Source: http://openjurist.org/943/f2d/1406
Timestamp: 2016-02-09 08:08:08
Document Index: 625246707

Matched Legal Cases: ['§ 4', 'sui generis', '§ 1363', '§ 1363', '§ 1480', '§ 1482', '§ 68', '§ 73', '§ 73', '§ 73', '§ 9', '§ 73']

943 F2d 1406 Caine v. Hardy | OpenJurist
943 F. 2d 1406 - Caine v. Hardy HomeFederal Reporter, Second Series 943 F.2d.
The easy answer to these questions is that Zinermon simply does not apply. We have found that Dr. Caine stated no claim for denial of procedural due process. His assertion that he was the victim of partisan decisionmaking is of no moment. He is stating no more than that the risk of erroneous decision presented by the participation of his competitors in the decision to suspend his privileges was unacceptable. The Mathews v. Eldridge balance has, however, answered that assertion--concluding that this is a tolerable risk when compared with the state's powerful interest in protecting patient safety. The State of Mississippi has provided Dr. Caine all the process that is due. The state has no constitutional duty to provide a procedural regimen that guarantees faultless decisionmaking; the state's interests in safety and efficiency find expression in the tolerable level of risk. When that balance has been fairly struck, a person states no claim by asserting that such risk was visited upon him.
We do not read Zinermon as fundamentally altering the balancing of personal and state interests that Mathews prescribed as the test for procedural due process. Rather, the Zinermon majority opinion characterizes its analysis as an application of the Parratt/ Hudson doctrine which in turn implemented Mathews balancing. 110 S.Ct. at 985ff. We emphasize that Dr. Caine received all the process he was due, taking into account the state's powerful interests as well as his private interests. But even if it be assumed arguendo that the bias and lack of notice of charges against him were not adequately redressed by the hospital's predeprivation procedures, we would nevertheless find Dr. Caine's claim foreclosed by the Parratt/ Hudson doctrine as refined by Zinermon.
Zinermon holds that if "random and unauthorized" conduct of state actors is alleged, the mere existence of even an "adequate" post-deprivation remedy does not satisfy procedural due process where (a) the particular pre-deprivation administrative procedure presents a high risk of erroneous deprivation, and (b) there is a substantial likelihood that further minimal procedural safeguards could prevent the erroneous deprivation. Zinermon thus requires a hard look at a Parratt/ Hudson defense to determine whether the state officials' conduct, under all the circumstances, could have been adequately foreseen and addressed by procedural safeguards. Zinermon did not explicitly or implicitly disavow the Parratt/ Hudson doctrine; instead, it requires case-by-case analysis of the deprivation at issue. See 110 S.Ct. at 987-90.
Zinermon stated three preconditions for application of the Parratt/ Hudson doctrine: the deprivation must truly have been unpredictable or unforeseeable; the pre-deprivation procedures must have been impotent to counter the state actors' particular conduct; and the conduct must have been "unauthorized" in the sense that it was not within the officials' express or implied authority. Id. at 987-88. Each of these criteria is established in the case before us.
Second, it is inconceivable that the state could have articulated more explicit procedural safeguards to protect Dr. Caine against the specific risk that his privileges would be suspended because of his peers' anti-competitive motives. See id. at 987-88. The hospital regulations state when, how, and for what reasons doctors may be disciplined. They permit immediate suspension only to protect the safety of patients--and then only after an investigation. Further, it is the multimember Executive Committee, not simply the affected doctor's "competitors" in his specialty field, who must take this action. In Zinermon, as previously observed, there was no pre-deprivation process to protect the incompetent mental patient from imprudently committing himself.
