Opinion ID: 172871
Heading Depth: 3
Heading Rank: 5

Heading: Administrative Proceeding

Text: On February 1, 2005, Patsy Carter sent Dr. Couch a letter formally charging him with two counts of disruptive conduct. Count I involved a litany of events including Dr. Couch's conflicts with Drs. Cesko and Thomas, and his recent failure to attend psychiatric treatment as required by the Executive Committee. Count II involved MHCC's concerns about Dr. Couch's charting and billing practices and his failure to attend training in proper coding as required by the Executive Committee. Dr. Couch requested a due process hearing on these charges, and MHCC and Dr. Couch entered into an agreement for a hearing before an independent panel. The scope of the hearing was subsequently expanded after the Credentials Committee voted to recommend denying Dr. Couch's reappointment to the medical staff of MHCC, which was communicated to Dr. Couch in January 2006. Re-appointment is required every two years, and based on Dr. Couch's behavioral issues and inappropriate care and treatment of several patients, including Ms. Klewin, the Credentials Committee had recommended to the Board that Dr. Couch not be reappointed to the medical staff. The independent hearing panel heard testimony over four days in May and July of 2006, during which time Dr. Couch was represented by legal counsel. On July 26, 2006, the independent three-person panel issued a thorough report. The panel determined that Dr. Couch is a generally technically proficient practitioner but had provided substandard care to several patients, including substandard management of diabetic ketoacidosis in the case of Corrine Klewin. (Aplt. App. 1069.) The panel concluded, however, that Dr. Couch had only billed for services that he had actually performed to Ms. Klewin, and that the panel did not have enough information to determine whether Dr. Couch had or had not billed for services that he did not perform for Ms. Wilda or Mr. Jones. The panel further found that Dr. Couch's inability to accept responsibility and get along with many of his peers is disruptive to hospital operations and impact[s] negatively on his ability to deal with hospital employees [and medical staff members]. (Id. at 1076.) Also, the panel found that Dr. Couch is disruptive in that he fails to fulfill his work on the committees of the hospital. [13] (Id.) The hearing panel ultimately recommended that: (1) Dr. Couch should be evaluated by a mutually agreed-upon psychiatrist; (2) Dr. Couch should properly follow-up on any recommendations made by the psychiatrist; (3) Dr. Couch should make a documented good faith effort to improve relations with MHCC staff and doctors; (4) Dr. Couch should attend his committee meetings; (5) Dr. Couch should demonstrate competence in Diabetic Ketoacidosis management; and (6) Dr. Couch's privilege to continue practicing at MHCC should be conditionally granted subject to the foregoing terms. (Aplt. App. 1071-72.) On October 23, 2006, the Board of Trustees adopted the independent panel's recommendations with only minor alterations. [14] (Aplt. App. 1082-84.)