Court Opinion

ID: 2963655
Source: CourtListenerOpinion
Date Created: 2015-09-21 21:13:33.903403+00
Date Added: 2024-06-11T11:42:44.337984
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USCA1 Opinion

	

          September 20, 1995    [NOT FOR PUBLICATION]

                   U.S. COURT OF APPEALS FOR FOR THE FIRST CIRCUIT

                                 ____________________

        No. 94-2211

                       WILLIAM HAMILTON AND CHARLENE HAMILTON,

                               Plaintiffs, Appellants,

                                          v.

                         BAYSTATE MEDICAL EDUCATION, ET AL.,

                                Defendants, Appellees.

                                 ____________________

                     APPEAL FROM THE UNITED STATES DISTRICT COURT

                          FOR THE DISTRICT OF MASSACHUSETTS

                      [Hon. Michael Ponsor, U.S. District Judge]
                                            ___________________

                                 ____________________

                                        Before

                                 Selya, Circuit Judge,
                                        _____________
                           Campbell, Senior Circuit Judge, 
                                     ____________________
                               and Cyr, Circuit Judge.
                                        _____________

                                 ____________________

            Wendy Sibbison for appellants.
            ______________
            Toby G.  Hartt, with  whom  Jay M.  Presser and  Skoler, Abbott  &
            ______________              _______________      _________________
        Presser, P.C. were on brief for appellees.
        _____________

                                 ____________________

                                 ____________________

                      CAMPBELL, Senior Circuit Judge.  This appeal arises
                                ____________________

            from the termination of employment of Dr. William Hamilton, a

            pathologist  at  Baystate   Medical  Center  ("Baystate")  in

            Springfield, Massachusetts.  Dr. Hamilton brought a diversity

            action  in the  district  court  against  Baystate,  Baystate

            Medical  Education  and  Research Foundation  ("BMERF"),  and

            Baystate Health Systems ("BHS"), alleging breach of contract,

            negligent  infliction of emotional  distress, and intentional

            infliction   of  emotional  distress.1     In  addition,  Dr.

            Hamilton's  wife,   Charlene  Hamilton,  sued   for  loss  of

            consortium.   The  district court granted  Defendants' motion

            for summary  judgment on  all counts.   Hamilton  v. Baystate
                                                    ________     ________

            Medical  Educ. & Research Found.,  866 F. Supp.  51 (D. Mass.
            ________________________________

            1994).  We affirm.

                                          I.
                                          I.

                      Dr.  Hamilton worked as  a pathologist  at Baystate

            from 1970 to 1989.  In 1986, BHS created BMERF, a corporation

            which  employs doctors to work  at Baystate.2   At that time,

            Dr.  Hamilton,  along  with  all  full-time  pathologists  at

            Baystate, entered  into a  series of annual  BMERF employment

            contracts. 

                                
            ____________________

            1.  We note Plaintiffs' statement  that "no claim of handicap
            discrimination was brought."

                 2BHS  is  the parent  corporation  of  both Baystate  (a
            hospital) and BMERF.

                                         -2-
                                          2

                      In   1986,  Dr.   Hamilton's   performance   as   a

            pathologist  began to deteriorate.   Over the next  two and a

            half years,  his performance became  progressively worse, and

            he made  a number of errors in  diagnoses and the labeling of

            specimens.  In early 1989,  Dr. John Sullivan, Chairperson of

            the Baystate Pathology Department,  learned that Dr. Hamilton

            had  made  an  egregious error  in  November  of  1988.   Dr.

            Hamilton  had incorrectly diagnosed  breast cancer, resulting

            in a  patient  receiving unnecessary  surgery, a  potentially

            carcinogenic dose of radiation therapy, and a toxic course of

            chemotherapy.  On January 19, 1989, Dr. Sullivan met with Dr.

