IN THE COURT OF APPEALS OF THE STATE OF MISSISSIPPI
NO. 2014-CA-00421-COA MICHAEL C. MOLLESTON, M.D. APPELLANT

v. RIVER OAKS HOSPITAL, INC., RIVER OAKS HEALTH SYSTEM D/B/A RIVER OAKS EAST APPELLEE

DATE OF JUDGMENT: 03/11/2014 TRIAL JUDGE: HON. W ILLIAM R. BARNETT COURT FROM W HICH APPEALED: RANKIN COUNTY CHANCERY COURT ATTORNEYS FOR APPELLANT: W H ITMAN B. JOHNSON III GAINES SPENCER BEARD JR. ATTORNEYS FOR APPELLEE: THOMAS L. KIRKLAND JR. ANDY LOW RY NATURE OF THE CASE: CIVIL - OTHER TRIAL COURT DISPOSITION: AFFIRMED APPELLEE’S DECISION TO DENY APPELLANT’S APPLICATION FOR MEDICAL-STAFF PRIVILEGES DISPOSITION: REVERSED AND REMANDED - 11/10/2015 MOTION FOR REHEARING FILED: MANDATE ISSUED: BEFORE LEE, C.J., CARLTON AND MAX WELL, JJ. CARLTON, J., FOR THE COURT: ¶1. Dr. Michael Molleston appeals River Oaks Hospital' s decision to deny his application
f or m edical-staf

f p rivileges. W e f

ind that River O aks violated Dr. Molleston’s due-process

r i ghts and its own by laws when it allowed a phy sician to actively participate in two stages
of the adm inistrative process. W e theref ore reverse the Rankin Count y Chancery Court’s judgm ent and rem and this case f or f urther proceedings consistent with this opinion.
FACTS¶2. Dr. Molleston, a neurosurgeo n , h a s p r a c t i c e d i n M i s s i s s i p p i s i n c e 1995. He

m aintained a private practice in Hattiesburg, Mississippi, and he was the neurosurgeon f or the University of Southern Mississi p p i f ootball team

. In 2011, Dr. Molleston decided to

m ove to Jackson. He successf ully applied f

or m edical-staf

f privileges at Central Mississippi
Medical Center. ¶3. Dr. Molleston also applied f or m edical-staf

f privileges at River Oaks on Septem ber
1 2 , 2011. On Novem

ber 7 , 2011, the Credentials Com m ittee of River Oaks m e t a n d
reviewed Dr. Molleston' s a pplication. T he r ecord ref lects that the Credentials Com m ittee

was com posed of the f

ollowing: D r. Bush, Com m ittee Chair; Dr. Davis; Dr. K even Vance;
D r
. W i l l i a m M c C raney ; Cindy Dishongh, Chief Operating Of f icer of Business Develop m e n t ; Shannon Brown, C hief O perating Of f icer; S herr y C o o k , Chief Nursing Of f icer; Rebecca
W i l s o n , M e d i c a l Staf

f Manager; Tam m y Chappell, Credentialing S pecialist ; a n d D a p G u n t e r , P1 Analy st. ¶4. According to the m inutes of that me e t i n g , D r
. W i l l i a m G

. B u s h c h a i r ed the
Credentials Com m ittee. Three other phy sicians attended t he m eeting, one of whom was Dr.
John Davis, a neurosurgeon. During the m eeting, Dr. Davis i nf orm ed t he Credenti als
Com m i ttee that v arious def ense attorney s and/or worker’s com pensation c arriers had previously asked him or one o f his partners to p r o v i d e s e c ond opinions regarding patients
whom Dr. Molleston had treated. Dr. Davis explained t hat af ter h i s p a s t experience of reviewing D r
. M o lleston’s patient records, he questioned Dr. Molleston’s clinical
decision-m aking in f

ive dif f erent patient cases. The Credentials Com m ittee tabled Dr.

2Molleston' s application without reaching any decision over its concerns about the privileged

nature of the m e dical inf

orm ation they

had received f

rom Dr. Davis. ¶5. The Credentials Com m ittee m et again on D e c e mb e r 5 , 2 0 1 1 , a n d d e c i d e d to

recom m end deny ing Dr. Molleston' s application f or m edical-staf

f privileges
based on concern f

or the best interest and w elf are of patients. T h i s decision was m ade due to questionable c om petency and judgm e nt, specif ically r elated to a h i s tory of p r oposing and/or perf o rm ing surgical procedures based on patient treatm ent recom m endations n otsupported af ter second neurological opinion, as well as applicant' s i n terpretations o f radiological f ilm s t hat conf

