{ "id": 4293270, "name": "KEITH DOOKERAN, Plaintiff-Appellee and Cross-Appellant, v. THE COUNTY OF COOK, Defendant-Appellant and Cross-Appellee", "name_abbreviation": "Dookeran v. County of Cook", "decision_date": "2009-12-14", "docket_number": "No. 1\u201408\u20141426", "first_page": "800", "last_page": "820", "citations": [ { "type": "official", "cite": "396 Ill. App. 3d 800" } ], "court": { "name_abbreviation": "Ill. App. Ct.", "id": 8837, "name": "Illinois Appellate Court" }, "jurisdiction": { "id": 29, "name_long": "Illinois", "name": "Ill." }, "cites_to": [ { "cite": "281 F.3d 105", "category": "reporters:federal", "reporter": "F.3d", "case_ids": [ 9391315 ], "year": 2002, "opinion_index": 0, "case_paths": [ "/f3d/281/0105-01" ] }, { "cite": "31 U.S.C. \u00a73730", "category": "laws:leg_statute", "reporter": "U.S.C.", "year": 2000, "pin_cites": [ { "page": "(h)" } ], "opinion_index": 0 }, { "cite": "259 N.E.2d 613", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1970, "opinion_index": 0 }, { "cite": "123 Ill. App. 2d 2", "category": "reporters:state", "reporter": "Ill. App. 2d", "case_ids": [ 1580227 ], "year": 1970, "opinion_index": 0, "case_paths": [ "/ill-app-2d/123/0002-01" ] }, { "cite": "281 N.E.2d 360", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1972, "opinion_index": 0 }, { "cite": "4 Ill. App. 3d 695", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 2916448 ], "year": 1972, "opinion_index": 0, "case_paths": [ "/ill-app-3d/4/0695-01" ] }, { "cite": "337 N.E.2d 344", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1975, "opinion_index": 0 }, { "cite": "32 Ill. App. 3d 1052", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 2795624 ], "year": 1975, "opinion_index": 0, "case_paths": [ "/ill-app-3d/32/1052-01" ] }, { "cite": "494 N.E.2d 838", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1986, "opinion_index": 0 }, { "cite": "144 Ill. App. 3d 141", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 3498964 ], "weight": 8, "year": 1986, "pin_cites": [ { "page": "142" }, { "page": "150" }, { "page": "151" }, { "page": "150" }, { "page": "142" }, { "page": "150-51" }, { "page": "151" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/144/0141-01" ] }, { "cite": "544 N.E.2d 733", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1989, "opinion_index": 0 }, { "cite": "129 Ill. 2d 497", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 5567341 ], "weight": 2, "year": 1989, "pin_cites": [ { "page": "507" }, { "page": "507" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/129/0497-01" ] }, { "cite": "742 N.E.2d 279", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2000, "opinion_index": 0 }, { "cite": "194 Ill. 2d 438", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 1096310 ], "weight": 2, "year": 2000, "pin_cites": [ { "page": "452" }, { "page": "452" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/194/0438-01" ] }, { "cite": "606 N.E.2d 1111", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1992, "opinion_index": 0 }, { "cite": "153 Ill. 2d 76", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 4738801 ], "weight": 2, "year": 1992, "pin_cites": [ { "page": "99" }, { "page": "99" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/153/0076-01" ] }, { "cite": "781 N.E.2d 415", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2002, "opinion_index": 0 }, { "cite": "335 Ill. App. 3d 886", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 637120 ], "year": 2002, "pin_cites": [ { "page": "893" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/335/0886-01" ] }, { "cite": "543 N.E.2d 172", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1989, "opinion_index": 0 }, { "cite": "187 Ill. App. 3d 287", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 2665534 ], "year": 1989, "pin_cites": [ { "page": "293" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/187/0287-01" ] }, { "cite": "774 N.E.2d 1", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2001, "opinion_index": 0 }, { "cite": "332 Ill. App. 3d 532", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 1033922 ], "year": 2001, "pin_cites": [ { "page": "547-48" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/332/0532-01" ] }, { "cite": "691 N.E.2d 191", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1998, "opinion_index": 0 }, { "cite": "294 Ill. App. 3d 520", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 35368 ], "year": 1998, "pin_cites": [ { "page": "530" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/294/0520-01" ] }, { "cite": "547 N.E.2d 1383", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1989, "pin_cites": [ { "parenthetical": "admission of testimony that was arguably hearsay at a suspension hearing did not violate an identical bylaw concerning admission of evidence" } ], "opinion_index": 0 }, { "cite": "191 Ill. App. 3d 694", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 2513415 ], "year": 1989, "pin_cites": [ { "page": "701-02", "parenthetical": "admission of testimony that was arguably hearsay at a suspension hearing did not violate an identical bylaw concerning admission of evidence" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/191/0694-01" ] }, { "cite": "785 N.E.2d 99", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2003, "opinion_index": 0 }, { "cite": "337 Ill. App. 3d 93", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 894481 ], "year": 2003, "pin_cites": [ { "page": "103" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/337/0093-01" ] }, { "cite": "809 N.E.2d 735", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2004, "opinion_index": 0 }, { "cite": "348 Ill. App. 3d 563", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 4022353 ], "year": 2004, "pin_cites": [ { "page": "569" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/348/0563-01" ] }, { "cite": "596 N.E.2d 691", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1992, "opinion_index": 0 }, { "cite": "232 Ill. App. 3d 180", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 8498549 ], "year": 1992, "pin_cites": [ { "page": "184" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/232/0180-01" ] }, { "cite": "785 N.E.2d 532", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2003, "opinion_index": 0 }, { "cite": "337 Ill. App. 3d 210", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 894553 ], "year": 2003, "pin_cites": [ { "page": "216" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/337/0210-01" ] }, { "cite": "863 N.E.2d 829", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2007, "pin_cites": [ { "parenthetical": "review of a hospital's dismissal is limited to whether the hospital complied with its bylaws" } ], "opinion_index": 0 }, { "cite": "371 Ill. App. 3d 597", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 4267973 ], "weight": 4, "year": 2007, "pin_cites": [ { "page": "602", "parenthetical": "review of a hospital's dismissal is limited to whether the hospital complied with its bylaws" }, { "page": "601-02" }, { "page": "602" }, { "page": "602" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/371/0597-01" ] }, { "cite": "232 N.E.2d 776", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1967, "opinion_index": 0 }, { "cite": "90 Ill. App. 2d 409", "category": "reporters:state", "reporter": "Ill. App. 2d", "case_ids": [ 2899529 ], "weight": 3, "year": 1967, "pin_cites": [ { "page": "413" }, { "page": "413" }, { "page": "413" } ], "opinion_index": 0, "case_paths": [ "/ill-app-2d/90/0409-01" ] }, { "cite": "617 N.E.2d 1211", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1993, "opinion_index": 0 }, { "cite": "247 Ill. App. 3d 717", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 2929840 ], "weight": 3, "year": 1993, "pin_cites": [ { "page": "729" }, { "page": "729" }, { "page": "729" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/247/0717-01" ] }, { "cite": "625 N.E.2d 945", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1993, "opinion_index": 0 }, { "cite": "254 Ill. App. 3d 191", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 2981580 ], "weight": 3, "year": 1993, "pin_cites": [ { "page": "204-05" }, { "page": "204-05" }, { "page": "204-05" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/254/0191-01" ] }, { "cite": "783 N.E.2d 96", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2002, "opinion_index": 0 }, { "cite": "335 Ill. App. 3d 1056", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 637040 ], "weight": 5, "year": 2002, "pin_cites": [ { "page": "1062" }, { "page": "1062" }, { "page": "1062" }, { "page": "1062" }, { "page": "1062" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/335/1056-01" ] }, { "cite": "847 N.E.2d 810", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2006, "opinion_index": 0 }, { "cite": "365 Ill. App. 3d 155", "category": "reporters:state", "reporter": "Ill. 