ÿWPC„ .# ”U:Ÿ %Ù 0(ßw@4G[b jv 0J~ 0TÈ 0^ 0hz 0râ 0|T 0†Ð 0V 1uæ 0d[U*¿B)é AQ Æc 0D) 0@m 0D­ DCñ D/4 Bc B€ D3 AMÐ  v~3 vÓ±˜HP LaserJet 4SiHPPCL5MS,ü,,,,,ü0nLhÎ, øð AZ‹"Arial RegularX($¡¡ EDDDÓ€(ê‚_#†88883|x(- ù -2 ÿÿ0Indent1Ô2ÔÔ3  Ô2" ÿÿ0Indent2à0 àÔ2ÔÔ3  Ô2, ÿÿ0Indent3à0 àà0 àÔ2ÔÔ3  Ô26 ÿÿ0Indent4à0 àà0 àà0 àÔ2ÔÔ3  Ô2@ ÿÿ0Indent5à0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2J ÿÿ0Indent6à0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2T ÿÿ0Indent7à0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2^ ÿÿ0Indent8à0 àà0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô ÿÿ?AGMSYaioIndent0I.A.1.a.(1)(a)i)a)P ÿÿ8Mac DefaultMac DefaultÓ ` °šXÓ< Œ 9p`(Arial% Line 7 d!"#$&Cþÿ<< CÿÿƒLevel 1Level 2Level 3Level 4Level 5(3¯$¢¢Ý ƒ!ÝÝ  Ý("ÿÿ$££Ò  ÒÒ  Ò($$””ò òÚ  Ú1Ú  Úó ó7Border 1dd(('÷ÿ dxd düÿP Pd'''''ÿÿdxd!#%Cþÿ << Gÿÿ Ý ƒ!ÝÑ  ÑÑ#€d#ÑÔ€ÔÝ  ÝÝ ƒ""ÝÝ  ÝÔ€ÔÓ  Óò òÔ YYY ÔFILEDÔ€XÔÌÌNovember€25,€1997ÌÌCecil€W.€CrowsonÌAppellate€Court€ClerkÔ  Ôó óPtPtHHÚ(ÿáÿâùFG(üHHØ(d'`Styl{WP}01•ÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃà Ãà Ãà Ãà Ãà ÃÃÃÃÃÃÃÃÃÃÃÐ ÐÐHHÐÐ  ÐÐ2ÐÐÿÿ¸æ$ÿÐÐHHÐÐÐÐÐÐÐÐ  ÐÐ ÐÐ ÐÑÑÑGenevaÑÑ ÑÑ € ÑÑ<Px–ÈÑÒÒÒ443!#4ÒÒ$ *$ÒÒ$*$ÒÒ ÿKK ÒÒ  Geneva ÒÒ  Geneva ÒÓ.,ÓÓÓÓ6ÓÓ ÓßßßßßßßßßßßßßßßßßßÑGenevaÑÑ ÑÒ  ion-F Geneva ÒÒ  ion-F Geneva ÒÝ ƒ!ÝÔ . ÔÔ€ÔÝ  ÝÑ  ÑÒ € ÒÒ ° ÒÒ € ÒÒ „ ÒÑ\R AØ'\ÑÑ\R AØ'\ÑÑ€ÑÑ7€ÃXXdædÈ7ÑÑ  ÑÑ  Ñ›Þ ÞÌJOE€BRYANT,€M.D.,à àà àà à)Ìà àà àà àà àà àà à)Ìà àPlaintiff/Appellee,à àà àà à)Ìà àà àà àà àà àà à)à àAppeal€No.Ìà àà àà àà àà àà à)à à01„A„01„9703„CH„00132ÌœVS›.à àà àà àà àà àà à)Ìà àà àà àà àà àà à)à àWilson€ChanceryÌà àà àà àà àà àà à)à àNo.€œ96332›ÌœÙ€!ÙßR€*+%A1-j|;` ç `€€@ÿRß›TENET,€INC.,€(NATIONAL€MEDICALà à)ÌENTERPRISES)€d/b/a€UNIVERSITYà à)ÌMEDICAL€CENTER,à àà àà à)Ìà àà àà àà àà àà à)Ìà àDefendant/Appellant.à àà à)ÌÌÌà@ àCOURT€OF€APPEALS€OF€TENNESSEEÌà@ àMIDDLE€SECTION€AT€NASHVILLEÌÌÌAPPEALED€FROM€THE€CHANCERY€COURT€OF€WILSON€COUNTYÌAT€LEBANON,€TENNESSEEÌÌTHE€HONORABLE€œC.€K.€SMITH,€CHANCELLOR›ÌÌÌÌÌÌHENRY€CLAY€BARRYÌ106€S.€CollegeÌLebanon,€Tennessee€37087Ìà àAttorney€for€Plaintiff/AppelleeÌÌWILLIAM€C.€MOODYÌThe€Cavalier€Building,€Suite€#509Ì95€White€Bridge€RoadÌNashville,€Tennessee€37205Ìà àAttorney€for€Defendant/AppellantÌÌÌÌÌÌà@ àREVERSED€AND€REMANDEDÌÌÌÌÌÌà àà àà àà àà àà àà àBEN€H.€œCANTRELL›,€JUDGEÌÌÌCONCUR:ÌKOCH,€J.ÌÌDISSENT:ÌTODD,€œP.J.›,€M.S.ÌÓÓÓ  Óà@ àò òòòÔ€„ÔO€P€I€N€I€O€Nó óóóÔ€XÔÌÌà àà àOn€the€basis€of€the€due€process€provision€of€Article€I,€œðð€8›€of€theÏTennessee€Constitution,€the€Chancery€Court€of€Wilson€County€enjoined€Tenet,ÏInc.,€the€owner€of€a€Lebanon€hospital,€from€proceeding€with€the€investigation€of€aÏcomplaint€against€a€physician€with€staff€privileges€at€the€hospital.€€œWe›€concludeÏthat€the€procedure€employed€by€the€hospital€does€not€violate€the€physicianððsÏconstitutional€or€contractual€œrights.€›€œWe,€therefore,›€reverse€the€lower€courtððsÏjudgment.