Third, it cannot be said that the decisionmakers in this case were "authorized" either to misuse the regulations or to discipline Dr. Caine for improper purposes. Our court has consistently held that mere conclusory allegations of bias do not render infirm otherwise constitutionally adequate procedures. Holloway v. Walker, 784 F.2d 1287, 1292-93 (5th Cir.1986); Laje v. R.E. Thomason Gen. Hosp., 564 F.2d 1159, 1162 (5th Cir.1977); Megill v. Board of Regents of Fla., 541 F.2d 1073, 1079 (5th Cir.1976); Duke v. North Tex. State Univ., 469 F.2d 829, 834 (5th Cir.1972). Zinermon provides no basis to disavow this rule. Although the hospital's bylaws provide that the initial investigation of a staff doctor will be undertaken by members of his clinical section, any final disciplinary decision is entrusted to the large, diverse Executive Committee. The regulations governing formal hearings, not invoked here by Dr. Caine, specifically prevent bias based on economic competition or prior investigatory responsibilities. See Bylaws Art. VII § 4(a), fn. 2 supra. The potential for biased decisionmaking was minimized significantly. In Zinermon, by contrast, the voluntary admission of the patient may have been an abuse of judgment by the mental hospital staff, but the exercise of that judgment was specifically condoned by the regulations: "Florida's [statutory scheme] ... gives state officials broad power and little guidance in admitting mental patients." 110 S.Ct. at 988 (emphasis added). Such is emphatically not the case here. The Ad Hoc Committee had to persuade the Executive Committee that Dr. Caine's conduct threatened patient safety, a stiff and exacting burden.
The facts that distinguish Zinermon from Parratt/ Hudson do not appear in this case. Even under Dr. Caine's conclusory allegations, the deprivation he suffered was "random and unauthorized." Moreover, there were adequate and prompt post-deprivation remedies available to Dr. Caine. Whether or not suspension is immediate, the hospital bylaws provide opportunity for a formal investigation and evidentiary hearing, possible appeal to the hospital board of trustees, and a final resort to the state courts for prompt judicial review.6 Therefore, according to Parratt/ Hudson, Dr. Caine was not deprived of property without due process of law.
One final observation supports our position. As the dissenters in Zinermon predicted, see 110 S.Ct. at 995, 996 (O'Connor, J. dissenting), and as Judge Easterbrook has observed, see Easter House v. Felder, 910 F.2d 1387, 1409 (7th Cir.1990) (Easterbrook, J., concurring), the courts of appeals have not found Zinermon easy to interpret. Nevertheless, in our research, none of the courts as yet called upon to apply Zinermon has found a procedural due process violation in claims of particular regulatory abuses carried out within the framework of controlling regulations. See, e.g., Easter House, 910 F.2d at 1396-1406 (en banc); New Burnham Prairie Homes, Inc. v. Village of Burnham, 910 F.2d 1474, 1480 (7th Cir.1990); Katz v. Klehammer, 902 F.2d 204 (2d Cir.1990); Amsden v. Moran, 904 F.2d 748, 754-57 (1st Cir.1990); Fields v. Durham, 909 F.2d 94 (4th Cir.1990); Plumer v. Maryland, 915 F.2d 927 (4th Cir.1990); Coriz v. Martinez, 915 F.2d 1469, 1470 (10th Cir.1990). Thus, as Zinermon counseled case-by-case application of its principles, so it seems at this stage to represent a sui generis situation.
It cannot be denied that the context in which a public employee expresses himself may be relevant to determining whether the speech expressed a matter of "public concern." Noyola v. Texas Dep't of Human Resources, 846 F.2d 1021, 1023 (5th Cir.1988). But context alone cannot transform an inherently self-interested opinion into one that implicates public issues. Had Dr. Caine proclaimed his opposition to Dr. Hardy's exclusive contract proposal from the steps of the Mississippi capitol, the characterization of this speech would not differ. Dr. Caine's alleged remarks concerned solely the internal management of the hospital anesthesiology department and reflected an intra-office dispute rather than an expression of opinion necessary for society to make informed decisions.
Terrell v. University of Tex. System Police, 792 F.2d 1360, 1362 (5th Cir.1986) (emphasis added); accord Ayoub v. Texas A & M Univ., 927 F.2d 834, 837 (5th Cir.1991). Dr. Caine did not object to the award of an exclusive anesthesia contract solely, or even primarily, because of his concern as a citizen for the sound management of his local hospital. Rather, his objections stemmed from his perfectly normal, but private interest as a hospital staff member that his job be as remunerative as possible. In Terrell 's terms, Dr. Caine's speech was made in his role as employee.
