In Granger v. Christus Health Central Louisiana d/b/a Christus St. Francis Cabrini, the Louisiana Supreme Court ruled that medical staff bylaws are a contract between the hospital and a the medical staff member.  The court ruled:

“In promulgating the Bylaws and in accepting the applications of the physicians who sought medical staff membership in their medical staff pursuant to those Bylaws, Cabrini obviously intended to be bound by the provisions set forth therein.  We conclude that the offer and acceptance between Cabrini and Dr. Granger… established a contractual relationship…”

The Supreme Court affirmed the jury’s verdict in the trial court that Cabrini did not qualify for immunity under the Health Care Quality Improvement Act (HCQIA) because the hospital could not prove that the peer review action was taken in furtherance of quality healthcare nor in the reasonable belief that the action was warranted by the known facts.