Hernandez v. Avera Queen of Peace Hosp. , 886 N.W.2d 338 ( 2016 )


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  • #27662-a-LSW
    
    2016 S.D. 68
    IN THE SUPREME COURT
    OF THE
    STATE OF SOUTH DAKOTA
    ****
    DR. SONIA HERNANDEZ, D.O.,                   Plaintiff and Appellant,
    v.
    AVERA QUEEN OF PEACE
    HOSPITAL (AQOP) and DR. JOE
    KRALL, Optometrist, in his official
    capacity and personally,                     Defendants and Appellees.
    ****
    APPEAL FROM THE CIRCUIT COURT OF
    THE FIRST JUDICIAL CIRCUIT
    DAVISON COUNTY, SOUTH DAKOTA
    ****
    THE HONORABLE TIMOTHY W. BJORKMAN
    Judge
    ****
    DR. SONIA HERNANDEZ, D.O.
    Grand Prairie, Texas                         Pro se plaintiff and appellant.
    LISA HANSEN MARSO
    MATTHEW D. MURPHY of
    Boyce Law Firm, LLP
    Sioux Falls, South Dakota                    Attorneys for defendants and
    appellees AQOP, Chris Lippert,
    R.N., Dr. Ray Birkenkamp and
    Dr. Jennifer Tegethoff.
    WILLIAM C. GARRY of
    Cadwell, Sanford, Deibert & Garry, LLP
    Sioux Falls, South Dakota                    Attorneys for defendant
    and appellee Dr. Joe Krall.
    ****
    CONSIDERED ON BRIEFS
    ON AUGUST 29, 2016
    OPINION FILED 09/28/16
    #27662
    WILBUR, Justice
    [¶1.]        After a hospital terminated its employee doctor, the doctor brought
    suit against the hospital and against multiple persons associated with the hospital.
    The circuit court dismissed a number of the doctor’s causes of action, leaving for a
    jury to determine whether the hospital breached the employment contract and
    whether one party defamed the doctor. During the jury trial, the court entered a
    judgment as a matter of law dismissing the defamation action. The jury returned a
    verdict in favor of the hospital on the breach of contract claim. The doctor appeals,
    asserting the circuit court erred when it dismissed many of her claims against the
    hospital and the additional parties and when it dismissed her defamation claim
    during trial. We affirm.
    Background
    [¶2.]        Avera Queen of Peace Hospital (Avera) of Mitchell, South Dakota
    began employment negotiations with Dr. Sonia Hernandez in 2011 while Dr.
    Hernandez finished her ophthalmology residency in New York. According to Dr.
    Hernandez, Avera wanted her to replace the practice of a retiring local
    ophthalmologist with a hospital-owned ophthalmology practice. She claimed that
    Avera offered incentives to entice her to move to South Dakota, such as providing
    her an office, support staff, and loan forgiveness. On February 11, 2011, the parties
    finalized the terms of their agreement, and Avera and Dr. Hernandez executed an
    employment contract.
    [¶3.]        In August 2011, Dr. Hernandez arrived in Mitchell, South Dakota and
    commenced her employment. She also purchased a home. Avera had leased space
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    from the Krall Eye Clinic in Mitchell for Dr. Hernandez to use as an office.
    According to Dr. Hernandez, when she arrived in August, the office was unprepared
    and Avera failed to provide sufficient staff or equipment. She alleged that Avera’s
    failure to honor its contractual agreement delayed her ability to see patients until
    October 2011.
    [¶4.]        Between October and November 2011, Dr. Hernandez performed six
    surgeries. Dr. Hernandez experienced complications during her first three
    surgeries. According to Dr. Hernandez, the complications occurred because the staff
    was not properly trained and the equipment was not in working order. After these
    first three surgeries, Avera assigned a proctor to work with Dr. Hernandez. Avera
    did so due to its concerns about Dr. Hernandez’s complication rate and other issues.
    Dr. Jeffery Stevens proctored the next three surgeries performed by Dr. Hernandez.
    Afterwards, Dr. Stevens met with Avera’s operating room director, Chris Lippert.
    Dr. Stevens informed Lippert that he had concerns about the way Dr. Hernandez
    operated because of her surgical techniques and the way she used the equipment.
