Revocation of hospital privileges affirmed against Fort Wayne cardiologist

A Fort Wayne doctor who lost privileges at an area hospital failed to convince the Court of Appeals of Indiana that his privileges should be reinstated.

Dr. Bhaktavatsala Apuri, a cardiologist who maintained privileges at all Fort Wayne-area hospitals, including Parkview Hospital beginning in 2001, lost those privileges on Oct. 15, 2014.

Parkview’s decision not to renew the privileges stemmed from issues that began in 2012, when the hospital’s quality department documented various complaints against Apuri concerning his failure to respond to pages and phone calls, his failure to round on patients, and his poor communication with nursing staff. Similar complaints continued for the next two years, despite formal collegial intervention, Apuri being placed on 100% chart review and a requirement that he to submit to mental and physical evaluations to help him improve practice management and personal accountability.

By 2014, at least 14 more incidents were documented where Apuri failed to round on his patients or communicate promptly. Consequently, Parkview Hospital’s Medical Staff Executive Committee decided not to renew his hospital privileges.

An ad hoc committee upheld that decision, as did a hospital appellate review committee.

Thus, Apuri sued Parkview Health System Inc., Parkview Hospital Inc. and Dr. Roy Robertson in federal court.

When the federal suit didn’t work out in his favor, he filed a state-court complaint in March 2019, asserting claims for the nonrenewal of his hospital privileges, breach of contract, intentional interference with a business relationship and intentional interference with a contract.

The Allen Superior Court ruled for the defendants, finding them immune based on the Health Care Quality Improvement Act. A panel of the COA affirmed, agreeing the appellees-defendants were immune in Bhaktavatsala R. Apuri, M.D. v. Parkview Health System, Inc., Parkview Hospital, Inc., and Roy Robertson, M.D., 21A-PL-591.

Regarding immunity under the act, the COA found Apuri did not designate evidence of a material factual dispute over whether he can overcome the presumption of adequate notice and hearing procedures. As such, it held that the trial court was correct to grant summary judgment against him.

The appellate court also disagreed with Apuri’s three reasons as to why the trial court was wrong to conclude that the adequate notice and hearing procedures requirement was deemed satisfied.

First, it noted Apuri did not explain how he was prejudiced by any unavailable documents he requested considering his other opportunities to present his own evidence and cross-examine witnesses.

Second, the COA rejected his argument that three of the five members of the ad hoc committee were competitors as employees of Parkview Physicians Group, whose incentive compensation was partially based on the overall growth of the group. Rather, it concluded that “if the growth incentive makes committee members economic competitors of Dr. Apuri, they are only indirect competitors at most.”

Third, the appellate panel disagreed with the assertion that the peer review process was procedurally unfair under the act because the ad hoc committee’s report and recommendation were untimely under the medical staff bylaws.

Lastly, the COA rejected Apuri’s assertion that summary judgment on his claims against Dr. Robertson for intentional interference with a business relationship and intentional interference with a contract were inappropriate because those claims originated outside the context of the peer review process and were therefore not subject to immunity.

“In sum, Appellees were immune from suit for Dr. Apuri’s claims, and the trial court therefore correctly concluded that Appellees were entitled to judgment as a matter of law,” the appellate panel concluded.

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