lict with Radiologists' determ inations.
The m inutes f

rom that m eeting show that Dr. Bush again chaired the Com m ittee m eeting. ¶6. The Medical Executive Com m ittee m et on Decem ber 9 , 2 0 1 1 , a n d a pproved the
Credentials Com m ittee' s decision to deny Dr. M olleston’s application. The Medical
Executive Com m ittee Mem bers p r esent a t the hearing were: Dr. Steven Patterson, Dr. Davis,
Dr. Steven Choteau, Dr. David W ender, Dr. Barry McCay , Dr. J ack Moriarity , Chief Nursing
Of f icer S herry Cook, Vicki Stribling (Risk Manager), Jan Shannon ( D i r e c t or of Quality ),
Reb e cca W ilson (Medical Staf f Manager), Dr. Missy McMinn, D r. David W estbrook, Dr.
Ron Cannon, Dr. David Carroll, Dr. Jam es O’Mara, Denny Bruns (Chief Executive Of f icer), Cindy Dishongh (Chief Operating Of f i cer/Business Developm ent), Bob Newton (Vice
President of

Surgical Services), and Shannon Brown (Chief Operating Of

f icer). ¶7. Once Dr. Molleston r eceived notice of t he Medical Executive Com m ittee' s decision

to adopt the Credentials Com m ittee' s recom m endation that his a pplication f

o r m edical-staf

f privileges be denied, he requested a hearing bef ore the Fair Hearing Plan Com m ittee at River

3O a k s
. 1 D r. Molleston received notice f rom the President a nd CEO of River Oaks that t h e hearing would com

ply with River Oaks’s By laws, specif i cally Article 15 of the Fair Hearing Plan, and Dr. W alter S helton would chair the f ive-person c o m m ittee. This letter s pecif ically
stated that the h e aring would b e held according to Article 15 of the Fair Hearing Plan in the
Medical Staf

f By l aws of River Oaks. Dr. Molleston was also inf orm ed t hat Dr. Bush would "present the case to support the adverse recom m endation" by t he Credentials Com m ittee, 2
and Dr. Davis would testif y a bout his disagreem ents w ith Dr. Molleston' s clinical decisions
in " various cases" at the F air Hearing Plan Com m ittee Meeting. However, despite requests
f or discovery by Dr. Molleston, he was not inf orm ed about t he “ various cases” that D r. Davis planned to discuss. ¶8. The Fair Hearing Plan C om m ittee convened on May 2, 2012, to hear Dr. Molleston' s appeal. At the hearing, Dr. Bush delegated to Dr. Davis the task of presenting t he case on behalf o f t he Medical Executive Com m ittee to s upport its d ecision to deny Dr. Molleston' s application. As stated, Dr. Bush and Dr. D avis s e rved o n t h e Credentials C o m m ittee that

recom m ended deny ing Dr. Molleston’s application. Dr. Bush rem ained in attendance during the hearing. ¶9. During the hearing, Dr. Molleston' s counsel objected to the f act that R iver Oaks f

ailed

1 A rticle 1 5 .1 .1 o f th e B y l aw s p ro v id es th at if “an y in d iv id u al rec e i v e s n o t i c e o f a reco m m en d atio n o f th e M ed ical E x ecu tiv e C o m m ittee t h at, i f r atif ied b y th e d ecisio n o f th e B o ard o f T r u s t e e s , w ill ad v ersely af f ect [ h is] a p p o in tm en t to o r statu s as a m em b er o f th e M ed ical S taf

f o r [ h is] ex ercise o f clin ical p riv ileg es[ ,] ” th en th at i n d iv i d u al is en titled to a h earin g b ef

o re a h earin g co mmittee o f th e m ed ical staf f , ref erred to h erein as th e F air H e arin g P lan C o m

m ittee.

2 S ee A rticle 1 5

. 5

. 8 o f th e B y law s. 4to d isclose the patient records and scans that Dr. Davis subm itted to support the Credentials

Com m i ttee’s recom m endation. A s a result, the hearing was postpon e d

. W hen the Fair Hearing Plan Com m ittee m et again on Novem ber 5, 2011, Dr. Shelton again p r e s i d e d as chairperson of the Fair H earing P lan C om m ittee and Drs. Bush and Davis both attended. The By laws e stablish that a m em ber of the Credentials Com m i ttee c ould provide support f or its
adverse recom m endation to t he Fair Hearing P lan Com m ittee, and the By law s f urther
establish that no s t af

f m em ber o r b o a r d m em

ber w h o participated in the adverse

com m endation could be a m em ber of the Fair H earing Plan Com m i ttee. The Fair Hearing
Plan C om m i ttee voted to af f irm the d ecision by the Medical Executive Com m ittee, thereby
d eny ing Dr. Molleston' s application f or m edical-staf

