Levine Staller Wins Due Process Appeal For Physician

After several years of litigation, Levine Staller is pleased to announce that it has won an Appellate Court case on behalf of a Cape May physician, Dr. Nanavati, who was denied staff privileges at Cape Regional Medical Center (the “Hospital”) over allegations of “disruptive behavior.” The case centered on what standards and procedures a hospital must afford a physician before terminating his or her clinical privileges. The Appellate Court confirmed that as a matter of fairness before a physician’s staff privileges are terminated for “disruptive behavior,” a physician must receive a fundamentally fair process. If a hospital seeks to dismiss a physician based upon a nebulous “prospective disharmony” theory, the hospital must bear the burden of proving that prospective disharmony “will probably have an adverse impact on patient care.” This standard serves to protect physicians, and by extension their patients, from being arbitrarily denied staff privileges.

In Nanavati v. Burdette Tomlin Memorial Hospital, 107 N.J. 240 (1987), the seminal case in New Jersey setting forth the procedural due process that hospitals must afford to physicians, the Supreme Court confirmed the straight forward notion that doctors need staff privileges to serve their patients and the public interest requires that hospitals treat doctors fairly in making decisions about those privileges. Thus, New Jersey law requires a physician to receive a fundamentally fair process before a hospital can revoke his or her staff privileges.

The Supreme Court further explained that the mere fact that a doctor annoys other doctors, nurses, and administrators is insufficient to warrant revocation of staff privileges. Instead, to merit revocation based on “disruptive behavior,” a hospital must present concrete evidence of specific instances of misbehavior that are so disruptive that “the probable outcome will be harm to the patients.”

In the years since the Supreme Court’s decision, Dr. Nanavati has openly expressed his disapproval of certain of the Hospital’s policies and some Hospital staff. This on-going conflict led the Hospital’s Credentials Committee to deny Dr. Nanavati’s request to have his staff privileges renewed in 2015.

Because the Credentialing Committee recommended against renewing his staff privileges, Dr. Nanavati was entitled to an internal administrative hearing. During the hearing, and over our objection, the Hospital placed the burden of proof on Dr. Nanavati; requiring him (as opposed to the Hospital) to prove “by clear and convincing evidence” that the record lacked any evidence that his behavior “could” adversely affect patient care.

The Appellate Court found that this standard was unfair and violated the Supreme Court’s prior decision requiring hospitals to prove probable harm. As the Court found, this standard made “Dr. Nanavati’s burden of proof insurmountable and predetermined the outcome.” Essentially, the standard employed by the Hospital impermissibly stacked the deck against a physician, requiring the Hospital’s version of events to be presumed to be true. As such, the Appellate Court found that “application of a less exacting standard for his conduct to impact patient care prejudiced his right to a fair hearing.”

Moving forward, it is clear that New Jersey Courts will not permit a physician to have his staff privileges revoked without first receiving a fundamentally fair procedure.

The case was primarily handled by Tony Morgano, Esq., who works with a variety of different employees and businesses in diverse industries throughout New Jersey.

Menu