JOHNNY B. DELASHAW, JR, SEATTLE TIMES COMPANY, and CHARLES COBBS, Case Document 1 Filed 04/11/18 Page 1 of 176 IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF WASHINGTON AT SEATTLE Case No. Plaintiff, COMPLAINT FOR LIBEL, DEF AMATION BY v. IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY Defendants. I. I. INTRODUCTION In early 2017, the Seattle Times (Times) published a series of sensational articles attacking the quality of patient care at the Swedish Neurosurgical Institute (SNI), a practice group within Swedish Health Services d/b/a Swedish Medical Group (Swedish), and accusing Dr. Johnny Delashaw and other SNI surgeons of endangering patients by racing through surgeries in order to make more money. 2. These claims were false. The main factual assertions in these articles, and the overall thesis and message conveyed by the articles, were false, defamatory and caused serious damage to the reputation and career of Dr. Johnny Delashaw, injured patients who needed his care. and damaged the quality of health care in the Paci?c Northwest. The Times was in possession of highly COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, LAW OFFICES HARRIGAN LEYH FARMER THOMSEN LLP 999 THIRD AVENUE. SUITE 4400 SEATTLE, WASHINGTON 98104 TEL (206) 623-1700 FAX (206) 623-87? UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - Case Document 1 Filed 04/11/18 Page 2 of 176 credible information demonstrating the falsity of its statements but chose to omit even a hint of the compelling, documented facts showing that its claims about SNI and Dr. Delashaw were false. 3. In its articles, the Times claimed that at the time of the articles and for many months before them, Dr. Delashaw was paid based on the volume of surgeries he performed and that, for this reason, Dr. Delashaw had neglected his patients by performing ?concurrent surgeries." The term ?concurrent surgeries? refers to a single lead surgeon running two surgeries at the same time, leaving one operating room in mideoperation to go to another. The article claimed that the result of this practice was that the lead surgeon was absent from at least one if not both surgeries during critical times, endangering patients. The Times asserted that Dr. Delashaw was engaging in these dangerous practices at the time of publication and for many months before and was placing patients at risk. The Times claimed that Dr. Delashaw?s ?concurrent surgery? practice included leaving the operating room as soon as the patient was under anesthesia and then moving to the next operation, resulting in increased complications and a general decline in the actual outcomes for patients treated by Dr. Delashaw and other surgeons at SNI. 4. Each of these claims is false. The Times? claimed ?motive? for the concurrent surgeries alleged to be taking place during the period before the articles were published was that Dr. Delashaw was paid based on volume. But for nearly two years before the Times went to print, Dr. Delashaw was on salary. He had no financial incentive to increase his surgical volume. 5. The claim that, because Dr. Delashaw was paid based on volume, "concurrent surgeries? were taking place at SNI is also false. There were no concurrent surgeries. An extensive Washington State Department of Health investigation that included scores of interviews of knowledgeable witnesses found that the Times? claim that SNI was engaging in ?concurrent surgeries? was not true. 6. The Times claimed that its ??ndings? were the product of an ?investigation,? but in Law amass HARRIGAN LEYH FARIVIER THOMSEN LLP 999 THIRD AVENUE. SUITE 4400 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 2 SEATTLE, WASHINGTON 98 104 TEL (206) 623-1700 FAX (206) 623-8717 Case Document 1 Filed 04/11/18 Page 3 of 176 fact the Times? claims would not have survived an actual ?investigation.?' 7. The Times had in its possession highly credible information from an eyewitness to hundreds ofDr. Delashaw?s surgeries clearly showing that its claims were false, but the Times chose not even to acknowledge the existence of this information. The Times? approach to its ?investigation? was to omit any information that did not fit the accusations it was determined to make. 8. The Times tried to bolster its basic thesis that Dr. Delashaw raced through concurrent surgeries, endangering patients, by also claiming that SNI had been experiencing poor patient outcomes when matched against comparable neurosurgical institutions. But objective data show that, during the period covered by the Times articles, SNI maintained its standing as a high quality neurosurgical institution with outcomes and quality of care as good as, or better than, comparable institutions. SNI achieved this high quality of care while expanding its volume of surgeries. which, in the case of Dr. Delashaw, involved many surgeries at the highest level of difficulty and risk. The Times turned the truth?a major local neurosurgical achievement?into a malicious ?ction. 9. The Times committed the very sins it purported to uncover: in an effort to generate readers via sensational press, the Times sacri?ced truth for accuracy, leveling catastrophic blows on Dr. Delashaw, his reputation, his finances, and his patients. Dr. Delashaw, the medical community in Seattle, and patients here and across the country who needed (and still need) Dr. Delashaw?s attention continue to suffer the consequences of the Times? knowingly false reporting. II. PARTIES 10. Plaintiff Dr. Johnny B. Delashaw, Jr., is a citizen of the state of Arizona, residing in Attached as Appendix A is a collection of eyewitness statements from the MQAC proceeding. These include statements from 45 individuals based on their personal interactions with Dr. Delashaw. These are representative of Dr. Delashaw?s character and approach to patient care and also consistent with information that was provided to, but disregarded by, the Times? reporter before the Times? series went to print. LAW OFFICES HARRIGAN LEVI-I THOMSEN LLP 99?) THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98104 TEL (206) 623?1700 FAX (206) 623-8717 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 3 Case Document 1 Filed 04/11/18 Page 4 of 176 Sedona, Arizona. Dr. Delashaw was employed at SNI from fall 2013 through March 1, 2017. 11. Defendant Seattle Times Company is a privately owned business incorporated in Delaware with its primary place of business at 1000 Denny Way, Seattle, Washington, 98109. 12. Defendant Dr. Charles Cobbs is a citizen of the state of Washington, residing in Mercer Island, Washington. He is currently employed at SNI. JURISDICTION AND VENUE 13. This Court has jurisdiction over the subject matter of this dispute pursuant to 28 U.S.C. 1332 because this is an action between citizens of different states and because the matter in controversy exceeds the sum of $75,000 exclusive of interest and costs. 14. This Court has personal jurisdiction over Defendants because each Defendant is licensed to and regularly does conduct business in Washington and the unlawful conduct alleged in this Complaint occurred in Washington. 15. Venue is proper in the United State District Court for the Western District of Washington pursuant to 28 U.S.C. 1391(a) and Each Defendant has continuous and systematic contacts with this District and a substantial part of the events giving rise to Plaintiff claims occurred in this District. IV. FACTUAL ALLEGATIONS A. Dr. Delashaw?s Medical Credentials 16. Dr. Delashaw was raised in Longview, Washington. He earned his Bachelor of Science degree in Biology with honors and distinction from Stanford University. and earned a medical degree from the University of Washington School of Medicine. He completed his residency at the University of Virginia under Dr. John Jane, who was a world-renowned neurosurgeon, a President of the Society of Neurological Surgeons, and a close mentor of Dr. Delashaw until Dr. Jane?s death in 2015. 17. immediately before going to SNI, Dr. Delashaw was the chief of neurological surgery marm- [mild $1551 moms ?m mum AVENUE, sows 4400 SEATTLE, WASHINGTON 98 10:1 TEL (206) 623-1 700 FAX (206) 623-8717 COMPLAINT OR LIBEL, DEFAMATION BY IMPLICATION. TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNF AIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 4 Case Document 1 Filed 04/11/18 Page 5 of 176 for University of California, Irvine Health, where he played an important role in building a facility widely recognized for excellence in treating spine problems. He pioneered a national surgical referral network for cranial disease. He served as Chairman of the Department of Neurological Surgery at UC Irvine?s School of Medicine. 18. Before going to UC Irvine, Dr. Delashaw spent twenty years at Oregon Health Science University (OHSU), where he held the positions of chief of Neuro?Oncology and Skull Base Surgery and professor of Neurological Surgery, Otolaryngology and Neurology. During his decades at OHSU, Dr. Delashaw traveled once a week to see patients in his hometown of Longview, Washington, where friends and neighbors still lived and in the town where his father had been a doctor. He resumed this practice afterjoining SNI?weekly he and his staff drove five hours round trip from Seattle to Longview, arriving in Longview at 8 where he saw patients all day before driving back to Seattle and then, where necessary, arranged for treatment for his patients at SNI. Dr. Delashaw also saw a need for improved neurosurgical treatment in remote areas of Alaska, opened a clinic there, and while at SNI traveled there to see patients, and then arranged for patients in need of surgery to be treated at SNI. 19. At the beginning of his career, Dr. Delashaw served as the chief of Neurosurgery at Gainesville Veteran?s Administration Hospital, and later became an assistant professor of Neurological Surgery at the University of Florida. 20. In the spring recruit Dr. Delashaw, who was then at UC Irvine, because of his exceptional surgical skills, his recognition in the profession for those skills, and his record of developing new highly effective surgical techniques. SNI was also very interested in the wide referral base Dr. Delashaw enjoyed as a result of professional recognition of his skills and methods. 21. Dr. Delashaw initially declined offer but a few months later was persuaded to accept, in part because of the unique opportunity SNI presented for new ways to achieve cures? HARRIGAN THOMSEN LLP 990 mm: AVENUE, sum 4400 SEATTLE, WASHINGTON TEL {206) 623-] 700 FAX (206) 623-87? COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 5 Case 2:18-cv-00537 Document 1 Filed 04/11/18 Page 6 of 176 combining advanced surgical skills and surgical improvements with previously untapped technological advances. Seattle and SNI represented the potential to blend surgical innovation with technological innovation to cure the previously incurable. 