Howard v. City of Sedalia, Missouri

CourtDistrict Court, W.D. Missouri
DecidedApril 21, 2022
Docket2:21-cv-04034
StatusUnknown

This text of Howard v. City of Sedalia, Missouri (Howard v. City of Sedalia, Missouri) is published on Counsel Stack Legal Research, covering District Court, W.D. Missouri primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Howard v. City of Sedalia, Missouri, (W.D. Mo. 2022).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF MISSOURI CENTRAL DIVISION

SAMANTHA HOWARD, ) ) Plaintiff, ) ) vs. ) Case No. 2:21-cv-04034-MDH ) CITY OF SEDALIA, MISSOURI, ) D/B/A BOTHWELL REGIONAL ) HEALTH CENTER, ) ) Defendant. )

ORDER

Before the Court is Defendant’s Motion for Summary Judgment. (Doc. 59).1 The motion has been fully briefed and is ripe for review. For the reasons set forth herein the Court denies Defendant’s motion. BACKGROUND Plaintiff, a pharmacist, has brought this lawsuit against her former employer, the City of Sedalia, Missouri, d/b/a Bothwell Regional Health Center, alleging disability discrimination – failure to accommodate. In her single count Complaint Plaintiff alleges she was employed by Defendant as a pharmacist and requested permission for a diabetic service dog to accompany her to work. Plaintiff alleges Defendant failed to engage in an interactive process in good faith to accommodate her disability and that she was compelled to resign her position in violation of her ADA rights. The facts of the case as presented in the parties’ briefing are largely uncontested.

1 Defendant also filed a Motion to Amend Exhibit to Doc. 60 - replacing Exhibit 4 of its suggestions in support of summary judgment filed on February 4, 2022. Plaintiff did not object to this motion. The Court grants Defendant’s motion to replace Exhibit 4 to its summary judgment brief. (Doc. 61). Plaintiff was diagnosed with Type 1 diabetes at or around 14 months old. Plaintiff was also diagnosed with hypoglycemic unawareness during pharmacy school between 2014 and 2018. Hypoglycemic unawareness is a condition where a person does not recognize their blood sugar levels have dropped to a dangerously low level. On or about June 5, 2017, Plaintiff requested a service animal to assist with management of her diabetes and hypoglycemic unawareness from

CARES, Inc. a company that trains and sells service dogs. CARES, Inc. put Plaintiff on a waiting list. Plaintiff was told it could be about two years before she received an animal. Plaintiff began working as a pharmacist at Bothwell on or around March 15, 2019. Plaintiff informed her supervisor, Pharmacy Director Brad Nicholson, that she had diabetes and he granted her request for an informal accommodation to have food and drink at her desk while she was working alone. Plaintiff did not inform Bothwell at that time about her pending request for a service animal. Within the Bothwell pharmacy, there are several distinct areas. Two of these areas are the anteroom and the clean room. The clean room is a sterile area, requiring Personal Protective

Equipment (“PPE”) to enter. IVs are prepared in this area. As part of Plaintiff’s job she was required to enter the clean room. The anteroom is located between the main pharmacy and the clean room and is an area where employees prepare to go into the clean room, including washing hands, putting on PPE, etc. Unlike the “sterile” clean room, the main pharmacy outside the anteroom and clean room is considered a “sanitary” area. Non-sterile drug compounding and preparation is performed in the main pharmacy.2 Occasionally Plaintiff would put drugs together in the main pharmacy area.

2 USP Section 795 is the governing standard applicable to compounding that is performed in the Defendant’s pharmacy, outside of the pharmacy anti-room and clean room (referred together herein as the Defendant’s “sterile compounding suite”). Pharmacy personnel are not required to wash their hands when entering or exiting the pharmacy and are not required to wear gloves, hair covering, gowns or other PPE when working in the pharmacy outside of the sterile compounding suite. The pharmacy personnel do “very little” compounding outside of the sterile compounding suite. The pharmacists’ workstations are in the room where non-sterile compounding takes place. Compounding is not done at their workstations.

Plaintiff states she only went into the clean room portion of the sterile compounding suite about once a week to make an IV. Bothwell estimates that a pharmacist would need to be inside the clean room anywhere from 5-20 times per shift, especially if the pharmacist is working the late shift when only one pharmacist is on duty. Plaintiff states once a shift she would go into the ante room to verify IVs prepared by technicians and that she was not required to pass the line of demarcation to verify the IV. Plaintiff also states one or two times per shift she would enter the ante room to get IVs from the refrigerator. Bothwell states a pharmacist would cross the line of demarcation to get IVs from the refrigerator. In early June 2020, Plaintiff received a notice from CARES, Inc. that a service dog had

become available for her to pick up in August. On or about June 8, 2020, Plaintiff informed Bothwell that she would be requiring a service animal by speaking with Lisa Irwin, Bothwell’s Executive Director of Human Resources & Support Services. Bothwell had never previously encountered a request to have a service animal in its pharmacy. Irwin provided Plaintiff a Request for Accommodation Packet so that Bothwell could gather additional information to assist in making a decision regarding the service animal. At this time, Plaintiff believed she would need the service dog at her side constantly for six months for training purposes, and then after that she could go to work without her. Plaintiff requested that her service dog be allowed in the main pharmacy, a sanitary area, but did not ask to bring her into the pharmacy’s anteroom or clean room. Irwin requested, and Plaintiff provided, an authorization that permitted Bothwell to speak directly to the physicians treating Plaintiff’s diabetes. On or about June 12, 2020, Defendant received a letter regarding Plaintiff’s need for a service animal from Plaintiff’s physicians, which included an invitation to Defendant to reach out to the physician if there were any questions. Irwin did not contact the physician’s office, nor did

she direct anyone to do so. In late June 2020, Plaintiff told Irwin that she did not believe she had to fill out the Request for Accommodation Packet to move forward with her request. Nevertheless, Plaintiff filled out the Accommodation Packet and left it in Irwin’s office on July 13, 2020. On or about July 24, 2020, Irwin wrote a letter to Plaintiff summarizing the status of the interactive process to that point and requested that Plaintiff have her doctor fill out an additional ADA Health Provider Questionnaire. Plaintiff provided the ADA Health Provider Questionnaire to Defendant on or about July 28, 2020. After Plaintiff provided her completed paperwork, Irwin set up a team to investigate and review Plaintiff’s request. She asked Nicholson, Jennifer Unkel (Bothwell’s

Risk/Regulatory/Compliance Manager), Kathy Trogden (Bothwell’s Interim Infection Preventionist), and Dr. Phillip Fracica (Bothwell’s Chief Medical Officer) to analyze the request and provide their opinions. Nicholson, Unkel, and Trogden were each asked to write a recommendation for whether the service animal should be in the pharmacy based on their individual investigations and respective specialties. Nicholson, Unkel, Trogden, Fracica, and Irwin performed a walkthrough of the Bothwell Pharmacy, including viewing the anteroom and clean room. Following the walkthrough, Nicholson, Unkel, and Trogden finalized their recommendation letters regarding Howard’s service request. All three independently determined that having a service dog in the pharmacy was a risk to the safety of Bothwell’s patients and should not be allowed. Unkel reviewed the Americans with Disabilities Act (“ADA”) and the Conditions of Participation for the Centers for Medicare and Medicaid (“CMS”) and focused on the CMS guidance that sterile or non-sterile compounded medications may be subject to contamination. She

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Howard v. City of Sedalia, Missouri, Counsel Stack Legal Research, https://law.counselstack.com/opinion/howard-v-city-of-sedalia-missouri-mowd-2022.