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Medical Staff Alert: Poliner decision overturned

Physicians who have been reluctant to participate in peer review activities can relax a bit knowing that the Health Care Quality Improvement Act (HCQIA) still stands on solid ground.

In 1998, Presbyterian Hospital of Dallas suspended Dr. Lawrence Poliner’s cardiac catheterization and echocardiography privileges after several physicians questioned his technical competence during peer review activities. Poliner rebutted with a law suit. During the 2003 trial, Poliner convinced the jury that the suspension damaged his career and caused mental anguish. The jury subsequently awarded him $370 million in damages. A trial court later reduced that amount to approximately $33 million.

On July 23, 2008, The U.S. Court of Appeals for the Fifth Circuit overturned the jury and the trial court’s decisions and found in favor of Texas Health System, concluding that the physicians who advocated for Poliner’s suspension are protected under the Health Care Quality Improvement Act. As a result, Poliner will not receive any monetary award for damages.

Read more about the Poliner vs. Texas Health Systems case.

http://www.ca5.uscourts.gov/opinions/pub/06/06-11235-CV0.wpd.pdf

La Pine: It seems we are protecting the practitioner, but are we harming the patient?

By now many MSPs have heard that the Fifth Circuit Court ruling released the Louisiana hospital from the duty to disclose negative information while saying the hospital has the duty not to make “affirmative misrepresentations.”  To put this into reality, here’s how this now plays out:  When you receive a letter requesting verification of medical staff membership, you need only tell the basics -- date on staff, date of resignation/termination.  Often the letter will ask if the physician was “in good standing.”  If the physician is one of those rare practitioners whose clinical competency was in question, do you leave the question blank?  How does this response help the investigating facility to ensure the practitioner candidate will deliver safe patient care to its patients?

This latest ruling on the Kadlec appeal is going to result in some very interesting debates among MSPs.  It further raises more questions about the “right” response.  While audio conferences will soon be presenting opinions on what information can and should be provided to requesting entities, I wonder if thought will be given regarding the patient.  Seems we are protecting the practitioner, but are we harming the patient?

La Pine’s Law:  Patient safety first.

Kadlec court ruling overturned

Breaking news from HCPro…

We’re sending out an email to our subscribers today alerting them that the ruling in the landmark Kadlec court case has been overturned. However, this information is too important not to share with everyone. Here’s what we know about the case:

A previous court ruling which held that a hospital had a duty to disclose to another facility evidence of a prior staff member’s impairment has been overturned. On May 8 The U.S. Court of Appeals for the Fifth Circuit ruled that a healthcare facility has no special relationship with another hospital to disclose information, says Michael R. Callahan, a lawyer in the healthcare department of Katten Muchin Rosenman LLP in Chicago. If a hospital chooses to respond to a questionnaire with neutral information that is acceptable, but it is not acceptable to disclose misleading information.

In 2001, Robert Berry, MD, an anesthesiologist at Lakeview Regional Medical Center in Covington, LA, was fired by his Lakeview Anesthesia Association (LAA) colleagues for working under the influence of prescription painkillers. Neither the medical center nor LAA reported his behavior to the National Practitioner Data Bank, the hospital board of trustees, or to the Louisiana Board of Medical Examiners. Berry then applied for a job at Kadlec Medical Center in Richland, WA, through a staffing agency. The medical center provided neutral information about Berry’s employment to Kadlec, while LAA provided a positive review of Berry that was misleading and did not reveal his drug impairment.

In 2002, Berry caused serious harm to a patient while providing care under the influence of Demerol. Kadlec settled a lawsuit with the patient’s family for $8.5 million. Then, Kadlec brought a lawsuit which included claims for intentional and negligent misrepresentation against Lakeview Regional Medical Center and LAA. The jury found the medical center and LAA at fault, and awarded $8.2 million to Kadlec, an amount that was later reduced to $5.5 million.

Callahan says the recent ruling is important for hospitals. “Although the Fifth circuit held that there was no duty to disclose, clearly hospitals have to be truthful and objective if they decide to provide a response to another hospital as part of the appointment and reappointment process,” he says. “Misleading information will serve as a basis for a potential liability claim.”

Click here to read the entire court ruling. http://www.ca5.uscourts.gov:8081/isysquery/irl2e8f/1/doc

What’s your reaction to this ruling? How much information does your hospital share with other facilities?

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