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Burns v. Georgetown University Medical Center

United States District Court, District of Columbia

August 12, 2016

ANTOINETTE BURNS, Plaintiff
v.
GEORGETOWN UNIVERSITY MEDICAL CENTER, et al., Defendants

          MEMORANDUM OPINION

          COLLEEN KOLLAR-KOTELLY United States District Judge.

         This case is about a medical fellowship gone awry. As a result of the events described below, Plaintiff Lieutenant Colonel Antoinette Burns-the participant in the fellowship-brings contract-based claims against Defendants Georgetown University Medical Center (“Georgetown” or “GUMC”) and against MedStar Georgetown University Hospital (“the Hospital”) (Counts I, II, and III).[1] Burns also brings three tort claims arising out of the events described below: a negligent defamation claim against the Hospital and against Dr. Matthew Levy (Count IV); an intentional defamation claim against Levy (Count V); and a claim for intentional interference with prospective economic advantage against Levy (Count VI). Defendants move for summary judgment on all of the claims in this case.

         Specifically, before the Court are Defendant MedStar Georgetown University Hospital’s [62] Motion for Summary Judgment as to Counts I, II, and III; Defendant Georgetown University Medical Center’s [63] Motion for Summary Judgment as to Counts I, II, and III; and Defendant MedStar Georgetown University Hospital’s and Defendant Matthew Levy, M.D.’s [64] Joint Motion for Summary Judgment as to Counts IV, V, and VI. In addition, before the Court are Defendants’ [65] Motion In Limine to Preclude Plaintiff’s Use at Trial of Evidence Inadmissible under the District of Columbia Peer Review Statute and Plaintiff’s [69] Motion In Limine to Exclude Evidence of Settlement Discussions. Upon consideration of the pleadings, [2]the relevant legal authorities, and the record as a whole, the Court GRANTS each of the three pending motions for summary judgment. Defendants, collectively, raise a host of arguments as to why none of the claims in this case survive summary judgment; the Court outlines and addresses those arguments below. In short, however, the Court concludes that Defendants prevail on each of the respective motions for summary judgment, and the Court grants summary judgment to Defendants on all claims in this case. With respect to the dueling motions in limine, the Court need not resolve them in order to resolve the three pending motions for summary judgment. Accordingly, the Court DENIES AS MOOT the two motions in limine. The Court dismisses this case in its entirety.

         I. BACKGROUND

         The Court presents here the minimal background necessary to set the stage for the discussion of the issues raised in the pending motions. Specifically, the Court focuses here on the establishment of Plaintiff’s fellowship, including the several agreements that set the parameters for that fellowship, as well as the events that led to the early termination of the fellowship.

         A. The Fellowship Begins

         Prior to the events that underlie this case, Plaintiff was trained as a physician and served as a pediatrician in the United States Air Force. See Pl.’s Counter-Statement of Undisputed Material Facts, ECF No. 71-1 (“Pl.’s Counter-Stmt.”), ¶¶ 8-12. In January 2011, Plaintiff was informed that she had been selected by the Armed Services’ Joint Graduate Medical Education Selection Board for additional civilian sponsored training in pediatrics, including a master’s degree in public health, for a period between August 1, 2011, and July 31, 2013. See Pl.’s Opp’n, Ex. 19 (Selection Letter); id., Ex. 11 (“Grau Test.”), at 19:10-20:22 (clarifying that date was January 2011). Plaintiff was to remain on active duty during the period of training under the command of the Air Force Institute of Technology. Selection Letter at 1. Plaintiff was prohibited from receiving a salary or stipend from the training institution. Id. After evaluating multiple opportunities, Plaintiff was accepted and chose to attend the program at Georgetown. Pl.’s Counter-Stmt. at ¶¶ 31, 34.

         Before the fellowship could commence, several agreements were signed-agreements that are at the heart of this case. The Court reviews the agreement between the Air Force and Georgetown University Medical Center, followed by the agreement between Plaintiff and Georgetown University Medical Center, as well as several related agreements.

         Georgetown University Medical Center and the United States Air Force entered into a “Medical Residency/Fellowship Agreement” regarding Plaintiff’s training. See Def.’s Mot., Ex. G at 2-3; Pl.’s Opp’n, Ex. 22 at 2-3 (“Medical Residency/Fellowship Agreement”). David Rubenstein, Vice President for Financial Planning and Analysis, signed the agreement on behalf of Georgetown University Medical Center on June 8, 2011; the next day, June 9, 2011, Lieutenant Colonel Debra Miesle signed the agreement on behalf of the United States, specifically on behalf of the Air Force Institute of Technology.[3] See Id. There were no other signatories to the agreement. The agreement appears to be based on a form agreement, with information specific to Plaintiff’s fellowship filled in as necessary. See id.; Pl.’s Opp’n, Ex. 21 (e-mail stating that the 2011 template should be used for the Medical Residency/Fellowship Agreement). The agreement begins with the following provision:

         1. It is understood that Antoinette Theodora Burns will take residency/fellowship training at Georgetown University Post Doctoral Fellowship in Community Pediatrics w/MPH concurrently with his/her official Air Force duties from 1 August 2011 to 31 July 2013.

