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Pal v. Jersey City Medical Center

United States District Court, D. New Jersey

October 24, 2014

NEELU PAL, Plaintiff,
v.
JERSEY CITY MEDICAL CENTER, et al., Defendants.

OPINION

STANLEY R. CHESLER, District Judge.

This matter comes before the Court on the renewed motion for summary judgment filed by Defendants Jersey City Medical Center ("JCMC"), the Medical-Dental Staff of JCMC and Nathaniel Holmes, M.D. (collectively, the "JCMC Defendants"). Pro se Plaintiff Neelu Pal, M.D. ("Plaintiff" or "Dr. Pal") opposes the motion. The Court has considered the papers filed by the parties and proceeds to rule without oral argument, pursuant to Federal Rule of Civil Procedure 78. For the reasons that follow, the Court will grant the JCMC Defendants' motion for summary judgment.

I. BACKGROUND

As previous Opinions have set forth, this action arises out of the denial of Dr. Pal's application for surgical privileges at JCMC. Dr. Pal, who is a female of Indian origin, claims that the denial was motivated by discrimination against her on the basis of gender and national origin. By Opinion and Order of July 21, 2014, the Court granted the motion for summary judgment brought by the Defendants affiliated with the University of Medicine and Dentistry of New Jersey ("UMDNJ"), who were involved in this action for their role in giving negative recommendations about Dr. Pal in JCMC's credentialing process. (The Court will refer to the other group of defendants as the "UMDNJ Defendants.") Dr. Pal had claimed the UMDNJ Defendants, physicians with whom she had worked prior to applying for privileges at JCMC, acted in a discriminatory manner and conspired with JCMC to deprive her of her surgical career. The Court found that Dr. Pal was collaterally estopped from pursuing her claims against the UMDNJ Defendants, including a conspiracy claim pursuant to 42 U.S.C. § 1985, because she had previously tried a case to verdict on the same issue before a jury in New Jersey Superior Court. (As it did in the July 21, 2014 Opinion, the Court will refer to that case as the "State Action.") Three claims, as to the JCMC Defendants, remain in this case: a claim under 42 U.S.C. § 1985, a breach of contract claim and a defamation claim. The following synopsis focuses on the facts relating to Dr. Pal's dispute with JCMC Defendants.

A. Dr. Pal's Application for Privileges at JCMC

In or about March 2009, Dr. Pal, a board-certified surgeon, applied for membership to the medical-dental staff of JCMC. As requested, she identified professional references in support of her application; these were Dr. Dorian Wilson, Dr. George Macheido and Dr. Edwin Deitch. Defendant Dr. Holmes, the chairman of JCMC's Credentials Committee, reviewed the application and began collecting information from the references she identified. The record shows that these physicians were sent a form provided by JCMC, which contained various pre-printed questions and set forth six areas of evaluation of general competence to be rated according to four categories: excellent, good, fair or poor. In the questionnaire he signed on March 20, 2009, Dr. Wilson, the program director for the general surgery residency program at UMDNJ-Newark, ranked all competence areas as "good" and checked the box corresponding to "recommended highly and without reservation." (Def. Ex. 2 at 59-60.) Dr. Deitch, the chairman of UMDNJ's department of surgery, submitted a questionnaire, also dated March 20, 2009, with the same ranking and recommendation. (Id. at 47-48.) Dr. Pal's third reference, Dr. Macheido, declined to comment. He responded to the request for information through his secretary, and the communication was noted in a memo from the coordinator of JCMC's Medical-Dental Staff Office to the Credentials Committee. The memo stated, in part, as follows:

On the above date [March 31, 2009], I received a call from Dr. Macheido's secretary at the VA New Jersey Healthcare System. She stated that since Dr. Pal had only rotated through the VA while serving her General Surgery residency at UMDNJ, Dr. Macheido does not feel he can provide a satisfactory evaluation of her clinical competence.

(Id. at 40.) The coordinator then emailed Dr. Pal on April 8, 2009 and informed her that "Dr. Macheido does not feel he can provide an accurate evaluation" because Dr. Pal had only done "a rotation through the VA while serving [her] residency at UMDNJ." (Id. at 39.) In that email, the coordinator also asked Dr. Pal to provide an alternate reference to replace Dr. Macheido. It does not appear from the record that another reference was provided.

By means of the same questionnaire, information was also collected from practitioners who had worked with Dr. Pal in the various residency and fellowship programs she identified in her application. Dr. Peter Scholz, program director of cardiothoracic surgery training at UMDNJ's Robert Wood Johnson Hospital (hereinafter "UMDNJ-RWJ"), ranked her interpersonal and communication skills and patient care skills as "fair" and checked the box for "recommended with some reservation." (Id. at 49-50.) Dr. Robert Brolin, program director of bariatric surgery at University Medical Center-Princeton, ranked Dr. Pal "good" in only two areas of general competence: medical knowledge and system-based practice. The other four areas, namely patient care, practice-based learning & improvement, interpersonal & communication skills and professionalism were rated as "fair." He noted that he could not comment on her ability to perform medical procedures during the training program because he generally did not observe her in performing them. Dr. Brolin responded "no" to the question about whether Dr. Pal had been subject to any sanctions but wrote in the comment "not at our medical center." He further responded that he was not willing to be contacted for further information about Dr. Pal, adding the handwritten comment "do your homework." Dr. Brolin checked the box for "recommended with some reservation, " adding the handwritten comment "personality." (Id. at 53-54.) Dr. Christine Ren, director of the bariatric surgery fellowship program at New York University Medical Center ("NYU"), telephonically informed the JCMC credentials office that she did not feel comfortable filling out the form but would speak to the department chair.