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App. 3d", "case_ids": [ 4272561 ], "weight": 8, "year": 2007, "pin_cites": [ { "page": "22" }, { "page": "22-23" }, { "page": "23" }, { "page": "23" }, { "page": "23" }, { "page": "23" }, { "page": "23" }, { "page": "23" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/375/0016-01" ] }, { "cite": "539 N.E.2d 1243", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 1989, "opinion_index": 0 }, { "cite": "128 Ill. 2d 490", "category": "reporters:state", "reporter": "Ill. 2d", "case_ids": [ 3228351 ], "year": 1989, "pin_cites": [ { "page": "497-99" } ], "opinion_index": 0, "case_paths": [ "/ill-2d/128/0490-01" ] }, { "cite": "833 N.E.2d 983", "category": "reporters:state_regional", "reporter": "N.E.2d", "year": 2005, "opinion_index": 0 }, { "cite": "359 Ill. App. 3d 152", "category": "reporters:state", "reporter": "Ill. App. 3d", "case_ids": [ 5596361 ], "weight": 2, "year": 2005, "pin_cites": [ { "page": "166" }, { "page": "166" } ], "opinion_index": 0, "case_paths": [ "/ill-app-3d/359/0152-01" ] } ], "analysis": { "cardinality": 1584, "char_count": 52068, "ocr_confidence": 0.758, "pagerank": { "raw": 4.46765605076141e-08, "percentile": 0.28008466902896656 }, "sha256": "c6f73d888f2fd09a64185c519e4919f6eb513bbcc3aefe1c7c36e7640344e990", "simhash": "1:3eb990fa89df34c5", "word_count": 8077 }, "last_updated": "2023-07-14T21:39:01.503812+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [], "parties": [ "KEITH DOOKERAN, Plaintiff-Appellee and Cross-Appellant, v. THE COUNTY OF COOK, Defendant-Appellant and Cross-Appellee." ], "opinions": [ { "text": "JUSTICE GARCIA\ndelivered the opinion of the court:\nThis appeal and cross-appeal arise from Dr. Keith Dookeran\u2019s petition for review, through a common law writ of certiorari, of the Cook County Board\u2019s denial of his 2004 application for reappointment to the medical staff at John H. Stroger, Jr., Hospital of Cook County (Stroger). Dr. Dookeran was first hired by Stroger in 2000, subject to biennial reappointments. In his 2004 reappointment application, Dr. Dookeran revealed for the first time that he received a formal reprimand from his previous employer. Neither his initial 1999 application nor his 2002 reappointment application detailed the reprimand. Several administrative committees at Stroger conducted inquiries into the omission and discovered both the details of the previous reprimand and a series of allegations that Dr. Dookeran behaved unprofessionally toward students, staff, and colleagues at Stroger. Pursuant to Stroger\u2019s medical staff bylaws (bylaws), a hearing committee was formed and heard testimony concerning the allegations against Dr. Dookeran.\nBased on its findings, the hearing committee recommended that Dr. Dookeran\u2019s reappointment application be denied. Although other administrative committees disagreed, the Cook County Board adopted the hearing committee\u2019s recommendation and denied Dr. Dookeran\u2019s reappointment application. Dr. Dookeran filed a petition for a writ of certiorari in the circuit court. Judge Kathleen M. Pantle reversed the Board\u2019s denial of Dr. Dookeran\u2019s reappointment in favor of the reprimand recommended by Stroger\u2019s executive medical staff (EMS) to suspend Dr. Dookeran\u2019s clinical privileges for 30 days.\nCook County appeals, arguing that Judge Pantle failed to give due deference to the facts set out in the administrative record supporting the Board\u2019s denial of Dr. Dookeran\u2019s reappointment.\nDr. Dookeran cross-appeals from the 30-day suspension.\nBecause the Board\u2019s decision to deny reappointment was not arbitrary or capricious, we affirm the Board\u2019s decision and reverse Judge Pantle\u2019s order.\nBACKGROUND\nDr. Dookeran\u2019s Employment History\nIn January 1997, Dr. Dookeran was hired at Mercy Hospital in Pittsburgh (Mercy) as a general surgeon and surgical oncologist. On November 18, 1998, Dr. Ronald Boron, chairman of the medical executive committee at Mercy, sent Dr. Dookeran a letter formally reprimanding him for \u201ccreating] a hostile work environment.\u201d The letter requested that Dr. Dookeran \u201crefrain from screaming and yelling at, berating, threatening and intimidating Mercy Hospital employees,\u201d and noted that \u201c[f]urther outbursts and disruptive behavior of this type\u201d would lead to \u201cmore serious action.\u201d In the letter, Mercy\u2019s medical executive committee recommended that Dr. Dookeran \u201cseek help in the form of counseling to assist in the control of this behavior.\u201d\nAlso in November 1998, Dr. Dookeran received a letter from the Greater Pittsburgh Surgical Associates (Greater Pittsburgh), a group practice at Mercy, terminating his position as director of surgical research and associate program director of the general surgery residency program. According to the letter, the terminations were \u201ca consequence of [Dr. Dookeran\u2019s] unprofessional conduct toward Mercy Hospital employees.\u201d\nApplications and Appointments at Stroger\nIn 1999, Dr. Dookeran applied for a position in the surgery department at Stroger. In his application, Dr. Dookeran noted that his contract with the Greater Pittsburgh practice group was terminated in November 1998. Although the application form asked if Dr. Dookeran\u2019s clinical privileges had ever been revoked, it did not request information regarding formal reprimands; Dr. Dookeran\u2019s application did not disclose his reprimand letter from Mercy. Dr. Dookeran\u2019s application included a letter of recommendation from Dr. Howard Zaren, who supervised Dr. Dookeran at Mercy and in 1999 was chairman of Stroger\u2019s surgery department. Dr. Zaren would later testify before Stroger\u2019s hearing committee that he was aware of Dr. Dookeran\u2019s Mercy reprimand when he wrote the recommendation, but he believed the reprimand was \u201cretaliation for a whistle blowing situation\u201d wherein Dr. Dookeran allegedly discovered that doctors at the Mercy Cancer Institute forged their names on a grant application Dr. Dookeran prepared. In his recommendation, Dr. Zaren did not mention the reprimand letter and rated Dr. Dookeran\u2019s relationships with students, colleagues, and paramedical staff as exceptional. Based in part on Dr. Zaren\u2019s recommendation, Cook County appointed Dr. Dookeran to the Stroger medical staff as an attending physician with clinical privileges.\nAfter his appointment, Dr. Dookeran was required by the bylaws to apply for reappointment biennially. In July 2002, Dr. Dookeran submitted an application for reappointment to his department chair, Dr. Zaren, who pursuant to the bylaws then submitted it to Stroger\u2019s credentials committee. On the form, Dr. Dookeran indicated that he had not been reprimanded by any health care organization over the prior four years, failing to note Mercy\u2019s reprimand three years and eight months earlier. Dr. Dookeran was reappointed.\nIn April 2004, Dr. Dookeran again applied for reappointment by submitting the same form to Dr. Zaren and the credentials committee. However, on the 2004 application Dr. Dookeran fully disclosed the details of his Mercy reprimand, which by this point dated back nearly seven years.