Filed 10/23/13 Sadeghi v. Sharp Mem. Med. Center CA4/1 NOT TO BE PUBLISHED IN OFFICIAL REPORTS
California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115. COURT OF APPEAL, FOURTH APPELLATE DISTRICT DIVISION ONE
STATE OF CALIFORNIA

H. MEHRDAD SADEGHI, Plaintiff and Appellant,

v. SHARP MEMORIAL MEDICAL CENTER CHULA VISTA, Defendant and Respondent. D060429

(Super. Ct. No. 37-2010-00080039- CU-WM-SC)

APPEAL from an order of the Superior Court of Sa n Diego County, William S. Cannon, Judge. Affirmed. H. Mehrdad Sadeghi, in pro. per.; An drews & Hensleigh, Ba rbara Hensleigh and Joseph Andrews, for Plaintiff and Appellant. Procopio, Cory, Hargreaves & Savitch, Richard D. Barton and Jaime D. Quient, for Defendant and Respondent. Dr. H. Mehrdad Sadeghi's medical staff privileges were summa rily suspended by the Medical Staff of Sharp Chula Vista Medical Center (SCV). Dr. Sadeghi appeals from2 the superior court order denying his petition fo r writ of administrative mandate to compel SCV to void its decisi on upholding the suspension. We affirm.
FACTUAL AND PROCEDURAL BACKGROUND 1 This matter arises from a failed surgical procedure by Dr. Sadeghi in 2007. After the procedure, SCV launched an investigation that raised serious concerns about Dr. Sadeghi's mental health and pote ntial violations of the standard of care. As a result, Dr. Sadeghi's medical privileges were suspen ded by the hospital' s Medical Executive Committee (MEC), the peer re view body responsible fo r administering physician privileges. Following this in itial suspension, Dr. Sadeghi's pr ivileges were reinstated, but they were again revoked when he failed to comply with conditions imposed by the MEC. Dr. Sadeghi invoked his right under the hospi tal's bylaws to a formal judicial review hearing of the MEC's actions. More than on e year into that proceeding, Dr. Sadeghi suspended the hearing to pursue an informal resolution. Wh en that attempt failed, the hearing resumed and the review panel ultimat ely upheld the MEC's actions. Dr. Sadeghi challenged the panel's determination in su perior court and this appeal followed. Dr. Sadeghi is board certified in intern al medicine, cardiolo gy and interventional cardiology. In 2003, SCV granted Dr. Sa deghi privileges in internal medicine,

1 Dr. Sadeghi filed a motion to lodge or file the administrativ e record under seal, which was not opposed by SCV. Due to the patient and peer review information contained in the administrative record, this court treated the motion as one to lodge the appendix as confidential and granted the motion. We endeavor to discuss the relevant facts in general terms to maintain confiden tiality. However, meaningf ul discussion of the issues raised by Dr. Sadeghi necessarily re quires reference to information contained in the administrative record.3 interventional cardiology, and peripheral interv entional procedures. His practice focused on interventional cardiology, a subspecialty of cardiology focu sed on diagnosis and treatment of cardiovascular disease with cath eter-based therapy. Dr. Sadeghi's practice also included catheter-based therapy in the kidneys an d legs, a field traditionally occupied by interventional radiologists and that was not performed at SCV until Dr. Sadeghi's arrival. In 2005 Dr. Sadeghi was appointed director of SCV's cardiac catheterization laboratory, or " cath lab." The cath lab consis ts of two suites dedicated to catheter-based interventional procedures sta ffed by nurses and tec hnicians trained in those therapies. Around the time he was appointed as direct or of the cath lab, Dr. Sadeghi and his partner, Dr. Mehran Moussavian, secured a c ontract that dramatically increased their business. Shortly after, Dr. Moussavian suffe red a personal loss, which further increased Dr. Sadeghi's workload. In late 2006, member s of the cath lab staff noticed changes in Dr. Sadeghi's behavior and ex pressed concern about the le ngth of time Dr. Sadeghi was taking to perform procedures. On February 22, 2007, Dr. Sadeghi began a procedure to attempt to save the leg of an 81-year-old patient who had refused am putation and was in unremitting pain from poor circulation. In addition to circulat ory disease, the patient suffered from numerous other life threatening illnesses. The patient and the patient's family were counseled by Dr. Sadeghi and Dr. Moussavian, and inte rnist Dr. Martha Lo zano, about the poor chances of the procedure's success, but the pa tient was steadfastly opposed to losing a leg and becoming a burden to the fa mily. Although initially sche duled to begin earlier, the4 procedure did not begin until 8:30 p.m. because of an unrelated problem with Dr. Sadeghi's medical record requ irements. The procedure wa s extraordinarily long and marked by numerous complications. As the surgery progressed past midnight and into the following day, the cath lab staff became increasingly concerned about Dr . Sadeghi's behavior, particularly his unwillingness to end the procedure and the patie nt's evident discomfo rt. On the morning of the second day of the procedure, the cath lab supervisor on du ty contacted the lab manager, who was on vacation at the time, an d also contacted hospital administration, including SCV's CEO Chris Bo yd. Throughout the morning, Boyd and other members of the administration came into the lab to addre ss the situation. Dr. Moussavian was also called to assist. The operation lasted 18 h ours, not ending until the afternoon of the second day. The patient pa ssed away a few days later. 2 As a result of the procedur e, SCV's chief of staff, Dr. Seung-Yil T. Song, initiated an investigation. Dr. Song requested a revi ew of the case by the hospital's endovascularmedicine chair, Dr. Walter Olsen, and intervie ws of the involved staff. Interviews of three staff members were conducted on Febr uary 27, 2007 by the hospital's cardiology director, Dr. Daniel Cepin, as well as a hum an resources representative and a member of the hospital's quality council. The three inte rviewees painted a picture of erratic and irrational behavior by Dr. Sadeghi. They described him criticizing other physicians and

