Lutes v. McCarthy

CourtDistrict Court, M.D. Tennessee
DecidedAugust 17, 2022
Docket3:20-cv-00209
StatusUnknown

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

Bluebook
Lutes v. McCarthy, (M.D. Tenn. 2022).

Opinion

UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF TENNESSEE NASHVILLE DIVISION

ALBERT LUTES, ) ) Plaintiff, ) ) v. ) Case No. 3:20-cv-00209 ) Judge Aleta A. Trauger ) CHRISTINE WORMUTH, Secretary of ) the Department of the Army, ) ) Defendant. )

MEMORANDUM The Secretary of the Army1 has filed a Motion for Summary Judgment (Doc. No. 28), to which Albert Lutes has filed a Response (Doc. No. 41), and the Secretary has filed a Reply (Doc. No. 44). Lutes has filed a Motion for Summary Judgment (Doc. No. 33), to which the Secretary has filed a Response (Doc. No. 42). For the reasons set out herein, the Secretary’s motion will be granted, and Lutes’ motion will be denied. I. BACKGROUND Lutes was born in 1962 and served in the United States Army for twenty-two years. In 2009, after he had retired from service, Lutes accepted a civilian position as a Radio Logistics Assistance Representative Equipment Specialist at Fort Campbell, along the border of Kentucky and Tennessee. (Doc. No. 43 ¶¶ 1–5.) Lutes’ job requires him to be available for deployment abroad as needed. As of the latest filings addressing the matter, Lutes had been deployed overseas

1 This case was originally filed against Acting Secretary Ryan D. McCarthy, in his official capacity. Secretary Christine Wormuth was automatically substituted as the named defendant pursuant to Fed. R. Civ. P. 25(d). in his civilian capacity six times, including deployments to Afghanistan and Guantanamo Bay, Cuba. (Doc. No. 43 ¶ 8.) U.S. Central Command (“CENTCOM”) requires that civilian employees over the age of 40 undergo a cardiovascular risk assessment before deploying to a CENTCOM Area of Operation

(“AOR”). (Doc. No. 43 ¶¶ 10–11.) Lutes, who turned 40 in 2002, is subject to that requirement. (Id. ¶ 14.) Because a cardiovascular risk assessment necessarily involves making difficult predictions based on limited information, certain factors that are known to represent substantial, well-established cardiovascular hazards inevitably play a large role. In Lutes’ case, one such factor is his smoking. At all points relevant to this case, Lutes smoked about a pack of cigarettes per day, which he has done for over twenty-five years. Lutes’ smoking places him at an immediate disadvantage in terms of obtaining a favorable risk assessment and renders it more likely that additional factors would push him above a level of risk that CENTCOM would be willing to accept. (Doc. No. 41-1 ¶¶ 5, 10.) The evaluation of the employee’s cardiovascular risk has historically been performed

pursuant to the Framingham Risk Assessment (“FRA”) tool, which is an algorithm that uses basic data about a patient to estimate the risk of developing coronary heart disease during the next ten years.2 (Id. ¶¶ 7–10.) The FRA uses information commonly collected from or about patients as part of ordinary examination and/or care—namely, the patient’s gender, age, total cholesterol (mg/dl), HDL cholesterol (mg/dl), and systolic blood pressure (mmHg), along with whether the patient is in treatment for hypertension and whether the patient is a smoker. (Id. ¶ 10.) Under

2 The FRA is apparently no longer considered the leading available tool for this purpose, having allegedly been superseded by the AtheroSchlerotic CardioVascular Disease (“ASCVD”) screening tool. (Doc. No. 41-1 ¶ 17.) The parties agree, however, that the FRA and ASCVD “would give roughly the same result,” and either was acceptable to CENTCOM. (Id. ¶ 18.) CENTCOM policy, if the employee scores 15% or higher on his risk assessment, he must obtain a waiver from CENTCOM before deploying. (Id. ¶ 12.) At the times most relevant to this case, waiver requests were governed by Modification Thirteen to CENTCOM’s Individual Protection and Individual-Unit Deployment Policy (“MOD

