State v. R.I. Comm'n for Human Rights
| Decision Date | 17 October 2014 |
| Docket Number | C.A. No. PC 07-7048 |
| Court | Rhode Island Superior Court |
| Parties | STATE OF RHODE ISLAND, DEPARTMENT OF MENTAL HEALTH, RETARDATION AND HOSPITALS (MHRH) v. RHODE ISLAND COMMISSION FOR HUMAN RIGHTS, AND THE ESTATE OF DR. JOHN SATTI, JULIA SATTI CONSENTINO, ADMINISTRATRIX |
MATOS, J., Before the Court is an appeal filed by the State of Rhode Island, Department of Mental Health, Retardation and Hospitals (MHRH) from a Decision and Order issued by the Rhode Island Commission for Human Rights (Commission) in favor of the Complainant, Dr. John Satti (Dr. Satti).1 In its Decision and Order, the Commission concluded that MHRH had retaliated against Dr. Satti for filing previous charges of discrimination and that it also had discriminated against him on the basis of age. Jurisdiction is pursuant to G.L. 1956 § 28-5-28 and G.L. 1956 § 42-35-15.
The controversy giving rise to this litigation had its genesis on August 18, 1987 when Dr. Satti, born May 16, 1926, filed his first charge against MHRH before the Commission (Satti I).In that complaint, Dr. Satti accused MHRH of age discrimination. At the time, he had been working as a physician consultant at MHRH since 1986. On March 26, 1992, while Satti I was pending, Dr. Satti filed a second charge against MHRH, this time for discrimination with respect to hire and in retaliation for filing the previous charge (Satti II). In November 1993, the Commission issued a Complaint and Notice of Hearing in the Satti I matter, and on March 28, 1994, it issued a Complaint and Notice of Hearing in Satti II. On March 30, 1995, the Commission concluded in Satti I that MHRH had discriminated against Dr. Satti on the basis of age.
Meanwhile, in 1995, Dr. Satti was approved for appointment and clinical privileges at the Eleanor Slater Hospital. In accordance with practice, such appointments and privileges are reviewed every two years by another physician, by the Chief of Medical Staff, and by the Executive Committee of the Medical Staff (Executive Committee).
In March 2001, Dr. Satti's clinical privileges at the Eleanor Slater Hospital were renewed after his regular biennial review. At the time, Dr. Satti, who was categorized as a Physician II (General), worked on the third floor of the Virks building (Virks III), where he was responsible for all of that floor's patients. The Virks building housed psycho-geriatric patients, who generally were long-term patients over fifty-five years of age with psychiatric issues. Dr. Satti's renewal was supported by his direct supervisor, Dr. Marco Calvo (Dr. Calvo), as well as by the Chief of Medical Staff, Dr. Edward Martin (Dr. Martin). Dr. Calvo was a primary-care physician who had been Dr. Satti's direct supervisor for several years. He rated Dr. Satti as "Good" in every category, while Dr. Martin rated him as "Meets Standard" or "Exceeds Standard" in every category.
In May 2001, Dr. Satti voluntarily agreed to a request from Dr. Calvo and Dr. Alex Andronic (Dr. Andronic) to switch floors with Dr. Andronic in order that Dr. Andronic avoid a conflict that he had been having with a nurse on the first floor (Virks I). Accordingly, Dr. Satti moved to Virks I and assumed responsibility for Dr. Andronic's twenty-two patients. This responsibility required him to review each patient's medical chart, some of which were sizeable.
According to MHRH policy, medication orders should be reviewed on a monthly basis. It is undisputed that between May 2001 and August 2001, Dr. Satti did not adjust the then-existing medication orders of certain patients.
On July 12, 2001 and August 24, 2001, the Commission conducted a hearing on the Satti II matter. Before the hearing concluded, Dr. Satti returned from vacation to find that, during his absence, Dr. Calvo had changed medications and ordered endocrine tests on some of his patients. Dr. Satti was upset with the changes and, on August 21, 2001, he spoke to Dr. Martin about Dr. Calvo's actions. Dr. Satti threatened to report the incident to the Board of Medical Licensure and Discipline (Medical Board). However, Dr. Martin advised him against pursuing such course of action. Dr. Satti took Dr. Martin's advice and also asked him for a second medical opinion with respect to Dr. Calvo's measures. Accordingly, Dr. Martin conducted a review of Dr. Satti's patients during the end of August 2001 and made some recommendations for changes in treatment. Dr. Satti duly accepted and adopted said recommendations.
