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Nathanson v. Medical College of Pennsylvania

filed: March 4, 1991.

JAYNE G. NATHANSON, APPELLANT
v.
THE MEDICAL COLLEGE OF PENNSYLVANIA



On Appeal from the United States District Court for the Eastern District of Pennsylvania; D.C. Civil Action No. 88-07914.

Dolores K. Sloviter, Chief Judge,*fn* Scirica and Alito, Circuit Judges. Alito, Circuit Judge, concurring and dissenting.

Author: Scirica

Opinion OF THE COURT

SCIRICA, Circuit Judge

Jayne G. Nathanson brought this suit against the Medical College of Pennsylvania (MCP) for alleged violations of § 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794(a) (1988), and for tortious interference with her present and future contracts with other medical schools. The district court granted MCP's motion for summary judgment on all counts. Nathanson v. Medical College of Pa., No. 88-7914, slip op. at 1, (E.D. Pa. Mar. 19, 1990) We will affirm the summary judgment on the tortious interference with contract claims. However, we will reverse the grant of summary judgment on § 504 of the Rehabilitation Act because the district court's decision was based on an error of law and because we find outstanding two material issues of fact: 1) whether MCP had reason to know that Nathanson's condition was a handicap, and 2) whether MCP provided reasonable accommodations for Nathanson's handicap.

I. FACTS AND BACKGROUND

With noted exceptions, the following facts are undisputed. In 1981, Nathanson was involved in an automobile accident that resulted in continuing back and neck injuries. During the next several years she engaged in physical therapy to recover from her injuries. In 1982, she decided that she wanted to go to medical school and began taking medical-related courses at Temple University and the University of Pennsylvania. In November, 1984, she applied for admission to MCP's 1985 entering class for the M.D. degree. On August 26, 1985, she was accepted for admission to MCP.

During her interviews with two MCP faculty members in July, 1985, and in the narrative section of her application, Nathanson informed MCP about her accident and injuries. She also told the MCP interviewers that she had not been able to sit in the seats provided for examinees for the Medical College Admissions Test (MCAT) because of her disability. Instead, she had been allowed to take the examination at an ordinary table. She stated, however, that she believed at that time that she would not require special accommodations at MCP because she had "never had a problem" with her seating arrangements during her prior course work at Temple and Penn. App. 132-36.

At issue in this case is what took place between Nathanson and MCP administrators from the time that Nathanson first attended MCP to the point of her final departure approximately one year later. Nathanson's transactions with MCP are important because they clarify when and whether MCP was ever aware that Nathanson had a handicap and had requested accommodations, and whether her requests were sufficiently specific for MCP to respond.

A. September 10, 12, 1985: Nathanson's Meetings with Appel and Beasley

Nathanson enrolled in MCP, completed a one-day orientation on Tuesday, September 3, 1985, and began classes on September 4, which she attended until Monday, September 9, 1985. According to Nathanson, her problems at MCP started "from the first day of class" when she encountered difficulty with the school's parking arrangements. She stated that although she spoke to someone about her parking problems, she could not remember the person's name or the title. However, she did remember that "he tried to be helpful and he referred me to, he referred me on to somebody Freeman after that, but I had left [MCP] before I got to speak to Mr. Freeman." App. 143-45.

On September 10, Nathanson met with Dr. Marilyn Appel, MCP's Assistant Dean for Medical Education, to inform her that she was concerned about her ability to continue to attend classes because she was unexpectedly having "severe" muscle spasms in her back and shoulders due to MCP's classroom seats.

A I remember going up to [Appel's] office, telling her the difficulty I was encountering, that it was unexpected, that I felt that the muscle spasms in my back and shoulders were very severe and I was very concerned about being able to continue.

Q What else do you recall?

A I was crying and she put her arms around me.

Q Do you recall anything else?

A. Yes. She told me to think about this and I told her I couldn't continue to sit in class in that circumstance any longer. She said, okay, but just think about this a day or so and then go to see Dr. Beasley.

Q In your meeting with Dr. Appel, did you ask Dr. Appel to have MCP obtain a desk or a chair that you could tolerate?

A Not in my meeting with Dr. Appel. I told her I didn't know what to do. I know I needed some help. I didn't ask her for anything in particular.

App. 145-48 (Deposition of Jayne G. Nathanson).

