Padmanabhan v. Cambridge Health Comm'n

Decision Date23 May 2023
Docket Number22-P-276
PartiesBHARANIDHARAN PADMANABHAN v. CAMBRIDGE HEALTH COMMISSION.
CourtAppeals Court of Massachusetts

Summary decisions issued by the Appeals Court pursuant to M.A.C. Rule 23.0, as appearing in 97 Mass.App.Ct. 1017 (2020) (formerly known as rule 1:28, as amended by 73 Mass.App.Ct. 1001 [2009]), are primarily directed to the parties and therefore, may not fully address the facts of the case or the panel's decisional rationale. Moreover, such decisions are not circulated to the entire court and, therefore represent only the views of the panel that decided the case. A summary decision pursuant to rule 23.0 or rule 1:28 issued after February 25, 2008, may be cited for its persuasive value but, because of the limitations noted above, not as binding precedent. See Chace v. Curran, 71 Mass.App.Ct. 258, 260 n.4 (2008).

MEMORANDUM AND ORDER PURSUANT TO RULE 23.0

Plaintiff Dr. Bharanidharan Padmanabhan, appeals from a summary judgment in favor of the defendant, Cambridge Health Commission (doing business as the Cambridge Health Alliance) (CHA), on his remaining claims arising from the termination of his employment.[1] We affirm.

Background.[2]

The facts are taken from the summary judgment record, viewed in the light most favorable to the nonmoving party, Padmanabhan. Between 2007 and 2011, Padmanabhan was a neurologist with medical staff privileges at a hospital operated by CHA. See Padmanabhan v. Cambridge, 99 Mass.App.Ct. 332, 334 (2021) (Padmanabhan I). Following the death of one of Padmanabhan's patients, CHA undertook an investigation and peer review process of his practice. In connection with that process, CHA scheduled an October 31, 2011 "fair hearing" to determine whether Padmanabhan's medical staff privileges would permanently be revoked, in which case CHA would be required by law to report the revocation and its reasons to the Board of Registration in Medicine (board) and the National Practitioner Data Bank (Databank), an internet-based database maintained by the United States Department of Health and Human Services "containing information on medical malpractice payments and certain adverse actions related to health care practitioners, providers, and suppliers." Id. at 335 &n.10 (quotation omitted).

In the weeks preceding the October 31 hearing, Padmanabhan, represented by counsel, and CHA negotiated on multiple issues, including the upcoming fair hearing, Padmanabhan's surrender of his medical staff privileges, and the precise language that CHA would use in its report to the board and the Databank. Padmanabhan's counsel indicated that Padmanabhan would resign his privileges provided that CHA agreed to use certain language and basis codes, suggested by Padmanabhan's counsel, in the Databank report. Relevant here, Padmanabhan's counsel requested that the Databank report contain the following language:

"In July 2011, an investigative committee reviewed the medical records of ten former patients of Dr. Padmanabhan, including seven pain patients. The investigative committee found, based on the materials it reviewed, that Dr. Padmanabhan did not meet the standard of practice expected of a CHA physician with respect to documentation: including sufficient medical history, examination, laboratory data, diagnosis, and follow up. Dr. Padmanabhan voluntarily resigned his medical staff privileges in October 2011."

After CHA agreed to the proposed language, counsel for Padmanabhan wrote to "confirm that Dr. Padmanabhan will be submitting a letter to CHA re: resignation, and, as a result, the Fair Hearing scheduled for Monday, October 31, 2011 will not take place." Upon CHA's receipt of that communication the pending fair hearing was cancelled.

On October 31, 2011, as counsel had promised, Padmanabhan submitted a letter to CHA. Padmanabhan commenced that communication by stating "at the outset that this is not a 'resignation' letter." However, Padmanabhan went on to state, among other things, that, "My credentials expired before the end of June 2011," he "no longer [was] a member of the CHA medical staff," and that he was "formally inform[ing] [CHA] that as of the end of June 2011, I am no longer on the medical staff at" CHA.

CHA informed Padmanabhan's counsel that it construed Padmanabhan's October 31 letter "as a resignation" of his medical staff privileges. Neither counsel nor Padmanabhan responded. CHA then submitted an "adverse action report" to the Databank using substantially the same language as Padmanabhan's counsel earlier had suggested and approved; rather than stating that "Padmanabhan voluntarily resigned his medical staff privileges in October 2011," as the parties had agreed, CHA's submitted report stated that:

"Dr. Padmanabhan indicated that he no longer considers himself part of the [CHA] Medical Staff -- which [CHA] and his counsel are treating as a resignation/voluntary surrender effective October 28, 2011."