            Hamilton and  suggested that  Dr. Hamilton  resign.   At that

            meeting, it  was agreed  that  Dr. Hamilton  would take  some

            vacation  time to determine whether he was ill.  Dr. Hamilton

            soon  learned that he had been  suffering from Graves Disease

            for  roughly the previous three  years.  Graves  Disease is a

            severe  disease of  the  thyroid gland  which, if  untreated,

            results in the impairment of a person's memory and ability to

            concentrate.   Dr. Hamilton's  treating physician, Dr.  Haag,

            Chief  of  the  Endocrine/Metabolic  Division   at  Baystate,

            characterized  Dr.  Hamilton's  condition   as  severe.    He

            suggested that it was probably responsible for Dr. Hamilton's

            poor  performance.    Dr.  Hamilton  took approximately  five

            months of sick leave and paid vacation.

                                         -3-
                                          3

                      By the summer of 1989, Dr. Hamilton's thyroid gland

            was functioning  normally,  but he  continued  to  experience

            episodes  of cardiac  arrhythmias.   In August,  Dr. Hamilton

            wrote to  Dr. Sullivan stating that although  he was not in a

            position  to make long-term decisions and he did not think he

            was completely cured, he wanted to return  to work on a part-

            time basis in  September.  In  early September, Dr.  Hamilton

            twice reiterated his desire to  return to Baystate, but  each

            time his request was denied.

                      Shortly  thereafter,  Dr.   Hamilton  retained   an

            attorney  to negotiate a severance agreement with Defendants.

            In  January 1990,  a medical  malpractice tribunal  found Dr.

            Hamilton  negligent in  the case  of the  misdiagnosed breast

            cancer,  and Dr.  Sullivan filled  out a  terminal evaluation

            form that  was back dated to September  1, 1989.  In February

            1990, settlement negotiations between Dr. Hamilton's attorney

            and Defendants  broke  down, and  Dr. Hamilton  was asked  to

            retrieve his belongings from Baystate. 

                                         II.
                                         II.

                                      Discussion
                                      Discussion

                      We  review the  district court's  grant of  summary

            judgment de novo.   Goldman v. First National Bank,  985 F.2d
                                _______    ___________________

            1113, 1116 (1st Cir. 1993); Velez-Gomez v. SMA Life Assurance
                                        ___________    __________________

            Co., 8  F.3d 873, 874 (1st Cir. 1993).  Summary judgment will
            ___

            be affirmed only if "no genuine issue of material fact exists

                                         -4-
                                          4

            and  the moving party is entitled  to judgment as a matter of

            law."   Fed. R. Civ. P. 56(c);  O'Connor v. Steeves, 994 F.2d
                                            ________    _______

            905,  906-907 (1st Cir. 1993).   A genuine  issue of material

            fact exists "if the  evidence is such that a  reasonable jury

            could return a verdict  for the nonmoving party."   Oliver v.
                                                                ______

            Digital Equipment  Corp., 846 F.2d  103, 105 (1st  Cir. 1988)
            ________________________

            (quoting  Anderson v. Liberty Lobby,  Inc., 477 U.S. 242, 248
                      ________    ____________________

            (1986)).

                      In  determining whether  a factual  dispute exists,

            all reasonable inferences are made in  favor of the nonmoving

            party, in this case,  the Hamiltons.  See O'Connor,  994 F.2d
                                                  ___ ________

            at 907.  Nevertheless, the Hamiltons must provide evidence of

            an  issue of  material fact,  and may  not rely  "merely upon

            conclusory    allegations,    improbable   inferences,    and

            unsupported  speculation."    Medina-Munoz v.  R.J.  Reynolds
                                          ____________     ______________

            Tobacco Co., 896 F.2d 5, 8 (1st Cir. 1990).
            ___________

            A.   Breach of Contract
            A.   Breach of Contract

                      Dr.  Hamilton had  two separate  relationships with

            Defendants:   an  employee-employer relationship  with BMERF3

            and  a professional  staff  appointment with  Baystate.   Dr.

            Hamilton  argues  that  Defendants  (1)  violated  the  BMERF

                                
            ____________________

                 3The relevant employment  contract between Dr.  Hamilton
            and  BMERF was between January 1, 1989, and January 31, 1990.
            Although no  signed contract  was produced  by either  of the
            parties,  Defendants  do not  object,  for  purposes of  this
            appeal,  to  the district  court's  finding  that an  implied
            contract  existed for the above period with the same terms as
            the standard 1989 BMERF physician employment contract.

