## Facts

- Dr. Suketu H. Nanavati, a board-certified cardiologist, held staff privileges at Burdette Tomlin Memorial Hospital, the only hospital in Cape May County, New Jersey.
- A dispute arose between Nanavati and Dr. Robert Sorensen (a senior hospital physician and leader) over allocation of paid EKG-reading work that generated substantial income; Sorensen had long controlled most of that work.
- After Nanavati sought additional EKG-reading opportunities and criticized Sorensen, relations deteriorated and Nanavati was accused of being disruptive and uncooperative, allegedly violating medical staff bylaws requiring harmonious conduct.
- On August 2, 1982, the medical staff executive committee voted unanimously to proceed toward revocation of Nanavati’s privileges.
- Hospital peer-review processes culminated in a decision to revoke Nanavati’s staff privileges, despite no finding that he provided substandard patient care.
- In Chancery Division litigation, Nanavati challenged the revocation as inconsistent with the hospital’s bylaws and basic fairness; the court found the hospital had prejudged the matter and entered a permanent injunction barring revocation.
- The Appellate Division affirmed the injunction (without prejudice to renewed charges) but held the trial court should not have made independent findings of fact; review should ask whether the hospital decision was supported by sufficient credible evidence.
- The New Jersey Supreme Court granted review.

## Issues

1. What standard governs judicial review of a private hospital’s decision to revoke a physician’s staff privileges.
2. Whether the hospital’s peer-review process was unfair due to prejudgment and potential bias arising from interpersonal and economic conflict.
3. Whether a trial court may make de novo factual findings on the merits of the charges, or must confine itself to deferential review of the hospital record.

## Decision

- The Supreme Court modified and affirmed the Appellate Division’s judgment and remanded the matter to the hospital.
- The Court held the trial court erred by making independent findings of fact; the court’s role is review, not de novo determination of the charges.
- The Court permitted the hospital, within a reasonable time, to reinstitute proceedings against Nanavati if conducted fairly and in accordance with the bylaws.
- The injunction protecting Nanavati’s privileges was to remain in effect pending the outcome of any properly renewed proceedings.

## Legal Principles

- Private hospitals must substantially comply with their bylaws when disciplining physicians and must provide basic procedural fairness, including an unbiased decision-making process and a meaningful opportunity to be heard.
- Judicial review of hospital staff-privilege determinations is deferential; courts generally ask whether the hospital’s action is supported by sufficient credible evidence and do not substitute their judgment for professional peer-review bodies.
- When hospital proceedings are tainted by prejudgment or unfairness, equitable relief may preserve privileges temporarily, while allowing the hospital to redo the process under fair procedures.

## Conclusion

The court preserved the physician’s privileges through an injunction because the hospital’s process was improperly prejudged, but it limited judicial involvement to deferential review and allowed the hospital to recommence peer-review proceedings under fair, bylaw-compliant procedures supported by sufficient credible evidence.


Nanavati v. Burdette Tomlin Mem'l Hosp., 107 N.J. 240, 526 A.2d 697 (N.J. 1987)