Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-2_05-cv-02117/USCOURTS-arwd-2_05-cv-02117-0/pdf.json

Nature of Suit Code: 440
Nature of Suit: Other Civil Rights
Cause of Action: 42:1983 Civil Rights Act

---

Page 1 of 11

IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FORT SMITH DIVISION

ROBERT L. KALE, M.D. PLAINTIFF

v. CASE NO. 2:05-CV-2117

W. RAY JOUETT, ORMAN SIMMONS,

DAVID JACKS, BOBBYE DENNIS,

ANNE BRITTON, SUE CHAMBERS,

TREAT PIERCE, E.ELDON TOMMEY,

ALONZO WILLIAMS, JAMES ZINI,

WARREN DOUGLAS, and J.R. BAKER DEFENDANTS

MEMORANDUM OPINION AND ORDER

Currently before the Court are Defendants’ Motion to Dismiss

(Doc. 2), Plaintiff’s response (Doc. 7), and Defendants’ reply

(Doc. 9). For their motion, Defendants state Plaintiff has failed

to state a claim upon which relief may be granted. See Fed. R.

Civ. P. 12(b)(6). Specifically, Defendants argue Plaintiff’s

Complaint under 42 U.S.C. § 1983 for due process violations should

be dismissed because Plaintiff has failed to allege a deprivation

of any constitutional rights. Defendants further contend they are

entitled to judicial immunity. In response, Plaintiff contends his

complaint alleges a deprivation of the right to practice medicine

without due process in violation of the First, Fifth and Fourteenth

Amendments to the Constitution. Plaintiff further argues

Defendants are not entitled to judicial immunity because they acted

without jurisdiction or authority. Based on the reasons that

follow, Defendant’s Motion to Dismiss is GRANTED and Plaintiff’s

Complaint is DISMISSED WITH PREJUDICE. 

Case 2:05-cv-02117-RTD Document 12 Filed 03/16/06 Page 1 of 11 PageID #: <pageID>
Ark. Code Ann. § 17-95-409(a)(2)(G) states: The words 1

“unprofessional conduct” as used in the Arkansas Medical

Practices Act...are declared to mean grossly negligent or

ignorant malpractice.

Regulation 2.4 states: 2

The Arkansas Medical Practices Act authorizes

the Arkansas State Medical Board to revoke or

suspend the license issued by the Board to

practice medicine if the holder thereof has been

Page 2 of 11

Background

Plaintiff Robert L. Kale, M.D., (“Dr. Kale”) is a licensed

physician in the State of Arkansas. Defendants Orman Simmons,

David Jacks, Bobbye Dennis, Anne Britton, Sue Chambers, Trent

Pierce, C. Eldon Tommey, Alonzo Williams, James Zini, Warren

Douglas, and J.R. Baker are members of the Arkansas State Medical

Board (the “Board”). Defendant W. Ray Jouett, M.D., (“Dr. Jouett”)

is chairman of the Board. At a time prior to August 2002, Dr. Kale

publicly called for the resignation or removal of Dr. Jouett as

chairman of the Board. In August 2002, the Board issued an

Emergency Order of Suspension and Notice of Hearing (“Emergency

Order”) to Dr. Kale pursuant to Ark. Code Ann. § 25-15-201, Ark.

Code Ann. § 25-15-211 both of the Administrative Procedure Act, and

Ark. Code Ann. § 17-95-410 of the Medical Practices Act. The Board

alleged Dr. Kale committed a violation of the Medical Practices

Act, specifically, Ark. Code Ann. § 17-95-409(a)(2)(G) , exhibiting 1

gross negligence and ignorant malpractice, by violating Regulation

2.4 of the Arkansas Medical Practices Acts and Regulations

(“AMPRA”).2

Case 2:05-cv-02117-RTD Document 12 Filed 03/16/06 Page 2 of 11 PageID #: <pageID>
found guilty of grossly negligent or ignorant

malpractice. 

“Malpractice” includes any professional

misconduct, unreasonable lack of skill or fidelity

in professional duties, evil practice, or illegal

or immoral conduct in the practice of medicine and

surgery. It shall include, among other things,

but not limited to....the prescribing of excessive

amount of controlled substances to a patient

including the writing of an excessive number of

prescriptions for an addicting or potentially

harmful drug to a patient. 

Page 3 of 11

The Emergency Order alleges Dr. Kale over-prescribed up to seven

medications to 12 individuals during a period of time from January

1997 to July 2002. Paragraph XIV states: 

Pursuant to the Administrative Procedure Act,

Ark. Code Ann. § 25-15-211(c), and upon an

affirmative vote of the majority of the Arkansas

State Medical Board, the Board finds that the acts

of Robert L. Kale, M.D., described hereinabove,

endangers the public health, safety and welfare;

and therefore the license to practice medicine in

the State of Arkansas of Robert L. Kale, M.D. is

suspended pending a disciplinary hearing in this

matter or further orders of the board. 

