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Babb v. Maryville Anesthesiologists P.C.

United States Court of Appeals, Sixth Circuit

November 6, 2019

Paula E. Babb, Plaintiff-Appellant,
v.
Maryville Anesthesiologists P.C., Defendant-Appellee.

          Appeal from the United States District Court for the Eastern District of Tennessee at Knoxville. No. 3:17-cv-00242-Thomas W. Phillips, District Judge.

         ON BRIEF:

          James H. Price, W. Allen McDonald, Michael R. Franz, LACY PRICE & WAGNER, P.C., Knoxville, Tennessee, for Appellant.

          Howard B. Jackson, WIMBERLY LAWSON WRIGHT DAVES & JONES, PLLC, Knoxville, Tennessee, for Appellee.

          Before: MOORE, McKEAGUE, and GRIFFIN, Circuit Judges.

          OPINION

          KAREN NELSON MOORE, CIRCUIT JUDGE.

         Under the Americans with Disabilities Act, your employer can't fire you because they think you are disabled, even if, in fact, you are not disabled. But Paula Babb contends that her former employer-Maryville Anesthesiologists, P.C.-did just that, i.e., it fired her because it thought she was visually disabled, even though, in reality, she is not visually disabled. Maryville Anesthesiologists wholeheartedly disagrees, and asserts that it fired Babb, not because of any visual disability (whether real or not), but, rather, because Babb committed two "clinical errors" that placed her patients at grave risk of injury. Thus, the central question in this litigation is a familiar one in employment discrimination law: why, exactly, did Maryville Anesthesiologists fire Paula Babb? The district court agreed with Maryville's narrative, and accordingly granted it summary judgment. But, because we think the district court overlooked too many genuine factual disputes in reaching that conclusion, and also improperly excluded expert testimony favorable to Babb along the way, we REVERSE the district court's grant of summary judgment and REMAND for further proceedings consistent with this opinion.

         I. BACKGROUND

         This case arrives to us on summary judgment, and so we consider the facts in the light most favorable to Babb, drawing all reasonable inferences in her favor. Ferrari v. Ford Motor Co., 826 F.3d 885, 891 (6th Cir. 2016).

         Paula Babb is a Certified Registered Nurse Anesthetist ("CRNA") who has practiced anesthesiology for over a decade. R.24-12 (Babb Resume) (Page ID #714-17). In June 2015, Babb began working as a CRNA at Maryville Anesthesiologists, P.C. ("Maryville"), a small practice group that does the bulk of its work at a local hospital called Blount Memorial. R.24-1 (Babb Dep. at 42) (Page ID #288); R.15-11 (Robertson Dec. ¶ 3) (Page ID #161).

         Babb's tenure at Maryville began uneventfully, with Babb's supervisors reporting no problems with her work. However, approximately a month into her employment, one of Maryville's physician-owners, Dr. Cheryl Coleman, observed Babb "placing her face very close to a computer screen," and asked Babb why she was doing that. R.15-4 (Coleman Aff. ¶ 3) (Page ID #153). Babb informed Dr. Coleman that she suffered from a "degenerative retinal condition" that made it hard for her to read certain screens and medical records. R.24-1 (Babb Dep. at 41-42) (Page ID #287-88); R.24-3 (Babb Dec. ¶¶ 10-11) (Page ID #551-52). But, Babb reassured Dr. Coleman, this disorder did not affect her ability to do her job. R.24-1 (Babb Dep. at 41-42) (Page ID #287-88).

         Dr. Coleman relayed this fact to Dr. Candace Robertson, the Maryville physician-owner responsible for personnel decisions, and added that, as she understood it, Babb "would be blind in ten years." R.24-2 (Robertson Dep. at 105-07) (Page ID #491-93). For her part, Babb denies telling Dr. Coleman that she "would be blind in ten years," and further attests that, in any event, that assertion is "not true." R.24-3 (Babb Dec. ¶ 11) (Page ID #552). Rather, in Babb's view, her condition merely means that she needs to hold written records "close to [her] eyes" to be able to read them; it does not inhibit her ability to read medical records as a matter of course, or impact her ability to perform anesthesiology. Id. ¶¶ 10-11 (Page ID #551-52).

