Pervaiz Chaudhry v. Tomas Aragon
68 F.4th 1161
9th Cir.2023Background
- Dr. Pervaiz Chaudhry, a cardiothoracic surgeon with ownership in Valley Cardiac, performed an April 2, 2012 open‑heart surgery on Silvino Perez; Perez suffered hypoxic brain injury postoperatively.
- The Hospital immediately opened an internal investigation; CDPH (state) and CMS (federal) later conducted surveys. CDPH published a combined state Statement of Deficiencies and Plan of Correction online in October 2013 referring to the surgeon as “CVS 1” and stating CVS 1 left the operating room before chest closure and while the patient was unstable.
- The Hospital imposed internal discipline (including a 14‑day suspension and requests that Chaudhry step down); it later declined to renew contracts with Chaudhry/Valley Cardiac. Hospital employee Robillard alerted the Perez family to possible malfeasance, and the Perez family filed suit.
- The Perez malpractice litigation proceeded and ultimately produced a jury judgment in excess of $60 million; Chaudhry’s insurer cancelled coverage and he ceased practicing in the U.S.
- Plaintiffs sued CDPH employees under 42 U.S.C. § 1983 asserting a “stigma‑plus” procedural due process claim based on the published state report. After a five‑day bench trial, the district court found plaintiffs failed to prove required elements and entered judgment for defendants.
- The Ninth Circuit affirmed, holding plaintiffs failed to prove the necessary causation (actual and proximate) between the state report and plaintiffs’ alleged deprivations, so § 1983 liability cannot attach.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether defendants’ publication caused plaintiffs’ alleged harms (actual and proximate causation under § 1983) | The CDPH state Statement of Deficiencies (published online) was the but‑for and proximate cause of lost positions, contracts, reputation, insurance loss, and end of U.S. practice | Hospital’s independent internal investigation, contemporaneous percipient witness accounts, Robillard’s disclosure to the Perez family, subsequent malpractice suits and judgment, and market/insurance responses would have caused the same harms irrespective of the state report | Affirmed for defendants: plaintiffs failed to prove but‑for and proximate causation; causation is dispositive and § 1983 claim fails. |
| Whether the state report constituted public disclosure of stigmatizing statements sufficient for a stigma‑plus claim | The state report publicly published false, stigmatizing findings about the surgeon (allegedly inaccurate) | Defendants noted the report did not name Chaudhry and that similar findings were already in the Hospital’s internal records and actions | Not reached on the merits: court assumed publication but dismissed claim on causation grounds. |
| Whether plaintiffs were deprived of a protected liberty/property interest (employment, reputation, ability to practice) entitling them to prepublication process | Plaintiffs: report plus resulting consequences stripped them of protected employment‑related interests and reputation | Defendants: any tangible deprivations flowed from Hospital discipline, malpractice suits, and insurers—not from the state report alone | Not reached: court did not decide protectability because claim failed for lack of causation. |
| Whether exclusion of prior testimony (Laura McComb) was reversible error | Plaintiffs: excluded testimony would show CDPH coerced harsher discipline and establish causation/intent | Defendants: exclusion proper and any error harmless; the testimony undermines plaintiffs’ theory when read in full | Court sustained exclusion as non‑prejudicial; even if considered, it would not establish causation sufficient to change outcome. |
Key Cases Cited
- Harper v. City of Los Angeles, 533 F.3d 1010 (9th Cir. 2008) (§ 1983 requires defendant conduct to be the actionable cause of the claimed injury)
- Gini v. Las Vegas Metro. Police Dep’t, 40 F.3d 1041 (9th Cir. 1994) (causation may be direct participation or by setting in motion acts leading to the deprivation)
- Merritt v. Mackey, 827 F.2d 1368 (9th Cir. 1987) (same; causation standards in § 1983 context)
- Paul v. Davis, 424 U.S. 693 (1976) (damage to reputation alone does not constitute a Fourteenth Amendment liberty interest)
- Paroline v. United States, 572 U.S. 434 (2014) (discussion of proximate causation and foreseeability)
- Van Ort v. Estate of Stanewich, 92 F.3d 831 (9th Cir. 1996) (no § 1983 liability without causation)
- Anderson v. City of Bessemer City, 470 U.S. 564 (1985) (clear‑error standard for reviewing factual findings)