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Lentini v. Geisinger Medical Center

United States District Court, M.D. Pennsylvania

March 26, 2018

DIANE M. LENTINI, Plaintiff
v.
GEISINGER MEDICAL CENTER, SHAMOKIN AREA COMMUNITY HOSPITAL, and GEISINGER HEALTH SYSTEM FOUNDATION, Defendants

          MEMORANDUM

          MANNION JUDGE

         Pending before the court is the defendant's motion for summary judgment. (Doc. 36). Based upon the court's review of the motion and related materials, the defendant's motion will be granted.

         Summary judgment is appropriate "if the pleadings, the discovery [including, depositions, answers to interrogatories, and admissions on file] and disclosure materials on file, and any affidavits show that there is no genuine issue as to any material fact and that the movant is entitled to judgment as a matter of law." Fed.R.Civ.P. 56(c): see also Celotex Corp. v. Catrett. 477 U.S. 317. 322-23 (1986); Turnery. Schering-Plough Corp.. 901 F.2d 335. 340 (3d Cir. 19901A factual dispute is genuine if a reasonable jury could find for the non-moving party, and is material if it will affect the outcome of the trial under governing substantive law. Anderson v. Liberty Lobby. Inc.. 477 U.S. 242. 248 (1986): Aetna Cas. & Sur. Co. v. Ericksen, 903 F.Supp. 836. 838 (M.D. Pa. 1995V At the summary judgment stage, "the judge's function is not himself to weigh the evidence and determine the truth of the matter but to determine whether there is a genuine issue for trial." Anderson, 477 U.S. at 249: see also Marino v. Indus. Crating Co.. 358 F.3d 241.247 (3d Cir. 2004) (a court may not weigh the evidence or make credibility determinations). Rather, the court must consider all evidence and inferences drawn there from in the light most favorable to the non-moving party. Andreoli v. Gates. 482 F.3d 641. 647 (3d Cir. 2007).

         To prevail on summary judgment, the moving party must affirmatively identify those portions of the record which demonstrate the absence of a genuine issue of material fact. Celotex, 477 U.S. at 323-24. The moving party can discharge the burden by showing that "on all the essential elements of its case on which it bears the burden of proof at trial, no reasonable jury could find for the non-moving party." In re Bressman. 327 F.3d 229. 238 (3d Cir. 2003); see also Celotex. 477 U.S. at 325. If the moving party meets this initial burden, the non-moving party "must do more than simply show that there is some metaphysical doubt as to material facts, " but must show sufficient evidence to support a jury verdict in its favor. Bovle v. County of Allegheny. 139 F.3d 386. 393 (3d Cir. 1998) (quoting Matsushita Elec. Indus. Co. v. Zenith Radio Corp.. 475 U.S. 574. 586 (1986)). However, if the non-moving party "fails to make a showing sufficient to establish the existence of an element essential to [the non-movant's] case, and on which [the non-movant] will bear the burden of proof at trial, " Rule 56 mandates the entry of summary judgment because such a failure "necessarily renders all other facts immaterial." Celotex Corp.. 477 U.S. at 322-23: Jakimas v. Hoffman-La Roche. Inc., 485 F.3d 770. 777 (3d Cir. 2007).

         The plaintiff has brought the instant action alleging age discrimination and retaliation under the Age Discrimination in Employment Act, ("ADEA"), as well as under the Pennsylvania Human Relations Act, ("PHRA")[1]. The undisputed facts, as supported by the record[2], establish that the plaintiff graduated from the Pottsville School of Nursing in 1966 and has been a registered nurse for 50 years. The plaintiff worked at the Pre-Surgery Clinic at the Shamokin Area Community Hospital, ("SACH"), as a staff nurse until SACH merged with Geisinger, ("G-SACH").