    Dr. Stevens also issued a report. In the report, he recommended that Dr.
    Hernandez be monitored closely for at least three months if she were to continue to
    perform surgical procedures at Avera.
    [¶5.]        On November 22, 2011, Dr. Hernandez became, as she described,
    “gravely ill.” Dr. Hernandez was hospitalized and informed Avera that she could
    not return to work until December 7, 2011. She took a leave of absence, which was
    indicated on Avera’s “Personnel Action Form” as a “Medical Leave of Absence.”
    While Dr. Hernandez was on medical leave, Avera orally informed her that it would
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    be terminating her immediately based on Section 8a of the employment contract.
    On January 18, 2012, Avera issued a letter giving Dr. Hernandez official notice that
    “Avera Queen of Peace is immediately terminating your employment.” Avera
    informed Dr. Hernandez that “three (3) of your six (6) surgical cases resulted in
    patient complications and two (2) of those were considered significant. Avera Queen
    of Peace considers that patient health or safety is in imminent and serious danger
    from your actions.” On the same day, Avera issued Dr. Hernandez a second letter
    informing her that it would be “summarily suspending [her] surgical privileges at
    Avera” due to her inability to “perform surgical procedures without such supervision
    and monitoring” and that “there is substantial likelihood of injury or damage to
    patients at Avera[.]”
    [¶6.]        After terminating Dr. Hernandez, Avera continued its peer review
    investigation of her cases and of its decision to suspend her privileges. Avera
    ceased its peer review because, according to Avera, Dr. Hernandez let her South
    Dakota medical license lapse. Under Avera’s bylaws and its fair hearing plan, a
    physician must be licensed in South Dakota to have privileges at Avera. In Avera’s
    view, because Dr. Hernandez let her medical license lapse, Avera did not need to
    review its decision to suspend Dr. Hernandez’s privileges. Also, according to Avera,
    under the Health Care Quality Improvement Act (HCQIA) 
    42 U.S.C. § 11101
     et seq.,
    Avera was required to report Dr. Hernandez’s licensure forfeiture and privileges
    suspension to the National Practitioners Data Bank (NPDB). Therefore, Avera filed
    a report with the NPDB indicating that Dr. Hernandez let her medical license lapse
    and no longer had privileges at Avera.
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    [¶7.]        In May 2012, Dr. Hernandez brought suit against Avera for (1)
    negligent misrepresentation, (2) fraud, constructive fraud, and fraud in the
    inducement, (3) breach of contract, (4) declaratory action, and (5) punitive damages.
    She asserted that she relied upon Avera’s representations to her detriment. She
    claimed that Avera induced her to accept long-term employment when it was aware
    that such position was experimental in nature and that Avera suppressed facts
    about the true nature of the commitment. She alleged that as a result of Avera’s
    breach of the implied covenant of good faith and fair dealing, she suffered damage.
    Dr. Hernandez asked the circuit court to declare that Avera be barred from seeking
    repayment of its loans to Dr. Hernandez.
    [¶8.]        Dr. Hernandez amended her complaint, adding Tom Clark, Chris
    Lippert, Dr. Ray Birkenkamp, Dr. Joe Krall, Dr. Jennifer Tegethoff, and Katena
    Products as parties. Dr. Hernandez added claims for discrimination, slander/libel,
    retaliation, gross negligence, and negligence per se. She alleged that Avera and
    Clark (the CEO of Avera) discriminated against her when they terminated her
    while she was on medical leave, when they violated the Americans with Disabilities
    Act (ADA), and when they terminated her based on her age, race, and sex in
    violation of Title VII of the Civil Rights Act of 1964. Dr. Hernandez asserted that
    Lippert and Dr. Krall “committed Slander or Libel” against her while she was
    employed at Avera, and Drs. Birkenkamp and Krall committed slander/libel after
    she returned from medical leave, and Lippert and Drs. Tegethoff and Birkenkamp
    committed slander/libel against her after Avera terminated her employment. Dr.
    Hernandez further claimed that because she refused to sign a severance agreement,
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    Avera and Clark retaliated against her, wrongfully terminated her, suspended her
    hospital privileges, and reported “a bias report” to the NPDB. According to Dr.