2 After the patient's death, the family pr aised Dr. Sadeghi's efforts in following the patient's wishes and refused to participate in any proceeding agains t Dr. Sadeghi arising from the procedure.5 members of the staff and expressing his belief that they were out to get him. A lab technician described another patient, who had been scheduled for a procedure that day, being brought to the cath lab at Dr. Sadegh i's request near midnight, and Dr. Sadeghi asking the technician to film the patient talking about the long hours Dr. Sadeghi was working. On the evening of February 27, 2007, an informal meet ing was arranged with Drs. Sadeghi, Song, Cepin, Lozano, Moussavian a nd Dr. Errol Korn, the hospital's chair of internal medicine, to discuss the procedure. The other doctors urged Dr. Sadeghi to take time off to rest, but he responded that was not possible. Directly after the meeting with Dr. Sadeghi, the MEC met to discuss the incident. After reports from Dr. Cepin on the three staff interviews and Dr. Korn on the meeting with D r. Sadeghi, the MEC voted to summarily suspend Dr. Sa deghi's privileges. Dr. Sadeghi was notified of the suspensi on the following day by a hand-delivered letter. The letter stated the hospital's medical staff had begun an investigation as a result of the February 22, 2007 proc edure. The letter explai ned the MEC had significant concerns as a result of the investigation an d that the summary susp ension was necessary to protect the hospital's patients from what it viewed as imminent danger. The letter instructed Dr. Sadeghi to contact the hos pital's wellbeing committee immediately for evaluation and notified him of hi s right under the hospital's bylaws to request an informal hearing with the MEC within seven days. Dr. Sadeghi invoked this right and appear ed before the MEC at its March 6, 2007 meeting. At the meeting, Dr. Sadeghi apol ogized for his behavior during the February6 22, 2007 procedure. He adm itted he exercised less than optim al judgment with the staff and took full responsibility for the patient's ou tcome. He also discussed the personal and professional stressors in his life, including Dr. Moussavian's absence from their practice, family pressure, and an unh ealthy work environment, he believed were contributing factors to the incident. Dr. Sadeghi also stat ed he would never again become too close to a family in a way that clouded his medical judgment and said he would resign from the practice of medicine if he were ever involved in a similar incident. Dr. Sadeghi also reported he met with the wellbeing committee as directed and had complied with that committee's request for a psychiatric evaluation. He stated the psychiatrist told him there was no need for a follow-up appo intment. A member of the MEC reported that Dr. Sadeghi had been cl eared by the wellbeing committee, but the committee was not available to make a report that day. Th e MEC voted to terminate the summary suspension. Some me mbers expressed concern that the determination to lift the suspension was premature, but the MEC rejected a motion to table the decision until more information became available, includi ng a report from the wellbeing committee. On March 9, 2007, the MEC reconvened to follow up on the termination of Dr. Sadeghi's suspension. After discussion, the MEC voted to validate its decision to terminate the summary suspension, but added a condition th at Dr. Sadeghi be required to undergo a second evaluation by the psychiatrist with a wr itten report submitted to the wellbeing committee and the ME C. Counsel for SCV, Richard Barton, was present to advise the MEC on Dr. Sadeghi' s case. He informed the MEC that an outside review of the February 22, 2007 incident was also being undertaken and experts were being7 contacted to evaluate the matter. 3 Dr. Sadeghi was advised of the new condition to the termination of his suspension by hand-delivered letter from Dr. Song that day. On April 2, 2007, Dr. Song delivered a second letter re minding Dr. Sadeghi of the requirement he undergo another psychiatric evaluation. On April 30, 2007, Dr. Sadeghi wrote to Dr. Korn concerning the second psychiatric evaluation. Dr. Sa deghi explained he had seen th e psychiatrist a second time before the MEC's March 9, 2007 meeting and, based on his conversations with the members of the wellbeing committee, believed th is second visit satis fied the condition on the termination of his suspension. Dr. Sadegh i stated that after he received Dr. Song's April 2, 2007 letter, he spoke with the we llbeing committee which confirmed no further action on his part was necessary . Dr. Sadeghi also outlined a number of concerns he had about the manner in which the investigation was being conducted, including that key witnesses involved in the February 22, 2007 procedure we re not interviewed, the failure of a member of the MEC invo lved in a business dispute with Dr. Sadeghi to recuse himself from the suspension vo te, and the qualifications a nd methodology of the outside reviewers. Dr. Song and Dr. Korn re sponded to Dr. Sadeghi by letter dated May 10, 2007, reassuring Dr. Sadeghi the information cont ained in his letter would be taken into consideration by the MEC. Th e letter also advised Dr. Sadeghi that despite his statement

3 Dr. Olsen provided a written report of hi s review to Dr. Song on May 16, 2007, stating that on February 26, 2007, he inform ed the MEC an indepe ndent outside review was warranted.8 that he had visited th e psychiatrist two times, he was no t in compliance w ith the condition set by the MEC because he had failed to advi se the MEC of the sp ecific date on which the visit occurred or provide ve rifying documentation. The le tter explicitly stated that the failure to provide this info rmation would be "considered a violation of [Dr. Sadeghi's] responsibilities under the bylaws" of the hospital . The letter also notified Dr. Sadeghi that hospital employees had complained of harassment by him resulting from his inquiries concerning the hosp ital's investigation and direct ed Dr. Sadeghi to cease and desist all contact with hospital employe es related to the investigation. The reports of three outside physicia ns engaged by the MEC to review the February 22, 2007 procedure were issued on April 23, April 30 and May 11, 2007. All three reports were highly critical of Dr. Sadeghi's conduct. One stated "[t]his was a monumental failure of judgement and proced ural conduct" and the "case demonstrates one of the worst violations of patient safety standards I have ever seen in my professional life." The two other reports were equally scathing. After receipt of the outside reviewer s' reports, the MEC scheduled a special meeting for May 17, 2007. Dr. Sadeghi was informed of the meeting and invited to submit additional information in writing to th e MEC. He submitted a detailed letter the day of the meeting. In it, Dr. Sadeghi in dicated he had an upcoming appointment for a third visit with the psychiatrist to comply with the MEC's directive in the May 10, 2007 letter from Dr. Song and Dr. Korn. He also detailed his performance in the cath lab since the termination of his suspen sion, including the length of procedures. Dr. Sadeghi explained, with backup documentation, th e procedures he had conducted with above9 average completion times, includ ing one on May 15, 2007, that lasted over seven hours. The MEC was separately informed of the Ma y 15, 2007 case, and as a result Dr. Song asked Dr. Cepin to review the case and provide a report to the MEC. At the May 17 meeting, the committee memb ers were provided with the reports of the outside reviewers. D r. Cepin reported on both the May 15 case and additional interviews that had been conducted with me mbers of the cath lab staff involved in the February case. The MEC meeting minutes i ndicate grave concern over both the findings in the various reports and Dr. Sadeghi's psychological wellbeing, specifically his interaction with employees and his failure to comply with the MEC's directive to follow up with another psychiatric visit. The co mmittee voted, with the member Dr. Sadeghi identified as being in a business dispute w ith him abstaining, to immediately impose a summary suspension of all of Dr. Sadeghi's pr ivileges. The committ ee also voted to (1) direct Dr. Sadeghi to attend the Physician Assessment and Clinical Education (PACE) Program at the University of California, San Diego 4 for assessment of his clinical knowledge and judgment, (2) direct him to re frain from any conduct with staff that might be considered threatening, ha rassing or disruptive, and (3) use the outside reviewers to conduct a second, broader revi ew of Dr. Sadeghi's cases. Dr. Sadeghi exercised this right and anot her informal hearing was held on May 29, 2007. By this time, Dr. Sadeghi had reta ined counsel, David Rosenberg, and Rosenberg

