T.E. v. State Med. Bd.
2022 Ohio 1471
| Ohio Ct. App. | 2022Background
- Dr. T.E., a board‑certified cardiologist, was diagnosed with malignant brain tumor in 2006 and experienced recurrent somatosensory seizures; he stopped performing invasive cardiology procedures beginning in 2010 and had voluntarily withdrawn hospital privileges.
- The State Medical Board of Ohio (the Board) appointed a neurologist (Dr. Hanna) to examine Dr. E. and also considered opinions from Dr. E.'s treating physicians recommending limits on invasive procedures.
- In November 2019 the Board issued an order limiting Dr. E.'s license to prohibit invasive procedures, including all cardiac electrophysiology, subject to conditions for reinstatement.
- Dr. E. administratively appealed; the Franklin County Court of Common Pleas affirmed the Board in a March 10, 2021 Decision and Entry.
- On appeal to the Tenth District, Dr. E. raised four assignments of error: (1) due‑process/tainted proceedings relating to Board staff statements and confidential monitoring, (2) statutory interpretation of R.C. 4731.22(B)(19) (‘‘inability to practice’’ must be complete), (3) disability‑discrimination (ADA/state law), and (4) improper reliance on Dr. Hanna (neurologist) to bar cardiac electrophysiology.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Due process / "tainted" proceedings (confidential monitoring program) | Board staff misrepresented Dr. E.'s eligibility for the non‑disciplinary confidential monitoring program, tainting the process and making the hearing fundamentally unfair | Board provided notice and hearing; there was no unequivocal agreement by Dr. E. to the monitoring program's restrictions; Board acted within its discretion | Court affirmed: no due‑process violation; record shows adequate notice and opportunity to be heard and no abuse of discretion by trial court |
| Meaning of R.C. 4731.22(B)(19) — "inability to practice" | "Inability" requires a complete, global inability to practice; partial impairments cannot trigger Board action under (B)(19) | Statute authorizes limiting a license where physical illness/decline adversely affects cognitive, motor, or perceptive skills; Board may impose limitations (not only suspension or revocation) to allow continued practice in other areas | Court held de novo that (B)(19) permits limitations for partial/graded inability; rejected plaintiff's hyperliteral reading |
| Disability discrimination (ADA / state law) | Board's restriction is discrimination because it is based solely on Dr. E.'s physical disability and prevents him from performing subspecialty work he says he can safely do | Antidiscrimination statutes apply to qualified individuals; Board may restrict practice when a physician is not currently qualified in the interest of patient safety | Court held Board action did not violate disability laws; Board may restrict unqualified practitioners on a record showing risk to patients |
| Reliance on Dr. Hanna (neurologist) / sufficiency of evidence | Dr. Hanna (a neurologist) lacked electrophysiology expertise and equated possibility of a seizure with a direct patient threat; Board's reliance violated due process and lacked reliable/probative/substantial evidence | Dr. Hanna's neurological opinion about seizure risk during invasive procedures was appropriate; his opinion was corroborated by Dr. E.'s treating physicians, and the Board considered accommodations and cross‑examination | Court held Board reliance was lawful and the order was supported by reliable, probative, and substantial evidence; even without Dr. Hanna, treating physicians’ opinions would suffice |
Key Cases Cited
- Great Lakes Bar Control, Inc. v. Testa, 156 Ohio St.3d 199 (2018) (statutory words must be read in textual context to determine ordinary meaning)
- Pons v. Ohio State Med. Bd., 66 Ohio St.3d 619 (1993) (courts must defer to medical board on technical and ethical matters; appellate review limited)
- Univ. of Cincinnati v. Conrad, 63 Ohio St.2d 108 (1980) (administrative‑review standard: affirm if supported by reliable, probative, substantial evidence)
- Our Place v. Liquor Control Comm., 63 Ohio St.3d 570 (1992) (definitions of reliable, probative, and substantial evidence for administrative review)
- Arlen v. State Med. Bd. of Ohio, 61 Ohio St.2d 168 (1980) (administrative hearings in regulated professions address technical questions within boards’ competence)
- Farrand v. State Med. Bd. of Ohio, 151 Ohio St. 222 (1949) (historical support for resolving professional technical questions via administrative boards)
- Toledo Bar Assn. v. Cook, 114 Ohio St.3d 108 (2007) (example of "complete" inability used to convey absolute incapacity)
- In re K.H., 119 Ohio St.3d 538 (2008) ("complete inability" contrasted with substantial limitations)
- State v. Pendergrass, 162 Ohio St.3d 25 (2020) (statutes must be read together to derive meaning)
- Alexander v. Margolis, 921 F. Supp. 482 (W.D. Mich. 1995) (state medical boards may lawfully consider patient safety when restricting practice)