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Haas v. Wyoming Valley Health Care System

March 31, 2008

JONATHAN HAAS, M.D., PLAINTIFF,
v.
WYOMING VALLEY HEALTH CARE SYSTEM, DEFENDANT.



The opinion of the court was delivered by: Judge Caputo

MEMORANDUM

Before meare Plaintiff Dr. Jonathan Haas' request for equitable relief pursuant to the Americans with Disabilities Act ("ADA") and motion for attorney's fees. (Doc. 137, 125.) Also before me is Defendant Wyoming Valley Health Care System's ("WVHCS") post-trial motions for judgment as a matter of law pursuant to Federal Rule of Civil Procedure 50(b), or in the alternative, for a new trial pursuant to Federal Rule of Civil Procedure 59. (Doc. 124.)

Judgment as a matter of law will be entered in favor of the Defendant on the Rehabilitation Act claim because Plaintiff Dr. Haas posed a "direct threat" to the health and safety of the patients in WVHCS. Because Defendant WVHCS is entitled to judgment as a matter of law under Rule 50(b) of the Federal Rules of Civil Procedure, I do not reach the Defendant's motion for a new trial. As the same analysis applies for a "direct threat" pursuant to the Rehabilitation Act and the ADA, Plaintiff's request for equitable relief will be denied. As Plaintiff is not a prevailing party, Plaintiff's motion for attorney's fees will also be denied.

BACKGROUND

Dr. Haas brought suit against WVHCS under the ADA and the Rehabilitation Act of 1973, 29 U.S.C. §§ 791 and 794, seeking equitable relief including reinstatement and damages, respectively. A trial was held before a jury on the Rehabilitation Act claim beginning April 2, 2007, and after five days of trial, the jury returned a verdict in favor of Dr. Haas in the amount of $250,000.00. (Doc. 120.)

The issues for legal relief pursuant to the Rehabilitation Act turn on essentially the same questions which must be decided for equitable relief pursuant to the ADA. These questions are whether Dr. Haas could perform as an orthopedic staff surgeon at the hospital with or without a reasonable accommodation, and, if so, did he pose a direct threat to the patients he might encounter in the operating room at the hospital.

Dr. Haas has a disability, bipolar disorder, and his disability had a substantial effect on the major life activity of thinking. He could not perform as an orthopedic staff surgeon at the hospital without a reasonable accommodation, but he could do so with a reasonable accommodation. The accommodation made by the WVHCS as a condition to reinstatement was reasonable. Lastly, in any, any event, the WVHCS met its burden of proof in demonstrating that Dr. Haas posed a direct threat to patients he might encounter in the operating room at the hospital without adherence to the conditions of accommodation proffered by WVHCS.

The salient facts are as follows. Dr. Haas was a well-educated and trained physician and orthopedic surgeon. Early in his career, while a resident in 1994, he suffered from an episode then diagnosed as a bipolar disorder. He received treatment and continued his career without recurrence until 1999 when he suffered another episode. After a similar diagnosis, he underwent psychiatric treatment and took medication. He recovered, or went into recession. In 2000, he wished to return to northeastern Pennsylvania and entered the employ of Dr. Michael Raklewicz, an orthopedic surgeon in Wilkes-Barre, Pennsylvania. He sought orthopedic privileges at Wilkes-Barre General Hospital, and in this process his mental illness and the episodes occasioned thereby became known to the hospital. Dr. Thomas L. Campbell required a psychiatric clearance of Dr. Haas, and Dr. Haas, in January 2001, secured such a clearance from Dr. Matthew Berger, a psychiatrist selected by Dr. Haas. Thereafter, Dr. Haas was given credentials as an orthopedic surgeon at the hospital.*fn1

On May 23, 2001, while performing a total knee replacement in the operating room at the hospital, Dr. Haas suffered an episode engendered by his mental illness (bipolar disorder). Part way into the surgery, he demonstrated confusion in his thought process to the extent that the assistant and the prosthesis manufacturer's representative gave him instructions on the performance of the procedure. In the course of the episode, he was distracted from the procedure and engaged in conversation with a student unrelated to the surgery. The evidence was abundant that he was confused in his thought processes such that he could not perform the operation without specific instructions and guidance from others.