The Emergency Order further states: 

Wherefore, it is Considered, Ordered, and

Adjudged that the license to practice medicine, as

issued by the State of Arkansas to Robert L. Kale,

M.D., is suspended, as to the authorization to

prescribe schedule medications, on an emergency

basis, pending a disciplinary hearing or further

orders of the Board. 

Dr. Kale contends he was ordered to surrender his DEA permit upon

issuance of the Emergency Order. On August 28, 2002, the Board

amended the Emergency Order deleting paragraph V of the original

order, which pertained to patient “T.B.”, and adding additional

Case 2:05-cv-02117-RTD Document 12 Filed 03/16/06 Page 3 of 11 PageID #: <pageID>
Dr. Kale has appealed that decision to the Circuit Court of 3

Sebastian County. 

Page 4 of 11

violations of the Medical Practices Act. 

The Board conducted a hearing on June 6, 2003, and found Dr.

Kale to not be in violation of Regulation 2.4 of the AMPRA which

relates to the over-prescribing of scheduled medication, but in

violation of Regulation 19 which relates to pain management

programs. The Board lifted the previous Emergency Order

prohibiting the prescribing of scheduled medication and proscribed

actions for Dr. Kale to obtain a new DEA permit. Shortly after 3

the Emergency Order was issued, Dr. Jouett was interviewed by a

local television station in his capacity as chairman of the Board

in which he stated: “The doctor is causing this individual to

become dependent. That’s part of it. The second part of it is

that there are a great number of drug seekers that utilize the

physicians to get drugs and then sell them on the street.” Dr.

Kale contends this statement was a reference to him and caused harm

to his good name and reputation. 

Defendants contend that Dr. Kale has alleged no constitutional

right violation, that they are entitled to qualified immunity, and

that Dr. Kale’s claims are barred by the abstention doctrine.

Defendants further contend Dr. Kale’s license to practice medicine

was not suspended, only limited in his ability to prescribe certain

medications. Dr. Kale contends he was entitled to notice and an

opportunity to be heard before the Emergency Order was issued and

his license suspended. Dr. Kale further contends he was entitled

Case 2:05-cv-02117-RTD Document 12 Filed 03/16/06 Page 4 of 11 PageID #: <pageID>
Page 5 of 11

to due process regarding Dr. Jouett’s statement. Dr. Kale finally

contends the Emergency Order was issued in retaliation for his

criticisms of Dr. Jouett. 

Discussion

A motion to dismiss should be granted when, assuming the

complaint’s factual allegations are true, it appears beyond doubt

that the plaintiff cannot prove any set of facts supporting the

claim. Moses.com Sec., Inc. v. Comprehensive Software Sys., Inc.,

406 F.3d 1052, 1062 (8 Cir. 2005). If the court relies on matters th

outside the pleadings, the motion to dismiss shall be treated as

one for summary judgment. See Fed.R.Civ.P. 12(b). But the court

may consider “some materials that are part of the public record or

do not contradict the complaint,” Missouri ex rel. Nixon v. Coeur

D’Alene Tribe, 164 F.3d 1102, 1107 (8 Cir.), cert denied, 527 U.S. th

1039, 119 S.Ct. 2400, 144 L.Ed.2d 799 (1999), as well as materials

that are “necessarily embraced by the pleadings.” Piper Jaffray

Cos. v. National Union Fire Ins. Co., 967 F.Supp. 1148, 1152

(D.Minn. 1997). In our analysis, we consider the Emergency Order

and the Board’s order regarding the June 6, 2003 hearing as public

records and because they are “necessarily embraced by the

pleadings.” 

To establish a claim under 42 U.S.C. § 1983, Dr. Kale must

first show a deprivation of a right, privilege, or immunity secured

by the Constitution or the laws of the United States. See Montano

v. Hedgepeth, 120 F.3d 844, 848 (8 Cir. 1997). Second, he must th

prove that the state’s deprivation of that interest was done

Case 2:05-cv-02117-RTD Document 12 Filed 03/16/06 Page 5 of 11 PageID #: <pageID>
Page 6 of 11

without due process. Krentz v. Roberson Fire Prot. Dist., 228 F.3d

897, 902 (8 Cir. 2000). th

Dr. Kale contends he has a property interest in practicing

medicine and this is not contested by the Defendants. A

physician’s right to practice medicine is a property right

deserving constitutional protection. See Hake v. Ark. State

Medical Board, 237 Ark. 506, 374 S.W.2d 173 (1964); Greene v.

McElroy, 360 U.S. 474, 492, 79 S.Ct. 1400, 1411, 3 L.Ed.2d 1377

(1959). Dr. Kale is a physician licensed by the State of Arkansas.

