On November 16, 2012, the United States District Court for the Eastern District of Michigan released an 80 page opinion granting Summary Judgment in favor of St. Mary Mercy Hospital in the case Brintley v. St. Mary Mercy et al (No. 09-cv-14014). The plaintiff was a former physician at St. Mary Mercy who had her privileges restricted and was eventually suspended by the hospital. In the opinion, drafted by Chief Judge Gerald Rosen, the court dismissed each of the plaintiff’s claims including claims for race and gender discrimination under federal and state law as well as her state law breach of contract and tort claims. The hospital was represented by Hall Render attorneys David French and Timothy Gutwald. The court found the relevant facts to be as follows.
On January 24, 2008, Dr. LaCesha Brintley, a female, African-American physician, performed a procedure at St. Mary Mercy Hospital that raised significant quality of care concerns. In performing the procedure, Dr. Brintley severed two major blood vessels, resulting in significant blood loss to the patient. The patient survived, but the hospital undertook an investigation to compare Dr. Brintley’s surgical complication rates to that of other surgeons at the hospital. When the investigation revealed plaintiff’s complication rate was significantly higher than that of other surgeons, the hospital’s Medical Executive Committee recommended that Dr. Brintley undergo a proctorship. However, Dr. Brintley refused to comply with the terms of the proctorship and the Medical Executive Committee summarily suspended her medical staff privileges. Pursuant to the hospital’s Medical Staff Bylaws, Dr. Brintley was granted a Peer Review Hearing. After four days of hearing, the panel recommend that Dr. Brintley’s suspension be upheld.
On October 9, 2009, Dr. Brintley filed an 11-count Complaint, alleging race and gender discrimination under state and federal law, and breach of contract and tort claims. The court first considered Dr. Brintley’s claim that she was an employee of the hospital entitled to protection under Title VII of the Civil Rights Act of 1964. Dr. Brintley claimed that she was an employee as a result of her medical staff membership and the proctorship she was compelled to undergo, which she alleged gave the hospital control over her practice. The court rejected this claim, relying heavily upon the language in the hospital’s Medical Staff Bylaws. The court held that “Dr. Brintley was never an employee of SMMH. She never had any kind of employment agreement or contract with SMMH.” The court noted that she maintained a separate professional corporation and conducted her own medical practice, and that the proctorship that was imposed upon her as part of peer review was not sufficient to consider her an employee of the hospital. As she was not an employee, Dr. Brintley could not make a valid claim of employment discrimination under Title VII. Having found no contract between the parties, the court also dismissed Dr. Brintley’s state law breach of contract and federal discrimination claim under 42 U.S.C §1981. This latter statute prohibits racial discrimination in the making and enforcement of contracts. The court specifically found that under Michigan law, the medical staff bylaws did not constitute a binding contract between the physician and the hospital. Finally, the court held that Dr. Brintley failed to prove discrimination because she had “not shown that for same or similar or similar conduct she was treated differently than non-protected class persons.” The court further held that the hospital suspended plaintiff’s privileges due to serious quality of care concerns and Dr. Brintley had failed to demonstrate that those concerns were mere pretext.
The Brintley decision is significant due to its comprehensive discussion of a number of claims that arise from hospital peer review decisions. The court held that the mere fact that a physician possessed medical staff membership and clinical privileges was insufficient to constitute “employment” with a hospital under Title VII, and comprehensively addressed the difference between an independent contractor and an employee. The opinion also extensively analyzed, and rejected, the claim that peer review actions imposing oversight of a physician’s practice amount to “control” of the delivery of care, thereby rendering the physician an “employee” of the hospital. The court thoroughly discussed whether hospital medical staff bylaws should be viewed as a contract between the physician and the hospital, and concluded that they are not a contract when the hospital board is not bound to accept the recommendations of medical staff peer review bodies. Moreover, the court also addressed the requirements for immunity for peer review decisions under the Health Care Quality Improvement Act. The opinion is informative reading for anyone involved or concerned with drafting medical staff bylaws or implementing peer review actions and hearings.
If you have any questions, or for more information, please contact David French at 248-457-7813 or Timothy Gutwald at 248-457-7892 or your regular Hall Render attorney.
