Court Opinion

ID: 9893386
Source: CourtListenerOpinion
Date Created: 2023-10-26 19:13:12.542203+00
Date Added: 2024-06-11T09:03:00.545614
License: Public Domain

IN THE SUPREME COURT OF APPEALS OF WEST VIRGINIA
                                                                        FILED
                          September 2023 Term
                          __________________                    October 26, 2023
                                                                     released at 3:00 p.m.
                                                                 EDYTHE NASH GAISER, CLERK
                              No. 21-0902                        SUPREME COURT OF APPEALS
                                                                      OF WEST VIRGINIA
                          __________________

         ROLAND F. CHALIFOUX, JR., D. O., individually and
          ROLAND F. CHALIFOUX, JR., D. O., PLLC d/b/a
             VALLEY PAIN MANAGEMENT CLINIC,

                       Plaintiffs Below, Petitioners,

                                     v.

    WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN
  RESOURCES, WEST VIRGINIA BUREAU OF PUBLIC HEALTH,
LETITIA TIERNEY, M. D., J. D., individually and in her former capacity as
 West Virginia Commissioner and State Health Officer, WEST VIRGINIA
   BOARD OF OSTEOPATHIC MEDICINE, and DIANA SHEPARD,
      individually and in her capacity as Executive Director for the
              West Virginia Board of Osteopathic Medicine,

                     Defendants Below, Respondents.

____________________________________________________________

              Appeal from the Circuit Court of Kanawha County
                  The Honorable Jennifer F. Bailey, Judge
                         Civil Action No. 16-C-844

                         AFFIRMED
____________________________________________________________

                     Submitted: September 13, 2023
                        Filed: October 26, 2023
Scott H. Kaminski, Esq.                Natalie C. Schaefer, Esq.
RAY, WINTON & KELLEY, PLLC             Caleb B. David, Esq.
Charleston, West Virginia              Kimberly M. Bandy, Esq.
Counsel for Petitioners                Shannon M. Rogers, Esq.
                                       SHUMAN MCCUSKEY SLICER
Perry W. Oxley, Esq.                   PLLC
L. R. Sammons, III, Esq.               Counsel for Respondents West
Samantha J. Fields, Esq.               Virginia Department of Health and
OXLEY RICH SAMMONS, PLLC               Human Resources, West Virginia
Huntington, West Virginia              Bureau for Public Health, and Letitia
Counsel for Respondents                Tierney, M. D., J. D.
West Virginia Board of Osteopathic
Medicine and Diana Shepard

JUSTICE WOOTON delivered the Opinion of the Court.
                              SYLLABUS BY THE COURT

              1.      “A circuit court’s entry of summary judgment is reviewed de novo.”

Syl. Pt. 1, Painter v. Peavy, 192 W.Va. 189, 451 S.E.2d 755 (1994).

              2.     “To the extent that governmental acts or omissions which give rise to

a cause of action fall within the category of discretionary functions, a reviewing court must

determine whether the plaintiff has demonstrated that such acts or omissions are in

violation of clearly established statutory or constitutional rights or laws of which a

reasonable person would have known or are otherwise fraudulent, malicious, or oppressive

in accordance with State v. Chase Securities, Inc., 188 W.Va. 356, 424 S.E.2d 591 (1992).

In absence of such a showing, both the State and its officials or employees charged with

such acts or omissions are immune from liability.” Syl. Pt. 11, W. Va. Reg’l Jail & Corr.

Facility Auth. v. A. B., 234 W. Va. 492, 766 S.E.2d 751 (2014).

              3.     “Before the prosecution of a lawsuit may be barred on the basis of res

judicata, three elements must be satisfied. First, there must have been a final adjudication

on the merits in the prior action by a court having jurisdiction of the proceedings. Second,

the two actions must involve either the same parties or persons in privity with those same

parties. Third, the cause of action identified for resolution in the subsequent proceeding

either must be identical to the cause of action determined in the prior action or must be

such that it could have been resolved, had it been presented, in the prior action.” Syl. Pt.

4, Blake v. Charleston Area Med. Ctr., Inc., 201 W. Va. 469, 498 S.E.2d 41 (1997).

                                              i
WOOTON, Justice:

              Petitioners/plaintiffs below Dr. Roland F. Chalifoux, Jr., D. O. and Roland

F. Chalifoux, Jr., D. O., PLLC d/b/a Valley Pain Management Clinic (collectively

“Chalifoux”) appeal the February 6, 2018, and October 4, 2021, orders entered by the

Circuit   Court    of   Kanawha      County       granting   summary   judgment     to   all

respondents/defendants below. In the underlying action Chalifoux alleged that respondents

West Virginia Department of Health and Human Resources, West Virginia Bureau for

Public Health (the “Bureau”), and its former Commissioner and State Health Officer,

Letitia Tierney, M. D., J. D., (collectively the “DHHR defendants”) breached their duty of

confidentiality by issuing a press release announcing that he and his clinic used unsafe

injection practices and urging patients to seek testing for bloodborne illnesses. As against

respondents West Virginia Board of Osteopathic Medicine (the “BOM”) and its Executive

Director, Diana Shepard (collectively the “BOM defendants”), Chalifoux asserted a due

process claim for failure to provide a hearing within fifteen days of their summary

suspension of his medical license as a result of the Bureau’s investigation.

              As to the DHHR defendants, the circuit court found that they were entitled

to qualified immunity because the issuance of a press release identifying Chalifoux and his

clinic was a discretionary act permitted by applicable regulations and Chalifoux produced

no evidence that they did so fraudulently or maliciously. As to the BOM defendants, the

circuit court found that Chalifoux’s claim for damages for failure to provide a timely

                                              1
hearing on his summary suspension could have been brought in a previously filed action

for injunctive relief—which action was settled and dismissed—and was therefore barred

by res judicata.

              After careful review of the briefs of the parties, their oral arguments, the

appendix record, and the applicable law, we find no error and therefore affirm the February

6, 2018, and October 4, 2021, orders of the circuit court.

