Alaama v. Presbyterian Intercommunity Hospital, Inc. ( 2019 )


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  • Filed 8/28/19
    IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
    SECOND APPELLATE DISTRICT
    DIVISION SEVEN
    ABDULMOUTI ALAAMA,                         B288360
    Plaintiff and Appellant,             (Los Angeles County
    Super. Ct. No. BC634219)
    v.
    PRESBYTERIAN
    INTERCOMMUNITY HOSPITAL,
    INC., et al.,
    Defendants and Respondents.
    APPEAL from an order of the Superior Court of
    Los Angeles County, James C. Chalfant, Judge. Reversed and
    remanded with directions.
    Alan I. Kaplan for Plaintiff and Appellant.
    Baker & Hostetler, Mark A. Kadzielski and Joelle A. Berle
    for Defendants and Respondents.
    _____________________________
    INTRODUCTION
    Business and Professions Code section 809.11 requires a
    hospital peer review board to give a physician notice and the
    right to request a hearing when the hospital revokes or
    terminates the physician’s membership, staff privileges, or
    employment for a “medical disciplinary cause or reason.” In 2016
    Presbyterian Intercommunity Hospital, Inc., doing business as
    PIH Health Hospital-Whittier, and PIH Health Physicians
    (collectively, the hospital) terminated Dr. Abdulmouti Alaama’s
    privileges and staff membership without giving him a hearing.
    Dr. Alaama filed a complaint that included causes of action
    seeking a writ of administrative mandate, alleging, among other
    things, the hospital denied him the right to a hearing before
    terminating his privileges. The trial court denied the petition.
    Because the hospital terminated Dr. Alaama’s privileges and
    staff membership for a “medical disciplinary cause or reason,” we
    reverse.
    FACTUAL AND PROCEDURAL BACKGROUND
    A.    Dr. Alaama Misbehaves in the Hospital
    Dr. Alaama was not always on his best behavior. In April
    2008 the hospital warned Dr. Alaama that he had to work
    cooperatively with doctors, nurses, and staff at the hospital and
    that he would be subject to discipline if he yelled at, verbally
    abused, or displayed any “physically inappropriate and
    1     Undesignated statutory references are to the Business and
    Professions Code.
    2
    unprofessional behavior” toward hospital patients or employees.
    In August 2010 the hospital placed Dr. Alaama on probation for
    one year “because of his inappropriate and unprofessional
    behavior directed towards an anesthesiologist and the nursing
    staff” during a medical procedure.
    But things did not improve. In March 2012 Dr. Alaama
    “yelled, verbally abused, physically hit, and displayed physically
    inappropriate and unprofessional behavior” toward a hospital
    employee. In April 2012 he “continued with a procedure on a
    patient whose blood pressure remained dangerously high, despite
    repeated requests by the anesthesiologist to abort the procedure.”
    Dr. Alaama acknowledged he had “a pattern of engaging in
    unprofessional, disruptive, and harassing behavior.”
    B.     Dr. Alaama Signs a Behavioral Agreement
    In April 2012 Dr. Alaama signed a written contract with
    the hospital titled “Behavioral Agreement,” in which he agreed to
    comply “in all respects” with the medical staff and hospital
    bylaws, rules, regulations, and policies. As a condition to
    retaining his medical privileges at the hospital, Dr. Alaama
    agreed to comply with a list of “Specific Behavioral
    Requirements.” For example, Dr. Alaama agreed not to “make
    any demeaning, discourteous, disrespectful, harassing, or profane
    statements, requests or demands” to any of the nurses,
    administrative staff members, or other employees at the hospital,
    including “name calling, profanity, sexual comments or
    innuendos, and/or racial, ethnic, or sexual jokes.” He also agreed
    not to “shout or otherwise raise his voice, act in an aggressive or
    abrasive manner, or engage in any type of verbally abusive
    behavior,” including when he responded to anyone who called to
    3
    discuss patient issues or concerns. He further agreed not to
    criticize anyone at the hospital “in front of or within earshot of”
    anyone else, including making “disparaging statements regarding
    an individual’s professional competence, comments that
    undermine a patient’s trust in other caregivers at [the hospital],
    and/or comments that undermine a caregiver’s self-confidence in
    caring for patients.” And he agreed not to “touch, hit, slap or
    otherwise engage in any physical behavior with” anyone at the
    hospital, including “touching, punching, slapping, pushing,
    shoving, smacking, inappropriate touching and/or throwing
    instruments, charts, or other objects.”
