Does the medical examiner of Woodbury County, Iowa, hate a local physician-owned hospital so much that he reported the alleged medical errors of a physician-investor to the state medical board? Apparently not, according to U.S. District Court Judge Linda Reade, who threw out a defamation suit filed by neurosurgeon Ralph Reeder, MD.

The case stems from a report of malpractice made by the medical examiner in 2004. Thomas Carroll, MD, PhD, wrote to the Iowa Board of Medicine alleging that surgical procedures performed by Dr. Reeder were at least in part responsible for the deaths of 3 patients. Dr. Carroll performed autopsies on 2 of the patients, according to court documents. The letter initiated a 4-year investigation that ended in dismissed charges against Dr. Reeder.

Regardless, the damage was done, says Dr. Reeder. The neurosurgeon sued Dr. Carroll in 2009 because he claimed his reputation in the Sioux City-area was tarnished by Dr. Carroll's report, which Reeder considered payback for his involvement building the Siouxland Surgery Center in Dakota Dunes, S.D. The specialty hospital competes with St. Luke's Regional Medical Center, in Sioux City, Iowa, where Dr. Carroll is on staff. The pathology company in which Dr. Carroll owns a one-fourth interest does 40% to 50% of its business with St. Luke's, according to court documents.

Dr. Reeder claimed he had to spend more than $200,000 to defend himself against the allegations. The surgeon and his attorney, Charles Patterson, were not immediately available to comment for this article. However, Mr. Patterson told the Des Moines Register that Dr. Reeder is a "victim of circumstances he couldn't control."

Dr. Carroll has been an outspoken opponent of physician ownership and has even traveled to Capitol Hill to discuss the issue with lawmakers. "I believe it is unethical for physicians to own an entity in which they have access to a facility fee," said Dr. Carroll, in court documents. It "takes revenue that the [hospital] would generate by having the surgery done at their hospital that can be used to further upgrade or update technologies or other services."

Dr. Reeder alleged that Dr. Carroll's feelings were so strong that he lashed out at Dr. Reeder because of his involvement in the specialty hospital. The judge disagreed. "The court finds that a reasonable jury could not find that Dr. Carroll published the letter with actual malice," she wrote. Dr. Carroll's attorney declined to comment on the judge's ruling.

This isn't the first time that a physician has sued the person who made a report to regulators. Mark Bowden, executive director of the medical board, told the Register that libel suits like this incite fear among regulators that healthcare providers won't report their colleagues. "This decision hopefully will reduce the chilling effect."

Kent Steinriede

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