Álvarez v. Hosp. Episcopal San Lucas, Inc., CIVIL NO. 15-2413 (PAD)

DR. HUGO AUDBERTO ÁLVAREZ, Plaintiff, v. HOSPITAL EPISCOPAL SAN LUCAS, INC., et al., Defendants.

CIVIL NO. 15-2413 (PAD)

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF PUERTO RICO

January 10, 2019

OPINION AND ORDER

Delgado-Hernández, District Judge.

Dr. Hugo Audberto Álvarez sued Hospital Episcopal San Lucas, Inc. ("HESLI") and others,¹ seeking injunctive relief and damages following his dismissal from an emergency medicine residency program after he stated that if the chief resident -his immediate superior in the program- had been a man, he would have punched her in the face for having interrupted him during a patient presentation and saying plaintiff was presenting a patient incorrectly (Docket No. 1).² Defendants answered the complaint denying liability (Docket Nos. 8 and 9) and upon conclusion of discovery, moved for summary judgment (Docket Nos. 77, 79, 85). Plaintiff opposed motions (Docket Nos. 99, 104, 106).³ Defendants replied (Docket Nos. 110, 118, 126). On May 31, 2016, the court denied plaintiff's request for a temporary restraining order and preliminary injunction (Docket No. 19), andon September 30, 2018, granted defendants' motions for summary judgment (Docket No. 131). Following are the grounds for the summary judgment rulings.

I. SUMMARY JUDGMENT STANDARD

Summary judgment is appropriate when "the pleadings, depositions, answers to interrogatories and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(c). The purpose of summary judgment is to pierce the pleadings and assess the proof in order to see whether there is need for trial. See, Mesnick v. General Elec. Co., 950 F.2d 816, 822 (1st Cir. 1991)(applying formulation). To this end, a factual dispute is "genuine" if it could be resolved in favor of either party. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249 (1986). It is "material" if it potentially affects the outcome of the case in light of applicable law. Calero-Cerezo v. U.S. Dept. of Justice, 355 F.3d 6, 19 (1st Cir. 2004).

The party moving for summary judgment bears the initial responsibility of demonstrating the absence of a genuine issue of material fact. See, Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986)(discussing issue). All reasonable factual inferences must be drawn in favor of the party against whom summary judgment is sought. See, Shafmaster v. U.S., 707 F.3d. 130, 135 (1st Cir. 2013)(so noting). Conclusory allegations, empty rhetoric, unsupported speculation, or evidence which, in the aggregate, is less than significantly probative will not suffice to ward off a properly supported summary judgment motion. See, Nieves-Romero v. U.S., 715 F.3d 375, 378 (1st Cir. 2013)(citing Rogan v. City of Boston, 267 F.3d 24, 27 (1st Cir.2001))(internal quotation marks omitted). Based on these parameters, careful record review shows absence of genuine factual dispute as to the facts identified in the section that follows.

II. OMNIBUS FINDINGS OF FACTS⁴

A. Plaintiff's Residency

From 2012 to 2014, plaintiff was a resident in emergency medicine in Hospital Episcopal San Lucas Ponce, property of St. Luke's Memorial Hospital. See, "Statement of Uncontested Material Facts in Support of Co-Defendants' Motion for Summary Judgment" (Docket No. 86), ¶ 80.⁵ St. Luke's does business as Hospital Episcopal San Lucas Ponce. See, Co-Defendants'SUMF (Docket No. 86), ¶ 80.⁶ Plaintiff participated in the residency through successive one-year contracts that he executed with the Puerto Rico Department of Health in 2012, 2013 and 2014. See, HELSI's "Statement of Uncontested Facts in Support of HELSI's Motion for Summary Judgment" (Docket No. 78), ¶ 1; "Plaintiffs' Statement of Contested Material Facts" ("SCMF") (Docket No. 97), ¶¶ 1, 6, 9. He was dismissed from the residency in 2014. See, "Statement of Uncontested Material Facts in Support of Dr. Yorlenis Hevia's Motion for Summary Judgment" (Docket No. 80), ¶ 25; Docket No. 80-9, p. 1. Plaintiff sued HESLI, albeit HESLI did not own or operate a hospital or residency programs. See, "Statement of Uncontested Material Facts in Support of HESLI's Motion for Summary Judgment" ("HESLI's SUMF")(Docket No. 78), ¶¶ 18-20; Docket Nos. 78-8, pp. 10-11; 78-9.⁷

