Bharanidharan Padmanabhan v. Cambridge Health Commission. ( 2023 )

NOTICE: Summary decisions issued by the Appeals Court pursuant to M.A.C. Rule
23.0, as appearing in 97 Mass. App. Ct. 1017 (2020) (formerly known as rule
1:28, as amended by 73 Mass. App. Ct. 1001 [2009]), are primarily directed to
the parties and, therefore, may not fully address the facts of the case or the
panel's decisional rationale. Moreover, such decisions are not circulated to
the entire court and, therefore, represent only the views of the panel that
decided the case. A summary decision pursuant to rule 23.0 or rule 1:28 issued
after February 25, 2008, may be cited for its persuasive value but, because of
the limitations noted above, not as binding precedent. See Chace v. Curran, 71
Mass. App. Ct. 258, 260 n.4 (2008).
COMMONWEALTH OF MASSACHUSETTS
APPEALS COURT
22-P-276
BHARANIDHARAN PADMANABHAN
vs.
CAMBRIDGE HEALTH COMMISSION.
MEMORANDUM AND ORDER PURSUANT TO RULE 23.0
Plaintiff, Dr. Bharanidharan Padmanabhan, appeals from a
summary judgment in favor of the defendant, Cambridge Health
Commission (doing business as the Cambridge Health Alliance)
(CHA), on his remaining claims arising from the termination of
his employment.1 We affirm.
Background.2 The facts are taken from the summary judgment
record, viewed in the light most favorable to the nonmoving
party, Padmanabhan. Between 2007 and 2011, Padmanabhan was a
1 In Padmanabhan v. Cambridge, 99 Mass. App. Ct. 332 (2021)
(Padmanabhan I), we affirmed the dismissal on statute of
limitation grounds of all but three claims. The present matter
is one of several in which Padmanabhan attempted to assert
claims arising from the events at issue here. See id. at 334
n.3 (2021) (listing cases). See also Padmanabhan v. Board of
Registration in Med., 101 Mass. App. Ct. 1109 (2022).
2 We take this summary from Padmanabhan I, as well as from the
facts set forth in CHA's statement of material facts and
attached documents, including Padmanabhan's amended complaint.
neurologist with medical staff privileges at a hospital operated
by CHA. See Padmanabhan v. Cambridge, 99 Mass. App. Ct. 332,
334 (2021) (Padmanabhan I). Following the death of one of
Padmanabhan's patients, CHA undertook an investigation and peer
review process of his practice. In connection with that
process, CHA scheduled an October 31, 2011 "fair hearing" to
determine whether Padmanabhan's medical staff privileges would
permanently be revoked, in which case CHA would be required by
law to report the revocation and its reasons to the Board of
Registration in Medicine (board) and the National Practitioner
Data Bank (Databank), an internet-based database maintained by
the United States Department of Health and Human Services
"containing information on medical malpractice payments and
certain adverse actions related to health care practitioners,
providers, and suppliers." Id. at 335 & n.10 (quotation
omitted).
In the weeks preceding the October 31 hearing, Padmanabhan,
represented by counsel, and CHA negotiated on multiple issues,
including the upcoming fair hearing, Padmanabhan's surrender of
his medical staff privileges, and the precise language that CHA
would use in its report to the board and the Databank.
Padmanabhan's counsel indicated that Padmanabhan would resign
his privileges provided that CHA agreed to use certain language
and basis codes, suggested by Padmanabhan's counsel, in the
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Databank report. Relevant here, Padmanabhan's counsel requested
that the Databank report contain the following language:
"In July 2011, an investigative committee reviewed the
medical records of ten former patients of Dr. Padmanabhan,
including seven pain patients. The investigative committee
found, based on the materials it reviewed, that Dr.
Padmanabhan did not meet the standard of practice expected
of a CHA physician with respect to documentation:
including sufficient medical history, examination,
laboratory data, diagnosis, and follow up. Dr. Padmanabhan
voluntarily resigned his medical staff privileges in
October 2011."
After CHA agreed to the proposed language, counsel for
Padmanabhan wrote to "confirm that Dr. Padmanabhan will be
submitting a letter to CHA re: resignation, and, as a result,
the Fair Hearing scheduled for Monday, October 31, 2011 will not
take place." Upon CHA's receipt of that communication the
pending fair hearing was cancelled.
On October 31, 2011, as counsel had promised, Padmanabhan
submitted a letter to CHA. Padmanabhan commenced that
communication by stating "at the outset that this is not a
'resignation' letter." However, Padmanabhan went on to state,
among other things, that, "My credentials expired before the end
of June 2011," he "no longer [was] a member of the CHA medical
staff," and that he was "formally inform[ing] [CHA] that as of
the end of June 2011, I am no longer on the medical staff at"
CHA.