We end where we began. Dr. Caine's summary suspension for reasons of patient safety was procedurally safeguarded in such a way as to satisfy fourteenth amendment due process standards, either under the classic Mathews test or under Zinermon 's wrinkle on the Parratt/ Hudson doctrine. His opposition to his colleagues' request for an exclusive anesthesiology contract with Hinds County General Hospital was not speech on a matter of public concern protected by the first amendment. The district court therefore properly dismissed his complaint.
JERRE S. WILLIAMS, Circuit Judge, with whom JOHN R. BROWN, Circuit Judge joins, dissenting:
First, this case was dismissed pursuant to Rule 12(b)(6). We must therefore accept Dr. Caine's allegations as true --not as unsubstantiated allegations. Dr. Caine's complaint does not merely "shine[ ] a different light on the formalities observed," as the majority contends. Instead, the facts alleged in the complaint must be taken as the true light.
An ad hoc investigating committee began procedures to suspend Dr. Caine's hospital privileges. Bias was clearly apparent because Dr. Hardy and one of his partners served on the three person investigating committee. Further, the ad hoc committee did not follow the hospital's bylaws, rules, and regulations. The committee failed to give Dr. Caine the required notice of the hearing and the charges. The ad hoc investigatory committee recommended that the Executive Committee suspend Dr. Caine's hospital privileges. The Executive Committee, of which Dr. Hardy and one of his partners were also members, followed this recommendation. This committee failed to give Dr. Caine notice or opportunity to be heard--thereby violating the medical staff rules. The procedural defaults at all stages are alleged in thorough detail in thirteen pages of the complaint. Thus, we have a case of Dr. Caine's competitors, whom Dr. Caine had publicly criticized and opposed on professional issues, playing a major role in terminating Dr. Caine's privileges without following the required procedures and under what should have been the controlling inhibition of a clear conflict of interest.
The majority concludes that Dr. Caine has set out no cause of action under the Fifth and Fourteenth Amendments for two reasons. First, the majority asserts that Dr. Caine received all the procedural due process to which he was entitled according to Mathews7 and Darlak.8 The hospital, they assert, suspended him under an exigent circumstance, a concern for patient safety, and therefore did not have to afford Dr. Caine further process before it deprived him of his hospital privileges. The Constitution only required the hospital to give Dr. Caine post-deprivation due process, and Dr. Caine only complains that he received inadequate pre-deprivation due process. He therefore asserts no cause of action. This also means that Zinermon9 is inapplicable because no due process rights were violated.
The majority misapplies Mathews because it ignores the procedural status of Dr. Caine's case. At the 12(b)(6) stage, we construe all of Dr. Caine's allegations in the light most favorable to him and accept all of his allegations as true. 5A C. Wright & A. Miller, Federal Practice and Procedure § 1363, at 460-61 (1990). Thus, we must accept Dr. Caine's assertion that the hospital terminated his privileges out of revenge--not out of a concern for personal safety of patients. Mathews and Darlak are therefore inapplicable. Darlak and Mathews come into play only when there is a valid legal finding that patient safety is at issue. Only then does revenge become an acceptable risk and pre-deprivation due process is not required. Here, there is no such finding. We instead must accept as true Dr. Caine's allegation that the hospital and the other defendants terminated Dr. Caine's privileges as the core of a personal vendetta.
Second, the majority argues that the Parratt/ Hudson doctrine,10 not Zinermon, applies to this case. According to the Parratt/ Hudson doctrine, when the conduct of state actors is random and unauthorized, the state cannot foresee, predict, or prevent a deprivation resulting from such conduct. In such a situation, post-deprivation procedure is the only process constitutionally required. Zinermon made a strong and sweeping addition to the Parratt/ Hudson doctrine. Here is one aspect of the en banc court going seriously wrong. Under Zinermon, Parratt/ Hudson is not applicable when (1) erroneous deprivation is foreseeable, (2) pre-deprivation process is practicable, and (3) challenged conduct is not "unauthorized," in that the "State delegated to [the state officials] the power and authority to effect the very deprivation complained of" by the plaintiff. Zinermon, 494 U.S. at ----, 110 S.Ct. at 989-90.
