Sokol v. Akron General Medical Center

173 F.3d 1026 (1999)

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Nature of the Case

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Facts

P is a cardiac surgeon on the staff of D. In the mid-1990s, the Medical Council at D noticed that P’s patients have an excessively high mortality rate. The Council created CABG (Coronary Artery Bypass Surgery) Surgery Quality Task Force in 1994 to conduct a review of the entire cardiac surgery program at the hospital. The Task Force hired Dr. Pine to perform statistical risk assessments for evaluating the performance of the hospital. Dr. Pine identified that P’s patients have a mortality rate of 12.09% and that the predicted mortality rate for P’s CABG patients was 3.65%, and something of ‘great concern warranting immediate action. The Chairman of P’s department appointed an Ad Hoc Investigatory Committee to review P’s CABG surgery performance by way of interviews and a conclusive report. The Investigatory Committee met with P three times and after a series of assessments and interviews led to the conclusion that P’s high mortality rate was due to two principal causes: poor case selection, and improper myocardial protection. The Committee recommended that (1) all cases of CABG Surgery referred to P must be evaluated by another cardiologist simultaneously, (2) P must not be permitted to do emergency surgery, and (3) a Myocardial protection protocol must be developed for all surgeons. P appeared before the Medical Council on November 21, 1996, which voted to implement the recommendations. By the provision of Akron General Medical Staff Bylaws, when the Council made a decision adverse to clinical privileges of a staff member, the staff member must be notified of the decision along with reasons for it. This allows the staff member to prepare for a hearing to review the Medical Council’s decision. On March 27, 1997, P appeared before an Ad Hoc Hearing Committee which after submission of testimonies, recommended the Medical Council to restore all of P’s CABG privileges. The Medical Council rejected the Hearing Committee’s recommendations and affirmed its original decision, which was later appealed by P to the Executive Committee of the Board of Trustees of Akron General. This committee re-affirmed the medical council’s decision and P asked for injunctive relief against D at the District Court. The District Court ruled that the notice provided to P by the medical Council was insufficient and the action was arbitrary. The lower court issued a permanent injunction and D appealed.