Dr. Pal's experience at NYU warrants further exposition. She disclosed on her JCMC staff membership application that she had been dismissed from the fellowship program in February 2006. In an addendum to the application, Dr. Pal explained that during her training at NYU, which she reported as having commenced on October 3, 2005, she brought serious issues "regarding the deficient quality of patient care, " to the attention of the program director. (Id. at 79.) Specifically, she stated that "there was a possibly preventable patient death as well as a serious adverse event with another patient." (Id.) Because, according to Dr. Pal, these issues were not addressed, she "contacted and suggested to a few patients that they discuss the procedure and the circumstances of their safety in detail with the surgeons and hospital administration prior to surgery." (Id.) When the program director, Dr. Ren, found out, Dr. Pal continued, she became "enraged." (Id.) Dr. Pal concluded the addendum by stating that she had retained legal counsel to deal with what she believed was an unjustified action by NYU in dismissing her and was "confident that [she] will prevail at legal proceedings against NYU." (Id.)

Thereafter, on June 4, 2009, Dr. Holmes met with Dr. Pal as part of the credentialing process. They give differing accounts of their meeting. Dr. Holmes states that he informed Dr. Pal that he found her references "potentially problematic" and advised her to look into other things or get other references.[1] He further contends that she became confrontational and threatened that he cannot deny her privileges. In Dr. Pal's version, she denies that she was ever told that her references were "potentially problematic" or that she was provided by Dr. Holmes with the opportunity to supplement her application with alternate letters. She also maintains that, at this meeting, she informed Dr. Holmes "of complaints of race and gender discrimination and retaliation [she] had made against UMDNJ-RWJMS and its employees (namely Peter Scholz, MD and George Batsides, MD)." (8/19/14 Pal Aff., ¶ 1.) According to Dr. Pal, Dr. Holmes demanded that she withdraw her application and she refused.

Dr. Holmes proceeded with the investigation of Dr. Pal's experience and qualifications for membership to the JCMC medical staff. Dr. Holmes felt he needed more information given the "unusual" nature of her application insofar as the references were concerned. In the Fair Hearing, he explained his concern as follows:

The application was quite unusual insofar as the - one of the first things I check is the letters of reference. 99 percent of the time, you know, if they say, you know, this is a great person, best thing since sliced bread, etc. and so forth, and everything else is kind of technical, then I review, you know, malpractice files as well as, you know, some other, you know, minor items. Her application was quite unusual in the fact that while occasionally you'll see somebody who has one reference that is maybe a little questionable, all of her references were questionable, which I've never seen before.

(5/4/10 Tr. at 34:6-19.)

To gather more information about Dr. Pal's clinical competence, training, ethics and behavior, Dr. Holmes had telephone conversations with various doctors who had been asked to submit questionnaires evaluating Dr. Pal. He spoke with Dr. Ren about the circumstances related to Dr. Pal's termination from NYU. Dr. Ren told him that Dr. Pal, who as a fellow in the program had no patients of her own, was making anonymous phone calls at night to the attending surgeons' patients and their families, warning them that it would be dangerous to go forward with their surgeries at NYU. Dr. Ren said that Dr. Pal was confronted about this conduct and admitted that she had made the phone calls. Dr. Ren confirmed to Dr. Holmes that this behavior resulted in Dr. Pal's termination. Dr. Holmes contacted Dr. Scholz, who supervised Dr. Pal in the cardiothoracic surgery program at UMDNJ-RWJ, where she had made complaints of discrimination. According to Dr. Holmes, Dr. Scholz acknowledged that Dr. Pal had complained about discriminatory comments made about her but informed him that these allegations were found to be unsubstantiated following an investigation. Dr. Scholz told Dr. Holmes that when Dr. Pal refused to retract her complaint, she was asked to resign from the residency program. Dr. Holmes also telephoned Dr. Wilson, who had supervised Dr. Pal in the general surgery residency she completed at UMDNJ-Newark. Dr. Wilson's questionnaire was favorable to Dr. Pal, but during the call, Dr. Wilson informed Dr. Holmes that he had since reviewed Dr. Pal's file and could no longer endorse her application based on his current knowledge. Dr. Holmes did not contact Dr. Deitch, also of UMDNJ-Newark, because, he explained, "typically, when you want information about a resident you go to the Program Director" and that was Dr. Wilson. (5/4/10 Tr. 112:22-23.) He contacted Dr. Brolin, Dr. Pal's supervisor in the residency she completed most recently to the time of her application, but as in his questionnaire, Dr. Brolin refused to discuss Dr. Pal or provide any information about her.

After these conversations, Dr. Holmes and Dr. Pal met a second time, on August 6, 2009. Again, Dr. Pal's version of what transpired during the meeting differs from the account given by Dr. Holmes when he testified at the Fair Hearing. According to Dr. Holmes, he advised Dr. Pal that based on her references and on the information he gathered, her application continued to lack proper support and was likely to be denied by the Credentials Committee. Thus, he states, he presented Dr. Pal with the option of having him present her application to the Credentials Committee or withdrawing the application. Dr. Pal denies that she was advised that her references were not supportive. Rather, according to Dr. Pal, Dr. Holmes expressed his opinion that she should not have made complaints about discrimination while at UMDNJ-RWJ and that as a result of her complaints, her application for privileges would be denied.

It is, nevertheless, undisputed that Dr. Pal pressed forward with the application. In presenting the application to the Credentials Committee at its September 1, 2009 meeting, Dr. Holmes recommended against her appointment to the JCMC medical staff due to her deficient references. Thereafter, the Medical Executive Committee recommended that the hospital's Board of Trustees deny Dr. Pal's application, noting that her credentials were reviewed and discussed by the Credentials Committee, which expressed general consensus to follow Dr. Holmes's recommendation. In reaching this conclusion, the Medical Executive ...


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