    Of particular relevance to this action, Dr. Alaama agreed in
    paragraph 2.6 of the Behavioral Agreement that he would “be
    readily available and exercise professional courtesy when called
    upon to discuss a patient’s course of treatment or medical care”
    and that he would “not exhibit any other inappropriate,
    unprofessional, abusive or harassing behavior” on the hospital’s
    premises, such as failing “to address the safety concerns or
    patient care needs expressed by another caregiver” or failing “to
    work collaboratively with other caregivers” at the hospital. He
    also agreed in paragraph 2.8 of the agreement not to retaliate or
    threaten to retaliate against anyone who reported behavior by
    him that violated the agreement or the hospital bylaws, rules,
    regulations, or policies. Dr. Alaama also acknowledged he
    understood any further failure to comply with the standards of
    the hospital medical staff would result in the “automatic
    termination” of his medical staff privileges. The Behavioral
    Agreement provided in paragraph 4.3 that, upon a finding by the
    hospital medical executive committee Dr. Alaama violated the
    agreement or hospital rules and regulations, his privileges would
    4
    be “automatically terminated.” Dr. Alaama agreed any “such
    automatic termination shall not give rise to any substantive or
    procedural rights under California Law” or the hospital’s bylaws.
    The parties further agreed the Behavioral Agreement, “in and of
    itself, does not require that a report be made to the Medical
    Board of California or any other federal or state agency.”
    C.    Dr. Alaama Misbehaves in the Hospital Again
    And yet, things did not improve. In particular, an incident
    occurred in November 2015 that gave rise to the termination of
    Dr. Alaama’s privileges at the hospital and, ultimately, this
    litigation.
    A hospital patient was lying in a bed on his stomach,
    “profusely vomiting” with his “face changing to shades of purple,”
    after an endoscopic retrograde cholangiopancreatography
    procedure. Two nurses and a gastrointestinal technician each
    asked Dr. Alaama to move a cart where he was “documenting” so
    they could move a bed into the room and turn over the patient.
    Dr. Alaama “responded to each request with words to the effect
    of, ‘No, they can wait.’” According to the nurses, Dr. Alaama
    motioned with his left hand and waved away the nurses and
    technicians without looking up from the computer screen he was
    working at on the cart, as though he did not want to be bothered,
    and “barked” repeatedly, “[T]ell them to wait.” One of the nurses
    said that Dr. Alaama “showed no concern” for the patient’s needs
    and put “himself first instead of the patient’s needs” and that
    “Dr. Alaama’s conduct (focusing on his documentation and his
    lack of cooperation) prevented staff from properly taking care of
    the patient’s needs.” The other nurse said Dr. Alaama did not
    properly address the patient’s needs, did not work collaboratively
    5
    with the staff, and did “what he wanted to do” without listening
    to the nurses. After Dr. Alaama learned one of the nurses had
    reported the incident, he asked the hospital not to assign that
    nurse to his cases.
    The hospital’s medical executive committee met in early
    December 2015 to consider what to do about the November 2015
    incident, as well as six other complaints filed against Dr. Alaama
    between May 2013 and November 2015. The courses of action
    the committee considered included requiring Dr. Alaama to
    receive “behavior modification counseling” or take a “late career
    practitioner examination,” updating the Behavioral Agreement to
    include additional instances of misconduct and requiring
    Dr. Alaama to “newly acknowledge his willingness to change,”
    and deciding there were “already enough medical and behavioral
    misadventure to proceed with termination from the medical staff
    based upon article 4.3 . . . of the Behavioral Agreement.” The
    committee also discussed “a number of anecdotal claims
    concerning poor interaction with other physicians/staff, questions
    regarding medical [judgment]/appropriateness of care given,” and
    “other potential care issues.” The committee observed that
    Dr. Alaama’s behavior “could be creating a ‘hostile workplace
    environment,’” that he had “a long history of verbal abuse and
    intimidation of hospital employees,” and that he had failed to
    correct behavior he acknowledged was unacceptable.
