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Beckley v. St. Luke's Episcopal-Presbyterian Hospitals

United States Court of Appeals, Eighth Circuit

May 16, 2019

Karen Beckley Plaintiff - Appellant
v.
St. Luke's Episcopal-Presbyterian Hospitals, doing business as St. Luke's Hospital Defendant-Appellee

          Submitted: April 16, 2019

          Appeal from United States District Court for the Eastern District of Missouri - St. Louis

          Before COLLOTON, GRUENDER, and ERICKSON, Circuit Judges.

          ERICKSON, Circuit Judge.

         Karen Beckley sued her former employer, St. Luke's Episcopal-Presbyterian Hospitals ("St. Luke's"), for allegedly interfering with her rights under the Family and Medical Leave Act ("FMLA"), 29 U.S.C. § 2601 et seq. The district court[1]granted summary judgment in favor of St. Luke's, and we affirm.

         I. Background

         When reviewing the district court's grant of summary judgment, we recite the facts in the light most favorable to Beckley. St. Luke's hired Beckley in 1995 to work as a surgical technician. A surgical technician's principal duty is to pass instruments in the operating room. Beckley began working in the Labor & Delivery Department. In October 2012, St. Luke's promoted Beckley to a full-time position in the Operating Room Department ("ORD"). The job description summarized that the surgical technician was expected to "[p]erform[] in the scrub role during surgical procedures, following all established Nursing Standards and Hospital Policies." When Beckley was promoted, she was already on intermittent FMLA leave, and St. Luke's understood that Beckley would need to take additional FMLA leave. St. Luke's approved Beckley's requests for intermittent FMLA leave while in the ORD during the following time periods:[2] from August 2012 through February 2013; from February 2013 through August 2013; and from April 2014, through April 20, 2015. St. Luke's terminated Beckley's employment on March 20, 2015.

         Beckley's departmental change to the ORD included a change in some of her job responsibilities, including "on-call" shifts. An on-call shift required the employee to be accessible while off-duty during the shift. During an on-call shift, an employee was to report to work within approximately 30 minutes of receiving an emergency call-in.

         St. Luke's reprimanded Beckley on multiple occasions for failing to respond appropriately to emergency call-in requests. On March 10, 2014, Beckley received a Level 1 warning for failing to respond to messages left on her cell phone and pager. Because of Beckley's failure to respond, St. Luke's was forced to contact the second on-call employee for the emergency. Beckley admitted that this reprimand was unrelated to her taking FMLA leave. On August 12, 2014, Beckley received a Level 2 warning for not responding appropriately to a call-in request. Beckley did not respond to the initial call-in message, but responded to the second contact approximately 35 minutes later. On August 25, 2014, Beckley received a Final Warning for failing to respond to an emergency call-in request. St. Luke's contacted another surgical technician for the emergency. As a consequence, St. Luke's prohibited Beckley from signing up for additional on-call shifts because of her repeated failures to respond appropriately when contacted. Each time Beckley was reprimanded, St. Luke's counseled her on appropriate on-call procedures and the ORD's expectations. St. Luke's informed Beckley each time that any additional occurrences may result in further disciplinary action, including discharge. Each disciplinary action involved a different charge nurse, none of whom played any role in Beckley's termination.

         In addition to the formal disciplinary actions, Beckley was counseled about other issues related to her work. On March 13, 2014, St. Luke's talked to Beckley about being inattentive to details. Beckley was reminded that she needed to focus more and talk less during surgical procedures. Beckley admitted this criticism of her work performance was unrelated to her FMLA leave. During her annual job evaluation on March 30, 2014, St. Luke's suggested Beckley keep a notebook and preference cards for the doctors so that she could focus on her role as technician and decrease the amount of talking and repetitive questioning during the procedure. According to Beckley's personnel file, on April 7, 2014, St. Luke's again discussed with Beckley the need to focus on the task at hand. She was also coached about having accurate surgical counts.

         Beckley, although not formally disciplined for improperly labeling a syringe, acknowledged that it was her responsibility and "a big deal." On July 25, 2014, while precepting a student, Beckley mislabeled a syringe, which was handed to the surgeon during the procedure. The syringe contained a medication rather than the saline solution the surgeon needed for a flush. Beckley admitted the mistake was serious and described the event as one where "the whole [operating] room was involved" and aware of her error.

         Less than seven months after being given a final warning, on March 9, 2015, [3]during a complicated surgical procedure, Beckley became contaminated while in the operating room when she touched a non-sterile object. Beckley recognized immediately that she broke sterility, but did not immediately change her gown or gloves. During the procedure, Beckley left the operating room to use the bathroom without letting the surgeon know. During the restroom break, Beckley had a conversation with a co-worker about the co-worker's upcoming facelift surgery. Beckley denied that this conversation delayed her return to the operating room. Before re-entering the operating room, Beckley had the option of sterilizing with a gel or re-scrubbing. Beckley chose to re-scrub, a ten-minute process, rather than use the gel, a two-or three-second process. By the time Beckley returned to the operating room, an estimated 10 to 15 minutes had elapsed. There was an additional employee who entered the operating room during Beckley's absence to assist with the procedure. After the surgery, the Director of Surgical Services received reports from both nurses who were in the operating room indicating Beckley broke sterility by walking to the sterile field twice while contaminated, she failed to break scrub according to Association of Perioperative Registered Nurse guidelines, she exercised poor judgment in conducting a surgical count during the procedure, and she left the operating room while the procedure was ongoing for an extended amount of time without letting anyone know of her need to leave. Beckley denied that she entered the sterile field while contaminated. She admitted that she was gone from the operating room for at least 15 minutes, but denied that another person entered the room to assume her role.

         Beckley attributed the complaints about her work performance from co-workers and her supervisor to be because of her increased FMLA leave. She asserted that one of her co-workers told her that she "needed to watch herself" with regard to her FMLA usage. Beckley viewed a supervisor's inquiry about whether she could schedule doctor's appointments during off-duty hours as a complaint or concern about her FMLA leave usage. Beckley believed it was because of her FMLA leave that she was being treated differently than other employees for what she viewed as minor infractions. Beckley brought this FMLA retaliation claim against St. Luke's, asserting she routinely suffered adverse employment actions following the exercise of FMLA leave.

         Without direct evidence of retaliation, the district court analyzed Beckley's claim under the burden-shifting framework of McDonnell Douglas Corp. v. Green, 411 U.S. 792 (1973). The court decided that Beckley's temporal proximity claim was insufficient to establish a causal connection to the disciplinary actions or termination and, therefore, she could not establish a prima facie case of retaliation. The court went on to find that St. Luke's ...


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