         In any event, not long after Dr. Robertson received this initial report from Dr. Coleman, two other Maryville physician-owners, Dr. Daniela Apostoaei and Dr. Gaelan Luhn, e-mailed Dr. Robertson with similar concerns regarding Babb's vision. R.15-11 (Robertson Aff. ¶¶ 5-6) (Page ID #161). Admittedly, the e-mails do not make clear the seriousness of Babb's vision issues-for instance, Dr. Luhn's e-mail acknowledges that he wasn't sure if Babb failed to read a certain medical record because of her eyesight or because of poor handwriting-but, nonetheless, following this series of reports Dr. Robertson decided to hold a meeting with Babb to discuss her vision. Id. ¶ 7 (Page ID #161, 166).

         At this meeting, which occurred on October 30, 2015, Babb "tearful[ly]" explained to Dr. Robertson and Dr. Wilma Proffitt (another Maryville physician-owner) that, approximately ten years prior, an ophthalmologist in Chattanooga had diagnosed her with a degenerative eye condition. Id., Ex. 3 (Page ID #166). But, again, Babb insisted that the disorder did not affect her ability to do her job, and that her vision was otherwise "stable." Id.; accord R.24-1 (Babb Dep. at 53-62) (Page ID #299-308). In response, Drs. Robertson and Proffitt first reassured Babb that, vision issues notwithstanding, she was a "good fit" and was "doing well." R.24-1 (Babb Dep. at 58, 62) (Page ID #304, 308). Then, the two physicians asked Babb to schedule an appointment with her ophthalmologist and report back, which Babb agreed to do. R.15-11 (Robertson Aff. ¶ 7, Ex. 3) (Page ID #166). Dr. Robertson, in turn, asked Babb if she had "disability insurance" (Babb did) because, in Dr. Robertson's words, she thought Babb "might have a disability." R.24-2 (Robertson Dep. at 71) (Page ID #457). And, finally, after the meeting's conclusion, Dr. Robertson e-mailed her fellow physician-owners to tell them that, because they "all kn[e]w that" an ophthalmologist couldn't issue an opinion definitively "clearing" Babb to practice anesthesiology (because ophthalmologists generally do not make those kinds of calls), Babb's situation might require them to "talk to [their] attorney." Id. at 73- 74 (Page ID #459-60); R.15-11 (Robertson Aff. ¶ 7, Ex. 3) (Page ID #166).

         The months of November and December did not go much better for Babb. Indeed, in an unfortunate catch-22, it appears that, because Babb occasionally began asking other CRNAs to read hospital monitors for her-pursuant to Drs. Proffitt's and Robertson's instructions, and to ensure that she wasn't misreading any vital data-Babb's "vision problems" appeared even more acute to her colleagues. R.24-3 (Babb Dec. ¶ 12) (Page ID #552). Accordingly, at least one CRNA and one Blount Memorial nurse reported further concerns about Babb's vision to Maryville physician-owners in the weeks following the October 30 meeting. R.24-6 (Aycocke Dep. at 43-45) (Page ID #618-20); R.15-10 (Price Aff. ¶ 7) (Page ID #160); see also R.15-13 (Wilson Aff. ¶ 3) (Page ID #177) (describing Babb's "difficulties with her vision" as "common knowledge among the CRNAs"). These concerns, in turn, made their way onto Babb's annual evaluations, which were penned by Maryville physician-owners sometime between December 2015 and January 2016. See R.24-11 (Babb Evaluation at 3) (Page ID #713) (stating, among other things, "[I am] worried about her eyesight," and "I see her questionable ability to see reflect on how surgeons and the medical staff lack accepting her"); see also R.24-2 (Robertson Dep. at 120-22) (Page ID #506-08) (providing background on the evaluation process).[1]