ÌÌà@ àò òI.Ìà@ àFacts€and€Procedural€Historyó óÌÌà àà àDr.€Joe€Bryant€has€practiced€for€many€years€as€a€general€surgeon€atÏthe€University€Medical€Center€(œUMC›)€in€Lebanon.€€UMC€is€a€private€hospitalÏowned€by€Tenet,€Inc.€and€is€the€only€hospital€in€Wilson€County.€€All€physiciansÏworking€at€UMC€subscribe€to€a€set€of€bylaws€governing€the€investigation€ofÏcomplaints.€€Pursuant€to€state€regulations€the€bylaws€œcontain›€a€fair€hearingÏprocedure€governing€decisions€affecting€medical€staff€privileges.€€òòSee€LewisburgÏCommunity€Hospital€v.€Alfredsonóó,€805€S.W.2d€756€(Tenn.€1991).ÌœÌà@ àò òa.€€The€Bylawsó óÌ›Ìà àà àThe€UMC€bylaws€œestablish€a€three„tier€process€that€is€intended€toÏincorporate€the€peer€review€process€endorsed€by€the€General€Assembly€in€Tenn.ÏCode€Ann.€ðð€63„6„219€(1997).€€The€process€is€triggered€by€the€filing€of€a€ð ðrequestÏfor€corrective€action.ðð€€The€first€step€of€the€process€is€an€informal€ð ðinvestigationðð€byÏthe€executive€committee.€€The€bylaws€state€specifically€that€this€step€is€not€aÏð ðhearingðð€and€permit€the€executive€committee€to€take€a€broad€range€of€actions.€ÏThe€bylaws€are€silent€about€the€role€of€lawyers€during€the€first€phase;€however,€itÏis€uncontradicted€that€the€hospital€does€not€permit€lawyers€for€anyone€to€beÏpresent€at€any€of€the€first€stage€meetings€during€the€investigative€process.€€AnyÏperson€dissatisfied€with€the€executive€committeeððs€recommendations€may€appeal.€ÌÌà àà àThe€second€stage€of€the€proceeding€is€much€more€formal€than€theÏfirst€and€involves€a€hearing€before€a€medical€review€committee€specificallyÏchosen€to€hear€the€appeal.€€The€bylaws€require€written€notices€at€this€stage.€€TheyÏalso€require€the€executive€committee€to€provide€the€physician€with€ð ðnotice€of€theÏacts€or€omissions€with€which€the€affected€practitioner€is€charged€or€a€list€of€theÏchart€numbers€under€question,€if€any,€or€the€reasons€for€the€action€orÏrecommendation.ðð€€The€parties€are€permitted€to€use€ð ðrepresentatives,ðð€and€theseÏrepresentatives€may€be€lawyers€if€all€parties€desire€counsel.€€The€hearingÏprocedure€is€also€quite€formal.€€The€hospital€must€present€its€case€first,€theÏphysician€second,€and€both€parties€are€permitted€to€present€rebuttal€proof.€€If€theÏphysician€is€the€appealing€party,€he€or€she€must€prove€by€clear€and€convincingÏevidence€that€the€action€or€the€recommendation€of€the€executive€committee€wasÏarbitrary,€unreasonable,€or€not€supported€by€substantial€evidence.ÌÌà àà àThe€third€and€final€step€of€the€process€is€an€appeal€to€the€governingÏbody€of€the€hospital.€€This€review€is€based€on€the€record€of€the€prior€proceedings,Ïand€the€grounds€for€review€include€(1)€the€failure€of€the€earlier€proceedings€toÏcomply€with€the€bylaws,€(2)€the€failure€to€afford€due€process€or€a€fair€hearing,€(3)Ïthat€the€recommendation€was€arbitrary,€unreasonable,€or€capricious,€(4)€that€theÏmedical€review€committeeððs€decision€was€contrary€to€the€weight€of€the€evidence,Ïor€(5)€that€any€bylaw€relied€on€by€the€medical€review€committee€lackedÏsubstantive€rationality.