Peer Review and Staff Privileges

In conducting peer review to determine whether to deprive a physician of staff privileges, a hospital's judicial review committee (JRC) was not required, under collateral estoppel principles, to treat findings of another hospital's JRC as binding where the first hospital's findings were under challenge in superior court and thus not final. Evidence of medical executive committee's willingness to refrain from reporting its action against a physician to state authority in exchange for a physician's resignation was properly considered by the JRC where it was not relevant to prove that hospital's motive was not patient safety, and bylaws provided for a broad standard of admissibility that did incorporate Evidence Code ban on proof of offers of compromise. Evidence of conflicts of economic and other interests between the owner of hospital and physician was properly considered by that JRC as to why hospital pursued peer review proceedings and why it did not pursue other action that would have been taken by an entity primarily concerned with patient safety. Evidence concerning refusal of other hospital to provide hospital with information about its peer review proceedings against physician, when viewed in the context of the common ownership of the hospitals, was properly considered by JRC as supporting inferences that undermined the reliability of the findings of the other hospital, which hospital treated as conclusive in its proceedings against physician. JRC's refusal to uphold lifting of physician's privileges based solely on findings of another hospital did not violate bylaws standard requiring that MEC's decision to lift privileges be upheld if "reasonable and warranted." Governing board's decision to lift staff privileges, contrary to the decision of JRC, was contrary to law where JRC's decision was supported by substantial evidence and was rendered in accordance with procedures set forth in bylaws.

The text of the opinion is posted: Smith v. Selma Community Hospital - filed July 21, 2008, Fifth District. Cite as 2008 SOS 4340