                                         -5-
                                          5

            employment contract by discharging  him without cause and (2)

            violated the  BMERF  and Baystate  contracts by  disregarding

            pre-termination procedural requirements.  We address each  of

            these contentions.

                      1.   Substantive Breach of Contract
                      1.   Substantive Breach of Contract

                      Dr. Hamilton alleges that he was discharged without

            cause in violation of his BMERF employment contract.  Summary

            judgment was correctly allowed if  the evidence, viewed in  a

            light  most  favorable  to Dr.  Hamilton,  was  such  that no

            reasonable  juror could  find  that his  termination violated

            either  the express terms of  his contract or  the common law

            standard of "just cause."   Under either standard, Defendants

            were justified in terminating Dr. Hamilton if they reasonably

            believed that he was unable to  fulfill the duties of a full-

            time pathologist  at Baystate.4   Based on the  record before

                                
            ____________________

                 4The employment contract provided in relevant part:

                      The Foundation [BMERF] may terminate this
                      Agreement    promptly    . . . if     the
                      Foundation learns  of circumstances which
                      the   Foundation    reasonably   believes
                      substantially  and  adversely affect  the
                      Member's  ability  to fulfill  the duties
                      hereunder . . . .

            The common law standard  of "just cause" has been  defined by
            Massachusetts courts to mean:

                      [T]here  existed  (1) a  reasonable basis
                      for  employer  dissatisfaction with  a[n]
                      . . .   employee,   entertained  in  good
                      faith,  for  reasons   such  as  lack  of
                      capacity or diligence, failure to conform
                      to usual standards  of conduct, or  other

                                         -6-
                                          6

            the district court, we  affirm the district court's  grant of

            summary judgment.

                      Dr.  Hamilton correctly  states  that, in  order to

            satisfy the terms of his employment contract, Defendants must

            have had a current belief at the time of termination that Dr.

            Hamilton  was  unable  to  perform  his  duties.     All  the

            admissible evidence here points  to such a belief:   there is

            little or nothing to the contrary.  Dr. Hamilton had suffered

            from untreated Graves Disease for approximately  three years.

            This illness most  affected his  brain, causing  him to  make

            repeated,  serious  mistakes.    Dr.  Hamilton  submitted  no

            evidence directly  from his  treating physicians that  he was

            fit  to return  to work in  September of 1989.   He tendered,

            instead, only  his own  hearsay statements that  his treating

            physician said  he was  cured of Graves  Disease,5 statements

                                
            ____________________

                      culpable  or  inappropriate behavior,  or
                      (2)  grounds   for  discharge  reasonably
                      related,   in   the   employer's   honest
                      judgement,  to the needs of his business.
                      (emphasis omitted). 

            Goldhor  v.  Hampshire College,  25 Mass.  App. Ct.  716, 521
            _______      _________________
            N.E.2d  1381,  1385  (1988)  (quoting Klein  v.  President  &
                                                  _____      ____________
            Fellows of Harvard College, 25 Mass. App. Ct. 204, 517 N.E.2d
            __________________________
            167, 169 (1987)).

                 5Dr. Hamilton alleges that his statements are persuasive
            evidence  that he was capable of returning to work.  Although
            a party  with the requisite degree of expertise may sometimes
            offer  opinion  evidence on  his own  behalf,   see  Shane v.
                                                            ___  ________
            Shane,  891 F.2d 976, 982  (1st Cir. 1989);  Von Henneberg v.
            _____                                        _____________
            Generazio,  403 Mass. 519, 531 N.E.2d  563, 566 (1988); Foley
            _________                                               _____
            v. Foley,  27 Mass. App.  Ct. 221, 537  N.E.2d 158, 160  n.4,
               _____
            review denied, 405 Mass. 1202, 541 N.E.2d 344 (1989), we need
            _____________

                                         -7-
                                          7

            which  must   be  read  in  conjunction   with  his  treating

            physician's deposition statement that,  in his opinion, as of

            September 1,  1989, he  did not  know whether  Dr. Hamilton's

            cognitive function  had returned to normal, that  he was very

            concerned  by the  slowness  of his  recovery,  and that  Dr.