22. had begun in 2004 with the goal of developing into a cutting edge neurosurgical institution in the Paci?c-Northwest. Eight years later, in 2012, SNI and Swedish became part of Providence St. Joseph Health (Providence), a non-pro?t health care provider consisting of about 50 hospitals and hundreds of clinics in Washington, Alaska, California, Oregon, Montana, New Mexico, and Texas. In April 2013, Dr. Rod Hochman, the former CEO of Swedish, became President and CEO of Providence. 23. Providence?s acquisition of Swedish immediately expanded SNl?s referral network and potential patient base. 24. Providence and Swedish recruited Dr. Delashaw with the expectation that his considerable skills and the high regard in which he was held among other neurosurgeons would help to transform SNI into a mecca for advanced neurosurgery. Dr. Marc Mayberg, then the Co-Director of SNI, advocated recruiting Dr. Delashaw and helped to persuade him to come to Seattle. 25. Dr. Delashaw joined SNI in October 2013, and performed as expected. He was a major force in transforming SNI from a good community hospital into a nationally recognized center of neurosurgical excellence. Dr. Delashaw?s reputation coupled with his referral base helped SNI to attract other top?flight surgeons. The resulting team increased capabilities and recognition, leading to increases in surgical patient volume and a high quality of care. 26. When SNI ?rst offered Dr. Delashaw a position in about March 2013, he declined. Then, in May 2013, Dr. Mayberg renewed the effort. Dr. Mayberg told Dr. Delashaw that if he joined SNI, he would have a leadership role. Dr. Mayberg had just been diagnosed with cancer, believed he would probably need to step down as Co-Executive Director of SNI, and was interested in ?nding a highly quali?ed neurosurgeon capable of leading SNI. LAW armies HARRIGAN LEYH FARMER THOMSEN LLP 999 THIRD AVENUE, SUITE 4400 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION. TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 6 SEATTLE, WASHINGTON 98104 TEL (206) 623-] 700 FAX (206) 623?871 7 Case 2:18-cv-00537 Document 1 Filed 04/11/18 Page 7 of 176 27. Dr. Delashawjoined SNI in October 2013. 28. After Dr. Delashaw?s arrival, SNI expanded both its volume of work and its capabilities in large part as a result of Dr. Delashaw?s reputation and hard work. Dr. Delashaw attracted other highly qualified neurosurgeons to join SNI, expanding capabilities, which in turn led to increased referrals and increasing recognition of SNI as a center capable of handling the most dif?cult cases. B. Dr. Delashaw Joined SNI at a Time of Signi?cant Internal Change 29. The changes that accompanied, and in part resulted from, Dr. Delashaw?s joining SNI created some turmoil among certain doctors, nurses, and staff who resented the loss of the more relaxed atmosphere they had previously enjoyed at a community hospital. The af?liation with the health care giant Providence also created friction. The increased pace and intensity of work that resulted from increased capabilities bothered some. Dr. Delashaw gradually became aware of these personnel problems. 30. Dr. Mayberg continued to be active and was recovering from his cancer. Dr. Mayberg?s compensation at the time Dr. Delashaw joined SNI was based in part on a pooling system for Relative Value Units (RVUskmeaning that revenue generated by other surgeons? work was allocated in part to Dr. Mayberg. When Dr. Delashaw was made a Providence employee. it was unclear whether his RVUs would be added to the pool. Dr. Mayberg wanted Dr. Delashaw?s RVUs added to the pool, which would have redounded to Dr. Mayberg?s ?nancial he would receive financial credit for work done by Dr. Delashaw. 31. Dr. Delashaw had a work ethic that was uncommon at SNI in the past though he was soon joined by others with a similar approach. Dr. Delashaw had high energy, and worked intensely at his surgical practice, at pursuing his goals for SNI, at implementing new techniques, and at bringing in new, very capable surgeons. Dr. Delashaw worked longer days and scheduled earlier surgeries than had previously been standard practice. In the meantime, Dr. Mayberg was recovering HARRIGAN moms 990 THIRD AVENUE, sums 4400 SEATTLE, WASHINGTON 98104 TEL {206) 623-1700 FAX (206) 623-87 I 7 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATION SHIP OR EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 7 Case 2:18-cv-00537 Document 1 Filed 04/11/18 Page 8 of 176 and had determined that he could maintain his leadership role, and took over sole leadership of SNI. Dr. Mayberg?s administrative salary combined with his surgery income (including his participation in a compensation pool at SNI) yielded him a $1.16 million income even though he performed fewer surgical procedures than many. The compensation pool allowed surgeons who were not actually performing surgical work on a patient to be paid a portion of the fees generated by those who did perform the surgeries. 32. Dr. Mayberg had expected that Dr. Delashaw would bring SNI many additional patients, but Dr. Mayberg did not take steps to prepare the hospital or its staff for increased volume. This failure led to some staff resenting the changes in ways that might have been avoided with better planning by Dr. Mayberg. This leadership failure aggravated the resentment some SNI personnel felt over the increased pace of work. 33. At the time of Dr. Delashaw?s arrival at SNI in 2013, about five hospitals and seven emergency rooms in greater Seattle were sending cases to SNI. During 2014, SNI was starting to attract increasing numbers of patients from the Paci?c Northwest, the greater West and to some extent from across the United States. This trend continued into 2015 and 2016. Between 2010 and 2015, patient volume grew 66%. 34. By 2016, SNI was the referral center for approximately forty hospitals across five states in the Northwest region and, especially for very difficult cases, for hospitals in other regions. This change was driven mainly by the high quality of work. 35. patient volume increase was also driven by a sharp increase in the number of other hospitals referring dif?cult cases to SN l?which was also in partthe result of the exceptional capabilities of SNl?s surgeons. This growth was augmented by affiliation with Providence and by the Affordable Care Act?s extension of insurance coverage to a large new segment of sick patients. 36. By 2016, the vision that had led SNI to recruit Dr. Delashaw, and that had led Dr. ?imam ?muses 999 mm AVENUE, sum. 4400 SEATTLE, WASHINGTON 93 04 TEL (206) 623-l 700 FAX (206) 623?87l7 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNF AIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 8 Case Document 1 Filed 04/11/18 Page 9 of 176 Delashaw to come to SNI, was being realized. The SNI achievement was part of a broader accomplishment brought about by some of Seattle?s leading citizens and physicians to improve neuroscience techniques, to combine them with technological advances, and to communicate the results around the world. That commitment centered on SNI and also on the non-profit Seattle Science Foundation (SSF). In 2007, a handful of people who saw the potential to blend technology with neurosurgery formed SSF to advance collaboration between patient care providers and technologists. By 2016, SSF had grown to worldwide recognition both for its scienti?c/medical research and development work and for its extraordinary achievement in communicating new surgical techniques to skilled surgeons around the world. SSF had developed systems for transmitting real time demonstrations of surgical techniques to scores of surgeons in remote locations. Instead of a highly skilled (and needed) surgeon spending five days traveling round trip to (for example) Tokyo to demonstrate a new technique to half a dozen surgeons, the same person could spend a few hours performing the technique in Seattle while high?quality real-time video and audio were transmitted to Tokyo and other places around the world, observed by dozens of surgeons. It was this kind of opportunity to blend neurosurgical advances with technology that had persuaded Dr. Delashaw to leave Southern California and come to Seattle. 37. While Dr. Delashaw and others were working to modernize and expand SNI to become a nationally recognized center of neurosurgical excellence, some incumbent surgeons and staff, including Drs. Cobbs and Mayberg, felt marginalized because of their diminished roles. 38. During 2014, Swedish management had decided to end the pooling system for compensation and to adopt a compensation system based on a surgeon?s own RVUS without any compensation pooling?rmeaning that Dr. Mayberg (and others) would no longer be paid for surgical care they did not deliver. Ending pooling had a number of bene?ts, including ensuring that physicians? compensation did not depend on a patient?s ability pay, and also ensuring that surgeons received pay for what they did without having it siphoned off by surgeons who were not performing HARRIGAV I THOMSFN LP 099 THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98104 TEL (206) 623?1700 FAX (206) 623-87l7 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 9 Case 2:18-cv-00537 Document 1 Filed 04/11/18 Page 10 of 176 the work. The change in compensation method was adopted and implemented by Swedish management, not by Dr. Delashaw, though he also believed it was best to align ?nancial reward with high quality surgical work. 39. The end of pooling produced unfavorable ?nancial results for Dr. Mayberg. He was no longer being paid for surgeries he did not perform. A parallel development also affected his compensation?a change in leadership. 40. In early 2014 at a meeting of surgeons at the Washington Athletic Club, it was reported that Swedish management was planning to change or end the existing medical directorships. The following month at a faculty meeting, Dr. Mayberg was questioned about how much he was drawing as an administrative salary. In mid?2014 Swedish management removed Dr. Mayberg as the medical director of 41. Between losing his position as medical director of and the elimination of the pooling compensation system, Dr. Mayberg?s annual compensation dropped from $1.16 million to about $360,000 (subject to his ability to increase it by doing more work). Dr. Mayberg associated both decisions with Dr. Delashaw even though both decisions were made by Swedish management. 