\nAdministrative Review at Stroger\nThe credentials committee requested in writing that Dr. Dookeran explain his failure to disclose Mercy\u2019s reprimand in either his 1999 job application or his 2002 reappointment application. In response, Dr. Dookeran wrote to the committee that the 1999 application form did not request information on reprimands, and that in July 2002 he \u201cperhaps believed that the reprimand had occurred almost four years previously and that there was no need for reporting.\u201d Dr. Dookeran added, \u201c[i]n my 2004 reapplication, I did not need to report the reprimand since it occurred 7 years ago, however, I did so in error.\u201d Subsequently, the credentials committee interviewed Dr. Dookeran and several other members of Stroger\u2019s staff to determine whether his behavior at Stroger was similarly unprofessional as his conduct at Mercy.\nPursuant to the bylaws, the credentials committee submitted a recommendation to deny Dr. Dookeran\u2019s reappointment application to the executive medical staff (EMS). The bylaws provide that the EMS should review the credentials committee\u2019s recommendation and submit a recommendation of its own to the medical director and the joint conference committee, which advises the Cook County Board on its final decision. However, the bylaws permit an alternative path for review; any staff member can file a report with the peer review committee whenever the conduct of a practitioner threatens patient safety or falls below professional standards. Before making its recommendation to the medical director and joint conference committee, the EMS utilized this alternative and referred the matter to the peer review committee to investigate Dr. Dookeran\u2019s alleged misconduct at Stroger.\nThe peer review committee reviewed the credentials committee\u2019s report, met with members of the credentials committee, and interviewed Dr. Dookeran, Dr. Zaren, and several other members of Stroger\u2019s staff. The peer review committee then issued a written recommendation to the EMS. In its recommendation, the peer review committee concluded that Dr. Dookeran \u201cwillfully falsified\u201d his 2002 reappointment application by denying the existence of the Mercy reprimand letter, and that Dr. Dookeran \u201chas a long history of inappropriate behavior with hospital personnel\u201d which \u201cconsists of verbal abuse.\u201d The committee also found that Dr. Dookeran \u201chas not shown the ability or willingness to change his behavior.\u201d However, the peer review committee recommended only a 29-day suspension of Dr. Dookeran\u2019s clinical privileges.\nThe EMS reviewed the peer review committee\u2019s recommendation and adopted it, but increased the length of the suggested suspension to 30 days. This would require Dr. Dookeran to report the suspension to the national physician data bank and adversely affect his future employment prospects. The bylaws provide that when the EMS makes such an adverse recommendation against a practitioner, it triggers that practitioner\u2019s right to a \u201chearing and appeal\u201d challenging that unfavorable decision before it is submitted to the joint conference committee. The bylaws further provided that at such a hearing, the practitioner \u201cshall have the burden of proving, by clear and convincing evidence, that the adverse action or recommendation lacks a factual basis or that the adverse action or recommendation is arbitrary, capricious or unreasonable.\u201d At Dr. Dookeran\u2019s request, a hearing committee composed of five attending members of the medical staff not previously involved in the case was appointed to hear his appeal.\nTestimony Before the Hearing Committee\nThe testimony before the hearing committee concerned Dr. Dookeran\u2019s reappointment applications and several allegations of unprofessional conduct by Dr. Dookeran at Stroger. Because the testimony was given at several different times based upon the availability of the relevant witnesses, we present it below according to its subject matter.\nDr. Dookeran\u2019s Reappointment Applications\nIn his testimony before the hearing committee, Dr. Dookeran admitted it was an error not to disclose his reprimand letter from Mercy on his 2002 reappointment application, but added that he \u201cinterpreted [the disclosure period] to be roughly four years.\u201d Dr. Dookeran testified that he received the reprimand after the vice president of Mercy Cancer Institute solicited false complaints against him in retaliation for Dr. Dookeran \u201cblowing the whistle\u201d on a fraudulent application for a research grant from the National Cancer Institute. Dr. Zaren also testified that he believed Dr. Dookeran received his reprimand letter from Mercy \u201cin retaliation\u201d for reporting the allegedly fraudulent grant application.\nIncidents With Rush University\nDr. Larry Goodman testified that in 2001 he was the dean of the Rush University Medical School. In 2001, Rush medical students did surgery rotations at Stroger, where Dr. Dookeran was appointed student site coordinator. Dr. Goodman testified that some of the students\u2019 written evaluations \u201cdescribed an environment *** that I thought was problematic.\u201d Specifically, Dr. Goodman recalled that one student used the term \u201cbullying\u201d to describe Dr. Dookeran\u2019s treatment of students. Dr. Goodman wrote a letter to Dr. Zaren indicating that he was assigning a new site coordinator and would not allow students to rotate in clinics or the operating room with Dr. Dookeran. Dr. Goodman never took similar actions with any other site coordinator.\nDr. Linnea Hauge, an assistant professor in the general surgery department at Rush, testified that she was also involved in the decision to remove Dr. Dookeran as site director. She testified that Rush students registered complaints against Dr. Dookeran for his \u201cintimidating behaviors and inappropriate language,\u201d as well as \u201cunprofessional interactions with students.\u201d Dr. Hauge also testified to unprofessional conduct by Dr. Dookeran directed at her. In 2000 she sought approval from Drs. Zaren and Dookeran to conduct a study at Stroger in her specialty, sports psychology. Drs. Zaren and Dookeran indicated that they would not approve the study unless it \u201c[had] their name on it\u201d as authors, although they did not intend to participate in the study as required for authorship credit under American Medical Association standards. Dr. Hauge testified that Dr. Dookeran \u201cinsulted and berated\u201d her and never approved the study.\nDr. Zaren testified that Dr. Goodman\u2019s concern about Rush medical students\u2019 complaints was \u201cstrange\u201d because Dr. Zaren had \u201cseen *** similar evaluations in the past in every medical school relationship that [he was] involved in.\u201d Nonetheless, Dr. Zaren admitted that he \u201cthought that [the complaints] were perhaps troublesome.\u201d He agreed with Dr. Goodman that Dr. Dookeran should no longer have contact. with Rush students and initiated sensitivity training at every level of the surgery department.\nIn response to the allegations of Drs. Goodman and Hauge, Dr. Dookeran testified that his position at Stroger required him to account for the costs and benefits of the Rush program, which led to tension with Rush administrators. He testified that their decision to remove him as Rush site coordinator and their testimony at the hearing were motivated by that conflict. Dr. Dookeran claimed that Dr. Hauge was lying when she testified that he and Dr. Zaren refused to approve her study unless they were credited as co-authors.\nChicago Medical School Incidents\nDr. Lecia Apantaku testified that she is the director of undergraduate education for the department of surgery at the Chicago Medical School (CMS) and oversees the surgical education of students, including their surgical rotations at Stroger. In 2001, Dr. Dookeran was internal coordinator for CMS students at Stroger. Dr. Apantaku testified that some of the students complained of being \u201cberated publicly\u201d by Dr. Dookeran. In February 2004, Dr. Apantaku called Dr. Dookeran to address the complaints. Dr. Dookeran claimed that those who registered complaints were poor students, then Dr. Dookeran resigned as the internal coordinator. Dr. Apantaku testified that after Dr. Dookeran\u2019s resignation, she received a letter from a student, Roderick Hart, in which he claimed that Dr. Dookeran \u201cunjustly criticized [him] in public in a very unprofessional manner.