Mostafa v. United States

In the United States Court of Federal Claims

GAMAL MOSTAFA,

Plaintiff,

No. 24-1100

v. Filed: March 9, 2026

THE UNITED STATES,

Defendant.

Jeff T. Schrameck, Schrameck Law PLLC, Canton, Michigan, for Plaintiff.

Laura Offenbacher Aradi, Trial Attorney, Matthew D. Lewis, Trial Attorney, Lisa L.

Donahue, Assistant Director, Patricia M. McCarthy, Director, Commercial Litigation

Branch, Brett A. Shumate, Assistant Attorney General, Civil Division, United States

Department of Justice, Washington, DC, for Defendant.

OPINION AND ORDER

HADJI, Judge.

Plaintiff Dr. Gamal Mostafa is a former Chief of Surgery and attending general

surgeon at the John D. Dingell Department of Veterans Affairs Medical Center in Detroit,

Michigan (Detroit VAMC). ECF 48 ¶ 1. In this action, he alleges that the United States,

through the VA, breached the terms of a settlement agreement entered into to resolve a

dispute surrounding the revocation of his clinical privileges. See generally ECF 11.

Plaintiff maintains that the VA’s alleged breaches of contract resulted in “lost wages and

benefits, including back pay and front pay, in an amount estimated at $500,000 to

$1,000,000” in damages. ECF 11 ¶ 77.

In June 2025, both parties moved for summary judgment. See ECF 20; ECF 24. The

Court orally denied both motions on June 17, 2025, concluding that a trial was necessary

to resolve this fact-specific case. See Docket, Case No. 24-1100.

A three-day trial was held in Washington, DC, beginning on November 3, 2025. See

ECF 83 at 1. The witnesses and evidence presented at trial were focused on Plaintiff’s sole

breach of contract claim. Plaintiff and the Government called two Joint Witnesses: (1)

Rebecca Schmidt, Credentialing & Privileging Manager at the Detroit VAMC; and (2) Dr.

Raghuram Matta, Chief of Staff at the Detroit VAMC. ECF 67 at 1-2. Plaintiff also called

three other witnesses: (1) Dr. Walter Salwen, a Detroit VAMC employee; (2) Christopher

Cauley, Director of the Detroit VAMC; and (3) Dr. Gamal Mostafa, himself. ECF 67 at 3.

The Government called only one witness, Amanda Rosas, Senior Strategic Business

Partner, also known as Chief of Human Resources, at the Detroit VAMC. ECF 67 at 4.

The central issues before the Court are: (1) whether the VA breached the terms of

the Settlement Agreement; and (2) if so, whether the breach(es) caused Plaintiff financial

harm. The Court has carefully considered the testimony presented and the exhibits the

parties offered into evidence. For the reasons set forth below, the Court finds that the VA

did not breach the Settlement Agreement, and that Plaintiff did not adequately prove

causation of any alleged damages. The Court therefore directs the entry of judgment for

the Government.

FINDINGS OF FACT

I. Plaintiff’s Detroit VAMC Employment and Revocation of Privileges

Plaintiff Dr. Gamal Mostafa was born and raised in Cairo, Egypt, where he attended

medical school. Tr. 303:2-3 (Mostafa). After graduating from medical school, he trained at

the Royal College of Surgeons in the United Kingdom before immigrating to the United

States. Tr. 303:3-10 (Mostafa). In the United States, he completed several fellowships and

retrained, culminating in becoming a fellow of the American College of Surgeons, a

credential he still holds in good standing. Tr. 303:11-14 (Mostafa). Following this training,

Plaintiff was appointed to a faculty position at the University of North Carolina in

Charlotte, NC. Tr. 303:15-18 (Mostafa).

Plaintiff joined the Detroit VAMC as Chief of Surgery in November 2012. Tr.

304:14-20 (Mostafa). It was a joint appointment, which also included a full professorship

at Wayne State University, a promotion from his position at the University of North

Carolina. Tr. 303:19-25 (Mostafa). Serving in these roles was personally meaningful for

Plaintiff because treating veterans was an opportunity to give back to the nation to which

he had immigrated and which had made him a citizen. Tr. 304:8-13 (Mostafa).

Plaintiff was brought into the Chief of Surgery role to help fix issues with the

surgical program in the Detroit VAMC. Tr. 304:2-7 (Mostafa). Prior to his arrival, veterans

who came in with problems necessitating surgery would often leave without obtaining the

necessary surgeries. Tr. 305:9-15 (Mostafa). In the role, Plaintiff dramatically increased

the volume of surgeries the Detroit VAMC was performing, transforming its residency

program from one nicknamed “VAcation,” for its reputation for not doing anything, to a

program that staffed the operating room late into the evening treating veterans with urgent

needs. 306:15-24 (Mostafa). As Chief of Surgery, Plaintiff managed various administrative

responsibilities on top of his active surgical practice. See Tr. 307:4-18 (Mostafa). Since

August 23, 2021, Plaintiff has not performed any surgery at the Detroit VAMC. Tr. 315:21-

316:2 (Mostafa). Around that time, Plaintiff was removed from his post as Chief of

Surgery, and he became subject to a series of disciplinary proceedings that led to the present

litigation. Tr. 315:5-20 (Mostafa).

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At the Detroit VAMC, a body called the Clinical Executive Committee1 handles

credentialing and clinical privileging matters. ECF 48 ¶ 9. The Committee is composed of

medical staff who serve as voting members according to the Medical Center Bylaws. ECF

48 ¶ 9; DX2002 at 328. Article V, Section 5.02(1)(b) of the Bylaws designates the

Committee voting members as follows:

Deputy Chief of Staff, Associate Chiefs of Staff for

Administrative Medicine Service, Diagnostic Radiology

Service, Geriatrics & Extended Care Service, Integrated

Clinical Services, Medicine Service, Mental Health Service,

Pathology & Laboratory Medicine Service, Research Service,

Primary Care Service, and Surgical Service. Also the Section

Chiefs for Dermatology, Pharmacy, Psychology, Rehab

Medicine and Dental.

DX2002 at 328. Indeed, Plaintiff served as a voting member of the Committee when he

was Chief of Surgery, see Tr. 307:4-8 (Mostafa), a position he held for almost ten years,

see Tr. 304:14-23 (Mostafa). The Committee holds two types of meetings: regular

Committee Meetings and special Committee Meetings. Tr. 127:9-17 (Matta). Regular

Committee Meetings deal with granting privileges to new employees or renewing existing

employees’ privileges, and they are held on a regular basis. Tr. 127:13-128:2 (Matta).

Special Committee Meetings are convened on an ad-hoc basis to consider revocation of

privileges for providers whose conduct has caused clinical care concerns. Tr. 128:3-10

(Matta). This case deals exclusively with special Committee Meetings. Tr. 168:2-6 (Matta).

