Kentuckyone Health, Inc. v. Benjamin Reid Jr M.D., 2017 Ky. LEXIS 224

Background

Dr. Benjamin Reid, a general surgeon and long‑time medical staff member at Jewish Hospital & St. Mary’s (operated by KentuckyOne Health), was notified of a focus review beginning Jan 31, 2013; by Feb 27, 2013 the Medical Executive Committee told him he could not perform surgeries unless accompanied by another board‑certified surgeon or gastroenterologist.
A nurse informed Reid’s assistant that a scheduled Feb 28, 2013 surgery would be restricted unless another surgeon accompanied Reid; Reid secured one for that procedure and performed no further surgeries at the hospital after Feb 2013.
On Aug 5, 2013 the Committee ended the focus review with no finding of quality concerns but granted Reid a conditional six‑month reappointment; Reid did not use privileges and his staff membership expired Aug 26, 2014.
Reid sued the Hospital in Jefferson Circuit Court asserting breach of contract, intentional infliction of emotional distress, tortious interference, and slander; the Hospital answered and later moved for judgment on the pleadings under CR 12.03 claiming immunity under the Health Care Quality Improvement Act (HCQIA).
The trial court granted the Hospital’s motion for judgment on the pleadings, finding the Committee’s recommendation was a professional review activity entitled to HCQIA immunity; the Court of Appeals reversed, characterizing the restriction as a “professional review action” (adverse action affecting clinical privileges) and remanded to determine immunity under 42 U.S.C. § 11112(a).
The Kentucky Supreme Court vacated both lower court rulings and remanded, holding the trial court improperly granted judgment on the pleadings because parties relied on materials outside the pleadings (which converts the motion into summary judgment) and factual disputes remain about whether the Hospital’s conduct constituted a professional review activity or a professional review action.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether judgment on the pleadings (CR 12.03) was appropriate	Reid: pleadings sufficiently allege claims; factual disputes exist so dismissal is premature	Hospital: pleadings and subsequent filings show HCQIA immunity applies, entitling it to judgment	Judgment on the pleadings was improper because parties relied on matters outside the pleadings and factual disputes preclude disposing of the case at this stage
Whether the Hospital’s conduct constituted a “professional review action” (adverse action affecting clinical privileges) under HCQIA	Reid: process did not satisfy conditions for an adverse professional review action; alleged acts are at most review activities without HCQIA protection	Hospital: the committee’s recommendation restricting Reid’s ability to operate constituted an adverse action affecting clinical privileges covered by HCQIA	Court: record is insufficient to find as a matter of law that Hospital took a professional review action; factual development required
Whether HCQIA immunity applies	Reid: immunity is rebuttable and requires statutory procedural protections; those were not satisfied here	Hospital: its actions related to professional review, so HCQIA immunity should shield it from liability	Court: could not decide on existing record; remanded for further factual development to assess immunity under 42 U.S.C. § 11112(a)
Proper procedural treatment when extraneous materials are considered on CR 12.03 motion	Reid: introduction of extraneous evidence necessitates conversion to summary judgment and factual determination	Hospital: relied on written materials to show immunity; urged disposition on pleadings	Court: when parties present matters outside pleadings and court considers them, motion must be treated as summary judgment under CR 56; here summary judgment would be premature due to factual disputes

Key Cases Cited

City of Pioneer Village v. Bullitt County, 104 S.W.3d 757 (Ky. 2003) (standard and purpose of CR 12.03 judgment on the pleadings)
Grand Aerie Fraternal Order of Eagles v. Carneyhan, 169 S.W.3d 840 (Ky. 2005) (complaint sufficiency under CR 8.01; fair notice standard)
Archer v. Citizens Fidelity Bank & Trust Co., 365 S.W.2d 727 (Ky. 1963) (pleadings treated as admitting opponent’s allegations for judgment on the pleadings)
Cincinnati, Newport & Covington Transp. Co. v. Fischer, 357 S.W.2d 870 (Ky. 1962) (notice pleading principles)
Spencer v. Woods, 282 S.W.2d 851 (Ky. 1955) (pleadings must show impossibility of any facts entitling relief for dismissal)
Underwood v. Underwood, 999 S.W.2d 716 (Ky. Ct. App. 1999) (examples of proper CR 12.03 use where only question of law remains)