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Searls v. Johns Hopkins Hospital
Citations: 158 F. Supp. 3d 427; 32 Am. Disabilities Cas. (BNA) 885; 2016 U.S. Dist. LEXIS 6887; 2016 WL 245229Docket: Civil No. CCB-14-2983
Court: District Court, D. Maryland; January 20, 2016; Federal District Court
Catherine C. Blake, United States District Judge, addresses a case brought by Lauren Searls against Johns Hopkins Hospital (JHH) for alleged disability discrimination under Title I of the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act. Searls seeks various forms of relief, including damages and attorney fees. She has filed a motion to strike JHH's expert designations and a motion for partial summary judgment regarding liability, while JHH has countered with a cross-motion for summary judgment on all claims. The court has decided to grant Searls' motions to strike and for partial summary judgment, while denying JHH's cross-motion. Searls, who is deaf and a 2012 nursing graduate from Johns Hopkins, utilized an ASL interpreter during her clinical rotations at JHH, where she received positive evaluations from faculty regarding her performance and communication skills. Shortly before her graduation, JHH encouraged her to apply for Nurse Clinician I positions, which she did, subsequently interviewing and receiving a job offer. The Nurse Clinician I role requires effective verbal communication and interpersonal skills, which are deemed essential for the position. Searls accepted an employment offer on the same day it was presented, which included a condition that her employment and start date were contingent upon successfully completing a health screening. The annual salary for the position was set at $59,508.80. Following her acceptance, Searls inquired about obtaining an ASL interpreter for her hearing impairment, which was acknowledged by Rotman, who advised her to contact the Department of Occupational Health during her pre-employment screening. Searls communicated her need for full-time ASL interpretation as an accommodation to the Department of Occupational Health, which prompted communication with Rhodora Osborn, the ADA Compliance Specialist. Mary Henderson from the Department informed Osborn of Searls' request and her history of hearing impairment. Osborn then coordinated with Kate Demers, the ADA/Accessibility Consultant, regarding the request. Demers assessed the costs associated with hiring interpreters, estimating that Searls would need a team of two interpreters at an annual cost of $240,000, given the average salary for interpreters proficient in medical terminology ranged from $40,000 to $60,000. In 2012, Halsted 8, where Searls was to work, had an operational budget of $3.4 million, while JHH's Department of Medicine had a budget of $88 million, and JHH's overall budget was $1.7 billion. On September 12, 2012, Demers shared the cost estimate with Rotman, who expressed concerns about the affordability of this expense, questioning why the department would need to bear the cost. Rotman conveyed Davis's opinion that due to the financial burden and potential scheduling issues posed by the requirement for an interpreter, accommodating Searls could be problematic, despite acknowledging her qualifications. Davis's email concluded with a note on Searls’ capabilities, aside from her hearing impairment. Haller informed that the requested accommodation could not be accommodated due to cost. Rotman later confirmed to Demers that the department could not accept the restrictions, citing financial constraints. Demers sought clarification on this decision, emphasizing the importance of thoroughly exploring all options for Searls, a qualified applicant. Rotman reiterated that cost was the primary reason for the refusal. Demers requested a detailed breakdown of the reasons for the accommodation denial to demonstrate good faith efforts, and inquired about the department’s budgetary limits for potential compromises. Davis joined the conversation, stating that accommodating Searls would require ongoing expenses that were not budgeted, and that the department's budget constraints would necessitate layoffs to fund the interpreter, which would compromise patient safety. No inquiries were made to Searls about how she would utilize an interpreter in practical situations, nor were alternative accommodations proposed. Searls clarified that she only needed one full-time ASL interpreter, which would reduce costs significantly, but the claim of undue hardship remained. Demers indicated a letter was being drafted to explain the decision based on cost, yet no additional reasons were provided by Rotman. Ultimately, on September 28, the job offer to Searls was rescinded, citing the inability to provide interpreter services due to the impact on departmental resources and operations. In January 2013, Searls began her employment as a nurse at Strong Memorial Hospital, successfully securing the position after a prolonged job search. Upon receiving the job offer, she requested a full-time American Sign Language (ASL) interpreter, which Strong provided. Since her employment began, Searls has consistently utilized the ASL interpreter without any negative impact on patient care or her professional responsibilities, as confirmed by her supervisor. Searls has exceeded performance standards in her reviews and has received promotions during her tenure. The excerpt also addresses the legal standards for granting summary judgment under Federal Rule of Civil Procedure 56(a), stating that summary judgment is appropriate when there is no genuine dispute