Opinion ID: 1729272
Heading Depth: 2
Heading Rank: 4

Heading: Statutory Immunity for the Spooner Defendants

Text: ¶ 72 Dr. Rechsteiner's claims against the Spooner defendants involve allegations that members of Spooner's Board defamed him and negligently communicated false information when they made statements about him to Hazelden staff. [11] ¶ 73 The Spooner defendants argue that Wis. Stat. § 146.37(1g) is to be interpreted broadly to protect the statements of participants involved in a medical peer review process. They point out that the language of § 146.37(1g) does not limit the persons granted immunity and insist that the Board, which initiated the peer review of Dr. Rechsteiner, constitutes an entity whose actions are immune under § 146.37. Furthermore, the Spooner defendants explain that when the Board was presented with the sheriff's incident report, it took a proactive approach in Dr. Rechsteiner's assessment, which is exactly what was envisioned by the legislature to prevent patient harm. ¶ 74 Dr. Rechsteiner argues that the employees and agents of Spooner, including Schafer, Cuskey, Long, and Stewart, are not immune from liability because Wis. Stat. § 146.37(1g) does not extend beyond the Board's own evaluation of his medical services. Dr. Rechsteiner emphasizes the fact that these defendants, who allegedly defamed him, are not surgeons or even physicians. Thus, he argues that they are not qualified to discuss the quality of treatment rendered by him. Furthermore, he contends that the statements the Spooner defendants made to Hazelden pertained to his personal life, rather than the quality of medical services he provides. Dr. Rechsteiner's assertions bring us to the fourth question: Do the actions and statements of the Spooner defendants qualify for immunity under Wis. Stat. § 146.37? ¶ 75 Wisconsin Stat. § 146.37(1g) states that no person acting in good faith who participates in the review or evaluation of the services of health care providers . . . is liable for any civil damages. In enacting this provision, the legislature chose not to distinguish between different classes of persons who enjoy immunity. Rather, the legislature extended immunity to any participating person acting in good faith. § 146.37(1g). The good faith of such persons is presumed. § 146.37(1m). Furthermore, § 146.37(1g) explicitly provides that immunity extends to the acts and omissions of peer review committees or hospital governing bodies in censuring, reprimanding, limiting or revoking hospital staff privileges. § 146.37(1g); see also Mallow, 148 Wis.2d at 330, 434 N.W.2d 839. ¶ 76 Wisconsin Stat. 146.37(1g) plainly applies to the actions of the Spooner Health System, the Spooner Board, its individual members (Cuskey, Long, and Stewart), and Spooner administrator/CEO Schafer in their review and evaluation of Dr. Rechsteiner's services and to any disciplinary action taken against him, so long as they were acting in good faith. As Dr. Rechsteiner acknowledges, disciplinary action taken by a governing body will be necessarily linked to the review of the physician's services by others knowledgeable in the same area of medicine. The Spooner defendants' actions in temporarily suspending Dr. Rechsteiner's privileges until he completed the required assessment and treatment with Hazelden fit squarely within the underlying objective of § 146.37, namely to encourage hospitals to perform quality-control reviews aimed at improving, prospectively, their services. Hofflander, 262 Wis.2d 539, ¶ 119, 664 N.W.2d 545 (citations omitted). The Spooner defendants' statements to Hazelden staff helped Hazelden perform its duty to assist Spooner in reviewing and prospectively improving the performance of its on-call surgeon. ¶ 77 Dr. Rechsteiner next contends that defendants Schafer, Cuskey, Long, and Stewart did not act in good faith when making statements to Hazelden. This implicates the fifth question: Did Dr. Rechsteiner provide evidence to the court that raised a genuine issue of material fact about the good faith of the Spooner defendants? Dr. Rechsteiner concedes that there is a presumption that a person participating in a peer review process is acting in good faith, but he argues that he should survive the defendants' motions for summary judgment because he presented facts that showed a triable dispute. Dr. Rechsteiner insists that the good faith analysis is a question of fact for a jury. ¶ 78 Two subsections of Wis. Stat. § 146.37 address the nature of good faith for purposes of immunity from civil liability, without actually defining the term. Wisconsin Stat. § 146.37(1m) provides: The good faith of any person specified in subs. (1g) and (3) shall be presumed in any civil action. Any person who asserts that such a person has not acted in good faith has the burden of proving that assertion by clear and convincing evidence. Wisconsin Stat. § 146.37(2) provides: In determining whether a member of the reviewing or evaluating organization or the medical director has acted in good faith under sub. (1g), the court shall consider whether the member or medical director has sought to prevent the health care provider or facility and its counsel from examining the documents and records used in the review or evaluation, from presenting witnesses, establishing pertinent facts and circumstances, questioning or refuting testimony and evidence, confronting and cross-examining adverse witnesses or from receiving a copy of the final report or recommendation of the reviewing organization or medical director. ¶ 79 We must keep in mind that this case comes to us on review of summary judgment. At summary judgment . . . [a plaintiff] must demonstrate only that a rational jury could find that [the plaintiff] had demonstrated lack of good faith by clear and convincing evidence. Harris, 13 F.3d at 1086. [12] In Harris, the Seventh Circuit interpreted Wis. Stat. § 146.37 and recognized that the legislature did not define good faith in the peer review