Hetzel Suit

IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF NORTH CAROLINA

ASHEVILLE DIVISION
)
DAVID JOHN HETZEL, M.D., )
) Case No. 1:23-cv-152
Plaintiff, )
)
v. ) COMPLAINT
)
ANC HEALTHCARE, INC.; ANC )
MISSION HOSPITAL, INC.; HCA ) JURY TRIAL DEMANDED
HEALTHCARE, INC.; HCA )
MANAGEMENT SERVICES, L.P.; )
MH MASTER HOLDINGS, LLLP; )
MH HOSPITAL MANAGER, LLC; )
MH MISSION HOSPITAL, LLLP; )
AND HCA HEALTHCARE )
MISSION FUND, LLC, )
)
Defendants.
COMES NOW Plaintiff David John Hetzel, M.D. (“Dr. Hetzel”), by and through
his counsel, and brings this action against Defendants ANC Healthcare, Inc., ANC
Mission Hospital, Inc., HCA Healthcare, Inc., HCA Management Services, L.P., MH
Master Holdings, LLLP, MH Hospital Manager, LLC, MH Mission Hospital, LLLP, and
HCA Healthcare Mission Fund, LLC (collectively, “Defendants”), alleging as follows:
INTRODUCTION
1. Dr. Hetzel is a board-certified gynecologic oncologist with decades of
experience who, in early 2020, was employed by Defendants to perform oncological
services and surgery at the Hope Women’s Cancer Center at Mission Hospital in
Asheville, North Carolina.
Case 1:23-cv-00152-MR-WCM Document 1 Filed 06/09/23 Page 1 of 30

2. In May 2020, Defendants erroneously reported Dr. Hetzel to the National
Practitioner’s Databank (“NPDB”), a national database operated by the United States
Department of Health and Human Services that serves as a repository of information
regarding medical malpractice payments and adverse actions against health care
providers. The NPDB is relied upon by medical entities nationwide in making licensing,
hiring and credentialing decisions.
3. Defendants knew that the action underlying the report – a precautionary
removal of Dr. Hetzel’s privileges – was not appropriate for reporting and was not the
result of any formal action or investigatory process, but rather was preliminary in nature
during the pendency of an investigation. Ultimately, that investigation found that Dr.
Hetzel had met the applicable standard of care, lifted the precautionary measure and
restored Dr. Hetzel’s privileges. Unfortunately, the damage had already been done.
4. As a result of Defendants’ false and improper report to the NPDB, Dr.
Hetzel’s reputation has been improperly and irreversibly marred. He has been unable to
obtain employment, secure licensure in another state and, most importantly, use his
medical skill to render critical, often life-saving care to the many cancer patients who need
it.
5. Dr. Hetzel brings claims against Defendants for libel per se, libel, breach of
the covenant of good faith and fair dealing, interference with prospective economic
advantage, intentional infliction of emotional distress, negligent infliction of emotional
distress and punitive damages.

PARTIES
6. Plaintiff David Hetzel (“Dr. Hetzel”) is a citizen and resident of the State
of Arizona, who was at all relevant times a board-certified gynecologist and obstetrician
as well as gynecologic oncologist. From 2013 until 2020, Dr. Hetzel was employed as a
physician by Defendants to work at Mission Hospital, located at 509 Biltmore Avenue, in
Asheville, North Carolina.
7. Defendant ANC Healthcare, Inc. is a North Carolina corporation with a
principal office located at 425 West New England Avenue, Suite 300, Winter Park, Florida
32789. It may be served through its registered agent, Corporation Service Company, at its
registered office and mailing address, which is 2626 Glenwood Avenue, Suite 550,
Raleigh, North Carolina 27608.
8. Defendant ANC Healthcare, Inc. was originally incorporated in 1981 for the
purposes of operating and performing the functions of Memorial Mission Hospital of
Western North Carolina. Defendant ANC Healthcare, Inc. has previously held the
following legal names: Memorial Mission Medical Center Foundation, Inc; Memorial
Mission Medical Center, Inc.; Mission Health System, Inc.; Mission Health, Inc. and
Mission-St. Joseph’s Health System, Inc.
9. Defendant ANC Mission Hospital, Inc. is a North Carolina corporation
with a principal office located at 425 West New England Avenue, Suite 300, Winter Park,
Florida 32789. It may be served through its registered agent, Corporation Service
Company, at its registered office and mailing address, which is 2626 Glenwood Avenue,
Suite 550, Raleigh, North Carolina 27608.

10. Defendant ANC Mission Hospital, Inc. was originally incorporated in 1951
as a merger of Memorial Mission Hospital of Western North Carolina, Inc., Norburn
Hospital, Inc. and Asheville Colored Hospital, Inc, with the trustees and board of
Memorial Mission Hospital of Western North Carolina, Inc. as the controlling entity.
Defendant ANC Mission Hospital, Inc. has previously held the following legal names:
Memorial Mission Hospital of Western North Carolina, Inc; Memorial Mission Hospital,
Inc.; Mission Hospital, Inc.; and Mission Hospitals, Inc.
11. Defendant HCA Healthcare, Inc. is a publicly held Delaware corporation
with a principal place of business in Nashville, Tennessee. Its principal office address is
One Park Plaza, Nashville, Tennessee 37203. It may be served through its registered
agent, The Corporation Trust Company, at its registered office and mailing address, which
is Corporation Trust Center, 1209 Orange Street, Wilmington, Delaware 19801.
12. HCA Healthcare, Inc. is the world’s largest for-profit hospital chain. It
owns and operates over 200 hospitals in 21 states. HCA’s revenues were over $51 billion
for 2020. Its net income was over $3.7 billion in 2020. Through its subsidiary, MH Master
Holdings, LLLP, HCA Healthcare, Inc. purchased the assets of Mission in 2019.
13. Defendant HCA Management Services, L.P. is a Delaware limited
partnership with its principal place of business located at One Park Plaza, Nashville,
Tennessee 37203. It is registered to do business in North Carolina, and may be served
through its registered agent, CT Corporation System, at its registered office and mailing
address, which is 160 Mine Lake Court, Suite 200, Raleigh, North Carolina 27601.