Specifically, the Court heard testimony about three Committee Meetings: one on October

20, 2022; another on January 23, 2023; and the final and most relevant on June 12, 2023.

See JX2A; JX3A; JX10A.

The conduct and structure of Committee Meetings are governed by the Medical

Center Bylaws. See DX2002 at 328-331; see Tr. 92:1-9 (Schmidt). But they also appear to

be modified by common practice, rather than strict adherence to the text of the Bylaws,

according to Dr. Raghuram Matta who has been chairperson of the Committee since

December 2021. See Tr. 176:15-24 (Matta); Tr. 126:18-127:4 (Matta); see also DX2002 at

328 (establishing the Chief of Staff as Chairperson). For example, the Bylaws list several

Section Chiefs as voting members, DX2002 at 328, but in practice, a Section Chief is only

invited when one of their providers is the subject of a particular Committee Meeting. Tr.

176:7-24 (Matta); 179:17-180:22 (Matta). When the Detroit VAMC’s Chief of Staff

becomes concerned about the quality of a provider’s clinical care, they can summarily

suspend the provider’s privileges. Tr. 166:11-19 (Matta). After summarily suspending a

provider’s privileges, the Chief of Staff initiates outside reviews of the relevant clinical

1

The parties and witnesses use the term “CEC” to refer both to the Clinical Executive Committee itself and

Committee meetings. For clarity, the Court will use the term “Committee” when referring to the voting

body, and the term “Committee Meeting” when referring to a meeting of the Clinical Executive Committee.

3

cases by independent medical professionals. Tr. 168:16-170:1 (Matta). The Chief of Staff

then convenes a special Committee Meeting, where the voting members are presented with

the results of the outside reviews, relevant medical records, and any response or evidence

submitted by the provider. Tr. 89:2-5 (Schmidt); Tr. 136:7-17; 166:3-10 (Matta). The

Credentialing & Privileging Manager circulates these documents prior to the Committee

Meeting. Tr. 89:2-5 (Schmidt); Tr. 136:7-17 (Matta). At the end of each Committee

Meeting, the voting members vote to make one of three recommendations: (1) privilege

revocation, (2) privilege reinstatement, or (3) Focused Professional Practice Evaluation

where the provider is closely supervised for a period of time. Tr. 167:6-168:1 (Matta). That

recommendation goes to the Detroit VAMC Medical Director, who either approves or

disapproves it. See Tr. 59:2-19 (Schmidt); Tr. 167:19-23 (Matta).

Committee Meeting attendance by individuals who are not voting members has been

a contested question in this litigation. The Court heard conflicting testimony on this point,

but ultimately the record indicates that non-voting members regularly attended Committee

Meetings. According to Rebecca Schmidt and Dr. Matta—who organized every Committee

Meeting and were responsible for inviting guests—staff and guests routinely attended

Committee Meetings. See Tr. 36:8-37:11 (Schmidt); Tr. 131:25-132:4 (Matta); see also Tr.

253:10-20 (Cauley); JX2A at 439; JX3A at 412. By contrast, Dr. Walter Salwen and

Plaintiff testified that guests never attended Committee Meetings. See Tr. 215:20-22

(Salwen); Tr. 312:23-313:4 (Mostafa). Given Dr. Matta’s and Schmidt’s central roles in

conducting Committee Meetings and determining the list of attendees, the Court finds their

testimony more persuasive and concludes that non-voting guests regularly attended

Committee Meetings. This conclusion is further supported by the fact that non-voting

guests attended all three of the Committee Meetings at issue in this case. Specifically, all

three Committee Meetings were attended by Credentialing & Privileging staff to capture

the minutes and by at least one VISN 10 employee.2 See JX2A at 439; JX3A at 412; JX10A

at 1811; Tr. 37:14-18 (Schmidt).

Plaintiff was the subject of a special Committee Meeting held on October 20, 2022.

JX2A at 439. The meeting minutes from that meeting reflect that two individuals, Dustin

Fitzpatrick and Dr. Dana Frazer, attended in addition to the regular voting members. JX2A

at 439; Tr. 169:7-15 (Matta). Fitzpatrick, a Health Systems Specialist, coordinated the

outside reviews of Plaintiff’s cases and attended as an ex-officio non-voting member

according to the Bylaws. JX2A at 439; see DX2002 at 329; Tr. 169:16-170:6 (Matta). Dr.

Frazer, VISN 10 Chief Surgery Consultant, attended as a surgery subject matter expert and

person familiar with one of the initial outside reviews of Plaintiff’s cases. JX2A at 439; Tr.

170:7-17 (Matta). Rebecca Schmidt also attended while training for her new role as

Credentialing & Privileging Manager. Tr. 37:14-18 (Schmidt). Nicole Metrusias, another

2

Though it was not explained in detail at trial, the Detroit VAMC is part of Veterans Integrated Service

Network (VISN) 10, a network of medical centers and outpatient clinics providing care to veterans in

Michigan, Ohio, Kentucky, and Indiana. See VISN 10, Dept. of Veterans Affairs,

https://department.va.gov/integrated-service-networks/visn-10/ (last visited March 9, 2026).

4

Credentialing & Privileging employee, attended and recorded the minutes. See JX2A at

462. After reviewing the relevant evidence, the Committee voted 7-to-5 in favor of

recommending that Plaintiff’s privileges be reinstated, subject to a Focused Professional

Practice Evaluation. JX2A at 462; Tr. 170:23-171:3 (Matta). The Interim Executive

Director, Michelle Martin, disapproved the Committee’s recommendation and

recommended revocation of Plaintiff’s privileges. JX2A at 462; Tr. 171:4-8 (Matta).

Plaintiff next went before a special Committee Meeting on January 23, 2023. JX3A

at 412. In advance of that meeting, Plaintiff provided materials to Schmidt, which she

circulated to the members of the Committee. Tr. 41:2-6 (Schmidt). The meeting minutes

reflect that five individuals attended in addition to the regular voting members. JX3A at

412. Fitzpatrick and Dr. Frazer attended for the same reasons as the prior Committee

Meeting. JX3A at 412; Tr. 171:22-25 (Matta). Schmidt again attended, supervising creation

of the minutes by Metrusias. JX3A at 412, 437; see ECF 48 ¶ 12; Tr. 171:25-172:6 (Matta);

Tr. 27:10-14 (Schmidt). Dr. Anthony Restuccio, Chief Medical Officer of VISN 10, also

attended the meeting. JX3A at 412; Tr. 100:1-9 (Schmidt). This meeting followed much

the same process as the October Committee Meeting, with the voting members reviewing

an evidence file and response from Plaintiff. Tr. 139:5-25 (Matta). The voting members at

the January Committee Meeting voted 9-to-3 to recommend revocation of Plaintiff’s

privileges, and the Interim Executive Medical Center Director, Amy Kennebeck, approved

that recommendation. JX3A at 437; Tr. 145:23-146:7 (Matta).