                     I.     FACTS AND PROCEDURAL HISTORY

              On October 22, 2013, a patient underwent an epidural steroid injection at

Chalifoux’s clinic, Valley Pain Management; later that evening she was diagnosed with

bacterial meningitis and a report was made to the Bureau. The Bureau initiated an outbreak

investigation that included an inspection of Chalifoux’s clinic.       During the initial

inspection, Chalifoux allegedly told investigators that he did not wear masks during

procedures other than placement of spinal cord devices. Laboratory results revealed that

the specific flora cultured from the patient’s meningitis was respiratory in nature which,

coupled with Chalifoux’s failure to wear a mask, caused the Bureau to conclude that the

patient’s meningitis was “highly suspicious for iatrogenic [i.e., related to medical

treatment] transmission.” No further meningitis cases were uncovered.

              However, during the inspection of Chalifoux’s clinic, investigators also

purportedly identified unsafe, non-sterile injection techniques. Although the specifics of
                                             2
Chalifoux’s alleged techniques and the risk presented are disputed by the parties, the

Bureau believed that Chalifoux admitted to “double-dipping” with syringes, i.e., entering

a vial with a used syringe and then later using the vial for a different patient, creating a risk

of bloodborne disease transmission. Following the initial inspection, the Bureau provided

recommendations to correct these and other practices; in a follow-up inspection in

December 2013, the Bureau’s report noted the clinic undertook a “rapid and complete

response” to the issues raised and that its procedures were then found to be “excellent.”

Nonetheless, the Bureau had residual concerns and recommendations.

              More specifically, as a result of the alleged “double-dipping,” the Bureau

became concerned that the clinic posed a risk of bloodborne disease transmission among

certain of its patient population. The Bureau contacted patients who underwent procedures

in October 2013 and requested certain clinical records from Chalifoux to conduct a cross-

match with the State’s hepatitis and HIV registries to ascertain if any of his patients

contracted or could have been a source of transmission of these diseases. Because some of

the clinic’s patients were from Ohio and Pennsylvania, the Bureau was also in contact with

those states’ public health officials during its investigation.

                                               3
              At the end of February 2014, Dr. Danae “Dee” Bixler of the Bureau, who led

the investigation, determined that there had been no evidence of transmission, 1 the risk of

transmission was low, and therefore opined in an internal memo that “no further action is

necessary.” However, upon further consultation with both Ohio officials and the Centers

for Disease Control (the “CDC”), Dr. Bixler changed her mind about closing the

investigation and accepted the CDC’s recommendation that further patient notification was

necessary given the seriousness of the potential risk. Despite the relatively few clinic

patients identified on the registries, the concern was that other potentially infected patients

had simply not been tested and therefore could have contracted and/or presented additional

sources of transmission.

              To narrow the scope of potential patients requiring notification, the Bureau

requested additional clinic records and sent Chalifoux a questionnaire inquiring about his

practices with specific medications and procedures. 2 In late April 2014, Chalifoux

       1
         A small number patients who underwent procedures at the clinic were listed on the
hepatitis C and human immunodeficiency virus (“HIV”) registries; however, it was
determined that none contracted the disease at the clinic.
       2
        During this process, the Bureau continued to communicate with Chalifoux about
the dangers of syringe reentry and continued use of leftover medications which had been
potentially contaminated as a result of the syringe reentry. The Bureau underscores that at
no time during the interviews or correspondence regarding the alleged unsafe procedures
or the requests for information did Chalifoux ever take issue with the Bureau’s
characterization that he was “double-dipping.” In fact, in the questionnaire provided to
Chalifoux he responded “yes” to separate questions asking whether he reentered vials with
the same syringe and whether he reused vials for other patients.
(continued . . .)
                                              4
ostensibly began to balk at the scope of the records requests and retained counsel.

Respondent Dr. Letitia Tierney (“Dr. Tierney”) advised Chalifoux in writing that his

refusal to cooperate “limit[ed]” the Bureau’s choices in terms of notification and gave him

a deadline to provide the requested records; her letter also referred Chalifoux to applicable

regulations requiring, inter alia, the Bureau to notify patients of potential exposure.

Internally at the Bureau, Dr. Tierney discussed Chalifoux’s lack of response to the records

request in an email stating that “I may need to send [a] letter to board of medicine about

him and we need to get patient lists. . . . [I]f he doesn’t cooperate, then we will put adds

[sic] in the paper to notify his patients.”

              After Chalifoux continued to refuse the Bureau’s additional records requests,

Dr. Tierney filed a complaint with the BOM on July 17, 2014. In the complaint, Dr.

Tierney stated that because Chalifoux refused to provide records to allow for a more

targeted patient notification, a general announcement in the newspaper was necessary.

However, she explained in sworn testimony that she and officials in Ohio and Pennsylvania

had reached an agreement to refrain from publicizing the unsafe practices at that juncture.

        However, Chalifoux insists these answers are misleading given the wording of the
questionnaire. Essentially, Chalifoux argues that simply reentering a vial with the same
syringe on the same patient creates no risk of infection transmission; it is only if that vial
is then used on another patient that risk of transmission exists. He agrees that he reentered
vials with the same syringe, and that he reused vials on other patients. However, he denies
reentering a vial with the same syringe and then using that same vial with another patient.
He contends that he only reused vials if they had only been entered with clean syringes.
                                               5
Therefore, she decided to first pursue an administrative subpoena duces tecum to compel

Chalifoux to produce the necessary records.

              An administrative subpoena duces tecum seeking the additional records was

issued on July 18, 2014. 3 However, before the subpoena was returnable, on July 21, 2014,

public health officials in Ohio unexpectedly issued a press release urging the clinic’s Ohio

patients to seek out testing due to the Bureau having “identified possible, unsafe injection

practices . . . which potentially exposed patients to blood-borne infectious diseases like

hepatitis B, hepatitis C, and human immunodeficiency virus (HIV).” As a result of Ohio’s

press release, the Bureau began receiving a volume of calls from concerned West Virginia

patients. The Bureau then determined that its own press release was necessary, purportedly

to address citizen concerns. Therefore, on July 21, 2014—but subsequent to Ohio’s press

release earlier that day—the Bureau likewise issued a press release stating that Chalifoux’s

clinic “reused syringes to enter vials and saline bags used for more than one patient[]” and

urging patients to seek testing.