4 The PACE Program evaluates physician s referred by hospitals or the California Medical Board. The Program includes eval uation of physician's clinical skills and knowledge, and also offers additional, more specific courses such as record keeping, ethics, prescription dispensi ng and anger management.10 was permitted to attend the hearing as an observer. Dr. Sadegh i and Rosenberg were provided with the reports of th e three outside reviewers in advance. At the hearing, Dr. Sadeghi submitted a report from a nother psychiatrist, Dr. Mark Kalish, who evaluated Dr. Sadeghi at Rosenberg's suggestion. Dr. Kalis h's report indicated he found no evidence that Dr. Sadeghi suffered from a diagnosable psychiatric illness. He recommended, however, that Dr. Sadeghi enroll in the PACE Program and particip ate in three to six months of psychotherapy to a ssist him in dealing with interpersonal issues and anger management. With respect to his failure to comply with the MEC's re quirement he be seen again by the first psychiatrist, Dr. Sadeghi again ex plained he met with the psychiatrist twice and had been told by the wellb eing committee that no further evaluation was necessary. Dr. Sadeghi also expressed disagreement wi th the outside reviewers and asked for the opportunity to provid e the MEC with literature supportin g his medical conduct during the February 22, 2007 procedure an d to address factual errors he perceived in the reports. Finally, Dr. Sadeghi stated he did not pose any risk of i mminent harm to patients and indicated his willingness to agree to psychoth erapy and to attend the PACE Program. After Dr. Sadeghi and his counsel were excused from the hearing, the MEC voted to continue its summary suspension of Dr. Sadeghi's interven tional cardiology and peripheral interventional privileges. It voted to terminate the suspen sion of Dr. Sadeghi's general medicine privileges if he satisfied four conditions: (1) submit to a proctoring program, (2) attend the PACE Program, (3 ) undergo psychotherapy for three to six months, and (4) abstain from conduct that might be considered hara ssment of the hospital11 staff. The MEC also agreed to use two of the outside reviewers to conduct a broader review of Dr. Sadeghi's practice. Dr. Sade ghi was informed of the MEC's decision by letter dated May 31, 2007, which also advise d Dr. Sadeghi of his right to demand a formal judicial review hearing under the ho spital's bylaws. Dr. Sadeghi invoked that right the same day. Shortly thereafter, Dr. Sadeghi also soug ht an injunction from the superior court requiring the hospital to reinst ate his interventional cardiology privileges. In addition to seeking an injunction, Dr. Sadeghi's comp laint included clai ms for intentional interference with contractual relations and pr ospective economic advantage, and a claim for "retaliation for reporting illegal conduct" a lleging the suspension of his privileges was reprisal for his reporting of medical billing fra ud. (Capitalization omitted.) Dr. Sadeghi's request for injunctive relief was denied for fa ilure to exhaust administrative remedies on July 8, 2007. 5 On June 29, 2007 Dr. Sadeghi was advise d by letter that the judicial review hearing would commence on July 9, 2007. The letter set fo rth the hospital's notice of