According to Nathanson, Appel made no further suggestions or comments. App. 147. On or about September 12, Nathanson followed Appel's suggestion and met with Dr. Andrew Beasley, MCP's Associate Dean for Student Affairs. Nathanson's depiction of the specificity of her request for seating at this time varies at different points in her deposition depending upon whether she is only describing her meeting on September 12, 1985, or whether she is comparing that meeting with her last meeting with Beasley on September 3, 1986. When she is comparing her first and last meetings with Beasley, she states that her request was very specific.

Q What happened in that meeting? [on September 12, 1985]

A Well, I described to him the difficulty I was encountering with the seating, and as a result the physical problems I was having with my neck and shoulders as a result of that, that I was surprised, I was disappointed. I asked him if there was anything that could be done to help. He listened to me and he didn't respond. He just, looked at me sympathetically when I talked to him about the pain I was in and the medication I was taking. He did not offer to do anything in terms of the seating in response to my request for help. At the end of the conversation I told him that I would very much like to defer beginning these classes until the next year, until the next September, the next academic year. I remember him looking at me and shaking his head.

Q To indicate?

A As if he understood what I was requesting.

A I recall him saying something about a concern about filling a spot, but that shouldn't be my problem. I thought that was strange and I said, no, I understood because I knew how long I waited all summer long to hear, that the sooner the school knows, if they have a vacancy and someone else can fill it, that I was very sympathetic with that. . . .

Q In that meeting did you discuss with Dr. Beasley in any way the seating arrangements that you had encountered at the University of Pennsylvania or at Temple?

A I remember telling him I was surprised that I was having difficulty with the seating arrangements at MCP because I hadn't had difficulty elsewhere.

Q And did you describe for him in that meeting in any way the difference between the seating arrangements at these other schools and at MCP?

A I remember we talked about it, but I don't remember the words I used.

Q Did you ask Dr. Beasley if it would be possible for MCP to get for you the kind of seating arrangement you had had at Temple or at Penn?

A I didn't use the words that you're using. I asked him for his help with the seating, as I said to you, so that I could be able to continue to sit for class.

App. 149-52.

Q Why didn't you simply ask Dr. Beasley to get you a chair like the chairs at Penn when you met with him during the week of . . . September 9, 1985?

A That was the gist of what our conversation was as I related it to you.

Q But why didn't you say to Dr. Beasley, look, can't you just get me a chair like the one I had at Penn? You didn't say that, did you?

A No. I asked him to help me with the seating the best he could.

App. 158.

Q Well, what did you have in mind, if anything, that MCP could have helped you put together that you could use?

A What I had described to Beasley before way back in [September] '85, and again when I spoke to him on the 3rd [September 3, 1986], that I just needed, and I described it to you, I needed a chair that was supportive with a continuous back with a high enough writing arm or some type of writing ability to write on a surface that was high, compared to where I was sitting, so that I would not have to lean all the way over.

Q Well, as of September 3rd, 1986, were you aware of the existence anywhere of any such arrangement that would have been available to MCP as of that date?

A I'm not referring to a specifically designed unique object; it could be any chair table height that had a supportive back, that the writing surface was high compared to where I was sitting and I'm sure something could have been put together. . . .

Q Are you telling me that all you needed was a chair with a straight supported back and a table that was of sufficient height so that you would not have to lean over to write; is that what you're saying?

A Yes. It was really very simple.

Q Did you ever make that clear to Dr. Beasley?

A Yes. And the first time I made it clear was when I spoke to him in September of '85. And I demonstrated, my normal way is to demonstrate physically, as well as saying it verbally.

App. 192-93 (Deposition of Jayne G. Nathanson).

According to Nathanson, because Beasley did not respond to her request for help, she informed him that she would like to defer beginning classes until the next year. Beasley asked that she put her request in writing. Apart from one brief contact, Nathanson had no further conversations with anyone at MCP until May 27, 1986.

Beasley depicted his September 12, 1985 meeting with Nathanson somewhat differently. He claimed that throughout their conversation, Nathanson requested only a one year deferral, and nothing more, from MCP. Moreover, "at no time then or at any time since has Ms. Nathanson asked me for any specific accommodative devices." App. 210. He did state, however, that Nathanson explained to him that her physical difficulties would preclude her from attending classes at MCP in the next academic year. App. 209.

