Marshall v. Planz

• Decision Date: 08 July 1998
• Docket Number: Civil Action No. 97-T-793-S.
• Citation: 13 F.Supp.2d 1231
• Parties: William G. MARSHALL, Jr., Plaintiff, v. Edward PLANZ, et al., Defendants.
• Court: U.S. District Court — Middle District of Alabama

13 F.Supp.2d 1231

William G. MARSHALL, Jr., Plaintiff, v. Edward PLANZ, et al., Defendants.

Civil Action No. 97-T-793-S.

United States District Court, M.D. Alabama, Southern Division.

July 8, 1998.

Joseph Terrace Carpenter, Nathan C. Prater, Montgomery, AL, Jeffrey S. Jacobovitz, Mark L. Rosenberg, Alan A.B. McDowell, Beth M. Kramer, Michaels, Wishner & Bonner, P.C., Washington, DC, for William G. Marshall, Jr., M.D. Kerry Phillip Luke, Edward O. Conerly, Hall, Conerly, Mudd & Bolvig, Birmingham, AL, John F. Mandt, Phillip A. Nichols, Balch & Bingham, Birmingham, AL, Michael Baird Beers, Winston Whitehead Edwards, Beers, Anderson, Jacksonn, Hughes & Patty, PC, Montgomery, AL, Joseph C. Espy, III, A. Lester (Les) Hayes, III, Melton, Espy, Williams & Hayes, P.C., Montgomery, AL, Paul G. Smith, Matthew C. Williams, Smith, Spires & Peddy, Birmingham, AL, for Edward Planz, M.D.

Kerry Phillip Luke, Edward O. Conerly, Hall, Conerly, Mudd & Bolvig, Birmingham, AL, John F. Mandt, Phillip A. Nichols, Balch & Bingham, Birmingham, AL, Michael Baird Beers, Winston Whitehead Edwards, Beers, Anderson, Jacksonn, Hughes & Patty, PC, Montgomery, AL, Joseph C. Espy, III, A. Lester (Les) Hayes, III, Melton, Espy, Williams & Hayes, P.C., Montgomery, AL, for Southeastern Cardiovascular Associates, P.C.

ORDER

MYRON H. THOMPSON, District Judge.

Plaintiff William G. Marshall, Jr., M.D., brings this lawsuit against defendants Edward Planz, M.D. (his former business partner) and Southeastern Cardiovascular Associates, P.C. ("SCA") (a corporation of which Planz is currently, and Marshall was formerly, a shareholder and employee) alleging claims grounded on §§ 1 and 2 of the Sherman Antitrust Act, 15 U.S.C.A. §§ 1 and 2, and § 4 of the Clayton Act, 15 U.S.C.A. § 15, as well as numerous state-law claims, namely tortious interference with business and contractual relations, defamation, breach of contract, monopolization, and civil conspiracy. All of Marshall's claims stem from Planz's termination of their business relationship, and events surrounding Marshall's loss of surgical privileges at two hospitals in Dothan, Alabama, where the two physicians conducted their surgical practices. This court has federal-question jurisdiction over this lawsuit pursuant to 28 U.S.C.A. §§ 1331 and 1337, and supplemental jurisdiction over Marshall's state-law claims pursuant to 28 U.S.C.A. § 1367(a).

Pending before the court is the motion for summary judgment filed by the defendants as to Marshall's federal and state antitrust claims.¹ The defendants' motion raises a difficult question concerning the so-called state-action immunity doctrine that is applicable in antitrust actions. Specifically, it is well-settled that states enjoy immunity from federal antitrust lawsuits that stem from their actions as sovereign. See Parker v. Brown, 317 U.S. 341, 351-53, 63 S.Ct. 307, 314, 87 L.Ed. 315 (1943); Crosby v. Hospital Auth. of Valdosta and Lowndes County, 93 F.3d 1515, 1521 (11th Cir.1996), cert. denied, ___ U.S. ___, 117 S.Ct. 1246, 137 L.Ed.2d 328 (1997). As currently applied, the doctrine may be invoked not only by states themselves, but also by states' political subdivisions, including municipal corporations. See City of Lafayette v. Louisiana Power & Light Co., 435 U.S. 389, 412, 98 S.Ct. 1123, 1137, 55 L.Ed.2d 364 (1978) (Brennan, J., plurality opinion); See also Town of Hallie v. City of Eau Claire, 471 U.S. 34, 38-39, 105 S.Ct. 1713, 1716, 85 L.Ed.2d 24 (1985). Moreover, state action immunity has also been extended to hospital authorities established under state statutes, see Crosby, 93 F.3d at 1522-26 (holding that a Georgia hospital is a political subdivision of the state, because the nexus between the hospital and the state is sufficiently close); Askew v. DCH Reg. Health Care Auth., 995 F.2d 1033, 1037-38 (11th Cir.1993) (holding that hospital authorities created under the Alabama Health Care Authorities Act are political subdivisions of the State of Alabama), and to physicians at such hospitals who participate as official members of peer-review committees. See Crosby, 93 F.3d at 1530. The difficult question presented here is whether state action immunity should be further extended to individual physicians who do not serve as official members of a hospital's peer-review committees, but who initiate proceedings against fellow physicians before the committees or furnish information to them. As explained below, however, the court does not need to address this question in view of its conclusion that the defendants' motion is due to be granted as to all of Marshall's antitrust claims because he has failed to establish that the defendants' actions actually caused his alleged antitrust injuries.