    A report prepared by the hospital’s human resource
    department regarding the November 2015 incident stated the
    nurses and technician “were concerned for patient safety and
    were acting on [the anesthesiologist’s] comments to get the
    patient a bed and get him on his back.” The report concluded
    Dr. Alaama may have violated paragraph 2.6 of the Behavioral
    6
    Agreement by failing to address the safety concerns or patient
    care needs expressed by other caregivers and paragraph 2.8 by
    retaliating against one of the nurses who reported the November
    2015 incident.
    D.     The Hospital Terminates Dr. Alaama’s Hospital Staff
    Privileges and Membership
    The hospital’s medical executive committee met again in
    January 2016 and considered the report. The committee
    members approved a motion finding Dr. Alaama had violated
    paragraphs 2.6 and 2.8 of the Behavioral Agreement and
    terminated his medical privileges at the hospital.
    The next day the president and chief of staff of the hospital
    wrote Dr. Alaama and informed him of the medical executive
    committee’s decision. This letter stated the committee found
    Dr. Alaama’s conduct in the November 2015 incident violated
    paragraph 2.6 of the Behavioral Agreement by failing to address
    safety concerns and patient care needs expressed by staff and
    failing to work collaboratively with operating room staff. The
    letter also stated the committee found Dr. Alaama violated
    paragraph 2.8 of the Behavioral Agreement by retaliating against
    the nurse who had reported the incident by “requesting that the
    nurse not be scheduled to work on [his] cases in the future.” The
    letter concluded by quoting paragraph 4.3 of the Behavioral
    Agreement and stating “this termination is immediate, and does
    not give rise to any substantive or procedural rights under
    California law or the [hospital] Bylaws. Further, because this
    action has not been taken for a ‘medical disciplinary cause or
    reason,’ as that term is defined at California Business and
    7
    Professions Code Section 805, no report will be filed with the
    Medical Board of California.”
    E.     Dr. Alaama Files This Action
    Dr. Alaama filed this action in September 2016, asserting
    two causes of action titled “administrative mandate,” one alleging
    the hospital did not give him a hearing and one seeking a judicial
    determination the Behavioral Agreement was unenforceable.
    Dr. Alaama also alleged causes of action for injunctive relief,
    defamation, and violation of the Americans with Disabilities Act.
    The case was transferred from the individual calendar court to
    the writs and receivers department for a hearing on the request
    for a writ of administrative mandate, and the latter court set the
    matter for trial and stayed all causes of action other than the
    petition for writ of mandate.2
    F.     The Trial Court Denies Dr. Alaama’s Petition for Writ
    of Administrative Mandate
    Dr. Alaama argued he was entitled to a writ of
    administrative mandate directing the hospital to restore his
    privileges “until he has been granted a hearing to determine
    whether he has in fact violated” the Behavioral Agreement. He
    also argued the waiver of his procedural and substantive rights
    in the agreement was unenforceable under applicable provisions
    of the Business and Professions Code. Dr. Alaama claimed it
    was “undisputed that he was not accorded a fair hearing, or
    2      We augment the record to include the complaint and the
    court’s February 15, 2017 and February 17, 2017 minute orders.
    (See Cal. Rules of Court, rule 8.155(a)(1)(A).)
    8
    indeed any hearing, under [the hospital’s] bylaws or under
    California law.”
    The hospital argued “no administrative peer review hearing
    was required under the circumstances, as [the hospital] did not
    terminate Dr. Alaama’s staff membership or privileges for a
    reportable ‘medical disciplinary cause or reason,’” which would
    require a hearing, but instead terminated his privileges “for
    breach of the Behavioral Agreement,” which did not. According
    to the hospital, because Dr. Alaama lost his privileges because of
    his “abusive and harassing behavior toward other physicians,
    nurses, and Hospital employees,” the statutory prohibition of
    “contractual waiver of peer review rights” did not apply. The
    hospital contended a physician had a right to a hearing only
    when a peer review body takes action that must be reported to
    the California Medical Board, and because Dr. Alaama’s
    termination for bad behavior was not a reportable event, he was
    not entitled to a hearing.
    At the hearing, the trial court stated the “threshold issue”
    was whether the hospital could “terminate Dr. Alaama without a
    hearing for breach of the [Behavioral Agreement].” The trial
    court stated, “[Y]es, it can. If he was terminated for non-medical
    reasons involving abusive or harassing behavior, then it would be
    for breach of the agreement and he’s not entitled to a hearing.”