›ÌÌÌœÌà@ àò òb.€€The€Complaint€and€Subsequent€ProcedureÌó óÌ›à àà àDr.€Bryantððs€treatment€of€a€particular€patient€became€the€subject€of€aÏcomplaint€to€UMCððs€administrator.€€œLater,›€UMCððs€chief€of€staff€discussed€theÏincident€with€Dr.€Bryant€and€asked€him€to€attend€a€meeting€of€the€hospitalððsÏexecutive€œcommittee›€to€review€the€incident.€€He€declined€to€attend€voluntarily€andÏlater€was€served€with€a€written€notice€of€the€meeting.€€He€also€received€a€copy€ofÏthe€patientððs€chart.ÌÌà àà àPrior€to€the€meeting,€Dr.€Bryant€wrote€a€lengthy,€detailed€letter€toÏUMCððs€administrator€presenting€his€side€of€the€controversy.€€On€the€day€of€theÏmeeting,€Dr.€Bryant€insisted€that€the€committee€permit€his€lawyer€to€œattend.€€The›Ïcommittee€denied€that€request,€œand€Dr.›€Bryant€refused€to€attend€œwithout€hisÏlawyer.›€€œThe›€œcommittee›€œmet€and€took€some€action€but€the€decision›€is€not€includedÏin€the€record.ÌÌà àà àShortly€thereafter,€Dr.€Bryant€filed€suit€against€Tenet,€Inc.€seeking€toÏenjoin€the€hospital€from€proceeding€under€its€bylaws€because€the€proceedingsÏviolated€the€due€process€provisions€of€the€federal€and€state€œconstitutions.€€He€laterÍamended€his€complaint€to€allege€that€Tenet€was€violating›€his€contractual€rightsÏunder€the€bylaws.€€The€trial€court€determined€that€the€hospital€procedures€did€notÏviolate€the€federal€constitution€but€that€they€did€violate€Dr.€Bryantððs€stateÏconstitutional€and€contractual€rights.€€Accordingly,€the€trial€court€entered€an€orderÏenjoining€UMC€from€conducting€any€further€disciplinary€proceedings€against€Dr.ÏBryant€until€it€(1)€provides€him€with€written€notice€of€the€complaint€against€him,€(2)Ïcommences€a€new€executive€committee€investigation,€and€(3)€allows€him€to€haveÏan€attorney€present€during€all€stages€of€the€proceedings.Ì̛̜à@ àò òII.Ìà@ àThe€Constitutional€Issuesó óÌÌà àà àWe€pass€over€the€first€issue€in€this€analysis,€the€issue€of€whether€Dr.ÏBryant€has€a€property€interest€in€his€staff€privileges€at€UMC.€€Although€ourÏSupreme€œCourt›€in€œòòNashville€Memorial€Hospital,€Inc.›€v.€Binkleyóó,€534€S.W.2d€318Ï(Tenn.€1976)€held€œthat€a€doctor€did€not€have€a€ð ðrightðð€to€practice€at€a€private›Ïœhospital,€for›€the€purposes€of€this€appeal€œwe›€assume€that€œDr.€Bryant€does€haveÏsuch€a€right.›ÌÌà àà àThe€next€question,€then,€is€whether€œArticle›€œI,›€œðð›€8€of€our€œConstitutionÏrequires€private€actors€to€conform€to€the€requirements€of€due€process€beforeÏtaking€action€with€respect€to€that€right.€€We€conclude›€that€it€does€not.ÌÌà àà àArticle€I,€œðð›€8€of€the€Tennessee€Constitution€provides€as€follows:ÌÓÓà8 àà8 àœThat›€no€man€shall€be€taken€or€imprisoned,€or€disseizedÏof€his€freehold,€liberties€or€privileges,€or€outlawed,€orÏexiled,€or€in€any€manner€destroyed€or€deprived€of€hisÏlife,€liberty€or€property,€but€by€the€judgment€of€his€peersÏor€the€law€of€the€land.