         On January 1, 2012, the plaintiff, at age 66, was retained by G-SACH as an at-will Pre-Surgery Center Registered Nurse, ("PSC RN"), at its Shamokin Campus. In this capacity, the plaintiffs patients included both high risk and pediatric patients. The plaintiffs job duties included performing assessment of patients' surgical and anesthesia risks in preparation for elective surgery, recording information in the patients' electronic health record, maintaining the highest level of patient confidentiality at all times, and demonstrating electronic patient information charting, ("EPIC"), computer skills. According to the Associate Vice President of Surgery and Anesthesia for the Geisinger Clinic, Kyle Snyder, appropriate charting by PSC RNs is critical. Patrick Konitzer, M.D., the anesthesiologist at the Pre-Surgery Clinic at G-SACH, testified that, if deviations or other information are not charted appropriately, it can put patients at risk and subject Geisinger to potential liability. The plaintiff herself has admitted that clarity in documentation is key to the anesthesia process and quality care can be compromised without it. Prior to her retention, in September 2011, the plaintiff participated in a five-day orientation session at Geisinger's Danville PSC, which included training on Geisinger's code of conduct policies, handbook policies, and other matters. The plaintiff also shadowed the Danville PSC RNs, received EPIC training, and engaged in one-on-one meetings with Geisinger's PSC Clinic Nurse Supervisor, Lori Naugle. The plaintiffs one-on-one meetings included reviewing Geisinger's human resources related and clinical policies and procedures, and discussing the plaintiffs duties as a PSC RN. After her hire, the plaintiff received a formal orientation that included job-specific topics like patient safety, HIPAA violations, and Geisinger's InfoWeb, an internal computing system containing Geisinger's policies.

         During her employment with G-SACH, the plaintiff was supervised by Ms. Naugle, who had the power to suspend and/or terminate her.[3] Although she did not recall specifics, Ms. Naugle testified that, during the first six months of the plaintiff's employment, there were occasions when she sat with the plaintiff and they reviewed patient charting together. At that time, Ms. Naugle testified that she believed that the plaintiff was qualified to perform her job. The plaintiff testified that, during this same time, she had no issues with Ms. Naugle. In fact, in June 2012, Ms. Naugle issued the plaintiff a 2.97 out of 4.0 overall score at her six-month performance evaluation, which was accompanied by a raise. The plaintiff scored better than her colleagues, who were younger than she was at the time. The plaintiff was 67 years old when she received this review.

         In July 2012, Ms. Naugle testified that she attended a managers meeting where G-SACH's surgical volumes were presented. As a result of this meeting, Ms. Naugle realized that the plaintiff's patient volume reports were reflecting a higher patient volume than what G-SACH was actually experiencing. Ms. Naugle testified that, as a result of the meeting, she asked her supervisor, Kyle Snyder, to confirm that the actual patient volume reported at the meeting was accurate. The numbers were confirmed, after which Ms. Naugle discussed the patient volume documentation issue with the plaintiff. No discipline was imposed at that time; however, the plaintiff was coached by Ms. Naugle about correctly documenting patient volume.

         In August 2012, the plaintiff was offered additional help by way of training with shortcuts on the computers. The plaintiff accepted the offer and Kathy Hill, a Danville PSC RN traveled to G-SACH for the training sessions from August 28, 2012, through August 31, 2012. During this time, the plaintiff received one-on-one training from Ms. Hill in areas such as EPIC shortcuts, phone pool protocol, the importance of documentation, Geisinger's anesthesia policies and where to find them on Geisinger's InfoWeb. The plaintiff admitted that she found value in the training and received detailed documentation summarizing the training.