of material fact. It emphasizes that a genuine dispute exists if a reasonable jury could favor the nonmoving party, while a material fact is one that could influence the suit's outcome. The court must view evidence favorably for the nonmoving party and prevent unsupported claims from advancing to trial. When considering cross-motions for summary judgment, each motion must be evaluated separately, resolving factual disputes in favor of the opposing party. Searls alleges that her job offer was rescinded by JHH in violation of the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act, contending she was a qualified individual capable of performing nursing duties with the accommodation of an ASL interpreter. The ADA prohibits discrimination against qualified individuals based on disability. To establish a prima facie case for failure to accommodate under the ADA, Searls must demonstrate: (1) she has a disability as defined by the ADA; (2) JHH was aware of her disability; (3) she could perform her job's essential functions with a reasonable accommodation; and (4) JHH denied such accommodation. Section 504 of the Rehabilitation Act similarly protects individuals with disabilities from discrimination in federally funded programs. Employment discrimination claims under Section 504 follow the same standards as those under Title I of the ADA. Even if Searls proves her case, JHH can avoid liability by showing that the proposed accommodation would cause undue hardship or that Searls posed a direct threat to others' health or safety. Both parties agree that Searls is deaf, qualifying as disabled under the ADA and Section 504. JHH had notice of her disability due to her previous employment involving ASL interpreters and her formal request for an interpreter during her health screening. JHH's refusal to provide a full-time ASL interpreter led to the rescission of her job offer. The core issue is whether the request for an ASL interpreter constitutes a reasonable accommodation, which hinges on whether it would require reallocating essential job functions. The reasonableness of an accommodation is determined by its feasibility and whether it allows the employee to perform essential job functions. Essential functions are those significantly related to the position. Congress recognizes the provision of qualified interpreters as a valid reasonable accommodation. Although not every request for an ASL interpreter is reasonable, they are generally acknowledged as a common form of accommodation under the ADA regulations. Thus, the determination of what constitutes a reasonable accommodation is context-dependent, with ASL interpreters included as a recognized option. Searls substantiates her request for accommodation by presenting expert evidence, her successful experience as a nurse at Strong with an ASL interpreter, and positive reviews from her clinical rotation at Halsted 8, where she also utilized an ASL interpreter. Rotman offered her a nursing position at Halsted 8 based on her effective performance during the clinical rotation, which was influenced by her colleagues' views. The ADA recognizes interpreters as reasonable accommodations, commonly provided by employers, and Searls has effectively worked with interpreters in both settings. JHH's argument against the accommodation hinges on whether hiring a full-time ASL interpreter would entail reallocating essential job functions. Legal precedents establish that reasonable accommodations do not necessitate the reallocation of essential job functions or the assignment of permanent light duty. For instance, a court ruled that reducing a counselor's caseload was unreasonable as it shifted responsibilities to others, and the ADA does not obligate employers to hire additional personnel to fulfill essential job functions. The Equal Employment Opportunity Commission’s regulations clarify that essential functions must be performed by the individual in the position, with or without reasonable accommodation. Relevant to this case, the essential functions for a JHH Nurse Clinician I include communicating with patients and monitoring alarms. While both parties acknowledge that Searls requires accommodation to perform these functions, they dispute whether providing an ASL interpreter would constitute a reallocation of duties. Searls’ case differs from prior rulings where accommodation requests were deemed unreasonable due to the reallocation of essential job functions. In those cases, such as E.E.O.C. v. Womble Carlyle Sandridge & Rice and Stephenson v. Pfizer Inc., employees sought accommodations that would leave them entirely unable to perform essential job functions, like heavy lifting or driving. Conversely, Searls, with the support of an ASL interpreter, would still engage significantly in essential job functions, including making decisions about inquiries, voicing for herself, and responding to alarms. An interpreter could not independently fulfill these responsibilities, particularly regarding patient care. This leads to the central issue of whether Searls' hearing impairment hindered her ability to communicate and respond to alarms under the ADA. It is determined that a plaintiff is considered unable to perform essential functions only if their impairment severely impacts their job performance. Citing Rohan v. Networks Presentations LLC, the court noted that minor impairments, such as Searls' inability to hear, did not prevent her from fulfilling her role as a nurse, especially since nursing duties encompass more than merely hearing alarms or patient communications. Searls would utilize