A physician involved in a lengthy surgery was properly suspended from the hospital staff, the Court of Appeal has ruled, dismissing the physician’s challenge to the hospital’s peer review process.
In Sadeghi v. Sharp Memorial Medical Center Chula Vista, the Fourth District Court of Appeal in San Diego reviewed the challenges raised by Dr. H. Mehrdad Sadeghi, an interventional cardiologist whose practice also includes catheter-based kidney and leg therapy, and concluded that the actions by Sharp Memorial met California’s law.
The dispute followed an 18-hour procedure on February 22, 2007, undertaken to save the leg of an 81-year-old patient who had steadfastly refused amputation for her poor circulation. The patient passed away a few days later and an investigation initiated by the chief of staff turned up comments by three staff members that, the court said, “painted a picture of erratic and irrational behavior” by the doctor. At an informal meeting with the chief of staff, Dr. Sadeghi’s medical partner, and others, the physicians urged Dr. Sadeghi to take time off to rest, but he responded that was not possible.
After the meeting, the Medical Executive Committee summarily suspended Dr. Sadeghi’s privileges. At an informal MEC hearing held on March 6, Dr. Sedeghi said he exercised less than optimal judgment with the staff, took full responsibility for the patient’s outcome, and discussed the personal and professional stressors in his life. He also said he had met with the well-being committee and had complied with that committee’s request for a psychiatric evaluation. The MEC voted to lift the suspension, but three days later added a condition that Dr. Sadeghi undergo a second psychiatric evaluation.
Dr. Sadeghi contended that he had already seen a second psychiatrist and in a letter outlined his concerns with the way the MEC had undertaken its evaluation. The chief of staff responded in a letter that without documentation of the second psychiatric visit, Dr. Sadeghi was in violation of his responsibilities under the bylaws. The letter also told Dr. Sadeghi that hospital employees had complained of harassment by him.
At a special meeting on May 17, 2007, the MEC met and reimposed the suspension of Dr. Sedeghi’s privileges. After another hearing on May 29, the MEC voted to terminate the suspension if Dr. Sedeghi submitted to a proctoring program, attended the Physician Assessment and Clinical Education (PACE) program, underwent psychotherapy for three to six months, and abstained from any conduct with hospital staff that might be considered harassing. Dr. Sadeghi then invoked his right to a formal judicial review hearing. The Judicial Review Committee (JRC) held hearings over the next three years and concluded in 2010 that the MEC established by a preponderance of the evidence that its actions on May 17, and May 29, 2007, were reasonable and warranted.
Dr. Sedeghi petitioned the courts challenging the JRC for, among other things, failing to consider whether the MEC’s 2007 actions continued to be reasonable when it issued its decision in 2010 and issuing an order barring Dr. Sedeghi from contacting medical staff during the proceedings.
In denying the contention that the JRC had an ongoing obligation to assess Dr. Sedeghi’s fitness, the Court of Appeal noted the JRC’s task was not to conduct “open-ended proceedings” but instead is to evaluate the correctness of the MEC’s final proposed action in 2007.
The Court of Appeal also rejected Dr. Sedeghi’s complaint that an order by the JRC hearing officer to not contact hospital staff deprived him of his right to defend himself. The Court noted that the order followed complaints from hospital staff about communications by Dr. Sedeghi. In light of that, the Court found the hearing officer’s order appropriate, that they did not apply to the physician’s counsel, and were within his right to “impose any safeguards” to protect the peer review process.
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