f privileges to River Oaks Hospital

. Signif icant to our decision on appeal, t h e mi n u t e s of t he Fair Hearing Plan Com m ittee
h e a r i n g r e f lect that D r. B ush participated in the com m ittee’s deliberations, vote, and d e c i s i o n
. ¶10. Dr. Molleston appealed to River Oaks’s B oard of Trustees. The Board m et o n January 16, 2013, and took the m a tter under advisem ent. On F ebruary 11, 2013, the B oard af f irm ed
the decision by t he Medical Executive Com m ittee and Fair Hearing Plan C om m ittee to deny Dr. Molleston’s application. ¶11. Then, o n April 8 , 2013, Dr. Molleston f iled an appeal in the chancery c ourt. Af ter
oral argum ent, t he chancellor entered an o rder af f irm ing River Oaks' s decision on March 11, 2014, f i nding "River Oaks Hospital af f orded [ D r. Molleston] s ubstantial com pliance with its by laws and procedural d u e process" and that "the decision of the A ppellee' s Board of Trustees was not arbitrary , capricious or unreasonable." This appeal f ollowed.

5¶12. Now on a ppeal bef o re this Court, Dr. Molleston again asserts that River Oaks violated
his due process rights, a s guaranteed by b oth its own by laws a nd com m o n law in t wo way s by : (1) a llowing a board m em ber who actively participated i n the decision to deny Dr.
Molleston privileges to then serve as a deliberating and voting m em ber of the F air Hearing
Plan C om m i ttee, a nd (2) allowing the chairm an of the F air H earing Plan Com m ittee to be a

m em ber of a private p r actice th a t w a s i n direct econom ic com p etition with Dr. Molleston.
Dr. Molleston also argues that River Oaks' s reasons f or deny ing his application f or m edicalstaf f p rivilege s f

a i l e d to com

ply with Mississippi C ode Annotated s ection 73-25-83 (Rev. 2012). 3

3 S ectio n 7 3 -2 5 -8 3 p ro v i d es:
T h e b o ard sh all h av e au th o rity to d en y an ap p licatio n f o r licen su re o r o th er au th o rizatio n to p r a ctice m ed icin e in th is state an d to d iscip lin e a p h y sician licen sed o r o th erw ise law f u lly p racticin g w ith in th i s state w h o , af ter a h earin g , h as b een a d

j u d g ed b y th e b o a rd as u n q u alif ied d u e to o n e o r m o re o f th e f o llo w in g reaso n s: (a) U n p ro f

e ssiona l co n d u ct as d ef

in ed i n th e p h y sician licen su re an d d i scip lin ary

law s, p u rsu an t to S ectio n 7 3 -2 5 -2 9 ; (b ) P ro f ess i o n a l in c o m

p eten cy in th e p r actice o f m ed icin e o r su rg ery ; o r (c) H av in g d iscip lin ary actio n tak en b y h is p eers w ith in an y p r o f e ssio n al m ed ical asso ciatio n o r so ciety , w h eth er an y su ch asso ciatio n o r so ciety is lo cal, reg io n al, state o r n a t i o n al in sco p e, o r b ei n g d iscip lin e d b y a licen sed h o sp ital o r m ed ical staf f o f said h o sp ital, o r th e v o lu n tary su rren d er o r restrictio n o f h o sp i tal s taf

f p r i v i leg es w h ile an in v e stig atio n o r d iscip lin ary p ro c eed in g is b ein g co n d u cted b y a licen sed h o sp ital o r m ed ical staf f o r m ed ical staf

f co m m it t e e o f said h o sp i tal. P ro v id ed f u rth er, a n y

b o d y tak in g actio n a s set f o rth i n t h is p arag rap h sh all rep o rt su c h actio n to th e b o ard w ith in th irty (3 0 ) d ay s o f
6STANDARD OF REVIEW

¶13. J urisprudence and statutory law provides great discretio n t o h o s p i t a l b o a r d s i n determ ining the m oral com m it m ent and com petence of i ts staf

f when considering whether

to accept applications f

or s taf f privileges. See Som v. Bd. of Trs. of Natchez Reg’l Med. Ctr. , 98 So. 3d 500, 502-03 (¶8) (Miss. Ct. App. 2012. Section 73-25-93(1) states that [ a]ny hospital licensed pursuant t o S ections 4 1-9-1 et s eq. is authorized to suspend, deny , revoke o r li mi t t h e hospital privileges of any p hy sician practicing or a

pply ing to pra c t i c e t herein, if the governing board o f such hospital, af

ter consultation with the m edical staf f considers such p hy sician to be unqual i f

i e d b e c a u se of any of the acts set f orth in S ection 73-25-83; provided, however, that the procedures f or such actions shall com