II. Plaintiff’s Appeal and Settlement Agreement

Following the January Committee Meeting, Dr. Matta submitted a proposal to

remove Plaintiff from employment at the Detroit VAMC. Tr. 146:8-11 (Matta); Tr. 232:13-

15 (Cauley). To contest that removal proposal, Plaintiff had the right to appear before the

deciding authority to provide both written and oral testimony in his favor. Tr. 146:16-19

(Matta); Tr. 232:16-23 (Cauley). In this case, the deciding authority was Acting Medical

Center Director, Christopher Cauley. Tr. 146:12-15 (Matta). Plaintiff met with Cauley on

March 15, 2023, to discuss Plaintiff’s proposed removal. Tr. 232:16-25 (Cauley). Plaintiff

provided Cauley with a written reply (which included PX1001 and PX1016) and oral reply.

Tr. 336:22-337:6 (Mostafa); 341:18-342:5 (Mostafa); Tr. 268:10-23 (Cauley). Cauley

understood Plaintiff to be providing him with those documents in relation to his potential

removal from employment, separate from the privilege revocation process. Tr. 242:21-

243:5 (Cauley). Cauley reviewed the January Committee Meeting minutes, Plaintiff’s

written reply, and Plaintiff’s oral reply, but Cauley did not consult Dr. Matta when

evaluating Plaintiff’s proposed removal. See Tr. 234:16-235:13 (Cauley). In the course of

considering these materials, Cauley removed one charge against Plaintiff. Tr. 246:13-247:5

(Cauley). Ultimately, Cauley made the decision to remove Plaintiff from employment with

the Detroit VAMC. See Tr. 235:4-15 (Cauley). Plaintiff was formally removed from his

position on April 5, 2023. Tr. 401:21-23 (Mostafa); ECF 48 ¶ 2.

5

To appeal his removal, Plaintiff initiated an appeal through the Disciplinary Appeals

Board (DAB). See Tr. 262:15-22 (Cauley); Tr. 145:10-22 (Matta); Tr. 344:21-345:8

(Mostafa). The DAB process led to a settlement agreement between Plaintiff and the VA,

executed on June 5, 2023. See JX8; Tr. 402:6-15 (Mostafa). The following provisions of

that agreement, reproduced here in full, give rise to the various disputes in this case:

I. The Agency hereby agrees as follows:

…

2. The Agency agrees that it will convene the Clinical

Executive Committee (“CEC”) on (insert date) [sic] for the

sole purpose of having it vote on the restoration of privileges

for Mostafa. The makeup of the CEC for this purpose will be

the normal voting members. Mostafa will be permitted 15

minutes to speak to the CEC prior to said vote. Mostafa

understands that the Agency does not control the outcome of

this vote, is not guaranteeing any result and that Mostafa

waives any right to any cause of action (pursuant to II (1)

below) as to the outcome of said vote.

…

4. In the event that Mostafa requests the Agency provide him

with employment verification for future or prospective

references and/or financial reasons, the Agency agrees to

provide employment verification that includes (and is limited

to) dates of employment, position title and salary, and the fact

that he retired. Mostafa understands that the Agency is only

obligated to provide this reference through the Chief of Human

Resources Detroit VAMC and that it is Mostafa’s obligation to

direct any such inquiries to this individual.

…

II. Mostafa hereby agrees as follows:

1. Mostafa hereby releases, forfeits, abandons, dismisses,

rescinds, withdraws and waives with prejudice any and all

complaints, grievances, appeals, remedies, actions and causes

of action, which he now has or may have had, whether known

or unknown, arising out of his employment with the Agency,

or any other matter, in any forum including, but not limited to,

the Disciplinary Appeals Board, State or Federal Courts, the

Equal Employment Opportunity Commission, or the Merit

Systems Protection Board, up to and including the date upon

which this Agreement is executed by Mostafa and for the

6

referenced action in I.3. above; against the Agency, its officers,

agents, assigns, and employees, in their individual and official

capacities. This Agreement shall not release, waive, or affect

adversely in any way the rights or claims that Mostafa may

have to vested retirement, pension benefits or other leave

benefits.

JX8 at 1636-37. The first two provisions, sections I(2) and I(4), create obligations that

Plaintiff alleges were breached. See ECF 11 ¶¶ 73-75. And the Government argues that the

final clause of Section I(2) and all of Section II(1) serve to waive Plaintiff’s ability to raise

various pieces of evidence. See generally ECF 50.

III. The June 2023 Clinical Executive Committee Meeting

In June 2023, Dr. Matta convened a special Committee Meeting to comply with the

terms of the Settlement Agreement. JX10A at 1811; see also Tr. 173:10-12 (Matta). The

conduct of the June Committee Meeting is central to this case, so the facts call for detailed

exposition.

Dr. Matta asked Rebecca Schmidt to invite all the regular voting members of the

Committee. Tr. 34:20-23 (Schmidt); see JX17 at 1809. Dr. Matta also asked Schmidt to

invite the following individuals: Dustin Fitzpatrick; Dr. Anthony Restuccio; Nicole

Metrusias; Tracy Taylor, VISN 10 Credentialing & Privileging Officer; and Amy Slameka

and Nicholas Kennedy, two lawyers for the VA Office of General Counsel. JX10A at 1811;

Tr. 96:20-98:25 (Schmidt). In addition, Dr. Louis Furicchia, Interim Assistant Chief of

Staff for Diagnostic Radiology Service, was the only regular voting member to attend the

June Committee Meeting but not the January Committee Meeting, from which he was

excused. Compare JX10A at 1811 with JX3A at 412.

Schmidt testified that she neither received nor circulated any documents to be

considered as evidence at the June Committee Meeting. Tr. 97:9-14 (Schmidt). Generally,

the Credentialing & Privileging Manager circulates the evidence file and any documents

submitted by the provider prior to the meeting. Tr. 158:18-159:3 (Matta). Dr. Matta

testified that no evidence file was prepared and circulated for the June Committee Meeting,

because the evidence file was the same as the file circulated for the January Committee

Meeting. Tr. 141:8-142:10 (Matta). In March 2023, Plaintiff had provided Christopher

Cauley with documents and records he believed had not been shared at the January

Committee Meeting. Tr. 336:22-337:6 (Mostafa). Cauley understood Plaintiff to be

providing him with those documents in relation to his potential removal from employment,

separate from the privilege revocation process. Tr. 242:21-243:5 (Cauley). Plaintiff did not

ask Cauley to circulate the documents to the June Committee voting members, nor did

Plaintiff provide the documents to Schmidt or Dr. Matta in advance of the June Committee

Meeting. Tr. 412:13-22 (Mostafa). Plaintiff also did not present any of those documents

during his oral presentation at the June Committee Meeting. Tr. 412:25-413:2 (Mostafa).

