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Nahas v. Shore Medical Center

United States District Court, D. New Jersey

April 27, 2018

Frederick NAHAS, M.D., Plaintiff,
SHORE MEDICAL CENTER, et al., Defendants.



         This matter comes before the Court today on Defendants' Motion for Summary Judgment. (ECF No. 107.) Plaintiff Frederick Nahas, M.D., has sued the Medical Executive Committee (“MEC”) of Shore Medical Center (“Shore Medical”). Defendants argue that the MEC simply does not exist as a legal entity with the capacity to sue or be sued, while Plaintiff maintains that it is. As we explain below, the Court finds that the MEC is capable of being sued. Defendants' motion is accordingly DENIED.

         I. THE FACTS

         This controversy, as set forth in the voluminous Second Amended Complaint (ECF No. 45), is a “malicious peer review” action premised on certain actions that adversely affected Plaintiff Dr. Nahas's privileges to perform endovascular surgery at Shore Medical. The Court has already visited the facts of his previous complaints (see Ops., ECF Nos. 14, 31, and 43), and need not do so again today because the only issue actually before the Court is narrow. Plaintiff has sued Shore Medical Center's Medical Executive Committee under the Sherman Act, 15 U.S.C. § 1; 42 U.S.C. § 1981; and state-law supplementary claims. After the parties were unable to resolve their differences over whether the MEC is capable of producing documents in discovery, Shore Medical has moved for summary judgment on whether the MEC is an entity that has the capacity to sue or be sued.

         A. The Medical Staff

         Although Defendants maintain that the Medical Staff of Shore Medical is irrelevant to this motion, the Court disagrees, as the nature of the Medical Executive Committee can only be understood in context.

         The State of New Jersey requires hospitals, as is the case in many other states, to establish both Medical Staffs and Medical Executive Committees:

(a) There shall be an organized medical staff that is responsible to the governing body of the hospital. Bylaws governing all medical staff members shall be implemented.
(g) There shall be an executive committee for the medical staff which performs supervisory functions.

         N.J. Admin. Code § 8:43G-16.1.

         Shore Medical is registered as a non-profit corporation in New Jersey, with more than 1500 employees, including more than 370 physicians. (Def. SUMF at ¶¶ 1-3.) Pursuant to New Jersey law, and as with many hospitals around the country, Shore Medical is divided into a Board of Trustees, the administrative staff, and the medical staff, consisting of medical professionals such as physicians. Cf. Gordon v. Lewistown Hosp., 272 F.Supp.2d 393, 398-99 (M.D. Pa. 2003), affd 423 F.3d 184 (3d Cir. 2005).

         The Medical Staff works together with Shore Medical and its Board of Trustees to provide medical services. (See Shore Medical Center Medical Staff Bylaws, July 15, 2014 (“2014 Bylaws”), Def. Ex. D); Shore Medical Center Medical Staff Bylaws, Sept. 14, 2010 (“2010 Bylaws”), Pl. Ex. C.)[1] The Medical Staff's Bylaws provide that the purpose of the Medical Staff is as follows:

The Medical Staff of Shore Memorial Hospital [the previous name of Shore Medical Center] is established by the Board of Trustees to assist the Hospital in meeting its mission and to carry out duties assigned to it by the Board in order to enhance the quality and safety of care, treatment, and services provided to patients.

         (2010 Bylaws, art. I.)

         Membership on Shore Medical's Medical Staff is a privilege granted only to professionally competent physicians who continuously meet the qualifications, standards, and requirements of the Bylaws. (2010 Bylaws, § 2.1.) All members of the Medical Staff are required to pay both an initial and reappointment fee to be part of the Medical Staff. (2014 Bylaws, § 12.3.) All members of the Medical Staff must also pay dues in an amount determined by the elected MEC. (Id.) Some members of the Medical Staff are employed by Shore Medical itself, while others are employed by Penn Medicine, an affiliate of the University of Pennsylvania Health System. (Pl. SUMF at ¶ 2.) Dr. Nahas has been a member of the Medical Staff of Shore Medical since 1978, with some interruptions because of his guilty plea to obstructing a Medicare fraud investigation. (Reply SUMF at ¶ 1.)

         There are four categories of individuals who are on the Medical Staff: active, affiliate, referral, and honorary. (2010 Bylaws, art. III.) Active staff members are granted clinical privileges by the Board and have the ability to vote on all matters presented at meetings of the Medical Staff, and at meetings of the Department to which they have been appointed. (Id.) Medical Staff members who are eligible may also vote for officers of the Medical Staff, including the President, Vice-President, and Immediate Past President. (Id. at art VI.)

         Physicians of the Medical Staff must, among other things, be licensed to practice medicine in New Jersey, have liability insurance, and be eligible to participate in Medicare, Medicaid, or other federal state payer programs. (Id.) Members of the Medical Staff are also obliged, among other things, to provide continuous and timely care to all of their patients; they must update the Hospital of new and pertinent information; they must refrain from fee-splitting or other illegal inducement relating to patient referrals; and they must satisfy continuing medical education requirements for licensure. (Id. at § 2.3.) Members of the Medical Staff also agree to abide by the Bylaws and to participate in peer review activities of the Medical Staff. (Id.)

         The Bylaws grant rights to all Medical Staff members. Among these rights are a right to an audience with the MEC on matters within the purview of the MEC's responsibilities, a right to initiate a recall vote, and a right to challenge any rule, regulation, or policy established by the MEC. (2014 Bylaws, art. IV.) Perhaps most significantly, the Bylaws also provide for indemnification of members of the Medical Staff “for all legal costs, settlements, and judgments or other monetary penalties resulting from a Medical Staff member's good faith participation in medical staff affairs.” (Id.) Shore Medical's indemnification of Medical Staff members extends to “peer review activities” and “carrying out responsibilities as a Medical Staff officer, Department, Division, section or committee Chair, or committee member.” (Id.) We note that this indemnification extends solely to the individuals on these committees, not to the committees themselves.

         B. The Medical Executive Committee

         Turning to the MEC, the Bylaws expressly provide for “Medical Staff Committees and Liaisons, ” stating that “[t]here shall be an Executive Committee of the Medical Staff.” (2014 Bylaws, § 8.) The Bylaws define the MEC as “[t]he executive committee of the Medical Staff that has oversight over all Medical Staff Activities and is accountable to the Board of Trustees.” (See 2014 Bylaws, Definitions.) All active Medical Staff members are eligible for MEC membership. (Id. at § 8.4.1.) The MEC consists of officers of the Medical Staff, along with Department Chairs, at-large members of the Medical Staff, and Chairs of other committees. (Id. at § 8.4.2.) “The membership of the Medical Staff exercises its authority over the MEC through the election of its members or the appointment of members by its elected officers.” (Id. at § 8.4.3.) Approximately 24 individuals sit on the MEC. (Def. SUMF at ¶ 8.)

         The MEC “shall represent the Medical Staff” and at all times acts “as the authorized delegate of the Medical Staff in regard to general and specific functions of the Medical Staff.” (2014 Bylaws, § 8.4.6.) It “receives and acts on reports, ” can adopt policies “on behalf of the Medical Staff which it deems prudent, ” and “carries out Investigations.” (2010 Bylaws, at § 8.4.) A significant responsibility of the MEC is to make Medical Staff recommendations directly to the governing body of Shore Medical for approval, including with respect to clinical privileges. (Id.) Rules or regulations adopted by the MEC are subject to approval by the Board of Trustees. (Id. at ยง 12.1.) Determinations about Medical Staff privileges are likewise recommendations to the Board-the MEC receives a privilege request from a credentials committee and ...

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