3
CHA informed Padmanabhan's counsel that it construed
Padmanabhan's October 31 letter "as a resignation" of his
medical staff privileges. Neither counsel nor Padmanabhan
responded. CHA then submitted an "adverse action report" to the
Databank using substantially the same language as Padmanabhan's
counsel earlier had suggested and approved; rather than stating
that "Padmanabhan voluntarily resigned his medical staff
privileges in October 2011," as the parties had agreed, CHA's
submitted report stated that:
"Dr. Padmanabhan indicated that he no longer considers
himself part of the [CHA] Medical Staff -- which [CHA] and
his counsel are treating as a resignation/voluntary
surrender effective October 28, 2011."
In addition, in the report, under a section titled "Adverse
Action Classification Code(s)," CHA used the code "1635," which
translated as "voluntary surrender of clinical privilege(s),
while under, or to avoid, investigation relating to professional
competence or conduct." This was the same coding that
Padmanabhan's counsel had requested in an email during
negotiations stating "[i]t is our preference that the action
code for the Board report be revised, if possible, to
resignation and that the action code for the NPDB report be
resignation."
Padmanabhan later challenged the action report, asserting,
among other things, that he "never 'voluntarily resigned' [his]
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privileges at CHA." Upon review, the Secretary of the
Department of Health and Human Services (Secretary) determined
that
"lapsing of your CHA credentials does not negate the fact
that you were considered to have voluntarily surrendered
your privileges while under investigation. . . . Most
importantly, for [Databank] reporting purposes, a
physician's failure to renew his clinical privileges while
under investigation is considered to be a voluntary
surrender of privileges while under investigation."
Accordingly, the Secretary ultimately determined "the Report is
factually accurate as submitted" and "there is no basis to
conclude that the report should not have been filed or that for
agency purposes it is not accurate, complete, timely or
relevant."
In 2014 Padmanadhan, in a "sprawling fifty-six-page
complaint asserting multiple claims against multiple
defendants," Padmanadhan I, 99 Mass. App. Ct. at 333, filed this
action. We affirmed the dismissal of all claims against
seventy-two named defendants except Padmanabhan's second
(retaliation), fourth (defamation), eighth (fraud), and
declaratory relief counts asserted against CHA. Id. at 343-344.
Shortly after Padmanadhan I was returned to the Superior Court's
docket, a judge conducted a litigation control conference. A
different judge (motion judge) conducted a hearing on CHA's
motion for summary judgment, after which Padmanabhan moved for
leave to file additional pleadings. The motion judge allowed
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CHA's motion, denied Padmanabhan's, and entered judgment for
CHA. This appeal followed.
Discussion. 1. Initial matters. We first address
Padmanabhan's claim that the motion judge was not impartial.
That the judge allowed certain of CHA's motions or, ultimately,
entered summary judgment on Padmanabhan's claims, does not by
itself demonstrate bias or partiality. Clark v. Clark, 47 Mass.
App. Ct. 737, 739 (1999) ("The mere fact that a party suffers
adverse rulings during litigation does not establish lack of
judicial impartiality"). In short, after a thorough review of
the record, we conclude that there is nothing in the judge's
statements, actions, or history that supports Padmanabhan's
assertion that the judge either "aided and abetted public
corruption" or displayed or otherwise reasonably could be
perceived to harbor any partiality.
Nor are we persuaded that Padmanabhan was denied discovery
before summary judgment. The order of remand in Padmanabhan I
did not require the judge to order discovery or set a trial.
Rather, the Padmanabhan I order partially vacated the judgment
and remanded, without specification, for further proceedings on
certain limited issues. Padmanabhan I, 99 Mass. App. Ct. at
344. "Case management is committed to the discretion of the
trial judge, and we review the decision for an abuse of
discretion." Eagle Fund, Ltd. v. Sarkans, 63 Mass. App. Ct. 79,
6
85 (2005). The litigation control conference judge acted well
within that discretion, after being informed that CHA intended
to serve a dispositive motion, by setting a briefing schedule
for CHA's summary judgment motion. Padmanabhan, despite the
opportunity to address the court during the litigation control
conference, did not request discovery in advance of the summary
judgment motion. Had Padmanabhan thereafter been unable "for
reasons stated" to present "facts essential to justify his
opposition" to that motion, he could have requested a
continuance to allow "deposition[s] to be taken or discovery to
be had." Mass. R. Civ. P. 56 (f), 365 Mass. 824 (1974).
Padmanabhan made no such request.
2. Summary judgment. Summary judgment is appropriate
where there are no genuine issues of material fact, and the
moving party is entitled to judgment as a matter of law. See
Mass. R. Civ. P. 56 (c), as amended, 436 Mass. 1404 (2002);
Kourouvacilis v. General Motors Corp., 410 Mass. 706, 716
(1991). "We review a grant of summary judgment de novo." Blake
v. Hometown Am. Communities, Inc., 486 Mass. 268, 272 (2020),
quoting DeWolfe v. Hingham Centre, Ltd., 464 Mass. 795, 799
(2013).
