Court: District Court, E.D. Wisconsin; September 24, 2014; Federal District Court
Dr. Juliana DiGiosia filed a lawsuit against her former employer, Aurora Health Care, claiming her leave and subsequent termination violated the Americans With Disabilities Act (ADA) and the ADA Amendments Act (ADAAA) of 2008. Aurora moved for summary judgment, which was granted. DiGiosia worked as an obstetrician-gynecologist at Aurora's Oshkosh clinic from 2002 until January 2009, during which she received good performance reviews and faced no disciplinary action. However, tensions arose following two tragic incidents involving the deaths of infants, leading to an internal peer review regarding her practices.
Concerns about DiGiosia's competence escalated after her husband was charged with manslaughter in 2007. In 2008, during a C-section, she was unable to complete the procedure, leading to a colleague intervening and delivering the baby, who unfortunately died. While DiGiosia attributed the death to a medical condition, others suggested it stemmed from complications during the delivery. An initial review panel found no fault in her actions, although the reliability of this review was questioned due to incomplete records.
In the summer of 2009, the situation worsened with complaints from colleagues about DiGiosia's work ethic and patient management. A nonstress test she ordered showed non-reactivity, but she misinterpreted a subsequent test as reactive, leading to the stillbirth of the fetus two days later. Dr. Laibly, the OB/GYN department chair, lost confidence in her abilities and initiated further peer reviews involving other physicians and Aurora's human resources, culminating in the decision to terminate her employment.
On September 19, 2008, Dr. Kiefer informed the Plaintiff that she would be placed on leave, which she requested to be medical leave. Subsequently, the other OB/GYN physicians voted 4-1 against her return to practice. An outside reviewer, Dr. Mason, highlighted concerns regarding Plaintiff's medical care, record-keeping, and interactions with other staff in a report dated November 19, 2008. While the report raised issues, it was not a definitive condemnation of Dr. DiGiosia, merely seeking further information. A follow-up indicated potential misinterpretation of nonstress test results and issues with her treatment of hypertensive patients.
The clinic's peer review committee accepted Dr. Mason's findings, allowing Plaintiff to defend her practices, yet concluded she had significant documentation and care issues. The case was escalated to the management committee, which had the final decision on her employment. An email from Dr. Devermann indicated that the peer review committee would recommend corrective actions like mentoring and education, while her colleagues favored termination due to a loss of trust in her work quality. In January 2009, the management committee unanimously decided to terminate her employment.
The case involves complexities due to the ADAAA's effective date of January 1, 2009, just before her termination. Plaintiff claims two adverse employment actions: being placed on leave in 2008 under the ADA and her termination in January 2009 under the ADAAA. The legal standards for these claims differ. Plaintiff contends the forced leave was due to her employer regarding her as disabled, needing to demonstrate that the employer mistakenly believed she had a substantial limitation in major life activities. However, while she claims her employers perceived her as unable to think and work, she provides insufficient evidence to support this assertion. There is, however, indication that some colleagues believed her job performance was impaired, leading to her termination.
Evidence must demonstrate that the employer perceived the Plaintiff as limited in her ability to perform not just one specific job, but a broad range of jobs for a “regarded as” claim to succeed, as established in Hanson v. Caterpillar, Inc. The “regarded as” provisions of the ADA aim to protect individuals from stereotypes and prejudices of employers who may misunderstand impairments. However, in this case, the decision-makers were a group of physicians knowledgeable about bipolar disorder, making it unlikely that their employment decisions were influenced by misconceptions regarding the Plaintiff's condition. The Plaintiff’s assertion of prejudice is further undermined by the fact that her colleagues worked with her for years after being aware of her bipolar disorder, raising questions about the plausibility of sudden bias.