         In September 2012, Ms. Naugle testified that she followed-up on the plaintiffs training by reviewing the plaintiffs charts from September 7, 2012 and September 10, 2012. Afterward, the plaintiff testified Ms. Naugle had a conversation with her in which she was informed that she was not doing her job to Ms. Naugle's expectations. When questioned on specific instances, the plaintiff admitted in her testimony that she had not followed policy in documenting medication instructions and had improperly copied forward information in a chart which should have been deleted. As a result of her performance issues, the plaintiff received a verbal warning under Geisinger's Performance Improvement Plan, ("PIP").[4] The plan included, among other things, "[i]mmediate and sustained improvement in the above areas to encompass the following ... 5. accuracy in documented data - This may mean double checking numbers for accuracy this needs to be 100%." After the PIP meeting, the plaintiff specifically asked Ms. Naugle to review her charts and email any problems found to the plaintiff's attention. The plaintiff has admitted that, if someone is on a PIP, he or she would be subjected to additional scrutiny. However, no other PSC nurse was placed on a PIP during this time period.

         Ms. Naugle testified that, if she found a repeated issue, she would talk to the nurse about it, and then follow up with charts they have done. If the nurse would continue to have the same charting errors, it would be a performance issue at that point. In her PIPs, Ms. Naugle did not reference any specific infractions that were repeated by the plaintiff testifying that the PIPs are only to contain a summation of errors, not every error identified.

         Erin Winn, Senior Human Resources Generalist, testified that Ms. Naugle reached out to her about work performance concerns regarding the plaintiff involving lack of documentation and not following protocols of the department. Ms. Winn provides human resource guidance to managers working through employee issues, as well as serving as a resource for employees. She maintains an office at G-SACH. Ms. Naugle was consistent in her concerns to Ms. Winn that the plaintiff demonstrated work performance issues in that patient-related work was not completed appropriately and documentation was not clear or complete.

         The plaintiff testified that her first interaction with Ms. Winn was prior to her written PIP when Ms. Winn called the plaintiff into her office to introduce herself and to express the concerns that Ms. Naugle was having with respect to the plaintiff. At that time, the plaintiff testified that, while Ms. Winn did not expressly do so, she felt Ms. Winn was suggesting that she resign or retire. Ms. Winn denies ever making such a suggestion, expressly or otherwise. Subsequently, in October 2012, Ms. Winn participated in the plaintiffs written warning meeting with Ms. Naugle and the plaintiff. According to the plaintiffs written warning PIP, the plaintiff was counseled, in part, that "attention to accurate documentation is a key part of [her] position. Clarity in documentation is key as the anesthesia process is a working document and if communication is not excellent then quality care is compromised." The plaintiffs action plan required immediate and sustained improvement in five areas, including accuracy in charting. The plaintiff testified that Ms. Winn asked her at the meeting if there was anything she or Ms. Naugle could do to help the plaintiff. In response, the plaintiff requested a bigger office and a privacy curtain for the patient when she was doing EKGs, but she did not ask for any additional EPIC or goals training. The plaintiff testified that she chose to move forward in meeting the expectations of the position, instead of undergoing some other type of training. At that point, the plaintiff knew that Ms. Naugle would be reviewing her charts, as she had already been doing so, and expressed to Ms. Winn and Ms. Naugle that she felt that she was being subjected to higher scrutiny than others.

         On a number of occasions between November 26, 2012 and November 29, 2012, the record reflects that the plaintiff was directed by Ms. Naugle to either correct or update medical information in her files. On November 29, 2012, Ms. Naugle emailed a copy of a suspension-level PIP to her supervisor, Mr. Snyder, and Ms. Winn. According to Ms. Naugle's verification and exhibits, she attempted to call the plaintiff on November 29, 2012, and email her on December 3, 2012 to schedule a meeting.[5] Also on December 3, 2012, the record demonstrates that Ms. Naugle informed the plaintiff of a number of issues occurring in her records. The plaintiff eventually advised Ms. Naugle that she was unable to meet with her until December 5, 2012.