Padmanabhan argues that there are genuinely disputed issues
of material fact based on his oral statement to the motion judge
that he "dispute[d] every single fact in the Defendant's . . .
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affidavit of facts." We disagree. After being served with
CHA's motion for summary judgment, Padmanabhan submitted an
opposition memorandum but he did not respond, as required, to
CHA's statements of material fact. See Rule 9A(b)(5)(iii)(A) of
the Rules of the Superior Court (2017) (party opposing summary
judgment motion must serve "a response to the Moving Party's
Statement of Facts," stating whether a specific fact "is
disputed, and, if so, cite to the specific evidence, if any, in
the Joint Appendix that demonstrates the dispute"). When
questioned by the motion judge, Padmanabhan responded only with
a blanket denial of the facts set forth by CHA. However, as the
motion judge observed, Padmanabhan did not cite to any
evidentiary material that would create a genuine dispute. See
LaLonde v. Eissner, 405 Mass. 207, 209 (1989) ("the opposing
party cannot rest on [their] . . . mere assertions of disputed
facts to defeat the motion for summary judgment"). Nor does he
do so now.3 Although he argues on appeal that, with discovery,
3 Indeed, although he here argues to the contrary, Padmanabhan
still has not identified any material facts that may arguably,
genuinely be in dispute. While Padmanabhan asserts, for
example, that he consistently denied that he "voluntarily
resigned" and that he did not know of his counsel's negotiations
or representations, even if we assume that such assertions are
sufficient to create a dispute of fact, such disputes would not
be material in the sense that those assertions, if credited,
would not provide a basis for a judgment in his favor. See
notes 4, 5, infra. See also Carey v. New England Organ Bank,
446 Mass. 270, 278 (2006) ("Only those facts that, if true,
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he could adduce evidence sufficient to demonstrate a genuine
issue of material fact, he did not timely request discovery in
the trial court.
As a result, the motion judge deemed the facts set forth in
CHA's statement to be without genuine dispute. In doing so the
judge acted within his discretion. See Mass. R. Civ. P. 56 (e),
365 Mass. 824 (1974) (party opposing summary judgment "may not
rest upon the mere allegations or denials of [their] pleading,
but [their] response . . . must set forth specific facts showing
that there is a genuine issue for trial"); Rule 9A(b)(5)(iii) of
the Rules of the Superior Court ("each fact set forth in the
moving party's statement of facts is deemed to have been
admitted unless properly controverted in the manner [set] forth
in this [p]aragraph").4
a. Retaliation. Padmanabhan alleges that CHA retaliated
against him when it "intentionally shared an incorrect report
with the board and the [Databank] on October 28, 2011,"
Padmanabhan I, 99 Mass. App. Ct. at 344, after Padmanabhan
purportedly disclosed CHA's "misconduct and illegalities." The
provide a basis for a reasonable jury to find for a party are
material").
4 Even if Padmanabhan had properly responded, as the judge noted,
it would have made no difference in this case because "those
now-admitted facts merely cite or accurately quote [litigation-
related] documents . . . whose contents cannot be disputed."
Thus, because "CHA's arguments turn on the undisputed content of
these Exhibits . . . analysis can focus on the documents
themselves."
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motion judge, reasoning that Padmanabhan was equitably estopped
from raising such a claim, entered summary judgment. We agree
with the judge's conclusion that the defendant was entitled to
summary judgment, but we need not go down the avenue of parsing
the finer points of equitable estoppel.
Like all the surviving claims, the retaliation claim is
predicated on an allegation that the report shared with the
board and the Databank was incorrect. See Padmanabhan I, 99
Mass. App. Ct. at 344. According to Padmanabhan, the report was
incorrect only to the extent that CHA represented that
Padmanabhan "voluntarily resigned" his CHA medical staff
privileges. However, the Secretary, who is responsible for
maintenance of the Database, specifically found CHA's statement
that "Padmanabhan indicated that he no longer considers himself
part of the [CHA] medical staff -- which [CHA] and his counsel
are treating as a resignation/voluntary surrender" was accurate
given the Secretary's construction of those words of art.
Because the claim of retaliation arises from the adverse action
letter and the coding, the undisputed fact that they are
accurate in the eyes of the Secretary means that Padmanabhan
will not be able to prove his claim of retaliation.5 Cf. Reilly
v. Associated Press, 59 Mass. App. Ct. 764, 770 (2003) ("when a
5 Accordingly, we need not address CHA's alternative privilege
arguments.