14. Defendant MH Master Holdings, LLLP is a Delaware limited
partnership with its principal place of business located at One Park Plaza, Nashville
Tennessee 37203. It is registered to do business in North Carolina as of August 23, 2018,
and may be served through its registered agent, CT Corporation System, at its registered
office and mailing address, which is 160 Mine Lake Court, Suite 200, Raleigh, North
Carolina 27601.
15. MH Master Holdings, LLLP’s general partner is MH Hospital Manager
LLC. MH Master Holdings, LLLP is a 99% limited partner in MH Mission Hospital,
LLLP, and is authorized to do business under brand names including “Mission Health,”
“Mission Health System” and the “HCA” brand. Defendant MH Master Holdings, LLLP
identifies itself as and holds itself out as being part of the North Carolina division of HCA
Healthcare, Inc.
16. Defendant MH Hospital Manager, LLC is a Delaware limited
partnership with its principal place of business located at One Park Plaza, Nashville
Tennessee 37203. It is registered to do business in North Carolina as of August 22, 2018,
and may be served through its registered agent, CT Corporation System, at its registered
office and mailing address, which is 160 Mine Lake Court, Suite 200, Raleigh, North
Carolina 27601.
17. Defendant MH Hospital Manager uses the assumed business name, “North
Carolina Division,” pursuant to an assumed name certificate dated April 22, 2019,
filed with the Buncombe County Register of Deeds. It is an entity with control and
management duties for Mission Hospital.

18. Defendant MH Mission Hospital, LLLP is a Delaware limited liability
limited partnership, with a principal place of business located at 509 Biltmore Avenue,
Asheville, North Carolina 28801. It may be served through its registered agent, CT
Corporation System, at its registered office and mailing address, which is 160 Mine Lake
Court, Suite 200, Raleigh, North Carolina 27615. It is an entity with control and
management duties for Mission Hospital.
19. Defendant HCA Healthcare Mission Fund, LLC is a Delaware
corporation with a principal office located at One Park Plaza, Nashville, TN 37203. It
may be served through its registered agent, CT Corporation System, at its registered office
and mailing address, which is 160 Mine Lake Court, Suite 200, Raleigh, North Carolina
27615-6417. The sole member of is Health Insight Capital, LLC, which has a principal
place of business located at One Park Plaza, Nashville, TN 37203.
20. Upon information and belief, all of these Defendants share control and
management responsibility over Mission Hospital, its physicians and the issues raised in
this Complaint.
JURISDICTION AND VENUE AND CONDITIONS PRECEDENT
21. This Court has subject matter jurisdiction over this action pursuant to 28
U.S.C. § 1332, because there is complete diversity of citizenship between Plaintiff and the
Defendants in this matter and because the amount in controversy exceeds $75,000.00.
22. Defendants are subject to the personal jurisdiction of this Court as they
either are companies incorporated in the State of North Carolina with a principal place of
business within the jurisdictional district of this Court or are regularly present in and/or

regularly transact business in the State of North Carolina within the jurisdictional district
of this Court.
23. Venue in this Court is proper pursuant to 28 U.S.C. § 1391(b)(1), because
Defendant MH Mission Hospital, LLLP resides in this judicial district. Moreover, much
of the conduct that is the subject of this lawsuit occurred and all Defendants regularly
transact business at or near Mission Hospital, which is located in Asheville, North
Carolina, within this judicial district.
24. This lawsuit was filed within all applicable statutes of limitations and
repose.
25. Dr. Hetzel has exhausted all administrative remedies available pursuant to
45 C.F.R. § 60.21.
FACTUAL ALLEGATIONS
Background
26. Dr. Hetzel was the first Fellowship-trained and Boarded gynecologic
oncologist in Western North Carolina. He joined the newly founded Hope Women’s
Cancer Center in Asheville, North Carolina, which did most of its Inpatient work at
Mission Hospital on March 1, 1997. They grew the practice and Hope Women’s Cancer
Center to include consults, chemotherapy infusions, research/clinical trials, imaging,
mammograms, stereotactic biopsies, and surveillance exams. The consolidated services
and expertise attracted patients to Asheville - the community and Mission Hospital
certainly benefitted from Hope Women’s Cancer Center.

27. In his decades-long practice, Dr. Hetzel routinely handled difficult cases of
gynecologic cancerous tumors, which often required complex surgical measures including
procedures to debulk identified tumors. He had been doing this type of surgery for over
25 years. Due to the nature of theses tumors, injury to surrounding organs – either
intraoperatively or naturally – is unfortunately common.
28. Dr. Hetzel resigned from Mission Hospital in February 2019, but that
resignation was not to become effective until July 2020, when his partners could replace
him with a newly trained gynecologic oncologist.
29. Dr. Hetzel obtained prospective employment as the Chief of Gynecologic
Oncology at Texas Teach El Paso Tenet Hospitals.
30. Defendant HCA Healthcare, Inc., a for-profit organization, purchased
Defendant ANC Healthcare, Inc. and other Mission Health entities in or around March
2018 for $1.5 billion. Defendant HCA Healthcare, Inc. took control of Defendant ANC
Healthcare, Inc. and other Mission Health entities, including Mission Hospital, on
February 1, 2019.
31. On January 13, 2020, Dr. Hetzel received from Defendants a letter placing
him on “Final Warning Status” for an alleged lack of participation in Mission Cancer
Center Breast conferences. They failed to realize, however, that Dr. Hetzel regularly
attended a second weekly breast conference located at the Hope Women’s Cancer Center.
Despite not keeping the attendance of this second conference – and not having been
otherwise made aware of any attendance concern – Defendants notified Dr. Hetzel he was
being placed on Final Warning Status.

Credentialing Issues and Committee Review
32. On March 2, 2020, Dr. Hetzel performed a surgery to debulk a massive
gynecologic tumor that he observed upon entering the patient’s abdomen. He successfully
removed the anterior abdominal tumor, resected the cancerous omentum and removed
tumor from the right and left colic gutter. He resected the uterus, ovaries and fallopian
tubes, then dissected the largest of the tumors, debulking the tumor in the pelvic area to
the extent that could be accomplished.
33. During the procedure, Dr. Hetzel also observed that the tumor heavily
affected the bowel and colon and understood that an enterotomy caused by tumor had
developed in the very proximal small bowel near the duodenum. Given the nature of the
tumor and its proximity to the bowel, it was impossible to bypass it without mobilizing
the duodenum. Dr. Hetzel made the intraoperative decision to involve a hepatobiliary
surgeon and surgical oncologist. The hepatobiliary surgeon and surgical oncologist did
not mobilize and bypass the bowel at first but rather continued to debulk the tumor to such
an extent that they ultimately removed the patient’s colon and all of the small bowel with
a high blood loss – which was a complication and risk of the surgery.
34. The next day, by letter from H. Michael Frisch, MD, Chief of Staff of
Mission Hospital, and Chad Patrick, Chief Executive Officer of Mission Hospital,
Defendants placed Dr. Hetzel’s clinical privileges on “precautionary suspension” because
of the reported complication and two other intraoperative organ injuries to patients in the
six months prior.

