Sweeney v. Athens Regional Medical Center

• Decision Date: 03 February 1989
• Docket Number: Civ. No. 87-06-ATH(DF).
• Citation: 705 F. Supp. 1556
• Parties: Deborah SWEENEY, Plaintiff, v. ATHENS REGIONAL MEDICAL CENTER, et al., Defendants.
• Court: U.S. District Court — Middle District of Georgia

705 F. Supp. 1556

Deborah SWEENEY, Plaintiff, v. ATHENS REGIONAL MEDICAL CENTER, et al., Defendants.

Civ. No. 87-06-ATH(DF).

United States District Court, M.D. Georgia, Athens Division.

February 3, 1989.

Mary M. Brockington, John C. Butters, A. Jack Hinton, Douglas R. Powell, McGee & Oxford, Atlanta, Ga., James F. Ponsoldt, Athens, Ga., for plaintiff.

Emmet J. Bondurant, Michael B. Terry, Bondurant, Mixson & Elmore, Atlanta, Ga., Gary B. Blasingame, Blasingame, Burch, Garrard & Bryant, J. Edward Allen, Fortson, Bentley & Griffin, Athens, Ga., for defendant Athens Regional Medical Center.

Sidney F. Wheeler, Earl W. Gunn, Suzanne M. Trexler, Long, Weinberg, Ansley & Wheeler, Atlanta, Ga., for defendants Athens Obstetrics and Gynecology, P.C., et al.

Terrance C. Sullivan, Hart & Sullivan, Atlanta, Ga., for defendants Athens Women's Clinic, et al.

Lynn M. Roberson, Swift, Currie, McGhee & Hiers, Atlanta, Ga., for defendant Thomas C. Lyons, M.D.

FITZPATRICK, District Judge.

Plaintiff Deborah Sweeney, a certified nurse-midwife, brought the above-referenced action against the Athens Regional Medical Center (ARMC), the Athens Women's Clinic (AWC), Athens Obstetrics and Gynecology, P.C. (AO & G), and several doctors who are connected with AWC and AO & G. In her original Complaint, Plaintiff alleged violations of the Sherman Act, 42 U.S.C.A. § 1983, and various provisions of State law. ARMC, AWC and its doctors, and AO & G and its doctors, have each filed motions for summary judgment as to all claims asserted by Plaintiff Sweeney. After initially considering all three motions, the court realized that the motions filed by the two groups of doctors involve similar claims and defenses, whereas the motion filed by ARMC involves, for the most part, entirely different claims and defenses. For this reason, as well as to give the parties the court's rulings as soon as they have been reached, the court has decided to address ARMC's motion for summary judgment in this Order and to address the motions of AWC and AO & G in a separate Order.

I. INTRODUCTION

In her seven-count Complaint, Plaintiff Sweeney asserted three claims against ARMC: (1) a Sherman Act claim; (2) a claim under 42 U.S.C.A. § 1983 for an alleged violation of her constitutional right to free speech; and (3) a claim under Georgia law for intentional infliction of emotional distress. ARMC has moved for summary judgment on all three claims. Before discussing the merits of these claims, the court will set forth those facts relevant to Ms. Sweeney's claims against ARMC.

II. BACKGROUND

After obtaining her masters degree in nurse-midwifery at Georgetown University in 1982, Plaintiff Sweeney worked as a labor and delivery nurse both at ARMC and at another local hospital in Athens, Georgia. During this time she held staff privileges at both hospitals. Affidavit of Deborah Sweeney, ¶ 2, and Exhibit B to this Affidavit. She also worked as a midwife in the ARMC midwifery clinic, and as an instructor in obstetrics nursing for the Medical College of Georgia (MCG) School of Nursing at Athens (SONAT) program at ARMC. Id. As part of her duties with the SONAT program, Ms. Sweeney supervised student nurses during their obstetrics/gynecology clinical rotation at ARMC. Id. at ¶ 8. Ms. Sweeney is licensed by the State of Georgia as a registered nurse and is certified as a nurse-midwife by the American College of Nurse Midwives, the national certifying body recognized by the Georgia Board of Nursing. Deposition of Deborah Sweeney, pp. 110-11, 114-16, 134 (hereinafter Sweeney Dep.).

Defendant ARMC, formally known as the Hospital Authority of Clarke County, is a public corporation created under the laws of the State of Georgia. ARMC is supported by public funds and operates exclusively as a not-for-profit entity. Affidavit of John Drew, ¶ 4; O.C.G.A. § 31-7-77 (1985). Pursuant to the Hospital Authorities Law, O.C.G.A. § 31-7-70 et seq., ARMC exercises a variety of powers, including but not limited to, making and executing contracts, establishing rates and charges for services and the use of its facilities, and appointing its officers, agents, and employees. O.C.G.A. § 31-7-75(3), (10), (18) (1985). Moreover, ARMC has been empowered to grant or deny privileges, and to revoke the privileges of those licensed medical practitioners who treat patients at the Hospital. O.C.G.A. § 31-7-7(a), (b) (1985).