Ultimately, the Committee voted 9-to-2 in favor of not reinstating Plaintiff’s privileges.

7

JX10A at 1817. Cauley approved that recommendation. JX10A at 1817. Indeed, Cauley

testified that he had never disagreed with the doctors’ findings from a Committee Meeting.

Tr. 275:17-18 (Cauley).

IV. The NPDB Report and Employment Verification Requests

Under certain circumstances, VA facilities are required to report adverse

credentialing actions to the National Practitioner Data Bank (NPDB), a central repository

that tracks such actions. Tr. 101:22-102:2 (Schmidt). As relevant here, VHA Handbook

110.17 reads:

VHA facilities must file a report with the NPDB … regarding:

…

b. Adverse clinical privileges actions (e.g., restriction,

suspension, revocation, etc.) taken against physicians and

dentists that are final and affect privileges for more than 30

calendar days, as well as acceptance of the surrender of clinical

privileges, or the restriction of clinical privileges of physicians

and dentists, when the action is related to professional

competence or professional conduct.

DX2001 at 1642-43. Schmidt filed an NPDB Report about Dr. Mostafa on July 12, 2023,

based on the permanent revocation of his privileges. JX11 at 60-61; Tr. 49:4-14 (Schmidt).

The information in the NPDB report was verified by Dr. Matta and Dr. Jason Pasley. Tr.

52:16-25 (Schmidt).

Prospective employers can make two kinds of requests to the Detroit VAMC:

employment verification requests and affiliation verification requests. Tr. 75:19-76:17

(Schmidt). Employment verification requests, addressed in Section I(4) of the Settlement

Agreement, involve the HR Department sharing an individual’s dates of employment,

position title and salary, and the manner in which they completed employment with the

VA. JX8 at 1637; Tr. 443:19-444:6 (Rosas). HR Director Amanda Rosas testified that the

information required in the Settlement Agreement is the same information she always

provides in response to employment verification requests. Tr. 444:23-445:4 (Rosas).

Affiliation verification requests, which are not addressed in the Settlement Agreement,

involve the Credentialing & Privileging Department sharing information on an individual’s

privileges at the hospital, including the provider’s name, dates of affiliation, and active or

inactive status of their privileges. Tr. 76:22-77:4 (Schmidt). Schmidt testified that she

responded to approximately three affiliation verification requests about Plaintiff. JX15;

DX2011; DX2012; Tr. 77:5-9 (Schmidt).

Under the terms of the Settlement Agreement, the Chief of Human Resources is

charged with responding to employment verification requests directed to them by Plaintiff.

See JX8 at 1637. Rosas became Chief of HR in April 2024. Tr. 441:13-19 (Rosas). Rosas

was not aware of the Settlement Agreement until October 2024, but she testified that all

8

employment verification responses are limited to the same information listed in the

Settlement Agreement. Tr. 441:23-442:9 (Rosas); Tr. 444:23-445:4 (Rosas). Rosas

recalled responding to at least two employment verification requests related to Plaintiff

without forwarding the requester to Credentialing & Privileging: one from Dr. Rajav Datta

(PX1012) and one from Jacqueline Parker. Tr. 456:24-457:7 (Rosas). However, Rosas later

testified that she forwarded Dr. Datta to Credentialing & Privileging. See PX1012 at 315;

Tr. 458:22-24 (Rosas).

V. Plaintiff’s Subsequent Employment History

When Plaintiff retired from his position as a general surgeon at the Detroit VAMC

in March 2023, his total annual salary was $377,164. JX5 at 3308 (Box 12C). By that point,

Plaintiff’s demotion from Chief of Surgery to general surgeon meant that he had lost a

“retention incentive” of an unspecified amount. Tr. 459:3-11 (Mostafa). At that time,

Plaintiff was also working as a Wayne State University professor for about $150,000

annually. Tr. 359:16-25 (Mostafa). Plaintiff was terminated from Wayne State in

September 2023. Tr. 362:6-15 (Mostafa). Before the Committee Meetings detailed above,

Plaintiff had accepted an offer to transfer to a role with the VA in Chicago. Tr. 356:5-7

(Mostafa). He lost that opportunity after his privileges were suspended. Tr. 356:8-12

(Mostafa). After losing his privileges, Plaintiff worked on a per diem basis for Beaumont

Health Systems and earned approximately $200,000 in that role between March 2023 and

July 2024. Tr. 418:13-19 (Mostafa); see also ECF 24-1 at 93 (identifying Beaumont Health

Systems’ complete name).

In May 2023, Plaintiff received an offer for employment from University of

Connecticut Health. See PX1006 at 370. The offer included $475,000 in annual base salary.

PX1006 at 372. It also included a $20,000 signing bonus and up to $20,000 in relocation

expenses. PX1006 at 372. Plaintiff signed this offer. See PX1006 at 377; Tr. 387:6-11

(Mostafa). But that offer was rescinded around late November 2023. See Tr. 388:1-16

(Mostafa).

In or around November 2024, Plaintiff received an offer for employment from

Southern Illinois Medical Services. See PX1005 at 336; Tr. 382:3-11 (Mostafa). That offer

included guaranteed annual base compensation of $543,388. PX1005 at 363. That offer

also included $80,000 for a signing bonus and relocation expenses, PX1005 at 362, and

tens of thousands of dollars of bonus potential, see PX1005 at 364. In late 2024, Plaintiff

was informed that this employment opportunity would not move forward. Tr. 382:3-11

(Mostafa).

Plaintiff now works full-time as an attending surgeon at MetroHealth Medical

Center in Cleveland, Ohio. Tr. 353:2-6 (Mostafa). In that position, he makes $375,000

annually and does not hold an academic appointment. Tr. 391:1-10 (Mostafa); Tr. 389:8-

23 (Mostafa). He began working for MetroHealth around December 2024. Tr. 382:3-24

(Mostafa).

9

CONCLUSIONS OF LAW

“It is axiomatic that a settlement agreement is a contract. Equally settled is the

principle that interpretation of the terms of a contract is a question of law.” Greco v. Dep’t

of the Army, 852 F.2d 558, 560 (Fed. Cir. 1988). To state a valid claim for breach of

contract, a plaintiff must show: “(1) a valid contract between the parties, (2) an obligation

or duty arising out of the contract, (3) a breach of that duty, and (4) damages caused by the

breach.” San Carlos Irrigation & Drainage Dist. v. United States, 877 F.2d 957, 959 (Fed.

Cir. 1989). The parties do not dispute that the Settlement Agreement was a valid contract,

so this case turns on the questions of duty, breach, and causation of damages.

