St. Peter’s Health Regional Medical Center photographed on October 4, 2023. (Photo by Nicole Girten/Daily Montanan)
The Montana Supreme Court has said that a popular former oncologist at St. Peter’s Health in Helena, who was also the subject of a national investigative story about his “substandard” medical practice, cannot sue his former employer for violating his due process rights or defamation.
In an unanimous ruling written by Justice Laurie McKinnon and signed by four other justices, they agreed that federal law shielded St. Peter’s when it decided to suspend and later revoke Dr. Thomas C. Weiner’s medical privileges because of concerns of imminent harm to patients.
The decision, released on Tuesday, upheld a ruling by Lewis and Clark District Court Judge Mike Menahan who agreed with the healthcare center that it took proper precautions and afforded Weiner due process by submitting more than 90 cases for peer review with many being flagged for improper or unsupported diagnoses. The most egregious case, known as “Patient 1,” involved a patient Weiner had diagnosed as having lung cancer, without doing a biopsy to confirm the diagnosis, and later prescribing chemotherapy drugs that led to that patient’s death. Medical reviewers and investigators with St. Peter’s also found that Weiner had prescribed narcotics without a proper oversight plan and other powerful drugs.
Weiner had also come under scrutiny for his exceptionally high patient load, and questions of whether he was practicing medicine too broadly in areas he didn’t have sufficient training. In court documents, Weiner said that he saw as many as 70 patients per day. Other areas of concern in the initial 2020 investigation included “manipulation of patients’ do not resuscitate orders without patient consent.”
Originally, six of Weiner’s patient cases were sent for review to the University of Utah, largely because St. Peter’s did not have another oncologist on staff, according to the court documents. When five of the six cases were flagged by that review, St. Peters then sent an additional 80 random cases to the Greeley Company, a medical consulting firm. It also sent an additional 13 cases which had been flagged for second opinions.
“The investigation revealed additional evidence that Weiner overprescribed narcotic medication without documentation, failed to have narcotic contracts, and treated non-cancer pain patients with narcotics or benzodiazepine for long periods of time at high dosages,” the court record said.
Weiner had claimed that St. Peter’s did not make an adequate review of his medical records, and that they failed to uphold his due process rights by suspending his privileges.
“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. St. Peter’s Health and the external reviewers had ample evidence that Weiner’s patient care was substandard,” the court said. “Weiner has failed to produce sufficient evidence that St. Peter’s and the external reviews could not reasonably have concluded that suspending Weiner’s privileges was in the best interest of Weiner’s patients.”
According to the Montana Board of Medical Examiners, Weiner’s license is still listed as active, and it expires on March 31. It also said that there is “no adverse information concerning this license.”
The court also said that staff at St. Peter’s, along with the peer medical reviewers, had cause to believe that even though Weiner had agreed to place his medical practice in “abeyance” — a legal term noting a pause — they suspected that he was still involved in patient care, which elevated their concern for risk.
“St. Peter’s believed that Weiner was actively participating in patients’ care plans even during his abeyance. This gave the professional review body concern that imminent harm may result if they failed to act,” the court’s decision said. “With reports that Weiner continued to influence patient care despite being on leave, peer reviewers held on objective, reasonable belief that danger may result if they did not summarily suspend Weiner.”
The court’s opinion, joined by justices James Jeremiah Shea, Ingrid Gustafson, Beth Baker and Jim Rice, found that Weiner’s summary suspension from St. Peter’s on Nov. 23, 2020, was justified.
“Weiner’s numerous, significant deviations from sound clinical practices warranted (summary suspension),” the court opinion said.