42. Around this time, Dr. Mayberg and his longtime colleague, nurse Mary Fearon. former Director of Perioperative Services, began encouraging SNI nurses to file anonymous complaints against Dr. Delashaw, taking advantage of the resentment a few of the staff. including nurses, felt as a result of the many changes in pace and intensity that accompanied transformation from a community hospital to a neurosurgical powerhouse. 43. In November 2014, Dr. Delashaw presented his strategic vision for SNI at a faculty meeting. Around a month later, in December and during a meeting at the Seattle Science Foundation. Providence Swedish leadership informed that Dr. Delashaw would assume the leadership role of Chairman of SNI, which he did on or about April of 2015. From that date forward?over 22 months before the Times articles?Dr. Delashaw was paid based on his SNI salary and did not HARRIGAN THOMS EN LLP 999 mm: AVENUE, sums 4400 SEATTLE, WASHINGTON 98104 TEL (206) 623-1700 FAX (206} 623-8717 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNF AIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 10 Case 2:18-cv-00537 Document 1 Filed 04/11/18 Page 11 of 176 bene?t ?nancially from performing a large volume of surgeries.2 Although Dr. Mayberg remained at SNI, Mary Fearon left in May 2015 after being advised by Swedish management that she was being uncooperative in scheduling Dr. Delashaw?s operating room time and that complaints she had recently had submitted about SNI were not credible. 44. After he became Chairman, Dr. Delashaw took several actions to improve quality of care, transparency, and accountability. Dr. Delashaw implemented more robust quality review processes designed to find and correct quality problems. Dr. Delashaw routinely attended and presented at the specialty conferences at SNI, including the Tumor Board, Cerebrovascular Conference, Mortality and Morbidity Conference, and Grand Rounds. Dr. Delashaw also established a formal Patient Outcome and Quality Review Committee in September 2015 to formalize the collection of detailed data on morbidity and mortality at to get objective data that would enable SNI to improve performance and results (which were already high). 45. Dr. Delashaw also implemented a method of choosing the best aneurysm treatment for each patient?a method that was designed to be objective and to avoid any individual bias for ?clipping? vs. ?coiling,? which could otherwise be influenced by the expertise a particular surgeon had for one method. Instead, this plan called for each patient?s case to be reviewed either by one surgeon who specialized in coiling and one who specialized in clipping, or by at least two surgeons, one of whom was pro?cient in both methods. 46. With Dr. Delashaw?s encouragement, SNI also hired Dr. Cameron McDougall, one of the country?s leading authorities in aneurysm treatments. Dr. Delashaw was not an advocate for a particular method of aneurysm treatment; he was an advocate of choosing the right aneurysm 2 Dr. Delashaw had been traveling regularly to Alaska to care for patients there and had been compensated on a per diem basis for doing so. After he became Chairman in April 2015, he arranged for SNI to hire two surgeons to take his place. Dr. Delashaw may have been paid a small sum after April 2015 for his Alaska work. LAW OFFICES HARRIGAN LEYH FARMER THOMSEN LLP 90?) THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98104 TEL (206) 623-1700 FAX (206) 623-8717 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY 11 Case 2:18?cv?00537 Document 1 Filed 04/11/18 Page 12 of 176 treatment. 47. Dr. Delashaw also revamped the referral process so that general referrals?meaning referrals to SNI vs. referrals to individual surgeons?were allocated to the right surgeons equitably and openly. The ?rst step was to require that all general referrals?sometimes called ?indirect? referrals?came to him as the leader, for distribution to the appropriate surgeon. To assure complete objectivity, in July 2016, he assigned Dr. McDougall to preside over the allocation process, with the results published so that all of the neurosurgeons were aware of them. This transparent practice is used at hospitals across the country, but, like some ofthe other reforms at SNI, it replaced an existing practice that allowed certain doctors to ?cherry pick? referrals for their own bene?t. One of these doctors was Dr. Cobbs. 48. When Dr. Cobbs joined SNI in August 2013 as the Director of Ivy Center for Advanced Brain Tumor Treatment, he thought that he should receive all brain tumor surgery referrals to SNI. After the reform of the allocation process, Dr. Cobbs was not receiving all brain tumor referrals, and he grew unhappy about his compensation. Even though Dr. Cobbs negotiated a $300,000 research incentive bonus with Dr. Delashaw, he objected to his compensation level and complained that the objective and transparent new referral system constituted ?poaching patients.? 49. Dr. Cobbs associated Dr. Delashaw with his resentment over his compensation. The new systems were in fact aligned with similar practices at other large hospitals, were designed to improve patient outcomes, and were based on objective, transparent criteria. Like Dr. Mayberg, Dr. Cobbs had benefited ?nancially from an inferior system and he resented the doctor who had properly used his authority to implement the improvements. C. Dr. Mayberg and Dr. Cobbs Plot Their Attack on Dr. Delashaw 50. Drs. Mayberg and Cobbs made an agreement to implement a plan to destroy Dr. Delashaw?s reputation in order to secure his termination, or at least his removal from his leadership role at SNI. They did so because they resented their loss of income and authority?losses that HARRIGAN THOVISEN LLP 999 THIRD AVENUE, surre 441m SEATTLE, WASI 98 04 TEL (206) 623-1 "100 FAX (206) 623-8717 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 12 Case Document 1 Filed 04/11/18 Page 13 of 176 resulted from changes highly bene?cial to patients. So they made a deal?a conspiracy?and set out to accuse Dr. Delashaw of endangering patients. This conspiracy is in writing, as are the plans for launching a series of attacks on Dr. Delashaw which included falsifying complaints, following a lawyer?s advice on how best to induce SNI management to get rid of Dr. Delashaw, and, ultimately, led to lying under oath to conceal their activities. 51. One of the Cobbs/Mayberg tactics was to abuse the SNI anonymous complaint system, which had been created to enable those with legitimate concerns to express them without fear of retaliation. In January 2016, Dr. Mayberg ?lled out an anonymous facilities complaint against SNI and sent it to the Department of Health from the Park Postal store in the Madison Park neighborhood of Seattle. The complaint asserted that numerous other complaints had been made anonymously about ?inappropriate surgeries, increase in complications and infection rates, unsupervised surgery and critical care by neurosurgical fellows? and that ?attempts to mitigate or resolve these issues have been unsuccessful? leading to ?widespread resignations.? These claims were fabricated by Dr. Mayberg. His anonymous complaint was investigated and evaluated by the Department of Health in July 2016. In its summary of ?ndings and conclusions, the investigator found with respect to every allegation: ?not substantiated due to lack of evidence.? 52. Much later, Dr. Mayberg sought to conceal that he was the author of the anonymous complaint. In May 2017, the Washington State Medical Quality Assurance Commission (MCAQ) suspended Dr. Delashaw?s license to practice medicine. Dr. Mayberg had been highly instrumental in bringing about this suspension. In the MCAQ proceeding, Dr. Mayberg?s deposition was taken by Dr. Delashaw?s lawyer, who asked him about the anonymous complaint. Dr. Mayberg lied at his deposition of December 18, 2017. When he was directly asked, ?Did you send that complaint in January 2016?? he stated, did not.? After Dr. Mayberg was visited by the FBI and retained a lawyer with expertise in criminal matters, he, in a later deposition, testi?ed that he had lied under oath on December 18, 2017, and admitted that he was the author of the complaint. Dr. Mayberg was THOVISFN LLP 909 mm AVENUE, sum 4400 SEATTLE, WASHINGTON 98 04 TEL (206) 623?[700 FAX (206) 623-87? COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 13 Case Document 1 Filed 04/11/18 Page 14 of 176 so committed to the course of action that he and Dr. Cobbs had adopted to destroy Dr. Delashaw that he committed perjury in order to sustain it and conceal his part in it. 53. The abuse of complaints was not limited to Dr. Mayberg?s anonymous January 2016 complaint. In March 2016, in an anonymous complaint to the Medical Commission, a complainant said that on December 21, 2015, ?Dr. Delashaw threw a phone at a nurse in the OR. The phone was shattered. The nurse involved was Trish Flett. She was very upset at the incident. Dr. Delashaw then went to the OR control desk and screamed at Deborah DesJardin-Rowland the charge nurse and threatened her job.? The Medical Commission began an investigation of this phone/yelling complaint, assigning it a low priority (Priority B). This incident also was a fabrication: the head of Human Resources at SNI and two doctors who had worked with Dr. Delashaw on the day in question signed sworn declarations that they had not witnessed Dr. Delashaw throw anything in the OR or yell at any of the staff, and were not aware of any reports of Dr. Delashaw throwing anything in the OR or yelling at any of. the staff. 54. Like Dr. Mayberg, Dr. Cobbs harbored resentment over compensation issues that underlay his actions against Dr. Delashaw. In the fall of2016, after learning that other surgeons did not have production caps in their contracts as he did, Dr. Cobbs attempted to renegotiate his compensation structure with the Swedish administration to enable him to make more money, but he failed. Dr. Cobbs was still offended by the improved system for cranial referrals that led to a decline in his referrals. In his own words, he decided to go ?nuclear and kick the hornets nest,? believing, as he stated, that Dr. Delashaw was responsible for the decline in his referral practice, and thus his income. 