ply with the hospital and/or m edical staf f by law requirem e nts f

or due process. ¶14. W e acknowledge that “[ t ]he legislatu r e h a s c l e a r l y lim ited j udicial surveillance of hospital disciplinary proceedings[ , including decisions t o grant, revoke, or suspend m edical
staf f p r ivileges,] t o t he narrow i nquiry of whether t he hospital com plied with the p rocedural due-process requirem ents prescribed by its own by laws.” W arnick v. Natchez Cmty. Hosp.,
Inc ., 904 So. 2d 1019, 1022 (¶11) (Miss. 2004) (citing W ong v. Garden Park Cmty. Hosp ., Inc., 565 So. 2d 550, 5 51 (Miss. 1990)). “The f undam e ntal requirem ent of due process is the opportunity to be heard ‘at a m eaningf ul tim e and in a m eaningf ul m a n n e r
. ’ ” Id. at (¶14) (citing M athews v. Eldridge , 424 U .S. 3 19, 333 (1976)). Moreover, o ur review is l im ited to
the record established bef ore the hospital. See W

ong v. Stripling , 881 F.2d 200, 202 (5th Cir. 1989). ¶15. This Court has recognized that when reviewing a hospital' s decision to lim it a doctor' s

its o ccu rren ce. 7privileges:

No court should substitute its evaluation of such m atters f or that of the hospital board. It is the board, not the court, which is charged with the responsibility of p roviding a com

petent staf

f of doctors. T he board h as chosen to rely on the advice of i ts m edical staf f , and the co urt cannot surrogate f or the Staf

f in exe c u t i n g this responsibility

. Hum a n lives are at s take, and the governing board m ust be given discretion in its selection so t hat it can have conf idence in the com

petence and m oral com m itm en t o f i ts staf f

. The evaluation of prof essional prof

iciency of doctors is best lef

t to the specialized e xpertise of their peers, subject only to lim ited j udicial s urveillance. The court is charged with the narrow r e sponsibility of assuring that the qualif ications im

posed by the board are reasonabl y r e l a t e d to the o peration of t he hospital and f a irly adm inistered. In short, so long as staf f s e lections are a d m inistered with f airness, geared by a rationale com p atible with hos p i tal responsibility , and unencum bered with irrelevant considerations, a court should not interf e re.
Som , 98 So. 3d at 502-03 (¶8) (citations om itted).
DISCUSSION ¶16. According to Dr. M olleston, River Oaks violated i ts own by laws and his due-process rights when Dr. Bush actively particpated in the Credentials Com m ittee’s decision to deny
his application, and then served as a deliberating and voting m em ber of the Fair Hearing Plan
Com m i ttee. Dr. M olleston also argues that R iver Oaks’s reason f o r deny ing his application
f ails to com

ply with section 73-25-93(1). Finally , Dr. Molleston alleges that River Oaks’s
decision should be r eversed because the chairm an o f the Fair Hearing Plan Com m ittee, Dr. Shelton, was a d irect econom ic com p e t i t o r. 4 W e will address o nly the dispositive issue of

4 A cco r d in g to D r. M o llesto n , s u b seq u en t to th e h earin g , h e l earn ed th at D r
. S h elto n , th e ch a irp erso n o f th e F air H e a r i n g P l an C o m m ittee, w o rk ed w i th a m e d i cal g ro u p w h o recen tly h ired a f ello w s h ip -train ed sp in al su rg eo n w h o p erf o rm ed s u rg eries sim ilar to th at o f D r. M o llesto n
. A s a resu lt, D r. M o llesto n claim s th at D r
. S h elto n ’ s g ro u p p ractice p laced h im in d irect eco n o m ic co m p etitio n w ith D r. M o l lesto n , a n d th u s d isq u alif ied h im a s a b o a rd
m em b er. D r
. M o llesto n p r o v id es th at D r. S h elto n f ailed to d isclo s e th is in f

o r m atio n at th e h earin g , th eref

o re D r. M o llesto n w as u n a w are o f t h i s a lleg e d co n f lict. H en ce, D r. M o llesto n 8whether R iver Oaks f a iled to com

ply with its own By law requirem ents due to D r. Bush’s participation in both the adverse credentialing r e c o m m endation and in t he subsequent
decision of

the Fair Hearing Plan Com m ittee. ¶17. The review hearing procedures established by the B y laws f or the review of

adverse credentialing recom m endations disqualif ied Dr. Bush f

rom participating in the deliberation
and decision of the Fair Hearing Plan Com m i ttee since he participated i n t he initial adverse credentialing r ecom m endation. 5 Dr. Bush’s participation in the deliberation and d ecision of
the Fair Hearin g P l a n C o mmittee violated the procedures established by River Oaks i n its

own By laws to provide f

or a f air review of an adverse recom m endation of an application f or

m edical-staf

f privileges. Mississippi Code Annotated sections 41-9-1 (Supp. 2 014) and 73-
25-93 authorize hospitals to deny h o s p i t a l privileges to a n y phy sician considered to be unqualif ied, so long as the hospital f ollows its own by laws. ¶18. Article 15.1.3 of the By laws states that “ a l l h e a r ings and appellate r eviews shall be
in a ccordance w ith t he procedural saf eguards set f

orth in this Article to assure that the
af f ected i ndividual is accorded all rights to w hich [ he] i s entitled.” As stated, our judicial
review is lim i ted i n this case to d e term ine whether R i ver Oaks f ollowed its o wn p rocedural due-process requirem ents, and we recognize t h a t “ [ t ] he f undam e ntal requirem ent of due

process is the opportun i t y t o b e heard at a m e aningf ul tim e and in a m e aningf ul m anner.”