“Contract interpretation begins with the plain language of the agreement.” Gould,

Inc. v. United States, 935 F.2d 1271, 1274 (Fed. Cir. 1991). The Court “must interpret the

contract in a manner that gives meaning to all of its provisions and makes sense.” McAbee

Const. Inc. v. United States, 97 F.3d 1431, 1435 (Fed. Cir. 1996). If a contract’s terms are

“clear and unambiguous,” the Court “may not resort to extrinsic evidence to interpret

them.” Id. “A contract is ambiguous only when it is susceptible to two reasonable

interpretations.” A-Transp. Nw. Co. v. United States, 36 F.3d 1576, 1584 (Fed. Cir. 1994).

“However, because an ambiguous or uncertain writing sometimes can only be understood

upon consideration of the surrounding circumstances, extrinsic evidence will be allowed

to interpret an ambiguous clause.” ViroMed Lab’ys, Inc. v. United States, 62 Fed. Cl. 206,

215 (2004) (citing Sylvania Elec. Prods., Inc. v. United States, 458 F.2d 994, 1005 (Ct. Cl.

1972)).

To show a breach, Plaintiff “must show material non-compliance by the agency with

the terms of the settlement agreement.” Lutz v. U.S. Postal Serv., 485 F.3d 1377, 1381

(Fed. Cir. 2007). “A breach is material when it relates to a matter of vital importance, or

goes to the essence of the contract.” Thomas v. Dep't of Hous. & Urb. Dev., 124 F.3d 1439,

1442 (Fed. Cir. 1997). To obtain damages, Plaintiff must show: “(1) the damages were

reasonably foreseeable by the breaching party at the time of contracting; (2) the breach is

a substantial causal factor in the damages; and (3) the damages are shown with reasonable

certainty.” Indiana Michigan Power Co. v. United States, 422 F.3d 1369, 1373 (Fed. Cir.

2005).

Plaintiff’s First Amended Complaint alleges that the VA breached the Settlement

Agreement by: (1) failing to convene the June Committee Meeting pursuant to the terms

of the Settlement Agreement and subsequently reporting negative information to the

NPDB; and (2) failing to provide required employment verifications. See ECF 11 ¶¶ 35-

36, 57, 60, 73-74; ECF 33 at 8-9. The Court addresses these allegations in turn.

I. Alleged Breaches Regarding the June Committee Meeting

Plaintiff alleges two procedural defects with the June Committee Meeting: (1) that

non-voting guests attended and participated in the meeting, and (2) that documents Plaintiff

sent to Christopher Cauley in March were not presented at the June Committee Meeting.

10

See ECF 33 at 3, 8-9; see also ECF 11 ¶¶ 35, 57, 75. And for the first time in post-trial

briefing, Plaintiff argues that the Section Chiefs should have been invited to the June

Committee Meeting. ECF 87 at 11.

The Settlement Agreement contains little detail on what the Committee Meeting

would require. The only provision regarding the Committee, Section I(2), reads:

I. The Agency hereby agrees as follows:

…

2. The Agency agrees that it will convene the Clinical

Executive Committee (“CEC”) on (insert date) [sic] for the

sole purpose of having it vote on the restoration of privileges

for Mostafa. The makeup of the CEC for this purpose will be

the normal voting members. Mostafa will be permitted 15

minutes to speak to the CEC prior to said vote. Mostafa

understands that the Agency does not control the outcome of

this vote, is not guaranteeing any result and that Mostafa

waives any right to any cause of action (pursuant to II (1)

below) as to the outcome of said vote.

JX8 at 1636. This provision creates three requirements for the convened Committee: (1)

the CEC will have “the sole purpose of … vot[ing] on the restoration of privileges for

Mostafa,” (2) “[t]he makeup of the CEC for this purpose will be the normal voting

members,” and (3) “Mostafa will be permitted 15 minutes to speak to the CEC prior to said

vote.” JX8 at 1636. It is undisputed that the Committee was convened. And Plaintiff

acknowledges that he was given 15 minutes to speak. Tr. 412:23-24 (Mostafa). Therefore,

Plaintiff’s claim for explicit violation of the terms of the Settlement Agreement boils down

to three complaints: (1) that the attendance and participation of non-voting guests changed

the “makeup of the CEC,” (2) that Section Chiefs are “normal voting members” who should

have been invited, and (3) that the Settlement Agreement required the Committee to

consider Plaintiff’s additional evidence before voting.

A. Attendance and Participation of Non-Voting Guests

Plaintiff first argues that the presence of non-voting guests at the June Committee

Meeting constituted a breach of the Settlement Agreement. ECF 33 at 10. The Court begins

by analyzing the plain text of the Settlement Agreement. Notably, the plain language of the

Settlement Agreement is silent as to guest attendance. Plaintiff claims that the relevant

provision “was designed precisely to eliminate influence from the VISN and OGC.” ECF

87 at 16. But nothing in the text reflects that interest, and nothing in the record indicates

that such concerns were raised during negotiations on the terms of the Settlement

11

Agreement. To prohibit guests, the parties could have included a clear statement that guests

could not attend—or at the very least could not participate.3 They did not do so.

In the absence of an explicit prohibition on guests, the Court turns to the provision

relating to the “makeup of the CEC.” The Settlement Agreement requires that “[t]he

makeup of the CEC … will be the normal voting members.” JX8 at 1636. This sentence

contains two potential ambiguities: the acronym “CEC” and the reference to “normal”

voting members. Resolution of the first ambiguity defeats Plaintiff’s claim about guest

attendance. As used by the parties, the term “CEC” can refer to both the Clinical Executive

Committee body and the meetings of that body.4 If the Settlement Agreement limits the

makeup of the body, then it places no limit on guest attendance, but if it limits the makeup

of the meeting, then guest attendance could plausibly violate the Settlement Agreement.

But the surrounding sentences clarify that the Settlement Agreement uses the term “CEC”

to refer to the Committee body. The prior sentence explicitly identifies the acronym “CEC”

as the “Clinical Executive Committee” and states that “the Clinical Executive Committee”

will convene “for the sole purpose of having it vote.” JX8 at 1636 (emphasis added). And

the provision gives Plaintiff “15 minutes to speak to the CEC.” JX8 at 1636 (emphasis

added). These provisions only make sense if the term “CEC” refers to the Committee body,

not the meeting. Therefore, Plaintiff’s arguments concerning “the makeup of the CEC” are

unavailing. The Court finds that the plain text of the Settlement Agreement does not appear

to support Plaintiff’s claim that the agreement barred guest attendance.

Nonetheless, the Court is mindful that “[b]efore arriving at a legal reading of a

contract provision, a court must consider the context and intentions of the parties.” Metric

3

The Court takes seriously Plaintiff’s concern about outside influence in the June Committee Meeting.