         In the meantime, on December 4, 2012, the plaintiff emailed Ms. Winn and alleged, for the first time, age discrimination and harassment by Ms. Naugle claiming that her records were being unfairly scrutinized. Also on December 4, 2012, Ms. Naugle emailed Ms. Winn about the plaintiff, stating "if [the plaintiff] is planning to resign the end of the next pay period [it's] fine with me ... I hope the meeting goes well." On December 5, 2012, the suspension meeting occurred at which the plaintiff was issued a one-day suspension. After reviewing her suspension, the plaintiff testified that she agreed that errors had been made in her charting.[6] The plaintiff further testified that she "absolutely" agreed with the improvement that was required of her. After her suspension on December 5, 2012, and up until January 14, 2013, a high percentage of the plaintiffs records were reviewed for accuracy.[7]

         The plaintiff filed an informal complaint with Ms. Winn alleging harassment on December 6, 2012. Ms. Winn emailed the plaintiff on December 7, 2012, and advised her that Brion T. Lieberman would investigate the plaintiff's complaint as a neutral party.

         On December 11, 2012, Ms. Naugle emailed her supervisors stating, in part, "Erin [Winn] assures me that this is all going to follow a path to termination without issue[.]" Ms. Naugle testified that "[a] path to termination would be if an employee does not choose to improve, it would go towards termination." A number of emails from Ms. Naugle to the plaintiff from December 2012 and January 2013 reflect continued performance issue critiques. In fact, Ms. Naugle admitted that she wanted to proceed with the plaintiff's termination as of December 13, 2012 because the plaintiffs performance issues at that time were "not at the level that [she] would have wanted [the plaintiff] to maintain employment at Geisinger".

         The plaintiff emailed Mr. Leiberman on December 12, 2012, and forwarded her formal grievance to him on December 13, 2012[8]. A handwritten notation on the email dated December 14, 2012 by Mr. Liberman indicates that Mr. Snyder would set a grievance meeting to address the plaintiff's performance concerns, while Mr. Lieberman would review and address the other items in the plaintiffs complaint, including her discrimination claim. After the plaintiff filed her formal grievance, Ms. Naugle emailed her colleagues and supervisor, stating that she had "great concerns about allowing [the plaintiff] to remain at GSACH unsupervised." Ms. Naugle indicated that "if [the plaintiff] was not voicing a harassment complaint, [she] would be pulling her to Danville for closer supervision or going over there." Also on December 13, 2012, Ms. Naugle emailed Ms. Winn and Mr. Snyder inquiring as to when they could proceed with the plaintiff's termination.

         On December 14, 2012, Mr. Leiberman met with the plaintiff in her G-SACH office. Because the plaintiffs complaint was a hybrid complaint about performance and alleged discrimination, Mr. Lieberman informed the plaintiff that Mr. Snyder would evaluate the performance challenges and he would investigate the age discrimination and harassment allegations. As part of his investigation, Mr. Leiberman met with Ms. Naugle and inquired of her scrutiny of the plaintiff as compared to others and how charts were reviewed and issues identified.[9] Ms. Naugle indicated that she held the plaintiff accountable for her performance errors and that she continued to perform quality checks of 20-30 randomly selected PSC RN charts for the entire PSC clinic. Mr. Lieberman did not speak with anyone else about the plaintiff's performance as he was satisfied with Ms. Naugle's explanation of what had occurred with the plaintiff and communicated the same to the plaintiff. Mr. Lieberman confirmed to the plaintiff that no other employees were on PIPs at that time. On December 19, 2012, Mr. Snyder met with the plaintiff to address the plaintiffs concerns about the validity of the errors identified in the suspension. According to the plaintiff's testimony, Mr. Snyder reviewed some of the matters that Ms. Naugle had listed on the PI P and indicated to the plaintiff that "these may not seem very important, but if Jayco were to come in, these would be zings." After reviewing the plaintiffs suspension document, Mr. Snyder decided to uphold the suspension. On December 27, 2012, Mr. Snyder issued his report on the review of the plaintiffs performance grievance. Of the eighteen numbered challenges by the plaintiff, Mr. Snyder agreed with Ms. ...


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