35. Dr. Hetzel was puzzled by the decision, given that his portion of the surgery
had been performed successfully and that there had been no substantive review of the
intraoperative complications.
36. At Mission Hospital, a “precautionary suspension is not in and of itself a
final professional review action that is reportable, but rather an interim step to protect
patients.” § 8.4, Medical Staff Bylaws of MH Mission Hospital, LLLP; see also, §
4.6.1(b), Policy on Appointment, Reappointment, and Clinical Privileges of MH Mission
Hospital, LLLP.
37. The Credentials Committee (“Committee”) was scheduled to review and
consider this precautionary suspension and was supposed to meet with the Dr. Hetzel to
hear his side of the story. He was not contacted for such meeting.
38. The Committee was comprised of the following individuals who
participated in and/or sanctioned the conduct described herein: Dr. Scott Joslin, Dr. Garth
Davis, Dr. William Harlan, Dr. Melissa Hicks, Dr. Stace Horein, Dr. Lemuel Kirby, Dr.
Scott Ramming, Dr. Theodor Rhenex, Dr. Gregg Stashenko, Dr. Derek Tomes, Dr. Harvey
Weiner and N.P. Katherine Shulman. None of the members of the Committee were from
Dr. Hetzel’s group or performed services similar to Dr. Hetzel.
39. On March 10, 2020, the Committee met to consider the precautionary
suspension, without first allowing Dr. Hetzel a meeting. At this time, the Committee
modified his precautionary suspension to a lesser sanction with conditions.
40. By letter of March 12, 2020, Dr. Hetzel was informed that the Investigative
Committee would further review the March 2, 2020, surgery including: (i) the general
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nature and existing evidence related to “the concern,” (ii) preoperative planning in “this
case,” (iii) Dr. Hetzel’s surgical technique, (iv) availability for postoperative consultation
with the patient’s family, and (v) other issues as encountered in the investigation. The
letter also informed Dr. Hetzel that he would have an opportunity to meet with the
Investigative Committee prior to any further decision.
41. Dr. Hetzel requested a meeting with the Investigative Committee the
following week. Again, no hearing or meeting with Dr. Hetzel was scheduled.
42. On March 25, 2020, Dr. Hetzel received a letter from Mr. Patrick and Scott
Joslin, M.D., Credentials Committee Chair, stating that the Committee had again imposed
a precautionary suspension of Dr. Hetzel’s privileges pending the full investigation.
43. On April 3, 2020, Dr. Hetzel provided a response letter to the Committee
explaining the reasonableness of his actions, which fell within the standard of care for a
physician with his training and experience. It addressed each of the issues raised for
investigation by the Committee’s March 12, 2020, letter.
44. On April 10, 2020, Dr. Hetzel met with the Investigating Committee. On
April 17, 2020, and April 22, 2020, Dr. Hetzel provided the Investigating Committee
additional written responses.
45. Following this investigation, Defendants concluded that the clinical care
that was the subject of the initial precautionary suspension did not warrant a limitation on
Dr. Hetzel’s clinical privileges.
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46. On April 23, 2020, the Committee modified Dr. Hetzel’s precautionary
suspension and fully restored his privileges, subject to Dr. Hetzel’s satisfactory
completion of a fitness for duty evaluation.
47. On May 4, 2020, Defendants initially reported Dr. Hetzel’s investigation to
the National Practitioner’s Databank (“NPDB”) for removal of privileges due to a
professional review action under 45 C.F.R. § 60.12, and/or for negative actions or findings
taken by peer review organizations under 45 C.F.R. § 60.12. This report was false and
contrary to 45 C.F.R. § 60.5.
48. Defendants had actual knowledge, at the time they reported Dr. Hetzel to
the NPDB, that Dr. Hetzel’s clinical privileges had been revoked as a precautionary
measure and not as the result of a professional review action as that term is defined in 45
C.F.R. § 60.3.
49. Defendants also had actual knowledge, at the time they reported Dr. Hetzel
to the NPDB, that Dr. Hetzel’s clinical privileges had not been revoked as the result of a
negative action taken by a peer review organization as that term is defined in 45 C.F.R. §
60.3.
50. Defendants further had actual knowledge that, prior to the report, the
Committee had resolved to revoke the precautionary suspension and fully restore Dr.
Hetzel’s clinical privileges.
51. On June 5, 2020, after an investigation of the matter was completed, the
Mission Hospital Medical Executive Committee (“MEC”) met, evaluated the results of its
internal investigation and concluded that the clinical care that was the subject of the initial
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precautionary suspension did not warrant a limitation on Dr. Hetzel’s clinical privileges.
On this day, the MEC made a final decision to lift the precautionary suspension of Dr.
Hetzel’s privileges and to reinstate his clinical privileges.
52. Dr. Hetzel was notified of this decision on June 9, 2020.
53. On June 16, 2020, Dr. Hetzel received a “letter of guidance” from Dr. Joslin
on behalf of the Committee, which outlined vague recommendations for improvement.
54. Dr. Hetzel elected not to return to work.
55. On July 9, 2020, Defendants submitted a Revision to Action notice to NPDB
regarding its initial filing related to precautionary suspension to indicate that Dr. Hetzel’s.
It did not, at any point, indicate the original filing of the report was made in error or request
the revocation or removal of such improper report.
56. On May 11, 2021, Dr. Hetzel was notified by letter that Defendants –
namely MH Mission Hospital, LLLP – had decided to “neither correct nor void the Initial
Adverse Action Report filed on May 4, 2020 concerning the precautionary suspension of
Dr. David Hetzel’s clinical privileges.”
57. On October 28, 2021, the North Carolina Medical Board completed its
investigation of the same report and found no violation of the Medical Practices Act and
that the management of the relevant care met the standard of care. The North Carolina
Medical Board further determined that the review did not need to be reported to any data
bank.
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Reporting to the NPDB
58. The NPDB was created by United States Congress as a workforce tool to
prevent practitioners from moving state to state without disclosure or discovery of
previous medical malpractice payments and adverse actions. Federal regulations require
eligible entities to report to the NPDB under specific circumstances. Eligible entities are
also authorized to query the NPDB. The purpose of the NPDB is to promote quality health
care, as well as to deter fraud and abuse within health care delivery systems.
59. Pursuant to 42 U.S.C. § 11133, a hospital must report to the NPDB a
professional review action that it has taken based on reasons related to professional
competence or conduct that adversely affect clinical privileges for a period longer than 30
days.
60. Under 42 U.S.C. § Section 1921, negative actions or findings by peer review
organizations also must be reported to the NPDB.
61. However, investigations for professional review purposes or by peer review
organizations should not be reported to the NPDB unless they result in the physician’s
voluntary surrender of clinical privileges or failure to renew clinical privileges while under
investigation or to avoid investigation.
62. Moreover, under 45 C.F.R. § 60.3:
a) a “formal peer review process” means the conduct of professional review
activities through formally adopted written procedures which provide for
adequate notice and an opportunity for a hearing; and
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b) a “professional review action” means an action or recommendation of a
health care entity:
i. Taken in the course of professional review activity;
ii. Based on the professional competence or professional conduct of
an individual health care practitioner which affects or could affect
adversely the health or welfare of a patient or patients; and
iii. Which adversely affects or may adversely affect the clinical
privileges or membership in a professional society of the health
care practitioner.
63. Pursuant to 45 C.F.R. § 60.6, “entities are responsible for the accuracy of
information which they report to the NPDB. If errors or omissions are found after
information has been reported, the person or entity which reported it must send an addition
or correction to the NPDB.”
Damages
64. At no time since its original reporting and determination that Dr. Hetzel’s
care met was appropriate have Defendants withdrawn their report to the NPDB or
corrected the errors of their original report.
65. In December 2020, Dr. Hetzel was informed that Tenet would not give him
credentials due to the NPDB report and his offer as the Chief of Gynecologic Oncology
at Texas Tech El Paso Tenet Hospitals was withdrawn.
15