\u201d Because Dr. Dookeran had already resigned his position with CMS, she did not pursue the matter.\nIn response to the allegations of misconduct toward CMS students, Dr. Dookeran testified that Dr. Apantaku never contacted him about complaints from students. He testified that he resigned as site coordinator \u201cbecause it was too much work.\u201d\nDr. Zaren testified that he met with Roderick Hart. Dr. Zaren was \u201cperplexed\u201d by Hart\u2019s complaints of racial discrimination because both Hart and Dr. Dookeran are black. Nonetheless, he told Hart that he could change Hart\u2019s rotation. Dr. Zaren also testified that all students complain when they receive negative evaluations.\nRelationship With Dr. Robert Walter\nDr. Robert Walter testified that prior to 2003 he was a scientific officer in the department of surgery at Stroger. His primary duties were to run a laboratory and conduct a research program. In 2002, Dr. Dookeran became Dr. Walter\u2019s supervisor. In 2003, Dr. Dookeran began requiring Dr. Walter to use a time clock to prove his attendance at the hospital because Dr. Dookeran repeatedly had difficulty locating Dr. Walter during work hours. Dr. Walter testified that to his knowledge no other scientific officers at Stroger are required to use a time clock.\nIn January 2003, Dr. Walter attended a meeting with Drs. Zaren and Dookeran at which Dr. Dookeran asked Dr. Walter to explain how the department of surgery benefitted from the various \u201ccollaborative projects\u201d Dr. Walter conducted with doctors in other departments and at other institutions. According to Dr. Walter\u2019s testimony, Dr. Dookeran asked how the department of surgery would be \u201cpaid back\u201d for his time, and at one point suggested that \u201cone of the ways the Department [of surgery] could be compensated is if these people that I was collaborating with were to pay *** for instance, to a Hektoen [bank] account. They could pay a monetary amount and then he said possibly to my Hektoen account.\u201d Dr. Walter testified that he was \u201cstunned,\u201d and subsequently he wrote a memo to Drs. Dookeran and Zaren asking for clarification. In response, Dr. Dookeran called Dr. Walter into his office, \u201cthen just started to rage *** and have a tirade about this memo\u201d for 10 to 15 minutes. Dr. Walter testified that Dr. Dookeran began \u201cshouting down at me and calling me a liar.\u201d\nDr. Zaren testified that Dr. Walter\u2019s testimony about the January 2003 meeting was \u201c[absolutely untrue.\u201d He also testified that Dr. Walter refused to follow the rules and regulations that Dr. Zaren established for him, and that any timekeeping requirements Dr. Dookeran imposed were at Dr. Zaren\u2019s behest. Dr. Zaren testified that Dr. Walter was subsequently transferred to the trauma burn department.\nDr. Dookeran testified that Dr. Walter was an unhelpful employee that refused to aid Drs. Dookeran and Zaren in developing a cancer center at Stroger. He testified that \u201ca lot\u201d of Dr. Walter\u2019s testimony did not \u201cadequately represent what happened.\u201d\nErica Radeke, an administrator that worked with Dr. Dookeran, testified that she shared an office with Dr. Dookeran and was present when Dr. Dookeran called Dr. Walter into the office to discuss his memo. Radeke testified that Dr. Dookeran was not threatening and did not call Dr. Walter a liar. She added that it was \u201cpublic knowledge\u201d that Dr. Dookeran was \u201ca little bit deaf,\u201d which often caused him to talk louder than most people.\nConduct Toward Dr. Gabriela Oana\nDr. John Greager, chairman of surgical oncology at Stroger, testified that in 2004 he received a letter from another student, Dr. Gabriela Oana, claiming that \u201cDr. Dookeran [did not act] in what was conceived as a professional manner\u201d when he paged her repeatedly during surgery and yelled at her. Dr. Greager wrote a memo to the associate chairwoman of education at Stroger requesting that Dr. Oana be reappointed in future rotations. Dr. Greager also testified that \u201ca number of incidences [were] reported to myself and others regarding a similar kind of scenario.\u201d\nNurse Luth Mendoza testified on Dr. Dookeran\u2019s behalf about the alleged incident in 2004 involving Dr. Oana. She testified that she was asked by Dr. Dookeran to page Dr. Oana repeatedly to join him in surgery, but Dr. Oana did not respond. When she later saw Dr. Oana in surgery with Dr. Dookeran, she did not see Dr. Dookeran yell at or threaten Dr. Oana. Nurse Alfredo Lazo also testified that he was in the operating room at the time of the incident and that Dr. Dookeran did not yell at Dr. Oana.\nDr. Dookeran testified that a number of the complaints against him \u201chave to do with Dr. Greager and people concerned with Dr. Greager,\u201d but suggested that these complaints were made in retaliation for \u201can altercation\u201d between Dr. Greager and Dr. Dookeran\u2019s staff.\nOther Incidents With Stroger Staff\nNurses Lori Supol and Adelina Jonson each testified that on May 10, 2004, Dr. Dookeran walked outside an operating room during a surgical procedure and started \u201cyelling\u201d for fixative that should have been kept stocked in the room. Nurse Jonson also read the statements of technician Joven Visperas and nurse Myung Earn into evidence, each of which confirmed the incident. Physician\u2019s assistant Wendy Rogowski testified that she was assisting Dr. Dookeran during the procedure on May 10, 2004. She testified that Dr. Dookeran left the room and stated that fixative \u201cwas needed now in a firmness,\u201d but his actions were appropriate for the case because fixative was needed immediately to complete a surgical procedure on a patient.\nNurse Celine Drwiega testified that on two occasions she was subjected to Dr. Dookeran\u2019s \u201cverbal abuse and bullying.\u201d In the first instance, she was assisting Dr. Dookeran on a breast biopsy. She removed a clamp from a tissue sample, accidentally dislodging a wire necessary to handle the sample. Nurse Drwiega testified that Dr. Dookeran repeatedly shouted \u201cyou are the most incompetent nurse, why did you remove that [clamp]?\u201d\nOn another occasion, Nurse Drwiega was assigned to prepare a room for a surgery Dr. Dookeran was to perform. When Dr. Dookeran arrived, an instrument requested by the anesthesiologist was being sterilized elsewhere and, thus, the room was not ready. Dr. Dookeran \u201cbecame angry and shouted loudly at me \u2018ymi are ignorant and I\u2019m not the only one that thinks so.\u2019 \u201d He also called nurse Drwiega incompetent.\nSusanne Klein, Stroger\u2019s director of quality assurance, testified that during a training session for the Illinois Department of Public Health\u2019s survey staff in 2004, a surveyor observed Dr. Dookeran become angry during a surgery. The surveyor said that Dr. Dookeran was \u201cvery unhappy with the staff in the room.\u201d Klein testified that this was the only time in her 15 years as director of quality assurance that a surveyor had brought a surgeon\u2019s behavior to her attention.\nPeer Review Committee Testimony\nDr. Jay Mayefsky, the chairman of the peer review committee, testified that during the peer review committee\u2019s interview with Dr. Dookeran, he asked Dr. Dookeran two questions in quick succession. Dr. Dookeran \u201cexploded in fury, accusing [Dr. Mayefsky] of not being courteous to him and was really, really angry.\u201d Dr. Robert Kern, another member of the peer review committee, also testified before the hearing committee. According to Dr. Kern\u2019s testimony, Dr. Dookeran did not \u201cexplode\u201d at Dr. Mayefsky, but only became \u201csomewhat defensive.