Valfer v. Evanston Northwestern Healthcare
2016 IL 119220
| Ill. | 2016Background
- Dr. Steven Valfer, an OB-GYN, applied for reappointment at Evanston Northwestern Healthcare in 2002 after concerns arose about unnecessary oophorectomies and other surgeries. Division chief Dr. Nelson and department chair Dr. Silver reviewed cases and recommended against reappointment. Operating privileges were suspended; plaintiff retained some non‑surgical privileges during review.
- Executive committee, hearing committee, appellate review committee, and hospital board all upheld the recommendation; nonreappointment became final in March 2005 after multilayered internal review and hearings at which Valfer had counsel and presented evidence.
- Valfer sued for breach of contract (medical staff bylaws) seeking damages, claiming the hospital used the wrong bylaws, allowed biased reviewers (competitors), and acted wilful and wanton.
- Hospital moved for summary judgment asserting it complied with bylaws and is immune from civil damages under section 10.2 of the Illinois Hospital Licensing Act (and HCQIA). Trial court granted summary judgment; appellate court affirmed based on Licensing Act immunity.
- Supreme Court granted review and affirmed: it construed the Licensing Act’s “wilful and wanton” exception as limited to conduct causing or risking physical harm and held the record did not raise a genuine fact issue that the hospital’s peer review was a sham or that physical‑harm‑level misconduct occurred.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does the Licensing Act’s “wilful and wanton” exception require physical harm? | Valfer: No — intent to harm (e.g., reputational/economic) or bylaw violations suffice. | Hospital: Yes — statute’s phrase about safety limits exception to physical‑harm conduct. | Held: Exception requires physical‑harm focus; statute’s definition references safety and limits scope to tortious, physical‑harm conduct. |
| Was Valfer "effectively reappointed" after May 31, 2002 (triggering different bylaws)? | Valfer: Continued admitting privileges meant he remained appointed, so peer‑review suspension rules should apply. | Hospital: No evidence of reappointment; continued limited privileges were procedural while reappointment pending. | Held: No genuine dispute that he was reappointed; record supports hospital’s characterization that reappointment was not renewed after May 31, 2002. |
| Is the hospital immune from civil damages under section 10.2 of the Licensing Act? | Valfer: Immunity shouldn’t apply where bylaws weren’t followed or reviewers had improper motive. | Hospital: Immunity applies because review served quality‑of‑care purpose and Valfer cannot show wilful and wanton misconduct causing physical harm. | Held: Immunity applies; plaintiff failed to present evidence creating a genuine issue that the review was a sham or involved wilful and wanton conduct as defined. |
| Can a bylaw violation alone defeat section 10.2 immunity (i.e., constitute wilful and wanton misconduct)? | Valfer: Yes — a bylaws breach amounts to willful/wanton misconduct preventing immunity. | Hospital: No — treating bylaw breach as automatic exception would nullify statutory immunity. | Held: No — a mere contract/bylaws breach is not the statutory wilful and wanton exception (which is a tort concept tied to physical harm); sham‑purpose allegations still may survive if well pleaded and supported by evidence. |
Key Cases Cited
- Ziarko v. Soo Line R.R. Co., 161 Ill. 2d 267 (1994) (defines willful and wanton conduct as hybrid between negligence and intentional tort and ties concept to danger/safety)
- Adkins v. Sarah Bush Lincoln Health Center, 129 Ill. 2d 497 (1989) (internal hospital staffing decisions generally not judicially reviewed; limited review where privileges revoked)
- Cardwell v. Rockford Memorial Hospital, 136 Ill. 2d 271 (1990) (distinguishes immunities in Medical Practice Act and Hospital Licensing Act)
- Morrow v. L.A. Goldschmidt Associates, Inc., 112 Ill. 2d 87 (1986) (intent/willfulness not generally relevant to breach of contract; punitive damages limited)
- Krywin v. Chicago Transit Authority, 238 Ill. 2d 215 (2010) (willful and wanton misconduct is an aggravated form of negligence)