66. Dr. Hetzel then obtained a position as the Chief of Gynecologic Oncology
at University of Texas Health East Texas. However, that job offer process stalled in March
2021, after the hospital learned of the NPDB report.
67. From March 2021 through as late as April 2023, Dr. Hetzel has continued
to be denied positions as a gynecologic oncologist, which upon information and belief
were due to the NPDB report. These denied opportunities included positions at the
following hospitals: Marshfield Clinic (Marshfield, Wisconsin), Virginia Hospital
System, Gunderson Clinic (La Crosse, Wisconsin), CARTI Health System (Little Rock,
Arkansas), Genesis Care (Venice and Lakewood Beach, Florida), Mercy Health
(Rockford, Illinois), Ironwood Cancer and Research Center (Phoenix, Arizona), Advocate
Aurora Health (Milwaukee, Wisconsin), Meritus Health (Hagerstown, Massachusetts),
UpState Medical University (Syracuse, New York), Northwell Health (Long Island, New
York), University of Miami and Holston Valley Hospital (Kingsport, Tennessee).
68. In January 2022, Dr. Hetzel was hired at Ironwood Cancer and Research
Center in Phoenix, Arizona, pending a background check and licensure in Arizona. Dr.
Hetzel was informed on October 1, 2022, that Ironwood’s offer was being withdrawn due
to NPDB and temporary suspension, which caused a growing unemployment gap and
delays in licensure.
69. Dr. Hetzel also applied for a medical license in the State of Arizona, which
was denied because of the NPDB report and temporary suspension which led to a greater
than two-year unemployment gap. The Arizona Medical Board offered Dr. Hetzel only a
probationary license, which would have led to yet another inappropriate NPDB entry.
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70. Despite repeated and exhaustive attempts to mitigate his losses, Dr. Hetzel
has suffered substantial damages as a result of wrongful report Defendants made to the
NPDB, including past and future lost wages, reputational and professional damages, loss
of enjoyment of life, severe emotional distress, and other economic and non-economic
harms.
COUNT I
Libel Per Se
Title VII, 42 U.S.C. § 2000e-2(a)
(Against All Defendants)
71. The allegations of paragraphs 1 through 70 are realleged and incorporated
by reference as if fully set forth herein.
72. Defendants’ actions described herein constitute publication of false and
defamatory statements and information about Dr. Hetzel to third persons – namely, the
NPDB and, relatedly, all entities with authorization to query the NPDB.
73. Specifically, Defendants wrote and possessed in written form a statement
reflecting that Dr. Hetzel had his privileges removed due to a professional review action
under 45 C.F.R. § 60.12 and/or for negative actions or findings taken by peer review
organizations under 45 C.F.R. § 60.12.
74. Defendants published these statements knowing that they were false.
75. Defendants’ statements constitute libel per se in that they impeach Dr.
Hetzel in his trade or profession as the statements specifically address and impugn Dr.
Hetzel’s capacity as a physician.
76. The libel per se is ongoing in nature, and Defendants continue to refuse to
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correct or rescind the libelous NPDB report, which continues to be republished to
perspective employers upon request.
77. As a direct and proximate result of Defendants’ libelous statement, Dr.
Hetzel continues to be denied job placement as a chief or staff gynecologic oncologist,
including the following denials and/or revocations of offers of employment:
a) Texas Tech El Paso Tenet Hospitals (on December 22, 2020);
b) Marshfield Clinic (March 9, 2021);
c) University of Texas Health East Texas (March 18, 2021);
d) Virginia Hospital System (April 1, 2021);
e) Gunderson Clinic (July 7, 2021);
f) CARTI Health System (October 1, 2021);
g) Genesis Care (November 1, 2021);
h) Mercy Health (November 16, 2021);
i) Ironwood Cancer and Research Center (January 19, 2022);
j) Advocate Aurora Health (August 22, 2022);
k) Meritus Health (September 26, 2022);
l) UpState Medical University (January 31, ,2023);
m) Northwell Health (February 23, 2023);
n) University of Miami (February 28, 2023); and
o) Holston Valley Hospital (April 15, 2023).
78. As a direct and proximate result of Defendants’ libelous statements to the
NPDB, Dr. Hetzel has suffered damages, including but not limited to, past and future lost
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wages, anxiety, embarrassment, loss of career, damage to reputation and career, mental
anguish, loss of enjoyment of life and other economic and non-economic harms.
79. Also, as a direct and proximate result of Defendants’ libelous statements,
Dr. Hetzel is entitled to all legal and equitable remedies available for Defendants’ libel
per se of him in an amount to be determined by a jury, which in any event exceeds
Seventy-Five Thousand Dollars ($75,000.00).
COUNT II
Libel
81. Defendants’ actions described herein constitute publication of false and
defamatory statements and information about Dr. Hetzel to third persons – namely, the
NPDB and, relatedly, all entities with authorization to query the NPDB.
82. Specifically, Defendants wrote and possessed in written form a statement
reflecting that Dr. Hetzel had his privileges removed due to a professional review action
under 45 C.F.R. § 60.12 and/or for negative actions or findings taken by peer review
organizations under 45 C.F.R. § 60.12.
83. Defendants published these statements knowing that they were false.
84. Defendants’ statements were intended to impeach, prejudice, discredit
and/or reflect unfavorably upon Dr. Hetzel in his trade or profession as a physician, as this
is the entire purpose of and resultant effect of the NPDB.
85. Defendants’ statements tend to and were intended to subject Dr. Hetzel to
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ridicule, contempt and/or disgrace.
86. The libel is ongoing in nature, and Defendants continue to refuse to correct
or rescind the libelous NPDB report, which continues to be republished to perspective
employers upon request.
87. As a direct and proximate result of Defendants’ libelous publication, Dr.
Hetzel continues to be denied job placement as a chief or staff gynecologic oncologist,
including the following denials and/or revocations of offers of employment:
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88. As a direct and proximate result of Defendants’ libelous statements to the
NPDB, Dr. Hetzel has suffered damages, including but not limited to, past and future lost
wages, anxiety, embarrassment, loss of career, damage to reputation and career, mental
anguish, loss of enjoyment of life and other economic and non-economic harms.
89. Also, as a direct and proximate result of Defendants’ libelous statements,
Dr. Hetzel is entitled to all legal and equitable remedies available for Defendants’ libel of
him in an amount to be determined by a jury, which in any event exceeds Seventy-Five
Thousand Dollars ($75,000.00).
COUNT III
Breach of Covenant of Good Faith and Fair Dealing
91. By virtue of the contractual employment relationship between Defendants
and Dr. Hetzel, Defendants had an implied duty of good faith and fair dealing to Dr.
Hetzel.
92. Defendants have breached their implied duty of good faith and fair dealing
by falsely and improperly reporting Dr. Hetzel to the NPDB prior to and without a proper
peer review or professional review investigation.
93. Defendants have further breached their implied duty of good faith and fair
dealing by refusing to provide adequate and/or legitimate explanations for their delays and
failures to remedy the ongoing false and improper report to the NPDB once they
completed the peer review or professional review action and found Dr. Hetzel had not
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breached the applicable standards of professional medical care. This breach is ongoing in
nature.
94. As a direct and proximate result of the breach, Dr. Hetzel continues to be
denied job placement as a chief or staff gynecologic oncologist, including the following
denials and/or revocations of offers of employment:
95. Defendants have further breached their implied duty of good faith and fair
dealing by engaging in the unfair and deceptive practices described herein, thereby
22