\u201d Dr. Kern testified that he would react similarly in a \u201ctense situation.\u201d\nCharacter Witnesses\nDr. Dookeran called several witnesses to testify to his professional character. Drs. Caroline Lopez, Karen Ferrer, and Marin Sekosan each testified that they saw Dr. Dookeran work with other staff members and students, and they had not seen him act unprofessionally nor had they heard any complaints about Dr. Dookeran\u2019s behavior.\nHearing Committee Recommendation\nAfter considering the above testimony, the hearing committee submitted written findings to the EMS president in accordance with the bylaws. The hearing committee found that Dr. Dookeran failed to provide \u201cclear and convincing evidence *** that he did not willfully falsify his 2002 reappointment application,\u201d and did not \u201cprovide convincing evidence that he did not display abusive or unprofessional behavior toward the several people presented at this hearing.\u201d The committee lamented that \u201c[w]ith absolutely no insight into his problem with anger management, one cannot expect that it will ever change.\u201d Dr. Dookeran \u201cfailed *** to successfully challenge the credibility of the evidence,\u201d and thus the hearing committee concluded that \u201cthe Credential Committee\u2019s recommendation [to deny reappointment] is based on fact and is not arbitrary, capricious or unreasonable.\u201d Choosing from six possible sanctions listed in the bylaws, the hearing committee recommended to the EMS the most severe: suspension or revocation of Dr. Dookeran\u2019s staff membership.\nFinal Action and Circuit Court Review\nIn accordance with the bylaws, the EMS reviewed the hearing committee\u2019s recommendation and made a recommendation of its own to the medical director and joint conference committee. The EMS again recommended a 30-day suspension of Dr. Dookeran\u2019s clinical privileges. However, the joint conference committee voted to adopt the hearing committee\u2019s position and revoke Dr. Dookeran\u2019s staff membership. The joint conference committee forwarded that recommendation to the Cook County Board for final action; on June 20, 2006, the Cook County Board adopted that recommendation and denied Dr. Dookeran\u2019s reappointment application, thereby terminating his employment at Stroger.\nDr. Dookeran filed a petition for a common law writ of certiorari in circuit court seeking review of the Cook County Board\u2019s action. On January 30, 2008, Judge Pantle issued an order in which she found that \u201cthere is ample evidence to support factual findings about a pattern of verbally abusive and inappropriate behavior on the part of Dr. Dookeran [and] that he failed to disclose [his Mercy reprimand] on his application for reappointment in 2002.\u201d However, Judge Pantle expressed concern with the hearing committee\u2019s recommendation, noting that it \u201ccontains no analysis of how the hearing committee came to [its] conclusion, and why lesser sanctions are inappropriate.\u201d Finding that the recommendation of the hearing committee, later adopted by the joint conference committee, \u201cis not supported by the facts,\u201d Judge Pantle \u201cvacated\u201d the denial of reappointment and \u201cremanded to the hearing committee to recommend a lesser sanction.\u201d\nCook County filed a motion for reconsideration. On April 30, 2008, Judge Pantle denied the motion, noting that the joint conference committee\u2019s \u201clack of any reasoning, coupled with the imposition of a burden on Dr. Dookeran to prove that the allegations did not occur (a burden which is contrary to well-established principles of law), warrant the conclusion that there is no competent evidence of record which supports the sanction imposed.\u201d However, Judge Pantle granted Cook County\u2019s motion for modification of the April 30, 2008, judgment; on May 16, 2008, Judge Pantle entered an order remanding to the Cook County Board to enter an order suspending Dr. Dookeran\u2019s clinical privileges for 30 days as recommended by the EMS. Judge Pantle noted that the May 16, 2008, order was final and appealable. Cook County timely appealed, and Dr. Dookeran timely cross-appealed.\nANALYSIS\nStandard of Review\n\u201cA common law writ of certiorari is a general method for obtaining court review of administrative actions when the act conferring power on the agency does not expressly adopt the Administrative Review Law [citation], and provides for no other form of review.\u201d Lapp v. Village of Winnetka, 359 Ill. App. 3d 152, 166, 833 N.E.2d 983 (2005), citing Dubin v. Personnel Board, 128 Ill. 2d 490, 497-99, 539 N.E.2d 1243 (1989). The standard of review of a writ of certiorari is identical to that under the Administrative Review Law (735 ILCS 5/3 \u2014 101 et seq. (West 2006)). Lapp, 359 Ill. App. 3d at 166.\nIn administrative review cases, we review the decision of the administrative agency, not the decision of the circuit court. Gaston v. CHAC, Inc., 375 Ill. App. 3d 16, 22, 872 N.E.2d 38 (2007), citing Ahmad v. Board of Education, 365 Ill. App. 3d 155, 162, 847 N.E.2d 810 (2006). Our review of an administrative agency\u2019s discharge of an employee proceeds in two stages: first we determine if the agency\u2019s findings of fact are contrary to the manifest weight of the evidence; then we decide whether \u201cthe agency\u2019s factual findings provide a sufficient basis for concluding \u2018cause\u2019 for discharge exists.\u201d Applegate v. Department of Transportation, 335 Ill. App. 3d 1056, 1062, 783 N.E.2d 96 (2002), citing Grames v. Illinois State Police, 254 Ill. App. 3d 191, 204-05, 625 N.E.2d 945 (1993).\nAt the first stage, we take the administrative agency\u2019s factual findings as prima facie true and correct; we will not reverse those findings unless they are against the manifest weight of the evidence. Gaston, 375 Ill. App. 3d at 22-23, citing Ahmad, 365 Ill. App. 3d at 162. On factual questions, we review the administrator or committee that \u201cacts as a fact finder, hearing testimony, determining the credibility of witnesses and drawing reasonable inferences from the evidence\u201d (Gaston, 375 Ill. App. 3d at 23, citing Ahmad, 365 Ill. App. 3d at 162); in this case, the hearing committee played that role.\nAt the second stage, we will overturn \u201ca public hospital\u2019s rejection of an application for staff membership *** [only] if the rejection was arbitrary, capricious or unreasonable.\u201d Evers v. Edward Hospital Ass\u2019n, 247 Ill. App. 3d 717, 729, 617 N.E.2d 1211 (1993), citing Mauer v. Highland Park Hospital Foundation, 90 Ill. App. 2d 409, 413, 232 N.E.2d 776 (1967).\nHearing Committee\u2019s Factual Findings\nIn its appeal, Cook County contends that the denial of Dr. Dookeran\u2019s reappointment application is not arbitrary or unreasonable, but is properly based upon the factual findings of the hearing committee, which Judge Pantle did not overturn. Thus, Cook County\u2019s appeal concerns only the second stage of review. See Applegate, 335 Ill. App. 3d at 1062, citing Grames, 254 Ill. App. 3d at 204-05. However, in his cross-appeal, Dr. Dookeran challenges nearly all of the hearing committee\u2019s factual findings, arguing that they are contrary to the manifest weight of the evidence and, thus, cannot support any adverse action. Because Dr. Dookeran\u2019s claims on cross-appeal address the hearing committee\u2019s factual findings, properly the subject of the first stage of our review, it is appropriate we address those claims first.