HAP312
Case Study 2
Fall 2022
Case Study 2:
Facts
Dr. Feelgood is a neurologist at Kinda Charitable Hospital (KCH), a 501(c)(3) and state tax exempt charitable hospital. While on call for the emergency department at KCH, he’s asked to examine Lucille, who has presented to the emergency department complaining of dizziness and shortness of breath. Dr. Feelgood determined that Lucille’s problem was most likely heart-related, and asked the on-call cardiologist, Dr. Hartworthy, to examine Lucille. The cardiologist said “yeah, whatever” and went back to reading his Archie and Jughead comic book. After waiting for another hour to be seen, Lucille decided to leave the hospital and try to go to another emergency room or urgent care clinic. As she was walking to her vehicle, she began to feel dizzy again, suffered cardiac arrest, and died soon after being brought back into the emergency department.
Following Lucille’s death, Dr. Hartworthy reported to the medical staff peer review committee that he thought Dr. Feelgood had failed to properly examine her, and that the issue was not cardiac in nature as Dr. Feelgood initially determined. Dr. Hartworthy claimed that he examined Lucille, found no indication of current heart trouble, and ordered her discharged.
Upon opening an investigation into Dr. Feelgood—looking at the outcomes for past patients as well as Lucille’s death—the peer review committee found that Dr. Feelgood had an excellent record at KCH and that, in fact, Lucille died from a massive heart attack as shown by an autopsy and blood tests. The committee further discovered that Dr. Hartworthy was asked multiple times to examine Lucille not only by Dr. Feelgood but also by numerous nurses on duty. Each time he claimed to be too busy, but it turns out he was just really into the story line of the comic book (something about an argument between Archie and Jughead over Betty).
Despite these facts, most of the members of the peer review committee were good friends with Dr. Hartworthy, and resented Dr. Feelgood for her skills and success. They decided that rather than censure Dr. Hartworthy or otherwise suspend or revoke his privileges at KCH, they would revoke Dr. Feelgood’s privileges under the pretense that she was the only physician to examine Lucille and therefore must have been at fault. After being informed of her dismissal, Dr. Feelgood was also dismayed to find that the peer review committee had published a hospital-wide newsletter identifying her and the “facts” that led to her loss of privileges at KCH, which were based on false testimony to the peer review committee by Dr. Hartworthy and a failure by the peer review committee to consider the role that Dr. Hartworthy played in Lucille’s death.
Dr. Feelgood complained to the CEO and the board of trustees of KCH, but they ignored her complaint because, like the peer review committee members, they were enamored of Dr. Hartworthy. In fact, when the Cardiologist soon threatened to leave KCH for a competing hospital, the board of trustees authorized a $10 million bonus if he stayed at KCH. The competing hospital, a private, for-profit facility, offered only $1 million.
Questions
Does Dr. Feelgood have a tort law claim against either Dr. Hartworthy and/or the peer review committee? If so, which tort(s), what elements must be proven for a successful lawsuit, and what facts, if any, support this cause of action?
Assuming that Dr. Feelgood files a lawsuit of some sort, can the peer review committee claim immunity under the provisions of the Health Care Quality Improvement Act? Why or why not? Specify here the applicable requirements of the HCQIA and whether the actions of the peer review committee satisfy the requirements for immunity.
Can KCH be liable under federal statute and/or state tort law for the events in the emergency department, including Lucille’s death? If so, and for each statute or tort answer separately:
what statute or tort is at issue
who might the plaintiff(s) be
what are the requirements that must be shown for a successful lawsuit, and
what is the likelihood of liability?
KCH is exempt from federal and state taxes as a charitable institution. Can any of the actions taken by KCH or others in this fact pattern lead to the loss of tax exemption, and why or why not?
Your paper should:
Answer ALL questions in parts 1-4.
Be between 3 and 3 ½ pages, 1.5 spaced, Times New Roman 12-point font (follow the format instructions in the syllabus!), 1” margins.
DO NOT provide a title page. Include only your name and “Case Study 2” at the top of the first page.
Answer each question separately, marking each response with the appropriate question number/part .
You MAY include a BRIEF introduction and conclusion, each no more than ¼ of a page, but DO NOT fully restate the facts or questions in your response. I will not count anything other than a brief introduction and conclusion towards the page requirement.
You DO NOT need to provide references, but if you do so please include them on a separate page.
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