requiring Dr. Hetzel to expend an unreasonable amount of time and resources in pursuing
reversal of their improper report directly with the NPDB.
96. By reason of the foregoing and as otherwise described herein, Defendants
breached the covenant of good faith and fair dealing they owed to Dr. Hetzel.
97. These breaches of the duty of good faith and fair dealing were designed to
and/or did in fact injure Dr. Hetzel. They have caused him denial of employment
opportunities, refusal of licensure, anxiety, embarrassment, loss of career, damage to
reputation and career, mental anguish, loss of enjoyment of life and other economic and
non-economic harms.
98. As a direct and proximate result of this breach, Dr. Hetzel has suffered
damages, including but not limited to, past and future lost wages, reputational and
professional damages, loss of enjoyment of life and other economic and non-economic
harms.
99. Also, as a direct and proximate result of this breach, Dr. Hetzel is entitled to
all legal and equitable remedies available for Defendants’ breach of the implied covenant
of good faith and fair dealing in an amount to be determined by a jury, which in any event
exceeds Seventy-Five Thousand Dollars ($75,000.00).
COUNT IV
Tortious Interference with Prospective Economic Advantage
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101. Plaintiff had a business relationship or expected to establish one with
prospective third-party employers in the health care field, including but not limited to:
a) Texas Tech El Paso Tenet Hospitals;
b) Marshfield Clinic;
c) University of Texas Health East Texas;
d) Virginia Hospital System;
e) Gunderson Clinic;
f) CARTI Health System;
g) Genesis Care;
h) Mercy Health;
i) Ironwood Cancer and Research Center;
j) Advocate Aurora Health;
k) Meritus Health;
l) UpState Medical University;
m) Northwell Health;
n) University of Miami; and
o) Holston Valley Hospital.
102. The prospective employment or partnership relationship with prospective
third-party employers in the health care field, including but not limited to those listed
herein, was likely or certain to benefit the Plaintiff financially.
103. Defendants were aware that Dr. Hetzel would or could seek employment
with other health care providers.
24

104. Defendants intentionally interfered with these potential relationships by
making the false and improper report to the NPDB.
105. Such interference was improper.
106. As a direct and proximate result of Defendants’ misconduct, Dr. Hetzel has
been unable to obtain other employment and continues to be denied job placement as a
chief or staff gynecologic oncologist, including the following denials and/or revocations
of offers of employment:
25

107. As a direct and proximate result of Defendants’ tortious conduct, Dr. Hetzel
has also been denied full licensure by the Arizona Medical Board, making future business
opportunities increasingly and exceedingly more difficult to secure.
108. As a direct and proximate result of Defendant’ actions, Dr. Hetzel has
suffered damages, including but not limited to, past and future lost wages, reputational
and professional damages, loss of enjoyment of life and other economic and non-
economic harms.
109. Also, as a direct and proximate result of the actions of Defendants, Dr.
Hetzel is entitled to all legal and equitable remedies available for Defendants’ tortious
interference with prospective economic advantage in an amount to be determined by a
jury, which in any event exceeds Seventy-Five Thousand Dollars ($75,000.00).
COUNT V
Intentional Infliction of Emotional Distress
111. Defendants intentionally inflicted emotional distress upon Dr. Hetzel.
112. Defendants each engaged in extreme and outrageous conduct by knowingly
and improperly reporting Dr. Hetzel to the NPDB, recognizing the impact that such a
report would have on his career as a physician.
113. Defendants knew or should have known that severe emotional distress
would likely result from their conduct. Defendants’ conduct was recklessly indifferent to
the likelihood that it would cause Dr. Hetzel severe emotional distress.
26