Specifically, Ms. Nathanson referred to muscle spasms in her neck and back and reluctantly concluded that, due to her pain, she would be unable to continue with class. . . . In this regard, she stated that during the one year period she hoped to sufficiently recover in strength and endurance to successfully attend classes. She also indicated that during that time she would consider modifications of her physical surroundings to reduce the strain on her neck and back.

App. 209-10 (Affidavit of Andrew B. Beasley).

B. September 13, 1985 to April 1, 1986

In response to Beasley's request, Nathanson wrote a letter dated September 13, 1985, addressed to Beasley, in which she requested permission to defer beginning classes at MCP for one year.*fn1 Beasley responded in a letter that same day and "granted her request for a year long leave of absence."*fn2 The differences in terminology used in these two letters became a primary issue in Nathanson's later arguments that she never matriculated at MCP.*fn3 According to Nathanson, if MCP had granted her a deferral, it apparently would not have considered her as being a matriculated student.

Nathanson's letter explained that she was withdrawing because of physical problems and that "she would try to consider modifications of her surroundings in order to reduce the strain on her neck during classes." App. 217. Beasley's letter in response requested that Nathanson inform the school by June 1, 1986 of her intention to return to MCP in September, 1986. App. 218. During the ensuing year, Nathanson "enrolled in and successfully completed medicine-related courses at Penn in order to maintain [her] study habits." App. 107.

In October, 1985, without informing MCP, Nathanson applied to six medical schools for the 1986-87 academic year using the American Medical College Application Service (AMCAS).*fn4 Nathanson did not indicate on the AMCAS form that she had attended, or matriculated at, MCP. For example, the 1986-87 AMCAS application requests that applicants list "all colleges, graduate and professional schools attended" and to "include previous medical schools." Nathanson did not list MCP. App. 220 (Question 8). The application also asks, "Have you ever matriculated in or attended any medical school as a candidate for the M.D. degree?" Nathanson checked "no." App. 224 (Question 16). Nathanson stated that she made these applications because of MCP's "unresponsiveness to [her] physical needs." Moreover, she decided that her "ability to attend medical school would be better encouraged at a different institution" because she had not experienced any physical problems while she was taking courses at Penn. App. 107.

In February or March, 1986, Nathanson met with Ms. Karen Pfordresher, Director, Student Services and Admissions at Georgetown University School of Medicine. According to Pfordresher's letter of December 5, 1988, addressed to Milton Corn, Dean of Georgetown's Medical School, Nathanson visited Pfordresher

at least once in February or March of 86 and described her needs relating to her injury. She did say that the facilities at MCP were not acceptable, but did not say that she was on leave of absence or was awarded a deferred accept from that institution. During her interview she stated that she would come to Georgetown unless she were accepted at a Philadelphia medical school. (Date March 12, 1986. Ms. Nathanson according to her admission believed herself to be accepted at a Philadelphia medical school on March 12, 1986 -- a deferred accept -- and therefore may have mislead the interviewer.)

App. 206. Letter from Karen Pfordresher to Milton Corn, M.D. (Dec. 5, 1988).

On April 1, 1986, Nathanson was accepted at Georgetown for the 1986-87 academic year. In mid-to-late April, she visited Georgetown to pay the deposit and to tour the facilities, which, she concluded at that time, were suitable for her back problem. App. 176.

C. May 27, 1986: Nathanson's Conversation and Correspondence with Beasley

Nathanson stated that because issues concerning her request for financial aid at Georgetown had not yet been resolved, she delayed her decision to matriculate there in the fall.*fn5 Therefore, during the spring of 1986 she continued to stay in contact with MCP about the suitability of her physical accommodations should she return to MCP in the fall.

On or about May 27, 1986, Nathanson telephoned Beasley requesting an extension of the June 1, 1986 deadline to give MCP notice of her intent to resume her course work in the fall. She did not tell Beasley that she had been accepted by Georgetown. She did tell him that she thought that MCP's facilities were inadequate for her physical condition and that she would investigate whether she could find "some type of chair similar to the one [she] sat in at the University of Pennsylvania." According to Nathanson, Beasley made no offer to help her with finding seating arrangements. App. 168. See also Letter from Jayne G. Nathanson to Dr. Andrew Beasley (June 23, 1986) (referring to their conversation on May 27, 1986). Beasley confirmed that Nathanson made this request, and stated that Nathanson told him that she was "exploring possible companies that could provide her with a chair that would satisfy her needs." App. 79. Beasley denied Nathanson's request for an extension but encouraged her to send a letter to hold her place because she could change her mind later on. App. 168-69.