\nAt the outset, we note Judge Pantle\u2019s concern that Dr. Dookeran bore the burden at the hearing to present clear and convincing evidence that the EMS lacked a factual basis to take the recommended adverse action. That the evidentiary burden falls on Dr. Dookeran is clearly set forth in the bylaws describing the hearing and appeal procedure. The hearing and appeal procedure was only triggered after the adverse recommendation was issued against Dr. Dookeran. We note that Dr. Dookeran does not challenge the validity of the bylaws that he bears the burden of challenging the factual basis for the adverse action. Where the bylaws themselves are not challenged, our review is limited to ensuring that the bylaws are duly followed. See, e.g., Goldberg v. Rush University Medical Center, 371 Ill. App. 3d 597, 602, 863 N.E.2d 829 (2007) (review of a hospital\u2019s dismissal is limited to whether the hospital complied with its bylaws). Further, we note that Illinois courts have consistently held that \u201ca plaintiff to an administrative proceeding holds the burden of proof, and relief will be denied if he or she fails to sustain that burden.\u201d Miller v. Hill, 337 Ill. App. 3d 210, 216, 785 N.E.2d 532 (2003), citing Iwanski v. Streamwood Police Pension Board, 232 Ill. App. 3d 180, 184, 596 N.E.2d 691 (1992). A clear-and-convincing-evidence burden is placed upon plaintiffs to administrative hearings in other contexts, such as a taxpayer contesting an assessment (United Airlines, Inc. v. Pappas, 348 Ill. App. 3d 563, 569, 809 N.E.2d 735 (2004)) or a driver petitioning for a restricted driving permit after a DUI-related license revocation (Cisneros v. White, 337 Ill. App. 3d 93, 103, 785 N.E.2d 99 (2003)). We do not share Judge Pantle\u2019s concern with Dr. Dookeran\u2019s burden at the \u201chearing and appeal\u201d as provided by the bylaws to challenge the findings of the hearing committee.\nDr. Dookeran first contends the hearing committee\u2019s finding that he willfully falsified his 2002 reappointment application is contrary to the manifest weight of the evidence. Dr. Dookeran points to Dr. Zaren\u2019s knowledge of the Mercy reprimand as evidence that he did not intentionally omit the information. We disagree. Dr. Zaren\u2019s awareness of Dr. Dookeran\u2019s Mercy reprimand is irrelevant; the 2002 reappointment application made clear that \u201comission of information may be grounds for rejection or termination.\u201d Dr. Dookeran admitted before the hearing committee that he indicated that he had not been reprimanded by any health care organization over the prior four years in his 2002 application. His later disclosure of the Mercy reprimand on his 2004 reappointment application did not absolve his 2002 omission. Dr. Dookeran\u2019s assertion that he \u201cinterpreted [the disclosure period] to be roughly four years\u201d does not explain the omission of the reprimand that fell within the four-year time period. The 2002 reappointment form\u2019s language is clear: Dr. Dookeran was required to disclose the Mercy reprimand because it was issued less than four years prior. Nor was disclosing his termination from the Greater Pittsburgh practice group in his 1999 application for the position at Stroger equivalent to disclosing the reprimand he received from Mercy itself. We find no evidence to undermine the hearing committee\u2019s finding that Dr. Dookeran willfully falsified his 2002 reappointment application.\nNext, Dr. Dookeran challenges the hearing committee\u2019s finding that he behaved unprofessionally toward Rush medical students and administrators. Dr. Goodman provided testimony about the nature of student evaluations he received from Rush students concerning Dr. Dookeran and recalled specifically one student referring to Dr. Dookeran\u2019s conduct as \u201cbullying.\u201d Dr. Goodman removed Dr. Dookeran as student coordinator for Rush medical students, an action he had never taken with another student coordinator in 15 years. The hearing committee specifically found Dr. Goodman\u2019s testimony credible. Dr. Goodman\u2019s testimony was reinforced by Dr. Hauge\u2019s testimony that Rush students complained that Dr. Dookeran acted unprofessionally in the course of instructing them.\nDr. Dookeran argues that this testimony is hearsay and therefore cannot constitute evidence of specific instances of misconduct, an assertion he repeats throughout his challenges to the various factual findings by the hearing committee. The bylaws, however, make clear that the hearing committee is not required to adhere to \u201cstrict rules of evidence\u201d and that \u201c[a]ny relevant matter upon which responsible persons customarily rely in the conduct of serious affairs [may] be admitted regardless of the admissibility of such evidence in a court of law.\u201d Dr. Dookeran does not contend that testimony attributed to the Rush medical students was not admissible under the bylaws. See Pulido v. St. Joseph Memorial Hospital, 191 Ill. App. 3d 694, 701-02, 547 N.E.2d 1383 (1989) (admission of testimony that was arguably hearsay at a suspension hearing did not violate an identical bylaw concerning admission of evidence). The testimony from Drs. Goodman and Hauge demonstrated a pattern of student complaints against Dr. Dookeran. Contrary to Dr. Dookeran\u2019s argument, the hearing committee was under no obligation to credit his explanation that the complaints were the result of economic concerns he raised regarding the Rush program, which Drs. Goodman and Hauge both favored, and that his removal was precipitated by that conflict. The hearing committee was free to rely upon the testimony of Drs. Goodman and Hauge to support its finding that Dr. Dookeran \u201cfailed to provide clear and convincing evidence that he did not act unprofessionally toward medical students from Rush.\u201d See Gaston, 375 Ill. App. 3d at 23, citing Ahmad, 365 Ill. App. 3d at 162.\nWe are also unpersuaded by the challenge to Dr. Hauge\u2019s testimony that Dr. Dookeran \u201cinsulted and berated\u201d her when she declined to add Dr. Dookeran and Dr. Zaren as co-authors of a study she sought approval for, which the two declined to give. Although Drs. Dookeran and Zaren testified that they did not make any inappropriate requests, the hearing committee was free to resolve this conflict in testimony in favor of Dr. Hauge. Gaston, 375 Ill. App. 3d at 23, citing Ahmad, 365 Ill. App. 3d at 162. Further, Dr. Dookeran provided no evidence contradicting Dr. Hauge\u2019s testimony that he later berated her in a telephone call about her study. Absent conflicting testimony, the hearing committee was free to credit Dr. Hauge\u2019s testimony that Dr. Dookeran berated her as another example of Dr. Dookeran\u2019s unprofessional behavior.\nDr. Dookeran next challenges the committee\u2019s finding that he acted unprofessionally toward CMS medical students, which the committee found was not overcome by clear and convincing evidence. Dr. Dookeran essentially argues that the hearing committee should have taken as true his testimony that he resigned his position as a CMS internal coordinator because it required too much work and his testimony that Dr. Apantaku never contacted him about a series of complaints from students concerning his unprofessional behavior. Again, it was for the committee to decide which of the conflicting versions it found credible and, once again, the committee found against the version offered by Dr. Dookeran. Gaston, 375 Ill. App. 3d at 23, citing Ahmad, 365 Ill. App. 3d at 162. Dr. Apantaku testified that several students complained that Dr. Dookeran publicly berated them, and when she called Dr. Dookeran to discuss the complaints, he resigned. She specifically recalled an incident where Dr. Dookeran called her and wanted a student removed because \u201cthe student wasn\u2019t wearing an appropriately clean white coat.\u201d Dr. Dookeran\u2019s argument that the letter written by Roderick Hart was explained away by a negative evaluation he received from Dr. Dookeran does not discredit the remaining evidence supporting the hearing committee\u2019s conclusion that Dr. Dookeran acted unprofessionally in his role as CMS\u2019s internal coordinator.\nNext, Dr. Dookeran contends he overcame by clear and convincing evidence the committee\u2019s finding that he displayed \u201cabusive and unprofessional behavior\u201d on May 10, 2004, in yelling for fixative outside an operating room. In this instance, Dr. Dookeran\u2019s position is well taken. While nurses Supol and Jonson each testified that Dr. Dookeran started \u201cyelling\u201d for fixative, physician\u2019s assistant Wendy Rogowski testified only that Dr. Dookeran said that fixative \u201cwas needed now in a firmness.