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Fahnestock v. Carlisle Regional Medical Center

United States District Court, M.D. Pennsylvania

April 28, 2015



JOHN E. JONES, III, District Judge.

Presently pending is Defendant's Motion for Summary Judgment in this Age Discrimination in Employment Act action alleging unlawful discharge. (Doc. 37). For the reasons that follow, the Court will grant the Motion.


Defendant, Carlisle Regional Medical Center, hired Plaintiff, Stephanie Fahenstock on July 2, 1984. (Doc. 38, ¶ 2). During her term of employment, Plaintiff worked as an ultra sonographer and certified ultrasound technologist. (Doc. 1, ¶ 21). Plaintiff worked virtually continuously for Defendant for almost 28 years, with the exception of a four-month period in 2001-02 during which she worked for a mobile ultrasound company. (Doc. 38, ¶¶ 10-14).[1] Plaintiff was terminated from her employment on April 30, 2012, according to Defendant, because of unsatisfactory performance. (Doc. 1, ¶ 19; Doc. 15, ¶ 19). Plaintiff was over 40 years-old at the time of her discharge.

Plaintiff's personnel file reflects various performance problems throughout her tenure. She received two Counseling Notifications in 1999, both based on patient complaints regarding Plaintiff's demeanor, comments, and tone of voice. (Doc. 38-3, p. 2; Doc. 38-4, p. 2). She received a notification in 2007 for using inappropriate language at the front desk while a patient was nearby. (Doc. 38-7, p. 2). In 2008, she was cited for failure to use the appropriate procedure when absent from work and/or utilizing flex time. (Doc. 38-8, p. 2).

There were multiple instances of corrective and disciplinary action against Plaintiff in 2011. At this time, Melissa Cooper was Plaintiff's direct supervisor, and Jennifer Dorrough was the Director of the Radiology Department and supervised Ms. Cooper. (Doc. 38, ¶¶ 15, 24-25). Plaintiff received an Associate Disciplinary Action Plan (Verbal Warning) on January 6, 2011, for noncompliance with hospital policy regarding requesting a sick day from work. (Doc. 38-9, p. 2). On May 12, 2011, she received an Associate Disciplinary Action Plan (Written Warning) in light of a patient complaint. (Doc. 38-10, p. 2). The citation reflects that a patient overheard Plaintiff commenting that the patient was at the wrong facility for the patient's particular concern and should not be there. (Id. ). The Action Plan states that other staff members performed "a full service recovery... for this patient" but that Plaintiff's comments were "inappropriate and gave the patient the wrong impression of our services, dep[artment] and hosp[ital]." (Id. ). The form describes that Plaintiff responded appropriately to the disciplinary action and took responsibility for the patient error. (Id. ).

On June 16, 2011, another Associate Disciplinary Action Plan (Written Warning) was issued, this time for substandard work. (Doc. 38-11, p. 2). The report relates that Plaintiff placed a biopsy guide on a transducer incorrectly, which resulted in a patient being stuck in the wrong location and could have harmed the patient. (Id. ).[2] Plaintiff's remarks printed on the form characterize the error as a "mistake" and suggest that she was having a "bad day" and that it would not happen again. (Id. ).

On November 23, 2011, Plaintiff received an Associate Corrective Action Plan, delineated as her Third Written Warning. (Doc. 38-12, p. 2). This citation described a number of performance concerns, including complaints from providers related to poor imaging and conveying results outside of scope; general customer service problems; and "multiple [quality assurance] errors, " including an October endovaginal scan using poor imaging technique, a November ovarian scan where there was a worksheet error and an incorrect tissue measurement, and a November carotid scan involving erroneous documentation, i.e., an incorrect ratio. (Id. ; Doc. 43-8, p. 12).

Plaintiff submitted a letter, dated February 20, 2012, responding to the November 23, 2011 Action Plan. (Doc. 38-12, pp. 5-6). Regarding the provider complaints, Plaintiff explained that the hospital acquired a new radiology group in July 2011 that has "high standards" and that it was "quiet [sic] an adjustment getting used to the new standards and protocols." (Id. at p. 5). She stated that all of the ultrasound technologists received additional training and noted that she discussed the issues with Ms. Dorrough and was confident that all problems were resolved. (Id. ). With respect to the customer service concerns, Plaintiff remarked that she also discussed these issues with Ms. Dorrough. (Id. ). Plaintiff next addressed each quality assurance error in turn. She stated that, after the poor endovaginal scan, she worked on her technique with Ms. Cooper in order to achieve the preferred images. (Id. ). Plaintiff explained that the ovarian scan was performed by a student whom she was supervising, and she had permitted the student to fill out the correspondent worksheet. (Id. ). Plaintiff stated that she had initially reviewed the student's work but failed to perform a final check, and that the student did not record all of the requisite measurements on the worksheet. (Id. ). Lastly, Plaintiff explained that the carotid worksheet had been reformatted recently, moving the line for the ratio from the bottom to elsewhere on the page. (Id. ). Plaintiff stated that "[i]n a hurry and out of habit" she incorrectly placed the ratio at the bottom. (Id. ). Plaintiff closed the letter by expressing that she welcomes continued feedback and comments and looks forward to continuing to provide excellent radiologic service on behalf of Defendant. (Id. at p. 6).

Meanwhile, Ms. Dorrough advised Leslie Shatto, Defendant's Human Resources Director, of Plaintiff's recent quality errors and customer service issues. In an email dated December 12, 2011, Ms. Dorrough recounted in detail the multiple recent quality errors, including that Plaintiff had released a patient with a low amniotic fluid index without consulting the radiology group or the attending physician and that her poor imaging in that case led to emergency physician call, unnecessary hospitalization, and an additional doctor's appointment for the patient. (Doc. 38-13, p. 2). On a different occasion, Plaintiff had told a patient that results of a scan were "normal" and permitted the patient to leave, again without consulting the radiology group or the attending physician. (Id. ). Ms. Dorrough remarked that it was never appropriate for an ultrasound technologist to comment on the result of an ultrasound and that, in fact, the patient's findings were critical. (Id. ). The patient had to return to the hospital immediately and be admitted. (Id. ). The email also stated that Plaintiff's scanning was evaluated as sub-standard in a conference with the radiology medical director. (Id. ). The radiologist commented that Plaintiff's "interest in learning... is something she has to want to do and want to fix" and they have not seen such initiative from her since the new radiology group came on board in July 2011. (Id. ).

Plaintiff received her annual written Performance Evaluation for 2011 on December 27, 2011. (Doc. 38-14, pp. 2-6). She received a total score of 62%. (Id. at p. 2). The evaluation contained 66 Job Functions/Performance Standards, each assessed on a scale of 1 to 5. (Id. ).[3] Plaintiff scored 3s in the vast majority of areas, and scored 2s or 2.5s on eight of the questions. (Id. at pp. 2-4). The questions on which Plaintiff received a 2 or 2.5 are listed here, along with the pertinent hand-written comments of the reviewer:

2.C. Indicates to Radiologist any additional pathology noticed not pertaining to ultrasound exam, assuring quality patient care. Comment: "continue to educate yourself to the exceptions to normal."
5.D Instructs patients politely, concerning preps or exams and handles questions in a concerned manner. Comment: "have seen major improvements here."
9.A Meets customer needs and expectations in an ethical, proficient, competent and timely manner. Comment: "need to ...

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