In a letter of May 27, 1986, Nathanson notified Beasley that she would attend MCP in September, 1986. She also indicated that she was concerned about, and was investigating alternatives for, her "physical arrangements" and that she wished to speak with him further about the situation.*fn6 Beasley did not respond to this letter, explaining that it was his understanding that Nathanson would contact him. App. 85-87.

Nathanson stated that she indicated to Beasley in her letter that she was assuming "the burden of the initial search and investigation [of the chair] simply because they [MCP] were not taking it on and I at that point felt that there was no other choice." App. 170. However, because of this, she also stated that she thought it was reasonable for Beasley to assume that she was "investigating the special chair and that [she] would come in and look at the facilities there and would be in touch with him." App. 171. Moreover, she thought that it was reasonable for Beasley to assume that she did not expect MCP to do anything about a chair until MCP had heard further from her. App. 171.

D. June, 1986: Nathanson's Visit to MCP and Conversation with Beasley

In June, 1986, Nathanson and her husband visited MCP to examine the facilities. According to Nathanson, she asked for Beasley's "help and cooperation" in installing a special chair in the lecture hall but she could not recall Beasley's response. App. 172-73. Nathanson stated that she also saw Appel in the cafeteria afterwards and explained that she was trying to sit in the seats again and determine "how something could fit in." Appel responded that "she didn't think the chairs were very comfortable to a person with my type of back. She understood why I was having a problem." App. 172-73.

With regard to the June, 1986 encounter, Beasley stated that Nathanson had not made an appointment with him but simply approached him while he was in the hall during a break between a class that he was teaching. He stated that Nathanson asked to see where her classes would be held in September and he directed her to the appropriate classrooms. "During our brief conversation, Ms. Nathanson did not discuss any particular seating arrangement with me and she did not ask for MCP's help in devising one." App. 211.

E. July 17, 1986 to August 20, 1986

On July 17, 1986, Beasley learned of Nathanson's acceptance by Georgetown through his secretary, who had been reviewing an AMCAS computer printout (the National Multiple Acceptance Listing). Upon further inquiry, he also learned that Nathanson had not indicated on her application that she had matriculated at MCP. App. 88.

In a letter of that same date, Beasley wrote to Nathanson requesting that he be informed of the "circumstances of her action."*fn7 App. 227. Also on that same day, Beasley informed Pfordresher about the situation by letter and a phone call. According to Beasley, he then sent, to Pfordresher and to Richard Randlett, Director of the Association of American Medical Colleges, copies of four letters: Nathanson's letters of September 13, 1985 (requesting that she defer classes for one year) and May 27, 1986 (notifying Beasley of her intent to begin classes at MCP in September) and Beasley's letters of September 13, 1985 (granting Nathanson a leave of absence) and July 17, 1986 (requesting that she explain the "circumstances of her action"). App. 92-93, 212. Beasley also sent a copy of his July 17, 1986 letter to Nathanson to Dr. Mary Ellen Hartman, another MCP administrator. App. 227.

Beasley explained that he contacted Georgetown before he contacted Nathanson because it was a "unique circumstance" to have a student on leave of absence who was holding a place at another medical school for the fall. App. 90, 94. Moreover, it was "quite routine" after June 1 in any admissions cycle to telephone among medical schools if a student was holding an acceptance at more than one medical school. App. 94.

Nathanson explained her ensuing behavior:

From that time [July 17, 1986] until the Promotions Committee [at MCP] acted formally to terminate my opportunity of studying at MCP, I was informed by MCP officials that my opportunity to study at MCP would be in grave doubt. I remained steady to order special seating if necessitated by (a) a refusal by Georgetown to honor its acceptance or to extend adequate financial aid, (b) MCP's ultimately allowing me to study at that institution in the fall, and (c) a continued refusal by MCP to take any steps itself to accommodate my injury. But given the threats and pessimistic indications given me by MCP, I did not order any special ...


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