Doc's letter over ER contract results in defamation suit

Marilyn Tennissen Nov. 26, 2007, 11:45am

Medical Center of Southeast Texas

Receiving a "Dear John" letter from a sweetheart can cause pain, but it was a "Dear colleagues" letter and a sweetheart deal that has caused litigation between a local doctor and a provider of emergency medical service.

When it opened in 2005, emergency care at the Medical Center of Southeast Texas was managed by Apollo ER, a professional association owned by Port Neches physician Kirk Williams.

When Apollo's contract expired in December 2006, emergency medicine management was awarded to Florida-based EDCare. This prompted Dr. Williams to write a letter to his colleagues in the medical community expressing just exactly what he thought about the new provider, the new contract and the hospital's parent company.

EDCare says the letter and verbal statement made by Dr. Williams are false and so defamatory that it filed suit against Apollo ER and Williams on Nov. 19 in Jefferson County District Court.

According to the plaintiff's original petition, Williams operated Apollo as an emergency medicine management provider for the Medical Center, a 225-bed hospital built in Port Arthur by Iasis Healthcare, which owns and operates 15 medical facilities in Arizona, Florida, Louisiana, Nevada, Texas and Utah.

For six years prior to the Medical Center's opening, Apollo ER had managed the emergency rooms at two smaller hospitals in Jefferson County that were owned by Iasis. Mid-Jefferson Hospital and Park Place Hospital were eventually closed and merged to create the Medical Center of Southeast Texas.

In late 2006, Iasis offered to renew Apollo's contract for the ER service at the Medical Center. However, Williams rejected the offer, complaining that the terms of the new contract were unacceptable.

After Williams' rejection, Iasis awarded the contract to Port Arthur Emergency Physicians PLLC, an affiliate of EDCare.

"PAEP's willingness to accept more competitive terms from the Medical Center's parent company angered Defendant Williams," the suit says.

When the contract was awarded to EDCare, it was then that Dr. Williams wrote what the suit refers to as the "Dear colleagues" letter, and is the basis of EDCare's allegations of defamation.

Written on Dec. 18, 2006, and sent to the Medical Center's Board of Directors, the executive committee, the chief of staff and the director of medical staff services, Williams' letter begins "Dear colleagues: It is with deep regret that Apollo ER Physicians will no longer provide emergency room services at the Medical Center of Southeast Texas."

He then explains that the departure of Apollo was because Iasis offered him a contract that "no physician in good conscience could execute."

EDCare claims it is statements like that that Williams made in the letter as well as verbal comments made in the healthcare community that constitute defamation.

The lawsuit says Williams' letter implied that he had knowledge of "undisclosed facts that reflected serious misconduct, as well as unprofessional and unlawful activities" on the part of EDCare and Iasis.

Williams did say that Iasis awarded the contract to EDCare without going through a proper bidding process.

"Regrettably, this award was given the same day of my notice of termination (12-06-06)," Williams wrote.

Williams also told his colleagues that EDCare has received 14 out of 15 contracts at Iasis facilities and alleged that EDCare conspired with Iasis.

"It appears obvious that whether I agreed with the terms of the contract or not, Iasis was going to replace me with EDCare," Williams wrote.

EDCare claims Williams made these statements "to heighten the damaging effects" of the letter.

In the "Dear colleagues" letter, Williams said the contract contained so many stipulations that there is "no way" a doctor could sign it and "not fall short."

The contract "required me to be somehow responsible for triage time," Williams explained, a responsibility he claimed is "clearly a nursing duty beyond my scope of practice."

The contract would also make him responsible for the percentage of patients who leave against medical advice or who leave without being seen.

"This is a well-established patient right that we can only influence, not control," Williams wrote.

In addition, Williams would have to ensure that ER patients would reach treatment rooms within 15 minutes and have an overall wait time in the department of less than two hours.

Williams argued that the process involves multiple departments – registration, nursing, ancillary, inpatient services – and not just the ER physician.

He called EDCare an "alter ego" of Iasis that operates with "corporate-driven rather than physician-driven" patient care

"I do not believe the necessary independence of the emergency department at the Medical Center of Southeast Texas will be maintained when there is such an intertwined relationship between Iasis and EDCare," Williams wrote.

Williams said "these dynamics will most certainly be contrary to the best interest of the patient."

He also emphasized his eight-year relationship with Iasis and his knowledge of the emergency management industry. ECare said this emphasis was done to "buttress" Williams' false statements.

EDCare said Williams rejected the contract offer from Iasis because the terms "might generate lower profits for Apollo than it had experienced in the past."

Because of Williams' letter and other defamatory statements, EDCare claims the doctor has injured its reputation and exposed it to "public scorn, contempt and financial injury."

"At the time, the defendants knew that the recipients of this false information would understand it in context as impugning EDCare and its management," the plaintiff claims.

By sending the "Dear colleagues" letter and making the defamatory verbal statements to others in the healthcare community, EDCare claims Williams acted with negligence, ill will and actual malice. Apollo is vicariously liable for the statements made by Williams because he made them within the scope of his agency relationship with and employment by Apollo.

EDCare is asking for a trial by jury and wants to recover from Williams and Apollo all natural and proximate losses resulting from the defamatory statements as well as presumptive and exemplary damages.

EDCare Management Inc. is represented by William C. Little of Mehaffy Weber PC in Beaumont.

The case has been assigned to Judge Bob Wortham, 58th District Court.

Case No. A180-790

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