Dubnow v. McDonough, No. 21-1045 (7th Cir. 2022)Annotate this Case
Dr. Dubnow, a board-certified physician with more than 40 years of experience, was Chief of the Emergency Department at Lovell Federal Health Care Center (FHCC). In 2017, he diverted an ambulance transporting an infant to Lake Forest Hospital, located a few minutes away from the FHCC. Lake Forest has a Level-II trauma center and is staffed with pediatric specialists. The child was pronounced dead upon arriving at Lake Forest. The FHCC, a VA hospital, investigated Dubnow’s diversion decision. This investigation eventually resulted in his removal. A review board concluded that none of the grounds for his removal were supported but the final reviewing authority reversed the review board’s decision. The district court affirmed the VA’s removal decision.
The Seventh Circuit vacated the removal. The VA failed to properly apply the deferential “clearly contrary to the evidence” standard when reviewing the board’s decision to overturn Dubnow’s removal; the decision was arbitrary. The relevant question was whether the diversion was appropriate; if so, Dubnow’s removal could not be sustained. To conclude that treating the patient at the FHCC was possible, or even appropriate, is not to conclude that diverting the ambulance to a better-equipped hospital was inappropriate. A “conclusion that there was ‘no need’ to divert the patient is two steps removed from the analysis” under 38 U.S.C. 7462(d).