            Hamilton "was not able  to return to a full-time  post, doing

            everything that a  general pathologist had  to do to  perform

            all of his duties."  Moreover, given the debilitating effects

            of Graves Disease, it  could reasonably be surmised that  Dr.

            Hamilton was unlikely  to have  kept abreast  of the  medical

            knowledge  within his field during the period of his illness.

            We  see no basis in  this record for  concluding anything but

            that Defendants'  discharge of  Dr. Hamilton was  prompted by

            their reasonable belief that his condition "substantially and

            adversely" affected  his ability to perform  as a pathologist

            at Baystate in September of 1989.

                      Dr.  Hamilton  cautions  against  the  granting  of

            summary judgment  when "state of  mind" is a  critical issue.

            See  Stepanischen v.  Merchants Despatch  Transp.  Corp., 722
            ___  ____________     __________________________________

            F.2d 922, 928-29  (1st Cir.  1983).  However,  the fact  that

                                
            ____________________

            not decide  whether a physician can  provide medical evidence
            as his own  expert witness  because Dr. Hamilton  was not  an
            expert in endocrinology nor did he base his statements on his
            own medical opinion but  rather on the purported opinions  of
            his   treating   physicians.      Dr.    Hamilton's   hearsay
            representation  of these opinions  was not competent evidence
            within  Fed. R.  Civ. P. 56(e).   See  Garside v.  Osco Drug,
                                              ___  _______     __________
            Inc., 895 F.2d 46, 50 (1st Cir. 1990).
            ____

                                         -8-
                                          8

            "state of mind" or motivation is an element of proof does not

            necessarily   preclude  summary  judgment   in  an  otherwise

            appropriate case.   Id.   Accord White v.  Hearst Corp.,  669
                                ___   ______ _____     ____________

            F.2d 14,  17 (1st Cir. 1982); Hahn  v. Sargent, 523 F.2d 461,
                                          ____     _______

            468 (1st Cir. 1975), cert. denied, 425 U.S. 904 (1976). 
                                 ____________

                      Dr. Hamilton  argues that there is  a triable issue

            as to whether Defendants were honest in their asserted belief

            that he was unable  to perform his duties at Baystate.  Under

            Massachusetts  law,  an  employer's reasons  for  termination

            cannot be  given in  bad faith.    See Klein  v. President  &
                                               ___ _____     ____________

            Fellows of Harvard College, 25 Mass. App. Ct. 204, 517 N.E.2d
            __________________________

            167, 169-170 (1987).  Defendants should have known, plaintiff

            argues, that his thyroid gland was functioning normally as of

            September  1989.   But, as  pointed out  above, Dr.  Hamilton

            presented no objective medical evidence that he was fully fit

            to  perform his duties then and, indeed, did not even himself

            claim that he was cured.  Dr. Hamilton urges that Defendants'

            failure  to   report  him  to  the   Massachusetts  Board  of

            Registration  in  Medicine  as an  "impaired  physician," and

            their failure to warn other hospitals where he was working in

            December of  1989, shows that  they did not  honestly believe

            that he was  unfit to  return to work,  and, therefore,  that

            they terminated him in  bad faith.  We think  these omissions

            were  insufficient, by  themselves,  to establish  bad faith.

            While believing that Dr. Hamilton was unfit to return to work

                                         -9-
                                          9

            at  Baystate,  Defendants may,  at  the same  time,  have not

            wanted  to destroy  his medical  career  by reporting  him to

            other hospitals and to the Registration Board.

                      Dr.   Hamilton  argues  that  Defendants  were  not

            reasonable in  believing that  he was  unable to  perform his

            duties  at Baystate.  He  points to their  failure to consult

            his  physicians  in September  of  1989 in  order  further to

            ascertain  his  medical  condition.     Given,  however,  the

            seriousness of Dr. Hamilton's prior mistakes, his hiatus from

            practicing medicine, his own admission that  he was not fully

            "cured,"  and his  own failure  to have  presented supporting

            letters  or the  like from  his physicians  attesting to  his

            fitness  to practice, we do not think that more was required.

