Morice v. Hosp. Serv. Dist. #3
| Decision Date | 08 April 2019 |
| Docket Number | CIVIL ACTION NO. 18-7945 SECTION M (3) |
| Parties | NATCHEZ J. MORICE, III, M.D. v. HOSPITAL SERVICE DISTRICT #3, et al. |
| Court | U.S. District Court — Eastern District of Louisiana |
Before the Court is a motion for preliminary injunction1 filed on behalf of the plaintiff, Natchez J. Morice, III, M.D. ("Dr. Morice"). Hospital Service District No. 3 Parish of Lafourche d/b/a Thibodaux Regional Medical Center ("TRMC"), Board of Commissioners of Thibodaux Regional Medical Center ("the Board"), Medical Executive Committee of Thibodaux Regional Medical Center ("MEC"), Credentials Committee of Thibodaux Regional Medical Center ("Credentials Committee"), and Greg Stock ("Stock"), the CEO of TRMC (collectively, "Defendants"), oppose the motion.2 Dr. Morice filed a supplemental memorandum in support of his motion for injunctive relief.3 The Court held an evidentiary hearing on March 28, 2019.4 Having considered the parties' memoranda, the evidence (including exhibits and testimony), argument presented at the hearing, and the applicable law, the Court issues this Order & Reasons.
This litigation arises from TRMC's suspension and denial of Dr. Morice's clinical privileges in obstetrics at TRMC.5 TRMC's Medical Staff Bylaws ("Bylaws") require a physicianto apply for renewal of privileges at TRMC every two years.6 As part of the written application, a physician must demonstrate "ability to work cooperatively with others," "provide peer recommendations," agree to continued peer review and quality review, and report any violations assessed by the MEC.7 The Credentials Committee initially reviews the application and makes a recommendation to the MEC, which, in turn, makes a recommendation to the Board, which renders the final decision.8 Under Article VII of the Bylaws, if the MEC makes an "adverse recommendation," the physician may generally initiate the "Hearing Procedure" set out in Article XI, which provides for a hearing conducted by a "Hearing Committee" (or Hearing Panel) and appellate review by the Board.9 According to the Bylaws, the recommendation forming the basis of the hearing and appeal does not become "effective and final" until the Board's determination upon final review.10
TRMC first granted Dr. Morice privileges in obstetrics and gynecology in 2006. Following notice of five violations spanning from late 2014 to early 2017, however, the MEC recommended corrective action in relation to Dr. Morice's privileges in obstetrics.11 The violations, which Dr. Morice maintains were fabricated, involved Dr. Morice's failure to promptly attend to his obstetrical patients.12 Dr. Morice then requested a hearing under Article XI,13 which took place on April 24-26, 2018, and May 8, 2018.14 On June 13, 2018, the Hearing Panel rendered a decisionto affirm the MEC's decision to suspend Dr. Morice.15 Following Dr. Morice's appeal to the Board, the Board affirmed the Hearing Panel's decision on August 13, 2018, suspending Dr. Morice's privileges in obstetrics for a period of six months, until February 13, 2019.16
Meanwhile, because Dr. Morice's two-year privileges appointment was set to expire on May 16, 2018, in the midst of the hearing-and-appeal process,17 the Board extended Dr. Morice's privileges "until the earlier to occur of (i) the expiration of 4 months from May 15, 2018, the date of reappointment, or (ii) such time as the hearing before the ad hoc medical staff committee ... and the appellate review by the Board ... have concluded and a final decision has been rendered as set forth in Article XI of the TRMC Medical Staff Bylaws."18 In this case, the latter term applied. Therefore, in the August 13, 2018 letter that informed Dr. Morice of the Board's final decision, Stock advised Dr. Morice to "submit your application for reappointment and clinical privileges for review by the Credentials Committee as soon as possible."19 Dr. Morice heeded Stock's instruction to make quick application for reappointment only as to his gynecological privileges. This application was submitted on August 16, 2018,20 and TRMC approved his reappointment application a month later.21 However, Dr. Morice waited to apply for privileges in obstetrics until December 17, 2018.22 The MEC recommended denial of his application for obstetrical privileges on January 14, 2019, citing a new violation of the professional standard of care and a variance report of unprofessional behavior in addition to the conduct for which Dr.Morice was suspended.23 Dr. Morice is currently pursuing the hearing-and-appeal process as to the denial of his application for obstetrical privileges. TRMC declined to grant Dr. Morice temporary obstetrical privileges during the pendency of his appeal.24
