Owens v. New Britain General Hosp.
| Decision Date | 14 June 1994 |
| Docket Number | No. 14840,14840 |
| Citation | 229 Conn. 592,643 A.2d 233 |
| Court | Connecticut Supreme Court |
| Parties | Guy OWENS v. NEW BRITAIN GENERAL HOSPITAL. |
Barbara L. Cox, with whom were William F. Gallagher and, on the brief, Dennis N. Garvey, New Haven, for appellant (plaintiff).
Theodore J. Tucci, with whom was Linda L. Morkan, Hartford, for appellee (defendant).
Before BORDEN, BERDON, KATZ, FREDERICK A. FREEDMAN and FRANCIS X. HENNESSY, JJ.
This appeal requires us to establish the proper test for determining whether a hospital sufficiently complied with its medical staff bylaw obligations for the purpose of terminating a physician's medical staff privileges. We conclude that the substantial compliance test is the proper standard by which to review the hospital's compliance with the bylaws, and therefore affirm the judgment of the Appellate Court.
The following undisputed facts are relevant to this appeal. The plaintiff, Guy Owens, is a neurosurgeon who enjoyed surgical privileges at the defendant, New Britain General Hospital (hospital), for several years prior to the events leading up to the hospital's decision not to reappoint him to its medical staff. In 1982, the hospital's chief of surgery, Gerald O. Strauch, appointed two outside neurosurgeons, William F. Collins, Jr., and Edward B. Schlesinger, to conduct a review of the entire neurosurgery section of the hospital. At the conclusion of their review, Collins and Schlesinger issued a report (Collins- Schlesinger report) that summarized their findings and concluded, inter alia, that the plaintiff inappropriately and unjustifiably had been performing disc surgery. The Collins-Schlesinger report recommended that the plaintiff obtain second opinions in all future cases of disc surgery and that the plaintiff refer certain patients for psychiatric consultations before performing particular surgical procedures. The Collins-Schlesinger report also recommended that an outside review of the neurological section be conducted on a monthly basis.
In response to the conclusions and recommendations contained in the Collins-Schlesinger report, Strauch implemented a set of measures (Strauch measures) with which the plaintiff, in writing, voluntarily agreed to comply. Pursuant to one of the Strauch measures, the plaintiff agreed to obtain second opinions for disc surgery and psychiatric consultations for patients who were to undergo certain other procedures. In accordance with a second Strauch measure, the hospital established a monthly review of the neurosurgery section, and charged Richard Simon, a neurosurgeon at the University of Connecticut Health Center, with its implementation. 1
Subsequently, the plaintiff informed Strauch that he would no longer adhere to the Strauch measure requiring him to obtain second opinions and psychiatric consultations. Thereafter, in December, 1984, Simon rendered a lengthy report (Simon report) containing a review of the plaintiff's compliance with the Strauch measures, as well as statistical data concerning the operative procedures performed by the plaintiff. The Simon report severely criticized the plaintiff's surgical practices 2 and concluded that the plaintiff had not complied with the Strauch measure requiring second opinions and consultations.
In February, 1985, Strauch furnished the plaintiff with the Simon report and advised him to prepare a written response. 3 On receipt of the plaintiff's response, Strauch filed with the hospital staff executive committee (executive committee), in accordance with article VII, § 1(a) of the medical staff bylaws, 4 a formal recommendation for corrective action against the plaintiff. 5 Subsequently, Strauch appointed a three person ad hoc committee, chaired by physician William Waskowitz, (Waskowitz committee) to consider Strauch's recommendation. 6
On October 18, 1985, after six meetings, the Waskowitz committee filed its report with the executive committee, recommending that the executive committee implement Strauch's recommendation for corrective action. In a follow-up report dated October 28, 1985, the Waskowitz committee stated that, in formulating its recommendation, it had relied on the Collins-Schlesinger report, the Simon report and thirty-five other records of the plaintiff's patients, selected by Strauch for the Waskowitz committee's review. The Waskowitz committee further stated that it had reached the following conclusions: ; and
Subsequently, by letter dated October 29, 1985, George H. Bray, the hospital's chief of staff and chair of the executive committee, informed the plaintiff that the executive committee had convened to consider both Strauch's recommendation for corrective action and the Waskowitz committee's report. In the same letter, Bray invited the plaintiff to appear informally before the executive committee on November 15, 1985, for the purpose of discussing his surgical practice. 7 Bray also advised the plaintiff that, because the executive committee had voted unanimously to require him to obtain corroborative second opinions in cases involving surgery, 8 he was strongly advised to abide by the Strauch measures pending the resolution of his case. The plaintiff thereafter agreed in writing to comply with the executive committee's requests.
