Knapik v. Mary Hitchcock Memorial Hospital
2015 U.S. Dist. LEXIS 13949
| D. Vt. | 2015Background
- Dr. Thersia Knapik and a colleague (Dr. Doe) were general surgery residents at Mary Hitchcock Memorial Hospital (MHMH/DHMC); Knapik received a copy of a February 2011 evaluative letter about Dr. Doe.
- In May 2012 Knapik anonymously mailed that letter to Dr. Doe’s prospective fellowship director and to the Kentucky medical licensing board; the envelopes bore MHMH’s return address.
- MHMH investigators traced the mailing to Knapik; she initially denied then admitted sending it. MHMH concluded her conduct violated confidentiality and professionalism and dismissed her on June 13, 2012. The dismissal letter offered the grievance procedure and a five-day window to request review.
- MHMH immediately informed faculty and the fellowship program in Miami; Miami rescinded Knapik’s post-graduation position. Knapik did not pursue the internal grievance process.
- Knapik sued for wrongful termination, breach of contract, and breach of the implied covenant of good faith and fair dealing. MHMH moved for summary judgment.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Knapik’s suit is barred for failure to exhaust internal remedies | Knapik contends exhaustion was unnecessary because MHMH skipped the required “recommendation” step and made dismissal effectively final, rendering appeal futile | MHMH argues plaintiffs must exhaust the Manual’s grievance process before suing | Court: Exhaustion ordinarily required, but here futility exception applies because MHMH’s immediate actions (notifying faculty and external program) effectively foreclosed meaningful administrative review; suit not barred |
| Whether dismissal was an academic decision entitled to deference | Knapik implies dismissal was non-academic and challenges its substantive reasonableness | MHMH contends dismissal was an academic judgment concerning professionalism/ethical fitness to practice and thus entitled to substantial judicial deference | Court: Dismissal was an academic decision about professionalism; review under arbitrary/capricious/unreasonable standard; MHMH met that standard |
| Whether factual disputes (how Knapik obtained the letter) preclude summary judgment | Knapik says Dr. Doe gave her the letter; disputes over alleged hacking create factual issues | MHMH notes disputed facts but maintains dismissal rested on the act of anonymously forwarding the letter, not on how it was obtained | Court: Even assuming Knapik’s version, undisputed facts show her anonymous disclosure (and related dishonesty/no remorse) supported dismissal; factual dispute on acquisition is not material |
| Whether MHMH violated its own policies such that dismissal was arbitrary or in bad faith | Knapik argues MHMH failed to follow its procedures and thus predetermined outcome | MHMH argues its actions were proper and based on legitimate professional-ethics judgment | Court: Although MHMH did not follow the sequential “recommendation” step, the substance of its academic judgment was reasonable; lack of procedural formality does not make dismissal arbitrary given the seriousness of the conduct |
Key Cases Cited
- Huard v. Town of Pelham, 986 A.2d 460 (N.H. 2009) (explaining exhaustion-of-remedies doctrine under New Hampshire law)
- DeVere v. State, 827 A.2d 997 (N.H. 2003) (recognizing futility exception to exhaustion where administrative remedy is effectively predetermined)
- Fenje v. Feld, 398 F.3d 620 (7th Cir. 2005) (upholding dismissal of resident for lack of candor as an academic judgment affecting fitness to practice)
- Regents of Univ. of Michigan v. Ewing, 474 U.S. 214 (U.S. 1985) (courts must defer to genuine academic decisions unless they are a substantial departure from academic norms)
- Bd. of Curators of Univ. of Missouri v. Horowitz, 435 U.S. 78 (U.S. 1978) (medical-residency dismissals are academic decisions entitled to deference)
- Censullo v. Brenka Video, Inc., 989 F.2d 40 (1st Cir. 1993) (addressing remedies available to contract employees; cited regarding wrongful termination/contract interplay)
- Porter v. City of Manchester, 849 A.2d 103 (N.H. 2004) (recognizing wrongful termination as a tort distinct from contract breach)