5 Dr. Sadeghi moves to augment the appella te record to include : (1) an April 2, 2008 letter from the hearing o fficer for the judicial review hearing to Barton and Dr. Sadeghi addressing briefing file d by Dr. Sadeghi; (2) an Apr il 18, 2008 letter brief from Barton to the hearing officer responding to the same briefing by Dr. Sadeghi; (3) the transcript from the January 25, 2010 judicial review hearing session; (4) pleadings related to Dr. Sadeghi's attempt to obta in an injunction; and (5) a se ries of documents concerning a second proceeding related to the MEC's later denial of reinstatement of Dr. Sadeghi's privileges that occurred after th e proceeding at issue here was concluded. SCV does not oppose the motion as to (1)-(4) and we grant the motion as to those documents. As to the documents related to the later procee ding, the motion is denied. (See Vons Companies, Inc. v. Seabest Foods, Inc. (1996) 14 Cal.4th 434, 444, fn . 3 [appellate court cannot augment record with informa tion concerning matters not be fore the superior court].)12 charges detailing the reasons for the MEC's acti ons on May 17 and May 29, 2007. It also identified five proposed members of the Ju dicial Review Committe e (JRC): Dr. David Ostrander, an interventional cardiologist like Dr. Sadeghi; Dr. Michael Plopper, a psychiatrist; Dr. David Hansen, an internist on the hospital's staff; Dr. Mark Huang, a cardiothoracic surgeon also on the hospita l's staff; and Dr. Mohsin Saeed, an interventional radiologist. A hearing offi cer for the proceeding, Carlo Coppo, was chosen jointly by Rose nberg and Barton. The hearing was convened on July 9, 2007, and counsel conducted voir dire of the JRC members. Prior to the start, Dr. Hans en was replaced by Dr. Marilyn Norton, an oncologist on the hospital's staff. At the conclusion of the voir dire, Dr. Sadeghi objected to Dr. Ostrander based on his prior relationshi p with Barton. Dr. Os trander had served as an expert consultant for Barton six year s earlier and worked with Barton when Dr. Ostrander served as the hospital's chief of staff. Coppo overruled the objection. As the judicial review h earing proceeded, the MEC recei ved the reports of the two outside reviewers asked to perform broader, re trospective reviews of Dr. Sadeghi's work. Both reviewers were again highly critical of Dr. Sadeghi's work and raised questions about his competence. Afte r receiving these reports, th e MEC amended its notice of charges. Dr. Song notified Dr. Sadeghi of the amendment by letter dated August 24, 2007, which added detailed charges based on the problems identified in the expanded reviews. The letter also added Dr. Sa deghi's failure to comply with the conditions imposed by the MEC in May, despite repeated assu rances from Rosenberg of Dr. Sadeghi's13 compliance, as an additional basis for the suspension. On September 4, 2007, the MEC reinstated the summary suspen sion of Dr. Sadeghi's general medicine privileges as a result of his failure to show compliance with the conditio ns set by the MEC on May 29, 2007. Dr. Sadeghi was notified by a letter the following day, and again advised of his right to an informal hearing. Dr. Sadeghi requested the informal hear ing and appeared with Rosenberg before the MEC on September 20, 2007. Rosenberg explicitly agreed to provide the MEC with confirmation of Dr. Sadeghi's enrollment in the PACE Program and expected completion date, as well as a report from Dr. Sadeghi's pr ivate therapist. An undated letter from Dr. Song to Dr. Sadeghi, but purportedly sent af ter the hearing, again amended the notice of charges. The letter states the informa tion promised by Rosenberg concerning Dr. Sadeghi's compliance with the MEC's conditions was not received. It also added a new charge of failure to comply with the MEC's directive to refrain from harassing behavior based on allegations of Dr. Sadeghi going into the cath lab to obtain information concerning the JRC hearing. At the start of the next judicial re view hearing session on September 25, 2007, Rosenberg challenged the makeup of the JRC, arguing the bylaws required at least three hospital staff members. Rosenberg also ob jected to the lack of an interventional cardiologist with experience in peripheral proc edures on the panel. In response, Barton argued there were only two members of the hos pital's staff because of the difficulty in finding doctors without a competing financial interest who also had experience in Dr. Sadeghi's medical specialty, as well as the medical staff's desire to have a panel member14 with psychiatric expertise who was not previous ly involved in the matter. With respect to the need for an inte rventional cardiologist with specif ic experience in peripheral procedures, Barton responded that it is a ra re and emerging subspecialty and the two subspecialties with crossover into the types of procedur es conducted by Dr. Sadeghi, interventional cardiologists and interventional radiologists, were represented by Drs. Ostrander and Saeed. The hearing officer overru led both objections and after opening statements, the evidentiary portion of the hear ing commenced. Six additiona l evidentiary sessions took place over the next several mont hs. On February 28, 2008, Dr. Sadeghi wrote to Coppo indicating he would no longe r be represented by Rosenberg and, citing Article VIII, Section 4.B of the hospital's bylaws, requesting the MEC discontinue its own representation. Coppo convened a conference call the fo llowing day with Dr. Sadeghi and Barton to discuss Dr. Sadeghi's reque st. During the call, Dr. Sa deghi stipulated to Barton's continued representation despite the fact that he would be re presenting himself, at least for the present. A letter fro m Coppo memorializing the call included a ruling the hearing would continue as sc heduled and Barton was permitted to continue his representation of the MEC. Dr. Sadeghi represented himself at the next hearing session, but Rosenberg resumed his representation thereafter. Five additional hearing sessions occurred in April, May and June, 2008. Then, on August 4, 2008, while the hearing was still ongoing, Dr. Sadeghi wrote to the hospital's new chief of staff, Dr. Jose A. Lira , and the members of the MEC15 requesting reinstatement of his privileges. Dr. Sadeghi stated he had been informed by the Medical Board of California (Medical Bo ard) that its investigation was over. Dr. Sadeghi also stated that although he ha d been informed by MEC members and Barton "that there were no issues with [his] competen cy and clinical expertise," he enrolled in the PACE Program and anticipat ed completion in four to six weeks. On August 11, 2008, Dr. Lira responded by letter that the MEC voted to take his request into consideration upon proof of his compliance with its earli er conditions, but that the judicial review hearing shou ld continue as scheduled. On August 8, 2008, Dr. Sa deghi sent an e-mail to Coppo advising he had retained additional counsel, Erin Muellenberg, and ha d asked Rosenberg not to work on the case pending the outcome of settlement negotiations with the MEC. The next month, the parties agreed to notify the J RC members they were working " 'on issues relevant to th[e] proceeding' " and further hearing dates were not expected until late October. Settlement negotiations proved unsuccessful and by March 2009, the MEC had voted not to reinstate Dr. Sadeghi's privileges and to resume the judicial review hearing. After some back and forth between the pa rties, in August 2 009 they agreed to continue the judicial review hearing and Co ppo began efforts to reconvene the JRC by contacting the panel members for their availab ility. In his communications with the panel members, Coppo stated that the JRC was "in a state of adjournment si nce [its] last session on June 4, 2008 [and] that the best efforts of the parties had not resu lted in a resolution of the matter. . . ." In resp onse to Coppo's communication, Dr. Ostrander indicated he would not be available until th e end of October 2009 and Dr. Norton was unwilling to16 commit to continued involvemen t. Coppo suggested proceedi ng with a reduced panel of three. By September 2009, Dr. Sadeghi an d the MEC agreed to this proposal and a hearing session was set for that month. Before hearings resumed, Muellenbe rg, who had taken over representing Dr. Sadeghi in the matter, raised the issue whether the MEC' s March 2009 denial of Dr. Sadeghi's request to be reinst ated should be considered by the JRC. On July 21, 2009, Muellenberg wrote to Barton re questing that, in addition to the determination of whether the 2007 suspension of Dr. Sadeghi's privileges was warran ted and reasonable, the JRC also decide "Dr. Sadeghi's continued medica l staff membership at Sharp." The MEC opposed this approach and sought to limit th e JRC to its initial charge of adjudicating whether the MEC's actions in 2007 were appropriate. The JRC reconvened on September 23, 20 09, with a second round of voir dire of the three remaining panel members. Eviden tiary hearing sessions resumed in November without a final resolution of th e scope of what the JRC would determine. On November 20, 2009, Muellenberg submitted a formal motion to Coppo re questing the JRC's determination of whether the summary susp ension imposed by the MEC was reasonable and warranted also include the MEC's March 2009 denial of Dr. Sadeghi's request for reinstatement. Coppo conclu ded the denial of reinstatement was "not relevant and, therefore, not admissible as evidence of whether or not the corrective actions taken against Dr. Sadeghi on Februa ry 26, May 17 and September [4], 2007 were reasonable and warranted." Coppo's letter ruling outlined his concern that "to include the denial of reappointment in the current proceedings would involve the addition of an unknown17 number of additional e xhibits and the testim ony of an unknown number of additional witnesses relating to" events that occurred su bsequent to the MEC's actions in 2007. Additional evidentiary hearing sessions continued throughout April with closing arguments on April 21, 2010. On May 26, 2010, the JRC issued its final decision. It concluded the MEC established by a prepond erance of evidence that its summary suspension of Dr. Sadeghi's privileges on May 17, 2007, a nd the modification of that action on May 29, 2007, were reasonable and warranted. The JRC's statement of decision outlines the facts upon which its deci sion was based with specific detail about Dr. Sadeghi's violation of the standard of care during the February 2007 event and Dr. Sadeghi's failure to rebut that evidence. Th e JRC also concluded the September 4, 2007 reinstatement of the summary suspension of Dr. Sadeghi's general medicine privileges was reasonable and warranted in light of Dr. Sadeghi's fa ilure to comp ly with the conditions imposed by the MEC for termination of the suspension. 6 Pursuant to the hospital's bylaws, Dr. Sa deghi appealed the fi ndings of the JRC to the hospital's board of directors, which appoin ted an appeal board to hear the matter. The appeal board received briefing from both parties and heard oral argument. It issued a written decision on July 22, 2010, affirming th e JRC. Dr. Sadeghi filed a petition for writ

