FLORIDA (September 11, 2019) – In a decision with potential implications
for hospitals nationwide, a Federal Judge has ordered a summary judgment
finding in favor of Parrish Medical Center (PMC) in a lawsuit brought
against PMC by seven oncology physicians whose credentials were not renewed
after they failed to provide, or cause to be provided, PMC with patient-centered data.
The Court’s published opinion, released August 22, clarifies that
hospital bylaws may “…allow issues outside the realm of clinical
competence to be considered when evaluating a staff member’s reappointment
application,” citing its February 24 order denying the physicians’
motion for preliminary injunctive relief.
“This ruling has implications nationally in favor of hospitals seeking
data from physicians applicable to their quality of care initiatives for
the benefit of patients,” said Joe Zumpano, who along with law partner
Leon Patricios of Zumpano Patricios, handled the matter. “This is
one of the largest instances of physician privileges’ non-renewal
of which we are aware.
“PMC CEO Dr. George Mikitarian and the Parrish Medical Center Board
of Directors should be credited for the successful efforts regarding the
matter,” Zumpano said.
In his order, U.S. District Court Judge Roy B. Dalton noted, with respect
to the case brought by the seven physicians affiliated with Health First
- and who had privileges at PMC - “…at bottom, this dispute
revolves around the thinly veiled effort of Health First to flex its muscle
in the long running, heavily litigated, ‘scorched earth’ turf
war for Brevard County’s health care business.”
The seven physicians “…have been employed as foot soldiers
in the intractable hostilities,” the Judge said.
“Whether Health First has any concern for the reputation of their
employee physicians, or the unfettered delivery of health care services
to Brevard County citizens, or simply disregards this as unfortunate but
necessary collateral damage is unclear. No sacrifice is too great when
it’s not yours,” Judge Dalton wrote.
“The patient-centered data PMC sought from the seven physicians was
essential for the hospital’s quality improvement initiatives,”
said Chris McAlpine, PMC senior vice president.
“Information timely provided is important in any environment, and
particularly in health care,” Zumpano said.
“Hospital quality initiatives matter and no one should be exempt
from doing their part to contribute the appropriate supporting data,”
Zumpano said. “We live in an age where patient-centered data and
hospital quality initiatives are inextricably tied to patient well-being.
That Parrish Medical Center's Board, CEO and managed care officers,
stood firm for that principle - despite the fierce opposition faced from
other interests - is both inspiring and comforting to our community.”
The summary judgment was granted in PMC’s favor on all claims brought
by the physicians - for violation of procedural due process, breach of
Bylaws, and violation of substantive due process.
In ruling for PMC on the procedural due process claim, the Court held that
through the hearing process provided by PMC, followed by plaintiffs exhausting
the appeal process, the seven physicians received, “the full panoply
of due process protections,” citing the 11th Circuit Court of Appeals
standard on such legal issues.
The physicians alleged that in the case of their privileges non-renewal,
hospital bylaws had been breached. However, the Court found that PMC was
entitled to invoke statutory immunity, given that PMC’s bylaws allow
consideration of issues outside of clinical competence when evaluating
The Court also found that Dr. Mikitarian’s representations to the
PMC Board, that PMC had requested the data, were truthful and supported.
Wrote the judge, “…all Plaintiffs admitted in their depositions
that they had been informed and/or asked about Health First providing
PMC data for accreditation purposes before the December Board Meeting.”
The Court further ruled that Dr. Mikitarian’s statements that PMC’s
accreditation was in jeopardy (due to the missing data) were also accurate.
PMC asserted that the patient-centered data was necessary for the re-accreditation
process with the Commission on Cancer (CoC): “…PMC fought
tooth and nail to gain reaccreditation and succeeded despite this missing
data. PMC worked with the CoC’s surveyor to brainstorm and create
workarounds to get at this missing data from another angle, via records
it could obtain,” the opinion stated.
The Court further complimented PMC for its tenacity and perseverance in
obtaining its re-accreditation despite the lack of the patient-centered data.
“Plaintiffs’ evidence shows that PMC didn’t take no for
an answer and still endeavored to obtain accreditation. But PMC’s
success does not mean the refusal to provide data didn’t undermine
and obstruct this process,” the Judge wrote.
Finally, the Court ruled in PMC’s favor in that the hospital satisfied
substantive due process principles in its decision to not renew the physicians’
privileges. The Court found that PMC’s grounds for denial of the
renewal of privileges were “reasonably related to the operation
of the hospital,” “fairly administered,” “geared
by a rationale compatible with hospital responsibility,” and relevant
to the seven physicians’ applications for the renewal of the privileges.
“I want to congratulate George Mikitarian, Chris McAlpine, Joe Zumpano
and Leon Patricios for this great outcome,” said Herman Cole, PMC
The federal district court order can be read
The Law360 article on this case can be read