The Montana Supreme Court on Tuesday sided with St. Peter’s Health in Helena and several doctors in a complaint filed by Dr. Tom Weiner, the health facility’s former oncologist, over the internal reviews leading up to his firing in 2020.
The unanimous decision by a panel of five justices, penned by Justice Laurie McKinnon, found that St. Peter’s Health has immunity against damages related to Weiner’s dismissal, upholding a state district court ruling from 2023.
“The district court was correct when it concluded that [St. Peter’s Health] review was sufficient, that it had made a reasonable effort to obtain the facts, and that SPH had a reasonable belief that its action was necessary to protect patients and quality health care,” the ruling said.
The decision brings to a close one legal element stemming from the protracted conflict between the doctor and the Helena hospital, reports the Montana Free Press.
Court records show that Weiner’s firing stemmed from myriad concerns over patient care and substandard treatment, claims that were further illustrated by an investigation published by ProPublica in December.
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The justices summarized the professional review taken by Weiner’s peers at St. Peter’s as appropriate given findings about the oncologist’s practices.
The ruling cited the 1986 federal Health Care Quality Improvement Act, which created protections for peer review processes in the interest of bettering medical care. The immunity extends to monetary damages “while preserving causes of action for aggrieved physicians that are outside the provisions of the [Improvement Act],” the decision stated.
The hospital’s peer review committee began looking into Weiner’s care in 2020 because of reports about his manipulation of patients’ do-not-resuscitate statuses, “substandard care” for patients treated for non-cancer issues and the administration of end-of-life care.
“The professional review action in revoking Weiner’s privileges and memberships was reasonable and warranted due to the quantity and severity of Weiner’s inappropriate patient care,” the Tuesday ruling stated.
The ruling summarized that, in total, the hospital’s medical executive committee considered dozens of case reviews from internal and external groups concerning Weiner’s patient caseload, alleged medical errors and inadequate documentation, pain management prescription practices and coordination with other providers.
Those cases included the care of Scot Warwick, who received 11 years of chemotherapy treatment for a lung cancer that, medical records and external reviews show, was never confirmed. Warwick was later found to have died from poisoning related to gemcitabine, a chemotherapy drug.
Additionally, the hospital’s actions grew from identified issues with Weiner’s prescribing of “high doses of narcotics to patients for conditions outside the scope of Weiner’s clinical privileges or in quantities that were dangerous and inappropriate for the patients’ complaints or medical history; failure to identify medications in patients’ current medication lists; and prescribing high-dosage opioids to patients without requiring patients to sign a pain contract and without monitoring patients for signs of abuse, performing urine drug tests and pill counts, or properly documenting a chronic treatment plan,” the ruling said.
“Given these facts, which the peer reviewers had at the time of their decision, we have little difficulty concluding that the [credentials committee] reasonably believed — as any peer review body would under these circumstances — that the decision to summarily suspend Weiner on November 17, 2020, would further the quality of health care,” the ruling said.
The justices noted that Weiner repeatedly asserted that the content and process of St. Peter’s review was inadequate. Specifically, Weiner said that the hospital did not properly vet external reviews and that he was not given an opportunity to respond or question the medical providers or patients involved in the reviewed cases.
The court found that Weiner’s arguments fell short of rebutting the hospital’s immunity.
“Weiner misunderstands the nature of the inquiry into whether a ‘reasonable effort’ was made to obtain the facts. We are unwilling to conclude that a failure to include every conceivable factor in a quality assurance review, or one or several mistaken attributes in a host of data, undermine an otherwise thorough investigation,” the decision said. “[St. Peter’s Health] and the external reviewers had ample evidence that Weiner’s patient care was substandard.”
The decision added that the core issue in question was whether the peer reviewers, “with the information available to them at the time of the professional review action, would reasonably have concluded that their actions would restrict incompetent behavior or would protect patients.”
In that regard, the justices found that Weiner’s arguments did not meet the legal standard.
Attorneys for Weiner did not respond to a request for comment Tuesday evening.
In an email, a spokesperson for St. Peter’s Health said the hospital was pleased with the court’s ruling.
“We stand by our commitment to providing the great care and experience our community deserves,” said Jacquelyn Tescher, St. Peter’s public relations supervisor.
In August, St. Peter’s Health agreed to a $10.8 million settlement with the U.S. Department of Justice related to false claims the hospital charged to federal health programs for Weiner’s patient care. A civil suit filed by U.S. Attorney Jesse Laslovich against Weiner alleging fraudulent billing is ongoing.