The summary judgment stage reveals a lack of evidence indicating that the decision-makers regarded the Plaintiff's bipolar disorder as a disability under the ADA. To qualify as disabled, an impairment must significantly affect major life activities, which is not supported here. The evidence suggests that the decision-makers believed the Plaintiff could no longer serve as an OB/GYN and surgeon, but there is no indication they thought she could not perform a broader range of jobs, such as a primary care physician. Complaints centered on her work ethic and specific job performance rather than any perceived disability. Previous cases highlight that awareness of a medical condition does not equate to viewing someone as disabled under the ADA. For example, workplace jokes about obesity do not reflect an assessment of an employee's ability to perform their job.
If an employer had made comments questioning an employee's ability to perform major life activities, it could be relevant to a discrimination claim, but that scenario did not occur here. Instead, a colleague's remarks about the employee's "manic" condition were not indicative of a belief that she was substantially limited in any major life activities. The remarks made by Dr. Pech, such as “Juliana’s gone manic again,” reflect a concern about the employee's job performance during a manic episode rather than a general belief about bipolar individuals' capabilities. This situation parallels the case of Povey v. City of Jeffersonville, where comments regarding an employee's inability to perform specific tasks did not imply a broader assessment of her overall employability. The statements made about the plaintiff's manic state were similarly limited and did not suggest an incapacity to perform a wide range of jobs. Moreover, evidence from performance reviews indicated that Dr. Pech recognized the plaintiff's bipolar disorder but still rated her work positively, indicating no substantial limitation in her job performance.
Evidence suggesting that the plaintiff's colleagues viewed her bipolar disorder as affecting her work as an OB/GYN is minimal and does not indicate that they believed it impaired her ability to perform major life activities. Knowledge of her mental illness does not equate to the belief that she is substantially limited in any major life activities. Therefore, neither Dr. Pech nor any other decision-makers regarded her as disabled when she was placed on leave, leading to the dismissal of her claim related to the 2008 leave.
To succeed in an ADAAA discrimination claim, the plaintiff must demonstrate (1) she is disabled under the ADAAA definition, (2) she is qualified for her job with or without reasonable accommodation, and (3) she experienced an adverse employment action due to her disability. Following the indirect method, she must first establish a prima facie case by showing these three elements.
After establishing the prima facie case, the burden shifts to the employer to provide a nondiscriminatory reason for the employment action. If the employer does so, the burden returns to the plaintiff to prove that this reason is a pretext for discrimination. Under the ADAAA, a person may be considered disabled if regarded as such due to an actual or perceived impairment, regardless of whether it limits a major life activity. The ADAAA broadens the definition of "regarded as" to include perceived impairments that do not substantially limit life activities. Consequently, adverse employment actions based on minor impairments, even if not traditionally viewed as disabilities, can violate the ADAAA. The plaintiff asserts that her coworkers' awareness of her bipolar disorder could support a jury's conclusion that she has a perceived mental impairment.
Knowledge of an employee's impairment by decision-makers does not automatically establish a case of discrimination under the ADAAA. The act requires that an employer not only recognizes an impairment but also takes prohibited action against the employee because of that perception. Causation is integral to the definition of disability under the ADAAA, meaning an employee must demonstrate that they were subjected to discriminatory actions specifically due to their impairment.
In the case discussed, the plaintiff attempted to show that colleagues were aware of her bipolar disorder, citing comments made by Dr. Pech. However, since Dr. Pech was not part of the decision-making committee that terminated her and had a long-standing professional relationship with the plaintiff, his remarks did not indicate discriminatory intent. Additionally, the plaintiff's reliance on a meeting with Dr. Kiefer, where he inquired about her condition, was undermined by Kiefer’s assertion that he was merely responding to her disclosures. Furthermore, Kiefer's positive comments about her surgical skills suggested a lack of discriminatory motive.
The management committee responsible for the termination consisted of ten voting members, and even if some members knew about the plaintiff's condition, they were not the individuals who made the termination decision. The plaintiff's general assertions about widespread knowledge of her condition were not supported by sufficient evidence to establish a direct link between that knowledge and the decision to terminate her employment.
