A disruptive Cleveland general surgeon whose hospital privileges were revoked in 2003 will continue to be barred from operating at the hospital, a U.S. district court in Ohio ruled in February. The court dismissed the surgeon's claim that his privileges should be reinstated because a steroid addiction qualified as a disability under the Americans with Disabilities Act.

The difficulties of Rafal Badri, MD, began in 2002, court documents say. During an altercation with a motorist following an accident, he was allegedly choked. Dr. Badri, an Iraqi who immigrated to the United States in the '70s, claimed that the accident and the assault left him with neck pain and neck spasms.

To alleviate the pain, Dr. Badri self-medicated with steroids and triptins. His overuse of steroids led him to develop Cushing's Syndrome (a hormonal disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol) and depression. In 2003, Dr. Badri began exhibiting unusual behaviors. According to legal documents, he blew up in the Huron Hospital GI lab after a room he was scheduled to use wasn't ready. He called a hospital employee demanding confidential information about a colleague whom he suspected of using drugs. He shouted at a medical resident who had removed a patient's chart in which he was planning to write. He discussed a patient's drug addiction in front of other patients and hospital staff.

Late that year, hospital management informed Dr. Badri that it had "received numerous complaints that [he] had been engaging in disruptive and harassing conduct directed toward hospital employees, residents and patients." The letter demanded that he sign a "code of conduct" and submit to psychological evaluation. Dr. Badri responded in court documents that he was not being treated fairly.

Early in 2004 the hospital suspended Dr. Badri's endoscopic privileges because of 2 negative patient outcomes and because Dr. Badri had not signed the code of conduct. Dr. Badri signed the code of conduct and submitted to a psychological evaluation, but his unusual behavior apparently continued. In May 2004, Dr. Badri loudly complained that "in order to get promoted around here, [Huron Chief Administrative Officer] Bev Lozar says you have to screw physicians," according to legal documents.

According to a deposition from a hospital employee, Dr. Badri later stood behind Huron Medical Department Chairman Keyvan Ravakhah, MD, and made a backstabbing motion as well as a "very rude motion as if to have something inserted in Dr. Ravakhah's behind." (Dr. Badri denied making the rude motion). Shortly after this incident the hospital suspended all of Dr. Badri's privileges and terminated him from the medical staff. Dr. Badri appealed but lost.

Dr. Badri filed suit in 2008, claiming in part that Huron Hospital violated Title III of the Americans with Disabilities Act and the Rehabilitation Act. He claimed disability due to Cushing's Syndrome, dysthymic disorder, depression and migraines. He claimed that Huron discriminated against him on the basis of his disabilities and failed to accommodate him.

But the court ruled that since Dr. Badri could still "get out of bed each morning and go to work tend to his patients and interact with staff," his problems did not qualify as a disability. Dr. Badri "has failed to come forward with any evidence to support the position that he is substantially limited in performing the tasks of a surgeon," wrote Justice Sara Elizabeth Lioi. She pointed out that although migraine headaches and neck spasms can cause severe discomfort and depression can affect one's mood, Dr. Badri was still seeing patients 6 days a week, and that he actually increased his surgical caseload in 2003. Dr. Badri's conditions are impairments, wrote Justice Lioi, but they do not substantially limit "any major life activities."

Outpatient Surgery Magazine staff