Tulare hospital district settles suit with former medical staff

CALAAEM News Service calaaem.news.service at gmail.com
Wed Jul 11 21:40:25 PDT 2018


July 5, 2018


Tulare hospital district settles suit with former medical staff


suit-with-former-medical-staff/> Valley Voice


by Tony Maldonado


A group of doctors ousted by the former Tulare Local Healthcare District
board has reached a settlement with the district. The Tulare Regional
Medical Center Medical Staff (TRMCMS) will be restored to its former status
under the settlement agreement; the district's board had previously voted to
separate itself from the group in January 2016.


Under the agreement, the district will dissolve the Professional Medical
Staff of Tulare Regional Medical Center, the group formed as a replacement,
and reinstate the bylaws that had existed before the TRMCMS group was pushed


"Doctors make any hospital successful," district board president Kevin
Northcraft said in a press release. "We are especially grateful for the
MEC's willingness to put the past behind us, resolve this matter and move
forward with us toward reopening the hospital."


The district would also agree to pay the group's legal expenses, estimated
at $300,000, and funds collected by the replacement group would be
transferred to the former medical staff. $100,000 would become payable four
months after the hospital reopens, another $100k eight months after it
reopens, and another $100k twelve months after it reopens.


Attorneys for the medical staff group indicate they have also reached a
settlement with Healthcare Conglomerate Associates (HCCA), the hospital's
former management company. The group had filed suit against the district,
HCCA, and the group of doctors formed as the replacement medical staff.


"[The] settlement is a significant victory in protecting the ability of
doctors, individually and through their medical staffs, to care for patients
in Tulare County," California Medical Association (CMA) President Theodore
M. Mazer, M.D. said in the press release. "This settlement brings closure to
a long legal fight over the improper interference into the physician-patient
relationship and the autonomy of a medical staff's responsibility for
medical decision making and peer review. It sends an important message well
beyond Tulare, but most importantly, it allows for the Tulare Regional
Medical Center to begin the process of reopening its doors to the patients
of Tulare County, who have suffered tremendously from its closure."


The settlement stipulates that the hospital's actions in disassociating with
the former medical staff violated the right to self-governance of the
doctors that practiced there.


The settlement, if entered as a judgement by the court, would close a
multi-year lawsuit that had snaked through the Tulare County Superior Court.
The group filed suit after the district's former board ousted them in
January 2016; former board members had claimed that an inspection by the
California Department of Public Health had caused them to believe the
hospital would be closed if they didn't do so.


All involved say Dr. Everett Davis, one of the inspectors, gave scathing
remarks during his inspection that led hospital officials to believe the
hospital could be closed without taking drastic action.


"I don't know what he told me. I don't recall that because he was so
insulting. I stopped hearing him. Looks like I was some kind of piece of
crap in front of him that he has to dehumanize me," Dr. Parmod Kumar, a
board member at the time, testified. "It was so - I just blocked my mind and
looked at 10 or 15 other inspectors in the room, and I said to myself, 'What
is this?' I don't know what the hell he was saying to me."


The relationship between the TRMCMS group and the board had been fractured
during the time leading up to the split. John Harwell, an attorney
representing the TRMCMS group, said at the time that the move was


"One day, in secret, the elected district board voted to fire the medical
staff, all 135 of them, and replaced them with a miraculous new medical
staff that included a member of the Board, his wife and someone associated
with Dr. (Benny) Benzeevi (CEO of Health Care Conglomerate Associates
(HCCA), which operates TRMC)," Harwell said . "(The replacement staff) just
sprung out of nowhere and announced they were a new medical staff, that they
had bylaws and regulations, which is just astonishing, because bylaws and
regulations take months to put together, not hours."


Hospital officials had charged that peer review and credentialing processes
had languished, and that they had been left unresolved for months to years.
"Peer review" is a process in which medical staffs can evaluate the work of
a fellow doctor and determine if any issues were present.


"The imminent threat created by the old medical staff was communicated to
hospital personnel by surveyors from the Center for Medicare and Medicaid
Services (CMS)," a statement issued by HCCA during the time of the trial
read. "CMS based their threat of closure in large part on the history of
dysfunction between the Governing Board and the leaders of the former
medical staff, which led to the failure of the medical staff to conduct
appropriate credentialing and peer review of physicians."