I. BACKGROUND

The pertinent facts of this lawsuit, viewed in the light most favorable to Marshall, who is the non-movant with respect to the defendants' motion for summary judgment concerning the federal and state antitrust claims, are as follows.

• In 1992, Marshall joined SCA, a professional corporation in which he and Planz were the sole shareholders and employees. The focus of both physicians' practices was cardiovascular surgery, although they also performed other surgical techniques. Both physicians maintained surgical privileges at Southeast Alabama Medical Center ("SAMC"), a hospital owned and operated by the Houston County Health Care Authority, and Flowers Hospital, the two primary care hospitals located in Dothan, Alabama. In 1988, SAMC had been reincorporated under the Alabama Health Care Authorities Act of 1982, 1975 Ala.Code §§ 22-21-310 through 22-21-344 (Michie 1997).

• In 1994, Marshall and Planz executed a shareholders and deferred compensation agreement, pursuant to which they became equal financial partners in SCA, dividing all revenues from their practices equally after expenses. Under the agreement, Planz retained authority to sever the partnership without cause. The agreement was silent, however, as to whether Marshall could continue to practice medicine independently in Dothan should the partnership be dissolved.

• In July 1996, Dr. Steven Johnson, a third cardiovascular surgeon, joined SCA.

• On July 23, 1996, Marshall and Planz were informed by letter that the Quality Risk Management Committee ("Quality Committee") had established an ad hoc committee to investigate the circumstances surrounding the unexpected deaths of five of Marshall's cardiovascular patients in the preceding two months.

• The Quality Committee's investigation into Marshall's performance at SAMC was not the first instance in which a hospital committee had responded to concerns and complaints regarding Marshall. Starting in 1993, both SAMC's Executive and Credentials Committee ("E & C Committee") and its Peer Review Committee met on numerous occasions to take up complaints about Marshall's "unacceptable" and "inappropriate" behavior toward hospital personnel, as well as concerns about Marshall's mortality statistics. On at least three occasions, in April and December 1994, and July 1995, the E & C Committee had voted to defer elevating Marshall's privileges from associate staff status to active staff status, citing Marshall's unacceptable conduct toward others at the hospital.

• In the summer of 1996, Planz attended a conference where he learned about expected changes in Medicare reimbursement for cardiac services, and he subsequently expressed concern to both Marshall and Johnson that the proposed decreases in reimbursement would adversely affect SCA's revenues and their individual incomes.

• Shortly after attending the summer conference, in August 1996, Planz informed James Blackmon, then Chief Executive Officer of SAMC, that he planned to terminate his partnership with Marshall.² Planz had not yet informed Marshall of his intentions. In his conversation with Blackmon, Planz sought assurances that SAMC would support Planz in his efforts to sever his relationship with Marshall. Planz and Blackmon also discussed the fact that the dissolution of the partnership would have repercussions for Marshall's privileges at SAMC. This aspect of the discussion appears to have focused on an exclusive contract that Planz purportedly signed with the hospital.³

• At some point during the Quality Committee's deliberations, Dr. George Veale, who headed the committee, informed Fred Pelle, who was then SAMC's Chief Operating Officer, that it would not be in the latter's "best interest to work against what the committee was trying to do and against what Dr. Planz wanted."

• On August 13, 1996, the E & C Committee, based upon the report prepared by the Quality Committee concerning the unexpected deaths of five of Marshall's cardiovascular patients, voted to request an independent clinical review of the hospital's provision of cardiovascular care. The American Medico-Legal Foundation was enlisted to conduct the review, which, though nominally directed to "Cardiac Surgery and Anesthesia Services" at SAMC, in fact focused primarily on Marshall's performance at the hospital.

• After completing its review, which included interviews with hospital staff, the foundation prepared a report, which stated that Marshall's practice demonstrated "an unacceptably high mortality rate and complication rate," perhaps due to his surgical techniques. The report also recommended that Marshall be subjected to a number of additional evaluations, including a medical evaluation of a cervical disc problem that he had suffered, drug testing, and a "preceptorship" at a major cardiac center for at least a month. The report advised that Marshall be suspended pending completion of these processes. Marshall raises numerous objections to the methodology employed in the preparation of this report, and contests its conclusions and recommendations.

• In mid-November 1996, Planz informed Marshall that he had decided to terminate their partnership pursuant to the terms of their shareholder agreement.

• On...