6 The JRC did, however, note its concern re garding the tone of interactions between the MEC and Dr. Sadeghi. The decision sp ecifically pointed to the lack of communication among the members of the ME C and wellbeing committee to confirm Dr. Sadeghi's compliance with its directive that D r. Sadeghi see its psychiatrist twice, which it believed should have been a relatively easy matter to c onfirm without Dr. Sadeghi's involvement. The JRC noted this failure in communication potentially led Dr. Sadeghi to take a legal adversarial approach to the pr oceedings that he otherwise might not have taken.18 of mandate under Code of Civil Procedur e section 1094.5 seeking to void the JRC's decision. The trial court denied the petition and this appeal followed.
DISCUSSION Our review of JRC's decision, like that of the superior court, is governed by Code of Civil Procedure section 1094.5. Under subd ivision (b) of this provision, we determine "whether there was a fair tr ial," and "whether there wa s any prejudicial abuse of discretion." (Code Civ. Proc., §1094.5, subd. (b).) "Abuse of discretion is established if the respondent has not proceeded in the manner required by la w, the order or decision is not supported by the findings, or the findings are not supported by the evidence." ( Ibid .) Abuse of discretion established by the respon dent's failure to proceed in the manner required by law is prejudicial and warrants relief only where "the deviation is material." ( El-Attar v. Hollywood Pres byterian Medical Center (2013) 56 Cal.4th 976, 991.)
I. "Decisions concerning medical staff memb ership and privileges are made through a process of hospital peer review. Every licensed hospital is required to have an organized medical staff respons ible for the adequacy and qu ality of the medical care rendered to patients in the hospital. [Citati ons.] The medical st aff must adopt written bylaws 'which provide formal procedures fo r the evaluation of staff applications and credentials, appointments, reappointments, as signment of clinical privileges, appeals mechanisms and such other subjects or condi tions which the medical staff and governing body deem appropriate.' [Citations.] The me dical staff acts chiefl y through peer review committees, which, among othe r things, investigate compla ints about physicians and19 recommend whether staff privileges s hould be granted or renewed." ( Mileikowsky v. West Hills Hospital & Medical Center (2009) 45 Cal.4th 1259, 1267 ( Mileikowsky ).) The peer review process is codified at Busine ss and Professions Code section 809 et seq. 7 and is a part of the "comprehensive statutor y scheme for the licensure of California physicians" required to be included in the medical staff bylaws of acute care facilities. ( Mileikowsky, supra , 45 Cal.4th at p. 1267.) "The primary purpose of the peer review process is to protect the health and welfare of the people of California by excl uding through the peer review mechanism 'those healing arts practitioners who provid e substandard care or who engage in professional misconduct.' [Citation.]" ( Mileikowsky , supra , 45 Cal.4th at p. 1267.) "Another purpose, also if not equally important, is to protect competent practitioners from being barred from practice for arbitrary or discriminatory reasons. Thus, section 809 recites: 'Peer review, fairly conducte d, is essential to preserving the highest standards of medical practice' ([§ 809], s ubd. (a)(3)), but '[p]eer review that is not conducted fairly results in ha rm both to patients and heali ng arts practitioners by limiting access to care' ([§ 809], subd. (a )(4)). Peer review that is not conducted fairly and results in the unwarranted loss of a qualified physicia n's right or privilege to use a hospital's facilities deprives the physician of a prop erty interest direc tly connected to the physician's livelihood. [Citation.]" ( Ibid. ) However, "[n]ot every violation of a

7 All further statutory references are to the Business and Professions Code unless otherwise noted.20 hospital's internal procedures provides grounds for judicial intervention." ( El-Attar v. Hollywood Presbyterian Medical Center, supra , 56 Cal.4th at p. 990.) Because hospitals are under stringent repo rting requirements, th e denial of staff privileges can be severely detrimental to a physician's career. Section 805 requires hospitals to report the denial or revocation of privileges to the Medical Board, which maintains a historical record that includes this informati on. Further, hospitals are "usually required to report di sciplinary actions to the National Practitioner Data Bank, established for the purpose of tracking th e activities of incompet ent physicians." ( Mileikowsky , supra , 45 Cal.4th at p. 1268.) Denial or revocation of "privileges therefore may have the effect of ending the physician's career." ( Ibid .) With respect to private hospitals, lik e Sharp Chula Vista Medical Center, the physician's fair procedure rights "arise fro m section 809 et seq. and not from the due process clauses of the state and federal Constitutions." ( Kaiser Foundation Hospitals v. Superior Court (2005) 128 Cal.App.4th 85, 102.) These statutes "establish[] minimum protections for physicians subject to adve rse action in the peer review system." ( Mileikowsky, supra , 45 Cal.4th at p. 1268.) The statutory scheme requires hospitals to provide an affected physician both notice and the opportunity for a hearing when a peer review committee has recommended a "final pr oposed action" that must be reported to the Medical Board. (§§ 809.1, subds. (a ), (b), 809.3, subd. (b)(1), (2) & (3).) The hearing must be held "before a trier of fact" that, as determined by the peer review body, is either "an arbitrator or arbitrators selected by a process mutually acceptable to the licentiate and the peer review body" or "a panel of unbiased individuals21 . . . which shall include, where feasible, an i ndividual practicing the same specialty as the licentiate." (§ 809.2, subd. (a ).) During the hearing, both par ties have the right "[t]o call, examine, and cross-examine w itnesses" and "[t]o present a nd rebut evidence determined by the arbitrator or presiding officer to be re levant." (§ 809.3, su bd. (a)(3), (4).) "Upon the completion of a hearing . . . the licentiate and the peer re view body involved have the right to . . . [a] written decision of the trie r of fact, including findings of fact and a conclusion articulating the connection between the evidence produced at the hearing and the decision reached." (§ 809.4, subd. (a)(1).)
II. As he did in the trial court, Dr. Sadeghi argues he was denied fair procedure by the MEC, SCV's peer review body , in a number of ways. He contends (1) the JRC applied an improper standard by not addressing the ac tions of the MEC that occurred after 2007; (2) the JRC was improperly constituted; (3) Dr. Sadeghi was improperly precluded from communicating with potential witnesses; (4) his lack of representation for one of the hearing sessions was a violation of his rights; and (5) the length of time it took to reach a hearing and the extended length of the hearing constituted a denial of due process. We22 reject these contentions. 8
A. Dr. Sadeghi argues the peer review statut es, specifically secti on 809.3, subdivision (b)(3), required the JRC to determine whether the MEC's actions in 20 07 continued to be reasonable and warranted at the time of its decision in May 2010. Section 809.3 sets forth rights of the parties during a physicia n-requested hearing after a final decision by the hospital's peer review body . Subdivision (b)(3) states: "the peer review body shall bear the burden of persuading the trier of fa ct by a preponderance of the evidence that the action or recommendation is r easonable and warranted." (§ 809.3, subd. (b)(3).) Consistent with this provision, SCV's bylaw s provide "the Medica l Executive Committee shall bear the burden of pe rsuading the Judicial Review Committee, by a preponderance of the evidence, that its action or reco mmendation was reasonable and warranted." As Dr. Sadeghi points out, the bylaws use the phrase " was reasonable and warranted," while the statute uses the phrase " is reasonable and warranted." (Second italics added.) Dr. Sadeghi contends the Legisl ature's use of the word "is" evidenced its intent "that the peer review body bears the burden of esta blishing that the action or