55. Unaware of the plot swirling around him, Dr. Delashaw continued to work to improve and expand SNI. On October 22, 2016, Swedish held its gala, raising over $6 million in fundraising for its various initiatives, many of which were driven by Dr. Delashaw and his cadre of surgeons. The event was a watershed moment for Dr. Delashaw and those working together to promote SNI to HARRIGAN THOMSEN LLP 99?) THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98104 TEL (206) 623-1700 FAX (206) 623-8717 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 14 Case 2:18?cv?00537 Document 1 Filed 04/11/18 Page 15 of 176 the forefront of neurosurgery. While speaking at the event, Dr. Delashaw reminded supporters that its goal was nothing less than to cure paralysis. The evening re?ected the signi?cant achievements of SNI in the few years since Dr. Delashaw?s arrival. 56. As Dr. Delashaw solidi?ed his leadership position, Drs. Cobbs and Mayberg and a few other disgruntled surgeons continued to conspire to bring him down and escalated their campaign against him. They lobbied other SNI surgeons to sign a letter of complaint against Dr. Delashaw. As part of the Mayberg/Cobbs conspiracy, Cobbs sought outside advice on the types of claims to make that would be best calculated to undermine the con?dence of Swedish management in Dr. Delashaw. In an email dated November I, 2016, Dr. Cobbs explained: Ijust spoke to a very experienced hospital administrator . . . . We need to change the tone of our letter. We need to minimize the focus on Johnny stealing cases and other gripes. . . . It will be critical to include (Providence CEO) Rod Hockman [sic] and Mike Butler in the letter. And, to [knock it] out of the park we need to send it to the Board of Providence 57. In fact, Dr. Cobbs has stated that he never witnessed disruptive behavior by Dr. Delashaw in the operating room and had never reported him for safety concerns to the Department of Health. Dr. Cobbs? actual reasons for resenting Dr. Delashaw had to do with Dr. Cobbs? decreased income (for which Dr. Delashaw had no responsibility). But Dr. Cobbs heeded the advice of the hospital administrator to stop talking about what was really motivating him?#money?and start inventing stories that would be troubling to SNI management. 58. As part of his and Dr. Mayberg?s refocused effort, Dr. Cobbs consulted a lawyer, who advised that the way to inflict maximum damage on Dr. Delashaw?s standing at SNI and potentially have him removed was to generate the kinds of complaints that would worry Swedish management. On November 1, 2016, Dr. Cobbs wrote an email to Dr. Ryder Gwinn, Dr. Rod Oskouian, and Dr. Jens Chapman. In the email, Dr. Cobbs did not suggest that the problems identi?ed actually existed, only that they were the types of complaints that would undermine Dr. Delashaw with SNI management: LAW OFFICES HARRIGAN LEYH FARMER THOMSEN LLP 909 THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98104 TEL (206) 623-1700 FAX (206) 623-8717 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 15 Case 2:18-cv-00537 Document 1 Filed 04/11/18 Page 16 of 176 Hey guys I have an amazing attorney who?s gonna look over the document. He?s my best friend from college and was number one at Harvard Law school and he?s also a really good friend of Ed Laws.3 First of all he wants to make sure that that message I sent out from Ed Laws goes nowhere and I told him I would say that. Secondly I need someone to send me right now the latest version of the cover letter and the other stuff. He knows exactly what we are dealing with and he said the critical issue is not necessarily what we believe is our complaints but what Will make the corporate people squirm. These types of things include evidence of workplace violation of intimidation, female stress, etc. and even worse cover-up of any quality metrics etc. We need to get our act together make sure we have access to documentation of these types of issues. Please send me the latest version now and I will send it to him ASAP. 59. In another e?mail sent a few hours later, Dr. Cobbs reiterated the plan of, first, identifying the kinds of issues that would worry management, and then cooking up allegations of such incidents: The off the cuff response of my lawyer friend is we can cry all we want, but the administration may feel culpability and thus maintain a defensive posture. He said it?s extremely important that we list things that are concrete violations of law such as work place discrimination, discrimination based on sex, suppression of quality control efforts, etc. He hasn?t evaluated our letter yet but I?m hoping he can find concrete terms that we can list (1, 2, 3, etc) that are considered nuclear bombs to the administration [and] which will make them think carefully about pushing back. 60. In short, Dr. Cobbs, with the help of a non?Swedish hospital administrator and a lawyer, started by identifying the kinds of complaints that would worry SNI management and then set about inventing them. Dr. Cobbs was hoping the lawyer could ??nd concrete terms that we can list? that are considered ?nuclear bombs.? The documents that Drs. Cobbs and Mayberg later generated were the? product of this plan: ?nd the accusations that will worry management and make those accusations??without regard to whether there was any truth to them. 61. Over the coming weeks, Dr. Cobbs put the attorney?s plan into action by repeatedly disparaging Dr. Delashaw in letters designed to make the Swedish ?corporate people squirm.? In these letters, he falsely stated that he was expressing the ?unanimous? views of faculty and 3 Ed Laws is the Director of the Pituitary and Neuroendocrine Center at Brigham and Women?s Hospital. COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY 16 LAW OFFICES HARRIGAN LEYH FARMER THOMSEN LLP W0 Till AVENUE, sun-1.1mm SEATTLE, 08104 6234700 FAX {206) rays-s7? Case Document 1 Filed 04/11/18 Page 17 of 176 falsely accused Dr. Delashaw of endangering patient safety and harming ?nancial condition. In a later deposition, when asked what he thought ?unanimous? meant Dr. Cobbs initially said it was more than ?fty percent and then testi?ed that don?t know exactly what ?unanimous? means . . . In fact, Dr. Cobbs? fellow surgeons refused to Sign the letter of so?called unanimous complaints and an SNI administrator has testi?ed that the Cobbs? materials purporting to summarize the events at the meeting of surgeons are not accurate. But Dr. Cobbs persisted in widely distributing these false materials. 62. Drs. Cobbs and Mayberg also continued to lobby their fellow neurosurgeons against Dr. Delashaw. Using their wives? e-mail accounts, they exchanged drafts of a ?Game Plan? to achieve their goal of ?accomplish[ing the] resignation of JD [Johnny Delashaw].? Their plan was not driven by concerns for patient safety but was designed to destroy Dr. Delashaw?s reputation and his standing at SNI. Following the attorney?s advice to try to develop claims that would make Swedish management ?squirm,? Drs. Cobbs and Mayberg urged their colleagues to join them in refusing to negotiate with Providence or with the other surgeons, in blocking discussion on issues that would not support their goal of removing Dr. Delashaw, and in taking whatever action would ensure that Dr. Delashaw would immediately lose all authority at SN1. 63. These plans authored by Drs. Cobbs and Mayberg would also?once Dr. Delashaw was out of the way?have allowed them to advance their compensation and professional stature at SNI?the ?nancial and professional ambitions that had motivated them to seek advice on how best to attack Dr. Delashaw. 64. Drs. Cobbs and Mayberg saw the wisdom of concealing their actual (?nancial) motives for seeking Dr. Delashaw?s removal. As Dr. Cobbs put it: ?if we look like we are doing this for greed it will make our case weaker.? So Dr. Cobbs recommended instead laying out ?a clear case that we are doing this for the bene?t of the common good and the Institute.? 65. On November 17, 2016, Dr. Cobbs broadcast his criticisms of Dr. Delashaw to anfifhxgirigsa THOMSFN LLP 999 THIRD AVENUE, sums 4400 SEATTLE, HINGTON 98 TEL (206) 623-1700 FAX (206) 623?8717 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION. TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - l7 Case Document 1 Filed 04/11/18 Page 18 of 176 Swedish executives and falsely stated that ?[a]lmost all? of SNI neurosurgeons supported his views. This was false. Dr. Cobbs claimed that other surgeons had declined to sign his letter for fear of retaliation, but in fact they did not support it. Within a week, Dr. Cobbs? false report of a consensus on the (false) claims about Dr. Delashaw was sent to dozens of Swedish employees through an anonymous email sent from a Gmail account using the pseudonym jbartsolo@gmail.com. The email was calculated to make the corporate types squirm: its subject line was ?Cherry Hill is not safe for patient care with Dr. Delashaw in a leadership role? and it demanded Dr. Delashaw?s resignation while asserting that he had ?all the hallmarks? of being a ?high-functioning 66. The Times reported these internal SNI communications that were obviously. and improperly, provided to the Times, and formed a cornerstone of its ?investigation? of SNI. D. The Times Claimed that in an ?Investigation? It Found that Dr. Delashaw and Others Were Engaging in ?Concurrent Surgeries? and that Dr. Delashaw Was Neglecting and Endangering Patients because He Was Paid Based on Volume. 67. Beginning on February 10, 2017. the Times published a series of articles accusing SNI in general, and Dr. Delashaw in particular, of endangering neurosurgical patients. 68. One such practice, according to the Times, was ?concurrent surgeries.? Concurrent surgeries are surgeries in which the critical portions of each operation occur simultaneously despite being led by the same doctor. The Times claimed that Dr. Delashaw was motivated to perform ?concurrent surgeries? because he was paid on a piecework basis?the more surgeries he could perform in a day, the more money he made. The Times claimed that Dr. Delashaw?s greedy pursuit of volume placed patient care in jeopardy. 69. Specifically, the Times published the following false and/or misleading statements in ?The OR Factory,? written by Mike Baker and Justin Mayo and published on February 10, 2017 (all emphasis added): a) ?The doctors in the neuroscience unit are incentivized to pursue a high?volume approach with contracts that compensate them for large patient numbers and complicated surgical techniques.? COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP OR EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 18 LAW OFFICES HARRIGAN LEYH FARMER THOMSEN LLP 999 THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98104 TEL (206) 623-1700 FAX (206) 623-8717 70. Case 2:18?cv?00537 Document 1 Filed 04/11/18 Page 19 of 176 ?In the past, the SNI surgeons pooled a portion of their pay and redistributed it among each other. It was a system designed to encourage doctors to pass along patients to their peers when they thought a co-worker might be a better specialist to handle the patient?s procedure. In some surgical settings, all income is pooled this way.? . . Providence and Swedish had overhauled the way Cherry Hill?s neuroscience program approaches the business of medicine, enriching the nonpro?t institution and its star surgeons.? ?The revised contracts at Cherry Hill?s SNI program ended the pooling system, according to records and interviews. Surgeons would be paid almost entirely on their production, as measured by Relative Value Units, or ?The top two doctors?