         Medical Residency/Fellowship Agreement at 2.[4] The agreement includes other provisions regarding remuneration of Plaintiff, insurance, liability, and the termination of this agreement. See Id. at 2-3. Further explanation of these provisions is reserved for the discussion of the issues below. This agreement was accompanied by a one-page “Memorandum for Training Institution” from Lieutenant Colonel Miesle, the Chief of the Healthcare Education Division of the Air Force Institute of Technology, who also signed the Medical Residency/Fellowship Agreement. Id. at 1. That Memorandum stated that “[w]e understand that an Air Force military officer, named in the attached agreement has been accepted for residency/fellowship training by your institution for periods indicated in the attached agreement.” Id. The Memorandum further stated that “[t]he Air Force officer will not be able to start training at your institution until both your institution and the Air Force sign this agreement.” Id.

         Through a letter dated August 1, 2011, on letterhead of Georgetown University Medical Center and addressed to Plaintiff by name, Plaintiff was offered “a non-paid Post-doctoral Research Fellowship appointment in the Department of Pediatrics at the Georgetown University Medical Center, effective August 1, 2011.” Pl.’s Opp’n, Ex. 25 (“GUMC Offer Letter”), at 1. The letter explained that Plaintiff was offered the fellowship position “pursuant to a Medical Residence/Fellowship Agreement between the U.S. Air Force and Georgetown.” Id. That document was accompanied by the GUMC Research Fellowship Agreement and the GUMC Research Fellowship Policy. Id. at 1-2. The offer letter further stated as follows:

If the terms specified in the letter and the accompanying Post-doctoral Research Fellowship Agreement are acceptable and you have read and agree to be bound by these terms and the policies referred to herein by reference, please sign this letter and the enclosed agreement and return both to me within fifteen (15) days of the date of receipt of this letter.

Id. at 2. The letter was signed by David B. Nelson, identified as Professor and Chair; in addition, the letterhead identifies Nelson as affiliated with Georgetown University Children’s Medical Center. Id. at 1-2. Plaintiff signed the letter, underneath text indicating that she was accepting the offer as set out in the letter, and dated it August 25, 2011. Id. at 2.

         An additional agreement between Plaintiff and the Georgetown University Medical Center, the “Research Fellowship Agreement: Georgetown University Medical Center, ” referenced in the offer letter, sets out obligations of the Research Fellow (Plaintiff) and of Georgetown University Medical Center. Def.’s Mot., Ex. I (“Research Fellowship Agreement”), at 1-4. The Research Fellowship Agreement was signed by Plaintiff and dated August 25, 2011, under the heading “for the Postdoctoral Fellow.” Id. at 4. For Georgetown University Medical Center, the agreement was signed by a faculty supervisor (dated August 24, 2011), by the department chair, Nelson (dated August 24, 2011), and by the senior associate dean for faculty and academic affairs (dated September 15, 2011).

         The record also includes a copy of a single page of an offer letter pertaining to the same position, with almost identical text, on letterhead of MedStar Georgetown University Hospital and dated June 2, 2011. Pl.’s Opp’n, Ex. 25. The letter does not include a signature page, and there is no indication whether the letter was sent to Plaintiff or signed by any of the parties. Id. The record does indicate, however, that multiple versions of the offer letter were exchanged between the parties during the summer of 2011. See Pl.’s Opp’n, Ex. 21, at MedStar-00000026. Like the offer letter on the Georgetown University Medical Center letterhead, the letter stated that Plaintiff was being offered a “full-time Post-doctoral Research Fellowship appointment in the Department of Pediatrics at the Georgetown University Medical Center.” Id., Ex. 25, at 1.[5]

         In addition to the agreements described above, the two institutional defendants in this case-Georgetown University Medical Center and MedStar Georgetown University Hospital- entered into a letter agreement regarding their respective responsibilities in connection with Plaintiff’s role as a Post-Doctoral Fellow in Community Pediatrics and Child Advocacy. Pl.’s Opp’n, Ex. 55, at 1. That letter was dated August 1, 2011. Id. On behalf of Georgetown University, it was signed by David Rubenstein, Vice President, Financial Planning and Analysis, Georgetown University. Id. at 2. On behalf of MedStar Georgetown University Hospital, it was signed by Richard Goldberg, President, and by David Nelson, Chair, Department of Pediatrics.[6]Id. at 4. Finally, Plaintiff applied for clinical privileges and then received credentials to serve as a provisional member of the professional staff at the Hospital. See Pl.’s Mot., Exs. 27, 34.