    Hernandez, Avera engaged in gross negligence or negligence per se because it
    breached “its duty to perform the necessary inspections on surgical instruments
    acquired from Katena Products,” because it did not have sufficient back up surgical
    instruments, and because its surgical instruments fell below the Joint Commission
    on Accreditation of Healthcare Organizations and Quality Care standards.
    [¶9.]        Each defendant filed an answer, and Avera asserted a counterclaim for
    payment due on its loan to Dr. Hernandez. The defendants also moved to dismiss
    Dr. Hernandez’s amended complaint for failure to state a claim upon which relief
    could be granted. The circuit court held a hearing on August 27, 2013. Dr.
    Hernandez appeared pro se. On September 13, 2013, the court issued an order
    granting Katena Products’ motion to dismiss with prejudice. The court granted
    Avera’s motion to dismiss with prejudice on the claims of gross
    negligence/negligence per se, slander/libel, and retaliation. The court granted
    Clark’s motion to dismiss with prejudice. The court granted Dr. Krall’s, Lippert’s,
    Dr. Birkenkamp’s, and Dr. Tegethoff’s motions to dismiss with prejudice. However,
    the court granted Dr. Hernandez “leave to file a second amended complaint as to
    her slander/libel allegations against these Defendants[.]”
    [¶10.]       Dr. Hernandez filed a second amended complaint in October 2013. She
    amended her defamation claims against Lippert and Drs. Birkenkamp and
    Tegethoff. She also restated her defamation claim against Avera. Avera moved to
    strike the second amended complaint and the other defendants moved to dismiss
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    the second amended complaint. The court held a hearing. It issued an order on
    November 12, 2013, dismissing the defamation claims against Lippert and Drs.
    Birkenkamp and Tegethoff and struck/dismissed the defamation claim against
    Avera. 1 After this order, the remaining causes of actions and parties included:
    slander/libel against Dr. Krall and negligent misrepresentation, fraud, breach of
    contract, and discrimination against Avera.
    [¶11.]         In April 2015, Avera and Dr. Krall moved for summary judgment on
    all of Dr. Hernandez’s remaining claims. The circuit court held a hearing on June 5,
    2015, and issued an order dismissing all claims except for the “Breach of
    Employment Contract claim relating to [Dr. Hernandez’s] termination only.” The
    court’s written order indicated that the court dismissed “Plaintiff’s pending
    Misrepresentation claim, Fraud claim, Discriminatory Discharge claim,
    Discriminatory National Practitioner Databank (NPDB) reporting or any other
    claim based upon [Avera’s] NPDB report about the Plaintiff, Breach of Contract
    claims relating to equipment, facilities, staff, supplies, and/or length of employment
    term, and her request for Punitive Damages.” The court denied Dr. Krall’s motion
    for summary judgment.
    [¶12.]         Dr. Hernandez’s case against Avera and Dr. Krall came before a jury
    on October 13, 2015. At the close of the case, Dr. Krall moved for a judgment as a
    1.       Dr. Hernandez appealed the court’s dismissal order to this Court. We
    dismissed the appeal on December 19, 2013, informing Dr. Hernandez that
    “the above-entitled matter is not an order appealable of right pursuant to
    SDCL 15-26A-3[.]” We issued a subsequent order on January 23, 2014,
    denying Dr. Hernandez’s motion to reinstate her appeal and stay
    proceedings.
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    matter of law. The court granted Dr. Krall’s motion. On October 16, 2015, the jury
    returned a verdict in favor of Avera on Dr. Hernandez’s claim that Avera breached
    the parties’ employment contract.
    [¶13.]      Dr. Hernandez, pro se, appeals and asserts the following issues for our
    review:
    1.     Did the circuit court err in dismissing the defamation
    claim against Lippert, Drs. Birkenkamp and Tegethoff,
    and Avera on the basis of immunity since those parties
    failed to meet the standards set forth in 
    42 U.S.C. § 11112
    (a), (b), and (c).
    2.     Did the circuit court err in dismissing the defamation
    claim against Lippert, Drs. Birkenkamp and Tegethoff,
    and Avera since those parties knowingly reported false
    and misleading information to the NPDB.
