Webb v. HCA Health Services of Midwest, Inc., 89-128

• Decision Date: 11 December 1989
• Docket Number: No. 89-128,89-128
• Parties: , 4 IER Cases 1869 Margaret WEBB, Appellant, v. HCA HEALTH SERVICES OF MIDWEST, INC. d/b/a Doctors Hospital and Nicholas E. Riegler, Appellees.
• Court: Arkansas Supreme Court

Page 571

780 S.W.2d 571

300 Ark. 613, 4 IER Cases 1869

Margaret WEBB, Appellant, v. HCA HEALTH SERVICES OF MIDWEST, INC. d/b/a Doctors Hospital and Nicholas E. Riegler, Appellees.

No. 89-128.

Supreme Court of Arkansas.

Dec. 11, 1989.

Rita S. Looney, Little Rock, for appellant.

E. Scott Smith, Patricia G. Griffith, Atlanta, Mike Huckabay, Timothy L. Boone, Little Rock, for appellees.

GLAZE, Justice.

Appellant filed a complaint alleging a cause of action for intentional infliction of emotional distress, commonly referred to as tort of outrage, against HCA Health Services (HCA) and Dr. Riegler. HCA does business as Doctors Hospital. The appellant also filed a cause of action against HCA for wrongful discharge. HCA and Riegler answered denying appellant's claims and Riegler moved to dismiss the claim against him based upon the statute of limitations. Dr. Riegler and HCA subsequently filed motions for summary judgment which the trial court granted in their favor on both the tort of outrage and wrongful discharge claims. Appellant appeals from the trial court's granting of summary judgment and Dr. Riegler cross-appeals from the trial court's denial of his motion to dismiss. We affirm the lower court decision denying appellant's tort of outrage claims, but reverse and remand the wrongful discharge claim against HCA.

Because this appeal is from the trial court's granting of summary judgment, our review is limited and focuses on the pleadings, deposition testimony and other documents filed by the parties in support of their respective arguments. From that record, the following relevant facts and events are disclosed. HCA entered into a Memorandum of Understanding with the Arkansas Foundation of Medical Care (AFMC) pursuant to 42 U.S.C. § 1395cc(a)(1)(F), which requires providers of health services to maintain an agreement with a professional standards or quality control organization that addresses utilization and quality control, including the appropriateness of admissions. In this connection, HCA employed appellant as a utilization review coordinator, and in that capacity, appellant reviewed the charts of Medicare and Medicaid patients to determine if their admissions and lengths of stay complied with criteria set out by AFMC. This review process is a part of a federal government program dealing with the cost containment of services. If, in appellant's opinion, the admissions or stays did not comply with criteria, she reported that fact to the designated physician advisor who assessed whether additional diagnoses should be made or the underlying charting improved so as to certify additional hospital days for the patient. To meet its obligations under the federal program, AFMC conducted independent audits of patient charts.

Dr. Riegler made no secret of the fact he disliked this utilization review procedure. He voiced criticism that his charts were out for review when he made hospital rounds and complained to Ms. Chandler, appellant's supervisor. Apparently, Dr. Riegler had been placed on 100% review so every chart of all his patients had to be reviewed. Ms. Chandler instructed appellant to avoid Dr. Riegler and to review his charts retroactively rather than reviewing the charts of patients upon their admissions and periodically thereafter.

In late December 1986 or early January 1987, appellant had problems when reviewing two of Dr. Riegler's patient charts, and in discussing the matter with Ms. Chandler, appellant claims Chandler asked her to submit false information regarding these two Medicaid patients' charts. Appellant refused, claiming the number of days the two patients spent in the hospital did not meet AFMC criteria. Chandler eventually certified the days and told appellant to place the certification documents with the patients' charts, which appellant did.

On January 13, 1987, the appellant was reviewing charts when Dr. Riegler made his rounds, and upon seeing appellant, Riegler went to Chandler to complain. Appellant was called to Chandler's office and informed of Dr. Riegler's complaints. Appellant was later terminated on January 22, 1987.

Appellant filed suit in March 1988, and in her count against Dr. Riegler alleged that he had made derogatory comments about her in the presence of others, had made unwarranted complaints to her supervisors, caused severe difficulty in her performing her duties and encouraged her supervisors to terminate her. In her deposition, however, appellant conceded that (1) she did not know if Dr. Riegler took part in or forced the hospital's decision to fire her, (2) Dr. Riegler did not make derogatory comments directly to her but told others within hearing that utilization review was "stinky," and (3) in general, Dr. Riegler had a problem with the utilization review process. Appellant further offered evidence that Dr. Riegler had told appellant (and a co-worker) not to touch his charts, that Riegler had threatened to sue everybody connected with the review procedure and that he was verbally abusive to the utilization review coordinators, which included appellant.

Even when viewing the foregoing evidence most favorably to appellant, as we are required to do, it simply fails to support a claim for the tort of outrage. In Ingram v. Pirelli-Cable Corp., 295 Ark. 154, 747 S.W.2d 103 (1988), we stated that the type conduct that meets the standard of an outrage cause of action must...