    The problem the court expressed, however, was that it did not
    “see abusive or harassing behavior” by Dr. Alaama. The court
    therefore stated its tentative ruling was the November 2015
    incident “cannot be described as harassing or abusive treatment
    of the nurses as that term in commonly understood. As found by
    the [medical executive committee, Dr.] Alaama simply refused on
    multiple occasions to move from the cart where he was writing,
    9
    thereby placing his paperwork before the patient’s medical care,”
    which was a reportable medical disciplinary cause or reason,
    which required a hearing. The court also found Dr. Alaama’s
    request the hospital not schedule a nurse to work with him was
    not retaliation because “there is nothing wrong with a request
    not to work with one’s accuser.”
    The court, however, changed its mind during the course of
    the hearing. The court stated that, if the nurses raised a concern,
    and Dr. Alaama “just blew them off, then that would be a
    [failure]-to-address safety concerns raised by the nurses.” Thus,
    the court stated, it did not matter whether the concerns
    expressed by the nurses were “correct. If they raised an issue to
    Dr. Alaama and he failed to address it, that is breach of the
    agreement,” even if the nurses’ concerns were not legitimate.
    The court explained, “They are accusing him of harassment,”
    which was “defined under the agreement as failing to respond to
    a nurse’s concern about patient needs and safety. That is, [it]
    doesn’t matter whether they’re right or wrong. If . . . they raise
    an issue and he doesn’t respond to them, that is considered
    harassment under the agreement. It doesn’t matter whether he
    actually was causing a safety issue or patient care issue.” The
    court ruled the Behavioral Agreement provided that “if you fail to
    address an issue of patient care raised by a nurse, whether or not
    it’s true, you’re guilty of harassing behavior . . . . I’m
    withdrawing my tentative. The petition’s denied.”
    The court subsequently filed a written order denying the
    petition for writ of mandate and dismissing with prejudice
    Dr. Alaama’s two causes of action for administrative mandate.
    The court stated in its written order: “The Court finds that the
    evidence in the administrative record establishes that
    10
    [Dr. Alaama] was terminated for a non-medical disciplinary
    cause or reason because [his] termination was for breach of
    [paragraph 2.6] the Behavioral Agreement. . . . Thus,
    [Dr. Alaama] was not entitled to a hearing pursuant
    to . . . section 809.1.”
    DISCUSSION
    A.     The Trial Court’s Order Denying the Petition for Writ
    of Administrative Mandate Is Appealable
    The hospital argues the trial court’s order denying
    Dr. Alaama’s petition for administrative mandate is “not
    appealable because there remain three causes of action pending,”
    namely, Dr. Alaama’s causes of action for injunctive relief,
    defamation, and violation of the Americans with Disabilities Act.
    Although the hospital acknowledges Dr. Alaama dismissed those
    causes of action without prejudice, the hospital argues “a
    dismissal without prejudice is insufficient because it does not
    create a final judgment from which an appeal may be made . . . .”
    According to the hospital, because Dr. Alaama “is still able to
    revive his remaining causes of action,” the trial court’s order
    denying Dr. Alaama’s petition “did not create a final judgment
    subject to appeal.”
    Well, yes and no. A voluntary dismissal, “unaccompanied
    by any agreement for future litigation, does create sufficient
    finality as to that cause of action so as to allow appeal from a
    judgment disposing of the other counts. [Citation.] That is
    because ‘a party’s voluntary dismissal without prejudice does not
    come equipped by law with an automatic tolling or waiver of all
    relevant limitations periods; instead, such a dismissal includes
    11
    the very real risk that an applicable statute of limitations will
    run before the party is in a position to renew the dismissed cause
    of action.’” (Kurwa v. Kislinger (2013) 
    57 Cal. 4th 1097
    ,
    1105-1106; see Alki Partners, LP v. DB Fund Services, LLC
    (2016) 4 Cal.App.5th 574, 589, fn. 6 [“Because the record does not
    indicate the dismissal was accompanied by any agreement for
    future litigation, the judgment is sufficiently final to be
    appealable.”]; Walters v. Boosinger (2016) 2 Cal.App.5th 421, 427,
    fn. 5 [dismissal without prejudice that “was not accompanied by
    any agreement between the parties regarding future litigation”
    was sufficient to “render the judgment appealable”]; Abatti v.