114. Defendants’ conduct did, in fact, cause Dr. Hetzel severe emotional distress.
115. As a direct and proximate result of Defendants’ intentional misconduct, Dr.
Hetzel has suffered, continues to suffer and will in the future continue to suffer severe
emotional distress, including anxiety, embarrassment, depression, loss of career, damage
to reputation and career, mental anguish and loss of enjoyment of life, as well as medical
expenses.
116. Dr. Hetzel’s severe emotional distress was the actual and proximate result
of Defendants’ actions and inactions through their managerial employees and the
consequences proximately caused by them.
117. Dr. Hetzel is entitled to recover all damages available under the law,
including compensatory and economic damages in an amount to be determined by a jury.
COUNT VI
Negligent Infliction of Emotional Distress
119. In the alternative to Count V, supra, Defendants negligently inflicted
emotional distress upon Dr. Hetzel.
120. Defendants had a duty of reasonable care to all physicians, including Dr.
Hetzel, within their employ to ensure reports to the NPDB were made properly and
accurately.
121. Defendants breached that duty when they did not exercise reasonable care
in the correct and truthful reporting of Dr. Hetzel to the NPDB and, as described herein,
27

improperly reported Dr. Hetzel to the NPDB prior to a full peer review or professional
review action that included due process.
122. Dr. Hetzel’s severe emotional distress was the reasonably foreseeable result
of Defendants’ breach of its duty of reasonable care to Dr. Hetzel.
123. As a direct and proximate result of Defendants’ negligence, Dr. Hetzel has
suffered, continues to suffer and will in the future continue to suffer severe emotional
distress, including anxiety, embarrassment, depression, loss of career, damage to
reputation and career, feelings of helplessness and hopelessness, suffering, mental anguish
and loss of enjoyment of life, as well as medical expenses.
124. Dr. Hetzel’s severe emotional distress was the actual and proximate result
of Defendants’ actions and inactions through their managerial employees and the
consequences proximately caused by them.
125. Dr. Hetzel is entitled to recover all damages available under the law,
including compensatory and economic damages in an amount to be determined by a jury.
COUNT VI
Punitive Damages
127. The conduct of Defendants, by and through their managers and officers as
described herein, constituted willful and wanton conduct and reckless disregard of Dr.
Hetzel’s rights and was without provocation, legal justification or any excuse.
28

128. Defendants’ managers and officers participated in and condoned such
conduct.
129. As such, punitive damages should be awarded against Defendants to deter
it and others from committing similar wrongful acts.
130. Dr. Hetzel seeks and is entitled to recover punitive damages against
Defendants in the full amount permitted under the law – three-times compensatory
damages or $250,000.00, whichever is greater.
PRAYER FOR RELIEF
WHEREFORE, Plaintiff David John Hetzel requests that this Court enter
judgment in her favor and against all Defendants, jointly and severally, and further:
(a) Award Dr. Hetzel compensatory damages to be determined by a jury, plus
demonstrated past and future pecuniary damages on each of the above-stated counts; and
(b) Award Dr. Hetzel punitive and exemplary damages, in an amount to be
determined by a jury, on each of the above-stated counts; and
(c) Award Dr. Hetzel appropriate past and future lost income; and
(d) Award Dr. Hetzel attorneys’ fees and costs of this action as allowable by
law;
(e) Tax the prejudgment interest of the damages, attorneys’ fees and costs of
this action to the Defendants, as of the date of the filing of this Complaint; and
(f) Award Dr. Hetzel such other and further relief as may be appropriate.
29

DEMAND FOR JURY TRIAL
Plaintiff respectfully demands a trial by jury with respect to each claim in this
Complaint.
This the 9th day of June, 2023. Respectfully submitted,
EDWARDS BEIGHTOL, LLC

/s/ Catharine E. Edwards
Catharine E. Edwards
N.C. State Bar No. 52705
Kristen L. Beightol
N.C. State Bar No. 27709
P.O. Box 6759
Raleigh, NC 27628
Phone: (919) 636-5100
cee@eblaw.com
klb@eblaw.com
30

JS 44 (Rev. 12/12) CIVIL COVER SHEET
The JS 44 civil cover sheet and the information contained herein neither replace nor supplement the filing and service of pleadings or other papers as required by law, except as
provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is required for the use of the Clerk of Court for the
purpose of initiating the civil docket sheet. (SEE INSTRUCTIONS ON NEXT PAGE OF THIS FORM.)
I. (a) PLAINTIFFS DEFENDANTS

ANC HEALTHCARE, INC.; ANC MISSION HOSPITAL, INC.; HCA
DAVID JOHN HETZEL, M.D HEALTHCARE, INC.; HCA MANAGEMENT SERVICES, L.P.; MH
MASTER HOLDINGS, LLLP; MH HOSPITAL MANAGER, LLC; MH
MISSION HOSPITAL, LLLP; AND HCA HEALTHCARE MISSION
(b) County of Residence of First Listed Plaintiff Arizona County of Residence of First Listed Defendant Florida
FUND, LLC
(EXCEPT IN U.S. PLAINTIFF CASES) (IN U.S. PLAINTIFF CASES ONLY)
NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF
THE TRACT OF LAND INVOLVED.
(c) Attorneys (Firm Name, Address, and Telephone Number) Attorneys (If Known)
Catharine Edwards and Kristen Beightol, Edwards Beightol, PO Box

6759, Raleigh, NC 27628
II. BASIS OF JURISDICTION (Place an “X” in One Box Only) III. CITIZENSHIP OF PRINCIPAL PARTIES (Place an “X” in One Box for Plaintiff
(For Diversity Cases Only) and One Box for Defendant)
’ 1 U.S. Government ’ 3 Federal Question PTF DEF PTF DEF
Plaintiff (U.S. Government Not a Party) Citizen of This State ’ 1 ’ 1 Incorporated or Principal Place ’ 4 ’ 4
of Business In This State
’ 2 U.S. Government ’ 4 Diversity Citizen of Another State ’ 2 ’ 2 Incorporated and Principal Place ’ 5 ’ 5
Defendant (Indicate Citizenship of Parties in Item III) of Business In Another State
Citizen or Subject of a ’ 3 ’ 3 Foreign Nation ’ 6 ’ 6

