WAILUKU - Three RadCare radiologists were performing procedures at Maui Memorial Medical Center on Wednesday afternoon, hours after a judge dissolved a temporary restraining order that had prevented the Dallas-based company from taking over exclusive radiology services at the hospital last week.
The transition from Maui Radiology Associates, which had the contract to provide the services since 2004, occurred at 2:30 p.m., said Wesley Lo, the hospital's chief executive officer and Maui region chief procurement officer for Hawaii Health Systems Corp.
"The RadCare team of three radiologists hit the ground running and was immediately performing procedures," Lo said in a statement. "We look forward to working with the RadCare radiologists."
The change followed Judge Kelsey Kawano's ruling Wednesday morning in 2nd Circuit Court lifting the temporary restraining order and denying Maui Radiology Associates' request for a preliminary injunction.
Kawano said the court lacked jurisdiction to review the claims. He also ruled that plaintiff Maui Radiology Associates hadn't shown that it was likely to prevail on the merits in the case.
"Does the court have jurisdiction to review the plaintiff's claims and grant the requested declaratory judgment and injunctive relief? The court's short answer is no," Kawano said.
The court action seeking the restraining order and preliminary injunction followed a May 29 vote by the Maui Regional Board of Hawai'i Health Systems Corp. to overrule the hospital's Medical Executive Committee recommendation in favor of Maui Radiology and to award a two-year contract to RadCare. RadCare was selected as the top bidder among four proposals, with Maui Radiology ranked last, officials said.
RadCare, a division of EmCare, a national health care company based in Dallas, had been scheduled to take over radiology services July 5 before the move was put on hold by the temporary restraining order.
Attorney Randy Vitousek, representing Hawai'i Health Systems Corp. and Lo, had argued that the court lacked jurisdiction because the setup of the state public hospital system was "intended to free the regions from the really strict requirements of the public procurement process."
"So the regions could make decisions like private hospitals could make decisions," he said after the hearing. "Internal rules of the region don't give rights to the public."
After reviewing the law, Kawano said he determined that the hospital procurement process "is not created or regulated by any statute or administrative regulations."
"Instead, this process is purely one of internal policies and procedures implemented by the Maui Regional Board of the Hawai'i Health Systems Corp.," he said.
Kawano said that by creating the regional board, the Legislature intended to facilitate autonomous operation "unfettered by bureaucratic oversight."
"The court can find no basis to permit judicial review under the statute," he said.
Kawano added: "I am very much concerned with this position that somehow something is happening at the hospital that is beyond the scope of judicial review. But, nevertheless, I can't make things up and take jurisdiction when there is a clear legislative intent."
Attorney Margery Bronster, representing Maui Radiology, asked the judge to stay his ruling dissolving the restraining order, pending emergency review by appeals courts. Kawano denied the request.
After the hearing, Bronster said the ruling "could end up endangering the lives of patients on Maui."
"There was a tremendous amount of time, money and effort in bringing a stroke center here," she said. "We don't believe that the company who's prepared to take over is going to be able to keep that going."
"There is a constitutional problem of the separation of powers because we're essentially having the Legislature get together with an executive department to pass law to make those two branches of government exempt from any review by the judiciary," Bronster said. "If there is no judicial review, it raises this huge constitutional issue."
Vitousek said the regional board was using the procurement process in an effort "to make sure that they take advantage of advancements in how care is delivered, both in terms of quality of care and how specialized care is delivered, and also the cost of the care."
"Instead of automatically renewing a contract, they see what's out there in the world," Vitousek said. "Are there things we could benefit from in terms of delivery of care and costs? It's our duty to deliver care at a reasonable price. That's really all they're trying to do."
He said RadCare has proposed to provide radiology services without the $600,000 annual subsidy that Maui Radiology sought in its bid.
"It's not saying Maui Radiology Associates are bad doctors," Vitousek said. "It's just saying someone else made a proposal that seemed to be in the best interest of the hospital, in the best interest of the patients in the community."
"We are extremely pleased with the court's decision," Lo said in his statement.
"We stand by the panel of experts on the selection committee whom we entrusted to make the best recommendation for our hospital and community," he said. "The selection committee was comprised of physicians from the medical staff and hospital employees. We support their recommendation and thank them for their time and efforts."
Dr. Dennis Kumura has been appointed chairman of the Department of Radiology.
Kumura is a board-certified general radiologist with additional training in body imaging, interventional radiology and nuclear medicine. He also is certified by the American Board of Nuclear Medicine and has spent the majority of his career in Hawaii. He completed his diagnostic radiology residency at Cedars-Sinai Medical Center in Los Angeles. In addition, he completed a yearlong body imaging and interventional training at St. Mary's Medical Center in Long Beach, Calif., and a two-year nuclear medicine training program at Veterans Hospital in West Los Angeles, Calif.
The other RadCare radiologists are:
* Dr. Nabil Yassa, a board-certified general radiologist with additional training in nuclear medicine and interventional radiology. He completed his diagnostic radiology residency at the University of Arkansas for Medical Sciences and also completed an interventional endovascular minifellowship in Honolulu and training in nuclear radiology.
* Dr. Peter Sunenshine, a board-certified general radiologist with a fellowship in neurointerventional radiology. He completed his seven-year combined neurology, radiology and neuroradiology residency and neurointerventional fellowship at New York University Medical Center. He is certified by the American Board of Psychiatry and Neurology and the American Board of Radiology. He has a certificate of added qualification in neuroradiology and is board eligible for the vascular neurology subspecialty examination.
* Dr. Ronald Boyd, an interventional radiologist, who has worked for Maui Radiology.
* Dr. Anoop Duggal, a board-certified general radiologist with a fellowship in nuclear medicine. He completed his diagnostic radiology residency at Penn State University College of Medicine and his nuclear radiology fellowship at Cleveland Clinic Foundation. He has worked for RadCare since December 2008.
* Dr. Frederick Wendt, a board-certified general radiologist. He completed his diagnostic radiology residency at University of Texas-Southwestern, Parkland Hospital. He has worked for RadCare since December.
* Lila Fujimoto can be reached at firstname.lastname@example.org.