The Defendant doctors are independent contractors. Although the doctors hold staff privileges at ARMC, they are neither employees nor agents of the Hospital. The patients at ARMC are the private patients of the doctors, and the doctors act as agents for their patients in making medical and other health-related decisions. Deposition of John Drew, President of ARMC, p. 72 (hereinafter Drew Dep.).

In the spring of 1985, Ms. Sweeney established a private business called "Family Birth." Sweeney Dep., pp. 13, 23. "Family Birth" provided a childbirth alternative to women in the Athens, Georgia area. The purpose of "Family Birth" was to have nurse-midwives, not doctors, provide prenatal care and complete assistance during the delivery. According to certain affidavits in the record, "Family Birth" provided a less expensive method for childbirth. Because the only role for doctors in the "Family Birth" program was to provide "backup," Ms. Sweeney limited her service to low-risk patients. Id. at pp. 13, 23.¹

In the summer of 1985, Ms. Sweeney placed an advertisement for "Family Birth" in a local newspaper. Ms. Sweeney received a favorable response from this advertisement. As a result of increased responsibilities in connection with "Family Birth," Ms. Sweeney decided to reduce her teaching load at MCG to half-time beginning in January of 1986. Id. at pp. 89-91.

Each woman using the "Family Birth" program was required to make their own arrangements with a physician for back-up consultation and referral. From the spring of 1985 until the fall of 1985, Dr. Kaushik Shah served as the "back-up" physician for at least some of Ms. Sweeney's clients. Id. at pp. 30-33. In September of 1985, however, shortly after Ms. Sweeney had advertised "Family Birth" in a local newspaper, Dr. Shah discontinued his practice as "back-up" for Ms. Sweeney's clients. Id.

From the fall of 1985 until the summer of 1987, Dr. George Rohrer provided back-up for Ms. Sweeney's home deliveries. Id. at p. 38. During the time that Dr. Rohrer provided back-up for Ms. Sweeney's clients, he was employed by the Northeast Georgia Medical Center, a federally-funded clinic located in Clarke County. Dr. Rohrer, who moved from the Athens area in the summer of 1987, was not connected with either AWC or AO & G.

In the fall of 1985, at about the same time Dr. Shah discontinued his back-up services for Ms. Sweeney's clients, the doctors comprising the Department of Obstetrics at ARMC and the doctors comprising the Department of Obstetrics at St. Mary's Hospital met jointly to discuss Ms. Sweeney's "Family Birth" business. As a result of this meeting, the Chief of the Department of Obstetrics for ARMC, Defendant Kelley, and the Chief of the Department of Obstetrics for St. Mary's, Defendant Hardman, wrote a joint letter which they mailed to the chief administrators at each of the two Athens' Hospitals. The letter, dated November 19, 1985, began as follows:

We have in our community a medical practice that we, as obstetricians, feel must be eliminated. Amy Hathaway, CNM, and Debbie Sweeny sic, CNM, are doing home deliveries without qualified physician supervision....

Letter from Dr. Robert E. Kelley, Jr. and Dr. William J. Hardman, Jr., dated Nov. 19, 1985 (a copy of the letter is attached as Plaintiff's Exhibit 1 to John Drew's deposition). Apparently, the doctors' belief that Ms. Sweeney did not have "qualified physician supervision" was based on the fact that none of the doctors at the joint meeting had provided back-up for Ms. Sweeney's clients.

The November 19th letter was written on the stationery of the Defendant doctors practicing at AWC. At the time the letter was written, the AWC doctors also discussed whether to allow Ms. Sweeney and her students to have contact with those hospital patients who were under the care of the AWC doctors at ARMC.

Subsequently, on January 16, 1986, at the nurses' station of the labor and delivery unit at ARMC, Defendant Mercer allegedly accused Ms. Sweeney of (1) practicing illegal medicine; (2) practicing without a back-up physician; (3) exposing patients to unnecessary risks; (4) failing to inform patients of risks; (5) being poorly trained as a midwife; and (6) being irresponsible for the welfare of her patients. Complaint, ¶ 21. According to Ms. Sweeney, Defendant Mercer made her accusations in the presence of several people including nurses, SONAT students, and patients. Id.

Shortly after the confrontation between Dr. Mercer and Ms. Sweeney, the doctors of AWC, Defendants R. Smith, Kelley, L. Smith, Mercer, and Lyons, agreed to prohibit Ms. Sweeney and her students from having access to patients under their care at ARMC. Deposition of Cynthia A. Mercer, M.D., pp. 36-37 (hereinafter Mercer Dep.). These doctors communicated their agreement to ARMC orally, and confirmed the agreement in writing. The letter, dated February 5, 1986, stated:

... we simply cannot allow our patients to be exposed to students who are being instructed by one who advocates the home delivery concept.

Letter from Drs. R. Smith, L. Smith, Lyons and Mercer to Mr. Martin Sparks, Director of Nursing of ARMC, dated Feb. 5, 1986 (a copy of the letter is attached as Plaintiff's Exhibit 4 to Dr. Mercer's deposition).

According to Ms. Sweeney, the doctors at AWC wanted to force her out of ARMC since she had a competing home birth business. The Defendant doctors contend that they took this action because Ms. Sweeney was espousing home birth to their patients. Mercer Dep. at p. 114. Ms. Sweeney denies this allegation, and...