Zinermon, not the narrower Parratt/ Hudson doctrine, applies to this case. The state can be expected to provide pre-deprivation remedies because the three Zinermon requirements are present. First, the deprivation is foreseeable and comes at a predictable time--when the hospital began termination proceedings. The state can know when the deprivation occurs because procedures are initiated, just as in Zinermon. This is not a case of a single state employee acting on his or her own as in Parratt and Hudson. The state in fact acknowledges that such a deprivation is foreseeable because it attempted to develop procedural safeguards to protect against erroneous deprivation. See Plumer v. State of Md., 915 F.2d 927, 931 (4th Cir.1990).
Second, pre-deprivation process is practicable because revenge is at issue--at least at this procedural juncture--not patient safety. Dr. Caine did attach to his original complaint a copy of many hospital records pertaining to his termination. He included a copy of a case history which was developed by the investigating committee that charged him with seriously mishandling a patient. Yet Dr. Caine alleges and therefore establishes as fact that this case had been earlier reviewed in a regular "re-credentialing" proceeding and at that time no issue was raised with respect to it by the Credentials Committee or the Executive Committee. We still must take Dr. Caine's case as one addressing revenge and not patient safety. The allegations in the complaint are taken as true, not the documents attached to the complaint which are inconsistent with the complaint.
Since the majority considers inconsistent documents outside the complaint, it is engaging in summary judgment procedure without giving Dr. Caine the benefit of filing supplemental sworn evidence. Dr. Caine alleges that he had responses to the charges about the case history in question which prove the charges were advanced as a matter of bias. I remind the Court that "the only information necessary for a decision on [a 12(b)(6) ] motion is to be found in the pleading itself; if outside evidence is considered, the motion becomes one for summary judgment." 5A C. Wright & A. Miller, Federal Practice and Procedure § 1363, at 460 (1990) (footnote omitted). The majority ignores the nature of a Rule 12(b)(6) motion. It asks only: do the allegations in the pleading state a valid claim for relief? Issues of fact are not decided because the allegations in the complaint are taken as true.
Third, the deprivation was not "unauthorized", "for the state had delegated to its employees 'the power and authority to effect the very deprivation complained of here, ... and also delegated to them the concomitant duty to initiate the procedural safeguards....' " Plumer, 915 F.2d at 931 (quoting Zinermon, 494 U.S. at ----; 110 S.Ct. at 990); see also Matthias v. Bingley, 906 F.2d 1047, 1056 (5th Cir.), modified on other grounds, 915 F.2d 946 (5th Cir.1990). In Parratt and Hudson, on the other hand, "the state employees had no similar broad authority to deprive prisoners of their personal property, and no similar duty to initiate ... the procedural safeguards required before deprivations occur." See Zinermon, 110 S.Ct. at 990.
This case significantly differs from Parratt and Hudson, as the Zinermon case demonstrates. The majority generally limits Zinermon strictly to its facts. Yet Zinermon controls. In the posture of a 12(b)(6) case Dr. Caine's allegations are true. This is a case of bias. Yet, the majority requires Dr. Caine to come forward with proof of bias and decides itself that there was little, if any, bias. This is an overt, and indeed blatant violation of Rule 12(b)(6)--we must accept as true Dr. Caine's allegation that the hospital committees were biased. Thus, in Section III of the opinion for the Court we find a meticulous analysis and reliance upon non-facts as to patient safety. They are non-facts because they are not subject to evaluation as to their veracity. The specific requirements of Rule 12(b)(6) have not been met. They are not sworn, they are contrary to the facts as established under Rule 12(b)(6) by Dr. Caine's pleadings, and also Dr. Caine never had the opportunity to counter them.
This case in no way limits, modifies, or jeopardizes the rule that a hospital can summarily suspend doctor privileges to protect patients. It does not do so because this is not a case about patient safety--at least at this stage--but instead a case about a personal vendetta against a doctor. The majority decision allows a hospital to terminate privileges out of bias, call it patient safety, and then fail to provide the required pretermination procedural due process. This holding constitutes a license to any public agency to deprive someone of a special right by stating a ground which would constitute an emergency--with no proof thereof--and then prevail in a Rule 12(b)(6) dismissal. This bootstrap device can be used in spite of allegations, which must be taken as true, that the motives for the deprivation were wholly discriminatory and that the procedures violated the United States Constitution. The deceased Dr. Caine's rights are entitled to total vindication as this case comes to us. I regret that my powers of persuasion are unable to pierce the smokescreen of the Court's groundless and extralegal analysis.
