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Chmura v. Monongalia Health System

United States District Court, N.D. West Virginia

August 9, 2019




         The plaintiff, registered nurse Georgette Chmura (“Chmura”), was terminated from her employment at Monongalia General Hospital (“Mon General”), a subsidiary of the defendant, Monongalia Health System (“Mon Health”), after failing to obtain a mandatory influenza vaccination. Chmura alleges that by terminating her employment Mon Health discriminated against her on the basis of her alleged disability, a latex allergy, in violation of the Americans with Disabilities Act (ADA). Pending before the Court is Mon Health's motion for summary judgment. For the reasons that follow, the Court GRANTS Mon Health's motion (Dkt. No. 25), and DISMISSES the case WITH PREJUDICE.[1]

         I. BACKGROUND

         A. Chmura's Employment History and Mon General's Influenza Vaccination Program

         Beginning in January 2007 Chmura was employed by Mon General as a per diem registered nurse (Dkt. No. 26-1 at 6-7). Chmura maintained that job title throughout the duration of her employment with Mon General, working approximately two to three days per week. Id. at 7, 9.

         Sometime in 2015, Mon General implemented a mandatory Influenza Vaccination Program. See Dkt. No. 26-2 (“Flu Vaccination Policy”); see also Dkt. No. 26-1 at 11. The stated purpose of the Flu Vaccination Policy was “to provide information to [Mon Health] Healthcare Workers (HCW) regarding the requirements for all employees, medical staff, allied health staff, residents, contract employees, and volunteers providing services on any [Mon Health] premises to be immunized against influenza” (Dkt. No. 26-2 at 1). Chmura testified during her deposition that the Policy was designed to “reduce [the] risk” of influenza to patients and staff members (Dkt. No. 26-1 at 11-12).

         According to the Flu Vaccination Policy, any healthcare worker having a medical contraindication that prevented him or her from obtaining the influenza vaccination “must submit a Medical Exemption Form in its entirety to [the] Employee Health [Department]” (Dkt. No. 26-2 at 1). The Medical Exemption Form “require[d] complete documentation” from the healthcare worker's physician, and an exemption request was subject to approval by the Chair of the Infection Prevention Committee and the Vice President/Medical Director. Id. A healthcare worker receiving an approved medical exemption “[was] required to wear a mask at all times while at work per annually established vaccination deadlines.” Id. Further, healthcare workers “[failing] to receive the influenza vaccination or obtain an approved exemption by the date determined annually, [were] considered as not meeting the conditions of employment and . . . considered to have resigned their employment.” Id. at 2.

         During her employment with Mon General, Chmura had reviewed the Flu Vaccination Policy and understood that it applied to her (Dkt. No. 26-1 at 10, 17).

         B. Chmura's 2015 Vaccination Exemption Request

         In October 2015, Chmura submitted a Medical Exemption Form completed by her primary care physician, Dr. Janice Allen (“Dr. Allen”) (Dkt. No. 26-3 at 2). The 2015 Medical Exemption Form provided three boxes that could be checked by a healthcare worker's physician, each of which referenced certain recognized contraindications to the influenza vaccination. The Form directed the physician to certify that the healthcare worker “should not be immunized for influenza for the following reasons (Please check all that apply):

[] History of previous allergic reaction and documented allergy testing to indicate an immediate hypersensitivity reaction to the influenza vaccine or a component of the vaccine. Please attach supporting DOCUMENTATION or MEDICAL RECORDS.
[] History of Guillain-Barre Syndrome within six weeks of receiving a previous vaccine. Please provide and attach a detailed narrative that describes the event.
[] Other - Please provide this information in a separate narrative that describe the exception in detail (these requests will be reviewed on a case-by-case basis).”

Id. at 2 (emphasis in original). On Chmura's 2015 Medical Exemption Form, Dr. Allen checked the box next to “Other, ” and noted “severe Latex allergy. Patient concerned Latex in vial or needle.” Id.

         Chmura testified in her deposition that, along with her completed Medical Exemption Form, she provided Mon General with a September 12, 2014 letter from Lisa Donahue, Patient Safety Officer at University of Pittsburgh Medical Center Shadyside (“Donahue”) (Dkt. No. 26-1 at 18-19).[2] In Donahue's words, “the purpose of this letter [wa]s to confirm that during . . . [a hospital] stay beginning September 4, 2014, [Chmura] experienced low blood pressure requiring medication during surgery from the use of latex gloves” (Dkt. No. 26-4). The only supporting documentation Chmura provided with her 2015 exemption request was Donahue's letter recounting her reaction to latex (Dkt. No. 26-1 at 22).

         In an email dated November 9, 2015, S. Nicole Linger, Employee Health & Wellness Manager for Mon General (“Linger”), informed Chmura that her “request for a medical exemption to the vaccine ha[d] been denied” (Dkt. No. 26-5) (emphasis in original). Linger's email also advised Chmura that, “[i]f you fail to receive the influenza vaccination by [November 13, 2015], you have failed to meet [Mon Health] conditions of employment and your actions will be considered a resignation of employment” (Dkt. No. 26-5).

         The following day, November 10, 2015, Linger sent an email to Dr. Dino Delaportas (“Dr. Delaportas”), stating that Chmura “was just in my office and would like to talk to you about her flu exemption . . . She has a Latex allergy.” See Dkt. No. 26-6. On the same date, Linger or another employee indicated in a handwritten note that she had “called [Chmura] and told her that Delaportas states he's not changing his mind on latex.” Id. Chmura's deposition testimony confirms that she never spoke to Dr. Delaportas following the denial of her 2015 exemption request but understood her request had been denied due to the availability of latex-free influenza vaccines (Dkt. No. 26-1 at 22).

         Three days after the denial of her exemption request, on November 12, 2015, Chmura received an intramuscular injection of Afluria®, a latex-free influenza vaccine (“Afluria”), at a Rite Aid pharmacy (Dkt. No. 26-7). Approximately two months after receiving Afluria, on January 19, 2016, Chmura completed a Vaccine Adverse Event Reporting System (VAERS) form, in which she reported that the vaccine had caused itching on her arm and wrist and redness on her hands and neck (Dkt. No. 26-8).

         C. Chmura's 2016 Vaccination Exemption Request

         The following year, in October 2016, Chmura met with Lisa Pifer, an Employee Health Nurse at Mon Health (“Pifer”), to discuss her 2016 influenza vaccination status. See Dkt. No. 26-9. During that meeting, Chmura provided Pifer with copies of her completed VAERS form and an observation note from George Anderson (“Anderson”), the Rite Aid pharmacist who had administered the Afluria vaccine to her (Dkt. No. 26-7). Anderson's note stated, in full, “Patient showed severe anxiety & nervousness due to latex allergy. Observed pt for over a half hour & showed anxiousness & itching. I did not observe any rash or breathing issues, but patient was itching midsection & various other parts of the body.” Id. Chmura testified in her deposition that Anderson's report accurately described her 2015 reaction to the Afluria vaccine (Dkt. No. 26-1 at 24).

         In an October 12, 2016 email memorializing her conversation with Chmura, Pifer reported that she had advised Chmura to “have her doctor fill out a medical exemption form with as much supporting documentation as possible.” Id. In the same email, Pifer wrote that Chmura “said she would not take the flu shot this year.” (Dkt. No. 26-9).

         A few weeks following her conversation with Pifer, Chmura submitted a Medical Exemption Form completed by her new primary care physician, Dr. Maria Gauna (“Dr. Gauna”) (Dkt. No. 26-11). Like the 2015 version of the Medical Exemption Form, the ...

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