    3.     Did the circuit court err in dismissing the defamation
    claim against Avera and Dr. Tegethoff since those parties
    knowingly reported false and misleading information to
    the Texas Medical Board on Form L.
    4.     Did the circuit court err in dismissing the discrimination
    action against Avera for terminating Dr. Hernandez in
    violation of the Family Medical Leave Act.
    5.     Did the circuit court err in dismissing the discrimination
    action against Avera for terminating Dr. Hernandez in
    violation of the Americans with Disabilities Act.
    6.     Did the circuit court err in dismissing the discrimination
    claim under Title VII because Avera knowingly reported
    false and misleading information to the NPDB.
    7.     Did the circuit court err in dismissing the wrongful
    termination and suspension of privileges claims before
    engaging in the peer review process of Dr. Hernandez
    under Avera’s bylaws and under 
    42 U.S.C. § 11112
    (a), (b),
    and (c).
    8.     Did the circuit court err in dismissing the discrimination
    claim under Title VII against Avera.
    9.     Did the circuit court err in dismissing the defamation
    claim against Dr. Krall in the middle of the trial due to
    Dr. Hernandez’s crying on the witness stand while
    testifying, and not as a matter of law.
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    Analysis
    [¶14.]         Dr. Hernandez’s first three issues concern her defamation causes of
    action. 2 In September and October 2013, the circuit court dismissed Dr.
    Hernandez’s defamation claims against Lippert, Drs. Birkenkamp and Tegethoff,
    and Avera with prejudice because Dr. Hernandez’s amended complaint failed to
    state a claim upon which relief could be granted under SDCL 15-6-12(b)(5).
    [¶15.]         We review the circuit court’s decision to grant a motion to dismiss
    under SDCL 15-6-12(b)(5) de novo. We no longer apply the rule that “a complaint
    should not be dismissed for failure to state a claim unless it appears beyond doubt
    that the plaintiff can prove no set of facts in support of his claim which would
    entitle him to relief.” See Sisney v. Best Inc., 
    2008 S.D. 70
    , ¶ 7, 
    754 N.W.2d 804
    ,
    808, abrogating Schlosser v. Norwest Bank S.D., 
    506 N.W.2d 416
    , 418 (S.D.1993).
    Instead, to survive a motion to dismiss under SDCL 15-6-12(b)(5), “[f]actual
    allegations must be enough to raise a right to relief above the speculative level. The
    pleading must contain something more than a statement of facts that merely
    creates a suspicion of a legally cognizable right of action on the assumption that all
    the allegations in the complaint are true (even if doubtful in fact).” Best, 
    2008 S.D. 70
    , ¶ 7, 
    754 N.W.2d at 808
     (quoting Bell Atlantic Corp. v. Twombly, 
    550 U.S. 544
    ,
    2.       Avera argues that Dr. Hernandez’s issues are not properly before this Court
    because Dr. Hernandez failed to identify the circuit court’s September 2013
    or November 2013 orders in her notice of appeal and failed to include the
    orders in the appendix of her brief to this Court. Dr. Hernandez is not
    represented by counsel on appeal. In her docketing statement filed with her
    notice of appeal, she indicated that the circuit court dismissed her claims for
    defamation against these parties. We consider her claims.
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    553, 
    127 S. Ct. 1955
    , 1964-65, 
    167 L. Ed. 2d 929
     (2007); Sisney v. State, 
    2008 S.D. 71
    , ¶ 8, 
    754 N.W.2d 639
    , 643. As we stated in Sisney:
    “While a complaint attacked by a Rule 12(b)(5) motion to dismiss
    does not need detailed factual allegations, a plaintiff’s obligation
    to provide the ‘grounds’ of his ‘entitlement to relief’ requires
    more than labels and conclusions, and a formulaic recitation of
    the elements of a cause action will not do.” The rules
    “contemplate a statement of circumstances, occurrences, and
    events in support of the claim presented.” Ultimately, the claim
    must allege facts, which, when taken as true, raise more than a
    speculative right to relief. Furthermore, “where the allegations
    show on the face of the complaint there is some insuperable bar
    to relief, dismissal under Rule 12(b)([5]) is appropriate.”