Plaintiff has noted that VISN 10 employees played a significant role in the January Committee Meeting,

and it is plausible that Plaintiff wished for a reconsideration of his privileges free from that kind of

influence. But there is no indication that Plaintiff bargained for that term in the Settlement Agreement. See

Const., Inc. v. United States, 203 Ct. Cl. 521, 530 (1974) (“The court must enforce a mutually agreed-upon

contract according to its terms.”) (citation omitted) (emphasis added). Furthermore, having reviewed the

June Committee Meeting minutes, the Court finds that VISN 10 employees only participated in the early

portion of the meeting to ask questions about the Settlement Agreement and implications of the

Committee’s future vote. See JX10 at 1813-14. Once the OGC lawyers finished their pre-meeting

discussion, the only individuals who spoke in the meeting were Plaintiff and the voting members of the

Committee. See JX10 at 1814-17. Neither the OGC lawyers nor VISN 10 employees were even present

when Plaintiff addressed the Committee or the vote was taken. Tr. 90:16-24 (Schmidt). Accordingly, even

though the Settlement Agreement did not impose the duty for which Plaintiff claims to have bargained, the

Court finds that the June Committee Meeting was free of outside influence over the vote of the Committee.

4

The dual meaning of the term “CEC” has been the core of the parties’ dispute since the summary judgment

stage. Though the parties never framed it in these terms, they have respectively insisted that their conflicting

interpretations comport with the clear, unambiguous text of the Settlement Agreement. See ECF 20 at 20-

21; ECF 24 at 12-13. They have repeated these claims in post-trial briefing. See ECF 87 at 11; ECF 88 at

21-24. It is clear to the Court from many witnesses’ testimony at trial that the common usage of “CEC”

refers roughly equally to both the Committee and its meetings (i.e., the CEC, versus a CEC).

12

Constructors, Inc. v. NASA, 169 F.3d 747, 752 (Fed. Cir. 1999). The Federal Circuit has

explained:

Trade practice and custom illuminate the context for the

parties’ contract negotiations and agreements. Before an

interpreting court can conclusively declare a contract

ambiguous or unambiguous, it must consult the context in

which the parties exchanged promises. Excluding evidence of

trade practice and custom because the contract terms are

“unambiguous” on their face ignores the reality of the context

in which the parties contracted. That context may well reveal

that the terms of the contract are not, and never were, clear on

their face. On the other hand, that context may well reveal that

contract terms are, and have consistently been, unambiguous.

Id. To determine whether an ambiguity arose as well as how to resolve any such an

ambiguity, the Court considers “evidence of trade practice and custom [a]s part of the initial

assessment of contract meaning.” Id.

Two facts persuade the Court that practice and custom permit the attendance of non-

voting guests at the June Committee Meeting, resolving any ambiguity in favor of the

Government. First, nothing in the Medical Center Bylaws expressly prohibits the inclusion

of guests. Rather, the Bylaws explicitly allow for at least two categories of non-voting

guests. See DX2002 at 329. Ex-officio non-voting members are permitted to attend

Committee Meetings, and the Committee chairperson is empowered to invite “[o]ther

facility staff … to serve as resources or attend committee meetings.” DX2002 at 329. There

is no evidence that the Settlement Agreement displaced these portions of the Bylaws.

And second, the Court finds it highly persuasive that non-voting guests attended all

three of the Committee Meetings at issue in this case. Specifically, all three Committee

Meetings were attended by Credentialing & Privileging staff to capture the minutes and by

at least one VISN 10 employee. See JX2A at 439; JX3A at 412; JX10A at 1811; Tr. 37:14-

18 (Schmidt). As the Court previously found, the record indicates that non-voting members

regularly attended Committee Meetings in general, according to Schmidt and Dr. Matta—

who organized every Committee Meeting and were responsible for inviting guests. See Tr.

36:8-37:11 (Schmidt); Tr. 131:25-132:4 (Matta); see also Tr. 253:10-20 (Cauley); JX2A

at 439; JX3A at 412. But see Tr. 215:20-22 (Salwen); Tr. 312:23-313:4 (Mostafa).

Therefore, the attendance of non-voting guests at the June Committee Meeting was entirely

consistent with the Committee’s general practice.

Interpreting the Settlement Agreement to exclude all non-voting members would

lead to illogical results. See McAbee, 97 F.3d at 1435. For one, that interpretation would

exclude the Credentialing & Privileging staff who regularly attend Committee Meetings to

record the meeting minutes and document the recommendation to be sent to the Executive

Director for approval. In addition, it would exclude attorneys from the VA Office of

13

General Counsel, depriving the Committee of legal advice. The availability of legal advice

seems particularly important in this case, given that this Committee Meeting was convened

according to the Settlement Agreement. The Court simply cannot countenance an

interpretation of the Settlement Agreement that would have deprived the Committee of

both its recordkeepers and its lawyers. Indeed, if the OGC lawyers had convened a meeting

of the exact same attendees to explain the Settlement Agreement just 30 minutes in advance

of the official Committee Meeting, there would be no argument that it was improper.

Accordingly, the Court concludes that the Settlement Agreement did not impose a duty on

the VA to exclude all non-voting guests. Therefore, the attendance of non-voting guests at

the June Committee Meeting did not breach the Settlement Agreement.

B. Failure to Invite Section Chiefs

For the first time in post-trial briefing, Plaintiff argues that the Settlement

Agreement required all voting members listed in the Medical Center Bylaws to be invited

to the June Committee Meeting. ECF 87 at 11. This argument flows from the second

potential ambiguity mentioned above: the use of the term “normal voting members.” JX8

at 1636 (emphasis added). Plaintiff argues that this term incorporates the Medical Center

Bylaws’ definition of voting members. See ECF 87 at 11. The Government argues that this

term incorporates the regular practices of the Committee, including the practice of not

inviting Section Chiefs to Committee Meetings for practitioners outside of their Section.

See ECF 88 at 21. As before, the Court turns to practice and custom to determine the best

reading of this term.

Based on the normal practices of the Committee and its Chair, Dr. Matta, the Court

concludes that the Government’s reading is most reasonable. The Medical Center Bylaws

list several Section Chiefs as “voting members.” DX2002 at 328. But in practice, a Section

Chief is only invited when one of their providers is the subject of a particular Committee

Meeting. Tr. 176:7-24 (Matta); 179:17-180:22 (Matta). Against this backdrop, the phrase

“normal voting members” would seem to invoke the Committee’s normal practice of not

inviting every single voting member to every Committee Meeting. Indeed, Plaintiff’s

argument—that all Section Chiefs should have been invited—would make more sense if

the Settlement Agreement omitted the word “normal.” Plaintiff’s position could also have

been more clearly stated in the Settlement Agreement if it required the votes of “all voting

members listed in the Medical Center Bylaws.” Because the Committee’s normal practice

is to invite Chiefs of Staff, and all Chiefs of Staff were invited to the June Committee

Meeting, the Court finds that there was no breach of the Settlement Agreement relating to

convening the “normal voting members.”