\u201d None of the testimony indicated that Dr. Dookeran used inappropriate language or berated any specific person. He wanted fixative, which should have been stocked in the operating room, quickly in order to properly complete a procedure on a patient. The manifest weight of the evidence does not support that Dr. Dookeran acted unprofessionally in what two witnesses characterized as \u201cyelling\u201d but another witness described as \u201cfirmness,\u201d for fixative to finish surgery for his patient\u2019s comfort and safety. However, this questionable finding does little to undercut the evidence demonstrating a pattern of unprofessional behavior on other occasions.\nThe next issue Dr. Dookeran raises concerns Dr. Walter\u2019s allegations. Dr. Dookeran attempts to justify the timekeeping requirements he placed on Dr. Walter, ignoring the testimony that no such requirements have ever been placed upon scientific officers at Stroger. Dr. Dookeran repeatedly asks us to credit his witnesses over Dr. Walter. He again presents Dr. Zaren\u2019s testimony that Dr. Walter fabricated his testimony that Dr. Dookeran requested contributions to his personal bank account. He also emphasizes administrator Radeke\u2019s testimony that Dr. Dookeran did not go on a \u201ctirade\u201d about the memo Dr. Walter wrote asking for clarification of Dr. Dookeran\u2019s personal contribution request. Once again, we decline Dr. Dookeran\u2019s implied invitation that we substitute our assessment of the evidence for the hearing committee\u2019s assessment that Dr. Walter\u2019s testimony credibly demonstrated that Dr. Dookeran behaved unprofessionally. Gaston, 375 Ill. App. 3d at 23, citing Ahmad, 365 Ill. App. 3d at 162.\nDr. Dookeran next disputes the hearing committee\u2019s finding that clear and convincing evidence was not marshaled to overcome the finding that Dr. Dookeran acted in an abusive and unprofessional manner toward Dr. Oana. Dr. Dookeran\u2019s argument again highlights the conflict in the evidence. He relies on the testimony of two nurses that did not see him yell at Dr. Oana when she did not respond to repeated pages asking her to join him in surgery. However, Dr. Oana\u2019s letter indicated that Dr. Dookeran acted unprofessionally. That Dr. Oana was still willing to work with Dr. Dookeran following the incident does not prove that the incident never occurred. Dr. Dookeran\u2019s reliance upon a memo from Dr. Bass, who investigated the incident nearly a month later, is misplaced; the memo does not absolve Dr. Dookeran of wrongdoing, but merely acknowledges that Dr. Oana and the two nurses had different perceptions of the incident and that more official channels of investigation, outlined in the bylaws and utilized in this case, are required to resolve such conflicts in perception. Further, Dr. Dookeran offers no challenge to Dr. Greager\u2019s testimony that he received reports of several other incidents of Dr. Dookeran\u2019s unprofessional behavior; it appears Dr. Dookeran has abandoned his trial testimony that the complaints were made in retaliation for an alleged altercation between Dr. Greager and Dr. Dookeran\u2019s staff. We find no basis to overturn these findings by the hearing committee.\nFinally, Dr. Dookeran challenges the hearing committee\u2019s reliance upon Dr. Mayefsky\u2019s testimony that Dr. Dookeran \u201cexploded in fury\u201d during his interview with the peer review committee, pointing to Dr. Kern\u2019s conflicting testimony that Dr. Dookeran only became \u201csomewhat defensive.\u201d Once again, the hearing committee was free to resolve this conflict in the evidence by crediting Dr. Mayefsky\u2019s testimony. Gaston, 375 Ill. App. 3d at 23, citing Ahmad, 365 Ill. App. 3d at 162.\nWe note that neither during the hearing nor on appeal has Dr. Dookeran challenged the testimony of nurse Celine Drwiega that on two specific occasions she was subjected to Dr. Dookeran\u2019s \u201cverbal abuse and bullying.\u201d Dr. Dookeran also does not attempt to explain the testimony of Stroger\u2019s director of quality assurance, Susanne Klein, who testified that an Illinois Department of Public Health surveyor reported his unprofessional behavior during a surgery in 2004.\nBased on our review of the record, the evidence presented at the hearing supported a finding that Dr. Dookeran engaged in a pattern of \u201cabusive or unprofessional behavior,\u201d separate and apart from his failure to disclose the Mercy reprimand on his 2002 reappointment application.\nDenial of Reappointment\nWe now turn to the second stage of our inquiry: whether the facts provided the Cook County Board with a sufficient basis for Dr. Dookeran\u2019s discharge. Applegate, 335 Ill. App. 3d at 1062, citing Grames, 254 Ill. App. 3d at 204-05.\nCook County contends that the denial of Dr. Dookeran\u2019s reappointment application should be sustained in light of the highly deferential standard of review, providing for reversal only if the decision is arbitrary or unreasonable. Dr. Dookeran responds that Cook County committed a due process violation by denying his reappointment based on what he characterizes as an accidental omission in his previous reappointment application regarding the Mercy reprimand and unreliable evidence that he engaged in abusive and unprofessional behavior at Stroger, which he contends, even if true, does not demonstrate that his behavior in any way affected patient care. On cross-appeal, he argues that the competent evidence was insufficient to support any suspension of his clinical privileges, an argument rejected by every reviewing committee at Stroger and by the circuit court below.\nThe Cook County Board\u2019s denial of reappointment as a sanction for Dr. Dookeran\u2019s omission of the Mercy reprimand on his 2002 reappointment application and his unprofessional conduct while at Stoger is subject to reversal only if it was arbitrary or unreasonable. Applegate, 335 Ill. App. 3d at 1062, citing Merrifield v. Illinois State Police Merit Board, 294 Ill. App. 3d 520, 530, 691 N.E.2d 191 (1998); Evers, 247 Ill. App. 3d at 729, citing Mauer, 90 Ill. App. 2d at 413. \u201cThe proper test is not whether the reviewing court would have imposed a lesser sanction if it were making the decision in the first place, but whether, in view of the circumstances, the agency acted unreasonably or arbitrarily in rendering its decision.\u201d Hickey v. Riera, 332 Ill. App. 3d 532, 547-48, 774 N.E.2d 1 (2001), citing Edwards v. Illinois Racing Board, 187 Ill. App. 3d 287, 293, 543 N.E.2d 172 (1989).\nReviewing courts defer to an administrative agency\u2019s \u201cexpertise and experience\u201d in determining the appropriateness of sanctions. Ulysse v. Lumpkin, 335 Ill. App. 3d 886, 893, 781 N.E.2d 415 (2002), citing Abrahamson v. Illinois Department of Professional Regulation, 153 Ill. 2d 76, 99, 606 N.E.2d 1111 (1992). Illinois courts have traditionally refused to review staffing decisions at private hospitals with only limited exceptions. Goldberg, 371 Ill. App. 3d at 601-02. \u201c \u2018 \u201cThe judicial reluctance to review these internal staff decisions reflects the unwillingness of courts to substitute their judgment for that of hospital officials with superior qualifications to consider and decide such issues.\u201d \u2019 \u201d Goldberg, 371 Ill. App. 3d at 602, quoting Garibaldi v. Applebaum, 194 Ill. 2d 438, 452, 742 N.E.2d 279 (2000), quoting Adkins v. Sarah Bush Lincoln Health Center, 129 Ill. 2d 497, 507, 544 N.E.2d 733 (1989).