              As a result of Dr. Tierney’s complaint to the BOM, the BOM held an

emergency meeting and issued a “summary suspension” of Chalifoux’s license on July 25,

2014. The suspension order states that the BOM found probable cause that Chalifoux

engaged in conduct that departed from professional standards and that “there is an

       3
         There was apparently considerable litigation in Marshall County, West Virginia,
relative to the administrative subpoena duces tecum. See infra n.15.
                                            6
immediate danger to the public” if he were to continue to practice. Pursuant to West

Virginia Code of State Rules § 24-6-5.17 (2001), 4 the suspension order further advises that

Chalifoux is “entitled to a hearing regarding this action within fifteen days of the date of

suspension[]” and that he “should contact the Board as soon as possible so that a hearing

may be scheduled within the proper time frame, unless the Respondent wishes to waive the

fifteen-day time period.”      Although the circumstances surrounding the summary

suspension hearing are heavily disputed, it appears undisputed that Chalifoux was never

provided a hearing on the summary suspension by the BOM. 5

The Injunctive Action

              On August 21, 2014, Chalifoux filed a “Complaint and Petition for

Permanent Injunction and Motion for Temporary Restraining Order or Injunctive Relief”

       West Virginia Code of State Rules § 24-6-5.17 provides the following with regard
       4

to summary suspension:

                     The Board may suspend or refuse to renew a license
              pending a hearing if the health, safety or welfare of the public
              necessitates such summary action. The Board shall provide a
              hearing on the necessity for the summary action within fifteen
              (15) days after the suspension. The Board shall render its
              decision within five (5) days of the conclusion of a hearing
              under this section.
       5
         In short, the BOM takes the position that Chalifoux either did not timely request
such a hearing or affirmatively waived it through counsel. Chalifoux disputes both of these
contentions while maintaining that the BOM is obliged to provide a hearing without
affirmative action from him. Because the details of this dispute are not germane to our
resolution, we will refrain from further belaboring the factual details on this issue.
                                              7
(the “injunctive action”) in the Circuit Court of Kanawha County against the BOM. In his

complaint, Chalifoux sought only to enjoin the BOM’s summary suspension of his license.

However, the complaint denied that an “outbreak” occurred, noted his voluntary provision

of 1,600 patient files, his compliance with the inspection recommendations, and decried

the Bureau’s press release as “false and inflammatory.” The complaint further alleged that

Chalifoux “has and will suffer irreparable harm without injunctive relief” from his

suspension. 6 The complaint demanded a hearing from the circuit court on the requested

injunction but made no request that the circuit court order a hearing to be held by the BOM

regarding the summary suspension 7 or underlying complaint.

              A hearing on Chalifoux’s request for injunctive relief was held on August

27, 2014; the next day, the circuit court granted the injunction, entering an order enjoining

the enforcement of the summary suspension order and ordering that Chalifoux could

       6
        By way of irreparable harm, Chalifoux claimed that 1) he “has likely lost patients”;
2) his malpractice insurance was set to expire on August 31 and if his license remained
suspended, he would be unable to renew and required to pay a non-refundable $45,000
premium for tail coverage; and 3) he had to fire four employees. Chalifoux further argued
that public health would not be harmed as evidenced by the nearly one-year lapse since the
incident at issue and that he was likely to succeed on the merits, claiming never to have
“double-dipped.” He asserted that the BOM complaint was not grounded in his clinical
practices, but rather a dispute over the Bureau’s records request.
       7
         Insofar as the summary suspension hearing is concerned, his complaint stated only
that Chalifoux had requested a hearing but “the [BOM] ha[d] failed to act upon his
request[,]” noting that “[f]ar more than fifteen (15) days have passed . . . and even after
repeated requests” he had yet to receive a hearing. Other than allowing Chalifoux to
resume his practice, the circuit court’s injunctive order afforded no further relief to
Chalifoux or required any action of the BOM.
                                              8
resume his practice “as if the summary suspension ha[d] not occurred.” Other than a brief

reference to Chalifoux’s request for “a hearing to which he is entitled, pursuant to W. Va.

Code R. § 24-6-5.17[,]” the order did not further address the summary suspension hearing

or the underlying complaint.

              Notably, the appendix record reflects that on December 15, 2014, the circuit

court held a hearing on a motion to amend filed by Chalifoux in the injunctive action.8

During the hearing, Chalifoux’s counsel indicated that he sought to amend his complaint

to add both Dr. Tierney and Cynthia Bean of the Bureau for Medical Services as parties,

claiming that both were interfering with his ability to participate in the Medicaid program

despite the order of suspension having been enjoined. Chalifoux further claimed the

amendment was necessary to compel the State “to pay Dr. Chalifoux money which he is

owed” from “prior to the time that his license was suspended.” 9 The court held Chalifoux’s

motion to amend in abeyance, but indicated its willingness to allow the amendment and

      8
         The appendix record contains a partial transcript of the hearing as exhibits to
various filings, but not the underlying motion.
      9
        There is no indication, however, that this monetary claim is directly associated
with the due process claim asserted in the underlying action.

                                            9
further suggested that a request for mandamus relief should also be added to the complaint

to compel a hearing from the BOM if it did not occur in short order. 10

              Approximately ten months later, on October 26, 2015, the BOM dismissed

the Bureau’s complaint against Chalifoux, finding “no probable cause”; neither the parties

nor the record indicate what precipitated the dismissal at this particular juncture.

Approximately eight months later, on June 27, 2016, Chalifoux filed the underlying civil

action. Five months later, by order entered November 29, 2016, the injunctive action was

dismissed “with prejudice” upon the joint motion of the parties, stating that “all claims”

against the BOM “in the above-styled action have been compromised and settled.” 11

The Underlying Action

              As indicated above, while the injunctive action was still pending—and five

months prior to its dismissal—Chalifoux filed the underlying civil action against the

       10
         The majority of the hearing consisted of the circuit court expressing its dismay
about the BOM’s failure to provide Chalifoux with a hearing despite the over three-month
passage of time since the injunction was issued. The BOM’s counsel indicated that the
BOM believed the court’s injunctive order effectively nullified its ability to conduct a
hearing because the order “erased” probable cause. The circuit court took issue with that
reading of the order, denied that was its intention, and instead indicated that its intention
was to allow Chalifoux to practice until a hearing could be held; regardless, the circuit
court made clear that a hearing should be held as soon as possible.
       11
         In March 2016, there was apparently a hearing on Chalifoux’s motion to dissolve
the injunction and dismiss the injunctive action; that motion and transcript are not in the
appendix record and there is no clear indication why the injunctive action was not
dismissed at that time.
                                            10
DHHR and BOM defendants seeking monetary damages. Against the DHHR defendants,

Chalifoux asserted that the issuance of the press release was defamatory and violated the

confidentiality requirements of West Virginia Code of State Rules § 64-7-7.7 (2013)

(“State Rule 7.7”). As against the BOM defendants, Chalifoux alleged that they violated

his due process rights by summarily suspending him without a hearing.