            Dr.  Hamilton   further  argues   that  a  jury   could  find

            Defendants' belief was not  reasonable because he was current

            in  his   continuing   medical  education   credits.     Yet,

            notwithstanding  such  credits,  Defendants could  reasonably

            surmise that his medical  knowledge could not have progressed

            at the normal rate during the three years he suffered acutely

            from Graves Disease.

                      2.  Violation of Procedural Safeguards
                      2.  Violation of Procedural Safeguards

                      Dr.  Hamilton  argues   that  Defendants   violated

            relevant procedural safeguards by not affording him notice or

            a  hearing.  It is undisputed that certain procedures must be

            followed upon  suspension of medical staff  privileges or any

                                         -10-
                                          10

            other specified  "adverse action" at Baystate.6   An "adverse

            action,"   as  defined  in   Baystate's  Fair  Hearing  Plan,

            includes:  revocation of medical staff membership,  reduction

            in staff category,7 special limitation of the right to  admit

            patients, or reduction of clinical privileges.

                      Dr. Hamilton  argues that he suffered  a suspension

            of staff  privileges and a reduction  in clinical privileges.

            Defendants respond  that they did not  suspend Dr. Hamilton's

            staff privileges at Baystate.  They point to the affidavit of

            Michael  Kujath, Executive  Director  of BMERF,  which stated

            that  Dr. Hamilton's  "medical staff membership  and clinical

                                
            ____________________

                 6The  procedural protections  set forth  in  the Medical
            Staff  Bylaws,  the  Medical  Staff  Credentialing  Procedure
            Manual, and  the Fair  Hearing Plan  include:  (1) review  of
            suspension  within  72  hours  by  a  Medical  Staff  Summary
            Suspension Review Committee, (2) written notice to the doctor
            of the suspension or "adverse action," and (3) a hearing.

                 7Dr.  Hamilton argues  that he  suffered a  reduction in
            staff category because he lost his appointment as Co-Director
            of Microbiology at Baystate.  Defendants respond in two ways.
            First,  they  point to  Baystate's  Fair  Hearing Plan  which
            states  that "the  removal of  a practitioner from  a medico-
            administrative office  within the  Medical  Center" does  not
            entitle the practitioner  to a hearing.   Second, they  argue
            that  the  reduction in  staff  category  argument is  waived
            because Dr.  Hamilton  failed to  raise  it in  the  district
            court.  Defendants  were  given  no  opportunity  to  present
            evidence as to  the meaning of "reduction  in staff category"
            and  "medico-administrative  office."     We  hold  that  Dr.
            Hamilton  has  waived this  line  of argument.    See Playboy
                                                              ___ _______
            Enters., Inc., v. Public Serv. Comm. of Puerto Rico, 906 F.2d
            _____________     _________________________________
            25,  40 (1st  Cir.),  cert. denied,  Rivera  Cruz v.  Playboy
                                  ____________   ____________     _______
            Enters., Inc., 498 U.S. 959 (1990) ("Issues not raised before
            _____________
            the  trial court  are waived  on appeal  . . . absent unusual
            circumstances  or  plain  error  suggesting  that  a   'clear
            miscarriage of justice' has occurred.")

                                         -11-
                                          11

            privileges  at Baystate  Medical Center,  were not,  in fact,

            ever suspended."  Suspension of staff privileges would affect

            Dr.  Hamilton's  ability to  practice  medicine  not only  at

            Baystate,  but at  any  facility.    Dr. Hamilton  relies  on

            Defendants'  statement  of intent  to  "remove  him from  the

            staff" made  at the January  1989 meeting where  Dr. Sullivan

            and  Dr. Hamilton  discussed what  should be  done  about Dr.

            Hamilton's  slipping performance.   But  the outcome  of that

            meeting  was a  decision that  Dr. Hamilton should  take some

            vacation time to  determine if  he was ill  and that  nothing

            would  be  done with  respect  to  Dr. Hamilton's  employment

            status at that time.  

