Synergy - May/June 2013 - 13

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In Meyers, both courts ruled that “general behavior and ethical conduct”
provide grounds for a professional review action.
court, referring to Meyers, stated, “I am in
agreement with the Sixth Circuit that “‘[q]
uality health care’ is not limited to clinical
competence, but includes matters of general
behavior and ethical conduct .”21

over their concerns that the physician
was creating disruptions and interfering
with patient care, the court found that the
hospital’s termination of his privileges was
reasonable for HCQIA immunity purposes .

The Tennessee Court of Appeals in
Curtsinger v. HCA, Inc., addressed the doctor
ranting and raving in the ER . The physician
argued that his disruptive behavior could not
hinder healthcare because his behavior had
no effect on his competence as a surgeon .22
The court rejected this argument relying on
the quote from Meyers . The court held that
disruptive conduct under HCQIA need not
actually harm patients and therefore found
that the hospital’s review action was taken
in furtherance of quality healthcare .

Meyers Relied Upon as
Recently as February 2010

Meyers Demonstrates the
“Breadth” of Conduct That Can
Justify Action
In Gordon v. Lewiston Hospital, the subject
physician harassed and intimidated elderly
patients by calling them to disparage the
skills of another physician .23 The court
relied on Meyers in finding immunity for an
action taken based solely on the physician’s
unprofessional conduct . It explained that
“[s]uch unprofessional conduct is within the
purview of a ‘professional review action’
under the HCQIA . The plain language of the
statute indicates the breadth of ‘conduct’ …
by the inclusion of conduct that ‘could affect
adversely the health or welfare of a patient .’”24
In Abu-Hatab v. Blount Memorial Hospital,
the physician was disciplined for improper
conduct toward several nurses, including his
refusal to work with one .25 The physician
disputed the truth of the allegations . The
court, relying on Meyers, responded, “[t]he
Court of Appeals for the Sixth Circuit, when
faced with a similar argument … explained
that [HCQIA] review … ‘is not directed
at whether each of the complaints were
undisputedly true, but whether Defendants
acted reasonably in considering and relying
on them .’”26 After noting that the hospital
had to spend many hours and meetings

The Meyers case was relied upon even as
recently as February 2010, this time by
the Northern District of Ohio in Badri v.
Huron Hospital .27
In 2002, Dr . Badri was involved in an
automobile accident, after which he “tailed”
the other driver, forcing him to pull over,
and in the ensuing exchange, the other
driver allegedly choked the physician,
leaving Badri with pain in his neck . For his
pain, the doctor self-medicated, including
taking steroids . Thereafter, he became more
irascible in the work environment, doing
such things as expressing his displeasure
for any inconvenience, chastising a
medical resident excessively, discussing a
patient’s drug addiction in the presence
of other patients and staff, and numerous
other incidences of “disruptive and
harassing conduct directed toward hospital
employees, residents and patients .”28
In granting the hospital’s motion for
summary judgment and finding HCQIA
immunity, the district court followed the
Meyers decision as a template . Specifically,
concerning disruptive behavior, the court
stated “in Meyers, the Sixth Circuit approved
of the district court’s observation that
‘quality health care’ is not limited to clinical
incompetence, but includes matters of
general behavior and ethical conduct .”29

The New Standard and the
Meyers Line of Cases
TJC announced its standard on disruptive
behavior in a sentinel alert in Summer
2008 .30 In that alert, it recognized many of
the justifications for dealing with disruptive
behavior expressed in the above-cited
cases . Namely, TJC noted that such

behaviors “undermine team effectiveness
and compromise the safety of patients” and
“should not be tolerated .”
In future actions involving physicians’
disruptive behavior, it can be expected that
the starting point for a hospital’s defense
will be the new TJC standard . The standard
is an affirmation of Meyers and its progeny .
These cases developed a body of law
that recognizes that disruptive behavior
alone can justify that a hospital’s action
taken against the physician was done in
furtherance of quality healthcare . ■

Mark W. Leach is a member of the Louisville,
Kentucky, office of Stites & Harbison PLLC. His
firm represented the hospital in the Meyers cases,
however, he was not involved in those matters.
Catipay v . Humility of Mary Health Partners, No . 2005-T-0030 at
*1-4 (Ohio Ct . App . Mar . 31, 2006) .
Curtsinger v . HCA, Inc ., No . M2006-00590-COA-R3-CV (Tenn . Ct .
App . Apr . 27, 2007) .
3
Sternberg v . Nanticoke Mem’l Hosp ., Inc ., No . 07C-10-011(THG)
(Del . Super . Ct ., Sep . 18, 2009) (subject to revision or withdrawal) .
4
341 F .3d 461, 464 (6th Cir . 2003) .
5
Id . at 465 .
6
Id .
7
Id . at 466 .
8
42 U .S .C . § 11111(a)(1); 11112(a) .
9
Id . at 468 (quoting Austin v . McNamara, 979 F .2d 728, 734 (9th
Cir . 1992)) .
10
Id . at 468 (quoting Austin v . McNamara, 979 F .2d 728, 734 (9th
Cir . 1992)) .
11
For cases not involving disruptive behavior, but citing Meyers, see,
e .g . Talwar v . Mercer Co . Joint Twp . Cmty . Hosp ., 520 F .Supp .2d 894
(N .D . Ohio 2007); Schindler v . Marshfield Clinic, No . 05-C-705-C
(W .D . Wis . Oct . 12, 2006); Lee v . Trinity Lutheran Hosp ., No .
00-0716-CV-W-HFS (W .D . Mo . Jan . 29, 2004) .
12
Meyers v . Logan Mem’l Hosp ., 82 F .Supp .2d 707, 715 (W .D . Ky .
2000) .
13
596 S .E .2d 179 (Ga . Ct . App . 2004) .
14
Id . at 185 .
15
Supra note 3 .
16
341 F .3d at 469 .
17
82 F .Supp .2d at 714 .
18
101 S .W .3d 76 (Tenn . App . 2002) .
19
Id . at 87 (citations and quotations omitted) .
20
No . JFM 07-2197 at *36 (D . Md . July 25, 2008) .
21
Id .
22
Supra note 2 .
23
Gordon v . Lewistown Hosp ., 423 F .3d 184 (3d Cir . 2005) .
24
Id . at 203-204 . (quoting 42 U .S .C . § 11151(9)) .
25
No . 3:06-CV-436 (E .D . Tenn . Filed Apr . 2, 2009) .
26
Id . at *31-32 (quoting Meyers, 341 F .3d at 468 n .5) .
27
No . 1:08CV1913 (N .D . Ohio Feb . 10, 2010) .
28
Id . at *2-6 .
29
Id . at *48 (quoting Meyers, 341 F .3d at 468) .
30
Issue 40 (July 9, 2008), available at www .jointcommission .org/
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sentinelevents/sentineleventalert/sea_40 .htm .

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