              After discovery, the DHHR defendants moved for summary judgment on the

grounds of qualified immunity, which the circuit court granted. In its February 6, 2018,

order, the circuit court concluded that the issuance of the press release was well within the

DHHR defendants’ discretion as per the regulations which authorize release of such

information when there is a “clear and convincing need” to protect public health “as

determined necessary by the Commissioner.” See id. § 64-7-20.3 (“State Rule 20.3”). It

further concluded that the DHHR defendants violated no clearly established law in issuing

the press release and that Chalifoux failed to offer evidence that they acted fraudulently,

maliciously, or oppressively, beyond mere “[s]peculation” and “opinion.” 12

              Thereafter, the BOM defendants moved for summary judgment on the basis

of: 1) qualified immunity; 2) collateral estoppel and res judicata; 3) absence of duty; and

4) quasi-judicial immunity. On October 4, 2021, the circuit court entered an order granting

summary judgment to the BOM defendants on the basis of res judicata. The court found

       12
         The order further addressed Chalifoux’s purported defamation claim which it
found failed as a matter of law; Chalifoux makes no mention of that claim on appeal.
                                            11
that because Chalifoux’s claim for damages “could have been asserted and litigated” in the

injunctive action, it was barred by res judicata. The court observed that the damages

Chalifoux asserted in the instant action were “raised and discussed, though no formal cause

of action . . . was brought” in the injunctive action and concluded that such a claim was

barred because res judicata applies not only to matters “‘actually determined, but as to

every other matter which the parties might have litigated as incident thereto[.]’” (citing

Syl. Pt. 1, In re Est. of McIntosh, 144 W. Va. 583, 109 S.E.2d 153 (1959)). 13 This appeal

of both the 2018 and 2021 orders followed.

                              II.    STANDARD OF REVIEW

              As is well-established, “[a] circuit court’s entry of summary judgment is

reviewed de novo.” Syl. Pt. 1, Painter v. Peavy, 192 W.Va. 189, 451 S.E.2d 755 (1994).

       13
          Despite finding res judicata “dispositive,” the circuit court’s order nonetheless
addresses the remaining grounds asserted in the BOM defendants’ motion. The court found
that the BOM defendants were entitled to qualified immunity for the summary suspension
itself, which was an act within their discretion, but not entitled to immunity for “its failure
to perform its non-discretionary duty to hold a hearing within fifteen days of the summary
suspension.” As to quasi-judicial immunity, the court found that the BOM was a quasi-
judicial agency but was not performing a quasi-judicial function in failing to provide a
summary suspension hearing. For much the same reasons, the court rejected the BOM
defendants’ “duty” arguments, finding that the regulations plainly create a non-
discretionary duty to afford a hearing within fifteen days of a summary suspension.

        Despite extensively briefing these issues in the instant appeal, the BOM defendants
did not cross-assign these adverse rulings as error. For that reason, and because we find
the circuit court’s res judicata determination dispositive, it is unnecessary to address these
issues for purposes of this appeal.
                                              12
With this standard in mind, we will address the grant of summary judgment as to each set

of defendants below.

                                    III.   DISCUSSION

   A. The DHHR Defendants

              As to the DHHR defendants, Chalifoux argues that the circuit court erred in

finding they were entitled to qualified immunity in light of their breach of the “non-

discretionary” confidentiality requirements of State Rule 7.7 by issuing the press release.

State Rule 7.7, pertaining to “Other Reportable Events: Disease Outbreaks or Clusters,”

provides, in part:

                     The Commissioner or the local health officer shall not
              disclose the identity of the community, school, camp, daycare,
              health care facility, restaurant or food establishment, or other
              setting where an outbreak or cluster of disease occurs, unless
              the release is necessary to inform the public to take preventive
              action to stop the spread of disease or to notify providers or
              laboratories to identify additional cases of disease. . . .

Id. § 64-7-7.7 (emphasis added).       Chalifoux argues that the press release was not

“necessary” under the rule because Dr. Tierney was merely attempting to compel Chalifoux

to produce additional patient records for which she could have used the administrative

subpoena process and avoided unnecessary publicity. Chalifoux further argues that, even

if Dr. Tierney’s actions were discretionary, Dr. Bixler’s conclusion that “no further action”

was necessary, coupled with the timeline of events, suggests that there are genuine issues

of material fact about whether Dr. Tierney nonetheless issued the press release for a

                                             13
malicious purpose and therefore the DHHR defendants are unprotected by qualified

immunity. 14

               The DHHR defendants counter that Dr. Tierney is expressly authorized to

release otherwise confidential information when she deems it necessary for public health

pursuant to State Rule 20.3: “In the case of a licensed facility, the Commissioner or a local

health officer may release confidential information to the public when there is a clear and

convincing need to protect the public’s health as determined necessary by the

Commissioner.” Id. § 64-7-20.3 (emphasis added). They argue that Dr. Tierney testified

that she found the press release necessary because Chalifoux refused to provide additional

records which would have helped narrow the scope of a targeted patient notification and,

more importantly, because Ohio proceeded with its press release causing alarm among

West Virginia patients who read it. As for Dr. Bixler’s statement that “no further action”

was necessary, the DHHR defendants argue that Chalifoux entirely ignores Dr. Bixler’s

       14
          The Court has held that “on occasion, the State will be entitled to immunity when
the official is not entitled to the same immunity; in others, the official will be entitled to
immunity when the State is not.” Syl. Pt. 9, in part, Parkulo v. W. Va. Bd. of Prob. and
Parole, 199 W. Va. 161, 483 S.E.2d 507 (1996). However, in either event, when the
conduct involved is discretionary, a plaintiff must first demonstrate a violation of a clearly
established right or that it was otherwise fraudulent, malicious, or oppressive. See Syl. Pt.
11, in part, W. Va. Reg’l Jail & Corr. Facility Auth. v. A. B., 234 W. Va. 492, 766 S.E.2d
751 (2014). “In absence of such a showing, both the State and its officials or employees
charged with such acts or omissions are immune from liability.” Id. (emphasis added).
Because we find that Chalifoux has failed to make such a showing, we treat the DHHR
defendants collectively for purposes of our qualified immunity discussion.
                                              14
explanation that she reconsidered her decision about further patient notification upon

advice from the CDC.

