In October 2006, Dr. Hannan Chaugle had completed a fellowship in cardiothoracic surgery and was eager to put his training into practice.
He accepted an offer from Valley Heart Associates and started treating patients with heart disease in Modesto.
But he was soon clashing with the nursing staff at Doctors Medical Center over patient care issues and complaining to administrators.
After 18 months in practice, officials with the hospital and Valley Heart told him to resign, court records show, leading to a lawsuit that makes a claim of patient care deficiencies at Doctors.
The lawsuit against Doctors and Valley Heart charges that they took action against Chaugle in retaliation for his advocating for patients.
Chaugle seeks more than $1 million in damages for lost earnings, embarrassment, humiliation and mental anguish. His attorney, Jeffrey Rager of Southern California, represented an obstetrician who was ousted from Memorial Hospital Los Banos, winning a $2.1 million judgment in 2008.
Doctors and Valley Heart maintain they were justified in taking action against Chaugle.
The hospital suspended him March 21, 2008, over charges he failed to document why patients needed procedures, created a hostile work environment with nurses, failed to cooperate with anesthesiologists and fell behind on medical records.
His partners at Valley Heart tried to mediate his disputes with nursing staff and an anesthesiologist at Doctors.
Rager said his client resigned under duress in April 2008. Chaugle and his wife, also a physician, moved to Washington, where he now works.
Doctors Medical Center issued a written statement Friday, saying: "The lawsuit in question was filed a year and a half ago after Dr. Chaugle voluntarily resigned from the medical staff at DMC. Since this action was filed, we have vigorously defended DMC against the claims made and we will continue to do so."
Valley Heart declined to comment for this story.
Chaugle's practice ran into trouble in January 2007 when two of his patients in the hospital died of cardiac arrest, the lawsuit says. He asked for a meeting with nursing manager Lani Dickinson and nursing staff to discuss what he saw as patient care deficiencies.
According to accounts of the meeting, the nurses criticized the surgeon and they reached no understanding.
Valley Heart and hospital representatives attended 10 meetings that year, discussing the surgeon's complaints about nursing and patient care issues -- and staff complaints about Chaugle.
The surgeon levels some serious charges in the lawsuit:
That nursing staff, instead of doctors, managed patients after heart surgery and became upset when he went to intensive care to manage patient care
That entrenched nurses ignored his requests to call him about changes in patient medical conditions and to patient orders
That patients after open-heart surgery were placed in a general intensive care unit with others who had surgical wounds, raising the risk of infection
That hospital staff became upset when Chaugle scheduled emergency surgeries for patients at all hours, instead of times more convenient for staff
Chaugle tried to improve cardiac services by having care teams routinely gather to discuss patients. But his proposals met with resistance from hospital staff, and the administration failed to support him, Rager said.
"I was just starting my practice and wanted to be involved in all aspects of my patient care," Chaugle wrote in response to his suspension. "I felt that it was my moral responsibility to make sure that patients get the advantage of my extensive training."
Doctors Medical Center didn't respond to the specific charges, but referred to the cardiac program's high marks on hospital quality report cards.
The hospital was one of five in the state to have "better than average" outcomes for coronary bypass surgeries in an Office of Statewide Health Planning and Development review last year. The program also received kudos from HealthGrades and the Society of Thoracic Surgeons.
Things came to a head after three of Chaugle's patients in March 2008 went into cardiac arrest on the operating table and had to be revived. The surgeon went back to administration with concerns about operating room procedures.
Rager said that instead of addressing the issues, administrators called for an investigation of Chaugle's behavior. The in-house investigation was slanted against Chaugle, Rager claims, because people who supported the surgeon were never questioned.
According to the two-page investigative report, nurses said Chaugle often refused to respond to questions regarding patient care and accused them of errors in the presence of patients and co-workers. The report further says he threw instruments and held grudges against nurses.
The lawsuit says the disciplinary action against Chaugle was unwarranted and excessive and that Valley Heart failed to pay money owed to Chaugle upon his departure.
Rager said he hopes the legal action will lead to improvements in patient care at Doctors.
"Without the civil justice system, none of these practices of the hospital would ever come to light," he said.
Bee staff writer Ken Carlson can be reached at email@example.com or 578-2321.