her medical expertise in interactions and responses, meaning her request for a full-time ASL interpreter would not constitute a reallocation of essential job functions. Therefore, her request was reasonable, and she established a prima facie case of disability discrimination. JHH contends that accommodating Searls with an interpreter would result in undue hardship for the hospital, asserting a defense under the ADA, which states that employers are not liable if they can prove such hardship. The ADA defines "undue hardship" as a significant difficulty or expense, and outlines relevant factors to assess this, including the nature and cost of the accommodation, financial resources of the involved facilities, and the overall financial status of the employer. JHH's argument highlights its operational budgets, particularly for Halsted 8 and the Department of Medicine, while neglecting to consider the broader context of JHH's total operational budget of $1.7 billion, where the interpreter's cost of $120,000 represents merely 0.007%. The court notes that the employer's budget for accommodations is not a valid consideration in determining undue hardship; a company could theoretically claim undue hardship by allocating no resources for reasonable accommodations. JHH's claim that the operational budgets of Halsted 8 and the Department of Medicine could not absorb the interpreter's cost fails to address this larger financial context. JHH further argues that funding the interpreter would necessitate layoffs of at least two full-time Registered Nurses, citing the starting salary of a nurse as approximately $60,000. Discharging two nurses to accommodate a full-time ASL interpreter would save JHH $120,000, highlighting that JHH budgeted $0 for reasonable accommodations. Davis, the director of Medical and Radiology Nursing, confirmed this budgetary threshold. Even if the interpreter's salary is higher than that of a nurse, it does not automatically qualify as an undue hardship under the EEOC’s guidance, which states that cost comparisons alone are insufficient. Strong has successfully accommodated deaf nurses in the past, indicating that JHH's reliance on a zero budget while managing a $1.7 billion budget does not substantiate its claim of undue hardship. Consequently, the plaintiff's motion for summary judgment on this defense will be granted. Regarding the direct threat defense, JHH contends that employing Searls would pose significant safety risks due to reliance on an interpreter for auditory alarms. However, this argument appears to be based on post-hoc rationalizations, suggesting possible pretext. The only contemporaneous support for this defense is an email from Rotman, which does not assert that Searls would be incapable of handling emergencies with an interpreter. Other evidence indicates that the decision to rescind Searls' job offer was primarily due to the costs associated with the accommodation, as stated in various emails. JHH failed to substantiate its direct threat defense regarding Searls' employment, as it did not raise patient safety concerns until after the lawsuit was initiated, and its reasoning for denying her an ASL interpreter was inconsistent and focused solely on costs. The defense lacks an individualized assessment of Searls' ability to perform her job safely, which is necessary under regulatory standards. JHH relied on stereotypes about deafness rather than objective evidence and did not provide any medical basis for its concerns, particularly regarding Searls' ability to hear alarms as a nurse. The testimony from JHH's representative, Rotman, did not demonstrate any observed failure by Searls to respond to alarms, and she did not communicate her concerns to Searls. Consequently, JHH has not established that Searls posed a direct threat to patient safety, leading the court to grant Searls' motion for partial summary judgment on this issue. Additionally, Searls has filed a motion to strike defense experts, arguing that their lack of expertise in deafness and related healthcare impacts their ability to testify effectively on the matter of alarm monitoring and response capabilities, while JHH contends these experts will only address Searls' ability to monitor alarms with or without an interpreter. Federal Rule of Evidence 702 outlines the criteria for admitting expert testimony, requiring that an expert's specialized knowledge aids in understanding evidence or determining facts, is based on sufficient data, relies on reliable principles and methods, and applies those principles reliably to the case's facts. Under the ruling in Daubert v. Merrell Dow Pharmaceuticals, expert testimony must be both reliable and relevant, with assessments depending on the specific context of the testimony. In this case, three experts, lacking experience with deaf healthcare or deafness, cannot adequately testify about the safety and effectiveness of a deaf nurse using an interpreter to monitor alarms. Additionally, the court finds that the defendant's defense lacks individualized assessment and relies on post-hoc rationalizations, rendering the proposed expert testimony irrelevant. Consequently, the court grants the plaintiff's motion to strike and for partial summary judgment, while denying the defendant’s cross-motion for summary judgment. The plaintiffs' experts noted that crucial nursing functions include communication and responding to alarms. The court also highlights inconsistencies in the defendant's cost estimates for a full-time interpreter, questioning a claim of $120,000 when prior estimates were significantly lower.