Wells v. Cincinnati Children's Hospital Medical Center

860 F. Supp. 2d 469, 18 Wage & Hour Cas.2d (BNA) 1342, 25 Am. Disabilities Cas. (BNA) 1498, 2012 U.S. Dist. LEXIS 19227, 2012 WL 510913
CourtDistrict Court, S.D. Ohio
DecidedFebruary 15, 2012
DocketCase No. 1:10-CV-619
StatusPublished
Cited by10 cases

This text of 860 F. Supp. 2d 469 (Wells v. Cincinnati Children's Hospital Medical Center) is published on Counsel Stack Legal Research, covering District Court, S.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wells v. Cincinnati Children's Hospital Medical Center, 860 F. Supp. 2d 469, 18 Wage & Hour Cas.2d (BNA) 1342, 25 Am. Disabilities Cas. (BNA) 1498, 2012 U.S. Dist. LEXIS 19227, 2012 WL 510913 (S.D. Ohio 2012).

Opinion

ORDER

SANDRA S. BECKWITH, Senior District Judge.

This matter is before the Court on Defendant Cincinnati Children’s Hospital Medical Center’s motion for summary judgment (Doc. No. 23). For the reasons that follow, Defendant’s motion for summary judgment is GRANTED IN PART AND DENIED IN PART.

I. Background

Plaintiff Elizabeth Wells is currently a registered nurse in Cincinnati Children’s Hospital Medical Center’s (“CCHMC”) bone marrow transplant unit but from 2003 to 2009 she worked in the Critical Airway Transplant Surgery unit. Plaint. Dep. at 10. The record rather vaguely defines this department’s function as caring for transplant patients and high-acuity, i.e., seriously ill, patients. Keegan Dep. at 16. Plaintiffs duties within the Critical Airway are similarly ill-defined except that they obviously involved patient care and included such tasks as properly documenting patient records, administering narcotic medication, changing ostomy bags and dressings, starting IWs, and briefing the on-coming shift nurses as to the status of her patients. See generally Doc. No. 42-1, at 15-18. Plaintiff consistently received good performance evaluations in the Critical Airway unit.

In 2008, Plaintiff began to experience gastrointestinal problems, including pain, vomiting, and diarrhea. The vomiting and diarrhea caused Plaintiff to become dehydrated and experience an electrolyte imbalance. Plaintiff underwent some procedures in 2008 to address these symptoms, including a cholecystecomy and removal of her gall bladder. At various times, Plaintiff was prescribed oxycodone and morphine for pain. Doc. No. 25-2, at 13.

Plaintiff applied for and received intermittent leave under the Family Medical Leave Act (“FMLA”) for the period September 2, 2008 through March 4, 2009. Doc. No., 25-4, at 6-7. She applied for and received continuous FMLA leave for the period November 5, 2008 through November 30, 2008. Doc. No. 25-4, at 8-10. Plaintiffs request for renewal of intermittent FMLA leave for the period March 4, 2009 through September 4, 2009 was also approved. Doc. No. 25-4, at 12.

In January 2009, Plaintiff advised her supervisors, Debra Ballinger and Lisa Keegan, that she had been prescribed and was taking morphine. CCHMC’s policy is that it is permissible for an employee to take prescription medication while on duty so long as it does not affect her ability to [473]*473perform her job. Ballinger Dep. (Doc. No. 26) at 3ÍM1; Doc. No. 32-2, at 35.

In May 2009, Ballinger became aware of several instances of unusual or erratic behavior on Plaintiffs part that called into question, at least in her mind, Plaintiffs fitness to practice in the unit. These incidents include:

1. documenting ostomy care on a patient that did not have an ostomy.
2. going to the wrong room to start an IV.
3. providing a jumbled and confused report at the end of her shift.
4. asking her immediate supervisor if she wanted to go to lunch with a nurse who had left several hours earlier.
5. discussing with a charge nurse a patient who was being discharged when in actuality there was no patient being discharged.
6. pulling morphine for a patient who had no order for morphine.
7. calling in sick one morning and then reporting to work anyway, and then denying that she had called in sick in the first place.

