LaCesha Brintley v. St. Mary Mercy Hospital
545 F. App'x 484 (2013)
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Rule of Law:
A physician with hospital privileges is generally considered an independent contractor, not an employee, and therefore cannot bring a racial discrimination claim under Title VII. Furthermore, hospital bylaws do not, by themselves, create a contract sufficient to support a discrimination claim under 42 U.S.C. § 1981.
Facts:
- Dr. LeCesha Brintley, an African-American surgeon, was granted medical-staff privileges at St. Mary Mercy Hospital in 2006, despite the hospital knowing another facility had previously suspended her privileges.
- In January 2008, Brintley accidentally cut two of a patient's major blood vessels during a routine appendectomy, causing the patient to suffer cardiac arrest and a day-long coma.
- The hospital discovered Brintley performed the surgery with a risky 'blind-trocar insertion' technique.
- An internal review revealed that Brintley had six avoidable surgical complications in just over a year, while the other nine surgeons at the hospital had only one such complication combined during the same period.
- The hospital required Brintley to undergo a proctorship, where other surgeons would supervise her work and have the authority to intervene.
- During the proctorship, Brintley was insubordinate, refused a proctor's directive to dim the lights, and attempted to use the prohibited blind-trocar technique again, telling a proctor, 'You are not here to tell me how to operate.'
- Two of her proctors, Dr. Zeni and Dr. Hallal, withdrew from the proctorship due to her poor performance and refusal to follow its requirements.
Procedural Posture:
- Dr. LeCesha Brintley sued St. Mary Mercy Hospital and several individual doctors in the United States District Court for the Eastern District of Michigan, the court of first instance.
- Brintley's complaint alleged racial discrimination in violation of Title VII, 42 U.S.C. § 1981, and the Michigan Elliott-Larsen Civil Rights Act.
- The defendants filed a motion for summary judgment, asking the court to rule in their favor without a full trial.
- The district court granted the defendants' motion for summary judgment on all claims.
- Brintley, as Plaintiff-Appellant, appealed the district court's grant of summary judgment to the United States Court of Appeals for the Sixth Circuit.
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Issue:
Does a hospital's revocation of a surgeon's medical privileges, following a history of serious surgical complications and non-compliance with a required proctorship, constitute unlawful racial discrimination under Title VII, 42 U.S.C. § 1981, or Michigan's Elliott-Larsen Civil Rights Act?
Opinions:
Majority - Kethledge, Circuit Judge
No, the hospital's revocation of Dr. Brintley's privileges did not constitute unlawful racial discrimination. First, her Title VII claim fails because she was an independent contractor, not an employee of the hospital. Applying the common law agency test, the court found that Brintley controlled her own surgeries, ran her own business, billed patients directly, was not paid a salary by the hospital, and paid her own malpractice insurance, all of which are indicia of an independent contractor relationship. Second, her § 1981 claim fails because it requires the existence of a contract, and the hospital's bylaws did not create a contractual relationship with her. Third, her state law claim under the Elliott-Larsen Act fails because she could not show she was treated differently than similarly-situated non-African-American doctors; the two Caucasian doctors she cited did not have a comparable history of serious complications and thus were not valid comparators.
Analysis:
This decision reinforces the significant hurdle physicians face when suing hospitals for discrimination after the revocation of medical privileges. It solidifies the view that physicians are typically independent contractors, placing them outside the protections of Title VII in this context. The ruling also narrows the grounds for § 1981 claims by clarifying that standard hospital bylaws generally do not constitute a contract for employment or services. The case empowers hospital credentialing and peer review committees to make decisions based on documented performance and patient safety concerns, providing a strong defense against discrimination claims absent clear evidence of pretext or disparate treatment of truly similarly-situated individuals.