    Imperial Irrigation Dist. (2012) 
    205 Cal. App. 4th 650
    , 665 [“claims
    that are dismissed without prejudice are no less final for
    purposes of the one final judgment rule than are adjudicated
    claims, unless . . . there is a stipulation between the parties that
    facilitates potential future litigation of the dismissed claims”].)
    There is no evidence or suggestion in the record of any
    agreement for future litigation. To the contrary, Dr. Alaama
    states he “waived [his] right to litigate the unresolved causes of
    action.” Thus, the problem is not that Dr. Alaama dismissed the
    three causes of action without prejudice. The problem is that he
    dismissed the three causes of action after he filed a notice of
    appeal. But even so, the trial court had jurisdiction to dismiss the
    three remaining causes of action. (See Holloway v. Quetel (2015)
    
    242 Cal. App. 4th 1425
    , 1431, fn. 6 [“[a]n appeal from a
    nonappealable order does not divest the trial court of
    jurisdiction”].)
    In any event, in his reply brief on appeal, Dr. Alaama
    agreed to treat his requested dismissal of the three unadjudicated
    causes of action as a request for dismissal with prejudice. “When
    12
    a party expressly waives on appeal the right to litigate an
    unresolved cause of action that deprived the judgment as entered
    of finality, the appellate court may give effect to the waiver by
    amending the judgment to reflect a dismissal of that cause
    of action with prejudice.” (Sullivan v. Delta Air Lines, Inc. (1997)
    
    15 Cal. 4th 288
    , 308-309; accord, Areso v. CarMax, Inc. (2011) 
    195 Cal. App. 4th 996
    , 1002.)3
    B.    The Hospital Failed To Give Dr. Alaama a Hearing as
    Required by Section 809.1
    1.     Standard of Review
    The hospital contends Code of Civil Procedure section 1085
    governing traditional mandate applies to Dr. Alaama’s petition
    because “this case involves a dispute over a contract.” Even if it
    did not, the hospital’s position finds support in Mileikowsky v.
    Tenet Healthsystem (2005) 
    128 Cal. App. 4th 531
    (Mileikowsky),
    overruled on a different ground in Mileikowsky v. West Hills
    Hospital & Medical Center (2009) 
    45 Cal. 4th 1259
    , 1273, where
    the court stated that “[f]ailure to provide a hearing required by
    law or regulation is remedied by a petition for traditional
    mandate.” (Mileikowsky, at p. 554.) Dr. Alaama contends Code
    of Civil Procedure section 1094.5 governing administrative
    mandate applies to “the quasi-adjudicative decisions of private
    hospital boards,” including the hospital’s decision to terminate
    his staff privileges and membership without giving him a
    hearing. (See Code Civ. Proc., § 1094.5, subd. (a) [statute applies
    where a “writ is issued for the purpose of inquiring into the
    3    We also treat the trial court’s order as a final and
    appealable determination of the rights of the parties.
    13
    validity of any final administrative order or decision made as the
    result of a proceeding in which by law a hearing is required to be
    given”]; Delta Dental Plan v. Banasky (1994) 
    27 Cal. App. 4th 1598
    , 1608 [“section 1094.5 . . . was intended to apply in all cases
    where the subject decision is the product of a proceeding in which
    a hearing and related procedural protections are required by
    law,’” italics omitted].)
    Under either statute, however, we independently review
    the issue “whether the hospital’s determination was made
    according to a fair procedure.” (Ellison v. Sequoia Health
    Services (2010) 
    183 Cal. App. 4th 1486
    , 1496; see Golden Day
    Schools, Inc. v. Office of Administrative Hearings (2017) 8
    Cal.App.5th 1012, 1020 [in mandamus proceedings “‘pure issues
    of law are always subject to independent appellate court
    review’”].) We also review de novo the application of a statute to
    a set of an undisputed facts. (Department of Health Care Services
    v. Office of Administrative Hearings (2016) 6 Cal.App.5th 120,
    141; M & B Construction v. Yuba County Water Agency (1999) 
    68 Cal. App. 4th 1353
    , 1359.)