On August 24, 2001, the Satti II hearing concluded. Meanwhile, sometime between August 21 and August 29, 2001, Dr. Satti received a quarterly peer review relating to one patient. The review raised an issue with respect to the dispensing of a salt tablet and diuretic combination of medications. On August 29, 2001, Dr. Martin wrote a memorandum to Dr. Satti requesting him to respond to the peer review comments by September 7, 2001. One day later, before Dr.Satti responded to the peer review comments, Dr. Martin informed Dr. Satti that he was transferring him to the Adult Psychiatric Services facility (APS) to serve as an adjunct physician to psychiatrist/primary-care physicians. The position involved a diminution of authority from his then-current position of Physician II (General). Dr. Martin made his decision to transfer Dr. Satti without consulting with Dr. Calvo or seeking his input. At the time, Dr. Martin was aware that the last physician who was transferred involuntarily to APS had resigned rather than take the position.
Dr. Satti strongly objected to the transfer and requested Dr. Martin to memorialize the transfer in writing. Accordingly, on September 6, 2001, Dr. Martin issued a written memorandum detailing the transfer in which he stated: "I believe your expertise in substance abuse can be put to good use with the many dual diagnosis patients." (Mem. from Dr. Martin, dated Sept. 6, 2001.)
Dr. Satti commenced work at APS in September 2001, and was replaced by a younger physician at Virks I. Shortly thereafter, Dr. Satti went out on sick leave. While on sick leave, Dr. Satti was terminated, effective November 30, 2001, for failure to provide adequate sick leave documentation. Dr. Satti filed a union grievance with respect to his transfer to APS and his termination. The matter duly went to arbitration and resulted in an arbitration ruling in Dr. Satti's favor on July 1, 2002. In that ruling, the arbitrator found that MHRH had violated the collective bargaining agreement when it transferred Dr. Satti. The arbitrator further found that, although Dr. Satti had provided insufficient sick leave documentation, MHRH had neither given Dr. Satti sufficient notice that it was a disciplinary matter nor had it given him sufficient time to rectify the problem before terminating him. As a result, the arbitrator ordered MHRH to reinstate Dr. Satti to his former position at Virks I. One week later, on July 8, 2002, Dr. Martin urged the Executive Committee to recommend to the Department Director, A. Katherine Power (the Director), that she suspend Dr. Satti's hospital privileges at the Eleanor Slater Hospital on an emergency basis. He took this action without the benefit of the advice of legal counsel. That same day, the Executive Committee voted to recommend the emergency suspension of Dr. Satti's privileges, and, on the following day, July 9, 2002, Dr. Martin informed the Director of the Executive Committee's recommendation. At the same time, Dr. Martin also referred Dr. Satti to the Medical Board for review.
In his letter to the Medical Board, Dr. Martin stated that the Executive Committee had recommended the suspension of Dr. Satti's privileges and that said recommendation had been forwarded to the hospital's governing body for final action. Dr. Martin further informed the Medical Board that he had questions about Dr. Satti's patient management skills and willingness to accept clinical supervision. He also raised concerns about Dr. Satti's medical judgment and ability to safely practice medicine. In so doing, Dr. Martin mentioned Dr. Satti's use of salt tablets with diuretics; his transfer to APS; and the arbitrator's subsequent order of reinstatement. Dr. Martin wrote this letter without the advice of legal counsel and before the Director had acted upon the Executive Committee's recommendation to suspend Dr. Satti's hospital privileges.
On July 12, 2002, the Medical Board replied to Dr. Martin's letter of complaint by notifying him that it would look into the matter. It then informed Dr. Martin that, should an investigation be warranted, the Medical Board would forward an unedited copy of the letter to Dr. Satti and provide him with the opportunity to respond.
On the same day, July 12, 2002, Dr. Martin sent an inter-office memorandum to the Director informing her that, according to legal counsel, Dr. Satti's return was not imminentbecause he had not submitted an acceptable medical certification of his fitness for duty and that, consequently, no immediate action was warranted. Dr. Martin further stated that, in the event that Dr. Satti were to provide acceptable certification, the Executive Committee intended to consider immediate suspension of Dr. Satti's privileges, but that, in the meantime, it would follow the procedures set forth in the Medical Staff Bylaws.
At some point after the arbitrator's ruling, Dr. Martin issued an undated report to the Executive Committee recommending termination of Dr. Satti's privileges.2 In that report, Dr. Martin referred to the subjects that had been raised at the August 2001 meeting between himself and Dr. Satti. Said subjects were: (1) Dr. Satti's plan to refer Dr. Calvo to the Medical Board; (2) Dr. Calvo's concerns about Dr. Satti's clinical management of patients with respect to his prescribing salt tablets and diuretics to two of his patients; and (3) Dr. Satti's belief that he was being singled out. Dr. Martin...
To continue reading
Request your trial