                      Dr. Hamilton also relies on the fact that his  name

            was omitted  from a list  of pathology department  members in

            the House  Staff Recruitment  Brochure.  However,  given that

            this omission  was made  at a time  when Dr. Hamilton  was on

            medical   leave,  and   given  Executive   Director  Kujath's

            affidavit that Dr. Hamilton  was not removed from the  staff,

            we  find  the  omission  of  Dr.  Hamilton's  name  from  the

            recruitment  brochure insufficient,  by itself,  to create  a

            triable issue as to whether Dr. Hamilton's medical privileges

            were reduced or suspended.  There is no probative evidence in

            the record that Dr. Hamilton's  staff privileges were in fact

            ever suspended.

                                         -12-
                                          12

                      Dr.  Hamilton  argues that  even if  his privileges

            were  not   formally   reduced  or   suspended,   they   were

            constructively suspended  as a necessary  consequence of  his

            termination  because all full-time Baystate pathologists must

            be  BMERF members.  However, in St. Louis v. Baystate Medical
                                            _________    ________________

            Center,  Inc., 30 Mass. App.  Ct. 393, 568  N.E.2d 1181, 1186
            _____________

            (1991),  the court noted that  physicians who no longer could

            perform  services  at   Baystate  could   still  have   staff

            privileges.8    Termination  of  BMERF  employment  does  not

            constructively  result   in  a  change   in  Baystate   staff

            privileges.  

                      Dr.   Hamilton  also   argues  that   the  Baystate

            procedural safeguards should apply  to the termination of his

            BMERF contract.  BMERF's bylaws provide that all its members'

            "professional activities"

                      shall  be  subject to  and  in compliance
                      with the medical staff review procedures,
                      bylaws,     rules,    and     regulations
                      established by the  hospital or  facility
                      in    which   Foundation    members   are
                      practicing.

            Dr. Hamilton argues that because his  professional activities

            were  governed  by  Baystate's   rules,  he  is  entitled  to

            Baystate's  procedural  protections  upon   termination  from

                                
            ____________________

                 8The court stated "[The] doctors no longer performed any
            professional services at Baystate, even though they continued
            to enjoy clinical privileges  there."  St. Louis,  568 N.E.2d
                                                   _________
            at 1186.  (The St. Louis case involved a different issue than
                           _________
            this case since there  Baystate proceeded to formally suspend
            the clinical privileges of the doctors in question.)

                                         -13-
                                          13

            BMERF.    This argument  fails because  Baystate's procedural

            protections  expressly apply only  to "adverse  actions," and

            the  exhaustive list  of "adverse  actions" does  not include

            termination  of a  physician's  contract with  BMERF.   Hence

            termination of Dr. Hamilton's  BMERF employment contract  did

            not trigger Baystate's hearing process.

            B.   Tort Claims
            B.   Tort Claims

                      Dr.   Hamilton   alleges   that   Defendants   both

            negligently  and  intentionally inflicted  emotional distress

            upon  him  because  of  their callous  treatment  during  his

            termination.   Defendants  allegedly  failed  to  notify  Dr.

            Hamilton of his termination for several months.  As a result,

            Dr. Hamilton asserts, he suffered emotional distress from the

            uncertainty  of not knowing when, if ever, he would return to

            his job.  The district court held that both the negligent and

            intentional  infliction of  emotional  distress  claims  were

            barred by  the Massachusetts Workers'  Compensation Act, and,

            in  addition,  that  Dr.   Hamilton  had  not  alleged  facts

            sufficient  to  make  out a  claim  for  either negligent  or

            intentional infliction of emotional distress.

                      Under  Massachusetts law,  common  law actions  are

            barred by the state's workers' compensation act where (1) the

            Plaintiff is an employee of  the Defendant, (2) the condition

            is a  "personal injury," and the injury arises "out of and in

            the course  of . . . employment."   Foley v.  Polaroid Corp.,
                                                _____     ______________

                                         -14-
                                          14

            381  Mass. 545, 413 N.E.2d 711, 713-714 (1980); Mass. Gen. L.

            ch.  152,    26.9    "Personal  injury"  includes "mental  or

            emotional disabilities only  where a significant contributing

            cause  of such disability [is]  an event or  series of events

            occurring within the employment."  Mass. Gen. L. ch. 152,   1

            (7A).   This bar applies to  claims of intentional infliction

            of emotional distress, see Tennaro v. Ryder System, Inc., 832
                                   ___ _______    __________________