[including] Delashaw?each exceeded $75 million in billed charges, almost $25 million more than the state?s nearest brain and spine surgeon outside of the SNI group.? ?But the aggressive pursuit of more patients, more surgeries and more dollars has undermined Providence?s values?rooted in the non-profit?s founding as a humble home where nuns served the poor?and placed patient care in jeopardy, a Seattle Times investigation has found.? ?The hospital touts its star surgeons to draw patients from hundreds of miles away, but six current and former staffers said those doctors will sometimes do little in the operating room once the patient is under anesthesia. Instead, the surgeons will leave less?experienced doctors receiving specialized training to handle parts of a surgery. That allows the primary surgeons to be in another operating room?a practice known as ?concurrent surgery??to maintain high volumes. It is not prohibited but can test the limits of Medicare rules.? In summary, the Times reported that its ?investigation? had revealed that Dr. Delashaw and other ?star surgeons? ?are incentivized? to maximize volume because they are ?paid almost entirely on their production? and that, for this reason, Dr. Delashaw and other surgeons were engaging in ?concurrent surgeries? to increase volume and make more money. The Times reported that, in order to increase volume and thus income, Dr. Delashaw was leaving important surgical tasks to less experienced doctors?Le, he and others ?do little in the operating room once the patient is under anesthesia,? leaving less experienced doctors to ?handle parts of the surgery.? The Times said that these alleged ongoing practices ?placed patient care in jeopardy.? COMPLAINT FOR LIBEL, DEF AMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, Each ofthese claims is false. LAW OFFICES LEYH FARMER THOMSEN LLP 999 AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98104 TEL (206) 623?1700 FAX (206) 623-87l7 UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 19 Case 2:18-cv-00537 Document 1 Filed 04/11/18 Page 20 of 176 72. Dr. Delashaw was on salary during the majority of his time at SNI, including the approximately two-year period of rapidly increasing surgical volume ending when he resigned in early 2017. The fundamental predicate for the Times? attack?volume-based compensation of Dr. Delashaw that was motivating him to race through surgeries endangering patients_was false. 73. The Times published a chart in an effort to show that Dr. Delashaw?s surgical volume rose as a result of the ?aggressive pursuit of more patients, more surgeries and more dollars.? The chart shows that for the calendar year 2015 Dr. Delashaw had over $76 million in ?billed charges,? placing him among the ?state?s top six brain and spine surgeons? and meaning he brought in $25 million more than ?the state?s nearest brain and spine surgeon outside of the SNI group.? The chart was intended to establish high surgical volume resulting from being ?paid almost entirely on [his] production,? but it demonstrates the opposite. Effective April 2015, Dr. Delashaw was placed on a ?xed salary and assumed his duties as Chair of Neurosurgical Division. For seventy-five percent of 2015 he had no financial incentive to work as hard as he did. He remained on a fixed salary through 2016 and until his departure in 2017. The chart shows that Dr. Delashaw worked very hard even though doing so did not increase his income. 74. There were no ?concurrent surgeries.? The Times knew that Dr. Delashaw did not engage in this practice. Dr. Delashaw?s colleague told the Times, and confirmed in writing, that he was a meticulous surgeon who performed every critical part of every operation himself?based on participating with ?him in hundreds of operations?but the Times disregarded this compelling information. 75. The Washington State Department of Health later confirmed what Dr. Delashaw?s colleague had told the Times: concurrent surgeries did not happen. The DOH investigated the Times? claims, interviewing 127 witnesses and publishing a 135-page report. The DOH found: LAW OFFICES HARRIGAN LEYH FARMER THOMSEN LLP 99?) THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98104 TEL (206} 623?1700 FAX (206) 623-8717 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 20 Case 2:18-cv-00537 Document 1 Filed 04/11/18 Page 21 of 176 ?In the concurrent surgeries, it was alleged the attending surgeon was not available or present during critical portions of the surgery. Concurrent surgeries by attending surgeons were not substantiated.?4 76. Finally, the claim that these non-existent practices placed patient care in jeopardy is false. surgical outcomes did not decline during Dr. Delashaw?s tenure, even though its surgeons were performing the most dif?cult operations, as explained further in the next Section. E. The Times Misrepresented Patient Outcomes as Poor When Objective Data the Times Had in Its Possession Showed that They Were Excellent. 77. The Times? repeatedly claimed that Dr. Delashaw?s and other SNI top surgeons? use of ?concurrent surgeries? (false) and premature departures from the operating room (false) in pursuit of more money (false) resulted in ?endangering patients.? Dr. Delashaw and other SNI surgeons took good care of their patients, and the results prove it. 78. Instead of using the available relevant, reliable data, the Times published non- indicative data and twisted it to support its story. The Times claimed in ?The OR Factory?: ?Among 10 patient safety indicators published by the federal government, Cherry Hill ranked below national levels in three areas in the data through the middle of 2015: blood clots after surgery, collapsed lungs and serious complications.? ?In benchmarks tracked by the federal government, Cherry Hill was flagged for having high rates of blood clots, collapsed lungs and serious surgical complications.? (Emphasis added.) 79. ?Cherry Hill? refers to the location of several Swedish Hospital facilities and is often contrasted with ?First Hill.? The statistics the Times reported regarding ?blood clots after surgery? and ?serious complications? covered many Swedish facilities located on ?Cherry Hill,? including Medicine, the Intensive Care Unit, and the cardiovascular center. The Times cited these statistics as supporting its claim that Dr. Delashaw and other SNI surgeons were ?endangering? patients at SNI, using data that did not reflect outcomes. 4 2017 Investigative Report, On-Site State and Federal Hospital Investigation, Swedish Medical Center-Cherry Hill, (?Investigative Report?) at 10 (Aug. 7, 2017). COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 21 LAW OFFICES HARRIGAN LEYH FARMER 8: TIIOMSEN LLP 990 THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98 104 TEL (206) 623?1700 FAX (206) 623-8717 Case 2:18-cv-00537 Document 1 Filed 04/11/18 Page 22 of 176 80. According to data relating to performance generated by a national ?rm on which hospitals across the country rely?Premier Quality Advisor (Premier)?SNI?s outcomes were better than institutions of comparable size across the United States. Premier analyzes and benchmarks patient outcomes using information from 3,750 major hospitals and closely monitors, records and compares mortality and other factors. numbers during the relevant period, as calculated by Premier, Show consistently excellent patient outcomes compared to its peer institutions. 81. For example, Premier uses its extensive database to set an expected mortality rate? that is, the mortality rate one can anticipate from ?normal? competent care. This expected mortality rate is then compared to the actual rate at a particular facility such as SNI. The comparison is called an ?Observed/Expected? ratio, which describes how the actual (observed) rate compares to the norm (expected). An mortality rate of one means the actual mortality rate was the same as the expected mortality rate. Less than one means the performance was better than expected. 82. Speci?c to SNI, the objective data covering more than 2,800 cases con?rms that their patient outcomes were better than expected using the national benchmark data. For example, for SNI cranial and spinal cases generally, as well as for Dr. Delashaw speci?cally, the Observed/Expected mortality rate was below one?meaning mortality was at a lower rate than expected for the procedures in question. 83. The DOH also investigated the Times? claims that patients were endangered in connection with expansion and found no basis for them. The DOH carefully assessed outcomes during the period of expansion and determined that patient outcomes remained excellent (all emphasis added): review of the quality data for the Swedish Neurosciences Institute from 2012 2017 did not reveal an increase in surgical complications and infections. The LAW OFFICES HARRIGAN LEYH FARMER THOMSEN 999 THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98 I 04 TEL (206) 623-1700 FAX (206) 623?87 [7 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 22 Case Document 1 Filed 04/11/18 Page 23 of 176 quality data was obtained from the electronic medical record and benchmarked externally.?S review of medical records of hospital deaths for patients undergoing spine and/or cranial surgery in 2014 and 2015 was undertaken. This did not reveal any patterns or trends regarding quality of care.?6 84. According to the DOH ?ndings, SNI maintained a high quality of patient care while undergoing a major increase in patient referrals from other hoSpitals and other increases in the number and complexity of neurosurgica] procedures. The objective facts are the opposite of the Times? claims. F. The Seattle Times Misrepresented the Reasons for and Results of Expansion. 85. The Times? claims that Dr. Delashaw was paid based on volume and as a result had delivered shoddy patient care were false. But the Times did not simply misrepresent what occurred; it misrepresented the motivation for and the results of the SNI expansion?and in the process it also completely missed the real SNI story while in?icting massive damage to the results that had been achieved and the people who achieved them. 86. As set forth above, SNI recruited Dr. Delashaw in an effort to realize the full potential of SNI?which was to ?become a mecca for outstanding neurosurgery. One goal was to join forces with SSF and take advantage of its depth in technological expertise. 