         B. The End of the Fellowship

         Fast forward approximately eight months.[7] On April 2, 2012, Joanne Odom[8] sent an email to Plaintiff informing her that she had a meeting with Dr. Matthew Levy and with Nelson the following day (April 3) at 1 p.m. Pl.’s Counter-Stmt., ¶ 109. Levy and Nelson both held academic appointments at Georgetown University and were employed by MedStar Georgetown University Hospital. Id., ¶ 38. Levy’s position was as Medical Director for Community Pediatrics. Id., ¶ 66. Also on April 2, 2012, Levy had a telephone conversation with Colonel Thomas Grau, Chief, Air Force Personnel Center, Physician Education Branch, and Susan Weeks, Deputy Chief, Air Force Institute of Technology, Healthcare Education Division. Id., ¶ 111. During that conversation, Levy apprised the Air Force that Plaintiff was being terminated from the fellowship program. Id. Grau asked Levy to send him additional information in writing indicating the specific competencies that Plaintiff had failed to satisfy. Id., ¶ 113; see also Pl.’s Mot., Ex 24 (April 3, 2012, Grau Memo for the Record) (“Grau Memo”). At a meeting the next day, April 3, 2012, Levy handed Plaintiff a letter stating that she was being terminated from the fellowship program. Pl.’s Counter-Stmt., ¶ 114. The letter, on letterhead of Georgetown University Medical Center, began as follows:

This letter is to inform you that the decision has been made to terminate your Research Fellowship Agreement with Georgetown University Medical Center and dismiss you from the Community Pediatrics and Child Advocacy Fellowship Program. This decision is made pursuant to Paragraph 8(a)(II) of the Research Fellowship Agreement, which provides for immediate termination “if Research Fellow has been intentionally or grossly delinquent in his or her conduct.” As detailed below, you have repeatedly been provided notice of the deficiencies in your conduct and have failed to correct them.

         Pl.’s Mot., Ex. 48 (Termination Letter), at 1 (emphasis added). After cataloguing four categories of deficiencies, [9] the letter stated that Plaintiff’s Research Fellowship Agreement-the agreement that Plaintiff Dated: August 25, 2011, as explained above-was terminated “effective immediately.” Id. at 2. As a result, the letter stated that Plaintiff was “not permitted to function in any capacity as a fellow from this point forward, and you should not enter the premises of the Medical Center for any reason other than a personal health need.” Id. The letter also explained that the Air Force would be notified regarding the decision “pursuant to the terms of the Medical Residency/Fellowship Agreement.” Id. The letter was signed by both Nelson, listed as “Chairman, Pediatrics, ” and Levy, listed as “Program Director, Community Pediatrics Fellowship.” Id. On April 4, 2012, at Plaintiff’s request, Grau had a conversation with Plaintiff regarding her notification that she was terminated. Pl.’s Counter-Stmt., ¶ 121.

         In December 2012, after negotiations between the parties, Plaintiff was allowed to submit a backdated resignation letter. See Pl.’s Counter-Stmt., ¶ 130; Def.’s Resp., ECF No. 73-1, ¶ 129. Plaintiff then sent a letter to Nelson, dated April 3, 2012, “respectfully request[ing] to be released from the non-paid Post-doctoral Research Fellowship in the Department of Pediatrics at the Georgetown University Medical Center.” Def.’s Mot., Ex. K (Resignation Letter); see Pl.’s Counter-Stmt. ¶ 130. Nelson responded to Plaintiff’s letter of resignation in a letter dated December 11, 2012, on letterhead of Georgetown University Medical Center. Id. ¶ 132. In that letter, Nelson stated as follows: “This letter confirms that, on April 3, 2012, you requested to be released from the non-paid Post-doctoral Research Fellowship Agreement with Georgetown University Medical Center and your request was granted.” Id. (citing Def.’s Mot., Ex. L). The letter further stated that, “[a]s a result, the Research Fellowship Agreement terminated on that date.” Id.