            F. Supp. 494, 500 (D. Mass. 1993);  Anzalone v. Massachusetts
                                                ________    _____________

            Bay Transp. Auth., 403 Mass. 119, 526 N.E.2d 246, 249 (1988);
            _________________

            Mullen  v. Ludlow  Hosp. Soc'y,  32 Mass.  App. Ct.  968, 592
            ______     ___________________

            N.E.2d  1342, 1345, review denied, 413 Mass. 1103, 598 N.E.2d
                                _____________

            1133 (1992), and claims  of negligent infliction of emotional

            distress, see Clarke v. Kentucky Fried Chicken of California,
                      ___ ______    _____________________________________

            Inc.,  57 F.3d 21, 27-29  (1st Cir. 1995);  Catalano v. First
            ____                                        ________    _____

            Essex Savings Bank, 37  Mass. App. Ct. 377, 639  N.E.2d 1113,
            __________________

            1115-16,  review  denied,  419  Mass. 1101,  644  N.E.2d  225
                      ______________

            (1994). 

                      Dr. Hamilton argues  that the Workers' Compensation

            Act is not applicable because he was no longer an employee at

            the  time Defendants  caused  his injuries.   However,  under

            Massachusetts law, injuries that arise out of the termination

            process  are  considered to  have  arisen "in  the  course of

                                
            ____________________

                 9There  is an  exception to  preemption if  the employee
            expressly reserves his  right to bring  common law causes  of
            action.  Mass.  Gen. L. c. 152,   24.   However, Dr. Hamilton
            does not assert that he reserved his right to sue outside the
            Workers' Compensation Act.

                                         -15-
                                          15

            employment" for purposes  of the  Workers' Compensation  Act.

            See   Bertrand v. Quincy  Mkt. Cold Storage  & Warehouse Co.,
            ___   ________    __________________________________________

            728  F.2d 568,  572 (1st  Cir. 1984)  (holding that  injuries

            caused  in  part by  a  letter that  may  have  been sent  to

            plaintiff  after  termination  were  nonetheless   barred  by

            Workers' Compensation  Act because it  was part  of a  single

            course  of   conduct  begun  when  plaintiff   was  still  an

            employee); Presto v. Sequoia Sys.,  Inc., 633 F. Supp.  1117,
                       ______    ___________________

            1120-21 (D. Mass. 1986);  Flynn v. New England Tel.  Co., 615
                                      _____    _____________________

            F.  Supp. 1205, 1209-10 (D. Mass. 1985) (holding that a claim

            for emotional  injury arising out of  termination process was

            barred  by  Workers' Compensation  Act).    The conduct  that

            allegedly  injured Dr.  Hamilton  was  part  of a  series  of

            actions that resulted  in his termination.   We conclude that

            Dr. Hamilton's personal  injury claims  against his  employer

            were barred by the Workers' Compensation Act.

                      After  deciding that the  emotional distress claims

            were statutorily  barred, the district court went on to find,

            in  addition, that Dr. Hamilton had failed to set forth facts

            sufficient  to make out  a claim of  negligent or intentional

            infliction of emotional distress.  The court was also correct

            in this determination.

                      The Supreme  Judicial  Court of  Massachusetts  has

            held  that the  negligent  infliction of  emotional  distress

            requires    physical    harm    "manifested   by    objective

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                                          16

            symptomatology."  Payton v.  Abbott Labs, 386 Mass.  540, 437
                              ______     ___________

            N.E.2d   171,  181   (1982).     There  must   be  "objective

            corroboration of the emotional distress alleged." Sullivan v.
                                                              ________

            Boston Gas Co.,  414 Mass.  129, 605 N.E.2d  805, 809  (1993)
            ______________

            (quoting Payton,  437 N.E.2d at  175).  Dr.  Hamilton alleges
                     ______

            that he  suffered severe  stomach pains,  frequent headaches,

            and insomnia as a result of Defendants' actions.  

