Case details
Doctor: Fair hearing following discrepancy not provided
SUMMARY
$2177000
Amount
Verdict-Plaintiff
Result type
Not present
Ruling
KEYWORDS
emotional distress, mental, psychological
FACTS
On Jan. 2, 2003, plaintiff Georgia Bode, M.D., began work as an anesthesiologist at Los Angeles Metropolitan Medical Center with a temporary, but renewable, 90-day practice privileges pending action on her application for membership on the hospital’s medical staff. She was subsequently subjected to a peer review meeting and a medical executive committee meeting due to a discrepancy as to why an ampule of Demerol was not returned to the pharmacy. The hospital previously instituted a computer-operated drug dispensary system called Sure-Med. In order to return unused drugs, a physician must enter information into the Sure-Med system specifying whether drugs were used, wasted (unreturned after disposal by an authorized method), or returned after not being used. Drug returns also had to be witnessed and signed off by an authorized hospital staff member. The hospital’s pharmacy staff would then confirm the return and would also review patient records to be sure physicians properly documented the use or wastage of unreturned drugs. Within Bode’s first three weeks at the hospital, she had problems properly documenting her use of various medications and six incidents were reported between Jan. 6, 2003, and Jan. 18, 2003. Some of the incidents were based on Bode’s failure to sign her name to patient records, while others involved the failure to document the dosage administered or the disposition of the drugs. On Jan. 22, 2003, the hospital’s surgical chief sent Bode a letter setting forth the six incidents. The letter ended by warning that any further occurrences “may result in disciplinary action including suspension of privileges.” The hospital’s records showed that Bode subsequently received training and counseling about these issues and seemed to have resolved them satisfactorily. On March 18, 2003, Bode withdrew several doses of medication to administer to a patient undergoing spinal surgery. The Sure-Med records showed that Bode obtained three ampules of Fentanyl, two vials of Versed and one ampule of Demerol. The patient’s chart showed that all of the Fentanyl and one of the Versed doses were administered, but not the Demerol. The Sure-Med records also showed that Bode entered the return of the Demerol and the remaining Versed vial. This was witnessed by a nurse, who entered her own user ID and password into the Sure-Med system to confirm Bode’s actions. However, when pharmacy staff checked the machines the next day, they could not find the Demerol ampule. On March 23, 2003, the hospital’s surgery department held an emergency peer review meeting, where the hospital’s chief of staff summarily suspended Bode’s temporary privileges. On March 25, 2003, Bode appeared before a meeting of the surgery department to explain the missing Demerol ampule and submitted a prepared statement. Bode claimed that an experienced recovery room nurse witnessed and signed for the return of the Demerol; that the Sure-Med system is complicated; that recovery room nurses should be able to recognize Demerol when they see it; and that she had never before had any problems with dispensing or returning controlled substances. The peer review committee was unable to “come to a concrete solution regarding the discrepancy.” As a result, on March 26, 2003, the surgery department recommended that Bode’s privileges remain suspended until their 90-day limit expired four days later. On March 31, 2003, Bode was given official notice from L.A. Metro that her temporary privileges would not be renewed “because of issues surrounding the return of controlled substances.” Bode subsequently asked for a hearing to rebut the charges and as part of that June 2003 demand, she told L.A. Metro that she had no further interest in practicing there, effectively withdrawing her application. However, the hospital refused to provide a hearing. As a result, Bode filed a mandate petition (Code Civ. Proc., § 1085) to compel L.A. Metro to provide the hearing. That petition was granted and the hospital scheduled a hearing on its decision to suspend and not renew Bode’s privileges. Pursuant to the hospital’s bylaws, the medical staff’s case against Bode was brought by the hospital’s medical executive committee. The finder of fact was a Judicial Review Committee comprised of medical staff members, assisted by a hearing officer. During that hearing, Bode testified that other hospitals using the Sure-Med system had experienced problems with missing drugs. She claimed that she did not return any Fentanyl because she had used all three ampules during the spinal surgery, but that she was sure the nurse saw her return the Demerol and could not explain what happened to it. Bode also claimed that the head of the hospital’s pharmacy department asked her to change the patient’s record to reflect that Demerol had been used, but that she declined to do so. The nurse’s statements were also in evidence, but the nurse did not testify. The Judicial Review Committee ultimately found that Bode “was involved in seven cases which raised concerns during the period of her temporary privileges and did not present adequate evidence of her proficiency as an anesthesiologist.” Bode subsequently filed an administrative mandate petition against the Board of Directors of Los Angeles Metropolitan Medical Center and the Board of Directors of Pacific Health Corp., contending that the Appellate Review Committee mistakenly placed the burden of proof on her and exceeded its authority by reweighing the evidence introduced before the Judicial Review Committee. The court found for Bode and the matter proceeded to the Superior Court. In the Los Angeles Superior Court, Bode claimed that the actions of L.A. Metropolitan Medical Center and Pacific Health Corp. constituted a denial of her right to a fair procedure and violation of California’s Business & Professions Code § 809 et seq. Bode claimed that under state law and L.A. Metro’s bylaws, the burden of proof for an initial applicant at this type of personnel hearing lay with the physician being disciplined, but that in all other cases, the burden of proof lay with the hospital. However, Bode alleged that the Judicial Review Committee was unsure whether to place the burden of proof on her and, acting on the hearing officer’s recommendation, decided the case in the alternative by first placing the burden on her and then by evaluating the evidence as if the hospital bore the burden of proof. She claimed that if the Judicial Review Committee had appropriately placed the burden of proof on the hospital first, it would have found that the hospital’s decision to suspend and not renew Bode’s temporary privileges was not reasonable or warranted. Thus, she claimed she was denied a fair hearing. The defendants raised the issue of immunity and noted that Bode had the chance to take part in the peer reviewed matter., Bode claimed she had an unblemished record since she began practicing in 1987 and even gave up her staff membership at Centinela Hospital Medical Center in Inglewood in order to come to L.A. Metro. However, she claimed after coming to L.A. Metro, she suffered emotional distress from the exhaustive proceedings that commenced in 2003. Bode reported that she had sleep issues, felt sick, had stomach problems and was emotional during the almost 10 years that followed. Plaintiff’s counsel noted that while Bode was technically allowed to still practice as an anesthesiologist, but that no hospital would allow her privileges due to the veil of being let go because of unreturned narcotics. Counsel asserted that although Bode was not banned, she was blackballed. As a result, Bode applied to anywhere from 30 to 40 hospitals for privileges, but was rejected by all of them.
COURT
Superior Court of Los Angeles County, Los Angeles, CA
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INJURIES:
- anxiety
- brain
- brain damage
- brain injury
- cognition
- depression
- epidural
- extradural hematoma
- face
- facial bone
- fracture
- head
- headaches
- hearing
- impairment
- insomnia
- loss of
- mental
- nose
- psychological
- scapula
- sensory
- shoulder
- skull
- speech
- subdural hematoma
- tinnitus
- traumatic brain injury
- vision
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