In addition, in the report, under a section titled "Adverse Action Classification Code(s)," CHA used the code "1635," which translated as "voluntary surrender of clinical privilege(s), while under, or to avoid, investigation relating to professional competence or conduct." This was the same coding that Padmanabhan's counsel had requested in an email during negotiations stating "[i]t is our preference that the action code for the Board report be revised, if possible, to resignation and that the action code for the NPDB report be resignation."

Padmanabhan later challenged the action report, asserting, among other things, that he "never 'voluntarily resigned' [his] privileges at CHA." Upon review, the Secretary of the Department of Health and Human Services (Secretary) determined that

"lapsing of your CHA credentials does not negate the fact that you were considered to have voluntarily surrendered your privileges while under investigation. . . .Most importantly, for [Databank] reporting purposes, a physician's failure to renew his clinical privileges while under investigation is considered to be a voluntary surrender of privileges while under investigation."

Accordingly, the Secretary ultimately determined "the Report is factually accurate as submitted" and "there is no basis to conclude that the report should not have been filed or that for agency purposes it is not accurate, complete, timely or relevant."

In 2014 Padmanadhan, in a "sprawling fifty-six-page complaint asserting multiple claims against multiple defendants," Padmanadhan I, 99 Mass.App.Ct. at 333, filed this action. We affirmed the dismissal of all claims against seventy-two named defendants except Padmanabhan's second (retaliation), fourth (defamation), eighth (fraud), and declaratory relief counts asserted against CHA. Id. at 343-344. Shortly after Padmanadhan I was returned to the Superior Court's docket, a judge conducted a litigation control conference. A different judge (motion judge) conducted a hearing on CHA's motion for summary judgment, after which Padmanabhan moved for leave to file additional pleadings. The motion judge allowed CHA's motion, denied Padmanabhan's, and entered judgment for CHA. This appeal followed.

Discussion.

1. Initial matters.

We first address Padmanabhan's claim that the motion judge was not impartial. That the judge allowed certain of CHA's motions or, ultimately, entered summary judgment on Padmanabhan's claims, does not by itself demonstrate bias or partiality. Clark v. Clark, 47 Mass.App.Ct. 737, 739 (1999) ("The mere fact that a party suffers adverse rulings during litigation does not establish lack of judicial impartiality"). In short, after a thorough review of the record, we conclude that there is nothing in the judge's statements, actions, or history that supports Padmanabhan's assertion that the judge either "aided and abetted public corruption" or displayed or otherwise reasonably could be perceived to harbor any partiality.

Nor are we persuaded that Padmanabhan was denied discovery before summary judgment. The order of remand in Padmanabhan I did not require the judge to order discovery or set a trial. Rather, the Padmanabhan I order partially vacated the judgment and remanded, without specification, for further proceedings on certain limited issues. Padmanabhan I, 99 Mass.App.Ct. at 344. "Case management is committed to the discretion of the trial judge, and we review the decision for an abuse of discretion." Eagle Fund, Ltd. v. Sarkans, 63 Mass.App.Ct. 79, 85 (2005).

The litigation control conference judge acted well within that discretion, after being informed that CHA intended to serve a dispositive motion, by setting a briefing schedule for CHA's summary judgment motion. Padmanabhan, despite the opportunity to address the court during the litigation control conference, did not request discovery in advance of the summary judgment motion. Had Padmanabhan thereafter been unable "for reasons stated" to present "facts essential to justify his opposition" to that motion, he could have requested a continuance to allow "deposition[s] to be taken or discovery to be had." Mass. R. Civ. P. 56 (f), 365 Mass. 824 (1974). Padmanabhan made no such request.

2. Summary judgment.

Summary judgment is appropriate where there are no genuine issues of material fact, and the moving party is entitled to judgment as a matter of law. See Mass. R. Civ. P. 56 (c), as amended, 436 Mass. 1404 (2002); Kourouvacilis v. General Motors Corp., 410 Mass. 706, 716 (1991). "We review a grant of summary judgment de novo." Blake v. Hometown Am. Communities, Inc., 486 Mass. 268, 272 (2020), quoting DeWolfe v. Hingham Centre, Ltd., 464 Mass. 795, (2013).

Padmanabhan argues that there are genuinely disputed issues of material fact based on his oral statement to the motion judge that he "dispu...

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