In the medical field, employers are often concerned about potential threats to patient safety when an employee requests an ADA accommodation. The good news for employers is that courts have recognized that possible threats to patient safety are a legitimate reason for denying a requested accommodation. For example, in Leme v. Southern Baptist Hospital of Florida (M.D. Florida 3/29/17), the employee had a degenerative visual disability known as optic nerve atrophy.  He met the SSA’s definition of legal blindness: his visual acuity was 20/120 in both eyes and he had difficulty seeing colors. He was initially employed by the hospital in an administrative role that did not have direct patient interaction.  He subsequently applied and was hired as an anesthesia technician (Tech) for the Surgical Services Department, and his new duties included, among other things, assisting the anesthesiologist. 

Threat to patient safetyDuring his initial training period in the role, he had difficulty performing some of his responsibilities (i.e., connecting A-lines) but a co-worker assisted him and helped to provide accommodations to assist him, including holding the line up to the light to help him see bubbles in the line. The hospital raised concerns that the proposed accommodations jeopardized patient safety, including, with regard to this proposed accommodation, that once a line was connected to the catheter inside the patient’s artery and bandaged to the patient’s wrist the employee could not hold it up because moving the line could put the patient and risk of a hematoma and could have required restarting the process.  The employee also proposed as an accommodation that the physician connect the A-lines on his or her own. However, the hospital rejected this proposed accommodation because anesthesiologists should keep their attention focused on the patient and connecting A-line could require the anesthesiologist to touch unsterile items. The hospital ultimately informed the employee that he was not able to successfully perform the job requirements and gave him a period of time to apply for other jobs at the hospital.

Not a Qualified Individual. The court granted the hospital’s motion for summary judgment on the employee’s ADA claim on the ground that the employee did not demonstrate that he was a “qualified individual” who could perform the essential functions of the jobs with or without reasonable accommodations. The court concluded that connecting A-lines was an essential function of his job and that no reasonable accommodation had been identified.  The employee asserted that he had “heard of” a Tech at the hospital who did not connect A-lines. However, the court rejected this general assertion as not being based on his personal knowledge and not having sufficient specificity. The court rejected the accommodation of having the physician insert the A-line on the ground that this removed an essential function which the law does not require. With respect to other accommodations suggested (including holding the line up to the light), the court rejected these accommodations on the ground that the hospital had reasonably determined that they posted a thread to patient safety. The court specifically commented that in a medical setting, “the ability to ensure patient safety is inherently a component of every essential function of the job.” The court cited a number of cases where courts have found proposed accommodations in the medical field to be unreasonable as a matter of law because of potential threats to patient safety.

Lessons for employers? This case and others like it should be comforting to employers in the medical field where patient safety is a chief concern.  Courts are inclined to defer to a medical employer’s determination that a proposed accommodation poses a risk to patient safety.  Employers should engage in an individualized analysis of each requested accommodation and articulate precisely how it imposes threats to patient safety. Thoughtful evaluations – and not generalized statements of concern -- are more likely to be approved by courts. In addition, in this case, the hospital allowed the employee to try a number of accommodations and did not act quickly to remove him from the position. Employers who show a willingness to engage in the interactive process and are open-minded about the possibility of accommodations are more likely to succeed in subsequent litigation.