              Although Chalifoux characterizes the DHHR defendants’ actions as violative

of the “non-discretionary” duty of confidentiality contained in State Rule 7.7, he offers no

meaningful rebuttal to the explicit discretionary authority granted to Dr. Tierney in State

Rule 20.3 to release such confidential information if deemed necessary for public health.

As such, he identifies no clearly established right or law violated by the DHHR defendants.

Therefore, we limit our analysis to whether there is a genuine issue of material fact about

whether her actions, although discretionary, were otherwise fraudulent, malicious, or

oppressive such as to strip the DHHR defendants of qualified immunity as instructed by

our holding in syllabus point eleven of A. B.:

                     To the extent that governmental acts or omissions which
              give rise to a cause of action fall within the category of
              discretionary functions, a reviewing court must determine
              whether the plaintiff has demonstrated that such acts or
              omissions are in violation of clearly established statutory or
              constitutional rights or laws of which a reasonable person
              would have known or are otherwise fraudulent, malicious, or
              oppressive in accordance with State v. Chase Securities, Inc.,
              188 W.Va. 356, 424 S.E.2d 591 (1992). In absence of such a
              showing, both the State and its officials or employees charged
              with such acts or omissions are immune from liability.

234 W. Va. at 49, 766 S.E.2d at 756, Syl. Pt. 11.

                                            15
              Admittedly, this Court has recognized that, generally, “whether a state

actor’s conduct was malicious is a ‘question[] for the fact-finder.’” W. Va. Div. of Nat.

Res. v. Dawson, 242 W. Va. 176, 191, 832 S.E.2d 102, 117 (2019) (quoting Maston v.

Wagner, 236 W. Va. 488, 508 n.15, 781 S.E.2d 936, 956 n.15 (2015)). However, Chalifoux

offers the Court no direct evidence of malice or fraud, arguing only that the timeline of

events permits an inference of Dr. Tierney’s attempt to “ruin” Chalifoux because she

“simply did not like [him] and was intent on teaching him a lesson.” Chalifoux offers no

evidence that Dr. Tierney did not like him or any indication as to why she would be

motivated to “ruin” him other than his suggestion that she took umbrage at his refusal to

“assent to her every whim” by producing the requested records. He maintains that Dr.

Tierney “threaten[ed]” him by stating in an email that she “may” need to send a letter to

the BOM and that newspaper ads may be needed for patient notification “if he doesn’t

cooperate[.]” Clearly, however, these statements merely outline the options provided in the

applicable regulations that were available to her in the exercise of her discretion.

              In that regard, we find that Chalifoux has failed to offer evidence upon which

a reasonable jury could conclude that the DHHR defendants’ actions were malicious or

fraudulent; in fact, the entirety of his claim against the DHHR defendants is premised on

acts that the DHHR defendants were legally obligated to perform. West Virginia Code of

State Rules § 64-7-7.4 requires that the DHHR defendants undertake an “appropriate

investigation” of a possible outbreak to include “[c]ase-finding.” State Rule § 64-7-7.4.d.3

provides that such “[c]ase-finding” includes “[p]ublic notification to identify and report
                                           16
additional cases,” if other means of case-finding are not feasible. While confidentiality is

generally required by State Rule 7.7, the language of that provision itself permits disclosure

of the involved clinic if “necessary to inform the public to take preventive action to stop

the spread of disease[.]” Id. § 64-7-7.7. This discretionary judgment to release confidential

information is reiterated in State Rule 20.3, permitting disclosure where there is “a clear

and convincing need to protect the public’s health.” Id. § 64-7-20.3; see also id. § 64-7-

7.9 (providing that the Commissioner “shall” notify patients found to be “at risk” of

exposure and “[i]n the course of notification of the patient, the Commissioner may identify

a health care provider or health care facility to the extent necessary to inform the patient of

the nature of the exposure or possible exposure.”).

              Chalifoux does not dispute that he refused to voluntarily provide the

requested additional records for targeted patient notification and identifies nothing which

requires the DHHR defendants to first utilize an administrative subpoena duces tecum to

compel him to provide that information. Cf. W. Va. Dep’t of Health & Hum. Res. v. Payne,

231 W. Va. 563, 573, 746 S.E.2d 554, 564 (2013) (finding no violation of clearly

established law where regulations provide that agency “‘may’” conduct additional

inspections “but is not required to do so.”). In attempting to articulate how his claim evades

qualified immunity, Chalifoux on the one hand chastises Dr. Tierney’s “haste” in filing the

BOM complaint and press release before she “allowed [the administrative subpoena]

                                              17
process to play out,” 15 yet professes to be “stagger[ed]” by her “wait[ing] nearly three

months” to take these actions if she “was so concerned about the public health risk[.]”

              At base, Chalifoux’s arguments are precisely the type of second-guessing

from which qualified immunity protects State officials acting within their discretionary

authority. Dr. Tierney plainly had regulatory authority to issue the press release if

“determined necessary” for public health—that necessity was created by Chalifoux himself

by failing to cooperate in developing a narrowly focused patient notification list. In that

regard, he bemoans nothing more than Dr. Tierney’s exercise of legislatively granted

discretion to fulfill her mandatory duties as the State’s public health officer. As we have

explained, “the purpose of qualified immunity is to allow officials to do their jobs and to

exercise judgment, wisdom, and sense without worry of being sued.” W. Va. Bd. of Educ.

v. Marple, 236 W. Va. 654, 661, 783 S.E.2d 75, 82 (2015). We therefore find no error in

the circuit court’s conclusion that the DHHR defendants are entitled to qualified immunity

and its grant of summary judgment on that basis.

   B. The BOM Defendants

              As to the BOM defendants, the circuit court found that Chalifoux could have

brought his claim for damages for their failure to provide a summary suspension hearing

       15
          Counsel for the DHHR defendants represented during oral argument that the
litigation of the miscellaneous action regarding the administrative subpoena duces tecum
was protracted, lasting for approximately fourteen months.
                                            18
in the injunctive action but failed to do so and therefore the claim is barred by res judicata.

