Jacquelyn Mares v. Miami Valley Hospital

96 F.4th 945
CourtCourt of Appeals for the Sixth Circuit
DecidedMarch 21, 2024
Docket23-3475
StatusPublished
Cited by1 cases

This text of 96 F.4th 945 (Jacquelyn Mares v. Miami Valley Hospital) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Jacquelyn Mares v. Miami Valley Hospital, 96 F.4th 945 (6th Cir. 2024).

Opinion

RECOMMENDED FOR PUBLICATION Pursuant to Sixth Circuit I.O.P. 32.1(b) File Name: 24a0062p.06

UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT

┐ JACQUELYN MARES, M.D., │ Plaintiff-Appellant, │ │ v. > No. 23-3475 │ │ MIAMI VALLEY HOSPITAL; PREMIER HEALTH │ PARTNERS; WRIGHT STATE UNIVERSITY; JEROME L. │ YAKLIC, M.D.; G. THEODORE TALBOT, M.D.; ALBERT │ F. PAINTER, Psy.D., │ Defendants-Appellees. │ ┘

Appeal from the United States District Court for the Southern District of Ohio at Dayton. No. 3:20-cv-00453—Michael J. Newman, District Judge.

Decided and Filed: March 21, 2024

Before: GIBBONS, BUSH, and MURPHY, Circuit Judges.

_________________

COUNSEL

ON BRIEF: Marc D. Mezibov, MEZIBOV BUTLER, Cincinnati, Ohio, Rachel Rutter, MAREK WEISMAN, LLC, Chicago, Illinois, for Appellant. Karen T. Dunlevey, JACKSON LEWIS PC, Cincinnati, Ohio, for Appellees Miami Valley Hospital and Premier Health Partners. Benjamin M. Flowers, Zachery P. Keller, OFFICE OF THE OHIO ATTORNEY GENERAL, Columbus, Ohio, for Appellees Wright State, Painter, Talbot, and Yaklic. No. 23-3475 Mares v. Miami Valley Hosp., et al. Page 2

OPINION _________________

JULIA SMITH GIBBONS, Circuit Judge. Dr. Jacquelyn Mares was dismissed from Wright State University Boonshoft School of Medicine’s (“WSU”) obstetrics and gynecology residency program after a long series of complaints and escalating discipline stemming from her unprofessional behavior. As a result of this dismissal, Mares was terminated from her position at Miami Valley Hospital (“MVH”), where she was employed during, and through, the course of her residency. Mares sued WSU, MVH, Premier Health Partners (MVH’s owner-operator), and several WSU employees, alleging violations of her procedural and substantive due process rights along with various contract-based state law claims. The district court granted summary judgment to the defendants on each claim. For the reasons outlined below, we affirm.

I.

Dr. Mares graduated from medical school in 2015 and matched with a preliminary, one- year residency program at Hofstra University. Naturally, Mares sought opportunities to enroll in a categorical, full-length residency program over the course of her temporary term. She applied to a handful of institutions and ultimately selected WSU, joining its OB/GYN program as a second-year resident. As part of the transition, Mares undertook several obligations. For example, she signed WSU’s Graduate Medical Education Agreement. The Agreement “outline[d] the terms and conditions of [Mares’s] appointment” to WSU’s residency program, including the school’s policies related to resident responsibilities, conditions for reappointment or promotion, and the due process procedures surrounding discipline and dismissal from the program.

Additionally, Mares agreed to work at MVH, the program’s employing institution. She formalized this arrangement by signing a Resident-Fellow Agreement with both WSU and MVH. The Resident-Fellow Agreement acted as Mares’s employment contract: it set out the expectations for each party, established that MVH employed Mares on an at-will basis, and outlined the conditions under which MVH could immediately terminate the Agreement with No. 23-3475 Mares v. Miami Valley Hosp., et al. Page 3

Mares. The Graduate Medical Education and Resident-Fellow Agreements both referenced Item 504 of WSU’s Resident Manual, which detailed how, and under what conditions, WSU could seek to discipline, and potentially remove, a resident from the program.