    
    2008 S.D. 71
    , ¶ 8, 
    754 N.W.2d at 643
     (internal citations omitted).
    [¶16.]       In her argument to this Court, Dr. Hernandez does not cite or refer to
    the allegations specifically contained in her amended complaint or second amended
    complaint, which are the two documents this Court is confined to reviewing because
    Dr. Hernandez’s claims were dismissed under SDCL 15-6-12(b)(5). Instead, Dr.
    Hernandez refers us to testimony offered at trial on her breach of contract claim
    against Avera and defamation claim against Krall. She also refers this Court to
    evidence that is not part of the record. Because, on this issue, we cannot review the
    record in its entirety or the testimony offered at trial, we analyze Dr. Hernandez’s
    argument by reviewing her amended complaint and second amended complaint.
    [¶17.]       In regard to her claim against Avera, Dr. Hernandez’s amended
    complaint alleges “[t]hat Defendant Avera Queen of Peace committed Libel against
    Plaintiff by providing information that was bias, to the National Practitioners Data
    Bank.” An action for libel under SDCL 20-11-3 requires an unprivileged, false
    publication. The court dismissed the claim against Avera relying on Wojewski v.
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    Rapid City Reg. Hosp., Inc., 
    2007 S.D. 33
    , 
    730 N.W.2d 626
    . It found that, under
    Wojewski, Dr. Hernandez’s cause of action, “could not under any set of
    circumstances result in a favorable outcome for the plaintiff because of the
    immunity” under HCQIA.
    [¶18.]       Avera argues that the circuit court relied on the wrong immunity
    provision, but was correct to rule that Dr. Hernandez would not be entitled to relief
    because Avera had immunity in making its report to the NPDB. Avera contends
    that immunity exists under 
    42 U.S.C. § 11137
    (c) rather than 
    42 U.S.C. § 11112
    relied upon by the circuit court. We agree. Under 
    42 U.S.C. § 11133
    , Avera is
    required to report adverse action taken with respect to the clinical privileges of its
    physicians. See Hooda v. W.C.A. Serv. Corp., No. 11-CV-504-A, 
    2013 WL 2161821
    (W.D.N.Y. May 17, 2013). Then, under 
    42 U.S.C. § 11137
    (c), Avera would have
    immunity from civil liability for making the report unless Dr. Hernandez could
    establish that the report was made with knowledge of the falsity of the information
    contained in the report. See Lee v. Hosp. Auth., 
    353 F. Supp. 2d 1255
    , 1265 (M.D.
    Ga. 2004) (immunity under this section arises when the claim is based on damages
    due to the report to the NPDB).
    [¶19.]       Here, Avera suspended Dr. Hernandez’s privileges and began an
    investigation. While the investigation was pending, Dr. Hernandez let her medical
    license lapse. Nowhere in her amended complaint does Dr. Hernandez claim that
    Avera’s report is false. She claims the report was “bias.” Because “the allegations
    show on the face of the complaint there is some insuperable bar to relief,” the circuit
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    court did not err when it dismissed Dr. Hernandez’s defamation claim against
    Avera. See Sinsey, 
    2008 S.D. 71
    , ¶ 8, 
    754 N.W.2d at 643
    .
    [¶20.]       In regard to her defamation claims against Lippert and Drs.
    Birkenkamp and Tegethoff, the circuit court allowed Dr. Hernandez to amend her
    amended complaint. In her second amended complaint, Dr. Hernandez alleged that
    Dr. Birkenkamp “intentionally and knowingly reported false and misleading
    information to the NPDB” when he gave her a poor rating after reviewing her work.
    She asserted that Dr. Birkenkamp committed libel by giving the poor report,
    contributing to her termination and suspension of privileges, his “involvement in a
    bias . . . report to the NPDB, loss of job opportunities, and inability to obtain a
    Texas Medical License to practice medicine in Texas.” In regard to Lippert, Dr.
    Hernandez alleged that he committed libel/slander when he discussed preoperative
    labs at a staff meeting in Dr. Hernandez’s presence and when he wrote inaccurate,
    false, and malicious statements to others associated with Avera related to Dr.
    Hernandez’s care of her patients. In Dr. Hernandez’s view, Lippert’s information
    was used in the report to the NPDB. Finally, in regard to Dr. Tegethoff, Dr.