    2.   The Hospital Terminated Dr. Alaama’s
    Privileges and Membership for a “Medical
    Disciplinary Cause or Reason”
    Once a hospital appoints a physician to its medical staff,
    the hospital may not take away the physician’s privileges or
    terminate his or her staff membership “‘absent a hearing and
    other procedural prerequisites consistent with minimal due
    process protections.’” (Sahlolbei v. Providence Healthcare,
    Inc. (2003) 
    112 Cal. App. 4th 1137
    , 1146; see Economy v. Sutter
    East Bay Hospitals (2019) 31 Cal.App.5th 1147, 1156 (Economy).)
    Section 809 et seq. set forth a comprehensive procedure
    14
    governing adverse action by a hospital against a staff physician.
    (Sahlolbei, at p. 1147.) “This procedure is mandatory for acute
    care hospitals and must be incorporated into their bylaws.”
    (Ibid.; see § 809, subd. (a)(8).) The hospital concedes section
    809.1 applies to certain adverse actions against its member
    physicians but argues the circumstances of Dr. Alaama’s
    termination did not trigger section 809.1’s procedural safeguards.
    Section 809.1 provides that a physician subject to a final
    proposed action by a peer review body “for which a report is
    required to be filed under Section 805” is entitled to written
    notice of the action and to request a hearing. (§ 809.1, subds. (a),
    (b)(3).) Section 805 requires that an officer, director, or peer
    review administrator of a licensed health care center or clinic
    must file a report with the applicable licensing agency when a
    physician’s membership, staff privileges, or employment is
    terminated or revoked for a “medical disciplinary cause or
    reason.” (§ 805, subd. (b)(2).) “‘Medical disciplinary cause or
    reason’ means that aspect of a [physician’s] competence or
    professional conduct that is reasonably likely to be detrimental to
    patient safety or to the delivery of patient care.” (§ 805, subd.
    (a)(6).) Section 809.6, subdivision (c), provides that the
    requirements of section 809.1 “may not be waived in [any
    applicable agreement or contract between the licentiate and
    health care entity] for a final proposed action for which a report is
    required to be filed under Section 805.”
    As stated, the medical executive committee terminated
    Dr. Alaama’s privileges and staff membership for two reasons,
    one of which was Dr. Alaama’s “fail[ure] to address the safety
    concerns and patient care needs expressed by . . . the operating
    room staff” in November 2015. The letter to Dr. Alaama from the
    chief of staff explained that Dr. Alaama violated section 2.6 of the
    Behavioral Agreement by, among other things, inhibiting the
    15
    hospital staff from providing a bed for a vomiting patient. Such
    conduct falls squarely within the definition in section 805 of
    “medical disciplinary cause or reason,” which includes a
    physician’s “professional conduct that is reasonably likely to be
    detrimental . . . to the delivery of patient care.” (§ 805, subd.
    (a)(6).) By blocking hospital staff from moving a bed into position
    for the patient, Dr. Alaama prevented the staff from delivering
    patient care, which under the statute is a medical disciplinary
    cause or reason. Thus, Dr. Alaama’s conduct triggered the
    mandatory reporting requirement of section 805, which, in turn,
    gave Dr. Alaama the right to a hearing under section 809.1. (See
    § 805, subd. (b)(2); § 809.1, subds. (a), (b)(3).)
    The hospital argues it terminated Dr. Alaama “because of
    his inappropriate, unprofessional, abusive and harassing
    behavior toward physicians, nurses, and Hospital employees in
    the workplace when he ‘failed to address patient care concerns
    that were expressed to him by staff’ . . . .” Attempting to
    distinguish Dr. Alaama’s conduct from conduct that amounts to a
    “medical disciplinary cause or reason,” the hospital places great
    significance (as did the trial court) on the fact Dr. Alaama failed
    to respond to “expressed” concerns about patient care. The
    hospital argues Dr. Alaama’s “disregard of multiple caregivers’
    expressions of patient care concern did not rise to the level of
    conduct that was detrimental to the patient’s safety or delivery of
    patient care.” The hospital cites its investigator’s interview with
    the anesthesiologist involved in the November 2015 incident, who
    said Dr. Alaama’s conduct “was not detrimental to the patient’s
    safety because the patient was oxygenating well despite the fact
    that the patient was vomiting.” The hospital also cites Dr.
