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Janes v. Centegra Health System

November 17, 1999


Appeal from the Circuit Court of McHenry County. No. 95--CH--120 Honorable Michael T. Caldwell, Judge, Presiding.

The opinion of the court was delivered by: Justice Rapp

Defendant, Centegra Health System, d/b/a Northern Illinois Medical Center (NIMC), appeals the trial court's entry of summary judgment in favor of plaintiff, William Janes, M.D. We affirm.

NIMC is a hospital located in McHenry County. In 1994 NIMC entered into a written pathology services agreement with Pathology and Nuclear Medicine Associates (PNMA). Pursuant to this agreement, PNMA was to staff NIMC with pathologists employed by PNMA and furnish pathology services to NIMC and its patients. All PNMA pathologists were required to apply for and be granted clinical privileges at NIMC.

Dr. Janes was a pathologist employed by PNMA pursuant to a written contract with PNMA. In 1995, Dr. Janes was granted clinical privileges at NIMC. PNMA thereafter assigned Dr. Janes to work at NIMC.

On May 10, 1995, Dr. Sherman Porter performed a dilatation and curettage (D&C) procedure on a patient at NIMC and obtained tissue specimens from the lining of the patient's uterus (endometrial tissue) and from the entrance to the uterus (endocervical tissue) for pathological examination to rule out possible malignancy. The tissue specimens were sent to Dr. Janes for examination, but the endometrial tissue specimen was lost before Dr. Janes could examine it.

The next day, Dr. Janes conferred with Dr. Bradley, another PNMA pathologist, about how to handle the situation. Dr. Bradley told Dr. Janes that if NIMC were to learn that another specimen had been lost, PNMA would be fired. PNMA had previously lost specimens at NIMC and other hospitals, including at least one other case involving Dr. Janes. After reviewing the endocervical tissue specimen, Dr. Bradley advised Dr. Janes to report his findings in a "general way." Dr. Janes understood this to mean that he should prepare his pathology report to combine his findings for the two tissue specimens so that the report would not reflect that the endometrial tissue specimen had been lost.

Dr. Janes then prepared and issued his report in that fashion, indicating that the tissue was benign. No mention was made of the lost tissue specimen. Dr. Janes admitted that standard practice required him to state in the report that the endometrial tissue specimen had been lost and not examined so that the surgeon could decide whether to repeat the procedure to obtain a new specimen.

Dr. Janes also talked to Dr. Porter by telephone and advised Dr. Porter that the tissue appeared benign. He never mentioned to Dr. Porter that the endometrial tissue specimen had been lost. Dr. Janes admitted that he should have told Dr. Porter that the specimen had been lost. After the report issued, Dr. Janes took no steps to advise anyone at NIMC that the specimen had been lost.

Dr. Janes then instructed a PNMA technician to prepare a false slide from endometrial tissue of another patient and to label it as the missing tissue sample. This was done in case Dr. Porter or anyone else wanted to see the slide of the endometrial tissue from Dr. Porter's patient. The slide was prepared in accordance with Dr. Janes's instructions and sent to his office at NIMC, where he placed it in his desk. Dr. Janes claimed that he got the idea from another PNMA pathologist who told him about a similar incident in which a specimen was lost and a false slide was prepared using tissue from another patient.

Dr. Janes later learned that the technician had confessed to a manager of PNMA that she had prepared the false slide. The president of PNMA confronted Dr. Janes and told him not talk to anyone about the incident and that he would "take care of it." Dr. Janes called another PNMA pathologist and instructed him to throw away the false slide. PNMA then reassigned Dr. Janes to work at another hospital.

Dr. Porter subsequently received an anonymous call informing him of the incident. As a result of the anonymous call, NIMC commenced an investigation.

NIMC held a special medical staff meeting concerning the incident, and an ad hoc committee of the medical staff was appointed to further investigate the incident in accordance with the medical staff bylaws. Pursuant to the medical staff bylaws, corrective action may be taken against a physician for reasonable cause or when his or her performance or professional conduct is considered detrimental to patient safety, compromises the quality of care, or violates NIMC's bylaws, rules or regulations. Corrective action may include a recommendation that the physician's privileges be revoked, limited, or suspended.

It was determined that Dr. Janes would be placed on "precautionary suspension" and that written notice of the action would be sent to Dr. Janes. "Precautionary suspension" under the medical staff bylaws is an emergency suspension of a physician's clinical privileges to practice at NIMC and is invoked in cases where the physician willfully or grossly violates hospital rules or behaves in a manner that requires prompt action to protect the health of patients. This procedure permits the temporary suspension of privileges without prior notice and hearing.

NIMC sent written notice to Dr. Janes advising him that he had been placed on precautionary suspension and that an ad hoc committee had been appointed to investigate the matter and to report whether further corrective action was warranted. The letter also advised Dr. Janes of his right under the medical staff bylaws to request a hearing concerning the precautionary suspension and his opportunity to interview with the ad hoc committee. PNMA terminated Dr. Janes's employment on the same day NIMC sent written notice to him.

Dr. Janes voluntarily appeared before the ad hoc committee and submitted to an interview concerning the incident. Dr. Janes understood that this was part of the formal peer review process under the medical staff bylaws.

By letter through his attorney, Dr. Janes requested a formal hearing on the precautionary suspension. The letter also informed NIMC of Dr. Janes's termination of employment with PNMA and his intent to resign from the medical staff as soon as the investigation was concluded.

After receiving the ad hoc committee's report, the medical executive committee of the medical staff met to review the matter and consider possible further corrective action against Dr. Janes. Dr. Janes voluntarily attended this meeting to present his views concerning the incident. The medical executive committee determined that further corrective action was warranted and subsequently gave written notice to Dr. Janes ...

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