8 We also reject Dr. Sadeghi's comparison of this case to Rosenblit v. Superior Court (1991) 231 Cal.App.3d 1434. None of the procedural problems at issue in Rosenblit that resulted in the court finding denial of fair process—lack of adequate notice of the charges against the physician, failure to provide the physicia n with documentation concerning his alleged malfeasance, a conclu sory verdict and voir di re of hearing panel members by only the hearing officer outside the presence of the physician—were present here. To the contrary, as discussed herein, Dr. Sadeghi was afforded fair process before and during the hearing as re quired by the hospital's bylaws and section 809 et seq.23 recommendation 'is reasonable and warranted' at the time of the hearing (i.e., the present) and not at the time the decision of th e peer review body [was ma de] (i.e., the past)." We disagree. The statutory scheme provides a mech anism for the licentiate to challenge a particular action of the peer review body. Section 809.1, subdivision (a) provides a physician with the right to written notice that includes "the right to request a hearing on the final proposed action." That provision de fines "final proposed action" as "the final decision or recommendation of the peer review body after informal investigatory activity or prehearing meetings, if any." (§ 809.1, subd. (a).) The hearin g required by section 809 et seq. is a safeguard to ensure the prior actions of a peer review body are justified. (See Mileikowsky, supra , 45 Cal.4th at pp. 1268-1269 ["A physician . . . has the right to have a second body of peers independently determine whether a peer review committee's recommendation . . . [was] reasonable and wa rranted . . . ."].) Nothing in these provisions contemplates an open-ended proceeding where the JRC subsumes the role of the MEC to determine, in the first instance, whether a physici an who has been previously sanctioned is later fit for reinstatement. In this case, Dr. Sadeghi was provided wi th notice of the final proposed action of the MEC (reinstatement of the summary su spension of Dr. Sadeghi's cardiology and interventional privileges) on May 31, 2007. He exercised his right to request a hearing that day. Based on the subseq uent actions of Dr. Sadeghi w ith respect to the conditions imposed by the MEC for termin ation of that suspension and additional information provided to the MEC by the outside reviewers, the MEC issued subsequent notices24 amending the initial charges on August 24, 2007 and Septembe r 5, 2007. At the time of the amendments, the JRC was at its initial stages. Coppo a llowed the inclusion of these new final proposed actions, including suspen sion of all of Dr. Sadeghi's privileges. 9 Under the bylaws and the peer review statut es, the JRC's role was to determine if the MEC's actions outlined in these notices was reasonabl e and warranted, not anything further. There was no mandate for the JRC to combine any later acti ons by the MEC into the ongoing proceeding. Any such action coul d be challenged in the same manner as the
MEC's 2007 actions. 10 Dr. Sadeghi also contends Coppo im properly precluded evidence about his conduct after September 2007. We disagree. Under both the relevant statutes and the hospital's bylaws, the hearing officer had au thority to make rulings concerning the relevance of the evidence. Section 809.3, subdivision (a)(4) provides that during the hearing both parties have the right to "present and rebut evidence determined by the . . . presiding officer to be relevant." Likewise , the bylaws provide: "The hearing officer

9 At the time the charges were amended, Dr. Sadeghi took the opposite position of that advanced here, arguing the hearing should pr oceed only with re spect to the initial notice of charges. Coppo allo wed the amended charges to be included in the proceeding conditioned on the first evidentiary hearing being postponed no mo re than 30 days.
10 In fact, Dr. Sadeghi's motion to take a dditional evidence in this court, which we deny, and his motion to augment indicate he has challenged the MEC' s subsequent denial of reinstatement of his privileges and a second judicial review hearing is underway. We note Dr. Sadeghi's allegation in his motion to take additional evidence that the MEC continued his privileges for six months at a time while the suspensi on was in place and the JRC proceeded. The SCV's bylaws, however, state clearly that "the terms of the summary suspension as sustained or as modi fied by the [MEC] shal l remain in effect pending a final decision thereon by the Govern ing Body[, either the JRC or SVC's appeal board]."25 shall be entitled to determine the order of or procedure for presenting evidence and argument during the hearing and shall have the authority and discretion to make all rulings on questions, whic h pertain to matters of law, pr ocedure or the admissibility of evidence." Since the JRC's charge was wh ether the MEC's actions in 2007 were reasonable and warranted, mitigating conduct by Dr. Sadeghi thereafter was irrelevant and could be appropriately excluded by Coppo. Additionally, much of the evidence Dr. Sadeghi complains was improperly excluded was actually admitted. For instance, Coppo explic itly permitted D r. Sadeghi to introduce evidence of his "p articipation in the UCSD PA CE Program . . . ." The administrative record includes both the certif icate of completion a nd assessment of Dr. Sadeghi's performance in the program, and D r. Sadeghi's and his wife's testimony about his participation in the program in 2008. Dr. Sadeghi and his wife also testified about the psychiatric treatment he recei ved after 2007, as well as the 2008 resolution of the accusation filed with the Medical Board. In sum, we find no denial of fair proced ure as a result of the JRC proceeding being confined to the MEC's 2007 actions or the exclusion of any evidence of mitigating conduct by Dr. Sadeghi after 2007.
B. Dr. Sadeghi argues the makeup of the JRC wa s defective in three respects: (1) the committee members were biased against him; (2) no member practic ed in his specialty; and (3) the panel had less than the requis ite three hospital staff members.26 Dr. Sadeghi asserts bias based on the fa ct that Barton, Boyd and Dr. Song made the initial contact with each member of the JRC and Bart on "outlin[ed] the case" to Dr. Ostrander. Under the hospital's bylaws, the MEC recommends a "Judicial Review Committee to the Board of Directors for appointment." The board then has the opportunity to object to the se lection of members or they are deemed approved. While the record does not address how the initial members were selected, the MEC was entitled to "the unilateral selection of [the] panel members and a hearing officer" subject to Dr. Sadeghi's right to voir dire. ( Kaiser Foundation Hospitals v. Superior Court, supra , 128 Cal.App.4th at p. 109; see also El-Attar v. Hollywood Presbyterian Medical Center,

