This is a series describing the ten important pro-immunity peer review cases where court have granted immunity to peer reviewers under the Health Care Quality Improvement Act of 1986, 42 U.S.C. Sec. 11112 (“HCQIA”).
No. 5: Bryan v. James E. Holmes Regional Medical Center, 33 F.3d 1318 (11th Cir. 1994).
Dr. Bryan received a $4.2 Million Dollar breach of contract award by a federal jury in the case in the District Court. The 11th Circuit Court of Appeals reversed. Dr. Bryan was by all accounts an excellent surgeon, but a less than competent human being. He was known to be ‘volcanic tempered perfectionist,” with an odd sense of humor. (He told a nurse that her patient had hanged himself in his room, to keep her on her toes.) The hospital and the medical staff tried a variety of graduated suspensions to try to curb Dr. Byran’s behavior. He had a penchant for slapping nurses on their hands when he disliked their performances. He collected over 50 written complaint reports from various staff.
Dr. Bryan claimed that he was terminated by the Board of Trustees because of personal animus directed at him, not quality of patient care. He presented no evidence of animosity. He also objected to the fact that the Board made their decision without reviewing a transcript of his fair hearing. The court responded that he should have presented it to hem himself if he thought it was important.
Dr. Bryan’s argument did little to overcome the court’s reluctance to overrule the decisions of a hospital board where any reasonable evidence supports a termination action.
Accordingly, as in all procedural due process cases, the role of federal courts "on review of such actions is not to substitute our judgment for that of the hospital's governing board or to reweigh the evidence regarding the renewal or termination of medical staff privileges." Shahawy v. Harrison, 875 F.2d 1529, 1533 (11th Cir.1989). No reasonable jury could conclude that Bryan had demonstrated, by a preponderance of the evidence, that the Hospital board did not act in the "reasonable belief that the [termination] was warranted by the facts known after reasonable effort to obtain facts" as required by section 11112(a)(4). 42 U.S.C. Sec. 11112(a)(4).