statute. Id. It noted that [o]ther courts interpreting peer review statutes similar to Wisconsin's have also held that `good faith' is at least in part a subjective inquiry. Id. at 1087 (citations omitted). ¶ 80 The immunity granted in Wis. Stat. § 146.37 anticipates unvarnished candor in the course of medical services review. Protecting candor is necessary to the full and open review envisioned by the statute. To protect this candor, § 146.37(1m) creates a presumption of good faith for peer review participants. Any person who asserts that [one covered by § 146.37(1g)] has not acted in good faith has the burden of proving that assertion by clear and convincing evidence. § 146.37(1m). ¶ 81 Dr. Rechsteiner asserts that the statements made by the defendants [13] were false and easily verifiable as false, permitting an inference that the defendants lacked good faith. For example, Dr. Rechsteiner argues that a comment that his wife was terminated from her position at Spooner due to issues with Rechsteiner's alcohol usage was easily verifiable as false by the Spooner Board member making the statement. Dr. Rechsteiner argues that allegedly defamatory statements referred to his personal life and personality rather than the quality of his medical services. He suggests that the nature of the statements demonstrates bad faith on the part of the Spooner defendants. ¶ 82 We conclude that Dr. Rechsteiner has failed to present facts that overcome the presumption of good faith established by Wis. Stat. § 146.37(1m). [14] Dr. Rechsteiner failed to present facts that show that the defendants' statements made to Hazelden personnel were indisputably false and defamatory. Dr. Rechsteiner made conclusory assertions about the allegedly false nature of the statements. ¶ 83 More important, Dr. Rechsteiner failed to present facts that demonstrate that the Spooner defendants were not acting in good faith. For example, he did not show that the Spooner defendants knew that their statements were false. He did not allege that any of the Spooner defendants made statements to anyone other than Hazelden personnel  that is, that they made statements to people outside the peer review process. This sort of evidence is critical because when a person in Dr. Rechsteiner's position accuses one or more participants in a peer review process of defamation, he must demonstrate that there is a genuine issue of material fact as to whether the alleged statements were made in good faith. See Wis. Stat. § 146.37(1m). ¶ 84 Dr. Rechsteiner's assertions are similar to those proffered by the plaintiff in Limjoco. In Limjoco the plaintiff argued that the deposition testimony of one of the defendants revealed that he held a grudge against the plaintiff because he stated that he thought Limjoco had misdiagnosed a case which resulted in a lawsuit being initiated against [the defendant]. Limjoco, 169 Wis.2d at 713, 486 N.W.2d 567. The court of appeals determined that the plaintiff failed to make the defendants' good faith a disputed issue of fact because [Limjoco] offer[ed] only conclusory statements about the grudge. . . . He [did] not present established facts from which inferences of bad faith could be drawn. Id. at 714-15, 486 N.W.2d 567. ¶ 85 In our view, Dr. Rechsteiner offered less evidence than the plaintiff in Limjoco who failed to meet the burden of demonstrating a triable issue of fact regarding the good faith of the defendants. Dr. Rechsteiner's conclusory statements do not permit his claims to survive summary judgment. ¶ 86 Dr. Rechsteiner asserts that the personal nature of the statements has nothing to do with the quality of the medical services he provided Spooner Health System. However, insight into a physician's social and personal behavior is relevant to an inquiry of alleged alcohol abuse. It was reasonable for Hazelden to gather information on Dr. Rechsteiner's personal life to discern whether alcohol influenced his behavior and daily functioning. Since Spooner was concerned about Dr. Rechsteiner's use of alcohol during periods when he was on call, it was reasonable for Hazelden to gather information to determine whether his past behavior revealed the influence of alcohol on his personality. The defendants' statements to Hazelden in this regard do not serve as proof that the defendants did not act in good faith. ¶ 87 Lastly, Dr. Rechsteiner contends that the refusal of the defendants to answer questions during their depositions on the basis of a Wis. Stat. § 146.38 [15] privilege also supports the conclusion that the Spooner defendants did not act in good faith. He argues that under the plain language of § 146.37, this fact is unquestionably evidence of bad faith that renders summary judgment inappropriate. Dr. Rechsteiner points to the portion of § 146.37(2) that allows the court to inquire into the extent to which members of the reviewing committee seek to prevent the physician from obtaining information during the review process. Dr. Rechsteiner claims that the defendants improperly asserted a privilege in refusing to answer his questions during their depositions, which demonstrates a lack of good faith. ¶ 88 We disagree. As the Seventh Circuit recognized, good faith under Wis. Stat. § 146.37 is at least in part a subjective inquiry. Harris, 13 F.3d at 1087. Thus, even if the Spooner defendants asserted an incorrect privilege, this alone is not per se proof of a lack of good faith. Refusing to answer a question during a deposition on the advice of counsel does not create a genuine issue of material fact that rebuts the presumption of good faith in § 146.37(1m). ¶ 89 We conclude that Wis. Stat. § 146.37 applies to the actions of the Spooner defendants and immunizes them from civil liability for Dr. Rechsteiner's claims of defamation and negligent communication of false information. Dr. Rechsteiner has failed to demonstrate that there is a genuine issue of material fact as to whether the Spooner defendants were acting in good faith.