\nThe parties dispute whether Dr. Dookeran had a property or liberty interest in his 2004 reappointment so as to trigger due process protection. We find no reason to resolve the dispute because, as Dr. Dookeran readily admits, the denial of his reappointment application raises due process concerns only when the decision is shown to be arbitrary or capricious, the same standard applied to hospital staffing decisions in Illinois. Evers, 247 Ill. App. 3d at 729, citing Mauer, 90 Ill. App. 2d at 413. Because the standard is identical, it follows that if we find the Cook County Board\u2019s action is not arbitrary or capricious, Dr. Dookeran\u2019s due process claim also fails. See Lapidot v. Memorial Medical Center, 144 Ill. App. 3d 141, 494 N.E.2d 838 (1986)\nLapidot, upon which Cook County relies, is instructive. In that case, the plaintiff\u2019s medical staff privileges were revoked after the defendant hospital discovered that in his application, the plaintiff falsely stated that his privileges had never been suspended, diminished, or revoked at another hospital. Lapidot, 144 Ill. App. 3d at 142. The application form specifically stated that \u201cany significant misstatements and/or admissions from this application constitute cause for summary dismissal.\u201d Lapidot, 144 Ill. App. 3d at 150. The court noted that \u201cfalse answers on applications for employment have repeatedly been considered proper grounds for dismissal in various other contexts.\u201d Lapidot, 144 Ill. App. 3d at 151, citing Munoz v. Civil Service Comm\u2019n, 32 Ill. App. 3d 1052, 337 N.E.2d 344 (1975), Roundtree v. Board of Review, 4 Ill. App. 3d 695, 281 N.E.2d 360 (1972), and Price v. Civil Service Board, 123 Ill. App. 2d 2, 259 N.E.2d 613 (1970). The court held that in the context of medical services providers, false answers also constituted proper grounds for dismissal. Accordingly, the hospital \u201cwas within its rights in terminating staff privileges for what it considered to be a material misrepresentation.\u201d Lapidot, 144 Ill. App. 3d at 150.\nDr. Dookeran\u2019s reappointment application contained nearly identical language to the application form in Lapidot \u2014 \u201comission of information may be grounds for rejection or termination.\u201d In Lapidot, the doctor\u2019s failure to provide the required information on the application was deemed a denial of the existence of past sanctions. Lapidot, 144 Ill. App. 3d at 142. In the instant case, Dr. Dookeran was found to have \u201cwillfully falsified\u201d his 2002 reappointment application in failing to disclose the Mercy reprimand. In an attempt to avoid the application of the holding in Lapidot to his situation, Dr. Dookeran stresses that in Lapidot there were also allegations of improper patient care against the physician. Lapidot, 144 Ill. App. 3d at 150-51. That there were additional grounds to find against the plaintiff in Lapidot provides no basis to place Dr. Dookeran beyond the holding in Lapidot.\nThe hearing committee\u2019s factual findings make clear that Dr. Dookeran engaged in abusive and unprofessional conduct in his interactions with students, colleagues, and staff at Stroger. Even if we were to find a basis to question these findings, which we do not, the Lapidot court made clear that a material misrepresentation on an application alone can support a dismissal or, in this case, the rejection of Dr. Dookeran\u2019s reappointment application. Lapidot, 144 Ill. App. 3d at 151.\nDr. Dookeran argues that omission of the Mercy reprimand from his 2002 reappointment application was de minimus, especially in light of his later disclosure of that information in 2004. He further contends that his alleged unprofessional behavior, even if it occurred, did not jeopardize patient care and thus did not warrant sanctions.\nWe first point out that, even if Dr. Dookeran\u2019s actions did not directly affect patient care, the bylaws provide that corrective action against a practitioner is appropriate when either patient care is endangered or the practitioner\u2019s behavior is \u201clower than the ethical or other professional standards of the medical community.\u201d As noted above, the evidence presented at the hearing was more than sufficient to support the conclusion that Dr. Dookeran berated and often acted in a bullying manner with various members of the Stroger community, behavior that could properly be considered unprofessional and worthy of sanctions. Thus, Dr. Dookeran\u2019s argument on cross-appeal that no sanction of any sort was justified is simply not supported by the record.\nFurther, we find no basis to question the Cook County Board\u2019s decision to deny reappointment. See Applegate, 335 Ill. App. 3d at 1062. It is true that suspension or revocation of Dr. Dookeran\u2019s staff membership was the most severe sanction the bylaws permitted the hearing committee to recommend. However, the variation between the recommendations of the peer review committee, the EMS, and the hearing committee demonstrates the difficulty of determining the appropriate sanction even amongst experienced practitioners in the medical field. Given that difficulty, it is unclear how judicial intrusion into the Cook County Board\u2019s final decision can be justified given our lack of medical expertise or knowledge of the subtleties that might warrant one sanction over another. Ulysse, 335 Ill. App. 3d at 893, citing Abrahamson, 153 Ill. 2d at 99; Goldberg, 371 Ill. App. 3d at 602, citing Garibaldi, 194 Ill. 2d at 452, citing Adkins, 129 Ill. 2d at 507. The wiser course, in a case where there was ample evidence that Dr. Dookeran\u2019s professional conduct warranted a sanction, is to uphold the sanction the Cook County Board has determined is both reasonable and within the bylaws of Stroger hospital.\nWe reverse Judge Pantle\u2019s order and uphold the denial of Dr. Dookeran\u2019s 2004 reappointment application, thereby terminating his employment at Stroger.\nCONCLUSION\nA series of investigations by various administrative committees at Stroger hospital revealed that Dr. Dookeran falsified his 2002 reappointment application by failing to disclose an official reprimand from his previous employer and that Dr. Dookeran was involved in a series of incidents of abusive and unprofessional behavior. The testimony introduced before the Stroger hearing committee was more than sufficient to demonstrate the falsification and the improper conduct engaged in by Dr. Dookeran. Based upon the findings of fact issued by the hearing committee, the Cook County Board\u2019s decision to deny Dr. Dookeran\u2019s 2004 reappointment application was not arbitrary or capricious. We uphold the Cook County Board\u2019s considered judgment.\nCircuit court reversed; Board affirmed.\nPATTI and LAMPKIN, JJ., concur.\nThe record also reflects that the joint conference committee directly reviewed and adopted in full the credentials committee\u2019s recommendation to deny reappointment prior to receiving a final recommendation from the EMS. The bylaws do not provide for such review, and no action was taken by the Cook County Board until the joint conference committee received a final recommendation from the EMS and voted again to deny reappointment.\nDr. Dookeran filed a complaint against Mercy for retaliatory discharge under the whistleblower provision of the False Claims Amendments Act of 1986 (31 U.S.C. \u00a73730(h) (2000)), which was dismissed. See Dookeran v. Mercy Hospital of Pittsburgh, 281 F.3d 105 (3d Cir. 2002).", "type": "majority", "author": "JUSTICE GARCIA" } ], "attorneys": [ "Richard A. Devine, State\u2019s Attorney, of Chicago (Patrick T. Driscoll, Jr., and Arleen C. Anderson, Assistant State\u2019s Attorneys, of counsel), for appellant.", "Jabob Pomeranz, of Cornfield & Feldman, of Chicago, for appellee." ], "corrections": "", "head_matter": "KEITH DOOKERAN, Plaintiff-Appellee and Cross-Appellant, v. THE COUNTY OF COOK, Defendant-Appellant and Cross-Appellee.\nFirst District (1st Division)\nNo. 1\u201408\u20141426\nOpinion filed December 14, 2009.\nRichard A. Devine, State\u2019s Attorney, of Chicago (Patrick T. Driscoll, Jr., and Arleen C. Anderson, Assistant State\u2019s Attorneys, of counsel), for appellant.\nJabob Pomeranz, of Cornfield & Feldman, of Chicago, for appellee." }, "file_name": "0800-01", "first_page_order": 816, "last_page_order": 836 }