Dr. Landauer was the only individual on the management committee with voting rights. The defendant argues that evidence regarding the plaintiff's bipolar disorder is insufficient, as only two voting members were aware of her condition, and there is no indication that the other eight members from various departments had knowledge of it. The "cat’s paw" theory, which allows for the imputation of discriminatory motives from a non-decisionmaker to an employer, does not apply here, as Dr. Pech was not the plaintiff's supervisor and Dr. Kiefer’s role as a committee member does not definitively classify him as a supervisor. Although Dr. Kiefer initiated an investigation due to serious concerns raised by other doctors, there is no evidence he disclosed the plaintiff’s mental health condition to the committee or influenced their decision. Additionally, Dr. Duffy, who led the peer review committee, was unaware of the plaintiff's bipolar disorder. Consequently, there is no evidence that a majority of the management committee knew about her condition or that it influenced their decision to terminate her employment. Thus, the plaintiff cannot demonstrate that her bipolar disorder was the cause of her termination under the ADAAA definition of disability. Even if she could establish a prima facie case of discrimination, the defendant's legitimate reasons for her placement on leave and termination—clinical and behavioral issues impacting patient safety—are not shown to be pretextual.
A plaintiff can establish pretext regarding an employer's adverse employment actions by showing that the employer's stated reasons (1) had no factual basis, (2) did not genuinely motivate the actions, or (3) were insufficient to justify the actions and thus pretextual. Simply disagreeing with the employer's reasons is insufficient; courts focus on the honesty of the employer's explanations rather than their correctness. An employer's good faith actions, even if misguided, are not subject to second-guessing. The credibility of the employer's account is what matters in summary judgment, with pretext defined as a false justification rather than an error. To indicate a genuine issue of fact regarding pretext, a plaintiff must demonstrate that it is more probable than not that a discriminatory motive influenced the employer's actions or that the employer's explanation lacks credibility.
In this case, Dr. DiGiosia failed to show either of these points. There were significant concerns regarding her actions related to two sentinel events involving patient deaths, as well as additional complaints about her case handling. The external review confirmed the validity of these concerns. Dr. Duffy and Dr. Mason, who were unaware of her disability, nonetheless expressed serious apprehensions about her medical care. A panel of physicians unanimously recommended her termination, prioritizing patient safety. Dr. DiGiosia has only shown a disagreement regarding the quality of her care, failing to demonstrate that her employer's concerns were unfounded or insincere.
Aurora's counterclaim alleges that Dr. DiGiosia breached her employment agreement by not returning an overpayment of $19,649, which remains undisputed as she did not respond to the counterclaim. Her claim of discrimination related to her leave lacks supporting evidence. Ultimately, while Dr. DiGiosia believes her medical treatment was exemplary, the record suggests her colleagues' frustrations with her may have contributed to her termination, beyond the stated concerns about patient care.
Plaintiff's lawsuit under the ADA and ADAAA fails to survive summary judgment, as she has not demonstrated that Aurora discriminated against her due to a real or perceived disability. The court grants the Defendant's motion for summary judgment, dismisses the Plaintiff's complaint, and awards the Defendant $19,649 plus interest and reasonable attorney’s fees on its counterclaim. Although Plaintiff contends that interpreting the test results involves ambiguity and that reasonable physicians can disagree, the matter cannot be resolved at this stage. Notably, multiple physicians questioned Dr. DiGiosia’s conclusions, although these reviews are not part of the record. Plaintiff's claim of having a "record of" disability is insufficiently presented and would fail because she must prove a physical impairment that substantially limits major life activities. The legal interpretation of disability is complex, as the statute defines it based on substantial limitations while also allowing for a "regarded-as" disability without a requirement for such limitations. Some courts, like in Mangel v. Reading Eagle Co., have suggested that knowing an employee has an impairment suffices, but causation remains essential. Furthermore, Plaintiff mentions colleagues at a different hospital during her treatment but does not clarify the relevance of their identities to the case, given the large number of patients hospitals admit annually.
