Dr. William Bithoney said Grady officials misled him and then stranded him, personally and professionally, in Atlanta.

Grady's promises led him to resign his post at a New York hospital, Bithoney said through his lawyer. He said Grady - a hospital that consistently operates millions in the red - owes him $612,500 in severance pay and that a lawsuit seeking damages could drive that amount to more than $1 million

Bithoney's lawyer sent Grady a "demand" letter dated April 14, a prelude to a lawsuit. It claims the hospital "blatantly violated Dr. Bithoney's legal rights" and is liable for breach of contract and fraud.

Pam Stephenson, Grady's interim chief executive and chairwoman of the Grady board, blamed the dispute on former Grady CEO Otis Story, who hired Bithoney as Grady's senior vice president of administration.

Stephenson said Story hired Bithoney without board approval. When the board discovered Story had hired Bithoney, she said, it scotched the deal and, a few months later, fired Story.

"[Story] was insubordinate at the very least," Stephenson said.

Moreover, she said Bithoney knew the deal was not final when he moved to Atlanta, so Grady owes him nothing.
Bithoney, 57, earned degrees from Harvard University, magna cum laude, and Yale University School of Medicine. He was vice president of medical affairs at Mercy Hospital of Philadelphia from 2003 to 2005. He left a job as physician in chief at New York's St. Vincent Catholic Medical Centers to come to Grady.
He and his wife bought a house in Fayetteville in October. They remain here while Bithoney looks for work.
Grady records, documents and e-mails, obtained by The Atlanta Journal-Constitution through the state Open Records Act, reveal a trail of correspondence between Bithoney and Story.
Story hired Bithoney in August, the records show.
"On behalf of the Grady Health System, we are pleased to confirm your acceptance of our offer of employment for the position of senior vice president of administration effective October 15, 2007..." said a letter from Story to Bithoney dated Aug. 30.

Stephenson said the hiring was not valid because board policy says Story needs board approval for employment contracts worth more than $250,000.
She said Story operated largely without the knowledge of the board to make Bithoney an "excessive" offer with a base salary of $490,000. With bonuses and benefits, the job was worth nearly $800,000, she said.
Bithoney's Atlanta attorney, Daniel Klein, said Story offered Bithoney a severance package worth 15 months of his base salary. While the deal was never finalized, Klein said Grady is bound by Story's oral assurances.
Stephenson disagreed.
"That offer was not approved," Stephenson said. "I found out a day or two before he was to report for work. ... I said no, he cannot start."
Story stopped the hiring process, Stephenson said.
Then, she said, he pressed a Grady consultant to employ Bithoney for $11,300 a week - an annualized wage of $587,600. Grady was to pay the salary, Stephenson said.

"That's even more egregious," Stephenson said. "The vendor said they couldn't say no."
The Grady board fired Story on Jan. 28 without citing any problem with Story's job performance.
The board's letter of dismissal, among the documents obtained by the newspaper this month, makes clear the Bithoney incident played a major part in Story's termination.
The board's dismissal letter points to the Bithoney issue and accuses Story of the "willful engaging in gross misconduct."
Story's termination kicked up its own storm of controversy. Story has demanded $2 million from the hospital, asserting that he has done nothing wrong and the board owes him his contractual severance pay. Story declined to comment for this story.
The entangled disputes and threatened lawsuits are but another tribulation for the troubled hospital.
Grady, metro Atlanta's only Level One trauma center and the medical center of last resort for the poor and uninsured, has long been criticized for ineffective leadership.
While some Grady board members defended the board's actions regarding Story and Bithoney, one member, Richard Teters, said Grady treated Bithoney "miserably."
"It's a natural course of action when a board is dysfunctional," Teters said.
Bithoney declined to comment, but Klein, his Atlanta attorney, said the doctor acted in good faith.
Story and Bithoney worked together from 2005 to 2007 at St. Vincent, where Bithoney helped the medical center through a bankruptcy.
Grady isn't in bankruptcy but has struggled for years with multimillion-dollar deficits, aging equipment and substantial debt.
Klein said Story did not act alone to recruit and hire Bithoney. Last June, he said, Bithoney flew to Atlanta and had dinner with Dr. Christopher Edwards, then vice chairman of the Grady board.
The next day, Klein said, Edwards instructed Story to hire Bithoney. Edwards had left a message saying that on Story's cellphone, which Story played for Bithoney, Klein said. Edwards could not be reached for comment.
Grady general counsel Tim Jefferson said, "We deny that any board member instructed Story to hire Bithoney."
Klein said Bithoney returned to Atlanta June 22 and met with Stephenson at her law office. She welcomed Bithoney to the Grady family, Klein said.
Stephenson said she did have a "courtesy" meeting with Bithoney at the request of Story, but said she made no overtures of employment.
"I didn't offer him a job," she said.
Klein disagreed with Stephenson that Grady bylaws required Story to get Grady board approval to hire Bithoney.
Bithoney had been issued a BlackBerry cellphone and Grady phone number when, on Oct. 14, the night before he was to begin work, Story called and said the board had directed him to withdraw the offer, Klein said.
"It would be a gross understatement to say that Dr. Bithoney was stunned and dismayed," Klein said in the letter to Grady.
Grady officials said that Bithoney knew he did not have a signed final contract with the hospital. He may have expected Story to obtain Grady board approval, but he moved to Atlanta at his own risk, Stephenson said.
"He knew the deal wasn't closed," Stephenson said.
Even after the board withdrew Bithoney's offer, Stephenson said, Story pressed on and found the doctor temporary work with a subcontractor for consultant PricewaterhouseCoopers, a contractor for Grady.

Klein said Stephenson approved the arrangement, but Stephenson said Story acted on his own. PricewaterhouseCoopers and the subcontractor declined comment.
Bithoney worked there for about two months before the Grady board stopped it.
In a Dec. 3 letter to Bithoney, Stephenson said, "At this time, the board has not approved any employment or employment contract based on your negotiations with Mr. Story. Any employment proposal that may have been made to you on behalf of the authority is void."

Stephenson added that Grady will not request that Bithoney return $20,000 for moving and other expenses. The expenses were approved by Story and Grady Human Resources Vice President Michael Black, records show.
Bithoney is now unemployed and has spent months looking for a job, Klein said.

Story may sue the hospital over his dismissal; attempts at resolution have thus far failed.
Klein said he hasn't received a response from Grady on the demand letter, increasing the prospect that Bithoney will sue Grady.
If Bithoney sues Grady, Grady may have to sue Story, because Grady officials say he brokered the hiring of Bithoney outside of hospital policy.
In short, another tribulation for the hospital.

Copyright © 2012 H.E.Butler III M.D., F.A.C.S.