Although the BOM defendants argue in support of the circuit court’s reasoning, we note

that at no time below did the BOM defendants argue that Chalifoux’s claim was barred

because he “could have brought” his claim for damages in the injunctive action. Instead,

the BOM defendants obtusely argued—somewhat interchangeably—that Chalifoux’s

claim was barred by both collateral estoppel and res judicata, because “the issue of a

hearing” had been “discussed” in the injunctive action and therefore had been “heard” and

“adjudicated[.]”

              Chalifoux, for his part, likewise conflates the concepts of collateral estoppel

and res judicata in his briefing before the Court, relying primarily on caselaw regarding

collateral estoppel and focusing largely on the fact that his damages were not “actually

litigated” in the injunctive action, rather than whether he could have brought the claim in

the injunctive action as determined by the circuit court. Therefore, before addressing the

circuit court’s ruling, we pause to address the confounding tenor of the BOM defendants’

arguments below and to clarify the distinction between the related, but independent,

concepts of collateral estoppel and res judicata.

              In their motion for summary judgment, the BOM defendants argued that

because Chalifoux “had a hearing” in the circuit court “related to the issues underlying his

summary suspension” and “whether his license should be restored,” res judicata and/or

                                              19
collateral estoppel applied. 16 In effect, the BOM defendants argued that because the circuit

court conducted a hearing and enjoined suspension of his license, Chalifoux had received

the hearing and potential relief the BOM was obligated to provide. They then argued that

the underlying action merely sought a different iteration of the relief Chalifoux had already

obtained. In so doing, the BOM defendants commingle the rights being vindicated through

the summary suspension hearing, the injunctive action, and the underlying action for

damages—all to bolster its argument that the instant action was previously “adjudicated”

for res judicata purposes.

              However, it is apparent that each of the various hearings and actions serve

different purposes and afford different relief. By rule, Chalifoux was entitled to a hearing

from the BOM on the merits of the summary suspension, i.e., whether immediate

suspension pending the investigation and adjudication of the BOM complaint was

warranted. See W. Va. Code R. § 24-6-5 (requiring hearing within fifteen days on “the

necessity for the summary action” when summary suspension is utilized). It is also clear

that the injunctive hearing held by the circuit court did not serve to replace the required

summary suspension hearing, but rather, was intervening relief granted pursuant to the

court’s statutory authority because Chalifoux had not yet been afforded that required

hearing. See W. Va. Code § 53-5-4 (1923). This relief served only to assess the immediate

       16
          In particular, the BOM defendants argued below that Chalifoux was “afforded
due process and had an extensive hearing related to the merits of the summary
suspension”—ostensibly referring to the injunctive hearing—and therefore his claims in
the instant case had been “adjudicated[.]”
                                           20
necessity of Chalifoux’s license suspension pending his receipt of a summary suspension

hearing from the duly-authorized entity—the BOM, which is knowledgeable about the

public health implications of the underlying allegations against Chalifoux and the necessity

of immediate action relative to his license until that complaint could be resolved. See Ne.

Nat. Energy LLC v. Pachira Energy LLC, 243 W. Va. 362, 370, 844 S.E.2d 133, 141 (2020)

(“‘[t]he purpose of a preliminary injunction is merely to preserve the relative positions of

the parties until a trial on the merits can be held.’” (quoting Univ. of Texas v. Camenisch,

451 U.S. 390, 395 (1981))).

              Moreover, regardless of whether the BOM defendants viewed the injunctive

relief granted by the circuit court as the functional equivalent of its own hearing on

Chalifoux’s summary suspension, it is apparent that the underlying civil action seeks an

entirely different form of relief as a consequence of the BOM defendants’ failure to provide

that hearing. Chalifoux’s complaint asserts a classic due process deprivation claim seeking

monetary damages. He did not seek relief from his summary suspension or even the

underlying BOM complaint in the instant action, but rather damages flowing from the due

process deprivation allegedly committed by the BOM defendants by failing to provide the

summary suspension hearing. As such, the BOM defendants’ insistence below that the

“exact issue asserted in the Complaint . . . [was] heard before the Circuit Court of Kanawha

County . . . [and] . . . adjudicated” is patently incorrect. Therefore, to the extent Chalifoux

argues that the instant claim was not “actually litigated” in the injunctive action, he is

                                              21
correct. However, as discussed infra, this conclusion is not dispositive for purposes of res

judicata.

              Turning now to the parties’ intermingling of the concepts of collateral

estoppel and res judicata, we observe that they differ in both scope and effect. Collateral

estoppel pertains to “issue” preclusion and requires that an identical issue have been

“actually litigated” among the parties or their privies in other litigation. Res judicata

pertains more broadly to “claim” preclusion and bars relitigation of claims that were either

actually litigated or could have been litigated in other proceedings. As commentators have

explained:

              [R]es judicata or claim preclusion bars the litigation of not only
              issues that were actually litigated, but also issues that could
              have been litigated, might have been litigated, or should have
              been litigated in the original suit or former proceedings. In this
              respect, res judicata, or claim preclusion, is a broader remedy
              than collateral estoppel which applies only to issues that were
              actually litigated.

46 Am. Jur.2d Judgments § 454 (2d ed. 2023) (footnotes omitted); see Slider v. State Farm

Mut. Auto. Ins. Co., 210 W. Va. 476, 481, 557 S.E.2d 883, 888 (2001) (“Claim preclusion

therefore functions as a rule governing the joinder of claims and defenses, since a party’s

failure to present a particular issue in the course of litigation may preclude its determination

in a subsequent action.”); cf. State v. Miller, 194 W. Va. 3, 9 n.6, 459 S.E.2d 114, 120 n.6

(1995) (“[C]ollateral estoppel is narrower [than res judicata] because it does not apply to

matters that could have been litigated but were not.”).

                                              22
                 Therefore, although we agree that Chalifoux’s due process claim was not

“actually litigated” in the injunctive action, this Court has repeatedly emphasized that res

judicata also applies to matters that could have been litigated in other proceedings: “[I]t is

well-established that res judicata applies not only to matters actually litigated, but to

matters which could have been litigated.” Bison Ints., LLC v. Antero Res. Corp., 244 W.

Va. 391, 398, 854 S.E.2d 211, 218 (2020); see Miller, 194 W. Va. at 9, 459 S.E.2d at 120

(“Res judicata generally applies when there is a final judgment on the merits which

precludes the parties or their privies from relitigating the issues that were decided or the

issues that could have been decided in the earlier action.” (Emphasis added)); Blake v.