87. Dr. Delashaw?s part of this effort included bringing his own exceptional skills to bear while also helping to recruit the very best surgeons from all over the United States to Seattle and to SNI. Part of the lure~?the same lure that brought Dr. Delashaw to SNI in 2013?was the opportunity to participate in revolutionizing neurosurgical care by working with outstanding surgeons and with 5 Investigative Report, at 4. 6 Investigative Report, at 4. COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 23 LAW OFFICES HARRIGAN LEYH FARMER 3r. THOMSEN 99?) THIRD AVENUE, 4400 SEATTLE, WASHINGTON 98104 TEL (206) 623-1700 FAX (206)633-8717 Case Document 1 Filed 04/11/18 Page 24 of 176 Seattle?s tech community on cures that surgery alone cannot achieve, and having the opportunity to communicate new techniques around the world using the facilities of SSF. 88. The volume of surgical work at SNI rose steeply in 2014 through 2016. This increase did not cause any decline in excellent care; it occurred largely because of excellent care combined with technological advances, expansion of operating spaces, and a resulting increase in referrals. By 2016, SNI was attracting referrals from ten times the number of hospitals that were referring tough cases to SNI before Dr. Delashaw arrived. Dr. Delashaw and his colleagues were in the midst of achieving the goal that had attracted him to Seattle and, at the gala in October 2016, raised over $6 million to continue growth and depth. 89. A key part of the expansion was to attract very capable surgeons. For example, before 2013, SNI had one open aneurysm surgeon and two interventional practitioners. By the summer of 2016, SNI had on staff two open aneurysm surgeons, two interventional practitioners, and two neurosurgeons versed in both techniques. This increase in numbers was also an increase in depth: there were more surgeons who were skilled in each of the two major techniques, making it easier to match a patient?s condition with the right surgeon. 90. Other reasons for the increase in surgical volume included Providence Health Services? acquisition of Swedish Medical Center in 2011, which broadened referral base significantly. By 2016, SNI was the referral center for hospitals across five states in the Northwest. A third factor leading to volume increase was the Affordable Care Act, which brought patients to SNI who had previously been untreated, leading to an in?ux of cases made more challenging by prior neglect. 91. The truth about expansion is the opposite of the Times? reporting: the real SNI story is one of remarkable achievement. Its increased volume of dif?cult neurosurgical cases resulted mainly from high?not low?quality. The Times? claims of greed-driven volumes resulting in patient neglect are not simply false; the truth is precisely the opposite. But the Times? false LAW omcss #5113 X?i?iiv'uif?s?i?i??iis?? SEATTLE, WASHINGTON 93104 TEL (206) 523?1700 FAX (206) 623-3717 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 24 Case 2:18-cv-00537 Document 1 Filed 04/11/18 Page 25 of 176 reporting has severely undermined an achievement in high-quality neurosurgical care that was of great value to the Puget Sound region and the western United States. G. The Times Falser Claimed that the Pursuit of ?More Dollars? ?Placed Patient Care in Jeopardy? because of ?Massive Caseloads? and Excess Burdens on Staff, Including ?ZO-Hour Days.? 92. The Times reported: ?[T]he aggressive pursuit of more patients, more surgeries and more dollars? resulted in ?massive caseloads? for ?medical staffers from the operating room to the intensive?care unit [which has] forced some nurses at Cherry Hill to be on duty for 20 hours in a day. . . . It?s not uncommon to see some nurses who support Cherry Hill?s operating-room work 20 hours in a 24-hour period, said Knapp, despite research showing that long shifts can lead to more mistakes.? 93. These Times? claims were false. The Department of Health investigated them, interviewing 127 witnesses, and found ?no evidence that staff worked beyond their scheduled hours or that staf?ng levels were below recommended staf?ng guidelines?? H. The Times Falser Claimed that Dr. Delashaw Engaged in Unnecessary Surgical Procedures and did so to Increase his Income. 94. The Times cited data from Dr. Delashaw?s time at UC Irvine and SNI as evidence that he performed the clipping procedure to generate pro?t. 95. The Times reported: a) ?When Delashaw moved to the Cherry Hill hospital in Seattle, that campus jumped from 36 percent of cases getting a clip in 2012 to 57 percent in 2014. The statewide average remained under 40 percent during that same time.? b) Seattle Times analysis of patient data shows dramatic shifts in aneurysm treatment as Delashaw moved between jobs. Before his 2012 arrival at UC Irvine, the university?s medical center performed clipping surgery in only about 13 percent of cases. After Delashaw?s arrival, 62 percent of aneurysm patients undergoing treatment at Irvine received a clip the highest rate among California hospitals who had at least 20 aneurysm cases, according to state data analyzed by The Times.? 7 Investigative Report, at 6 (emphasis added). COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 25 LAW OFFICES HARRIGAN LEYH FARMER THOMSEN 099 THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98104 TEL (.106) 623?1700 FAX (206) 623-8717 Case 2:18-cv-00537 Document 1 Filed 04/11/18 Page 26 of 176 96. When Dr. Delashaw arrived at UC Irvine, a number of aneurysm referrals followed him and he performed approximately 60 clipping procedures in his first few months, which were completed with a mortality rate of The Times omitted this information, which demonstrates the complete falsity of the claim that, under Dr. Delashaw, the choice of aneurysm treatments was driven by pro?t rather than by patient care. 97. The Times extensively described the clipping procedure for and repeatedly stated or implied that the clipping procedure was unnecessarily invasive and/or was performed because it was more costly and would line the pockets of the surgeons. The Times made no effort to ?nd out or report to its readers on the reasons that clipping is often the best treatment for particular patients, and avoided any mention of the objective system SNI had instituted to make sure that the right procedure was chosen for each patient. 98. One important factor in choosing clipping is that it is less likely than coiling to require further treatment at a later time. patient base was geographically widespread and included remote areas of Alaska. After arriving at SNI, Dr. Delashaw contracted with the Alaska Native Tribal Health Consortium, traveled to and worked in Alaska, and deveIOped a strong referral base in Alaska. For a patient with an aneurysm that requires follow?up, as coiling often does, avoiding multiple arduous trips from Alaska to Seattle can be a life-saving factor in itself. For these far-flung patients, the clipping procedure was often the right choice for that reason alone. 99. Dr. Delashaw also established a procedure at SNI that was designed to ensure that the choice of treatment for every aneurysm was reviewed by at least two doctors, including one surgeon capable of clipping and another capable of coilingu?in short, the purpose of the system was to ensure that two surgeons with combined expertise in each method made the initial decision regarding which treatment was more apprOpriate for each patient. In addition, all non-emergent g. non?ruptured) were reviewed at a weekly stroke conference attended by SNI faculty (including fellows) which determined the best course of care. In addition, under Dr. Delashaw?s HARRIGAN THOMSFN LLP 999 THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98104 TEL (206) 623-1700 FAX (206) 623-8717 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 26 Case 2:18-cv-00537 Document 1 Filed 04/11/18 Page 27 of 176 leadership, SNI hired Dr. Cameron McDougall, an acknowledged expert in aneurysm treatment who Specialized in coiling. 100. Instead of reporting the truth, which was that Dr. Delashaw led a concerted effort to assure rigorous and objective treatment choices for the Times printed a falsehood: ?[Interventional neuro-radiologist Dr. Joe] Eskridge said he and Newell [a surgeon who handled many aneurysm clippings] often discussed to assess whether the patient would have better results with a clip or coil procedure. . . . ?Delashaw never did that,? said Eskridge . . . Dr. Delashaw went beyond ?discussing? the treatment choice; he implemented a rigorous system for making the best choice in each case. I. The Main Claims the Times Made in Its Articles Were False and the Conclusions the Times Presented Were Based on Claims the Times Knew Were False. 101. A fundamental falsehood in the Times articles about Swedish hospital was the claim that its reporting resulted from an ?investigation.? It did not. No investigation would have failed to uncover that in the period on which the articles focused Dr. Delashaw was not pursuing ?more surgeries, more dollars? because he was paid based on volume; he was not. A request for his contract?or a simple question?would have shown that during the nearly two years preceding publication of the Times? articles, Dr. Delashaw was on salary. The Times also deliberately ignored and withheld from its articles highly reliable information showing that no ?concurrent surgeries? were taking place at the DOH later determined?but instead falsely reported that Dr. Delashaw (and others) were making brief appearances in the OR and then leaving for another ?concurrent? surgery once the patient was under anesthesia. 