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Ramamurthy v. JFK Medical Center

May 21, 2010


On appeal from the Superior Court of New Jersey, Chancery Division, Middlesex County, Docket No. C-34-09.

Per curiam.


Telephonically Argued February 23, 2010

Before Judges Axelrad, Fisher and Sapp-Peterson.

Plaintiff, Dr. Kotta Ramamurthy, appeals the ninety-day suspension of his clinical privileges at defendant John F. Kennedy Medical Center ("JFK" or "hospital"). We affirm.

Plaintiff is a medical doctor licensed to practice in New Jersey and has had staff privileges at JFK since 1975. On June 10, 2007, M.M. presented to JFK's emergency room with complaints of "diffuse abdominal pains." Dr. Moheb Abdelmalek, the ER doctor on call, ordered diagnostic testing, the results of which reported an impression of "high-grade small bowel obstruction." Dr. Abdelmalek discussed the case with Dr. Edgar R. Hobayan, a surgeon, who instructed that M.M. be "admit[ed] to Medicine."*fn1

Dr. Daniel Mondrow, the physician on call that day, was contacted and he admitted M.M. around midnight. Dr. Mondrow then contacted Dr. Richard Constable, Chief of General Surgery at JFK, who at the time was leaving the hospital to attend to a family emergency. He later called his secretary and asked her to "do [him] a favor, call Dr. [Ramamurthy] and let him know that he has this patient in the emergency room[.]" A phone conversation subsequently took place at about 8:00 p.m. on June 11 between plaintiff and Audrey Irish, R.N., in which plaintiff gave an order for a CT scan, Demerol,*fn2 Vistaril*fn3 and renewed intravenous fluids.

On June 11, plaintiff examined M.M. and ordered a CT scan of M.M.'s abdomen and pelvis and prescribed medication. According to the testimony given at the June 3, 2008 hospital hearing by Angela Wei, R.N., who was present when plaintiff examined M.M., plaintiff lifted up M.M.'s gown, examined her and told her that he was going to perform surgery and may have to "take part of the colon out . . . ." Wei heard plaintiff call the operating room and schedule the surgery for M.M., and while simultaneously flipping M.M.'s chart, he then stated, "oh, I was - - oh, patient self pay?" Wei testified that Ramamurthy left the area shortly thereafter. Plaintiff maintains that he cancelled the surgery because M.M.'s chart indicated that another surgeon, Dr. Hobayan, had already been consulted. M.M. succumbed while still hospitalized four days later.

Dr. Barry Ellman, Chairman of the Department of Surgery, and Dr. Oser met with Drs. Constable and Hobayan to discuss M.M.'s treatment, after which plaintiff was advised in a letter dated June 22, that a "more formal review and possible corrective action will be necessary." In a letter dated July 17, JFK notified plaintiff that Dr. Matthew Smith, President, Medical/Dental Staff, had appointed an ad hoc committee of three senior surgeons to investigate the matter and report back to him.

Dr. Smith testified that although his intent was for the review panel to conduct a formal investigation, "the three surgeons involved marched to their own drummer and they did a very informal thing." He indicated that although "they reviewed the records, they did not speak with any of the physicians involved in the case, not the least of which was Dr. Ramamurthy, who they also did not speak with[.]" Consequently, Dr. Smith did not use or present the review panel's findings because he determined that they did not follow the proper procedure. Dr. Smith appointed a second ad hoc investigative committee chaired by Dr. Jerold Grubman (Grubman Committee). Plaintiff met with only two of the five Grubman Committee members. However, when they issued their report, their findings and recommendations reflected a consensus of the committee members. Plaintiff was subsequently invited to the November 20, 2007 Medical Executive Committee (MEC) meeting to discuss the Grubman Committee's report, but chose not to attend. On December 11, 2007, the MEC voted to recommend a ninety-day suspension of plaintiff's clinical privileges. Plaintiff was not extended an invitation to attend the December 11 meeting.

Plaintiff requested a "Fair Hearing" Pursuant to Article VII of the JFK Medical/Dental Staff Bylaws (Bylaws). That hearing was conducted on June 3 and July 1, 2008, before a five-physician committee moderated by retired Judge Robert A. Longhi. Plaintiff participated in this proceeding and was represented by counsel. On July 29, 2008, the Fair Hearing Committee (FHC) voted to affirm the MEC's recommendation to suspend plaintiff's privileges for ninety days.

Plaintiff appealed the FHC's decision, pursuant to Article VII, Section 6 of the Bylaws, to the Appellate Review Committee, which, on November 12, 2008, affirmed the MEC's recommendation. The Board of Trustees (Board) reviewed the recommendations of the FHC and Appellate Review Committee and affirmed their recommendations to suspend plaintiff's privileges for ninety days, effective March 1, 2009.

Plaintiff filed a verified complaint against JFK, Solaris Health System*fn4 and John P. McGee*fn5 on February 18, 2009, seeking preliminary and permanent injunctive relief. Specifically, plaintiff sought reversal of the suspension and an order preventing defendants from reporting the suspension to the New Jersey Division of Consumer Affairs and the Medical Practitioner Review Panel of the New Jersey State Board of Medical Examiners. Defendants filed an answer on March 23, 2009.

On May 11, 2009, Judge Frank M. Ciuffani, P.J.Ch., dismissed plaintiff's complaint with prejudice and granted defendants' motion for summary ...

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