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statement is substantially true, a minor inaccuracy will not
support a defamation claim").
b. Defamation. The same is true of Padmanabhan's
defamation claim. In order to establish a claim for defamation,
a plaintiff must prove four elements: "(1) the defendant
published a defamatory statement of and concerning the
plaintiff; (2) the statement was a false statement of fact (as
opposed to opinion); (3) the defendant was at fault for making
the statement, and any privilege that may have attached to the
statement was abused; and (4) the plaintiff suffered damages as
a result, or the statement was of the type that is actionable
without proof of economic loss." Lawless v. Estrella, 99 Mass.
App. Ct. 16, 18-19 (2020). A defamation claim will not lie if
the statement to which objection is taken in fact is true. See
Rzeznik v. Chief of Police of Southampton, 374 Mass. 475, 482
(1978) ("truth is an absolute defense"). Therefore, CHA is
entitled to summary judgment on the claim of defamation.
c. Fraud. "[A] claim for deceit (i.e., fraud) must show
the defendant (1) made a false representation of material fact,
(2) with knowledge of its falsity, (3) for the purpose of
inducing the plaintiff to act on this representation, (4) which
the plaintiff justifiably relied on as being true, to her [or
his] detriment." Sullivan v. Five Acres Realty Trust, 487 Mass.
64, 73 (2021), quoting Greenleaf Arms Realty Trust I, LLC v. New
11
Boston Fund, Inc., 81 Mass. App. Ct. 282, 288 (2012). As
limited by Padmanabhan I, the remaining fraud claim against CHA
is based on CHA's representation in its adverse action report
that Padmanabhan had resigned his medical staff privileges (as
opposed to being terminated from his position). Padmanabhan I,
99 Mass. App. Ct. at 343-344. Padmanabhan's fraud claim is
fundamentally without basis because it is not directed at any
statement by CHA that was intended to induce reliance by
Padmanabhan. In other words, the record is devoid of evidence
that CHA made any misrepresentation intended to induce
Padmanabhan to act in any particular manner or that he in fact
relied on any alleged misrepresentation to his detriment. See
Sullivan, 487 Mass. at 73. In any event, the accuracy of the
representation, as reflected in the Secretary's determination
that is part of the summary judgment record, would serve
independently to defeat Padmanabhan's claim of fraud.
Accordingly, we conclude that CHA was entitled to summary
judgment on the claim of fraud.
3. Final matters. After the Padmanabhan I rescript
entered, a Superior Court judge conducted a litigation control
conference. In response to the judge's inquiry "what do we need
to do next," counsel for CHA informed the judge and Padmanabhan
that CHA intended to file a motion to dismiss on all remaining
claims based on correspondence by and between CHA and
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Padmanabhan's counsel. The judge responded that a motion for
judgment on the pleadings or summary judgment might "make more
sense." She asked Padmanabhan, "Dr. what do you see as being
the next steps?" Padmanabhan began to discuss the factual basis
for the case, observed that "it has been an incredibly long
case," and addressed the time he thought necessary to respond to
CHA. The judge then set a briefing schedule and a hearing date
for "whatever the dispositive motion is that [CHA] is bringing."
About six weeks thereafter, Padmanabhan filed a motion for
sanctions, arguing in substance that counsel, by disclosing the
referenced correspondence, and by stating CHA's intent to file a
dispositive motion based thereon, committed a fraud on the court
and unreasonably delayed the proceedings "given that CHA . . .
waited a full three (3) months before declaring its intention to
file a second motion to dismiss." The judge denied
Padmanabhan's motion "as unjustified in fact or law." Based on
our review of the record, we discern no abuse of discretion in
this ruling. See Wong v. Luu, 472 Mass. 208, 220 (2015) ("We
review the judge's imposition of sanctions under the court's
inherent powers for abuse of discretion").
Finally, after the hearing on CHA's summary judgment
motion, Padmanabhan sought leave to file pleadings that,
collectively considered, amounted to an additional opposition to
CHA's summary judgment motion; one of those pleadings purported
13
to be a rule 9A response to CHA's statements of material facts.
The judge denied Padmanabhan's motion. After reviewing
Padmanabhan's proffered pleadings, we see nothing that was not,
or at the very least could not have been, raised before hearing.
We agree with the judge's conclusion that, even in his
attempted, albeit untimely, response to CHA's statements of
material fact, Padmanabhan paid "only lip service to the . . .
requirement" that he support any purported factual disputes by
specific citation to supporting record materials. Accordingly,
we discern no abuse of discretion in the judge's denial of
Padmanabhan's motion.6
Judgment affirmed.
By the Court (Rubin,
Englander & Brennan, JJ.7),
Clerk
Entered: May 23, 2023.
6 To the extent we have not specifically addressed any of
Padmanabhan's arguments, "they have not been overlooked. We
find nothing in them that requires discussion." Department of
Revenue v. Ryan R., 62 Mass. App. Ct. 380, 389 (2004) (quotation
omitted).
7 The panelists are listed in order of seniority.
14