Dr. Vincent L. Guinn, an African American Cardiologist, brought a sham peer review suit against Mount Carmel Health and a number of physicians in the U.S. District Court in the Southern District of Ohio. He alleged two principal federal claims: antitrust conspiracy and monopolization and a violation of his civil rights. Mt. Carmel summarily suspended Dr. Guinn’s privileges after a colleague alleged that he had placed an intracardial device in a patient “pocket” that had broken down and was infected. The defendants sought to have the two claims dismissed for lack of standing under a number of different theories. The Court in Guinn v. Mount Carmel Health, et al., S.D. Ohio, No. 2:09-cv-226, 2/27/12, dismissed the antitrust case on the pleadings, but chose to allow Dr. Guinn to move forward with his discrimination case.
Most antitrust cases brought by physicians are dismissed on the basis of a lack of proof of “antitrust injury.” Such is the case with Dr. Guinn. Even though in some respects the physician peer review process is ripe for claims of conspiracy to restrain trade under Section I of the Sherman Act or monopolization under Section II, a claim must on its face demonstrate harm to “competition” and not just damage to an individual physician. If there are only two physicians in a relevant market and one is excluded as a result of anticompetitive conduct, there would be a colorable claim for harm to “competition” in the surviving physician’s monopolization, his ability to raise prices or his perhaps inferior qualifications. The court held;
The ‘elimination” of a single competitor, standing alone, does not prove anticompetitive effect.
Dr. Guinn, in his pleadings, used the correct conclusory language, but failed to allege specific facts to show that the defendants had gained a monopoly, had the power to raise prices or that the quality of the care available to patients suffered as a result. Antitrust injury has been a requirement of an antitrust action since the Supreme Court’s decision in Brunswick Corp. v. Pueblo Bowl-O-Mat, 429 US 477, 488 (antitrust laws are for the protection of competition, not competitors).
On the other hand the court ruled that Dr. Guinn had adequately stated a claim for relief under federal civil rights acts, in making allegations that he was treated less favorably than similarly situated white co-workers. Dr. Guinn alleged that the defendants fabricated a “patently untrue patient care incident allowing them to institute a “sham” peer review that they then utilized to drive Dr. Guinn from the hospital because he was an African American. He alleged that white colleagues with actual patient care issues had not been subjected to peer review.