A Michigan physician will get his day in court after a federal judge refused to dismiss his EMTALA retaliation claims when the court ruled the Health Care Quality Improvement Act does not provide protection for the hospital's decision to summarily suspend the physician or the board's decision to re-institute the suspension after the MEC's vote to remove the suspension.

The physician maintains that his privileges at LaPeer Regional Medical Center were suspended in retaliation for his refusal to transfer a woman in labor.

According to the complaint, the woman was 20 weeks gestation and in labor.  The physician wanted to admit the patient and evacuate the uterus, since the child was not viable at 20 weeks. Another physician, however, disagreed and maintained the patient was not in labor and needed to be transferred.

The court opinion indicates that the hospital CEO threatened to terminate the physician's privileges if he did not transfer the patient.  The physician refused maintaining the patient was unstable and faced imminent delivery. Before a transfer could be arranged, the patient delivered the pre-term fetus.

Subsequently, the physician's privileges were suspended, but the MEC determined that he should be reinstated.  The hospital Board, however, refused the reinstatement and the matter went to extended hearing over the following year.

The ostensible reason for the suspension was excessive utilization of vacuum extraction in delivery without documentation supporting the procedure.  The court ruled that the verbal threat of the CEO and the action of the Board in ignoring the MEC were evidence of retaliation and outside the protection of the peer review immunity provided by the Quality Improvement Act.

The final decision of the peer review process hearings were ruled to be protected by the Quality Improvement Act immunity
and various counts challenging that outcome were thrown out, leaving the case to go to trial on the EMTALA retaliation
counts.

Ritten v Lapeer Reg'l Med. Ctr., No 07-10265, (ND Mich)