Charleston Area Med. Ctr., Inc., 201 W. Va. 469, 477, 498 S.E.2d 41, 49 (1997) (“[R]es

judicata may operate to bar a subsequent proceeding even if the precise cause of action

involved was not actually litigated in the former proceeding so long as the claim could have

been raised and determined.”); Lloyd’s, Inc. v. Lloyd, 225 W. Va. 377, 383, 693 S.E.2d

451, 457 (2010) (finding res judicata barred subsequent action although “not identical to

the cause of action determined in the previous civil action[]” because the claim could have

been resolved in previous action); Dan Ryan Builders, Inc. v. Crystal Ridge Dev., Inc., 239

W. Va. 549, 561, 803 S.E.2d 519, 531 (2017) (“West Virginia’s law of res judicata

prohibits not only the re-litigation of claims that were actually asserted in the prior action,

but also precludes ‘every other matter which the parties might have litigated as incident

thereto[.]’”).

                                              23
                In that regard, the circuit court concluded that Chalifoux could have litigated

his due process claim for damages in the injunctive action, finding that all three required

elements of res judicata were satisfied pursuant to syllabus point four of Blake:

                First, there must have been a final adjudication on the merits in
                the prior action by a court having jurisdiction of the
                proceedings. Second, the two actions must involve either the
                same parties or persons in privity with those same parties.
                Third, the cause of action identified for resolution in the
                subsequent proceeding either must be identical to the cause of
                action determined in the prior action or must be such that it
                could have been resolved, had it been presented, in the prior
                action.

201 W. Va. at 469, 498 S.E.2d at 41, Syl. Pt. 4, in part. Although largely preoccupied with

whether his claim was “actually litigated,” Chalifoux does offer mild opposition to each of

the Blake elements—including whether his claim “could have been” litigated—which we

must address.

                First, Chalifoux argues that the injunctive action and the instant action do not

involve a “prior action” and a “subsequent proceeding” as contemplated by Blake because

the two actions were pending simultaneously for a period of time. However, the terms

“prior” and “subsequent” in our res judicata jurisprudence do not refer only to actions filed

and pending in succession to each other. Rather, it is generally understood that when two

claims are pending contemporaneously, whichever action reaches a final adjudication first

is res judicata as to the other. See Restatement (Second) of Judgments § 14 (Am. L. Inst.

1982) (“[W]hen two actions are pending which are based on the same claim, or which

                                               24
involve the same issue, it is the final judgment first rendered in one of the actions which

becomes conclusive in the other action (assuming any further prerequisites are met),

regardless of which action was first brought.”); see also 18 Charles Alan Wright, Arthur

R. Miller & Edward H. Cooper, Fed. Prac. & Proc. Juris. § 4404 (3d ed. 2023) (“[A]s

between actions pending at the same time, res judicata attaches to the first judgment

regardless of the sequence in which the actions were commenced.” (footnote omitted)).

              As to Blake’s second requirement, Chalifoux argues that the instant case does

not involve the “same parties” as there are parties to this action in addition to those named

in the injunctive action—namely, his clinic is an additional plaintiff and Dr. Shepard is an

additional defendant. However, he fails to address whether these parties are “in privity”

with those named in the injunctive action, as prescribed by Blake. We have little difficulty

concluding that Chalifoux stands in privity with his clinic which organizationally bears his

name and to which he refers to as “his business” throughout his pleadings and briefs. See

Jordache Enters., Inc. v. Nat’l Union Fire Ins. Co. of Pittsburgh, Pa., 204 W. Va. 465, 478,

513 S.E.2d 692, 705 (1998) (“‘In general, it may be said that . . . privity involves a person

so identified in interest with another that he represents the same legal right.’” (citations

omitted)). Further, Dr. Shepard, as the Executive Director of the BOM, plainly stands in

privity with the BOM for purposes of Chalifoux’s allegations in this matter. See Baker v.

Chemours Co. FC, LLC, 244 W. Va. 553, 562, 855 S.E.2d 344, 353 (2021) (“‘[C]ommon

interests implicit in an employment relationship ordinarily would tend to bind employers

                                             25
and employees in privity for the purpose of res judicata[.]’” (quoting Warner v. German,

642 A.2d 239, 245 (Md. 1994))).

              As to the third and final element of the Blake test, Chalifoux contends that

he could not have brought his claim for damages in the injunctive action because those

damages had not yet accrued at the time the injunctive action was filed. The BOM

defendants counter that the injunctive complaint alleges that Chalifoux “has” suffered

“irreparable harm” and therefore Chalifoux conceded that he had already incurred damages

at that time. More importantly, the BOM defendants briefly note that Chalifoux had over

two years during the pendency of the injunctive action to amend his complaint to assert the

claims in the instant case but simply chose, at his peril, to file a separate action instead.

We agree.

              The Court has recently held that claims or damages which accrue during the

pendency of an action but were not initially pled must also be raised in that action lest they

be barred by res judicata. In Baker, the Court addressed an employee’s attempt to file a

new action to redress additional incidents of discrimination and harassment which “post-

dated” incidents alleged in a previously filed action but which occurred while that action

was pending. 244 W. Va. at 559, 855 S.E.2d at 350. The Court rejected the employee’s

attempt to evade res judicata on that basis because “it treats the allegations in the [initial]

complaint as if they were fixed and immutable, incapable of amendment or

supplementation pursuant to Rule 15 of the West Virginia Rules of Civil Procedure[.]” Id.
                                              26
The Baker Court drew particular emphasis to Rule 15’s language permitting

supplementation of pleadings to accommodate “‘transactions or occurrences or events

which have happened since the date of the pleading sought to be supplemented.’” Id.

Therefore, regardless of whether Chalifoux’s damages were fully realized at the time of

filing of the injunctive action, they clearly accrued during its pendency as evidenced by the

filing of the instant action alleging those very damages five months before the injunctive

action’s dismissal.

