Salcedo v. Penn State Health Milton S. Hershey Medical Center

District Court, M.D. Pennsylvania·Decided February 26, 2024·No. 1:19-cv-02201-YK·Unknown

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA

PABLO A. SALCEDO, : Plaintiff : No. 1:19-cv-02201 : v. : (Judge Kane) : MILTON S. HERSHEY MEDICAL : CENTER, : Defendant :

MEMORANDUM

This case arises out of the termination of Plaintiff Pablo A. Salcedo (“Plaintiff”)’s employment as a medical resident with Defendant Milton S. Hershey Medical Center (“Defendant”) in March 2018, which Plaintiff alleges violated the Americans with Disabilities Act (“ADA”), Section 504 of the Rehabilitation Act of 1973 (“RA”), and the Pennsylvania Human Relations Act (“PHRA”). Before the Court is Defendant’s motion for summary judgment. (Doc. No. 73.) For the reasons that follow, the Court will grant the motion in its entirety. I. BACKGROUND1 In March of 2017, Plaintiff accepted a position in Defendant’s medical residency program (“Residency Program”). (Doc. No. 73-95 ¶ 1.) At that time, Plaintiff signed a twelve- month contract with Defendant (the “Resident Agreement”) running from July 1, 2017 through June 30, 2018. (Id. ¶ 3.) The Residency Program featured supervisory oversight from the Chief Residents (“Chiefs”): Dr. James Kogut, Dr. Britt Marshall, and Dr. Simranjit Bedi. (Id. ¶ 5.)

1 The following relevant facts of record are taken from Defendant’s Statement of Uncontested Material Facts (“SUMF”) (Doc. No. 73-95) and Plaintiff’s Response to Defendant’s Statement of Uncontested Material Facts (“PRMF”) (Doc. No. 80-6). Both the SUMF and PRMF contain specific citations to the record at each numbered paragraph. The facts are undisputed unless otherwise noted. The program was coordinated and supervised by Residency Program Director Dr. Nicole Swallow. (Id. ¶ 6.) The Medical Residency Program uses the Accreditation Council for Graduate Medical Education (“ACGME”) Program Requirements and Milestone Evaluations to evaluate the

performance of medical residents. (Id. ¶ 7.) Defendant’s Graduate Medical Education Policies require that every training program have a comprehensive evaluation system in place for residents. (Id. ¶ 8.) Under Defendant’s policies, members of the Clinical Competency Committee (“CCC”) consult with the Residency Program Director to “make decisions regarding each resident or fellow’s promotion to the next year of training.” (Id. ¶ 9.) In the Resident Agreement itself, Defendant describes the criterion used by the CCC and Residency Program Director in making the determination on reappointment to resident positions. (Id. ¶ 10.) The metrics used include “patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, system-based practice, evaluations, ACGME

Milestones,” and other factors that the CCC or Residency Program Director deem “necessary to advance to the next level of training.” (Id.) The parties dispute the role of the ACGME Milestones in the context of resident evaluation and promotion. Defendant claims that core competencies in the ACGME Milestones must be met to advance in the program. (Id. ¶ 11.) Plaintiff argues that the ACGME Milestones themselves are “progressive” and a graduation “target,” not “requirement.” (Doc. No. 80-6 ¶ 11.) At the time Plaintiff worked as a Medical Resident in Defendant’s Residency Program, the CCC consisted of Dr. Swallow, Dr. DeWaters, Dr. Glod, Dr. Hempel, Dr. Peng, Dr. Krok, Dr. Miller, Dr. Munyon, Dr. Popjes, Dr. Sivarajah, Dr. Wojnar, Dr. Williams, and Dr. Ghahramani. (Doc. No. 73-95 ¶ 12.) In following the ACGME Common Program Requirements, the CCC reviewed and prepared reports on all residents on a semi-annual basis. (Id. ¶ 13.) These evaluations would inform the ACGME whether residents were meeting the