At the executive committee's November 15 meeting, the plaintiff addressed the executive committee, criticized both the Collins-Schlesinger and Simon reports, and presented statements from consulting experts he had retained. Following that meeting, the executive committee recommended the imposition of various restrictions on the plaintiff's clinical and surgical privileges. The plaintiff appealed from the executive committee's recommendation, thereby staying the effect of the restrictions. 9
In response to the plaintiff's appeal, a second ad hoc committee, chaired by Thomas J. Devers (Devers committee), was appointed to hold a hearing. 10 In April, 1986, after completing the formal hearing process, the Devers committee recommended confirmation of the executive committee's recommendation to impose restrictions on the plaintiff's practice, 11 and the plaintiff appealed from that decision to the hospital board of directors. 12
In May, 1986, while that appeal was pending, Bray informed the plaintiff that another neurosurgeon on the hospital staff, Ali Nourizadeh, had written a letter to the executive committee raising several serious charges against the plaintiff. 13 On June 9, 1986, the executive committee held a special meeting, at which the plaintiff was present, to consider the charges. 14 Following that meeting, by letter dated June 10, 1986, the plaintiff was notified that, pursuant to article V, § 3(b) of the medical staff bylaws, 15 the executive committee had voted to recommend that he not be reappointed. 16 Subsequently, the plaintiff appealed from the executive committee's recommendation. 17
While that appeal was pending, in late June, 1986, the plaintiff withdrew his appeal from the Devers committee's confirmation of the executive committee's recommendation to impose restrictions on his practice, 18 ] thereby triggering the immediate implementation of the restrictions. A three member committee subsequently began monitoring the plaintiff's practice for compliance with the restrictions.
Concurrently, in response to the plaintiff's appeal from the executive committee's recommendation not to reappoint him to the medical staff, another ad hoc committee was formed, chaired by Martin Dinep (Dinep committee). 19 After a series of hearings, the Dinep committee released its report, dated October 15, 1986, in which it unanimously upheld the executive committee's decision not to recommend the plaintiff's reappointment. 20 Subsequently, the executive committee accepted the Dinep committee's report and the plaintiff appealed to the board of directors. 21
An appellate review committee, composed of members of the board of directors, chaired by Anthony A. Cooper (Cooper committee), was formed to review the Dinep committee's conclusions. On January 20, 1987, after three evidentiary hearings and two sessions of deliberations, the Cooper committee concluded that the executive committee's recommendation not to reappoint the plaintiff was supported by the record. Consequently, the Cooper committee unanimously recommended that the board of directors confirm the executive committee's recommendation not to reappoint the plaintiff. On February 19, 1987, the hospital officially notified the plaintiff that the board of directors had voted to terminate his medical staff privileges.
The plaintiff initiated this action against the hospital, seeking money damages for breach of contract and negligent infliction of emotional distress, as well as injunctive relief in the form of reinstatement of his staff privileges. After the trial court rendered judgment for the hospital, the plaintiff appealed to the Appellate Court, claiming, inter alia, that the trial court improperly applied a test of substantial compliance in determining whether, in the course of terminating his staff privileges, the hospital had complied with the bylaw obligations to him. 22 On appeal, the Appellate Court affirmed the judgment of the trial court, concluding, inter alia, that: (1) the test of substantial compliance is the proper standard by which to measure the hospital's performance under the bylaws; and (2) the hospital had not breached the bylaws by failing to renew the plaintiff's medical staff privileges. Owens v. New Britain General Hospital, 32 Conn.App. 56, 58, 627 A.2d 1373 (1993). We granted the plaintiff's ...
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