After the completion of the knee replacement, Dr. Haas continued to exhibit behavior that was consistent with a confusing thought process. He asked the same question five times of two other physicians who were puzzled by his behavior. This was observed by Dr. Raklewicz, who also found Dr. Haas uncommunicative.

After this operating room incident, Dr. Haas relinquished his privileges, and he was granted a one year leave of absence, effective May 24, 2001. Dr. Haas, in an effort to gain reinstatement, asked Dr. Berger to write a letter concerning his condition, which Dr. Berger did in August 2001. The letter opined that Dr. Haas was presently not exhibiting any active mental disease. (Pl.'s Ex. 61.) In November 2001, Dr. Berger wrote advising the hospital that he was unable to clear Dr. Haas for practice. (D.'s Ex. 27.) The letter stated in part that "[a]s to whether Dr. Haas had a psychiatric problem, I am unable to make that determination and say whether a psychiatric problem existed. Therefore, I am unable to psychiatrically clear him." (D.'s Ex. 27.) The letter also states, however, "[that] on interview with me, the patient showed no evidence [of] any Axis I psychiatric disorder. As to Axis II issues, i.e. his personality, the patient does tend to be rather introspective and socially naive in his interactions. However, I do not believe that this reaches the threshold which could be considered a disorder and/or a disease." (D.'s Ex. 27.) Five days later, the Credentials Committee advised Dr. Haas he would need unequivocal psychiatric clearance before he could be considered for reinstatement. (Pl.'s Ex. 39.)

Thereafter, Dr. Haas engaged Dr. Kelly J. Felins in an effort to gain psychiatric clearance. By letter of June 26, 2002, Dr. Felins wrote to Dr. Thomas Campbell. (Pl.'s Ex. 44.) No reinstatement was granted as a result of the June 26, 2002 Felins letter. The letter opined "Regarding Dr. Haas's clinical abilities: I have no way of judging his surgical skills but find that he is quite capable of problem-solving. My reservation would be that under stress, he may have difficulty relating to patients or staff. I recommend that this possibility be directly evaluated, if possible, before making any decisions to resolve this matter." (Pl.'s Ex. 44.) Dr. Felins wrote a second letter on November 4, 2002, in which she "strongly recommended" that Dr. Haas end his voluntary leave and return to work without restrictions. (Pl.'s Ex. 50.) This letter stated, in its entirety:

This letter is a follow-up regarding Jonathan Haas, M.D. Since my last letter he has followed up fully with my recommendations to enter into treatment with Dominic Mazza, M.D. and continues in weekly psychotherapy.

His personality disorder is stable and in no way should interfere with his return to work. I therefore recommend strongly that he end his voluntary medical leave and return to work without restrictions as soon as possible. (Pl.'s Ex. 50.) In the meantime, Dr. Haas had been treated by Dr. Mazza, a psychiatrist, for his bipolar disorder. On November 27, 2002, Dr. Mazza wrote a letter indicating that Dr. Haas was making satisfactory progress, and that he supported Dr. Felins' recommendation. (Pl.'s Ex. 53.) Dr. Mazza's letter, in its entirety, stated "Dr. Jonathan Haas is a patient of mine in individual psychotherapy and is making satisfactory progress. I am aware of Dr. Felins' evaluation and recommendations and support those." (Pl.'s Ex 53.) On December 4, 2002, the Credentials Committee recommended that Dr. Haas' privileges be reinstated with the conditions that he be supervised/assisted in the operating room for a period of six months by a Board Certified Orthopedic Surgeon who was on the staff of the hospital; that Dr. Haas was responsible for securing such an orthopedic surgeon; that Dr. Haas continue with his psychiatric treatment; and, that his treating psychiatrist provide periodic reports of his progress to the hospital. (Pl.'s Ex. 54.) Dr. Haas was notified of these conditions for reinstatement by letter of December 18, 2002 from Dr. Host, the Chief Executive Officer of WVHCS. (Pl.'s Ex. 55.)

