Paula E. Babb, Plaintiff-Appellant,
Maryville Anesthesiologists P.C., Defendant-Appellee.
from the United States District Court for the Eastern
District of Tennessee at Knoxville. No. 3:17-cv-00242-Thomas
W. Phillips, District Judge.
H. Price, W. Allen McDonald, Michael R. Franz, LACY PRICE
& WAGNER, P.C., Knoxville, Tennessee, for Appellant.
B. Jackson, WIMBERLY LAWSON WRIGHT DAVES & JONES, PLLC,
Knoxville, Tennessee, for Appellee.
Before: MOORE, McKEAGUE, and GRIFFIN, Circuit Judges.
NELSON MOORE, CIRCUIT JUDGE.
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.
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).
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
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).
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
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).
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).
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).
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).
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
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.").
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").
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
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. 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
R.15-3 (Aycocke Aff., Ex.1) (Page ID #152) ...