Elaine Hughes v. Norton Healthcare, Inc.

Court of Appeals of Kentucky·Decided December 10, 2020·No. 2019 CA 000222·Unknown

Opinion

RENDERED: DECEMBER 11, 2020; 10:00 A.M.

NOT TO BE PUBLISHED

Commonwealth of Kentucky

Court of Appeals

NO. 2019-CA-0222-MR

ELAINE HUGHES APPELLANT

APPEAL FROM JEFFERSON CIRCUIT COURT v. HONORABLE JUDITH E. MCDONALD-BURKMAN, JUDGE ACTION NO. 16-CI-002098

NORTON HEALTHCARE, INC. APPELLEE

OPINION

AFFIRMING IN PART, REVERSING IN PART, AND REMANDING

** ** ** ** **

BEFORE: COMBS, JONES, AND MCNEILL, JUDGES. JONES, JUDGE: Appellant, Elaine Hughes (“Hughes”), appeals the order of the Jefferson Circuit Court, which granted summary judgment to Appellee, Norton Healthcare, Inc. (“Norton”), on claims of retaliation under KRS1 216B.165,

1 Kentucky Revised Statutes.

wrongful discharge in violation of KRS 216B.165, and intentional infliction of emotional distress following her termination.

Having reviewed the record in conjunction with all applicable legal authority, we affirm the circuit court’s summary judgment on Hughes’s claims of retaliation and intentional infliction of emotional distress. We reverse the circuit court’s judgment with respect to Hughes’s claim for wrongful discharge in violation of public policy and remand for additional analysis and factual findings.

I. BACKGROUND AND PROCEDURAL HISTORY Until the events giving rise to this litigation occurred, 55-year-old Hughes was employed by Norton as an Assistant Nurse Manager (“ANM”). Hughes began working at Norton in 1987 as a staff nurse in the obstetrics and gynecology departments. Over the years, she did her job well and received several promotions, culminating in her promotion to ANM for the hospital’s Operating Room (“OR”) in 2010.

As an ANM in the OR, Hughes’s duties were largely managerial, and she rarely scrubbed in on cases. Instead, Hughes ran the Surgery Scheduling Board, meaning she organized the flow of cases in the OR, scheduling nurses and coordinating with surgeons, anesthesiologists, and other hospital professionals to do so. Hughes’s additional responsibilities included scheduling staff, handling some payroll duties, meeting with other ANMs weekly, and working an on-call

shift one weekend approximately every five weeks. As an ANM, Hughes was an at-will employee, and she understood that Norton could terminate her employment at any time, with or without cause.

In March of 2015, Kimberly Ransdell was hired by Norton as the Surgery Manager. This made Ransdell Hughes’s direct supervisor. Ransdell reported to Pam Photiadis, the Director of Surgical Services. Both Ransdell and Photiadis agreed that Hughes was a good nurse and well-qualified for her position. According to Photiadis, Hughes was a “fine woman” but had at times exhibited poor judgment in her employment. Hughes received a disciplinary corrective action in 2010 prior to Ransdell’s becoming her direct supervisor and several “coachings” from Ransdell regarding scheduling in the OR in the spring and summer of 2015.

In May of 2015, just months after Ransdell became Surgery Manager, Ransdell recorded notes of several “coaching” meetings she conducted with Hughes. According to Ransdell, keeping coaching notes was common practice for supervisors, and she did so for all the ANMs under her supervision. In May, Ransdell documented that she met with Hughes to discuss improving Hughes’s working relationship with anesthesia with regard to scheduling cases in the OR. The two met again in June to address comments Hughes made to a Norton surgeon about getting her hands “slapped” during the May coaching. In October, Ransdell

met with Hughes twice more to discuss an incident in which Hughes “bumped” a patient’s OR time for a non-emergency case, causing the patient’s surgery to be cancelled for a second time and postponed until the second day. Ransdell did not take any written corrective action related to these notes, nor did she provide Hughes with a copy of the notes. Hughes claims in her post-deposition affidavit that these meetings did not take place.

Hughes was known by her supervisors and coworkers to voice her opinions, which she did in spring of 2015 when she became aware that Norton’s OR was unprepared to deal with an increasing rate of obstetrical issues. Hughes was particularly alarmed by an increase in cases involving placenta accreta, a serious and often sudden pregnancy complication that can result in severe blood loss following delivery. Hughes had observed a growing trend in accreta patients being transferred from the Labor and Delivery section of the hospital to the OR without notice and believed that the OR needed a plan in place for handling these emergency cases. Other Norton employees shared the same patient safety concerns, including Ransdell and Photiadis; Hughes was not alone.

In particular, Hughes was involved in two incidents in which patients with severe obstetric complications arrived in the Norton OR without warning. The first occurred in late spring or early summer of 2015, when Labor and Delivery called Hughes in the OR to tell her that they were bringing an accreta

patient into the OR immediately, without ensuring that there was a clean room available before doing so. The second incident also occurred that summer when Labor and Delivery sent a patient to the OR for monitoring and testing, neither of which were ordinary functions of the OR.

After the second incident, Hughes was asked to meet with Risk Management in a nondisciplinary capacity to address what had happened. To her knowledge, Hughes was the only employee to meet with Risk Management about obstetric issues. During that meeting, Risk Management acknowledged that there was a “disconnect” in communication between Gynecology and the OR. Although that particular event had not involved an accreta patient, Hughes also voluntarily brought up her concerns regarding the accreta issue.

Hughes testified that she also reported one or both of the incidents to a number of Norton employees: Ransdell, Photiadis, the Gynecology ANM Theresa Vincent, Norton Anesthesia, Risk Management, and several other ANMs. The other Norton employees all agreed that the OR needed a specific plan for dealing with accreta patients to ensure patient safety. Both Ransdell and Photiadis testified that they encouraged Hughes to raise the issue. According to Photiadis, not only was Hughes not in trouble for reporting the accreta issue, she was a part of the solution to the problem. It was Norton’s policy to encourage reporting patient care and safety issues, and employees commonly did so.

Later that summer, Hughes, Ransdell, anesthesia, Labor and Delivery, and other employees met to discuss a plan for handling accreta patients. Hughes testified that she was aware that Vincent created a designated “accreta cart” containing all of the necessary instrumentation and supplies for handling accreta cases. The parties dispute whether Hughes’s concerns were addressed by fall of 2015, when Hughes was terminated. Hughes claims to have continued her complaints until then; Photiadis, however, testified that a plan had been formulated to address the accreta issue by 2016.2 However, Photiadis admitted that a written plan was not established until 2017.

On Friday, October 30, 2015, Hughes was scheduled to be the on-call ANM for the weekend shift ending the morning of Monday, November 2, 2015.3 Hughes said that being on-call as an ANM required “answer[ing] questions, phone calls, [and] trouble-shoot[ing] if there was an issue in surgery.” Appellant’s Br. Exhibit 1, Hughes Dep. at 20. According to Ransdell, Hughes was to support the staff in whatever way was needed, whether that be coming into the hospital to help

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