Stratienko v. Chattanooga-Hamilton Cnty. Hosp. Auth., E2011-01699-COA-R3-CV
| Decision Date | 21 November 2013 |
| Docket Number | No. E2011-01699-COA-R3-CV,E2011-01699-COA-R3-CV |
| Parties | ALEXANDER A. STRATIENKO, M.D. v. CHATTANOOGA-HAMILTON COUNTY HOSPITAL AUTHORITY, ET AL. |
| Court | Tennessee Court of Appeals |
ALEXANDER A. STRATIENKO, M.D.
v.
CHATTANOOGA-HAMILTON COUNTY HOSPITAL AUTHORITY, ET AL.
No. E2011-01699-COA-R3-CV
COURT OF APPEALS OF TENNESSEE AT KNOXVILLE
August 6, 2013 Session
Filed November 21, 2013
Over nine years of litigation in both state and federal courts has stemmed from a 2004 incident ("the Incident") wherein Alexander A. Stratienko, M.D. ("Plaintiff") pushed Van Stephen Monroe, Jr., M.D. while in a staff break room at Erlanger Hospital ("the Hospital") in Hamilton County, Tennessee. In this appeal, Plaintiff raises issues regarding whether the Trial Court erred in granting partial summary judgment to Chattanooga-Hamilton County Hospital Authority, in not allowing another amendment to the complaint and additional discovery, in excluding claims at trial relative to an administrative hearing, and in holding that Plaintiff failed to prove at trial intentional interference with business relations. We find no error in the Trial Court's judgments and, we affirm.
D. MICHAEL SWINEY, J., delivered the opinion of the Court, in which CHARLES D. SUSANO, JR., P.J., and THOMAS R. FRIERSON, II, J., joined.
John P. Konvalinka, Mathew D. Brownfield, and Thomas M. Gautreaux, Chattanooga, Tennessee, for the appellant, Alexander A. Stratienko, M.D.
Fred H. Moore, Joseph R. White, and James H. Payne, Chattanooga, Tennessee, for the appellee, Chattanooga-Hamilton County Hospital Authority.
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This case has an extensive procedural history having been before not only this Court previously, but also our Supreme Court, the United States District Court for the Eastern District of Tennessee ("District Court"), and the United States Court of Appeals for the Sixth Circuit. We need not discuss in detail in this Opinion the underlying facts of the suit as they have been discussed in detail in the several appellate opinions already issued in this case and any such further discussion is unnecessary to our resolution of this appeal. Further details on the underlying facts can be found in Alexander A. Stratienko, M.D. v. Chattanooga-Hamilton County Hospital Authority, Nos. 09-5334, 09-5485, 09-6005, 402 Fed. Appx. 990, 2010 U.S. App. LEXIS 23746 (6th Cir. Nov. 17, 2010); Alexander A. Stratienko, M.D. v. Chattanooga-Hamilton County Hospital Authority, No. 1:07-CV-258, 2009 U.S. Dist. LEXIS 60750 (E.D. Tenn. July 16, 2009); Alexander A. Stratienko, M.D. v. Chattanooga-Hamilton County Hospital Authority, No. 1:07-CV-258, 2009 U.S. Dist. LEXIS 21683 (E.D. Tenn. March 17, 2009); Alexander A. Stratienko, M.D. v. Chattanooga-Hamilton County Hospital Authority, 226 S.W.3d 280 (Tenn. 2007); Alexander A. Stratienko, M.D. v. Chattanooga-Hamilton County Hospital Authority, No. E2005-01043-COA-R9-CV, 2006 Tenn. App. LEXIS 161 (Tenn. Ct. App. March 8, 2006).
This case is currently before us after being remanded from the District Court to the Trial Court. Upon remand to the Trial Court, Mitchell L. Mutter, M.D., Daniel F. Fisher, M.D., and Nita Shumaker, M.D. filed a motion for summary judgment. The Trial Court granted Mitchell L. Mutter, M.D., Daniel F. Fisher, M.D., and Nita Shumaker, M.D. summary judgment, and these parties are not involved in this appeal.
The Hospital also filed a motion for summary judgment. By order entered on February 16, 2011, the Trial Court granted the Hospital partial summary judgment on Plaintiff's claims of breach of contract, inducement of breach of contract, conspiracy, and immunity. The case proceeded to trial on Plaintiff's sole remaining claim of intentional interference with business relations.