ÌÌÌÌÓÓà àà àIn€òòState€v.€Haleóó,€840€S.W.2d€œ307,€312›€(Tenn.€1992),€our€SupremeÏCourt€said:ÌœÓÓà8 àà8 àThe€phrase,€ððthe€law€of€the€landðð,€used€in€this€section€ofÏour€State€Constitution,€and€the€phrase,€ððdue€process€ofÏlaw,ðð€used€in€the€Fifth€Amendment€and€in€the€firstÏsection€of€the€Fourteenth€Amendment€to€theÏConstitution€of€the€United€States,€are€synonymousÏphrases€meaning€one€and€the€same€thing.›ÌÌòòÓÓSee€also€Burford€v.€Stateóó,€845€S.W.2d€204€(Tenn.€1992);€òòState€v.€Smithóó,€834ÏS.W.2d€915€(Tenn.€œ1992).€€Since€ð ðstate€actionðð€is€necessary€to€invoke€theÏprotection€of€the€Fourteenth€Amendment,€òòLong€v.€Stateóó,€510€S.W.2d€83€(Tenn.ÏCrim.€App.€1974),€we€conclude€that€the€same€is€true€with€respect€to€Article€I,€ðð€8.›ÌÌà àà àWe€recognize€that€œArticle›€I,€œðð›€8€has€been€interpreted€as€prohibitingÏsome€state€actions€that€would€not€violate€the€due€process€provisions€of€the€FifthÍand€Fourteenth€Amendments€to€the€United€States€Constitution.€€òòCompareóó€òòNorth€v.ÏRussellóó,€427€U.S.€328€(1976)€and€òòState€ex€rel.€œAnglin›€v.€Mitchellóó,€596€S.W.2d€779Ï(Tenn.€1980).€€œBut,›€despite€the€differences€in€wording€in€the€two€constitutionalÏprovisions,€the€fundamental€protection€provided€by€each€is€protection€from€theÏgovernment.€€œòòState€v.€Heer›óó,€412€S.W.2d€œ218,€220€Tenn.€36€(1967);›€òòœEnnis›€v.€Stateóó,Ï549€S.W.2d€380€(Tenn.€œCrim›.€œApp›.€1977).€€We€know€of€no€case€that€applies€theÏprotection€of€œArticle›€I,€œðð€8›€to€actions€by€individuals.ÌÌà àà àDr.€Bryant€cites€òòLyle€v.€Local€452óó,€124€S.W.2d€œ701,€174€Tenn.€222Ï(1939)€in›€support€of€his€contention€that€œArticle›€I,€œðð›€8€does€apply€to€private€actions.€ÏIn€that€case,€our€Supreme€œCourt›€œfound€that€a€unionððs€picketing€of€the€plaintiffððsÏbusiness›€œwas›€unlawful,€a€nuisance,€and€causing€irreparable€injury€to€the€plaintiffððsÏproperty€œrights.€›€œThe›€œcourt,€accordingly,›€issued€a€permanent€injunction€œto€prohibitÏthe€picketing.›€€The€court€did€say,€ð ðwe€conclude€therefore€that€complainant,€as€aÏresult€of€the€conduct€of€defendants,€was€deprived€of€his€liberty€and€property,€asÏguaranteed€to€him€by€the€œ5th›€and€œ14th›€Amendments€to€the€Federal€Constitution€.€.Ï.€and€Article€œ1,›€Section€œ8,›€of€the€Constitution€of€Tennessee.ðð€€124€S.W.2d€at€704.€ÏœBut,›€we€read€the€quoted€part€of€the€courtððs€opinion€as€a€description€of€the€rightÏinvaded€by€the€defendantsðð€unlawful€action€rather€than€a€finding€that€theÏdefendantsðð€action€was€prohibited€by€the€constitutional€provisions€cited.€€The€courtÏhardly€needed€a€constitutional€basis€for€the€œinjunction€since›€œthe›€common€lawÏremedies€available€for€the€prevention€of€irreparable€harm€were€œentirely›€adequate.