The case (Lawrence R. Poliner, MD v. Texas Health Systems) centered on the suspension of Dr. Poliner, a cardiologist, who had his cardiac catheterization lab and echocardiography privileges at Presbyterian Hospital suspended after a peer review, according to published sources.
Dr. Poliner filed his suit in May 2000, with the case eventually going to the jury based on grounds of defamation. In November 2006, Dr. Poliner was awarded $22.5 million plus prejudgment interest, which added an additional approximately $11 million to the judgment, by a district court.
In overturning the district court?s decision, the United States Court of Appeals for the Fifth Circuit ruled that the defendants are immune from damage liability under HCQIA. The ruling states:
“Immunity from damages means peer reviewers can act in the best interest of patients using reasonable judgment without fear of physician lawsuits. In fact, the HCQIA establishes a presumption that the actions of peer reviewers are reasonable in a suit brought by a physician.
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“The district court?s critical mistake in this case was to confuse hospital bylaw requirements with the standards for HCQIA immunity. In two separate provisions, the HCQIA immunizes the temporary deprivation of privileges whether or not the physician has had an opportunity to be heard, whether or not the physician agrees to it, and whether or not there is a ‘present danger.’ Those provisions encourage hospitals to take the necessary precautions to protect patient safety. The two provisions independently apply here.
“Where either of these provisions apply, Congress has barred damages
recovery under ‘any law.’ ? Congress excepted civil rights suits and some Attorney General suits but did not make an exception for state law tort or contract claims. For that reason, HCQIA immunity defeats any claim made under hospital bylaws“As a result, the HCQIA immunizes the defendants from damage liability.”
Dr. Poliner had originally received an award of $366 million, which caught significant attention not only because of the significant award but also because Dr. Poliner received the award despite the defendants claims that they should receive immunity under the HCQIA. The ruling, and even subsequent reduction to $33 million, has doctors concerned that the decision would “chill peer review,” according to the AMA.
The possibility exists for further appeal by Dr. Poliner.
Read the court’s ruling in Poliner v. Texas Health Systems (PDF).
