Karim v. New York City Health And Hospitals Corporation

Background

Syed Mohammad Aftab Karim, M.D., challenged Lincoln Hospital and the New York City Health and Hospitals Corporation’s denial of his application for clinical privileges. He also sued several individual defendants. His claims were: (1) a claim under 42 U.S.C. § 1983 alleging denial of due process; (2) a § 1983 claim alleging discrimination under the Equal Protection Clause; and (3) a claim under the New York City Human Rights Law alleging discrimination based on ancestry, ethnicity, national origin, and religion.

The hospital initially denied Karim’s application after receiving mostly favorable responses from other institutions but also receiving responses expressing reservations about his ability to work with subordinates and stating that one reviewer lacked sufficient knowledge to recommend him. The New York Public Health and Health Planning Council later found that the denial was not sufficiently related to certain statutory standards and instructed the hospital to review its actions. The hospital again denied privileges, and a New York appellate court later held that the denial was made in good faith and on reasonable grounds.

Procedural History

The district court granted defendants’ motion to dismiss Karim’s second amended complaint on March 6, 2019. While the motion to dismiss was pending, Karim sought permission to file a third amended complaint. Magistrate Judge Ona T. Wang issued a report and recommendation concluding that amendment would be futile, meaning the proposed complaint would still fail to state a legally sufficient claim. Karim filed objections.

Judge Torres reviewed the challenged portions of the report and recommendation anew and reviewed the unchallenged portions for clear error. The court rejected Karim’s argument that it was procedurally unfair to deny amendment because he had proposed the third amended complaint before the court ruled on the motion to dismiss. The court concluded that Karim had already addressed the deficiencies identified in the dismissal ruling through his proposed pleadings and objections.

Analysis

Due process claim. The court had previously concluded that Karim did not adequately allege a protected property or liberty interest. His proposed allegation that the hospital routinely granted privileges did not identify an adopted policy or practice creating an entitlement to privileges. The proposed amendments also did not allege the stigmatizing statements needed for a liberty-interest claim based on reputational harm. The court therefore agreed that amendment of the due-process claim would be futile.

Equal protection claim. The court held that the proposed allegations still did not plausibly support an inference that defendants denied Karim privileges because he was Indian or Muslim, or because of his ancestry, ethnicity, national origin, or religion. The court noted that a physician born in India had been granted privileges at the hospital, although the record did not establish whether that physician was Muslim. Karim’s repeated assertions of discrimination were not supported by enough factual detail. The court also found that the proposed comparators were inadequate: two identified physicians had previously received privileges, making them materially different from someone applying initially, while the allegations about unnamed surgeons were speculative and conclusory.

New York City Human Rights Law claim. The court applied the New York City Human Rights Law separately from the federal claims and recognized that the law requires only differential treatment to some degree based on discriminatory motive. Even under that standard, however, the proposed complaint did not plausibly allege that Karim was treated differently because of a protected characteristic. Allegations that defendants withheld his file, disregarded favorable evidence, or gave false reasons for the denial did not, without more, establish discriminatory intent. The proposed comparator allegations likewise did not supply sufficient facts.

Discovery objection. The court rejected Karim’s argument that the magistrate judge had improperly prevented further discovery. It held that Karim had waived objections to earlier discovery rulings by not timely objecting and, in any event, that Judge Wang had provided repeated opportunities to seek discoverable information or present arguments for additional discovery.

Disposition

Judge Torres overruled Karim’s objections and adopted the report and recommendation in its entirety. The court denied Karim’s request for leave to file a third amended complaint. The Clerk of Court was directed to close the case.