Finding that the Amended Complaint fails to state a claim upon which relief can be granted, the Court exercises its discretion pursuant to Federal Rule of Civil Procedure 15(a) to deny Caine's Motion for Leave to Amend Complaint. Numerous courts have ruled that leave to amend is properly denied when the complaint, as amended, is subject to dismissal. See, e.g., Wedgeworth v. Fibreboard Corp., 706 F.2d 541 (5th Cir.1983); Bache Halsey Stuart Shields Inc v. Tracy Collins Bank & Trust Co., 558 F.Supp. 1042 (D.Utah 1983).
The first sentence of Rule 15(a) provides in relevant part that "[a] party may amend the party's pleading once as a matter of course at any time before a responsive pleading is served." (emphasis added.) The defendants have never filed a responsive pleading in this case; only a Rule 12(b)(6) motion was filed.11 See Zaidi v. Ehrlich, 732 F.2d 1218, 1219-20 (5th Cir.1984); see also Fed.R.Civ.P. 7(a). Dr. Caine under all federal procedural authority should have been allowed to amend his pleading once "as a matter of course." Rule 15(a) requires no court permission when no responsive pleading has been filed. The district court thus had no discretion to deny Dr. Caine's request. "[A] party may amend a pleading once without the permission of the court or the consent of any of the other parties to the action if he does so ... before a responsive pleading has been served." 6 C. Wright, A. Miller, & M. Kane, Federal Practice and Procedure § 1480, 574-75 (1990) (footnotes omitted) (emphasis added). It is axiomatic that neither a 12(b)(6) motion nor a summary judgment motion is a "responsive pleading". Dr. Caine did not even need to make a motion to file an amended complaint. He already had that right under Rule 15(a). The fact that Dr. Caine filed a motion to amend did not affect his absolute right to file an amended complaint. "If a party erroneously moves for leave to amend before the time for amending as of course has expired, ... the amendment should not be handled as a matter addressed to the court's discretion but should be allowed as of right." Id. at § 1482, 580 (footnote omitted) (emphasis added); see also Zaidi, 732 F.2d at 1220.
Dr. Caine wished to amend for an extremely serious purpose--to state and undertake to prove a First Amendment claim. "A state may not discharge an employee for exercising his right to free speech on matters of public concern." Page v. De Laune, 837 F.2d 233, 237 (5th Cir.1988); see also Connick v. Myers, 461 U.S. 138, 146, 103 S.Ct. 1684, 1689, 75 L.Ed.2d 708 (1983). Whether his speech addressed a matter of public concern must be determined by the "content, form, and context of a given statement, as revealed by the whole record." Connick, 461 U.S. at 147-48, 103 S.Ct. at 1690 (footnote omitted). Yet, the majority today countenances denying Dr. Caine the opportunity to develop the whole record because it has decided for him that he could make no claim to have spoken out on a matter of public concern. This conclusion, again, is overt legal error. The alleged and uncontroverted facts reveal a real likelihood that Dr. Caine could make a valid First Amendment claim.
Dr. Caine spoke out about the quality of health care at the public hospital. The quality of health care inescapably is of public concern. Frazier v. King, 873 F.2d 820, 825 (5th Cir.), cert. denied, --- U.S. ----, 110 S.Ct. 502, 107 L.Ed.2d 504 (1989). Dr. Caine's outspoken opposition to the Hardy monopoly move can be treated as an unworthy free speech claim only by an inexplicable desire that the case presented to the court were something other than what it is. The majority fastened upon his allegation that his concern was about loss of work. This allegation, establishing a property interest in his right to sue, cannot be found as a self limiting pleading in the light of his proposed amendment raising the free speech issue. Dr. Caine was speaking out concerning the actions of public officials. Further, the actions would create a monopoly and would bar members of the public from using their own doctors in a public hospital. In short, Dr. Caine asked to allege that he undertook to speak out on issues having clear ramifications that deeply involved matters of public concern. Doctors are intimately associated with such matters. The welfare of the patients--about which Dr. Caine spoke--is always a matter of "serious public concern." Price v. Brittain, 874 F.2d 252, 258 (5th Cir.1989).