         Notably, however, in late December 2015, while Dr. Proffitt was conversing with a Blount Memorial nurse named Charles Price about Babb's vision problems, Dr. Proffitt learned that Babb had apparently committed an error completely unrelated to her vision back in October 2015. R.24-5 (Price Dep. at 43-46) (Page ID #568-71). As Price explained it, Babb had been assisting him during the surgery of an obese patient, but, near the end of the surgery, Babb began to wake the patient up too early, before the patient had been placed on the proper bed. R.15-10 (Price Aff. ¶ 4) (Page ID #160); R.19 (Updated Price Aff.) (Page ID #190). This error purportedly caused the patient nearly to fall off the operating table (also called a "fracture table"). Id. On January 2, 2016, Dr. Proffitt relayed Price's "fracture table" story (and Price's vision concerns) to Dr. Robertson, and further requested that Dr. Robertson "include these events in Paula Babb's personnel file." R.15-11 (Robertson Aff. ¶¶ 9-10, Ex.4) (Page ID #161, 167).

         And, adding fuel to the fire, just a few days later-on January 5, 2016-Dr. Luhn emailed Dr. Robertson to inform her that, prior to a "robotic arm" surgery he conducted earlier that day, one of Babb's patients had an unusually high number of "twitches" (four, to be exact), which suggested that Babb had not sufficiently paralyzed the patient. Id. ¶¶ 11-12, Ex. 5 (Page ID #162, 168).[2]

         About a week later, on January 13, 2016, Maryville's physician-owners held their regular monthly meeting. R.15-11 (Robertson Aff. ¶ 15, Ex. 7) (Page ID #162, 172). At this meeting, the physician-owners discussed Babb "at length," and touched on both Babb's vision difficulties and Babb's "clinical errors," i.e., the "fracture table" incident and the "robotic arm" incident. Id. At the end of this discussion, the physician-owners voted to fire Babb. As Maryville tells it, it reached this decision solely because Babb's "clinical errors" demonstrated that "she could not provide safe and appropriate patient care." Id. Accordingly, when communicating its termination decision to Babb, Maryville focused exclusively on the clinical errors, and made no mention of Babb's vision. See, e.g., R.15-14 (Jan. 19, 2016 Robertson E-mail) (Page ID #178) ("I explained [to Babb] that she had been dismissed for cause because of the concerns we had over the robotic case and the fracture table incident.").

         Maryville's decision "blindsided" Babb, as nobody at the practice had criticized her anesthesiology techniques prior to her termination. R.24-1 (Babb Dep. at 79-80) (Page ID #325-26). Indeed, at the October 30 meeting, Drs. Robertson and Proffitt had informed Babb that, vision issues notwithstanding, she was a "good fit" and was "doing well." Id. at 58, 62 (Page ID #304, 308). But, as Dr. Robertson emphasized at her deposition, Babb's mistakes during the "fracture table" incident and the "robotic arm" incident were "critical" errors that evinced "terrible clinical judgment." R.24-2 (Robertson Dep. at 60-61) (Page ID #446-47); see also id. at 117 (Page ID #503) (adding that Babb's mistake during the "robotic arm" incident was "something that CRNA students should know [not to do] the first day they're in the robotic room as a student").

         Curiously, though, in an e-mail sent by one of Babb's fellow CRNAs (Crystal Aycocke) just hours after Babb's firing, Aycocke stated that Maryville had fired Babb almost entirely for the other issue discussed during the January 13 meeting, namely, Babb's "worsening" eyesight. The e-mail, which was sent to all Maryville CRNAs, read as follows:

As most of you know, [Babb] has been having major issues with her eyesight and as of late, it has seemed to be getting even worse. We have had numerous complaints from [hospital] staff regarding her inability to read the monitor, etc. Over the past several months the group has given her several opportunities to provide documentation from her eye specialist saying that she was safe to practice. [Babb] was unable to provide this documentation.[3] This, in addition to a few other issues, has forced the group to make a very difficult decision. As of today, she is no longer with our group. Sorry to be the bearer of bad news. This was one of the reasons that our meeting was postponed. See you all tomorrow.
Crystal.

R.15-3 (Aycocke Aff., Ex.1) (Page ID #152) ...


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