                      Dr.  Hamilton argues  that under  Massachusetts law

            his  symptoms  suffice  to  sustain  a  claim  for  negligent

            infliction of  emotional distress.   Sullivan, 605  N.E.2d at
                                                 ________

            806-07, 810-11.   The  Sullivan court found  that plaintiffs'
                                   ________

            showing satisfied the physical harm requirement of a claim of

            negligent infliction  of emotional  distress.  In  that case,

            one   plaintiff  suffered  from   tension  headaches,  muscle

            tenderness,   insomnia,   gastrointestinal  distress,   upset

            stomach,  nightmares,  depression,  despair,   difficulty  in

            driving and working, and concentration and reading  problems.

            The second plaintiff  suffered from severe  physical symptoms

            associated  with  clinical  post  traumatic  stress  disorder

            including diarrhea, heart palpitations,  insomnia, depression

            and  despair.    Both   plaintiffs  provided  expert  medical

            evidence of their physical harm. Id.  Dr. Hamilton's  alleged
                                             ___

            symptoms were  less severe than  those in Sullivan,  were not
                                                      ________

            treated,   resulted  in   no   related  expenses,   and  were

                                         -17-
                                          17

            corroborated  by no  medical testimony.   The  Sullivan court
                                                           ________

            stated that

                      plaintiffs must  corroborate their mental
                      distress  claims  with  enough  objective
                      evidence of harm to convince a judge that
                      their   claims   present   a   sufficient
                      likelihood of genuineness to go to trial.
                      Expert medical testimony may be needed to
                      make this showing . . . .  The judge will
                      consider  each  case  in  its  particular
                      factual context . . . . [T]he  judge will
                      use his or her discretion to evaluate the
                      evidence.

            Id.  at 810.  The  record here supports  the district court's
            ___

            conclusion that Dr. Hamilton "is unable to prove the physical

            harm that is required."  Hamilton, 866 F. Supp. at 57.
                                     ________

                      The district court also ruled that Dr. Hamilton had

            not  set forth facts sufficient to meet the requirements of a

            claim of  intentional infliction of emotional  distress.  The

            standard for this cause of action is "extreme and outrageous"

            conduct, "beyond all possible bounds of decency" and "utterly

            intolerable in  a civilized  community."  Redgrave  v. Boston
                                                      ________     ______

            Symphony  Orchestra, Inc.,  557 F.  Supp. 230, 236  (D. Mass.
            _________________________

            1983);  Foley v. Polaroid Corp., 400 Mass. 82, 508 N.E.2d 72,
                    _____    ______________

            82 (1987); Agis  v. Howard  Johnson Co., 371  Mass. 140,  355
                       ____     ___________________

            N.E.2d  315, 318-19 (1976).  We agree with the district court

            that  none  of the  Defendants'  actions, viewed  in  a light

            favorable to Dr. Hamilton, rises to this level.

                      Dr.  Hamilton argues  that  Defendants mislead  him

            into believing  that he might be  able to return to  work and

                                         -18-
                                          18

            withheld notice of  his termination for  a period of  several

            months.  Whatever Defendants' motivation, the actions alleged

            were  not extreme,  outrageous  or intolerable.    We see  no

            evidence  of  behavior  sufficient  to sustain  a  claim  for

            intentional infliction of emotional distress.

            C.   Loss of Consortium
            C.   Loss of Consortium

                      Mrs. Hamilton  appeals  from the  grant  of summary

            judgment  for Defendants  on  her loss  of consortium  claim.

            Mrs. Hamilton's  claim fails for two reasons.  First, spousal

            loss of consortium claims based on injuries compensable under

            the Workers' Compensation Act are specifically barred.  Mass.

            Gen.  L. ch. 152,   24.   Second, Mrs. Hamilton's claim fails

            because  summary judgment  was appropriately  granted against

            the  underlying  tort  claims  of emotional  distress.    Any

            recovery  for loss of spousal consortium  requires proof of a

            tortious  act causing injury to the spouse.  See Mouradian v.
                                                         ___ _________

            General Electric Co., 23 Mass. App. Ct. 538, 503 N.E.2d 1318,
            ____________________

            1321, review denied, 399 Mass. 1105, 507 N.E.2d 1056 (1987). 
                  _____________

                      Affirmed.
                      Affirmed
                      ________

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