102. This claim was refuted by Dr. Prashant Kelkar. Before publishing the first article, the Times interviewed Dr. Kelkar, a neurosurgeon and fellow at SNI who had worked with Dr. Delashaw in the operating room at SNI hundreds of times. After the interview, Dr. Kelkar followed up by sending an e-mail to Mr. Baker of the Times recapping elements of the interview to make sure that LAW OFFICES HARRIGAN LEYH FARMER THOMSEN LLP 99?) THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98104 TEL {206) 623?1700 FAX (206) 623-3717 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.36 ET SEQ. AND CIVIL CONSPIRACY - 27 Case 2:18-cv-00537 Document 1 Filed 04/11/18 Page 28 of 176 Mr. Baker understood the information Dr. Kelkar had given to him. Dr. Kelkar wrote to Mr. Baker on February 6, 2017, as followsnever had an experience over hundreds of surgeries I performed with him [Dr. Delashaw] that he was anything but respectful, courteous and cognizant of his actions and comments in the OR with nurses/surgical techs/anesthesiologists/ residents/fellows. He is a well-liked surgeon from every interaction I was a part of. Dr. Delashaw is a caring, compassionate physician who enjoys practicing neurosurgery and takes pride in being ?the best? and having good outcomes. In my experience over hundreds of surgeries with Dr. Delashaw, he was scrubbed and actively engaged in the critical part of every surgery without fail. There was never an instance where he was unavailable or immediately not present for any surgery. We clarified that the main surgeons including myself operating with Dr. Delashaw were highly trained Board Eligible Neurosurgeons at the time. This is a fact that you were not aware of till today. I believe Dr. Delashaw came to SNI well intentioned to grow and develop a Neurosciences program beyond the ability of the faculty that was there at the time. His success certainly leads to scrutiny by others around him, whether that be due to jealousy, anger. greed, change, or other. Each instance in medicine where I see someone of power get scrutinized there is always two sides to the story and my ask of you is that you not ruin a good man?s career to write a ?sexier? story. Please feel free to call me at any time for any further follow up. 103. There is no mention of either the interview or the letter in the Times? article; instead, the Times wrote only: ?Another former fellow, Dr. Prashant Kelkar, said Delashaw always came in a timely fashion.? Dr. Kelkar and other neurosurgeons provided Mr. Baker with ?rst?hand accounts of personal observations of Dr. Delashaw that uniformly and directly contradicted the main assertions in the imes? articles. Before the Times went to press, it had been advised by the doctors who actually operated with Dr. Delashaw that he was always present for the critical portions of surgeries, that he was invariably responsible in his patient care, and that there was no factual support for the claims of problematic behavior. After speaking with these doctors, the Times? reporters BUSINESS RELATIONSHIP EXPECTANCY, SEATTLE, 98 [04 UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW (206) ?mm 19.86 ET SEQ. AND CIVIL CONSPIRACY - 23 Case Document 1 Filed 04/11/18 Page 29 of 176 knew, or should have known, that they had been provided ?misinformation and bad data? by their sources. 104. In the wake of these attacks, Dr. Delashaw was unable to focus on patient care, so he resigned from Swedish at the end of February 2017. 105. The false accusations filed against Dr. Delashaw had led to a ?Priority (low priority) MQAC investigation starting in March 2016. Over six months later, on October 7, 2016, a panel of the Medical Commission had authorized only a summary ?restriction? of Dr. Delashaw?s license. As part of the MQAC investigation, SNI had provided statements from surgical fellows and the head of human resources that showed that the phone-throwing claim was false. As soon as the Times articles came out on February 10, 2017, MQAC did an about face on its low-priority, careful approach to the unsupported claims against Dr. Delashaw. In response to the Times article, State Senator Karen Keiser pressured the MQAC to take swift action. The investigator Stephen Correa had interviewed the surgeons identi?ed in the newspaper article. Those surgeons admitted that they had never seen any disruptive behavior by Dr. Delashaw. But under pressure from Senator Keiser and in the politically charged environment the Times articles had created, MQAC proceeded to suspend Dr. Delashaw?s medical license on the basis that he posed an ?immediate risk to the public health and safety? despite the fact that he was no longer practicing. In short, based on the very same evidence that had led to months of inaction followed by a mere restriction of Dr. DelashaW?s license, suddenly, in direct response to the Times? articles and with no further investigation, Dr. Delashaw was deprived of his license to practice medicine. 106. Discovery in the MQAC proceeding has revealed that Dr. Cobbs and Dr. Mayberg conspired to damage Dr. Delashaw?s reputation and standing in order to effect his removal from his position at that they intentionally violated their obligations to Swedish in this effort to displace Dr. Delashaw so that they could improve their own professional and financial opportunities; that they did so using their wives? personal email accounts to avoid detection of their conspiracy; and THOMSFN I LP 999 mum AVENUE, sums 4400 SEATTLE, WASHINGTON 98104 TEL (206) 623-1700 FAX {206) 623?87 1 7 COMPLAINT FOR DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 29 Case Document 1 Filed 04/11/18 Page 30 of 176 that they lied in order to cover up their actions and committed other abuses of their discovery obligations in the MQAC proceeding in furtherance of their conspiracy, including making knowingly false statements under oath, and withholding hundreds of pages of documents that evidenced a concerted effort to destroy Dr. Delashaw. 107. The Times? false claims and the Cobbs/Mayberg conspiracy have destroyed Dr. Delashaw?s career and have led directly to an unjusti?ed suspension of his license, which has led to serious ?collateral damage.? Dr. Delashaw has a unique skill level in certain kinds of neurosurgical procedures and patients with conditions few can treat who need continuing care. He has patients in Longview, Washington, who need his help, for which there is no substitute. V. CAUSES OF ACTION FIRST CAUSE OF ACTION: DEFAMATION LIBEL (AGAINST THE TIMES) 108. Plaintiff realleges and incorporates by reference the allegations in Paragraphs 1?107 as if stated herein. 109. On February 10, 2017, and in subsequent articles, the Times published multiple false statements defaming the character, motivations, and quality of medical care provided by Dr. Johnny Delashaw. 1 10. Those statements were unprivileged. 1 11. The Times actually knew or, in the exercise of reasonable care, should have known, that its statements were false or would create a false impression in a material respect. 112. The controversy and his role in it were Dr. Delashaw is not a public figure. manufactured by the Times in an attempt to increase its readership and advertising revenue; to the extent that Dr. Delashaw subsequently participated in the controversy, he was forced to do so by the Times? defamatory statements and the public firestorm they were calculated to create. The Times also acted with malice; the Times knew the defamatory statements were false, or acted with reckless LAW OFFICES HARRIGAN LEYH FARMER 81: THOMSEN LLP 99?) THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98] 04 TEL (206) 623?1700 FAX (206) 623-8717 COMPLAINT FOR LIBEL, DEF AMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 30 Case Document 1 Filed 04/11/18 Page 31 of 176 disregard for their falsity, when it published them. The Times has continued to publish the false statements on its website despite its knowledge that the Department of Health investigation reached conclusions that ?atly contradict the Times? reports about Dr. Delashaw. 113. The Times? false statements impugned Dr. Delashaw?s professional reputation and caused him significant professional inju1y. 114. The Times? abuse of its role as the community?s newspaper of record has proximately caused and continues to cause massive damage to Dr. Delashaw, including but not limited to extreme reputational harm and loss of employment opportunities. SECOND CAUSE OF ACTION: DEFAMATION BY IMPLICATION (AGAINST THE TIMES) 15. Plaintiff realleges and incorporates by reference the allegations in Paragraphs 1?107 as if stated herein. 116. The Times? ?watch dog? series about SNI, beginning with the article, ?The OR. actony,? taken as a whole, created the false impression that Dr. Delashaw was driven by greed to maximize his income by performing unnecessary surgeries; that he abandoned patients during surgery in violation of his professional obligations; and that he presided over an Factory? that harmed patients. The Times created this false impression by publishing multiple false statements about Dr. Delashaw and in part by omitting material facts that were contrary to the Times? desired story line. 117. The Times? articles, read holistically, created the blatantly false implication that Dr. Delashaw posed a threat to the very patients he sought to help and the equally false implication that he should be removed from his leadership position at SNI. 118. The Times? articles, read holistically, created the demonstrably false implication that patient-care outcomes declined during Dr. Delashaw?s tenure at SNI. The Times omitted material facts that were contrary to its objective of demonizing Dr. Delashaw, including but not LAW OFFICES LEYH FARMER LLP 99?) THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 93104 TEL {206) 623?1700 FAX (206) 623-3717 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 31 Case Document 1 Filed 04/11/18 Page 32 of 176 limited to the fact that health outcomes during Dr. Delashaw?s tenure at SNI did not decline; that Dr. Delashaw?s income was not tied to his surgery volume during the two-year period on which the Times articles focus; that he never engaged in ?concurrent surgeries?; and that he implemented a process to assure that treatments for patients, including aneurysm treatments, were chosen objectively in the best interests of the patient. 119. The Times? false statements were unprivileged. 120. The Times knew or, in the exercise of reasonable care, should have known that its statements were false or would create a false impression in a material respect. 121. Dr. Delashaw is not a public figure. The controversy and his role in it were manufactured by The Times; Dr. Delashaw?s subsequent participation in the controversy was the result of a controversy created by the Times? proliferation of its defamatory statements. 122. The Times acted with malice in its false statements and in its omission of material facts because the Times knew the statements it made were false or incomplete, or it exercised so little care in ascertaining the facts that its conduct was reckless and without regard for the truth. 