Wrangell physician Greg Salard emerged as the victor this week after winning a portion of a motion he filed against Wrangell Medical Center in First District Court, along with Alaska Island Community Services, seeking to have his hospital privileges reinstated.
A ruling by Judge Kevin Miller on Monday, Dec. 12, temporarily reinstated Salard, with restrictions, and directed that all parties move forward with a hearing to evaluate his permanent access to hospital privileges under Title IX of the WMC bylaws.
The case, which was heard before Judge Miller on Wednesday, Dec. 7, was titled “Motion For Temporary Restraining Order and Preliminary Injunction,” and sought to force the hospital board to reinstate Salard’s privileges immediately, prevent further denial of those privileges absent a ruling by the court under hospital bylaws, and to prevent the hospital board from reporting the denial to any state or federal medical board unless allowed to by the court.
The basis for Salard’s motion stemmed from four claims against the hospital, namely that WMC violated his due process rights under hospital bylaws and the Alaska State Constitution, interfered with his employment contract, breached the contract with AICS providing for on-call emergency room coverage, and breach of good faith in dealing with AICS.
Salard, who has been practicing in Wrangell since February 2009, was denied hospital privileges after discussion in an executive session and subsequent vote in regular session of the Nov. 16 WMC Board of Directors meeting. A letter from hospital CEO Noel Selle-Rea the next day informed Salard of that decision and removed his access to the hospital.
In his legal conclusion, Judge Miller stated “Dr. Salard is entitled to a preliminary injunction placing him back on WMC’s medical staff with the privileges that existed before the November 17, 2011 letter.”
Judge Miller, however, refused to grant Salard’s request to prevent the hospital from permanently revoking his privileges, and instead, ordered a hearing.
“I will not permanently enjoin WMC from revoking Dr. Salard’s privileges as I find that the anticipated administrative hearing (provides) adequate due process that complies with established procedures,” Judge Miller stated.
Selle-Rea offered his opinion after the decision came out of Judge Miller’s chambers.
“The court’s decision appears to dismiss any of the claims by AICS, but it says that Salard could possibly suffer harm,” Selle-Rea said. “Because we didn’t make claims regarding clinical decisions, they will allow temporary privileges until a review hearing. While we don’t necessarily agree with it, we will provide him temporary privileges until the meeting scheduled in a couple of weeks.”
Only minutes after the decision was released Salard said he was ebullient at the result of the judge’s decision.
“This is a great day for my family and for Wrangell Medical Center,” Salard said. “Most importantly, this is a great day for the patients who will experience a better level of service now.”
According to Salard’s attorney, Lee Holen of Anchorage, Salard’s privileging process should have been completed by February of this year – and that the move by the board to limit his ability to practice is detrimental to the ability of AICS and WMC to offer healthcare in the borough.
Under hospital rules, all physicians employed by AICS are contractually required to maintain privileges at WMC to care for emergency and long-term patients. Initially, physicians are granted provisional privileges for a period not to exceed 24 months. After that period, they must apply for permanent privileges with the board.
The charge of not adhering to its bylaws is partly based, the documents added, upon the hospital failing to reinstate Salard’s privileges after WMC staff rejected a suspension put in place by Selle-Rea.
Salard alleges that on April 15, Selle-Rea summarily suspended his medical center privileges – a move which was reversed after a hearing in front of WMC medical staff.
The filing also goes on to state that the suspension came after an April 12 letter written by Salard to the Borough Assembly and Mayor Jeremy Maxand which provided information that was “critical of the hospital’s treatment of nurses and its poor handling of a nursing shortage.”
According to the Salard’s filing, hospital administrators are not authorized to remove privileges for any physician without a review hearing unless there is an immediate and substantial risk to patients or hospital employees. The documents also allege that the hospital breached its contractual agreement with AICS by not notifying the organization of concerns over Salard, nor did it give AICS an opportunity to address any concerns or manage Salard effectively.
Another allegation Salard believes the hospital is pursuing against him revolves around a two-year investigation by Arkansas State Police that began in 2007 and involved a report of child abuse by his ex-wife.
The case, which was investigated by ASP’s Crimes Against Children Division, began in September 2007. One month later, the lead investigator recommended an investigation move forward against Salard, who, along with his attorneys, requested an administrative law hearing.
The hearing took place in December 2009 before Arkansas Administrative Law Judge Shannon Mashburn.
Judge Mashburn’s ruling exonerated Salard in the investigation after finding insufficient evidence the he engaged in abuse of his children and due to what the judge called “inconsistent statements” by Salard’s daughter.
“It was probable that (her) testimony and statements were coerced or influenced,” Judge Mashburn said in his findings.
Both Judge Mashburn and the lead investigator in the Arkansas case declined to comment for this story.
Salard’s 2011 professional review was conducted by former WMC Chief of Staff Margaret Torreano and dealt with the allegations. Dr. Torreano’s report recommended that Salard be privileged, though with adoption of a new policy, for all physicians at WMC, to require that the parents or guardians of patients under 18 years of age be present during specific types of examinations.
“As troubling as the abuse allegations are, the medical staff cannot find a substantial likelihood of immediate injury or damage to the health or safety of any patient at WMC sufficient to summary suspension of privileges,” the report said.
The WMC Board of Directors has not yet scheduled a hearing in Salard’s privileging matter.
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