Alaama v. Presbyterian Intercommunity Hospital, Inc., et al. (Aug. 28, 2019, B288360) __ Cal.App.5th __ [2019 WL 4492624], certified for publication Sept. 18, 2019

Hospital cannot contractually avoid statutory notice and hearing requirements governing medical staff peer review.

Dr. Abdulmouti Alaama, who had medical staff privileges at Presbyterian Intercommunity Hospital, also had a history of “unprofessional, disruptive, and harassing behavior.” He and the hospital entered into a written “Behavioral Agreement” in which he agreed not to harass hospital employees and to refrain from verbally and physically abusing anyone at the hospital. Dr. Alaama also promised “to address the safety concerns or patient care needs expressed by another caregiver” and agreed that his medical staff privileges would “automatically terminate” if the hospital medical executive committee found that Dr. Alaama violated the Agreement or hospital rules. Subsequently, a nurse reported that Dr. Alaama refused to move a cart where he was documenting so nurses could bring a bed to a vomiting patient. Dr. Alaama told the nursing staff to wait. The MEC found Dr. Alaama had violated the Agreement and terminated his privileges. Dr. Alaama sought a writ of administrative mandate, contending that the hospital failed to provide him with a hearing and seeking a determination that the Agreement was unenforceable. (See Bus. & Prof. Code, § 809.1 [requiring notice and an opportunity to request a hearing before a physician’s privileges may be terminated for a “medical disciplinary . . . reason”].) The trial court denied Dr. Alaama’s petition, ruling that he was terminated for a non-medical disciplinary reason—breaching the Agreement by refusing to collaborate with the nursing staff—and therefore no hearing was required.

The Court of Appeal reversed. First, the court held that Dr. Alaama’s allegations fell within section 809.1 because the MEC had terminated his privileges (in part) for “failing to address the safety concerns and patient care needs expressed by . . . the operating room staff,” a “medical disciplinary” reason. (See Bus. & Prof. Code, § 805, subd. (a)(6).) Second, the court held that a hospital cannot avoid the requirements of sections 805 and 809.1 by substituting alternative dispute procedures. (Bus. & Prof. Code, § 809.6, subd. (c).)  Thus, the court refused to enforce the provision stating that a termination under the Behavioral Agreement would not “give rise to any substantive or procedural rights under California law.” 

The bulletin describing the Court of Appeal’s decision was originally prepared for the California Society for Healthcare Attorneys (CSHA) by H. Thomas Watson and Peder K. Batalden, Horvitz & Levy LLP, and is republished with permission. For more information regarding this bulletin, please contact H. Thomas Watson, Horvitz & Levy LLP, at 818-995-0800 or htwatson@horvitzlevy.com.