raised n o o b

j ectio n to D r. S h elto n ’s p resen c e
. We ack n o w led g e th at t h e reco rd sh o w s t h at th e B y law s state th at “m em b ers” p o ssess a rig h t to a F air H earin g P lan C o m m ittee f ree o f eco n o m ic co m

p etito rs. W e d eclin e to a d d ress th e issu e o f an y alleg ed eco n o m ic c o n f lict as ap p lied to an “ap p lican t” f o r m ed ical staf

f p riv ileg es.

5 S ee A rticle 1 5

. 4

. 1 o f th e B y law s. 9W

arnick , 904 So. 2d at 1022 ( ¶11). River Oaks def ined f o r itself withi n i t s B y l a ws what
constituted a m e aningf

ul tim e and m eaningf

u l opportunity

to be heard. ¶19. The Mississippi D e p a r t me n t o f H e a l t h p e r f o r ms the licensing of h ospitals in Mississippi, in a ccordance with Mississippi Code Annotated section 41- 9

- 1 1 (Rev. 2013).
See Claypool v. Mladineo , 724 So. 2d 373, 379 (¶18) (Miss. 1998) (discussing the licensing
of state hospitals and the rules a nd regulations, o r m inim um standards, governing the licensing a nd standards f

or the operation of hospitals in Mississippi). To m aintain its license,

a h o s p i t a l m

ust com ply with the Departm ent o f Health’s rules and regulations governin g hospital o p erations. Hospital by laws ensure that the procedures of the hospital’s governing
boards com

ply with the prof

essional standards required f or licencing. The Departm ent of
Health “prom

ulgates rules and regul a t i o n s governing the licensing and standards f or the operation of

hospitals in the state” in accordance with Mississippi Code Annotated section 41-9-17 (Rev. 2013). Id . In Claypool, the Mississippi Suprem e Court explained:
These r egulations, known as the Minim um Standards of Operation f or Mississippi Hospita l s (M.S.O.M.H.), require each hospital to establish a m edical staf

f which has the overall r esponsibility f or the quality of m edical care provided t o patients in t he hospital. Hospital governi n g b o a rds are required t o d elegate to their m edical staf f s the r esponsibility f

or evaluation of the prof e ssional com

petence of

their f ellow m edical staf

f m em bers.
Id

. (internal citations om itted). Additionally , these “ m inim u m standards d o not require the

m edical staf

f to be em ploy ees of

the hospital.” Id . at (¶19). 6

6 A s ack n o w l ed g ed b y th e su p rem e co u rt i n C la yp o o l , m e d i cal-staf

f b y l aw s estab lish co m m ittees an d p ro ced u res to acco m p lish th e ev alu atio n o f p ro f essio n al c o m

p eten ce, as req u ired b y th e h o s p ital m in im u m stan d ard s in o rd er f

o r h o sp itals to m ain tain l icen sin g
. C l a yp o o l , 7 2 4 S o
. 2 d at 3 7 9 (¶1 8 ). T h e su p rem e co u rt h as ex p lain ed th a t th e “ev alu atio n o f th e co m p eten ce an d q u alif

icatio n o f m ed ical staf

f m em b ers is m o s t o f

ten p erf o rm ed in th e 1 0¶20. Mississ i ppi Adm inistrative Code 1 5-16-1:41.5 provides that a hospital’s governing

body possesses “ overall responsibility f or the conduct of the hospital in a m anner consistent

. . . [ with] high quality of p atient c are.” The Code f urther provides that am ong the duties of
the hospital’s governing b o d y i s t he duty to adopt by laws. I d

. A hospital’s by laws m ust “provide the m ethod o f appointm ent, re-appointm ent, and r emoval of m em b ers of the

m edical staf

f .” Id

. B y laws m

u st also establish com m i ttees to c o n d u c t the review of applicants f

or m edical staf

f m e m b ership. See Miss. A dm in. Code 15-16-1:41.6. T he Code
also specif

ically allows the governing body to “delegate to the m e dical staf f the authority to
evaluate the prof

essional com

petence of appli c a n t s f

or staf f m e m bership a n d/or clinical privileges[ ,]” a nd requires t hat the governing body “hold t h e m edical s taf f responsible f

or

m aking recom m endations to the governing body concerning initial staf f a ppointm ents” and grant of clinical privileges. Id