At trial, Daniel Franklin Fisher, Jr., M.D. testified that he was the Chief of Staff at the Hospital in 2004. Dr. Fisher testified that Dr. Monroe had a contract with the Hospital to evaluate potential kidney transplant patients for cardiology issues. He stated that even if a patient was being seen by one of Dr. Monroe's partners, the patient still would have to be seen by Dr. Monroe "because we have deemed him to have special - - special insights into their problems and we want clearance from him, . . ." prior to a transplant. Dr. Fisher further testified:
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our routine, and we don't vacillate from it, is to send all these patients, regardless of what kind of cardiology background they have, regardless of what doctor they've seen, regardless of who their cardiologist is, we send them all to Dr. Monroe for a cardiology evaluation, specifically asking the question, are they a candidate to go on the list for a kidney transplant operation.
Dr. Fisher explained that the patients are evaluated by Dr. Monroe and then "go back to their original cardiologist for routine treatment or longitudinal follow-up."
Dr. Fisher agreed that he and Plaintiff had talked and had "a general agreement that he would try to follow his patients and I would try to follow mine." Dr. Fisher testified that at some point in time after he and Plaintiff reached this agreement, Dr. Fisher began referring patients to Dr. Monroe. Dr. Fisher could not recall specifically the time period during which these referrals occurred. He testified:
Now, I've had patients that tell me that they want to go in another direction and, you know, that happens to me, and I'm sure it's happened to Dr. Stratienko. I'm sure it's happened to Dr. Monroe. It's happened to Dr. Twiest who used to be sitting in that audience. I mean, we've all had patients that, for one reason or another, decide they don't want to continue to see us if they need that speciality, and so they go to another doctor in the same speciality, and there have been times that a patient will tell me, I want to leave Dr. X, but I need an orthopaedic surgeon and so I want to go to Y in the same speciality, and I help them to go see Y. I mean, that kind of stuff happens all the time. It happens to everybody. There are personality conflicts. There are other issues that occur. And for that reason, sure, there are patients that will wander from Dr. A to Dr. B to Dr. C. That happens all the time in medicine. Probably happens in law too.
Van Stephen Monroe, Jr., M.D. testified that at the time of the Incident he worked for The Cardiovascular Group, which was also known as Chattanooga Heart Institute. Dr. Monroe had a contract to do cardiac evaluation of pre-kidney transplant patients and follow-up longitudinal care on post-transplant cardiac patients for the Hospital. He testified:
As part of the protocol, if it was somebody else's patient, whether it be one of my partner's patients, whether it be another practicing cardiologist in town's patient, or whether it was an out-of-town cardiologist's patient, I would do the initial evaluation, and the transplant program's intent was that there's consistency as there's varying levels of pretesting and evaluation that goes on,
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depending upon the cardiologist, the group, et cetera. That's just the art of medicine.
And so, the transplant committee and a lot of the national organizations felt that having a unified approach to transplantation approval that a patient is a candidate tended to have better long-term outcomes, and so the process would be, if it was my patient, obviously, I'd see them and make a recommendation, yes or no. I don't make the approval. If there was another cardiologist's patient, I would see them for my recommendations to the transplant committee, and they recognized that I would not take over that patient's cardiac care, and that I would see them once a year unless there was something that happened as a medical event that would change their transplantation candidacy, so I was not - - I did not take over all their cardiologists' cardiac care.
Dr. Monroe agreed that he would see Plaintiff's patients through the kidney transplant program, but he assumed that the patient would go back to Plaintiff for ongoing cardiac care. When asked if any patients had refused to allow him to do the cardiac evaluation Dr. Monroe stated: "perhaps there have been. I don't recall specifically."
Melvin Wayne Twiest, M.D. testified that he was not aware of any instance from September 20, 2004 to the time of trial where Plaintiff could not treat a patient at the Hospital or anywhere else due to this lawsuit .
Patricia Eller testified that she has been the Medical Staff Affairs Coordinator at the Hospital since 1980. Ms. Eller holds a Master's Degree. She testified that reappointment letters are not available for public review as they are considered part of the peer review process. Ms. Eller testified that a moratorium was placed on carotid stenting in March of 2005, and was lifted in June of 2005. This moratorium extended to radiologists, vascular surgeons, and cardiologists. Ms. Eller stated that there were physicians other than Plaintiff who were doing carotid stenting in 2004.
Plaintiff testified at trial that he was the only physician doing carotid stenting in the cardiac cath lab at the Hospital in June of 2004. He admitted that other cardiologists were performing carotid...
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