In his amended complaint and application for preliminary injunction,25 Dr. Morice alleges that TRMC was obligated to reinstate his obstetrical privileges after his suspension lifted, despite the fact that TRMC had, in the interim, denied his application for such privileges on the basis of the new violations when considered with his past violations. Dr. Morice essentially argues that the sense of the word "suspension" implies that his obstetrical privileges would go back into effect after the suspension ran, and that, under the Bylaws, the denial of his application for reappointment as to his obstetrical privileges does not take effect until the Board's final decision on his appeal of such denial. Therefore, Dr. Morice claims he is entitled to exercise obstetrical privileges until the hearing-and-appeal process is complete.26 Dr. Morice alleges that the Bylaws constitute a contract and that Defendants breached their contractual obligations to him, breached this contract (the Bylaws) in bad faith, and tortiously interfered with his rights under the Bylaws. Further, Dr. Morice alleges that Defendants committed an abuse of rights and negligent misrepresentations, intentionally inflicted emotional distress and defamed him, violated the Louisiana Unfair Trade Practices and Consumer Protection Law, violated his due process and equal protection rights, and violated the Health Care Quality Improvement Act ("HCQIA").27
Dr. Morice's motion for preliminary injunction seeks reinstatement of Dr. Morice's obstetrical privileges pending the outcome of the ongoing hearing and appeal of TRMC's denial of his December 2018 application for such privileges. Dr. Morice argues that, because the Bylaws state that an adverse recommendation - here, the decision to deny privileges - is not "final and effective" until the Board renders its decision as part of the hearing-and-appeal process, he is contractually entitled to privileges in the interim. Dr. Morice argues that Defendants unilaterally and impermissibly altered the two-year period of his privileges reappointments (which ran from May to May) by extending the period ending on May 16, 2018, to August 13, 2018. By so doing, says Dr. Morice, Defendants created a trap for Dr. Morice's privileges to lapse, so they could shut him out of local competition for obstetrical services.28 Because Dr. Morice served the entirety of his suspension and complied with all related conditions, Dr. Morice contends that the denial of his reappointment of obstetrical privileges is largely based upon the same "trumped up" allegations for which he was already punished.29 Moreover, Dr. Morice says he believed his privileges were to go back into effect at the end of his "suspension" because such a penalty plainly effected a temporary removal of privileges and not an outright termination. And Dr. Morice claims that his application for reappointment of obstetrical privileges was timely in that he submitted it two months before the end of his suspension.30
Dr. Morice argues that his obstetrical patients scheduled to give birth and undergo birth-related procedures now lack medical care and will suffer irreparable injury.31 Dr. Morice also argues that, without obstetrical privileges to support his obstetrics practice, his medical practicewill suffer an incalculable amount of damages and likely dissolve, and that Dr. Morice himself will be unable to sustain the litigation.32 Dr. Morice submits a letter from TRMC reprimanding him for inadequate call coverage for his gynecological patients to suggest that his gynecological privileges are now in jeapordy.33 Dr. Morice's declaration and testimony at the evidentiary hearing repeated these assertions in conclusory fashion.34
Defendants argue that Dr. Morice lacks standing to assert irreparable injury on behalf of his patients,35 but nonetheless, they point to the declaration of TRMC Chief Quality Resource Officer and Compliance Officer Dana Rodrigue, in which she attests that the hospital's OB/GYN physicians provide care to Dr. Morice's patients when his chosen substitute physicians, Dr. Lisa Colon and Dr. Judith Blaise, are unavailable.36 Thus, Defendants contend that Dr. Morice's damages are simply economic and reparable.37 To the extent Dr. Morice says he suffers exceptional economic damages that warrant injunctive relief, Defendants note that Dr. Morice still maintains gynecological privileges and carries on that portion of his practice.38 Overall, Defendants say a preliminary injunction is inappropriate because the grant of temporary obstetrical privileges would usurp the hospital's peer review process in violation of the primary jurisdiction doctrine.39
Furthermore, Defendants argue that issuing a preliminary injunction is inappropriate because doing so would not preserve the status quo but would give Dr. Morice new and unwarranted provisional privileges, thus placing Dr. Morice in a superior position to the one henow occupies. Defendants claim that TRMC only extended Dr. Morice's then-existing privileges pending the outcome of his suspension appeal because the privileges he then had were set to expire in the midst of that process. But here, Dr. Morice began the hearing-and-appeal process...
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