Sally Hilden v. Hurley Medical Center

504 F. App'x 408
CourtCourt of Appeals for the Sixth Circuit
DecidedNovember 5, 2012
Docket11-2583
StatusUnpublished
Cited by4 cases

This text of 504 F. App'x 408 (Sally Hilden v. Hurley Medical Center) 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
Sally Hilden v. Hurley Medical Center, 504 F. App'x 408 (6th Cir. 2012).

Opinion

GRIFFIN, Circuit Judge.

Plaintiffs Sally Hilden and Jerome Flynn filed suit against defendants Hurley Medical Center (“HMC”), Varuna Tewari, Sheila Moore, and David Szczepanski, alleging violations of Michigan’s Whistle-blowers’ Protection Act (“WPA”), Mich. Comp. Laws § 15.361, et seq. The district court determined that Hilden and Flynn failed to present evidence of a causal link between their protected activity and the adverse employment action taken against them. Accordingly, it granted summary judgment in favor of defendants. We affirm.

I.

At times relevant to this case, Hilden and Flynn worked as medical technologists in the clinical laboratory at HMC, located • in Flint, Michigan. Among other functions, the clinical laboratory processes microbiology specimens received from doctors’ offices for the purpose of identifying bacteria. A physician uses a cotton swab to collect a specimen from a patient’s wound, throat, or other site. The swab is then placed in a sterile plastic tube containing a nutrient liquid to facilitate bacteria growth. The swab and tube together are referred to as “transport media.” Transport media is delivered to the clinical laboratory for processing. Once received, a medical technologist removes the swab from the tube and inoculates (i.e., “sets up”) the culture on a culture plate or in a vial of Lim broth, referred to as “culture media.” After bacteria grows, another staff member identifies the bacteria and provides a report to the physician.

Tewari is HMC’s microbiologist; he is responsible for HMC’s clinical laboratory, including the processing of microbiology specimens. Moore is the administrative director of the clinical laboratory, and Szczepanski is HMC’s labor relations administrator.

On the afternoon of January 19, 2010, Sarah Martinson, a medical technologist, noticed that the clinical laboratory had re *410 ceived expired transport media. Martin-son sent a message to HMC’s “outreach troubleshooter group,” the liaison between HMC and the doctors’ offices, asking the troubleshooters to contact the physician’s office and ask it to discard any other expired transport media in its inventory. The message indicated that Martinson had still inoculated the culture.

During the early morning hours of January 20, 2010, Hilden emailed the troubleshooters regarding the culture media prepared by Martinson. She asked the troubleshooters to request a new specimen from the physician and stated that the use of expired transport media violated a standard established by the Joint Commission for Accreditation of Hospitals Organization (“Joint Commission”), a nonprofit organization that regulates quality and safety in the delivery of healthcare. Hilden then discarded both the swab and the Lim broth that Martinson had prepared.

That afternoon, in an email, Tewari told the staff to notify the microbiology department when expired transport media was received so that physician offices could be notified. Nonetheless, he instructed the staff to prepare expired transport media for processing:

I am insisting that cultures be set up because in many cases, patients do not return for recollection. Many of the clinics deal with patients that have poor compliance with medical instruction. Therefore, the best course of action is to set the culture up while we are waiting for a recollection. If pathogens are recovered, the patient will get treatment earlier than if we had to wait for a recollection. Obviously, a recollection is the only sure way to know that the specimen was not compromised, and we should always request another. But I think that we do owe it to the patient to get started on the work as quickly as we can.

According to Tewari, the expiration date that appears on transport media provides a conservative, suggested date after which the reliable identification of bacteria is not guaranteed. Still, he stated that processing transport media after the expiration date is sometimes “perfectly okay” and can yield a valid result. He explained that the patient is not harmed by processing expired transport media because the worst-case scenario is a false negative; there is no risk of a false positive so long as the packaging remains sterile. Indeed, in the event of a valid positive result, the patient is benefitted by the processing of expired transport media because the physician can begin treating the bacteria sooner than if the laboratory had waited for a new specimen. As Tewari further noted, because requests for a new specimen are not always acted upon, destroying expired transport media can foreclose ever obtaining a valid positive result and treating the patient. Accordingly, Tewari indicated that there is no clinical basis to support destroying expired transport media.

After reading Tewari’s directive, Hilden and Flynn went to their immediate supervisor, Emily Mahank, and voiced their objections to the processing of expired transport media. Mahank told them that she would notify Tewari regarding their concerns.

Early the next morning, January 21, 2010, Hilden discarded two swabs and culture plates from expired transport media that had been prepared for processing by another medical technologist. She sent a message to the troubleshooters, asking that they notify the physicians, but she did not mention that she had discarded the swabs and culture plates.

Later that same morning, Hilden and Flynn met with Moore, the administrative *411 director of the laboratory, to discuss their concerns with Tewari’s directive. They told Moore their belief that processing expired transport media violated Joint Commission standards. At the time, Moore did not know that Hilden had already violated Tewari’s directive.

Following the meeting, Moore spoke •with Tewari and asked him to call Megan Sawchuk, the individual responsible for interpreting the Joint Commission standards, to verify that he was correct on the issue of expired transport media. Tewari contacted Sawchuk as requested. Saw-chuk responded to Tewari that afternoon:

[T]he laboratory director may use clinical judgment to determine a reasonable specimen rejection policy when receiving expired collection or culture materials.... If the laboratory has had experience with recovering significant isolates from expired materials and it is suspected that recollection will be difficult or impossible, it is reasonable to proceed and perform testing. The physician should be informed of the test limitations and that recollection is suggested. It is preferable to include this information in the laboratory report as a comment or disclaimer.

In light of this response confirming his position, Tewari sent another email to the staff instructing them to include a comment on laboratory reports of expired transport media to let the physicians know that the results may be suspect and to discard any remaining expired media in their inventory. The email did not indicate that anyone had contacted the Joint Commission or that Sawchuk had endorsed Tewari’s rationale for processing expired transport media.

When Moore discovered that Hilden had destroyed swabs and culture plates in violation of Tewari’s directive (which had not been retracted), she contacted Szczepan-ski, the labor relations administrator.

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504 F. App'x 408, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sally-hilden-v-hurley-medical-center-ca6-2012.