As a licensed physician, he is subject to the rules and regulations

of the Arkansas Medical Practices Act codified at Ark. Code Ann. §

17-95-201 et seq, and under the authority of the Arkansas State

Medical Board. 

The Arkansas State Medical Board is a state agency authorized

by the Arkansas Legislature to make and adopt all rules,

regulations, and bylaws regarding the practice of medicine and to

promulgate and put such rules and regulations as are necessary into

effect. See Ark. Code Ann. § 17-95-303. This includes the power

to suspend or revoke medical licenses within the State of Arkansas.

See Ark. Code Ann. § 17-95-409. The procedural format for the

Board’s actions concerning the license suspension of a physician is

governed by the Arkansas Administrative Procedures Act codified at

Ark. Code Ann. § 25-15-201 et seq. Ark. Code Ann. § 25-15-211(c)

provides: 

No revocation, suspension annulment, or

withdrawal of any license is lawful unless the

agency gives notice by mail to the licensee of

facts or conduct warranting the intended

action and unless the licensee is given an

opportunity to show compliance with all lawful

Case 2:05-cv-02117-RTD Document 12 Filed 03/16/06 Page 6 of 11 PageID #: <pageID>
Page 7 of 11

requirements for the retention of the license.

If the agency finds that public health,

safety, or welfare imperatively requires

emergency action and incorporates a finding to

that effect in its order, summary suspension

of a license may be ordered pending

proceedings for revocation or other action,

which proceedings shall be promptly instituted

and determined. 

Dr. Kale contends that this section of the Arkansas Code guarantees

the procedural protection granted under Ark. Code Ann. § 17-95-410

which requires at least 30 days written notice before a physician’s

license can be suspended or revoked, even temporarily. We disagree

for Ark. Code Ann. § 17-95-410(b) & (c) provides that the Board

shall review any complaint against a licensee and issue a written

order and notice of hearing to the licensee by mail. At the time

of the hearing, the Board shall receive evidence and shall accord

the licensee a full and fair opportunity to be heard in his

defense. See Ark. Code Ann. § 17-95-410(d). If the accused is

found guilty, the Board may revoke or suspend his license. See

Ark. Code Ann. § 17-95-410(e)(3). Section 17-95-410 and the first

sentence of Section 25-15-211(c) both provide for a final

determination as to a suspension or revocation of a license. The

second sentence of Section 25-15-211(c) provides for a summary

suspension of a license. If a summary suspension and a final

suspension required the same procedural notice requirements, there

would be no need for the Legislature to have adopted the second

sentence. The Legislature has specifically provided for the

summary suspension when an agency finds that public health, safety,

or welfare imperatively requires emergency action and promptly

institutes proceedings subsequent to the summary suspension. To

Case 2:05-cv-02117-RTD Document 12 Filed 03/16/06 Page 7 of 11 PageID #: <pageID>
Page 8 of 11

accept Dr. Kale’s contention would be tantamount to declaring an

act of the Legislature a nullity. 

Dr. Kale next contends that even if the Board has the lawful

authority to suspend a physician without a hearing in emergency

circumstances, they can not do so for an allegation of grossly

ignorant or negligent malpractice under Ark. Code Ann. § 17-95-

409(2)(G). Dr. Kale argues the Board must have the testimony of an

expert witness to support the allegation and cites Hollabaugh v.

Arkansas State Medical Board, 43 Ark. App. 83, 861 S.W.2d 317

(1993) for support. Dr. Kale’s reliance on Hollabaugh is

misplaced. In Hollabaugh, the doctor’s license was suspended by the

Board for gross negligence or ignorant malpractice following a

hearing. On appeal, the Hollabaugh court could not affirm the

suspension without expert testimony establishing the standard of

care to which Dr. Hollabaugh was to be held and whether she

violated that standard of care. The evidentiary issue in

Hollabaugh was not about a summary suspension of a license. As

stated previously, the Board is only required to find that public

health, safety, or welfare imperatively requires emergency action

and incorporates a finding to that effect in its order. See Ark.

Code Ann. 25-15-211(c); see also Arkansas State Medical Board v.

Leonard, 267 Ark. 61, 590 S.W.2d 849 (1979)(decision under prior

law)(“The Board [] has the authority to summarily suspend a license

pending a hearing if it finds that emergency action is required and

‘incorporates a finding to that effect in its order.’”) In the

Emergency Order, the Board alleged Dr. Kale to have over-prescribed

at least one and as many as seven medications to 11 individuals as

Case 2:05-cv-02117-RTD Document 12 Filed 03/16/06 Page 8 of 11 PageID #: <pageID>
In his response, Dr. Kale characterizes the claim against 4

Dr. Jouett as a state claim for defamation for which he argues

diversity jurisdiction exists pursuant to 28 U.S.C. 1332. 