The opinion of the Court denies Dr. Caine the opportunity to assert these claims and develop the record. Instead, it has decided for Dr. Caine what he did and did not say and why. It therefore improperly denies him the chance to develop the content, form, and context of his advocacy. Further, the majority focuses upon motive. A strong element of personal concern necessary to establish the right to sue does not remove speech from the realm of public concern. See Thompson v. City of Starkville, 901 F.2d 456, 465-66 (5th Cir.1990). Courts still must fully analyze the content, form, and context of speech as the Supreme Court required in Connick.
On this record established law requires that the case be reversed and remanded. Dr. Caine's representatives should be granted the chance to develop their claims that the defendants violated Dr. Caine's Constitutional procedural rights under Zinermon and the critical free speech right of advocacy as to a matter of obvious public concern. Yet these critical assertions of Constitutional default are treated as trivia by the en banc Court, so much so that no denial or explanation or even answer is permitted. In what appears to be an overwhelming desire in the Court to hold against Dr. Caine, even before the facts are developed, the Court simply ignores the firmly established law which governs this case. There is no doubt about the controlling law of Federal Rules of Civil Procedure 12(b)(6) and 15(a). So the Court in its wholly inappropriate ad hoc drive to deny whatever rights Dr. Caine claimed and might establish simply ignores the law and the procedural posture of the case. "Such result-oriented decision making can only erode respect for the federal judiciary." Christophersen v. Allied Signal Corp., 939 F.2d 1106, 1137 (5th Cir.1991) (King, J. dissenting opinion).
Judge Emilio M. Garza became a member of the Court after this case was heard en banc but elected not to participate in the decision; Judge Sam D. Johnson took senior status after the case was heard but before this opinion was rendered and did not participate in the decision of this case. See United States v. Anderson, 885 F.2d 1248, 1249 (5th Cir.1989) (en banc )
Hinds County General Hospital, Medical Staff Bylaws, Rules and Regulations (1987)
a. Whenever ... any member of the Medical Staff ... has cause to question, with respect to an individual holding a current Medical Staff appointment:
a written request for an investigation shall be addressed to the Executive Committee making specific reference to the activity or conduct which gives rise to the request....
b. The Executive Committee shall forward any requests for corrective action to the Section Chief of the Clinical Section in which the questioned activity or conduct occurred, and to the Chief of Staff. The Chief of Staff shall immediately appoint a three member ad hoc committee consisting of members of the Clinical Section or department affected to investigate the matter. Within twenty (20) days after the receipt of the request for corrective action, the committee shall forward its written report of the investigation to the Executive Committee. Prior to the making of any such report that would recommend probation, reduction, suspension or revocation of clinical privileges, ... the practitioner against whom corrective action has been requested shall have an opportunity for an interview with the ad hoc investigative committee. At such interview, the affected practitioner shall be informed of the general nature of the charges against him, and shall be invited to discuss, explain or refute them....
a. Whenever a practitioner willfully disregards these By-laws or other Hospital policies, or whenever his conduct requires that immediate action be taken to protect the life of any patient(s) or to reduce the substantial likelihood of immediate injury or damage to the health or safety of any patient, ... the Executive Committee of the Medical Staff shall have the authority to summarily suspend ... the clinical privileges of such practitioner....
HEARING AND APPELLATE REVIEW PROCEDURE
h. Each party shall have the following rights: To call and examine witnesses, to introduce written evidence, to cross-examine any witness or any matter relevant to the issue of the hearing, to challenge any witness and to rebut any evidence....
j. Within twenty (20) days after final adjournment of the hearing, the hearing committee shall make a written report and recommendation and shall forward the same together with the hearing record and all other documentation to the Executive Committee.... The report may recommend confirmation, modification or rejection of the original adverse recommendation of the Executive Committee....