123. The Times? conduct has proximately caused and continues to cause massive damage to Dr. Delashaw, including but not limited to extreme reputational harm and loss of employment opportunities. THIRD CAUSE OF ACTION: TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY (AGAINST THE TIMES) 124. Plaintiff realleges and incorporates by reference the allegations in Paragraphs 1?107 as if stated herein. 125. At the time of the conduct at issue, Dr. Delashaw had a business relationship with Swedish Health Services d/b/a Swedish Medical Group and had a business expectancy arising from his vast referral base, which extended to the entire United States and to other countries. The referral LAW OFFICES HARRIGAN LEYH FARMER THOMSEN 999 THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98 1114 TEL (206) 623-1700 FAX (206) 623-3717 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 32 Case Document 1 Filed 04/11/18 Page 33 of 176 base consisted of scores if not hundreds of physicians, clinics and hospitals who knew of and respected Dr. Delashaw?s exceptional capabilities, devotion to patients, and work ethic, and who referred neurosurgical patients to him, including those with the most challenging neurosurgical problems. But for Defendants? conduct, Dr. Delashaw?s business relationship with Swedish Health Services would have continued, and his referral base would have continued to Operate as it had for decades, resulting in a steady and very substantial source of patients requiring Dr. Delashaw?s skills. 126. The Times knew of Dr. Delashaw?s relationship with Swedish Health Services and of the value, reliability, and importance of his referral base. 127. The Times intentionally induced or caused the termination of these business relationships and expectancies through its repeated publication of false and defamatory statements about Dr. Delashaw. 128. The Times? interference was for an improper purpose?to generate a public scandal in order to promote readership of the Times? ?watch dog? series?and was accomplished through improper means, including publication of knowingly false and defamatory statements about Dr. Delashaw. 129. The Times? conduct was a proximate cause of damages to Dr. Delashaw. FOURTH CAUSE OF ACTION: UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. (AGAINST THE TIMES) 130. Plaintiff realleges and incorporates by reference the allegations in Paragraphs 1?107 as if stated herein. 131. In its quest to generate a controversy, the Times deceived its readers and the general public. The Times touted its ?watch dog? series as the product of a thorough independent investigation when, in fact, it was not the result of an investigation but was designed to create a scandal about a local hospital. The Times deceived its readers by failing to disclose the actual facts regarding the subject matter of its report, including the fact (known by the Times) that a primary LAW omcas HARRIGAN LEVI-I FARMER THOMSEN LLP 99?) THIRD AVENUE, SUITE 4400 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECT ANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 33 SEATTLE, WASHINGTON 98 04 TEL (206) 623-1700 FAX (206) 623?87 I 7 Case 2:18-cv-00537 Document 1 Filed 04/11/18 Page 34 of 176 source, Dr. Mayberg, acted with a fundamental con?ict of interest throughout all of his interactions with the Times. The Times published deceptive statements regarding Dr. Delashaw and promoted its false reports through its website, newspaper, and social media as part of a multimedia marketing strategy in order to maximize the controversy to attract readers to its website to increase its revenue, and the Times? false reports remain available today on internet sites across the world. 132. The Times? deceptive acts occurred in trade or commerce. The Times? disparagement of Dr. Delashaw was a key component of its multi-media marketing strategy to increase the Times? revenue and notoriety. 133. The Times? publication of the false articles is a betrayal of its readers? trust and profoundly affected the public interest by damaging health care in Seattle. The Times? false reporting has the capacity to deceive (and did deceive) a substantial portion of the public. The Times? deceptive acts have resulted in damage to Dr. Delashaw?s reputation, including the unprecedented summary suspension of his medical license in the wake of the Times? articles. The Times? false reporting has prevented sick individuals from receiving medical care from Dr Delashaw and has damaged the quality of health care available in the Seattle area. FIFTH CAUSE OF ACTION: DEFAMATION LIBEL (AGAINST COBBS) 134. Plaintiff realleges and incorporates by reference the allegations in Paragraphs lw107 as if stated herein. 135. Throughout 2016, Dr. Cobbs made multiple false statements, both directly and by implication, defaming the character, motivations, and quality of medical care provided by Dr. Johnny Delashaw. 136. Those statements were unprivileged. 137. Dr. Cobbs actually knew or, in the exercise of reasonable care, should have known that his statements were false or would create a false impression in a material respect. LAW OFFICES LEYH FARMER THOMSEN 999 THIRD AVENUE, SUITE 4400 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 34 SEATTLE, WASHINGTON 98104 TEL {206} 623-1700 FAX (206) 623-8717 Case 2:18-cv-00537 Document 1 Filed 04/11l18 Page 35 of 176 138. Dr. Delashaw is not a public ?gure. The controversy and his role in it were manufactured by Defendants? conduct; Dr. Delashaw?s subsequent participation and role in the controversy were a forced response to the Times? defamatory statements and the publication of Dr. Cobbs? defamatory statements. Dr. Cobbs also acted with malice; he knew that his statements about Dr. Delashaw were false, or acted with reckless disregard for their falsity, when he made them. 139. Dr. Cobbs? false statements impugned Dr. Delashaw?s professional reputation and caused him signi?cant professional injury. 140. Dr. Cobbs? conduct has proximately caused and continues to cause damage to Dr. Delashaw, including but not limited to extreme reputational harm and loss of employment opportunities. SIXTH CAUSE OF ACTION: TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY (AGAINST COBBS) 141. Plaintiff realleges and incorporates by reference the allegations in Paragraphs 1?107 as if stated herein. 142. At the time of the conduct at issue, Dr. Delashaw had a business relationship with Swedish Health Services d/b/a Swedish Medical Group and had a business expectancy arising from his vast referral base, which extended to the entire United States and to other countries. The referral base consisted of scores if not hundreds of physicians, clinics and hospitals who knew of and respected Dr. Delashaw?s exceptional capabilities, devotion to patients, and work ethic, and who referred neurosurgical patients to him, including those with the most challenging neurosurgical problems. But for Defendants? conduct, Dr. Delashaw?s business relationship with Swedish Health Services would have continued, and his referral base would have continued to operate as it had for decades, resulting in a steady and very substantial source of patients requiring Dr. Delashaw?s skills. 143. Dr. Cobbs knew of Dr. Delashaw?s relationship with Swedish Health Services and his referral base. LAW omcas HARRIGAN LEYH FARMER S: TIIOMSEN LLP 99?) THIRD AVENUE, SUITE 4400 COMPLAINT OR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 35 SEATTLE, WASHINGTON 98104 TEL (206) 623-1700 FAX (206) 623-8717 Case Document 1 Filed 04/11/18 Page 36 of 176 144. Dr. Cobbs intentionally induced or caused the termination of these business relationships and expectancies through his campaign to undermine Dr. Delashaw?s reputation. 145. Dr. Cobbs? interference was for an improper purpose?specifically to promote the ouster of and otherwise inflict harm on Dr. Delashaw?and was accomplished through improper means, including defamation and Dr. Cobbs? violation of his obligations to Swedish. 146. Dr. Cobbs? conduct was a proximate cause of damages to Dr. Delashaw. SEVENTH CAUSE OF ACTION: CIVIL CONSPIRACY (AGAINST COBBS) 147. Plaintiff realleges and incorporates by reference the allegations in Paragraphs 1?107 as if stated herein. 148. As alleged ?in detail above, Dr. Cobbs and Dr. Mayberg acted in concert to destroy Dr. Delashaw?s reputation and career at SNI by defaming him; tortiously interfering with Dr. Delashaw?s business relationship with Swedish Health Services, and his business expectancy from referrals; and through other unlawful means. 149. Dr. Cobbs and Dr. Mayberg entered into an agreement to accomplish the conspiracy to destroy Dr. Delashaw?s reputation and career and worked in concert to do so. 150. Dr. Cobbs and Dr. Mayberg acted on each other?s behalf in furtherance of the conspiracy. 151. Dr. Cobbs? and Dr. Mayberg?s conspiracy was the proximate cause of harm to Dr. Delashaw, including the destruction of his professional reputation and other damages. LAW OFFICES HARRIGAN LEYH FARMER (191?) THIRD AVENUE, SUITE 4400 SEATTLE, WASHINGTON 98104 TEL (206) 623?1700 FAX (206) 623-8717 COMPLAINT FOR LIBEL, DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.36 ET SEQ. AND CIVIL CONSPIRACY - 36 Case 2:18-ev-00537 Document 1 Filed 04/11/18 Page 37 of 176 VI. PRAYER FOR RELIEF In light of the foregoing, Dr. Delashaw prays for the following: 1. An order enjoining the Times from publishing false statements about Dr. Delashaw and requiring that it remove the false statements about Dr. Delashaw from its website and publish a retraction; 2. An order enjoining Dr. Cobbs from making false statements about Dr. Delashaw; 3. Monetary damages in an amount to be proven at trial, including an award. of prejudgment interest in an amount to be proven at trial; 4. Reasonable costs, disbursements, attorney?s fees, and prejudgment interest on all liquidated costs and expenses of litigation and additional taxes resulting from the payment to Plaintiffof all of the foregoing; and 5. Any such further relief as the Court deems just and equitable. RESPECTFULLY SUBMITTED this 1 1th day of April, 2018. HARRIGAN LEYH FARMER THOMSEN LLP By:_ 3/ Arthur W. Harri can, Jr. Arthur W. Harrigan, Jr., WSBA #1751 By: s/ rler L. Farmer Tyler L. Farmer, WSBA #39912 Arthur W. Harrigan, Jr., WSBA #1751 Tyler L. Farmer, WSBA #39912 999 Third Avenue, Suite 4400 Seattle, WA 98104 Tel: (206) 623-1700 Fax: (206) 623?8717 Email: arthurh@harriganleyh.com Email: tylerf@harriganleyh.com Attorneys for Johnny B. Delaslzaw, Jr. LAW OFFICES HARRIGAN LEYH FARMER LLP 09?) THIRD AVENUE, SUITE 4400 COMPLAINT FOR LIBEL. DEFAMATION BY IMPLICATION, TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP EXPECTANCY, UNFAIR BUSINESS PRACTICES IN VIOLATION OF RCW 19.86 ET SEQ. AND CIVIL CONSPIRACY - 37 SEATTLE, WASHINGTON 98104 TEL (206) 623?1700 FAX (206) 623-8717