Source: http://openjurist.org/87/f3d/1325/verducci-v-sonoma-valley-hospital-district-a-verducci
Timestamp: 2015-10-09 11:06:14
Document Index: 557601904

Matched Legal Cases: ['§ 1', '§ 2', '§ 1983', '§ 11113', '§ 1988', '§ 1', '§ 2']

87 F3d 1325 Verducci v. Sonoma Valley Hospital District a Verducci | OpenJurist
87 F. 3d 1325 - Verducci v. Sonoma Valley Hospital District a Verducci Home
87 F3d 1325 Verducci v. Sonoma Valley Hospital District a Verducci 87 F.3d 1325
1996-2 Trade Cases P 71,466
Mona A. VERDUCCI, M.D., Plaintiff-Appellant,v.SONOMA VALLEY HOSPITAL DISTRICT, et. al, Defendant-Appellee.Mona A. VERDUCCI, M.D., Plaintiff-Appellee,v.SONOMA VALLEY HOSPITAL DISTRICT, et. al, Defendant-Appellant.
No. 95-15067.
Argued and Submitted April 8, 1996.Decided June 18, 1996.
Before: BROWNING and NOONAN, Circuit Judges, and MERHIGE, District Judge*.
Dr. Mona Verducci, Plaintiff-Appellant, filed a complaint in the district court for the Northern District of California on September 16, 1991, alleging that Defendant-Appellants, Sonoma Valley Hospital District and certain named defendants, conspired to run her out of business in violation of § 1 and § 2 of the Sherman Act. Verducci filed a second amended complaint on July 20, 1992 adding certain named defendants and causes of action alleging violations of constitutional rights under § 1983.
On August 9, 1993, the district court granted the Hospital's motion for summary judgment on Verducci's antitrust claims. The district court granted the Hospital's motion for summary judgment on Verducci's free speech and equal protection claims and on her claim that she was deprived of a liberty interest and property interest by the Hospital's peer review system on August 19, 1994. It denied summary judgment for the defendants in part, finding a triable issue of fact as to whether individuals at the Hospital conspired to deprive her of her constitutional rights in the recruitment of two other obstetricians.
On December 6, 1994, the district court granted the Hospital's motion for summary judgment on that claim, finding that as a quasi-legislative body, the Hospital's conformance with the Brown Act sufficed to provide Verducci with due process in the recruitment of the two other obstetricians. The district court dismissed Verducci's action with prejudice. Verducci has timely appealed the district court's dismissal.
The Hospital moved for attorneys' fees against Verducci under the Health Care Quality Control Act of 1986, 42 U.S.C. § 11113, and under 42 U.S.C. § 1988. The district court denied attorneys' fees on both grounds finding that Verducci's claims were neither frivolous nor unreasonable. The Hospital appeals the district court's denial of fees.
Mona Verducci is an obstetrician-gynecologist who has had staff privileges at Sonoma Valley Hospital since 1987. Sonoma Valley Hospital District owns and operates Sonoma Valley Hospital, which is located in Sonoma, California. The other Defendants are physicians at Sonoma Valley Hospital. The Defendants will be referred to collectively as "the Hospital."
In 1990, the Hospital recruited two OB/GYNs, Dr. Cohn and Dr. McCord, to come to Sonoma. At this time, Verducci applied to be reappointed to the Hospital staff. Verducci had received a number of complaints from the nursing staff and a poor review by the American College of Obstetrics and Gynecology, and the Hospital arranged for her to be reviewed by the California Medical Association. The CMA conducted two reviews, both of which were critical of Verducci's practice, although the second review, which was conducted at Verducci's request, was less critical.
In March 1991, the Medical Executive Committee recommended that Verducci be reappointed and her privileges be renewed, but that she be required to consult with another physician for some obstetric patients. Verducci challenged these findings and requested a hearing before the Hospital's Judicial Review Committee (JRC). Pending the completion of this process, Verducci retained full and unrestricted staff privileges.
On April 28, 1992, the JRC upheld the consultation requirement placed on Verducci for patients diagnosed as potential vaginal breech deliveries, finding that Verducci lacked the skill to perform them. Verducci appealed this decision to the Board of Directors, but the Board affirmed it in September 1993. Verducci applied for a writ of administrative mandamus from the California Superior Court to overturn the Board's decision. That court denied her petition. Verducci subsequently filed this suit in the district court for the Northern District of California.
This court reviews the district court's grant of summary judgment for the Hospital de novo. Warren v. City of Carlsbad, 58 F.3d 439, 441 (9th Cir.1995). Summary judgment is appropriate if there is no genuine issue as to any material fact and the moving party is entitled to a judgment as a matter of law. Id.
I. VERDUCCI'S ANTITRUST CLAIMS
Verducci claims that the Hospital has attempted to drive her out of business in order to hamper competition by recruiting two other obstetricians to the area and limiting her staff privileges. She argues that the Hospital's actions have violated both § 1 and § 2 of the Sherman Act.
A. Verducci's Claims Should Be Analyzed Under the Rule of Reason.
The district court correctly analyzed Verducci's claims under the rule of reason. Verducci's allegations are quite similar to those leveled in Austin v. McNamara, 979 F.2d 728, 738 (9th Cir.1992), in which this court held that the rule of reason was the appropriate standard to evaluate a doctor's claims that attacks on his professional judgment and ability by other members of the medical staff, other doctors' refusal to cover for him, and the hospital's actions to suspend his staff privileges were part of a conspiracy in restraint of trade. Even if these acts "were somehow intended to lead to a denial of staff privileges, a per se approach still would not be appropriate." Id.
Verducci's efforts to characterize the Hospital's actions as a group boycott do not change this analysis: only those boycotts or refusals to deal that almost always tend to be predominately anticompetitive are per se illegal. Bhan v. NME Hospitals, Inc., 929 F.2d 1404, 1411-12 (9th Cir.) cert. denied, 502 U.S. 994 (1991). The Hospital's actions are not of that kind. A hospital has the right to monitor the performance of the doctors on its staff and to limit their privileges if they are not providing quality care to patients. The district court was correct to evaluate Verducci's claims under the rule of reason.
Under the rule of reason, Verducci must establish 1) an agreement, conspiracy, or combination among two or more persons; 2) that is intended to harm or unreasonably restrain competition; and 3) that actually causes injury to competition within the field of commerce in which the claimant is engaged, beyond the effect on the claimant. Austin, 979 F.2d at 738.
B. The Relevant Markets.
Verducci has the burden of proving the relevant market and showing the deleterious effects on competition within that market. The relevant market has two components: the geographic market and the service market. Generally, the definition of a market is a question of fact for the jury. Morgan, Strand, Wheeler & Biggs v. Radiology, Ltd., 924 F.2d 1484, 1489 (9th Cir.1991).
1. Geographic Market.
"A geographic market is an area of effective competition where buyers can turn for alternate sources of supply." Id. at 1490 (internal quotations omitted). Verducci contends there is a genuine issue of material fact as to the scope of the geographic market because she came forth with evidence that the relevant geographic market was that of hospitals i