. ¶21. R i v e r O a k s a d o pted the By laws and delegated to its m e dical staf f the authority

to
evaluate t he prof

essional com

petence of applicants f

or m edical-staf

f privileges. Section 73-
25-93 required River Oaks and its m edical staf f to abide by the p r o c e d u r es set f orth in the By laws regarding due p r ocess. S ee W a rn i c k , 904 So. 2d a t 1022 (¶12). In this case, the
Credentials Com m ittee m et twice, and Dr

. Bush served as chair of the Credentials

ap p o in t m en t an d reap p o in tm en t p ro ced u res sp ecif ied in th e m ed ical staf

f b y law s,” an d th e su p rem e c o u r

t ack n o w led g ed th at t h ese p ro ced u res a re req u ired b y t h e M .S .O .M .H

. C l a yp o o l , 7 2 4 S o
. 2 d at 3 7 9 (¶2 0 )

. “T h e m ed ical s taf f b y l aw s estab l ish co m m i ttees f o r th e rev iew o f q u alif

icatio n s an d co m

p eten ce o f a

p p lican ts f

o r m ed ical staf

f m em b ersh ip an d cu rren t m e d ical staf

f m em b e rs.” I d

. U p o n ap p licatio n f

o r ap p o in tm en t to th e m ed ical staf f o f a h o sp ital, a c red en tials co m m i ttee f irst rev iew s t h e ap p lican t’s q u alif icatio n s. Id

. N ex t, “[ t] h e c red en tials co m m ittee m ak es a reco mme n d a tio n to th e m ed ical staf f ex ecu t iv e co m m ittee[ ,] w h ich in tu rn m ak es a reco m m en d atio n to th e h o sp i tal b o a r d .” Id

. 1 1Com m i tt ee. The relevant article of the By l aws provides that w hen the Credentials

C o mmi t tee recom m ends d eny ing an applicant’s request f or hospital m edical-staf f

m em bership, the applicant m ay request a hearing bef ore the Fair Hearing Plan Com m ittee. The By laws also provide the f ollowing:
15.4 Com

p osition of

Hearing Com m ittee:
15.4.1 If a hearing i s requested in a tim ely m anner, the hearing shall be held bef ore a com m ittee of f

ive (5) Active Medical Staf f m e mb e r s w h o are appointed by the Medica l E x e cutive Com m i ttee, and are not in direct econom ic com petition with the staf

f m em ber involved.

. . . No Staff member or B oard member who h a s a ctively participated in the consideration of the a dverse recommendation o r decis i o n s hall be appointed a member of this h earing committee

. (Em phasis added). ¶22. Relevant to t he disposition of this a ppeal, a v iolation of A rticle 15.4.1 occurred when
Dr. Bush participated i n the deliberation and decision of the Fair Hearing Plan Com m ittee
af ter he served a s chair o f the Credentials C om m ittee. 7 As discussed, t he Credentials

7 Wh i le w e f

i n d s ectio n 7 3 -2 5 -9 3 (1 ) c o n tro llin g , w e ack n o w led g e th at D r
. M o llesto n cites t o B a n a n a v. S ta te , 6 3 8 S o .2 d 1 3 2 9 , 1 3 3 0 -3 1 (M iss. 1 9 9 4 ), an d arg u e s t h at th e co n cep t th at t h e sam e p erso n c an n o t serv e in b o th a p ro s ecu to rial an d j u d icial p o sitio n o n th e sam e m atter is w ell-estab l ish e d in a crim in a l settin g
. In B a n a n a , b o th circu i t j u d g e s in th e d istrict
w e re d i sq u alif

ied f ro m p resid in g o v er th e p o st-co n v ictio n relief m o tio n b ecau se o n e j u d g e h ad b een th e d istrict atto rn ey at th e tim e o f p ro secu t io n , w h ile th e o th er w as th e assistan t d istrict atto rn ey at th e sam e tim e. Id

. at 1 3 3 1

. D r. M o llesto n asserts th at th is s am e co n cep t carries o v er to an ad m i n istrativ e p ro ceed in g
. S e e F reem a n v. P u b