Diversity jurisdiction exists, in part, between people of

different states. See 28 U.S.C. 1332. As Dr. Kale states in

his complaint, he and Dr. Jouett are citizens and residents of

Arkansas. Therefore, diversity jurisdiction does not exist. And

as Dr. Kale has not established a 42 U.S.C. § 1983 claim, we

would not exercise jurisdiction over any state law claim under 28

U.S.C. § 1367. 

Page 9 of 11

recently as July 2002. The Board stated in paragraph XIV that the

actions of Dr. Kale “endanger[ed] the public health, safety and

welfare.” We find the Board acted within its authority under

Arkansas law to issue the Emergency Order. 

 Dr. Kale further contends defendant Dr. Jouett, as chairman of

the Arkansas Medical Board, deprived him of a liberty interest in

his reputation and good name without due process. Injury to 4

reputation alone is not a liberty interest protected under the

Fourteenth Amendment. Siegert v. Gilley, 500 U.S. 226, 233-34, 111

S.C.t 1789, 114 L.Ed.2d 277 (1991). Accordingly, the Eighth

Circuit has limited this claim to cases in which a public employer

terminated an employee and published reasons for the discharge that

seriously damaged the employee’s standing in the community or

foreclosed other employment opportunities. See Putnam v. Keller,

332 F.3d 541, 546 (8 Cir. 2003); Speer v. City of Wynne, 276 F.3d th

980, 984 (8 Cir. 2002); accord Stidham v. Peace Officer Standards th

& Training, 265 F.3d 1144, 1153-54 (10 Cir. 2001). The Eighth th

Circuit has further limited this claim to government accusations

“so damaging as to make it difficult or impossible for the employee

to escape the stigma of those charges.” Allen v. City of

Pocahontas, 340 F.3d 551, 556 (8 Cir. 2003)(quotation omitted), th

Case 2:05-cv-02117-RTD Document 12 Filed 03/16/06 Page 9 of 11 PageID #: <pageID>
Page 10 of 11

cert. denied, 540 U.S. 1182, 124 S.Ct. 1420, 158 L.Ed.2d 85 (2004);

see Mercer v. City of Cedar Rapids, 308 F.3d 840, 845 (8 Cir. th

2002)(allegations of “dishonesty, immorality, criminality, racism,

and the like”)(quotation omitted). Here, Dr. Kale is not a

terminated public employee, nor has he suffered a comparable injury

such as a revocation of his license. 

Dr. Kale finally contends the Board’s actions were in

retaliation for his criticisms of Dr. Jouett and in calling for his

resignation. To state a First Amendment claim under 42 U.S.C. §

1983, Dr. Kale must show his speech concerned matters protected by

the First Amendment and the protected speech was a substantial

factor in the Board’s decision. See O’Sullivan v. Minnesota, 191

F.3d 965 (8 Cir. 1999). Dr. Kale’s complaint only states that he th

publicly called for the resignation or removal of Dr. Jouett as

chairman of the Board at a time prior to August 8, 2002, for acting

on behalf of insurance companies and big corporations rather than

acting on behalf of individual patients and patient rights. (Doc.

1, Dr. Kale’s Complaint, ¶ 6). Dr. Kale has alleged no facts that

any members of the Board, including Dr. Jouett, were aware of the

criticisms. Even if the members of the Board were aware of Dr.

Kale’s criticism, that was not the stated reason the Board issued

the Emergency Order. Instead, it was that the Board found a danger

to public health, safety and welfare in the over-prescribing of

medications by Dr. Kale. In any event, the Board’s order following

the June 6, 2003, hearing lifting the Emergency Order removes any

further inference of causation between his speech and the decision

to issue the Emergency Order. 

Case 2:05-cv-02117-RTD Document 12 Filed 03/16/06 Page 10 of 11 PageID #: <pageID>
Page 11 of 11

Conclusion

Dr. Kale’s Complaint fails to allege a due process claim in

violation of his constitutional rights as a matter of law, fails to

state a due process claim against Dr. Jouett as a matter of law,

and fails to state a First Amendment violation as a matter of law.

Having reached these conclusions, we need not resolve whether the

Board was entitled to immunity on the claims.

IT IS, THEREFORE, CONSIDERED, ORDERED, ADJUDGED AND DECREED

that Defendants’ Motion to Dismiss is GRANTED. Plaintiff’s

Complaint is DISMISSED WITH PREJUDICE. All parties are to bear

their own fees and costs. 

IT IS SO ORDERED this 16 day of March, 2006. th

/s/Robert T. Dawson

Robert T. Dawson

United States District Judge 

Case 2:05-cv-02117-RTD Document 12 Filed 03/16/06 Page 11 of 11 PageID #: <pageID>