              Further, Chalifoux provides no reason why he could not have amended his

injunctive complaint to plead his due process claim. Indeed, such a position would be

wholly disingenuous given that he did, in fact, seek to amend his complaint to add

additional parties and claims approximately four months after the injunctive action was

filed. As previously stated, Chalifoux filed a motion to add Dr. Tierney—one of the DHHR

defendants below—and Cynthia Bean of the Bureau for Medical Services as parties to the

injunctive action to advance a claim against them for alleged “interference” in his Medicaid

participation, along with a claim for damages for Medicaid reimbursements previously

owed to him. See supra n.9. Although the circuit court held that motion in abeyance, the

hearing transcript reflects that the court was not only amenable to this amendment to

enlarge the scope of the litigation, but even invited Chalifoux to further amend his

                                             27
complaint to seek mandamus relief against the BOM to obtain the required hearings

regarding his licensure and/or the underlying BOM complaint. 17

              Instead, Chalifoux appears to take the position that there is nothing that

“requires” him to bring all of his claims against the defendants and their privies stemming

from the same set of underlying facts within the same action. To the contrary, the

application of res judicata requires him to do so. The Court has warned that where a

plaintiff makes “the strategic decision to pursue [] claims in a piecemeal fashion, asserting

different theories and measures of relief” in different actions, res judicata may constitute a

bar. Dan Ryan, 239 W. Va. at 562, 803 S.E.2d at 532. Like the plaintiff in Dan Ryan,

Chalifoux “plainly could and should have pursued all of [his] factually intertwined claims”

in the injunctive action. Id. Chalifoux’s requested amendment to add Dr. Tierney and

others to the injunctive action for purposes of addressing the Medicaid fallout from his

suspension demonstrates the feasibility of amendment to encompass any additional claims

arising from the same underlying facts. 18

       17
          In addressing Chalifoux’s motion, the circuit court stated: “If the [BOM] has not
scheduled and provided the necessary hearings, then I will grant your complaint—or your
amendment. But also I want you to amend, if you would, your complaint to add a cause of
action for the issuance of a rule to show cause for mandamus.” The court further addressed
counsel’s request to add additional parties and claims stating “you can turn it into a
monstrous piece of litigation with the additional allegations[.]”
       18
         Chalifoux also briefly mentions that the BOM defendants litigated the case for
several years before asserting res judicata in their motion for summary judgment. Although
(continued . . .)
                                               28
              “‘The doctrine of res judicata reflects the refusal of the law to tolerate a

multiplicity of litigation[.]’” Bison Ints., 244 W. Va. at 402, 854 S.E.2d at 222 (quoting

Chalifoux’s argument regarding the BOM defendants’ acquiescence to the litigation of the
instant action could be generously read as alluding to the BOM defendants’ “waiver” of
the affirmative defense of res judicata, we observe that he never invokes that term nor
provides any authority in support.

       Nonetheless, we are compelled to acknowledge that neither of the BOM defendants
expressly asserted the affirmative defense of res judicata in their respect answers. Instead,
the answers individually and specifically assert a variety of other affirmative defenses and
only generally assert “any and all defenses afforded to [them] by Rules 8 and 12 of the
West Virginia Rules of Civil Procedure.” Rule 8(c) provides, in part:

                      In pleading to a preceding pleading, a party shall set
              forth affirmatively accord and satisfaction, arbitration and
              award, assumption of risk, contributory negligence, discharge
              in bankruptcy, duress, estoppel, failure of consideration, fraud,
              illegality, injury by fellow servant, laches, license, payment,
              release, res judicata, statute of frauds, statute of limitations,
              waiver, and any other matter constituting an avoidance or
              affirmative defense.

(Emphasis added); see Dan Ryan, 239 W. Va. at 557 n.23, 803 S.E.2d at 527 n.23 (“Res
judicata/claim preclusion is an affirmative defense that should be raised under Rule 8(c)
of the Rules of Civil Procedure.”). If it is not raised in the answer, it is typically deemed
waived. See, e.g., Davignon v. Clemmey, 322 F.3d 1, 15 (1st Cir. 2003) (“As an affirmative
defense enumerated in Federal Rule of Civil Procedure 8(c), normally res judicata is
deemed waived unless raised in the answer.”); but see Dan Ryan, 239 W. Va. at 557 n.23,
803 S.E.2d at 527 n.23 (“[A] party may raise res judicata by summary judgment motion
when the defense was unavailable at the time of the original answer.”).

       However, because Chalifoux at no point—either below or before this Court—
expressly argues or provides supporting authority for the proposition that the BOM
defendants waived the defense of res judicata, we decline to grant him relief from its effects
on this basis. See Syl. Pt. 13, A. B., 234 W. Va. at 497, 766 S.E.2d at 757 (“The Court
takes the pleadings and record as it finds them and the adversarial process makes it
incumbent on the parties to plead the causes of action and present the requisite evidence
necessary to maintain viability of their case. Courts cannot concoct or resurrect arguments
neither made nor advanced by the parties.”).
                                              29
Franklin Collection Serv., Inc. v. Stewart, 863 So.2d 925, 929 (Miss. 2003)). More

specifically, it precludes “‘piecemeal litigation’” occasioned by splitting “‘different legal

theor[ies] . . . for different relief’” into serial litigation. Dan Ryan, 239 W. Va. at 559, 803

S.E.2d at 529 (quoting Gonzales v. California Dep’t of Corr., 739 F.3d 1226, 1232 (9th

Cir. 2014)). Just as we observed in Dan Ryan, “[West Virginia Rule of Civil Procedure]

18(a) allows [a] party to . . . join . . . ‘as many claims, legal or equitable, as the party has

against’” another party and Chalifoux “deliberately chose not to avail [him]self of this

process.” 239 W. Va. at 562, 803 S.E.2d at 532. 19 We therefore find no error in the circuit

court’s conclusion that Chalifoux could have brought his due process claim in the

injunctive action and its grant of summary judgment to the BOM defendants as a result.

       19
         Rule 18(a) of the West Virginia Rules of Civil Procedure provides: “A party
asserting a claim to relief as an original claim, counterclaim, cross-claim, or third-party
claim, may join, either as independent or as alternate claims, as many claims, legal or
equitable, as the party has against an opposing party.”

       As a corollary to this rule and as a final matter, we note Chalifoux’s terse insistence
that the BOM defendants could simply have moved to consolidate the two actions.
However, he provides neither a discussion of Rule 42 of the West Virginia Rules of Civil
Procedure nor its interplay, if any, with res judicata. More importantly, he fails to articulate
why the burden of seeking consolidation to cure the preclusive effects of res judicata on
his own case falls on the BOM defendants.
                                                30
                                IV. CONCLUSION

             For the foregoing reasons, we affirm the February 6, 2018, and October 4,

2021, orders of the Circuit Court of Kanawha County, West Virginia.

                                                                        Affirmed.

                                          31