. E m

p
. R et. S ys. , 8 2 2 S o
. 2 d 2 7 4 , 2 8 1 (¶2 1 ) (M iss. 2 0 0 2 ) ("A d m in i strativ e p ro ceed in g s sh o u ld b e co n d u cted in a f air an d im p artial m a n n er, f

ree f ro m an y su sp icio n o f

p rej u d ice o r u n f

airn ess. . . . D u e p ro cess g u aran t ees n eu trality

o n th e p art o f

th o se sittin g in a j u d icial o r sem i-j u d icial cap acity ."). In D ea n v
. P u b lic E m

p lo yees' R etirem en t S

ystem , 7 9 7 S o
. 2 d 8 3 0 , 8 3 3 (¶1 8 ) (M iss. 2 0 0 0 ), tw o m em

b ers o f th e M ed ical B o ard w h o rev iew ed an ap p l i c a t i o n f o r b en ef its also later s a t o n th e D isab ility A p p eals C o m m ittee. T h e su p r em e co u rt h e ld t h at th e B o ard o f T r u stees w as n o t au th o rized "to ap p o in t a co m m ittee co m p rised p artly o f me mb e r s o f th e M ed ical B o ard t o sit as h earin g o f f icers in rev iew o f a d ecisio n b y th e M e d i cal B o ard ." Id

. 1 2Com m i ttee recom m ended deny ing Dr. Molleston’s application.

¶23. “The f

undam ental r equirem ent of due pro c e s s i s t h e opportunity t o be heard ‘at a

m eaningf u l t i m e and in a m eaningf ul m anner[ ,]’” and we m

ust look t o the h ospital’s own by laws to determ i ne if the proceedings adhered to the by laws’ requirem ents f or m eaningf

ul

m anner and m eaningf

ul tim e. W

a r n i c k , 9 0 4 S o
. 2d a t 1 022 ( ¶14). In t his case, the

com position of the Fair H earing Plan Com m ittee m em bers parti c i p ating in the decision to deny Dr. Molleston’ s application violated Article 15.4.1. Additionally , this violation of a

m andatory By law provision during the proceedings was not rem edied prior t o t h e f inal
decision by River Oaks, and th e r e f o r e c o nstitutes error because the m anner of the

p r o c e e d ings f

ailed to com

port with the By laws. In W arnick , the suprem e court f o und t ha t
the c laim ed by law violation and lack o f n otic e w e r e rem edied w hen a hospital held a subsequent h earing giving W a r n i c k t wo opportunities to attend, p resent e vidence, and testif y
. Id

. at 1023 (¶17). The W

arnick c ourt f

ound the c ase of N

o xubee County Board of

E ducation

v. O v e r t on , 483 So. 2 d 301, 302-03 (Miss. 1 985), sim ilar i n that the “m andatory dictates”

were not f

ollowed, but the error w as later rem edied by a subsequent hearing. I d

. at (¶18).
See W ong , 565 So. 2d a t 551. W e t hus f ind in this case that the f ail u r e t o r e m edy the
violation o f the By laws’ m andatory dictate as t o t he com pos i t i o n o f the F air Hearing Plan
Com m i ttee results in reversible error. ¶24. Based u

pon the f oregoing, we reverse the chancery c ourt’s judgm ent, a nd we rem and

at 8 3 6 (¶¶2 5 -2 6 ). T h e su p rem e co u rt ex p lain ed th at it w o u l d n o t ad d ress th e p o ssib le d u e p ro cess v io latio n sin ce statu to ry law f ailed to au th o rize M ed ical B o a rd m em b ers t o serv e o n th e A p p eals C o m m ittee. Id

. at 8 3 6 -3 7 (¶2 7 ).
1 3this case to the Board of Trustees to review Dr. Molleston’s application in accordance with

procedures e stablished in the By laws. Dr. Molleston’s r em aining issues a re m oot; we decline

to c om m ent upon the weight or suf f iciency of the evidence subm itted below, since we m ust

reverse on procedural due-process grounds f or t he f a ilure to com

p ly with applicable hospital by law procedures. ¶25. T H E JUDGMENT OF THE RANKIN COUNTY C H A N C E R Y C O U R T I S REVERSED, AND THIS C ASE IS REMANDED FOR FURTHER PROCEEDINGS CONSISTENT W I T H THIS OPINION. ALL COSTS OF THIS APPEAL ARE ASSESSED TO THE APPELLEE. LEE, C .J., I RVING, P .J., BARNES, ISHEE, MAX WELL AND J A M E S , JJ., CONCUR. G R I FFIS, P.J., DISSENTS W I T H SEPARATE WRITTEN OPINION, JOINED IN PART BY WILSON, J. FAIR, J., NOT PARTICIPATING. GRIFFIS, P.J., DISSENTING: ¶26. I respectf

ully dissent. ¶27. I begin with m y c oncern a s to whether D r. M olleston preserved his objection to a dueprocess violation. D r. Molleston was aware that Dr. Bush was present at the hearing. Yet
Dr. Molleston m ade n o o bjection. Instead, the objection was raised only a f ter h e received an adverse ruling. ¶28. According to the transcript of the May 2 hearing, the chair identif ied t he com m ittee

me mb e rs and included Dr. Bush. Dr. Molleston was aware that Dr. Bush had been o n t h e Credentials Com m ittee and m a de no objection. ¶29. Due process c ertainly provides Dr. Mol l e s t o n t h e r i g h t to be heard. I t does not, however, allow Dr. Molleston to rem ain silent until a f ter the h earing. I am of the opinion
that Dr. Molleston waived his due-process objection because he did not tim e l y raise it. See