supra , 56 Cal.4th at p. 996 ["In the admini strative law context, an adjudicator's impartiality in reviewing the propriety of an adverse action taken by an agency may be presumed even if the adjudicator is chos en by, and is a memb er of, the agency prosecuting the matter."].) Further, the questioning during voir dire revealed nothing improper about the initial communications with the panel members, which were necessary to assemble the JRC. For instance, when aske d "how did you first hear abou t this case," Dr. Ostrander responded the "[f]irst time I heard there wa s a JRC was from Mr. Barton. He called and asked if I would participate as a member. [¶] . . . [¶ ] He asked if I w ould be willing to sit on a panel and gave a very brie f thumbnail sketch of the el ements of the case." We do not find anything improper in the MEC's se lection of the JRC members or its initial contacts with them.27 Dr. Sadeghi next argues the panel was defective because it did not include "an interventional cardiologist with experience in lower extrem ity intervention." Section 809.2, subdivision (a) states "[ t]he hearing shall be held, as determined by the peer review body, before a trier of fact, which shall be . . . before a panel of unbiased individuals who shall gain no direct financ ial benefit from the outcome, who have not acted as an accuser, investigator, factfinder, or initial decisionmaker in the same matter, and which shall include, where feasible , an individual practicing the same specialty as the licentiate." (Italics added.) The hospital's bylaws model th is statute, providing that "[m]embership on a Judicial Review Committee shall, where feasible , include an individual practicing the same specialty as the member." (Italics added.) When the JRC was initially empanelled, it included an interventional cardiologist, Dr. Ostrander, who Dr. Sadeghi describes as similar to himself, and an interventional radiologist, Dr. Saeed. Wh en the JRC reconvened in Se ptember 2009, Dr. Sadeghi stipulated to the reduced pane l without Dr. Ostrander and did not request he be replaced with another interventional cardiologist. Further, Dr. Sadeghi explained during the hearing that his practice involved a crossove r of these two specia lties. In fact, Dr. Sadeghi testified his own practice had an ag reement with the hospital's radiology group that if there were complications with proc edures involving the lower extremities, an interventional radiologist would be called to assist. In light of Dr. Sadeghi's testimony concerning the involvement of both specialties in lower extr emity procedures, we reject his contention that the panel did not in clude a specialist in his practice area.28 We also reject Dr. Sadeghi's argument that the panel was improperly constituted because it contained only two members of th e hospital's medical st aff. The hospital's bylaws state the JRC "shall be composed of not less than three members of the Medical Staff who are not in direct economic compe tition with the membe r[] who requested the hearing, who shall gain no di rect financial benefit from th e outcome, who have not acted as accuser, investigator, fact finder, in itial decision maker or otherwise have not . . . actively participated in the cons ideration of the matte r leading up to the recommendation or action." As with the physic ian's specialty, if "it is not feasible to appoint[] a [JRC] from the active Medical Staff, the Medical Executive Committee may appoint members from other staff categories or practitioners who are not members of the Medical Staff." When Dr. Sadeghi challenged the makeup of the panel at the hearing, Barton argued it was not feasible for the panel to in clude three members of the hospital's medical staff because of the need to include an invasive cardiologist who was not in economic competition with Dr. Sadeghi. Barton stated the "medical staff does not encompass enough people where the claim couldn't be made that somebody fro m invasive cardiology here wouldn't be in direct competition with Dr. Sadeghi . . . ." Barton further argued the MEC wanted the JRC to also in clude an interventional radiol ogist and a psychiatrist, both of which also needed to come from outside the hospital. As with the invasive cardiologist, an outside interventional radi ologist was necessary because of economic competition with Dr. Sadeghi. An outside psychiatrist was needed because those on the medical staff were involved in Dr. Sadeghi's case in some way. Dr. Sadeghi did not29 dispute these assertions. In light of these fa cts, we conclude the hearing officer's decision to deny Dr. Sadeghi's request to include anot her member of the hosp ital staff was within the limitations imposed by se ction 809.2, subdivision (a) and the hospital's bylaws.
C. On September 21, 2007, Co ppo issued an order prec luding Dr. Sadeghi from any "further ex parte communications, either ora lly, by e-mail, by fax, or by ordinary mail, with the Hearing Officer, Mr. Barton, Sharp Chula Vista Medical Staff, the Sharp Chula Vista Medical Executive Committee, employees, agents and ancillary personnel of Sharp Chula Vista Hospital, on any matter relating to the Notice of Charges which frames the issues to be tried in this Judicial Review proceeding." Dr. Sadeghi contends there was no basis for Coppo to issue this order and that it prevented him from preparing an adequate defense in violation of his right to fair process. We disagree. Dr. Sadeghi correctly asserts a fair heari ng "requires that the doctor be given a full and fair opportunity to examine and collect evidence and prepare his case for the hearing." (See Rosenblit v. Superior Court, supra , 231 Cal.App.3d at p. 1445 [in drafting its peer review procedure, the organizati on should "insure a fair opportunity for an applicant to present his position"], italics omitte d.) As discussed, the physician's right to fair procedure arises from the statutory peer review scheme. ( Kaiser Foundation Hospitals v. Superior Court, supra , 128 Cal.App.4th at p. 1 02.) While no particular statutory provision addresses the physician's right to communicate directly with potential witnesses, two provisions address the ability to present a defense. Section 809.2, subdivision (d) provides the licentiate "the right to insp ect and copy . . . any documentary30 information relevant to the charges which th e peer review body has in its possession or under its control. . . ." This right, however, is limited. "The . . . presiding officer shall consider and rule upon any request for acce ss to information, and may impose any safeguards the protection of the peer review proc ess and justice requires." (§ 809.2, subd. (d).) Section 809.3, subdivisio n (a)(3) gives the parties the ri ght to "call, examine, and cross examine witnesses." The discovery rights afforded by these statutes are "not as broad as a civil discovery standard." ( Unnamed Physician v. Board of Trustees (2001) 93 Cal.App.4th 607, 627.) The September 21, 2007 order was precip itated by complaints from hospital staff about communications by Dr. Sadeghi that we re perceived as harassing, Dr. Sadeghi's intrusions into the hospital's medical records department, and Dr. Sadeghi's direct written communication with Coppo. In light of thes e events, we find Coppo's order appropriate and within his right to "impos e any safeguards" to protect the peer review process. (§ 809.2, subd. (d).) The order applied to Dr. Sadeghi individually, not his counsel, and was not an obstacle to Rosenberg's or Muellenberg's ability to obtain evidence or call
witnesses. 11 It did not, therefore, violate any procedural right created by the statutory peer review system or prejudice Dr. Sade ghi's ability to present his defense.
D. As discussed, on February 28, 2008, Dr. Sadeghi wrote to Coppo to state he would no longer be represented by Rosenberg and to request the MEC lik ewise proceed without

