On June 6, 2013, the United States District Court of the Northern District of Indiana granted a motion for summary judgment for an Indiana hospital, holding the Indiana Peer Review Statute grants immunity in the earliest stages of an initial (or “pre-peer review”) investigation and during communications regarding physician credentialing. This case provides reassurance to those involved in the initial stages of peer review and credentialing communications that they continue to qualify for immunity under Indiana law.
A common question facing medical staff leadership is, “At what point are individuals involved in the peer review process shielded from civil claims under Indiana Peer Review Statues?” In Rouben v. Parkview Hospital, Inc. and Greg Johnson, 1, the court ruled that peer review committees and those involved with peer review proceedings enjoy immunity from civil action from the beginning stages of peer review investigations and during their honest communications with other hospitals regarding credentialing processes.
In the Parkview case, hospital administration received complaints that Dr. Rouben was making inappropriate comments, engaging in inappropriate workplace touching and had, on at least one occasion, been disruptive and yelled at staff in front of a patient’s family. Pursuant to Parkview’s policies, Dr. Johnson, one of Parkview’s administrators, assigned a human resources manager to conduct an internal investigation into the complaints. Before the human resources manager finished her initial investigation and before any formal peer review proceedings began, Dr. Rouben resigned his position at Parkview and elected to pursue privileges and employment with another hospital (“Gulfport”). Gulfport contacted Parkview about the circumstances of Dr. Rouben’s departure. A series of communications occurred in which Parkview disclosed the nature of the allegations against Dr. Rouben, Parkview’s preliminary analysis of the events and other peer review information to Gulfport. After these conversations, Gulfport opted not to move forward with Dr. Rouben’s credentialing process and declined to employ him. Dr. Rouben then brought suit claiming that Parkview defamed him, interfered with his ability to pursue employment and violated its own policies and bylaws by denying him reasonable access to records when he requested them.
The court held that Parkview was entitled to immunity under the Indiana Peer Review Statute. Dr. Johnson’s initial decision to investigate, the human resources manager’s subsequent investigation and all communications between Parkview and Gulfport were ruled immune from civil liability. The court found these actions were part of an appropriate pre-peer review investigation and part of lawful communications with Gulfport. The court stated that, while Dr. Rouben was never subject to a formal peer review process, the preliminary pre-peer review investigation still qualified for immunity under Indiana law. Additionally, Parkview’s disclosure of the complaints regarding Dr. Rouben, resulting investigations and conclusions to Gulfport were truthful and accurate and so qualified for peer review protection.
Practical Takeaway
Parkview reinforces the application of immunity in Indiana’s Peer Review Statutes. Authorized persons conducting investigations or engaging in good faith, honest communications for the purpose of peer review processes will be granted immunity from civil claims. Hospitals and medical staffs should review their medical staff bylaws and peer review policies to ensure they appropriately encompass the full breadth of ongoing peer review activities.
If you have questions, please contact James Hogan at 317-977-1439 or jhogan@hallrender.com, Ellen Chambers at 317-429-3642 or echambers@hallrender.com or your regular Hall Render attorney.
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1 2013 WL 2470252