    Hernandez alleged that she “intentionally libeled Plaintiff and committed
    defamation of Plaintiff by libeling Plaintiff on the Texas Medical Board, (TMB),
    Form L,” by referring to the NPDB report.
    [¶21.]       The circuit court dismissed Dr. Hernandez’s defamation claims against
    these parties because Dr. Hernandez failed to support her claim that these parties
    published objectively false statements defaming Dr. Hernandez, not because these
    parties had immunity under 
    42 U.S.C. § 11112
    . Our review of the record supports
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    the court’s conclusion. The second amended complaint does not include “a
    statement of circumstances, occurrences, and events in support of the claim
    presented” or “allege facts, which, when taken as true, raise more than a
    speculative right to relief.” See Sinsey, 
    2008 S.D. 71
    , ¶ 8, 
    754 N.W.2d at 643
    (quoting Best, 
    2008 S.D. 70
    , ¶ 7, 
    754 N.W.2d at 808
    ). In her second amended
    complaint, Dr. Hernandez does not claim that the report to the NPDB was itself
    false. Nor does she identify an objectively false fact published by Lippert or Drs.
    Birkenkamp and Tegethoff. The form completed by Dr. Tegethoff for the Texas
    Licensure Board merely refers the reader to the NPDB report. And Dr.
    Birkenkamp’s notes, even if they contained false statements, were never published.
    Lastly, Dr. Hernandez attributes no falsity to Lippert’s statements or notes.
    Because the court dismissed Dr. Hernandez’s claims against Lippert and Drs.
    Birkenkamp and Tegethoff for Dr. Hernandez’s failure to show she is entitled to
    relief, we need not examine the court’s decision to dismiss the claims based on
    immunity under 
    42 U.S.C. § 11112
    .
    [¶22.]       Dr. Hernandez’s next three issues and the eighth issue concern the
    court’s dismissal of her discrimination claim against Avera on summary judgment.
    She asserts that Avera discriminated against her in violation of the Family Medical
    Leave Act (FMLA) and the ADA. She also claims that Avera discriminated against
    her in violation of Title VII based on the NPDB report and based on her sex, age,
    race, and religion.
    [¶23.]       Dr. Hernandez’s claim that Avera discriminated against her in
    violation of the FMLA cannot survive because Dr. Hernandez never asserted a
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    cause of action against Avera for a violation of the FMLA. In fact, Dr. Hernandez
    indicated in her second amended complaint that she was on “medical leave that had
    been approved by Defendants,” not FMLA leave. A review of the record confirms
    that Dr. Hernandez was not on FMLA leave. On Avera’s personnel action report,
    the box indicating leave under the FMLA was unchecked. The reason listed for
    leave on that report was “Medical Leave of Absence” and the box indicating the type
    of leave was “Leave of Absence.”
    [¶24.]       Similarly, the court properly granted summary judgment against Dr.
    Hernandez’s claim that Avera discriminated against her in violation of the ADA.
    Dr. Hernandez offered no evidence that she has a qualifying disability or evidence
    that Avera perceived her as disabled. We further decline to review Dr. Hernandez’s
    claim that Avera discriminated against her under Title VII in violation of her civil
    rights in general or when it filed its report with the NPDB. Dr. Hernandez
    informed the circuit court at the summary judgment hearing that she was not
    moving forward on her discrimination claim based upon the NPDB report.
    [¶25.]       Dr. Hernandez’s seventh issue asserts the circuit court erred when it
    dismissed “the wrongful termination and suspension of privileges claims before
    engaging in the peer review process of Dr. Hernandez under Avera’s bylaws and
    under 
    42 U.S.C. § 11112
    (a), (b), and (c).” In her brief on the issue, Dr. Hernandez
    claims that she was “wrongfully fired” because Avera failed to follow the provisions
    of 
    42 U.S.C. § 11112
    , and that Avera “violated her rights by suspending her
    privileges and then reporting that suspension to the NPDB without giving her
    notice or an opportunity to be heard.” A review of the record reveals no cause of
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    action against Avera by Dr. Hernandez for wrongful termination or suspension of
    privileges based on Avera’s bylaws or 
    42 U.S.C. § 11112
    (a), (b), and (c). Dr.