Foreign Country
IV. NATURE OF SUIT (Place an “X” in One Box Only)
CONTRACT TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES
’ 110 Insurance PERSONAL INJURY PERSONAL INJURY ’ 625 Drug Related Seizure ’ 422 Appeal 28 USC 158 ’ 375 False Claims Act
’ 120 Marine ’ 310 Airplane ’ 365 Personal Injury - of Property 21 USC 881 ’ 423 Withdrawal ’ 400 State Reapportionment
’ 130 Miller Act ’ 315 Airplane Product Product Liability ’ 690 Other 28 USC 157 ’ 410 Antitrust
’ 140 Negotiable Instrument Liability ’ 367 Health Care/ ’ 430 Banks and Banking
’ 150 Recovery of Overpayment ’ 320 Assault, Libel & Pharmaceutical PROPERTY RIGHTS ’ 450 Commerce
& Enforcement of Judgment Slander Personal Injury ’ 820 Copyrights ’ 460 Deportation
’ 151 Medicare Act ’ 330 Federal Employers’ Product Liability ’ 830 Patent ’ 470 Racketeer Influenced and
’ 152 Recovery of Defaulted Liability ’ 368 Asbestos Personal ’ 840 Trademark Corrupt Organizations
Student Loans ’ 340 Marine Injury Product ’ 480 Consumer Credit
(Excludes Veterans) ’ 345 Marine Product Liability LABOR SOCIAL SECURITY ’ 490 Cable/Sat TV
’ 153 Recovery of Overpayment Liability PERSONAL PROPERTY ’ 710 Fair Labor Standards ’ 861 HIA (1395ff) ’ 850 Securities/Commodities/
of Veteran’s Benefits ’ 350 Motor Vehicle ’ 370 Other Fraud Act ’ 862 Black Lung (923) Exchange
’ 160 Stockholders’ Suits ’ 355 Motor Vehicle ’ 371 Truth in Lending ’ 720 Labor/Management ’ 863 DIWC/DIWW (405(g)) ’ 890 Other Statutory Actions
’ 190 Other Contract Product Liability ’ 380 Other Personal Relations ’ 864 SSID Title XVI ’ 891 Agricultural Acts
’ 195 Contract Product Liability ’ 360 Other Personal Property Damage ’ 740 Railway Labor Act ’ 865 RSI (405(g)) ’ 893 Environmental Matters
’ 196 Franchise Injury ’ 385 Property Damage ’ 751 Family and Medical ’ 895 Freedom of Information
’ 362 Personal Injury - Product Liability Leave Act Act
Medical Malpractice ’ 790 Other Labor Litigation ’ 896 Arbitration
REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS ’ 791 Employee Retirement FEDERAL TAX SUITS ’ 899 Administrative Procedure
’ 210 Land Condemnation ’ 440 Other Civil Rights Habeas Corpus: Income Security Act ’ 870 Taxes (U.S. Plaintiff Act/Review or Appeal of
’ 220 Foreclosure ’ 441 Voting ’ 463 Alien Detainee or Defendant) Agency Decision
’ 230 Rent Lease & Ejectment ’ 442 Employment ’ 510 Motions to Vacate ’ 871 IRS—Third Party ’ 950 Constitutionality of
’ 240 Torts to Land ’ 443 Housing/ Sentence 26 USC 7609 State Statutes
’ 245 Tort Product Liability Accommodations ’ 530 General
’ 290 All Other Real Property ’ 445 Amer. w/Disabilities - ’ 535 Death Penalty IMMIGRATION
Employment Other: ’ 462 Naturalization Application
’ 446 Amer. w/Disabilities - ’ 540 Mandamus & Other ’ 465 Other Immigration
Other ’ 550 Civil Rights Actions
’ 448 Education ’ 555 Prison Condition
’ 560 Civil Detainee -
Conditions of
Confinement
V. ORIGIN (Place an “X” in One Box Only)
’ 1 Original ’ 2 Removed from ’ 3 Remanded from ’ 4 Reinstated or ’ 5 Transferred from ’ 6 Multidistrict
Proceeding State Court Appellate Court Reopened Another District Litigation
(specify)
Cite the U.S. Civil Statute under which you are filing (Do not cite jurisdictional statutes unless diversity):
28 U.S.C. § 1332
VI. CAUSE OF ACTION Brief description of cause:
libel, breach of the covenant of good faith and fair dealing, interference with prospective economic advantage
VII. REQUESTED IN ’ CHECK IF THIS IS A CLASS ACTION DEMAND $ CHECK YES only if demanded in complaint:
COMPLAINT: UNDER RULE 23, F.R.Cv.P. JURY DEMAND: ’ Yes ’ No
VIII. RELATED CASE(S)
(See instructions):
IF ANY JUDGE DOCKET NUMBER
DATE SIGNATURE OF ATTORNEY OF RECORD
06/09/2023 /s/ Catharine E. Edwards
FOR OFFICE USE ONLY
RECEIPT # Case 1:23-cv-00152-MR-WCM

AMOUNT APPLYING IFPDocument 1-1 Filed
JUDGE 06/09/23 Page
MAG. 1 of 2
JUDGE
JS 44 Reverse (Rev. 12/12)
INSTRUCTIONS FOR ATTORNEYS COMPLETING CIVIL COVER SHEET FORM JS 44

Authority For Civil Cover Sheet
The JS 44 civil cover sheet and the information contained herein neither replaces nor supplements the filings and service of pleading or other papers as
required by law, except as provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is
required for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. Consequently, a civil cover sheet is submitted to the Clerk of
Court for each civil complaint filed. The attorney filing a case should complete the form as follows:
I.(a) Plaintiffs-Defendants. Enter names (last, first, middle initial) of plaintiff and defendant. If the plaintiff or defendant is a government agency, use
only the full name or standard abbreviations. If the plaintiff or defendant is an official within a government agency, identify first the agency and
then the official, giving both name and title.
(b) County of Residence. For each civil case filed, except U.S. plaintiff cases, enter the name of the county where the first listed plaintiff resides at the
time of filing. In U.S. plaintiff cases, enter the name of the county in which the first listed defendant resides at the time of filing. (NOTE: In land
condemnation cases, the county of residence of the "defendant" is the location of the tract of land involved.)
(c) Attorneys. Enter the firm name, address, telephone number, and attorney of record. If there are several attorneys, list them on an attachment, noting
in this section "(see attachment)".
II. Jurisdiction. The basis of jurisdiction is set forth under Rule 8(a), F.R.Cv.P., which requires that jurisdictions be shown in pleadings. Place an "X"
in one of the boxes. If there is more than one basis of jurisdiction, precedence is given in the order shown below.
United States plaintiff. (1) Jurisdiction based on 28 U.S.C. 1345 and 1348. Suits by agencies and officers of the United States are included here.
United States defendant. (2) When the plaintiff is suing the United States, its officers or agencies, place an "X" in this box.
Federal question. (3) This refers to suits under 28 U.S.C. 1331, where jurisdiction arises under the Constitution of the United States, an amendment
to the Constitution, an act of Congress or a treaty of the United States. In cases where the U.S. is a party, the U.S. plaintiff or defendant code takes
precedence, and box 1 or 2 should be marked.
Diversity of citizenship. (4) This refers to suits under 28 U.S.C. 1332, where parties are citizens of different states. When Box 4 is checked, the
citizenship of the different parties must be checked. (See Section III below; NOTE: federal question actions take precedence over diversity
cases.)
III. Residence (citizenship) of Principal Parties. This section of the JS 44 is to be completed if diversity of citizenship was indicated above. Mark this
section for each principal party.
IV. Nature of Suit. Place an "X" in the appropriate box. If the nature of suit cannot be determined, be sure the cause of action, in Section VI below, is
sufficient to enable the deputy clerk or the statistical clerk(s) in the Administrative Office to determine the nature of suit. If the cause fits more than
one nature of suit, select the most definitive.
V. Origin. Place an "X" in one of the six boxes.

