exist; that Dr. Long's conspiracy theory was evidence of psychiatric problems; and that Dr. Long resigned from the hospital because he did not want to submit to a psychiatric examination. Dr. Long alleges that NMC knew each of those statements to be false and fraudulent, and intended "to ensure that the Secretary would not cause the [AAR] to be removed from the NPDB." ECF 41 at 11, ¶ 57.
By letter dated February 27, 2012, Dr. Long was notified by the Secretary that as result of its review, it was "denying your dispute" and the AAR would remain in the NPDB. ECF 1-2 at 30. In support of its determination, the Secretary found that Dr. Long was the subject of an ongoing professional review process at the time of his resignation, and that the AAR was properly filed. A notation was thus added to the AAR stating that ECF 1-3 at 3.
The current action centers on the Bowen Report and the revised AAR, claiming libel per se and tortious interference with prospective business relationships. Count One of the FAC asserts that the statements in the Bowen Response were malicious and caused the NPDB to maintain the revised AAR containing the Secretary's notation. Count One also claims that the revised AAR was provided to all potential employers who queried the NPDB, thus costing Dr. Long over one year's income. Count Two contends that NMC knew, or should have known, that it could decline the Secretary's request for additional information, and that this would have resulted in the original AAR being removed from the NPDB. Instead, NMC submitted allegedly-false statements, thereby interfering with Dr. Long's ability to secure employment.
In 2005, Dr. Long filed an action in this Court against QHR, NMC, and others who were affiliated with NMC and/or involved in the 2004 peer review process. See Long v. Quorum Health Resources, LLC et al., No. 2:05-cv-21 (the "2005 Case"). The 2005 Case included allegations regarding NMC's investigation ofDr. Long's claims and behaviors, the recommendations that arose out of that investigation, and the adoption of those recommendations by NMC's Medical Executive Committee and CEO. Causes of action asserted in the 2005 Case included libel and tortious interference. That litigation concluded with a settlement and a stipulation of dismissal with prejudice in 2008.
Concurrent with the settlement, Dr. Long signed a general release of all claims. The release applied to a host of parties, including the defendants, their successors and assigns, and insurer Medical Mutual Insurance Company of Maine. The terms of the release covered any claims "that [Dr. Long] made or could have made," including those "of which [he was] totally unaware and unsuspecting," excepting only claims under Dr. Long's medical malpractice insurance policies, "up to and as of the date" the release was signed. ECF 37-1 at 1. The settlement agreement did not require removal of the AAR from the NPDB.
In 2012, Dr. Long filed suit against Lloyd Parry, Esq. and his law firm, Davis, Parry & Tyler, P.C. See Long v. Parry, No. 2:12-cv-81 (the "Parry Case"). Attorney Parry represented Dr. Long in the 2005 Case. Dr. Long claims Parry defied his instructions and negotiated a settlement that did not require NMC to void the AAR. Dr. Long also claims that Parry threatened to withdraw if Dr. Long did not accept the $4,000,000 settlement. The Parry Case is currently pending.
I. Motion to Dismiss
To survive a motion to dismiss under Rule 12(b)(6), a complaint must plead "enough facts to state a claim to relief that is plausible on its face." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). A claim will only have "facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable...
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