Kumar later emerged as a pivotal figure in the switch to a new medical staff
- multiple physicians say he had reached out to them to form the new group.


Drs. Ronald Ostrom, Anthony Trujillo, and Rebecca Zulim testified that they
had all been contacted by Kumar, who had asked them to join the new staff.


"He said we needed to form a new MEC," Ostrom said.


The group later met at the home of former Tulare City Councilman Skip
Barwick, where they decided to move forward with the creation of new bylaws,
utilizing the hospital's former law firm, BakerHostetler.


"The decision was made at that meeting at Mr. Barwick's house, we're going
to go forward with the medical staff," Kumar said during the trial.


Attorneys for the former medical staff had charged that the motivation to
disassociate from the former group was, at least in part, due to
disciplinary actions the staff's Medical Executive Committee had lodged
against Kumar. He was required to take classes for recordkeeping after it
was found that he had backdated certain records, and take anger management
classes as well.


Dr. Anthony Vierra said that he had been given a deadline to either complete
those classes or face suspension of his privileges to practice at Tulare


"[It was] necessary for him to keep his privileges. If he didn't do it," Dr.
Anthony Vierra, a Tulare-based anesthesiologist testified, "he would not
have privileges [at TRMC.]"


In a declaration separate from the case, Kumar testified that he later took
both the anger management and recordkeeping classes


"I insisted that I take the anger management class, the recordkeeping class,
and see a psychiatrist, so to avoid any I claim of bias or impropriety by
Dr. Betre or the former MEC in the future. The new MEC agreed, and I
presented proof of compliance to the new MEC, which then formally closed the
'investigation,'" Kumar wrote.


With the lawsuit settled, the physicians that had left Tulare Regional
Medical Center after the group's ouster are able to return - and keep their
old positions, if they had them, on the staff's Medical Executive Committee.
The move would significantly ease the hospital's search for doctors as it
looks to reopen under the stewardship of Adventist Health.


"To have a successful reopening, we need our doctors back, and the
settlement of the lawsuit with our doctors is a critical step to our
reopening. It also reverses one of the horrific mistakes of the former board
that led to our hospital's bankruptcy," Northcraft said.



Jeff Wells
Deputy Editor, CAL/AAEM News Service


Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service


Contact us at:  <mailto:calaaem.news.service1 at gmail.com>
calaaem.news.service1 at gmail.com

For more articles, visit our

 <mailto:somcaaem at uci.edu> To
<https://maillists.uci.edu/mailman/listinfo/calaaem>  unsubscribe from this
list, visit our mail server.

Copyright (C) 2018. The California Chapter of the American Academy of
Emergency Medicine (CAL/AAEM).  <http://www.calaaem.org/>
http://www.calaaem.org. All rights reserved.

CAL/AAEM, a nonprofit professional organization for emergency physicians,
operates the CAL/AAEM News Service solely as an educational resource for
physicians. Dissemination of an article by CAL/AAEM News Service does not
imply endorsement, agreement, or recommendation by CAL/AAEM News Service,


Follow CAL/AAEM on Facebook and Twitter and check out WestJEM:


 <http://www.facebook.com/CALAAEM>       <https://twitter.com/CALAAEM>



-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://maillists.uci.edu/pipermail/calaaem/attachments/20180711/9ee1b244/attachment-0001.html>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image001.jpg
Type: image/jpeg
Size: 14160 bytes
Desc: not available
URL: <http://maillists.uci.edu/pipermail/calaaem/attachments/20180711/9ee1b244/attachment-0004.jpg>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image002.jpg
Type: image/jpeg
Size: 982 bytes
Desc: not available
URL: <http://maillists.uci.edu/pipermail/calaaem/attachments/20180711/9ee1b244/attachment-0005.jpg>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image003.jpg
Type: image/jpeg
Size: 919 bytes
Desc: not available
URL: <http://maillists.uci.edu/pipermail/calaaem/attachments/20180711/9ee1b244/attachment-0006.jpg>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image004.jpg
Type: image/jpeg
Size: 2533 bytes
Desc: not available
URL: <http://maillists.uci.edu/pipermail/calaaem/attachments/20180711/9ee1b244/attachment-0007.jpg>

More information about the CALAAEM mailing list