Original Proceedings. (1) Cases which originate in the United States district courts.
Removed from State Court. (2) Proceedings initiated in state courts may be removed to the district courts under Title 28 U.S.C., Section 1441.
When the petition for removal is granted, check this box.
Remanded from Appellate Court. (3) Check this box for cases remanded to the district court for further action. Use the date of remand as the filing
date.
Reinstated or Reopened. (4) Check this box for cases reinstated or reopened in the district court. Use the reopening date as the filing date.
Transferred from Another District. (5) For cases transferred under Title 28 U.S.C. Section 1404(a). Do not use this for within district transfers or
multidistrict litigation transfers.
Multidistrict Litigation. (6) Check this box when a multidistrict case is transferred into the district under authority of Title 28 U.S.C. Section 1407.
When this box is checked, do not check (5) above.
VI. Cause of Action. Report the civil statute directly related to the cause of action and give a brief description of the cause. Do not cite jurisdictional
statutes unless diversity. Example: U.S. Civil Statute: 47 USC 553 Brief Description: Unauthorized reception of cable service
VII. Requested in Complaint. Class Action. Place an "X" in this box if you are filing a class action under Rule 23, F.R.Cv.P.
Demand. In this space enter the actual dollar amount being demanded or indicate other demand, such as a preliminary injunction.
Jury Demand. Check the appropriate box to indicate whether or not a jury is being demanded.
VIII. Related Cases. This section of the JS 44 is used to reference related pending cases, if any. If there are related pending cases, insert the docket
numbers and the corresponding judge names for such cases.
Date and Attorney Signature. Date and sign the civil cover sheet.
Case 1:23-cv-00152-MR-WCM Document 1-1 Filed 06/09/23 Page 2 of 2

Hetzel Suit

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Hetzel Suit

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IN THE UNITED STATES DISTRICT COURT

FOR THE WESTERN DISTRICT OF NORTH CAROLINA

HCA Healthcare Mission Fund, LLC (collectively, “Defendants”), alleging as follows:

1. Dr. Hetzel is a board-certified gynecologic oncologist with decades of

experience who, in early 2020, was employed by Defendants to perform oncological

Asheville, North Carolina.

Case 1:23-cv-00152-MR-WCM Document 1 Filed 06/09/23 Page 1 of 30

Practitioner’s Databank (“NPDB”), a national database operated by the United States

Department of Health and Human Services that serves as a repository of information

hiring and credentialing decisions.

3. Defendants knew that the action underlying the report – a precautionary

4. As a result of Defendants’ false and improper report to the NPDB, Dr.

advantage, intentional infliction of emotional distress, negligent infliction of emotional

distress and punitive damages.

Case 1:23-cv-00152-MR-WCM Document 1 Filed 06/09/23 Page 2 of 30

physician by Defendants to work at Mission Hospital, located at 509 Biltmore Avenue, in

Asheville, North Carolina.

7. Defendant ANC Healthcare, Inc. is a North Carolina corporation with a

Raleigh, North Carolina 27608.

purposes of operating and performing the functions of Memorial Mission Hospital of

Mission-St. Joseph’s Health System, Inc.

9. Defendant ANC Mission Hospital, Inc. is a North Carolina corporation

Suite 550, Raleigh, North Carolina 27608.

Case 1:23-cv-00152-MR-WCM Document 1 Filed 06/09/23 Page 3 of 30

as a merger of Memorial Mission Hospital of Western North Carolina, Inc., Norburn

Inc.; Mission Hospital, Inc.; and Mission Hospitals, Inc.

11. Defendant HCA Healthcare, Inc. is a publicly held Delaware corporation

is Corporation Trust Center, 1209 Orange Street, Wilmington, Delaware 19801.

13. Defendant HCA Management Services, L.P. is a Delaware limited

Tennessee 37203. It is registered to do business in North Carolina, and may be served

Case 1:23-cv-00152-MR-WCM Document 1 Filed 06/09/23 Page 4 of 30

Tennessee 37203. It is registered to do business in North Carolina as of August 23, 2018,

15. MH Master Holdings, LLLP’s general partner is MH Hospital Manager

LLC. MH Master Holdings, LLLP is a 99% limited partner in MH Mission Hospital,

16. Defendant MH Hospital Manager, LLC is a Delaware limited

Tennessee 37203. It is registered to do business in North Carolina as of August 22, 2018,

management duties for Mission Hospital.

Case 1:23-cv-00152-MR-WCM Document 1 Filed 06/09/23 Page 5 of 30

management duties for Mission Hospital.

19. Defendant HCA Healthcare Mission Fund, LLC is a Delaware

place of business located at One Park Plaza, Nashville, TN 37203.

JURISDICTION AND VENUE AND CONDITIONS PRECEDENT

Case 1:23-cv-00152-MR-WCM Document 1 Filed 06/09/23 Page 6 of 30

23. Venue in this Court is proper pursuant to 28 U.S.C. § 1391(b)(1), because

transact business at or near Mission Hospital, which is located in Asheville, North

Carolina, within this judicial district.

Center to include consults, chemotherapy infusions, research/clinical trials, imaging,

mammograms, stereotactic biopsies, and surveillance exams. The consolidated services

certainly benefitted from Hope Women’s Cancer Center.

Case 1:23-cv-00152-MR-WCM Document 1 Filed 06/09/23 Page 7 of 30

intraoperatively or naturally – is unfortunately common.

him with a newly trained gynecologic oncologist.

29. Dr. Hetzel obtained prospective employment as the Chief of Gynecologic

Oncology at Texas Teach El Paso Tenet Hospitals.

30. Defendant HCA Healthcare, Inc., a for-profit organization, purchased

being placed on Final Warning Status.

Case 1:23-cv-00152-MR-WCM Document 1 Filed 06/09/23 Page 8 of 30

32. On March 2, 2020, Dr. Hetzel performed a surgery to debulk a massive

the extent that could be accomplished.

Defendants placed Dr. Hetzel’s clinical privileges on “precautionary suspension” because

six months prior.

Case 1:23-cv-00152-MR-WCM Document 1 Filed 06/09/23 Page 9 of 30

36. At Mission Hospital, a “precautionary suspension is not in and of itself a