Medical resident dismissed from program following reports about her performance, attendance, patient care
Under California’s Labor Code, morbid obesity does not qualify as an impairment if there is no evidence that an underlying physiological disorder or condition causes it, a recent ruling said.
The respondent in a recent case started working as medical resident at the emergency-medicine department of Texas Tech University School of Medicine in El Paso in 2015. During her residency, she was morbidly obese, weighing around 400 pounds.
About five months into her first year of residency, a professor and attending physician emailed Dr. Radosveta Wells, who ran the residency program, to report that the respondent was struggling while they were performing a procedure together.
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In December 2015, the respondent missed her shift and failed to timely inform Wells about her absence. She instead appeared as a patient in the emergency department, where she was supposed to be working, to complain about heart palpitations.
In January 2016, Wells learned that the respondent self-prescribed a refill for her blood-pressure medication, which breached the university’s policy for residents. A chief resident then reported to Wells that the respondent chose not to perform a procedure because a gown of the proper size was not readily available.
Wells arranged an emergency meeting of the Clinical Competency Committee, which recommended that she impose a three-month probation with a remediation plan. At the end of January 2016, she and the chair of the emergency-medicine department told the respondent that she would be on probation and under a remediation plan.
Complaints about performance
The respondent successfully requested a one-month leave of absence and returned to her residency in March 2016. By late March, Wells received more reports from faculty members expressing concerns about the respondent’s performance, attendance, professionalism, and patient care.
On one occasion, the respondent left within an hour of arriving at work with flu-like symptoms. She failed to finish her notes and to order labs for her patients. Two incidents involved the respondent refusing to evaluate critically-ill patients. These reports alleged that she posed a patient safety risk.
At another emergency meeting, the committee recommended the respondent’s suspension pending an investigation and evaluation of her post-leave performance. It later recommended her dismissal from the residency program.
The chair of the emergency-medicine department agreed with the recommendation and notified the respondent about the recommendation via an April 2016 letter. The university’s appeals panel upheld the recommendation. The university’s president dismissed her in May 2016.
The respondent filed a lawsuit claiming that the university dismissed her because of her morbid obesity, which amounted to unlawful discrimination due to a disability under the Texas Commission on Human Rights Act (TCHRA), codified in chapter 21 of the state’s Labor Code.
The university argued that the case should be dismissed for lack of jurisdiction and that the Labor Code did not waive its sovereign immunity. The trial court and the court of appeals disagreed and ruled in the respondent’s favor.
University wins before Supreme Court
In Texas Tech University Health Sciences Center – El Paso v. Dr. Lindsey Niehay, the Texas Supreme Court dismissed the case for lack of jurisdiction upon reversing the appellate court’s judgment.
The TCHRA made it unlawful for an employer to discharge a worker because of disability. To file a disability discrimination claim under the TCHRA, the respondent should demonstrate that the university perceived her as having an impairment and terminated her based on that perception.
If the claim was based on an allegation that the employer regarded the worker as morbidly obese, there should be evidence that a physiological disorder or condition caused the morbid obesity or else it would not be considered an impairment under the Labor Code, the Supreme Court said.
The respondent’s claim failed due to lack of jurisdiction because the university was immune from suit, the Supreme Court concluded. The respondent failed to show that a physiological disorder caused her morbid obesity, that the university perceived her as having an impairment, and that she consequently had a disability as defined by the Labor Code, the Supreme Court explained.