Ballinger Dep. at 59-62; Doc. No. 42-1 at 15 — 48. While Plaintiff has explanations for all of these incidents, she does not deny that they occurred. Plaint. Dep. at 32-36. Plaintiff in fact admits that she felt ill and was confused for about a four hour block of time in late April 2009. Id. at 68. Plaintiff also admitted that she “blacked out a little bit,” id., that she “felt like I was out of my body,” and that she “was extremely confused and dizzy.” Doc. No. 25-4, at 38. Plaintiff also admits in her brief that at this time she was taking Lotronex for her gastrointestinal condition, which has “dangerous side effects, including neurological ones like confusion, sedation, and equilibrium disorders.” Doc. No. 38, at 11 (internal parentheses omitted)

In any event, these incidents cause Ballinger to consider whether they were just errors, whether Plaintiff was impaired because of her prescriptions, or whether she was diverting drugs. Ballinger Dep. at 70; Doc. No. 42-1, at 15. CCHMC, however, rather quickly ruled out drug diversion as the cause of Plaintiffs behavior. Rodell Dep. at 22; Doc. No. 32-2, at 44. An audit of the pyxis dispensing machine showed that her access was within normal limits and another nurse had witnessed her destruction of the morphine she had removed without an order. Doc. No. 42-1, at 4. Ballinger, Keegan, and Terri Thrasher, Director of the Employee Health Department, and Maria Rodell, Director of Employee Relations and Compliance, determined that the appropriate course of action was to suspend Plaintiff without pay pending completion of a fitness-for-duty examination performed by CCHMC’s third-party employee assistance plan (“EAP”) provider, CONCERN.

Plaintiff was suspended on May 19, 2009 and referred to CONCERN. She was also required to submit to a breathalyzer test and provide a urine sample for a drug test. Doc. No. 42-1, at 16; Doc. No. 25-4, at 14. Plaintiff in fact tested positive for two different controlled substances but she was considered to have passed the drug test because the levels were within the limits of her prescriptions. Thrasher Dep. at 51-58. There was concern, nevertheless, that the amount of medication Plaintiff was taking affected her ability to practice safely. Id. at 54-55.

CONCERN referred Plaintiff to Dr. Michael Miller for a psychiatric evaluation. Dr. Miller provided a report to CONCERN dated May 27, 2009. Doc. No. 25-4, at 15-22. In addition to interviewing Plaintiff and having her complete an [474]*474MMDP-2 test, Dr. Miller contacted her other health care providers, and obtained a list of her recent prescription fills. Dr. Miller’s conclusions were damning. Dr. Miller felt that Plaintiff downplayed the seriousness of the events leading to her referral and that she was deceptive and in denial about her use of opiates, had little insight into her behaviors, was doctor-shopping and had been engaging in drug-seeking behavior. Dr. Miller’s ultimate conclusion was:

I do not believe that she should be allowed to work in a clinical setting considering the documented problems in the referral packet and the persistent use of opiates and Apidex. She poses a critical risk to her patients in light of the problems documented by the CCHMC staff. She has not managed her medical condition in a mature and responsible manner. Instead, she has misused and abused opiates, which is of even greater concern considering that she had an incident at work which involved morphine. Her prognosis is guarded due to her minimalization, denial, and out-and-out dishonesty. Chemical dependency treatment is critical at this juncture.

Doc. No. 25 — 4, at 21 (emphasis in original).

On June 5, 2009, as a condition of remaining employed, CCHMC required Plaintiff to enter into a return-to-work agreement. Doe. No. 32-5, at 19.

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Bluebook (online)
860 F. Supp. 2d 469, 18 Wage & Hour Cas.2d (BNA) 1342, 25 Am. Disabilities Cas. (BNA) 1498, 2012 U.S. Dist. LEXIS 19227, 2012 WL 510913, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wells-v-cincinnati-childrens-hospital-medical-center-ohsd-2012.