ACGME Milestones. (Id.) Plaintiff’s hours were “limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house clinical and educational activities, clinical work done from home, and moonlighting.” (Id. ¶ 14.) Defendant asserts that its Human Resources Department (“HR”) handles all accommodation requests, such as those under the ADA. (Id. ¶ 15.) In an effort to dispute this fact, Plaintiff argues that, while HR can handle ADA claims, it is not the sole entity equipped to manage such complaints and requests. (Doc. No. 80-6 ¶ 15.) It is undisputed that, upon receiving an accommodation request from an employee, HR can send the employee an ADA Accommodation Request form, which HR can subsequently review and act upon if the form is returned and HR finds the accommodation request to have merit. (Doc. No. 73-95 ¶¶ 16–17; 80-

6 ¶¶ 16–17.) Defendant has a policy stating that residents who inform the Residency Program Director or other faculty members of an accommodations request should be directed to HR. (Doc. No. 73-95 ¶ 18.) Plaintiff made a request for information about accommodations through an email sent to HR on August 19, 2017. (Id. ¶ 19) On August 22, 2017, Barb Hundermark, a member of the HR Department, sent Plaintiff a copy of the ADA Accommodations Request form. (Id. ¶ 20.) It is undisputed that, after receiving the ADA Accommodations Request form, Plaintiff made no additional contact with HR. (Id. ¶ 21; Doc. No. 80-6 ¶ 21.) Plaintiff maintains that he did not follow up with HR because Dr. Swallow told him that she would take care of the accommodations herself. (Doc. No. 80-6 ¶ 21.) On June 27, 2017, before the Residency Program began, Plaintiff spoke with Dr. Kogut. (Doc. No. 73-95 ¶ 26.) During that conversation, Plaintiff discussed his anxiety and depression as well as his fears about “starting in a new work environment.” (Id.) Early the following

month, Dr. Kogut checked in with Plaintiff to see how he was adjusting to the rigors of the Residency Program. (Id. ¶ 27.) Plaintiff told Dr. Kogut that he was “doing okay” given his apprehensions about beginning work in a new setting. (Id. ¶ 28.) Dr. Kogut subsequently acknowledged the challenges of adjusting to life in the Residency Program. (Id. ¶ 29.) Dr. Kogut recommended that Plaintiff schedule an appointment with Mazzitti and Sullivan, a counseling service. (Id. ¶ 30.) Plaintiff took Dr. Kogut’s advice and attended an evaluative session at Mazzitti and Sullivan on July 14, 2017. (Id. ¶ 32.) Michelle Batz of Mazzitti and Sullivan performed the evaluation. (Id.) Plaintiff was diagnosed with “generalized anxiety disorder; major depressive disorder in partial remission, recurrent episode; and social anxiety disorder.” (Id.) This diagnosis was never disclosed to Defendant’s HR Department. (Id. ¶ 33.)

On August 16, 2017, Plaintiff emailed Dr. Kogut and requested a meeting. (Id. ¶ 34.) Dr. Kogut replied with his availability, while reminding Plaintiff that he could also “reach out to the other Chiefs” if he had any issues. (Id. ¶ 35.) On August 24, 2017, Plaintiff met with the Chiefs to discuss his anxiety. (Id. ¶ 36.) The Chiefs suggested to Plaintiff that “having a quiet place to work, requesting pre-round sit down opportunities, [and] meeting attending doctors before new rotations could assist him as a resident.” (Id. ¶ 37.) On August 25, 2017, Plaintiff attended an appointment with Dr. Marshall at the Hope Drive Clinic to discuss physical health concerns and establish a care plan. (Id. ¶¶ 38–39.) During Plaintiff’s appointment with Dr. Marshall, Plaintiff informed Dr. Marshall about his history with generalized anxiety, major depressive disorder, as well as Attention Deficit Hyperactivity Disorder (“ADHD”). (Id. ¶ 40.) At that appointment, Plaintiff disclosed that he was taking medications to manage these diagnoses. (Id.) Plaintiff received a treatment plan that included follow up consultation with his psychiatrist and psychologist. (Id. ¶ 41.) The next day,

Plaintiff emailed Dr. Kogut to thank him for taking the time to meet with him. (Id. ¶ 42.) Plaintiff expressed the desire to “work on his social anxiety” and improve as an intern.

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Salcedo v. Penn State Health Milton S. Hershey Medical Center, (M.D. Pa. 2024).

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