Representative Cases

Medical Peer Review

1. Factual Analysis
Dr. John Doe was a surgeon with privileges at Harris County Hospital. He had a close relationship with and OR nurse, Nurse Jane Darling. Dr. Doe was very impressed by Nurse Darling’s work in the OR. He thought they were good friends; they would talk after leaving the OR, she would greet him whenever she saw him in the parking lot and they even had lunch on several occasions. Additionally, they would discuss their personal lives: he would tell her about his family and she would discuss her pending divorce. He would hug her or lightly kiss her forehead to say goodbye to her. Nurse Darling never complained to Dr. Doe that she did not enjoy his friendship and that she felt uncomfortable by their relationship and the way he touched her. On her birthday, Dr. Doe gave Nurse Darling a card signed by himself and his wife. Later that day he arranged to give Nurse Darling her birthday present – a bottle of wine and a pendant. He invited her to share some wine with him at the hotel next to the hospital to celebrate her birthday before he drove home. Nurse Darling declined. The next day, Nurse Darling reported Dr. Doe to the Human Resources Department at the hospital. She wrote a complaint that said that the way Dr. Doe treated her made her very uncomfortable. She complained about his hugs and kisses on the forehead, the amount of time he would talk to her, and the birthday gifts he gave her. She also said that she felt that this relationship threatened her job. See attached Exhibit 14. Pursuant to hospital bylaws, an Ad Hoc Committee meets to investigate Nurse Darling’s complaints. They issue a report recommending that Dr. Doe lose his privileges at the hospital. This report is sent to the Medical Executive Committee. Dr. Doe is suspended without pay.

The Medical Executive Committee meets and allows Dr. Doe to appear before them. See attached Exhibit 15. They too decide that he has failed to meet the qualifications required for a physician to be awarded privileges at Harris County Hospital. The Medical Executive Committee sends a letter to the CEO of the hospital recommending the revocation of Dr. Doe’s privileges. A letter is sent to Dr. Doe informing him of his right to a hearing under the by laws. See attached Exhibit 16. He is notified of the time, date and location of the hearing, the witnesses that will be called, his right to counsel, his right to call his own witnesses and cross-examine the hospital’s witnesses, and his right to present evidence and rebut the hospital’s evidence. See attached Exhibit 17. Dr. Doe sends a letter to the hospital informing them that he will attend the hearing. In the letter he also states that Nurse Darling exaggerated her allegations and at no time ever indicated to him that she was uncomfortable with her relationship. He also alleges that the hospital is discriminating against him because of his ethnicity. Dr. Doe then decides to hire an attorney to represent him at the hearing.

2. Legal Course of Action
Dr. Doe’s attorney attempts to negotiate a resolution for him that would not involve a report being made by Harris County Hospital to the National Practitioner Data Bank. His early negotiations are unsuccessful. See attached Exhibit 18.

Dr. Doe’s attorney, in preparation for the hearing, refers him to a psychiatrist for an evaluation to determine whether Dr. Doe may have a medial condition that is causing him to misinterpret or misunderstand his relationship with Nurse Darling. The psychiatrist who evaluates Dr. Doe concludes that he is not suffering from any type of medical condition and that he is not delusional. The psychiatrist also notes that Dr. Doe seems genuinely puzzled as to Nurse Darling’s allegations. See attached Exhibit 19.

Dr. Doe’s attorney also calls other physicians with whom Dr. Doe works on a daily basis and asks them to write letters in support of Dr. Doe. Four physicians who have worked in the OR with both Dr. Doe and Nurse Darling write letters in support of Dr. Doe. The letters all state that none of the physicians has ever seen Dr. Doe behave in an inappropriate manner.

A hearing examiner is appointed and the hearing is held. Nurse Darling is not present to testify. The hospital presents testimony from other nurses who worked with Nurse Darling. Dr. Doe again denies any inappropriate conduct. The hearing examiner makes a ruling to revoke Dr. Doe’s medical privileges and the Medical Executive Committee upholds that ruling. They send him a letter notifying him of the revocation of his privileges and his right to an appellate review.

3. Outcome
Dr. Doe is given the opportunity to resign from the hospital. He writes a letter of resignation and makes his resignation effective the day of the hearing. The hospital accepts his resignation and because it was made effective before the hearing, the decision of the hearing is moot and the hospital has nothing to report to the National Practitioner’s Data Bank. Dr. Doe is give back pay by the hospital so that he is paid through the date of his resignation. See attached Exhibit 20.

4. Lessons to be Learned
Once allegations of sexual harassment have been made against a physician the chances of maintaining privileges at a hospital becomes extremely slim. Although, the Medical Executive Committee may make allowances for cultural differences and misunderstandings, constant physical touching and overtures are never appropriate in the workplace.