11 The record also s hows that at the point Dr. Sadegh i decided to represent himself, Coppo reconsidered the contact limiting order.31 representation. The followin g day, Coppo convened a conf erence call with Dr. Sadeghi and Barton to discuss this request. During the call, Dr. Sadeghi stipulated to Barton's continued representation of the MEC. Dr. Sa deghi represented himself at one session. Thereafter Rosenberg resumed his re presentation of Dr. Sadeghi. Despite these facts, Dr. Sadeghi now c ontends the one hearing session (out of more than 35) in which he was not represen ted violated a fair pr ocess right created by section 809.3, subdivision (c) and the hospital's bylaws. 12 We do not ag ree. The record is clear Dr. Sadeghi agreed to the MEC proceeding with representation and this alone obviates his complaint. (See Anton v. San Antonio Community Hospital (1977) 19 Cal.3d 802, 826 [failure of physician to raise object ion before the panel or at later hospital appellate review hearing constituted waiver].)
E. Dr. Sadeghi argues the JRC was not comme nced within 60 days as mandated by section 809.2, subdivision (h) and Article VIII, Section 3.C of the hospital's bylaws. 13 This argument was appropriately rejected by the superior court. Dr. Sadeghi first

12 Section 809.3, subdivision (c) require s the peer review bo dy to "adopt written provisions governing whether a licentiate shall have the option of being represented by an attorney at the licentiate's expe nse." It further provides "[ n]o peer review body shall be represented by an attorney if th e licentiate is not so represen ted . . . ." (§ 809.3, subd. (c).) Article VIII, Section 4.B of the hospita l's bylaws provides the medical staff member is "entitled to representation by legal counsel in any phase of the hearing by an attorney at law" and that the "Medical Executive Committee shall not be represented by an attorney at law if the member is not so represented."
13 Although Dr. Sadeghi refers to 60 days as the relevant time limit, the hospital's bylaws require the hearing to be commenced w ithin 45 days if a su mmary suspension is involved.32 exercised his right to a formal hearing on May 31, 2007. The hearing commenced 40 days later with voir dire of the JRC memb ers on July 9, 2007, within the required timeframe. Dr. Sadeghi argues Code of Civil Procedure, section 581, subdivision (a)(6), which defines commencement of a trial as the beginning of opening statements or the examination of the first witness, applies. According to Dr. Sadeghi, therefore, the hearing did not commence until the first witne ss was called on Sept ember 25, 2007. Dr. Sadeghi provides no support for this contenti on. We decline to impose a definition set forth in the Code of Civil Procedure on the medical peer review system. Dr. Sadeghi also contends the hearing was not completed within a reasonable time and Coppo granted continuan ces without good cause as re quired by section 809.2, subdivision (h). Dr. Sadeghi a sserts that throughout the thr ee-year ordeal he was pressing to move the hearing forward while the MEC and its counsel frustrated those efforts. While there is no question the hearing took an inordinate amount of time, the record does not corroborate Dr. Sadeghi's account of the delay. Most notably, a 15-month break in the pr oceedings, from June 2008 to September 2009, resulted from Dr. Sadeghi's own course of action. Specifically, after 15 hearing sessions, Dr. Sadeghi retained new counsel a nd changed strategy. After cancellation of the hearing session scheduled fo r June 23, 2008, despite C oppo's repeated requests for additional hearing dates, Mue llenberg failed to pr ovide dates for the summer of 2008. Instead, on August 4, 2008 , Dr. Sadeghi sent a letter to the MEC requesting reinstatement. Thereafter, Dr. Sadeghi agre ed to adjourn proceed ings while the MEC considered his request. After the MEC declined to reinstate Dr. Sadeghi,33 communications among counsel, the hearing officer and the panel members concerning the reconstitution of the JRC occurred through the summer of 2009. By the parties' agreement, the judicial re view hearing finally resumed on September 23, 2009. Also contrary to Dr. Sadeghi's assertions , the record relating to the scheduling of hearings before and after the interim adjour nment shows cooperation among all parties to move the proceedings forward as quickly as possible. The one 30-day continuance granted in August 2007 was ba sed on a showing of good caus e and was granted only after briefing and oral argument. Hearing dates were otherwise set based on the parties' agreement. The pace of th e proceedings was understa ndably constrained by the schedules of the five panel members, all bus y practicing physicians, the hearing officer, counsel for both sides, and 21 pe rcipient and expert witnesses. Despite these constraints, Coppo worked diligently to advance the case. In light of these facts, we find no denial of Dr. Sadeghi' s right to have the charges adjudicated within a reasonable amount of time.
III. Finally, Dr. Sadeghi contends insufficien t evidence supported the JRC's finding that the suspension of his pr ivileges "as of the time of the JRC decision" was reasonable and warranted. He argues had he been able to present evidence concerning his technical ability, mental wellbeing and fulfillment of th e requirements imposed by the MEC after his privileges were suspended, the MEC could not have sustained its burden of proof. We reject this hypothetical. As discu ssed, the JRC was charged with determining whether the MEC's decisions in 2007 were reasonable and warranted at the time they34 were made. Dr. Sadeghi does not contend in sufficient evidence supported those findings. Further, after our independent review of the record, we conclude the JRC's findings were supported by substan tial evidence.
DISPOSITION The order is affirmed. Each party to bear its own costs.

HALLER, J. WE CONCUR:

HUFFMAN, Acting P. J.

IRION, J.