In starting the new position, Mares quickly realized the “huge difference” between her last residency program and this one. DE 52, Mares Dep., Page ID 889. Residents at Hofstra adopted more “rigid” roles due to the high volume of patients that the program oversaw. As a result, Mares had less exposure to clinical opportunities than the second-year residents that attended WSU from the start. And the feedback she received during her initial rotations reflected her inexperience, as Mares’s supervisors noted that her surgical skills were lacking.

At the same time, Mares’s supervisors also expressed concern over her professionalism. For example, after her first rotation, Dr. Michael Galloway, then director of WSU’s OB/GYN residency program, remarked that Mares should develop her communication skills and strive to keep others more informed. And after her second rotation, Dr. Nancy Lo stated that Mares must work both on her patient and faculty relationships, highlighting that she ought to improve in “accepting timely feedback in a constructive manner.” DE 52-28, Mem. for R., Page ID 1322.

In January of 2017, WSU’s Clinical Competency Committee, the entity responsible for assessing the progress of residents, met with Mares to discuss her progress and provide feedback. The Committee emphasized that Mares needed to better her “professionalism in relating to students, nurses and other residents.” DE 52-30, Resident Feedback Meeting, Page ID 1324. Likewise, the Committee asked that Mares be more understanding, patient, and a better communicator. The Committee issued this feedback shortly before it received several complaints from medical students under Mares’s instruction. One complaint characterized Mares as “extremely hostile to every medical student she worked with” and that she “insulted attendings, fellow residents, and students routinely.” DE 52-32, Student Mistreatment Concern, Page ID 1327.

Mares received mixed feedback on her professionalism in the spring of 2017; but, in May, the Clinical Competency Committee advanced Mares to her third year of residency. Yet the Committee again expressed apprehension over Mares’s “overall professionalism” and No. 23-3475 Mares v. Miami Valley Hosp., et al. Page 4

expressed that it “expect[s] to see progression on these fronts if [Mares is] to complete the program on schedule.” DE 52-41, Clinical Competency Committee Letter, Page ID 1340. A few days later, Dr. Galloway issued Mares an official letter of warning on behalf of the program. In it, he highlighted problems with Mares’s “Interpersonal/Communication and Professionalism,” specifically that her “demeanor, attitude, [and] willingness to be responsive are a major concern,” stressed a need for “significant improvement” on the subject, and outlined a personalized remediation plan. DE 52-43, Letter of Warning/Concern, Page ID 1346. Less than a month after receiving the letter, the program suspended Mares for five days after she shirked her responsibility to check in on a patient, lost her temper when confronted about the situation by a supervisor, and arrived twenty minutes late to the meeting set to discuss these events and her behavior.

Despite these repeated warnings, Mares’s professionalism did not meaningfully improve. Over the next several months, Mares showed moments of growth but still received further critiques of her behavior. Ultimately, the program placed her on probation in March 2018. The Clinical Competency Committee notified Mares of this decision in writing, and contended that, although she showed “[s]ome improvement,” her “deficiencies in the areas of professionalism and interpersonal/communication . . . interfere[d] with teaching by the Attending” and “have a negative effect on transitions of patient care and thus impact[ed] patient safety.” DE 52-65, Notice of Probation, Page ID 1676.

After the probation decision, Mares again started showing some improvement. She frequently met with Dr. Theodore Talbot, the next director of WSU’s OB/GYN residency program; showed pockets of “dramatic improvement” related to her professionalism, see DE 52- 19, Resident Evaluation, Page ID 1306; and advanced to her fourth year of residency. Again, however, Mares’s behavior shifted a few months later.

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96 F.4th 945, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jacquelyn-mares-v-miami-valley-hospital-ca6-2024.