ÌÌà àà àWe€are€convinced€that€œArticle›€I,€œSection›€8€of€the€TennesseeÏConstitution€did€not€apply€to€the€actions€of€UMC,€a€private€corporation.ÌÌà@ àò òIII.ó óÌÌà àà àDr.€Bryant€amended€his€complaint€in€the€court€below€to€assert€aÏclaim€that€Tenet,€Inc.€was€violating€his€contractual€rights€under€the€hospitalÏbylaws.€€We€do€not€question€the€fact€that€the€bylaws€are€part€of€Dr.€BryantððsÏcontract€with€the€hospital.€€òòSee€Lewisburg€Community€Hosp.€v.€Alfredsonóó,€805ÏS.W.2d€at€759€(Tenn.€1991).€€But€the€sections€of€the€bylaws€governing€correctiveÏactions€do€not€give€him€the€rights€he€seeks€(formal€written€notice€œand›€the€right€toÏbe€represented€by€an€attorney€òòat€the€investigative€stageóó.)€€His€complaint€on€thisÏissue€reverts€to€his€constitutional€arguments;€in€effect€he€complains€that€theÏbylaws€do€not€provide€what€due€process€requires.€€œSince›€we€have€alreadyÏresolved€that€issue€adversely€to€Dr.€Bryant,€we€think€his€complaint€based€on€theÏbylaws€must€also€fail.ÌÌà àà àThe€judgment€of€the€court€below€is€reversed€and€the€complaint€isÏdismissed.€€Remand€the€cause€to€the€œChancery›€Court€of€Wilson€County€for€anyÏfurther€necessary€proceedings.€€Tax€the€costs€on€appeal€to€the€appellee.ÌÌÌÌÓÓà àà àà àà àà àà à_____________________________Ìà àà àà àà àà àà àBEN€H.€CANTRELL,€JUDGEÌÌÌÌCONCUR:ÌÌÌœÌ_______________________________›ÌWILLIAM€C.€KOCH,€JR.,€JUDGEÌ̛̜ÌDISSENTING€OPINION:ÌHENRY€F.€TODD,€PRESIDING€JUDGEÌMIDDLE€SECTIONÌÌÑ  Ñà@ àIN€THE€COURT€OF€APPEALS€OF€TENNESSEEÌà@ àMIDDLE€SECTION€AT€NASHVILLEÌÌÌÌJOE€BRYANT,€M.D.,à àà àà à)Ìà àà àà àà àà àà à)Ìà àPlaintiff/Appellee,à àà àà à)Ìà àà àà àà àà àà à)à àAppeal€No.Ìà àà àà àà àà àà à)à à01„A„01„9703„CH„00132ÌVS.à àà àà àà àà àà à)Ìà àà àà àà àà àà à)à àWilson€ChanceryÌà àà àà àà àà àà à)à àNo.€œ96332›ÌTENET,€INC.,€(NATIONAL€MEDICALà à)ÌENTERPRISES)€d/b/a€UNIVERSITYà à)ÌMEDICAL€CENTER,à àà àà à)à àReversed€andÌà àà àà àà àà àà à)à àRemandedÌà àDefendant/Appellant.à àà à)ÌÌÌà@ àò òòòÔ€¼ÔJ€U€D€G€M€E€N€Tó óóóÔ€XÔÌÌÌÓÓà àà àThis€cause€came€on€to€be€heard€upon€the€record€on€appeal€from€theÏChancery€Court€of€Wilson€County,€briefs€and€argument€of€counsel;€uponÏconsideration€whereof,€this€Court€is€of€the€opinion€that€in€the€decree€of€theÏChancellor€there€is€reversible€error.Ìà àà àIn€accordance€with€the€opinion€of€the€Court€filed€herein,€it€is,Ïtherefore,€ordered€and€decreed€by€this€Court€that€the€decree€œof€the€Chancellor€be›Ïreversed.€€The€cause€is€œdismissed,€remanded›€to€the€œChancery€Court›€of€œWilsonÏCounty›€for€any€further€proceedings€œnecessary,›€and€for€the€œcollection›€of€the€costsÏaccrued€below.Ìà àà àCosts€of€this€appeal€are€taxed€against€Dr.€Joe€Bryant,€for€whichÏexecution€may€issue€if€necessary.Ìà àà àENTER€_______________________.ÌÌÌÓÓà àà àà àà àà àà à_________________________________Ìà àà àà àà àà àà àBEN€H.€CANTRELL,€JUDGEÌÌÌà àà àà àà àà àà à_________________________________Ìà àà àà àà àà àà àWILLIAM€C.€KOCH,€JR.,€JUDGEÌÌ