C. Failure to Distribute and Consider Certain Evidence

Plaintiff also argues that the VA breached the Settlement Agreement by not

considering certain evidence at the June Committee Meeting. ECF 33 at 10-11.

Specifically, in March 2023, Plaintiff provided Christopher Cauley with medical records

that allegedly directly rebutted the allegations of substandard care. See Tr. 341:18-342:5

14

(Mostafa). Plaintiff believed that these documents should have been shared with the

Committee in advance of the June Committee Meeting. See Tr. 336:22-337:19 (Mostafa);

341:4-342:2 (Mostafa). The Settlement Agreement is silent about the presentation of

evidence at the June Committee Meeting. See JX8 at 1636. Plaintiff’s argument fails at the

outset because the Settlement Agreement places no evidence-related duty on the

Committee. The Court “cannot insert words into the contract that the parties never agreed

to.” Anchorage v. United States, 123 F.4th 1315, 1320 (Fed. Cir. 2024) (citing George

Hyman Const. Co. v. United States, 832 F.2d 574, 581 (Fed. Cir. 1987)). But Plaintiff’s

contemporaneous actions also defeat his argument.

First, Plaintiff did not submit any evidence to Rebecca Schmidt to be circulated

before the June Committee Meeting. Before a Committee Meeting, the Credentialing &

Privileging Manager would generally circulate an evidence file and any documents

submitted by the provider. Tr. 158:18-159:3 (Matta); Tr. 41:7-14 (Schmidt). Plaintiff is

aware of this practice, as he submitted evidence to Schmidt before the January Committee

Meeting. See Tr. 41:2-6 (Schmidt). Dr. Matta testified that no evidence file was prepared

and circulated for the June Committee Meeting, because the evidence file was the same as

the file circulated for the January Committee Meeting, and thus had already been shared

with the Committee.5 Tr. 141:8-142:10 (Matta). Cauley testified that it is the provider’s

burden to submit for circulation any additional documents he or she wishes the Committee

to consider. Tr. 248:5-11 (Cauley). Schmidt testified that she neither received nor

circulated any documents to be considered as evidence at the June Committee Meeting. Tr.

97:9-14 (Schmidt). In March 2023, Plaintiff provided Cauley with documents and records

he believed had not been shared at the January Committee Meeting. Tr. 336:22-337:6

(Mostafa). Cauley understood Plaintiff to be providing him with those documents in

relation to his potential removal from employment, separate from the privilege revocation

process. Tr. 242:21-243:5 (Cauley). Plaintiff did not ask Cauley to circulate the documents

to the June Committee Meeting voting members, nor did Plaintiff provide the documents

to Schmidt or Dr. Matta in advance of the June Committee Meeting. Tr. 412:13-22

(Mostafa). The Court cannot agree with Plaintiff that sharing evidence with Cauley in

March created an obligation for the Committee to consider that evidence at the June

Committee Meeting.

Second, Plaintiff did not present any of those documents during his oral presentation

at the June Committee Meeting. Tr. 412:25-413:2 (Mostafa). The Settlement Agreement

explicitly granted Plaintiff 15 minutes to speak to the Committee. See JX8 at 1636. Even

5

As the Court has previously noted, Dr. Louis Furicchia, Interim Assistant Chief of Staff for Diagnostic

Radiology Service, was the only regular voting member to attend the June Committee Meeting but not the

January Committee Meeting, from which he was excused. Compare JX10A at 1811 with JX3A at 412.

Given that the evidence file would have been circulated in advance of the January Committee Meeting, see

Tr. 158:18-159:3 (Matta), the Court assumes that Dr. Furicchia would have received the evidence file. But

even if not, Dr. Furicchia was free to request the evidence file in advance of the June Committee Meeting,

where he did vote.

15

if Plaintiff did not ask Schmidt to circulate the evidence in advance, he certainly had the

opportunity to present or discuss that evidence at the June Committee Meeting. The record

reflects that Plaintiff did not do so. See JX10 at 1814-15. The Court finds that the

Settlement Agreement did not impose an evidence-related duty on the Committee. But even

if it had, the Committee did not breach the Settlement Agreement by failing to consider

evidence which Plaintiff never attempted to present.6

D. Subsequent NPDB Report

Plaintiff’s complaints about the NPDB report flow directly from his complaints

about the June Committee Meeting. See ECF 11 ¶ 75. The Court, having concluded that

the June Committee Meeting complied with requirements of the Settlement Agreement,

declines to indulge Plaintiff’s attempt to relitigate the substance of the information included

in the NPDB Report. As the Court made clear throughout trial, Plaintiff’s claims must be

limited to procedural defects, not substantive ones, because Plaintiff waived his ability to

challenge the substantive outcome of the Committee vote in the Settlement Agreement. See

JX8 at 1637; Tr. 45:21-47:1 (Court). Plaintiff has not advanced any argument that the

NPDB Report itself was procedurally defective, nor has Plaintiff identified any term of the

Settlement Agreement that purports to constrain the Credentialing & Privileging

Department’s reporting obligations. Accordingly, the Court finds no breach related to the

NPDB Report.

II. Alleged Breach Regarding the VA’s Employment Verification Obligations

In the First Amended Complaint, Plaintiff claims that the VA breached the

Settlement Agreement when Chief of Human Resources Amanda Rosas directed a

prospective employer to the Credentialing & Privileging Department. ECF 11 ¶¶ 73-74. At

trial, Plaintiff’s case-in-chief did not include any evidence about this alleged breach. In

addition, this claim is absent from Plaintiff’s post-trial briefs, as is any mention of Rosas,

a Government witness. See generally ECF 87; ECF 89. Because Plaintiff did not meet his

burden to prove the claim during his case-in-chief, and even considering the limited

evidence brought in during Plaintiff’s cross-examination of Rosas during the

Government’s case-in-chief, the Court finds for the Government on this claim.

The Settlement Agreement places the following obligation on the VA: “the Agency

agrees to provide employment verification that includes (and is limited to) dates of

employment, position title and salary, and the fact that he retired.” JX8 at 1637. Plaintiff

6

Plaintiff makes an additional argument that the structure of the Settlement Agreement “presuppose[s] a

substantive evaluative process.” ECF 87 at 13. But that is not correct. As Plaintiff points out, the Settlement

Agreement “required the VA to convene a CEC composed of the normal voting members, provide Dr.

Mostafa an opportunity to speak, and conduct a vote on the restoration of his privileges.” ECF 87 at 13. It

is telling that Plaintiff’s own summary of the Committee’s obligations does not mention reviewing any

particular evidence. In providing Plaintiff the opportunity to present evidence and be heard—consistent

with his insistence throughout trial that he believed he had evidence that would change the Committee’s

mind, see, e.g., Tr. 341:18-342:2 (Mostafa)—the Settlement Agreement did not implicitly agree to more.