    Alaama’s opening brief on appeal in which he states, “[t]he
    anesthesiologist does not claim that patient care was an issue.”
    But even if Dr. Alaama’s conduct in connection with the
    16
    November 2015 incident was not detrimental to patient safety, it
    was detrimental “to the delivery of patient care.” (§ 805, subd.
    (a)(6).) And that, under the statute, is enough.
    The hospital also argues it satisfied Dr. Alaama’s due
    process rights by providing a fair procedure conducted by the
    medical executive committee. But section 809.1 establishes the
    “minimum procedural standards” for terminating a physician’s
    hospital privileges and membership. 
    (Economy, supra
    , 31
    Cal.App.5th at p. 1157.) A hospital cannot avoid the
    requirements of sections 805 and 809.1 by substituting its
    procedures for those established by the Legislature. (See
    Economy, at p. 1158 [hospital cannot substitute its procedures for
    section 809.1 because the “plaintiff’s right to practice medicine
    would be substantially restricted without due process and,
    despite the hospital’s concern that plaintiff was endangering
    patient safety, the state licensing board would never be
    notified”].)
    Finally, the hospital cannot avoid its obligation to afford
    Dr. Alaama a hearing by enforcing section 4.3 of the Behavioral
    Agreement, which states that any termination as a result of
    violating the terms of the agreement does not give rise to any
    substantive or procedural rights under California law. The
    hospital argues this provision is enforceable because the
    circumstances under which the hospital terminated Dr. Alaama’s
    membership did not implicate section 809.1. But because it did,
    section 4.3 of the Behavioral Agreement is unenforceable. (See
    § 809.6, subd. (c).)4
    4    Dr. Alaama does not argue any other provision of the
    Behavioral Agreement is unenforceable. The hospital does not
    argue we should affirm the trial court’s ruling on the basis of
    paragraph 2.8 concerning retaliation.
    17
    DISPOSITION
    The order denying the petition for administrative mandate
    is reversed. The trial court is directed to enter a new order
    granting Dr. Alaama’s petition for mandate requesting a hearing.
    Dr. Alaama is to recover his costs on appeal.
    SEGAL, J.
    We concur:
    PERLUSS, P. J.
    FEUER, J.
    18
    Filed 9/18/19
    CERTIFIED FOR PUBLICATION
    IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
    SECOND APPELLATE DISTRICT
    DIVISION SEVEN
    ABDULMOUTI ALAAMA,                              B288360
    Plaintiff and Appellant,                 (Los Angeles County
    Super. Ct. No. BC634219)
    v.
    ORDER MODIFYING AND
    PRESBYTERIAN                                    CERTIFYING OPINION FOR
    INTERCOMMUNITY HOSPITAL,
    PUBLICATION; NO CHANGE IN
    INC., et al.,
    APPELLATE JUDGMENT
    Defendants and Respondents.
    THE COURT:
    The opinion filed on August 28, 2019 and not certified for publication, is
    modified as follows:
    On page 17, the text in footnote 4 is deleted and replaced with:
    Dr. Alaama does not argue any other provision of the Behavioral
    Agreement is unenforceable. Although the hospital in its
    respondent’s brief explains that its medical executive committee
    found Dr. Alaama violated paragraph 2.8 of the Behavioral
    Agreement, the trial court did not make that finding, and the
    hospital does not argue we should affirm the trial court’s order on
    the basis of paragraph 2.8.
    The opinion in this case filed August 28, 2019 was not certified for
    publication. Because the opinion meets the standards for publication
    specified in California Rules of Court, rule 8.1105(c), the non-parties’
    requests for publication under California Rules of Court, rule 8.1120(a), are
    granted.
    IT IS HEREBY CERTIFIED that the opinion meets the standards for
    publication specified in California Rules of Court, rule 8.1105(c); and
    ORDERED that the opinion be published in the Official Reports.
    Respondents’ petition for rehearing is denied.
    This order does not change the appellate judgment.
    PERLUSS, P. J.                SEGAL, J.                    FEUER, J.
    2
    

Document Info

Docket Number: B288360

Filed Date: 9/18/2019

Precedential Status: Precedential

Modified Date: 9/18/2019