Stressed out by legal fight, doctor will close her clinic

YAKIMA -- Citing exhaustion from a two-year legal battle that she launched against Yakima Valley Memorial Hospital, obstetrician Dr. Diana Smigaj said she will close her practice -- Cascade Women's Healthcare Associates in Yakima -- by the end of the year.

Smigaj, who accuses the hospital of trying to drive her out of business, lost the case earlier this fall on summary judgment in Yakima County Superior Court.

"I've been under incredible pressure and stress," from Memorial, said 62-year-old Smigaj. "I'm getting to a point where I feel so threatened and so much of a target that I can't practice."

Rick Linneweh, Memorial's CEO, said the hospital played no role in Smigaj's decision to close her practice.

"Any accusation that we've run her out of business makes no sense whatsoever," Linneweh said. "Her decision to close is a self-made decision."

In her lawsuit, Smigaj claimed the hospital was ruining her reputation with "spurious" inquiries into her practice methods. She called the hospital's peer review process a "sham."

She also claimed to have been repeatedly targeted by the hospital because she is a woman and because she posed a threat to Memorial's control of birth and mater-nity care in Yakima County.

But Kittitas County Superior Court Judge Michael Cooper, who heard the case because all Yakima judges recused themselves, said Smigaj did not meet the high threshold of evidence required under state law to prove her claims.

He also said the court can't supplant its own judgment for that of a com-mittee of her peers reviewing her care of patients.

Cooper also found that she received due process in the peer-review process. Peer review is the way physicians analyze cases that have had questionable outcomes in the hospital.

She is appealing the ruling to the Washington State Court of Appeals.

Smigaj was recruited to Yakima in 1994 by what was then Providence-Yakima Medical Center, now Yakima Regional Medical and Cardiac Center.

She had recently completed a specialty fellowship in perinatology, the field of maternal-fetal medicine. In 2001, she opened her own practice, which grew to the point where she said she has been handling 30 percent of the deliveries in the county along with many high-risk births, including VBAC, or vaginal birth after Cesarean.

Almost immediately upon being hired at Providence, Linneweh began ordering quality assurance reviews of her cases, Smigaj said in her lawsuit. In response, Providence hired an anti-trust lawyer to warn Memorial not to interfere in its birthing business. Providence later closed its maternity unit.

In her lawsuit, she claimed Memorial protected some male Ob/Gyn practitioners who have "committed acts of gross medical negligence in recent years, even causing deaths."

Details about the unsafe medical practices or Smigaj's practices that Memorial referred to peer review aren't explained in the lawsuit, and Memorial officials won't discuss them because of confidentiality and patient privacy rules.

Smigaj said she's spent two years trying to clear her name.

"With the way the law is interpreted, a medical staff member who's being targeted does not have the legal rights of a common criminal to due process," she said.

Linneweh said the hospital is seeking to recover its legal fees from Smigaj, which he estimated at $500,000.

* Erin Snelgrove can be reached at 509-577-7684 or esnelgrove@yakimaherald.com.