         On or about December 11, 2012, the date of Nelson’s letter accepting Plaintiff’s resignation, a second termination letter was drafted for Nelson’s signature. Id., ¶ 134. The letter was similar to the letter originally handed to Plaintiff on April 3, 2012, except that it was on letterhead of MedStar Georgetown University Hospital-rather than that of Georgetown University Medical Center-and that it removed all references to the Research Fellowship Agreement in the original letter. Id. Specifically, the opening and closing of the two letters, which explained the effects of the respective letters, were different, while the explanation of Plaintiff’s substantive deficiencies was similar. The second letter opened as follows:

This letter is to inform you that the decision has been made to dismiss you from the Community Pediatrics and Child Advocacy Fellowship Training Program. As detailed below, you have repeatedly been provided notice of the deficiencies in your conduct and have failed to correct them.

         Pl.’s Opp’n, Ex. 57 (MedStar Termination Letter), at 1. After explaining the identified deficiencies, with the same explanation as provided in the original termination letter, the letter then closed by stating that “[w]e strongly advise you to contact the Georgetown University Medical Center regarding your Research Fellowship Agreement.” Id. at 2. While the second termination letter was dated April 3, 2012, Nelson testified that he believed he signed the second letter in December, 2012. Pl.’s Counter-Stmt., ¶ 134. The letter was also signed by Levy. MedStar Termination Letter, at 2.

         In addition, on December 12, 2012, Jamie Padmore, Vice President for Academic Affairs of MedStar Health, Inc., sent a letter to Colonel Michael Tankersley-Grau’s successor- regarding the status of Plaintiff’s fellowship. See Pl.’s Counter-Stmt. ¶ 137; Defs.’ Resp. Stmt. ¶ 137 (citing Def.’s Mot., Ex. A, ¶ 2). The letter stated as follows:

Per your request, the purpose of this letter is to provide you with information regarding Dr. Antoinette Burns and the Community Pediatrics and Child Advocacy Fellowship Training Program at MedStar Georgetown University Hospital (“Pediatrics Fellowship”).
Dr. Burns was enrolled in the Pediatrics Fellowship at MedStar-Georgetown University Hospital (“Hospital”) on August 1, 2011, pursuant to an agreement between the Hospital and Georgetown University Medical Center (“GUMC”). D r. Burns was dismissed from the Pediatrics Fellowship by the Hospital on April 3, 2012 for poor performance.
Following her dismissal from the Pediatrics Fellowship at the Hospital, Dr. Burns voluntarily resigned from her Research Fellowship Agreement with GUMC. Additionally, Dr. Burns resigned from her clinical privileges at the Hospital following her dismissal from the Pediatrics Fellowship.
The program director, Dr. Matthew Levy, will complete a Final Summative Assessment of her academic performance in the Pediatrics Fellowship and send to you in the near future.

         Pl.’s Opp’n, Ex. 58.

         On January 18, 2013, the Air Force Centralized Credentials Verification Office sent a form to MedStar Georgetown University Hospital in order to verify Plaintiff’s training at the hospital. See Pl.’s Opp’n, Ex. 51 (Verification Form); Pl.’s Counter-Stmt., ¶ 139. The form included the following question: “Was this provider ever subject to any disciplinary action, such as admonition, reprimand, suspension, or termination?” Verification Form, at 1. The answer “yes” to that question was marked. Id. The completed form included a notation stating, “see attached document dated 2/4/2012.”[10] Id. Levy signed the form, which was dated February 4, 2013. Id. The attached document was a Final Summative Assessment prepared regarding Plaintiff’s fellowship; the document was on the letterhead of MedStar Georgetown University Hospital and was prepared and signed by Levy. Pl.’s Opp’n, Ex. 52, at 1, 4. The introduction to the document was as follows:

Introduction: Dr. Antoinette Burns enrolled in the 2-year Georgetown University Hospital fellowship program in Community Pediatrics and Child Advocacy on August 1, 2011. Dr. Burns was actively enrolled in the Air Force and was seeking this additional training with the support of her military supervisors. Dr. Burns completed 8 months of the fellowship program and was subsequently dismissed for poor academic performance on April 3, 2012. The following is a summary of D r. B u rns’ academic performance based on the six core competencies: …

Id. at 1. Plaintiff was then evaluated according to six core competencies. The letter concluded as follows:

In sum, Dr. Antoinette Burns’ performance was unacceptable as measured by all six core competencies. Her academic performance was insufficient for that of an advanced trainee. Dr. Burns received ongoing assessments, formative and summative feedback, and was unable to modify her performance, actions and behaviors to an acceptable level. The program made the decision to dismiss her from the academic program effective April 3, 201[2].[11]

Id. at 3-4.

         In light of the foregoing events, Plaintiff filed this action, and now before the Court are Defendants’ ...


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