Dr. Haas was unable to secure an orthopedic surgeon to supervise him in the operating room. Dr. DePasquale, the Chief of Surgery at the hospital, and a general surgeon, volunteered to accompany him, but the hospital required an orthopedic surgeon, viewing a general surgeon as not being qualified to do orthopedic surgery of the type performed by Dr. Haas.

Dr. Haas informed the hospital he was unable to obtain a qualifying orthopedic surgeon, and requested that this condition be eliminated. The hospital did not respond to Dr. Haas in this regard.

LEGAL STANDARD

I. Judgment as a Matter of Law - Standard

Under Rule 50(b), a party may renew its request for a motion for judgment as a matter of law by filing a motion no more than ten (10) days after judgment is entered. SeeFED. R. CIV. P. 50(b). In the present case, Defendants' Rule 50(b) motion was timely filed in accordance with the Court's May 1, 2007 Order setting post-trial briefing deadlines. (Docs. 131, 148.) Judgment notwithstanding the verdict should be granted sparingly. See Walter v. Holiday Inns, Inc., 985 F.2d 1232, 1238 (3d Cir. 1993). In deciding whether to grant a Rule 50(b) motion: the trial court must view the evidence in the light most favorable to the non-moving party, and determine whether the record contains "the minimum quantum of evidence from which a jury might reasonably afford relief." The court may not weigh evidence, determine the credibility of witnesses or substitute its version of the facts for that of the jury. The court may, however, enter judgment notwithstanding the verdict if upon review of the record, it can be said as a matter of law that the verdict is not supported by legally sufficient evidence.

Parkway Garage, Inc. v. City of Philadelphia, 5 F.3d 685, 691-92 (3d Cir. 1993), abrogation on other grounds recognized by United Artists Theatre Circuit, Inc. v. Twp. of Warrington, Pa., 316 F.3d 392 (3d Cir. 2003) (citations omitted). The question is not whether there is literally no evidence supporting the non-moving party, but whether there is evidence upon which the jury could properly find for the non-moving party. See Walter, 985 F.2d at 1238(citing Patzig v. O'Neil, 577 F.2d 841, 846 (3d Cir. 1978)).

DISCUSSION

I. Standing

The Defendant WVHCS first argues that it is entitled to judgment as a matter of law because Dr. Haas is a non-employee seeking medical staff privileges at the hospital. For that reason, Defendant argues that Dr. Haas is not a member of the protected class of individuals under the Rehabilitation Act or the ADA. The Defendant WVHCS cites Wojewski v. Rapid City Reg'l Hosp., 450 F.3d 338 (8th Cir. 2006), an Eighth Circuit Court of Appeals case in support of its theory.In Wojewski, the plaintiff physician sued the defendant hospital alleging that the termination of his privileges at the hospital violated Title I of Americans with Disabilities Act ("ADA") and the Rehabilitation Act.

The Eight Circuit Court of Appeal's analysis focused first on the plaintiff physician's standing under Title I of the ADA. First, the court noted that Title I of the ADA deals solely with employment discrimination actions. The plaintiff physician was a member of the medical staff, which permitted him to admit patients, use the hospital's facilities, and perform surgeries. Id. at 340. However, the plaintiff physician also leased separate office space and maintained his own staff. Id. The defendant hospital did not bill patients for the plaintiff's services, and the hospital did not pay the plaintiff. Id. The plaintiff physician was later diagnosed with bipolar disorder, and took a leave of absence. Id. Later that year, the defendant hospital reinstated the plaintiff physician subject to certain conditions. Id. After reinstatement, the plaintiff physician experienced an acute episode during surgery, and the defendant hospital terminated the plaintiff physician's medical staff privileges. Id. at 341.

In Wojewski, the Eighth Circuit Court of Appeals affirmed the district court's grant of summary judgment, finding that the plaintiff physician did not have standing under Title I of the ADA because he was not an employee of the hospital, but an independent contractor. Id. at 342. Such a finding was based upon the facts that the plaintiff physician maintained its own office and was not paid by the hospital. Id. Furthermore, the court held that given the similarity between the ADA and the Rehabilitation ...


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