As recently as 1987, the Mississippi Supreme Court found no occasion to overrule the common-law doctrine of employment-at-will and create a tort action for wrongful discharge. See Perry v. Sears, Roebuck & Co., 508 So.2d 1086, 1089-90 (Miss.1987) (declining to reconsider Kelly v. Mississippi Valley Gas Co., 397 So.2d 874 (Miss.1981)). We note, however, that a federal district court in a diversity case held that the state supreme court "would recognize a limited public policy exception to the employment-at-will rule." Laws v. Aetna Finance Co., 667 F.Supp. 342, 348 (N.D.Miss.1987)
Although we must assume the truth of Dr. Caine's allegations for purposes of reviewing the court's Rule 12(b)(6) dismissal, those allegations must be read in tandem with the vouchsafed exhibits attached to Dr. Caine's complaint. See Zinermon, 110 S.Ct. at 979
The dissent asserts that as a result of our analysis, Rule 12(b)(6) is a dead letter because we have effectively drawn factual inferences against Dr. Caine, rather than assuming the truth of his allegations. C. Wright, Federal Courts, 3d Ed. § 68. This hyperbole is incorrect. Dr. Caine's complaint nowhere took issue with the original ground for the investigation against him, the death of one of his patients. This fact is clearly stated in the documents attached to his petition. It is our position that this fact invokes the "public safety" rationale for truncated predeprivation process followed by an adequate post-suspension remedy. Zinermon, 110 S.Ct. at 984. We continue to assume that bias infected the outcome of the investigation but, given the exigent circumstances, that defect does not change the due process analysis. To hold otherwise would eviscerate the public safety component of due process analysis.
For purposes of Parratt/ Hudson, this judicial review is an "adequate post-deprivation remedy" for random and unauthorized violations of the hospital regulations. Under the statutory review provisions, the aggrieved physician may appeal to the chancery court within 30 days of receiving notice of the final decision to suspend or revoke his medical privileges. See Miss.Code Ann. § 73-25-93 (incorporating id. § 73-25-27). The statute requires the court to consider whether "the procedures followed by [the hospital] violated its own bylaws for due process." Wong v. Garden Park Community Hosp., 565 So.2d 550, 553 (Miss.1990). If the procedures did violate the bylaws, the chancery court's general equity powers would be available for appropriate redress. See Miss.Code Ann. § 73-25-27 (the appeal "shall be conducted as other matters coming before the [chancery] court"); id. § 9-1-19 (chancery courts may "grant injunctions all other remedial writs, in all cases where the same may properly be granted according to right and justice")
Furthermore, the aggrieved physician may pursue an action for damages against any person, including the hospital itself, who is responsible for the violations of the bylaws. The statute grants immunity only for "any action taken without malice in carrying out the provisions of [the medical staff bylaw requirements]." Id. § 73-25-93(2) (emphasis added). As the Mississippi Supreme Court noted in Wong v. Garden Park Community Hospital, "[t]he statutory scheme does not foreclose an independent legal action to determine the propriety of the termination on the facts." 565 So.2d at 553 (quoting Wong v. Stripling, 881 F.2d 200, 202 (5th Cir.1989)). For example, individual physicians who intentionally violated hospital bylaws in order to drive a competitor out of business might be liable for tortious interference with business relations. See Galloway v. Travelers Ins. Co., 515 So.2d 678, 682-83 (Miss.1987).
Darlak v. Bobear, 814 F.2d 1055 (5th Cir.1987)
Zinermon v. Burch, 494 U.S. 113, 110 S.Ct. 975, 108 L.Ed.2d 100 (1990)
See Hudson v. Palmer, 468 U.S. 517, 104 S.Ct. 3194, 82 L.Ed.2d 393 (1984); Parratt v. Taylor, 451 U.S. 527, 101 S.Ct. 1908, 68 L.Ed.2d 420 (1981), overruled in part on other grounds, Daniels v. Williams, 474 U.S. 327, 106 S.Ct. 662, 88 L.Ed.2d 662 (1986)
In their 12(b)(6) motion, defendants added a routine alternative motion for summary judgment. But the defendants and the court treated the motion as a 12(b)(6) motion throughout, and the court's judgment was based upon 12(b)(6)