1 4Terrell v. Tschirn , 6 56 So. 2d 1150, 1152 (Miss. 1995) (“ T e r r e ll should not be allowed to

take his ch a n c e s w ith a j ury and then, af ter he loses, f

ile his m otion.”); Buchanan v.
B u chanan , 587 So. 2d 892, 897 (Miss. 1991) (a c o urt “will not allow a party t o t a k e h i s chances w ith a j udge about whom he knows of g rounds f or r ecusal and then, a f

t er he loses,
f ile his m otion”); W

ilbanks v. Gray , 795 So. 2d 541, 547 (¶25) (Miss. Ct. App. 2001) (“If the appellants had a problem with the religious af f iliation of the special c hancellor, t heir m otion
f or recusal should have been f iled at the beginning of the action rather than a f ter r eceipt of

an adverse ruling.”). For these reasons, I would f ind Dr. Molleston waived his due-process objection. ¶30. Further , I a m o f t h e o pinion that Dr. Molleston has not shown a violation of the by laws. The com

position of

the Hearing Com m ittee was established in article 15.4.1. Dr.
Molleston argues that D r. Bush’s participation violated t he last sentence, which reads: “No
Staf f m em ber or B oard m e m

b er who has actively participated in the considera tion of the
adverse recom m endation or dec i s i o n s h all b e appointed a m e m ber of this Hearing
Com m i ttee.” ¶31. T h e by laws also provide that the right to a h e a r i n g i s f o r t h e r e v i e w o f “ a

recom m endation of t he Medical Executive Com m ittee that

. . . will adversely af f e ct his/her appointm e nt

. . . .” A rticle 15.1.1. Article 15.2.1 provides f or “notice of an adverse

recom m endation by the Medical Executive Com m ittee.” T hen, article 1 5.5.11 provides that
the H earing Com m ittee’s recom m endation pertains to “the original adverse recom m endation

o f t h e M edical Executive Com m ittee.” Theref ore, t he ref

erence in article 15.4.1 to “th e

1 5consideration o f the adverse recom m endation or d ecision,” is t o t he “recom m endation of the

Medical Executive Com m ittee,” not to any p relim inary recom m e n dation by the Credentials
Com m i ttee. ¶32. Dr. Bush served on th e C r e d e n t i a l s C o m m i t t ee, not t he Medical Executive Com m ittee.
The b y l aws do not prohibit a phy sician in that capacity f rom serving on the Hearing
Com m i ttee. According to the record, D r. Bush did not “actively participate” in t he Medical
Executive Com m i ttee’s decision. The Medical Executive Com m ittee’s m inutes state:
DR. BUSH: I was not [ at the Medical Executive Com m ittee m eeting].

I’m part of the Credentials Com m ittee—
DR. MORIARITY: Oh, okay

. I’m n ot part o f credentials, so I don’t—I have

not—I can’t speak about that m eeting.
DR. BUSH: B u t I w a s not at either of the m eetings of the Med[ ical ] Exec[ utive Com m ittee]. ¶33. Also, article 15.4.1 p rohibits a pe r s o n w h o p a r t icipated in the Medical Executive
Com m i ttee decision f

rom being “appointed a m em ber o f this Hearing C om m ittee.” There
is n o indication in the record that Dr. Bush was appointed a m em ber of the Hearing
Com m i ttee. Dr. Molleston does not m ake this argum e n t; instead, Dr. Molleston states that
Dr. Bush “deliberated with the Fair Hearin g Com m ittee” and “apparently ” voted “as a

m em ber of the Fair Hearing Com m ittee.” There appears t o be no appointm ent of Dr. Bush

as a m em ber of the Com m i ttee, which would violate the by laws. ¶34. The chancellor held:
The decision m akers were those doctors specif ically nam ed to the Com m ittee. Dr. Bus h , w i t h o t her p ersons not on the Com m ittee, did p articipate at the hearing and t he disc u s s i o n af ter the hearing and all who attended the

1 6discussion signed the m inutes or opinion. A l l c o m m ittee m em bers p resent ruled unanim ously against the A p p e l l a n t

. W hile it m ay h ave been b etter if only the a ctual com m itt e e me mb e rs signed the m inutes or opinion, the signature o f Dr. Bush and the other non-com m ittee m em bers c onstitutes harm less error. ¶35. I f ind no e rror i n the chancellor’s decision. Theref ore, I respectf

ully dissent. I would
af f irm the chancellor’s judgm ent. WILSON, J., JOINS THIS OPINION IN PART.

1 7