13”), which stated: If the individual’s calculated 10-year [risk assessment score] is 15% or greater, the individual should be referred for further cardiology work-up and evaluation, to include at least one of the following: graded exercise test with a myocardial scintigraphy (SPECT scan) or stress echocardiography as determined by the evaluating cardiologist. Results of the evaluation . . . and testing, along with the evaluating cardiologist’s recommendation regarding suitability for deployment, should be included in a waiver request to deploy.

(Doc. No. 43 ¶ 10.) MOD13 directed that “the final authority of who may deploy to the CENTCOM AOR rests with the CENTCOM Surgeon and/or the Service Component Surgeon’s waiver authority, not the individual’s medical evaluating entity or deploying platform.” (Doc. No. 41-1 ¶ 15.) In late 2017, Lutes was informed that he was scheduled to be deployed to a CENTCOM AOR—specifically, Kuwait—in February of 2018. (Doc. No. 43 ¶ 23; Doc. No. 45 ¶ 58.) A few years earlier, in 2014, Lutes had been required to undergo a significant battery of tests due to an above-threshold FRA score calculated in connection with another planned deployment. In that instance, he ultimately underwent a cardiac catheterization and received a waiver that permitted him to deploy, albeit later than expected. (Doc. No. 43 ¶¶ 12–22.) Lutes testified that, in light of the extensive process that he had undertaken to become deployment-ready in 2014, he did not expect there to be much problem being cleared before deployment in 2018. (Id. ¶ 24.) The first part of Lutes’ pre-deployment physical was performed on January 3, 2018. Because Lutes was over 40, the information from that physical was used to calculate his FRA score, which came in at 20%. (Id. ¶ 25.) A second part of the physical was performed a week later, on January 10, 2018. After that encounter, Nurse Susan Hightower submitted a request for a CENTCOM waiver related to Lutes’ FRA score. The parties disagree regarding whether Lutes specifically requested that she do so, but they agree that, under CENTCOM’s policy, such a waiver

was necessary. (Id. ¶ 28.) Hightower’s initial request for a waiver on Lutes’ behalf was denied, with an instruction to “[p]lease provide updated cardiac evaluation for proper adjudication of request.” (Id. ¶ 29; Doc. No. 32-2 at 2.) To that end, Lutes scheduled a stress test, to be performed by Dr. Thomas Dove on January 26, 2018. (Doc. No. 41-1 ¶ 86–87.) Before the treadmill component of the test could begin, however, Lutes’ blood pressure was taken to, among other things, determine whether it was within a safe range for the administration of an exercise-based test. It was not, at least not in the assessment of Dr. Dove. Specifically, Lutes’ diastolic blood pressure—the lower of the two numbers included in a standard blood pressure score—had risen to 104 or 105, which left Dr. Dove “very concerned.”3 Dr. Dove postponed the test and arranged a follow-up with Lutes’ private

physician, Dr. Ramon Aquino. (Id. ¶¶ 88–90; Doc. No. 34-2 at 86.) Lutes was already on blood pressure medication and had been “for years.” (Doc. No. 41-1 ¶ 92.) During his deposition, Lutes admitted that his unexpectedly high reading on January 26, 2018, was due to the fact that his “body [had] changed and the medication didn’t,” although Lutes also mentioned the possibility that he “wasn’t keeping up with it.” (Id. ¶ 93; Doc. No. 34-1 at .) In any event, Lutes visited Dr. Aquino, who agreed that his blood pressure warranted attention, and

3 Lutes’ blood pressure had been 132/88 on January 3, 2018, when he underwent the first part of his physical. (Id. ¶¶ 25–26.) His blood pressure at the time of the second exam a week later, however, was 148/74. (Id.

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