16

had the obligation to direct prospective employers to the Chief of HR. JX8 at 1637. HR

Chief Rosas testified that she responded to at least two requests regarding Plaintiff. Tr.

456:24-457:7 (Rosas). The only evidence in the record which purports to be an

employment verification request is an email from Dr. Rajav Datta of Mount Sinai. See

generally PX1012. In Dr. Datta’s initial email to Rosas, Dr. Datta wrote: “Dr. Mostafa has

applied for a position with us and has shared his NPDB report, which was initiated at the

VA. I would appreciate the opportunity to connect with you regarding his candidacy.”

PX1012 at 316. Rosas responded that she “can provide dates of employment, but cannot

speak on behalf of his clinical tenure and skills while employed with the VA,” and she

asked if Dr. Datta wished to be put in contact with Credentialing & Privileging. PX1012 at

315. Rosas understood Dr. Datta to be requesting information that Credentialing &

Privileging would provide. See Tr. 452:18-453:17 (Rosas). Ultimately, she forwarded Dr.

Datta to Credentialing & Privileging, Tr. 458:22-24 (Rosas).

The Court finds no breach from Rosas’ conduct. The Settlement Agreement requires

the HR Chief to provide limited employment verifications when requested. JX8 at 1637.

The terms of the Settlement Agreement limit the contents of that response. JX8 at 1637.

When the HR Chief receives a request that is not an employment verification request, the

Settlement Agreement places no limitation on their conduct. See Anchorage, 123 F.4th at

1320 (noting that the Court “cannot insert words into the contract that the parties never

agreed to”) (citation omitted). Here, Rosas sought to clarify Dr. Datta’s request and

ultimately forwarded Dr. Datta to Credentialing & Privileging. Tr. 458:22-24 (Rosas).

Given that Mount Sinai subsequently sought and obtained an affiliation verification from

Credentialing & Privileging, see generally JX15, the Court infers that Rosas was correct in

her decision to clarify Dr. Datta’s request. This conclusion is further supported by the fact

that the record contains no evidence that Dr. Datta followed up to request employment

verification from Rosas. Thus, the only evidence in the record relating to an employment

verification seems to have actually been a request for an affiliation verification. Rosas did

not breach the Settlement Agreement by responding appropriately to an affiliation

verification request that should have been directed to Credentialing & Privileging. Based

on the lack of any other evidence in the record on the VA’s alleged breach of Section I(4)

of the Settlement Agreement, the Court finds no breach.

III. Plaintiff’s Failure to Prove the VA’s Actions Caused His Damages

Even if Plaintiff had proven a breach of the Settlement Agreement, he failed to prove

that any alleged breach caused the damages he claims. On the stand at trial, Plaintiff—the

only witness to testify to damages—gave a candid assessment of his damages claim: “I

really cannot give a money number…. I’m here for the truth.” Tr. 419:7-13 (Mostafa). To

the extent Plaintiff’s limited claim for relief in this case is for money damages, not truth,

he must show “the breach is a substantial causal factor in the damages,” and show the

damages “with reasonable certainty.” Indiana Michigan Power, 422 F.3d at 1373. Plaintiff

has satisfied neither requirement.

17

In support of his damages claim, Plaintiff provided evidence of two employment

offers he says were rescinded, one from Southern Illinois Medical Services and one from

the University of Connecticut.7 Tr. 381:24-382:11, 388:9-16 (Mostafa). He provided an

unsigned, unexecuted employment agreement between himself and Southern Illinois as

well as a letter from the Southern Illinois Credential Committee declining to approve his

request for membership and privileges. See PX1005. With respect to his University of

Connecticut offer, he provided a copy of his May 2023 employment offer. See PX1006.

He also testified that he lost his positions at Detroit VAMC and Wayne State University,

though Plaintiff’s retirement from Detroit VAMC was a term of the Settlement Agreement.

JX8 at 1636; Tr. 391:17-20 (Mostafa); Tr. 362:6-15 (Mostafa). Plaintiff has failed to

connect the losses of both his employment offers and positions to the alleged breaches of

the Settlement Agreement. It may well be that Plaintiff did not get future opportunities

because his privileges had been revoked, but the Court has no first-hand testimony or other

admissible evidence to that fact, beyond Plaintiff’s own speculation. As the Government

pointed out in its Rule 52(c) presentation, the prospective employers could have reached

their decisions for a wide range of reasons, including public reporting unrelated to the

Settlement Agreement. See Tr. 430:13-431:5 (Lewis). Presented only with the bare facts

that the offers were revoked, the Court concludes that Plaintiff has not met his burden of

proof on the issue of causation. See Indiana Michigan, 422 F.3d at 1373.

Plaintiff has also failed to prove damages with reasonable certainty. The Court

knows Plaintiff’s Detroit VAMC salary, JX5 at 3308 (Box 12); his current MetroHealth

salary, Tr. 391:1-10 (Mostafa); and the compensation terms of the two employment offers

discussed above, PX1006 at 372, PX1005 at 363-366. Plaintiff also testified that he earned

approximately $200,000 in a per diem role for Beaumont Health Systems between March

2023 and July 2024. Tr. 418:13-19 (Mostafa). From the beginning, Plaintiff’s theory of

recovery has been unclear, as he has never stated a specific amount of damages claimed.

A theory of recovery based on the revoked employment offers is entirely speculative and

would lead to an uncertain amount in damages. Would the Court grant Plaintiff the

difference between the higher revoked salary and his MetroHealth salary, in perpetuity?

Plaintiff has not articulated his theory of damages with reasonable certainty, and the trial

record does not support a coherent theory of damages, let alone one with reasonable

certainty. Accordingly, the Court further concludes that Plaintiff has not met his burden of

proof on the reasonable certainty of damages.8 See Indiana Michigan, 422 F.3d at 1373.

7

Plaintiff testified about the existence and recission of a third employment offer with Rush University

Medical Center, but he provided no evidence or testimony about the terms of that agreement. See Tr. 364:2-

365:5 (Mostafa). Therefore, the Court excludes this alleged agreement from its discussion of damages.

8

Plaintiff argues that the Court could award nominal damages if Plaintiff has not proven damages with

sufficient certainty. ECF 87 at 10. Because the Court has found against Plaintiff on his breach claims, the

Court declines to address the question of nominal damages. See Hubbard v. United States, 480 F.3d 1327,

1331 (Fed. Cir. 2007) (‘“Nominal damages’ ordinarily are awarded where, although the plaintiff has

established the merits of his claim, he has not shown any actual damages.”).

18

CONCLUSION

For the foregoing reasons, the Clerk is DIRECTED to enter judgment for the

Government.

IT IS SO ORDERED.

PHILIP S. HADJI

Judge

19