Community Medical Centers has expanded its lawsuit against a local physicians’ medical group and a healthcare CEO over a contract-related work stoppage in September 2020 that jeopardized patient safety as well as Community Regional Medical Center’s Level 1 Trauma Center designation.

CMC’s amended complaint now names the Central California Faculty Medical Group, University Neurosciences Institute, and Joyce Fields-Keene, CEO of the two agencies, as plaintiffs. The lawsuit also identifies Fields-Keene as the fiancée of Scott Wells, executive director of Santé Health System.

Wells and the Community Regional Medical Staff Medical Group were named as defendants in the original suit filed in September 2021.

The amended lawsuit, filed May 6 in Fresno County Superior Court, seeks unspecific compensatory and punitive damages for breach of contract and of good faith, and intentional interference with contract.

The suit labels the defendants’ conduct “nothing short of despicable” for putting public health and people’s lives at risk while seeking to achieve personal financial gain.

Because of the work stoppage, CMC officials had to scramble in September 2020 — while both the Creek Fire and COVID-19 pandemic were raging — to find other neurosurgeons who could fill in as needed. Some patients were redirected to other hospitals in the meantime, and the hospital came within one day of losing its Level 1 Trauma Center designation.

Suit Says Walkout Was Negotiating Tactic

The lawsuit alleges that Fields-Keene discussed with at least one neurosurgeon organizing a physician walkout at CRMC, the region’s only Level 1 Trauma Center that treats the most serious of medical cases.

The suit alleges that Fields-Keene said in a text message that it was “my idea” to stop neurosurgeons from taking calls to provide medical services at the hospital, and that as early as July 7 she and a UNI neurosurgeon had discussed “the chances we go nuclear and stop services [S]ept. 1…”

CMC and the Central California Faculty Medical Group had been in negotiations for clinic-based services in the spring and summer, but those services did not include the on-call neurosurgeons, the suit says.

Defendants’ Response

Ersilia R. Lacaze, director of marketing and communications for the Central California Faculty Medical Group, said Fields-Keene and the organization would have no comment on the amended lawsuit’s specific allegations. She released the following statement Monday afternoon:

“As a leading healthcare provider in Central California, Central California Faculty Medical Group (CCFMG) employs the qualified physicians that serve several local hospitals, including the Community Medical Centers (CMC) hospital network, outpatient offices and care facilities. Our UCSF faculty physicians train future doctors through the UCSF Fresno Branch Campus, and provide much-needed patient care in an area that is plagued by doctor shortages and barriers to access. CCFMG has worked closely with CMC for more than 24 years. This partnership relies on stable, long-term funding agreements that mutually benefit our patients, CMC and physicians.

“Today, just like it was in 1979 — CCFMG continues to be committed to the exceptional care of our community. To caring for today’s patients, while teaching tomorrow’s doctors. Our mission remains advancing the health of the diverse communities we serve through excellence in patient care, education and research in an environment of collaboration and respect. We are deeply saddened by continued developments as it relates to our partnership and relationship with CMC, but we remain steadfast in our focus on what matters most: the care and health of our community. At the advice of counsel, we have no other statements at this time.”

The lawsuit sheds light on the complicated system of CMC’s healthcare providers, with some on staff and others hired through contracts with outside agencies such as the Central California Faculty Medical Group, University Neurosciences Institute, and the Community Regional Medical Staff Medical Group.

The Community Regional Medical Staff Medical Group, which has provided on-call trauma physicians to Community Regional hospital since the first contract was signed in 2005, is part of the Central California Faculty Medical Group.

Community’s two-year contract for neurosurgery call coverage with Community Regional Medical Staff Medical Group, using University Neurosciences Institute physicians, was supposed to run from Sept. 1, 2019, through Aug. 31, 2021, said Michelle Von Tersch, senior vice president of communications and legislative affairs for Community Health System.

Neurosurgeons Not Informed

The suit alleges that the defendants orchestrated the 2020 work stoppage, coordinated campaigns to convince officials to strip Community Regional of its Level 1 Trauma Center designation, and hired a public relations firm to announce the walkout in a news release in which Fields-Keene was quoted as saying a long-term funding agreement was necessary to provide patients specialized care such as neurosurgery and to provide physicians with “greater protections and certainty.”

According to the suit, some of UNI’s neurosurgeons were unaware of plans for the work stoppage until the on-call coverage had been terminated.

The suit alleges that the contract between Community Regional Medical Staff Medical Group and Community Medical Centers required 90 days’ notice in advance of terminating the agreement. Fields-Keene allegedly sent a notice on behalf of UNI to the Community Regional medical group on Aug. 3 that the agreement with Community Medical Centers would be terminated in 30 days. The same notice was not provided to CMC.

“CMC believes this letter was sent without securing the agreement or approval of all the neurosurgeons practicing with UNI,” the suit alleges.

The suit says that at the Aug. 31, 2020, meeting of the Central California medical group board, Fields-Keene lied when she told board members that CMC had received proper notification that the neurosurgeons would stop providing on-call services to the hospital as of Sept. 2. The board then directed UNI to “repudiate its obligation” to provide on-call services to the hospital, according to the lawsuit.

Fields-Keene informed Craig Wagoner, CMC’s chief operating officer, in a phone call on Sept. 1 that on-call neurosurgeons would no longer be available as of 5 p.m. the following day, the suit says.

CMC is seeking a jury trial on the lawsuit’s four causes of action.

The Amended Lawsuit