    Hernandez claims the issue was resolved at a motions hearing, but a review of the
    transcripts from the various motion hearings reveals no argument related to these
    causes of action. In her reply brief, Dr. Hernandez does not identify how this claim
    is before this Court. Because Dr. Hernandez never asserted this claim below, we
    decline to consider it on appeal.
    [¶26.]       Dr. Hernandez’s last issue concerns her cause of action against Dr.
    Krall. She contends that the circuit court erred when it granted a judgment as a
    matter of law and dismissed her claim in the middle of trial. According to Dr.
    Hernandez, “Dr. Krall admitted to not being a medical doctor, never observing
    Hernandez perform surgeries, never seeing his patients after surgery to compare
    before and after surgery.” She avers Dr. Krall knew Avera had malfunctioning
    equipment and defective instruments, supplies, and staff. Based on this
    information, she argues that the jury should have had the opportunity to consider
    whether Dr. Krall knowingly gave false statements amounting to malice sufficient
    to overcome his common interest privilege.
    [¶27.]       Dr. Krall responds that the circuit court correctly ruled that the
    statements he made fell within the common interest privilege as a matter of law
    because the comments were made between interested individuals. Dr. Krall also
    asserts that Dr. Hernandez presented no evidence that he made the statements
    with malice or in reckless disregard of the truth. Dr. Krall shared an office space
    with Dr. Hernandez. She operated on at least two of Dr. Krall’s patients. Thus, in
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    his view, the concerns he shared were based on his experiences and were not with
    malice.
    [¶28.]       “If during a trial by jury a party has been fully heard on an issue and
    there is no legally sufficient evidentiary basis for a reasonable jury to find for that
    party on that issue, the court may determine the issue against that party and may
    grant a motion for judgment as a matter of law against that party with respect to a
    claim or defense that cannot under the controlling law be maintained or defeated
    without a favorable finding on that issue.” SDCL 15-6-50(a)(1). We recently
    explained that the appropriate standard of review on a court’s decision to grant or
    deny a motion for a judgment as a matter of law is de novo. Magner v. Brinkman,
    
    2016 S.D. 50
    , ¶ 13, 
    883 N.W.2d 74
    , 80-81.
    [¶29.]       Defamation under SDCL 20-11-2 includes libel and slander. Both libel
    and slander require false and unprivileged communications. SDCL 20-11-3, -4. “If
    a communication is ‘privileged,’ it is not actionable.” Kieser v. Se. Props., 
    1997 S.D. 87
    , ¶ 13, 
    566 N.W.2d 833
    , 837. Under SDCL 20-11-5(3):
    [a] privileged communication is one made: . . . (3) In a
    communication, without malice, to a person interested therein,
    by one who is also interested, or by one who stands in such
    relation to the person interested as to afford a reasonable
    ground for supposing the motive for the communication
    innocent, or who is requested by the person interested to give
    the information[.]
    Here, Dr. Hernandez does not ask this Court to reverse the court’s ruling that Dr.
    Krall’s communication was privileged. Once a communication is deemed privileged,
    the communication between those interested persons is protected unless made with
    malice. Schwaiger v. Avera Queen of Peace, 
    2006 S.D. 44
    , ¶ 9, 
    714 N.W.2d 874
    , 878.
    -15-
    #27662
    But “malice cannot be inferred from the defamatory communication alone.” Id.
    ¶ 10. The plaintiff must present evidence that the defendant “in fact entertained
    serious doubts as to the truth of his publications.” Id. (quoting Petersen v. Dacy,
    
    1996 S.D. 72
    , ¶ 8, 
    550 N.W.2d 91
    , 93). From our review of the record, the circuit
    court did not err when it granted Dr. Krall a judgment as a matter of law. Malice
    cannot be presumed, and Dr. Hernandez offered no evidence that Dr. Krall made
    the statements in reckless disregard of their truth or that he entertained serious
    doubts as to their truth.
    [¶30.]       Affirmed.
    [¶31.]       GILBERTSON, Chief Justice, and ZINTER, SEVERSON, and KERN,
    Justices, concur.
    -16-