B. Residency Contracts

The 2012 Contract expresses plaintiff was to provide services as a resident in Hospital Episcopal San Lucas Ponce, property of Saint Luke's Memorial Hospital. See, HESLI's SUMF ¶ (Docket No. 78) ¶ 2; Docket No. 78-2, p. 1.⁸ In exchange for plaintiff's medical services, thePuerto Rico Department of Health paid him a monthly salary. See, HESLI's SUMF (Docket No. 78) ¶ 4.⁹ Similarly, the 2013 Contract states that plaintiff was to provide services as a resident in Hospital Episcopal San Lucas Ponce, property of Saint Luke's Memorial Hospital. See, HESLI's SUMF (Docket No. 78) ¶ 10; Docket No. 78-3, p. 1.¹⁰ Like under the 2012 Contract, the Puerto Rico Department of Health would pay plaintiff a monthly salary in exchange for his services. See, HESLI's SUMF (Docket No. 78) ¶ 9.¹¹ The 2014 Contract, between plaintiff and the Puerto Rico Department of Health, provides that plaintiff was to serve as a resident in Hospital Episcopal San Lucas Ponce, property of Saint Luke's Memorial Hospital (HESLI's SUMF (Docket No. 78) ¶ 12;Docket No. 78-4, p. 1),¹² and that the Puerto Rico Department of Health would pay him a monthly salary in exchange for his services. See, HESLI's SUMF (Docket No. 78) ¶ 13.¹³

C. Rules and Regulations

The 2014 Contract states that plaintiff could be dismissed after a hearing provided for in the rules and regulations, if he incurred in improper conduct, if his professional execution violated rules and regulations or if his academic progress or academic skills were deficient. See, Co-Defendants' SUMF (Docket No. 86) ¶ 8.¹⁴ Plaintiff received a copy of the resident's manual; which includes the rules and regulations. See, Co-Defendants' SUMF (Docket No. 86) ¶¶ 10, 11; SCMF 2 (Docket No. 103) ¶ 10.¹⁵

In their operation, the rules and regulations recognize various grounds for non-renewal or dismissal, including conduct deemed grossly unprofessional, incompetent, erratic, potentially criminal; and conduct threatening to the well-being of patients, other residents, faculty, staff, or the resident. See, Docket No. 86-5, p. 10. To channel adverse actions, they express that when theGraduate Medical Education Director, Program Director or member of the Teaching Staff identifies a reason for adverse action against a resident -including remediation, probation, non-promotion to next level of training, non-renewal of residency appointment, and automatic dismissal- a written note must be sent to the Evaluation and Promotion Committee for evaluation and recommendation. See, Co-Defendants' SUMF (Docket No. 86) ¶ 15; Docket No. 86-5, p. 11.¹⁶ In the event of a recommendation adverse to the resident, the Program Director informs the resident in writing, stating the decision, its reason, and the resident's right to appeal. See, Docket No. 86-5, p. 11.

Should the resident appeal, the Program Director submits the appeal to the Evaluation and Promotion Committee or to an Ad-Hoc Committee, which may order a hearing. See, Docket No. 86-5, p. 11. Thereafter, the Committee submits a recommendation to the Program Director, who in turn prepares a report with the decision and notifies the report to the resident and the General Medical Education Committee. See, Co-Defendants' SUMF (Docket No. 86) ¶¶ 16-17; Docket No. 86-5, p. 12.¹⁷ The resident may appeal this decision to the Graduate Medical Education Committee by requesting a formal hearing, and after the hearing and an evaluation of the case, that Committee submits its final decision to the resident and Program Director. See, Co-Defendants' SUMF (Docket No. 86) ¶¶ 18-19; Docket No. 86-5, p 12.¹⁸ The Program Director mayimmediately suspend the resident in case his professional behavior adversely affects the health or safety of the patients under his care or places anyone at a security risk. See, Co-Defendants' SUMF (Docket No. 86) ¶ 20; Docket No. 86-5, p. 12.¹⁹ Furthermore, automatic dismissal is justified in response to misconduct, examples of which include disorderly conduct, harassment of other employees, use of abusive language on the premises (hospital or affiliated sites), fighting, threatening, attempting or causing injury to another person on the premises. See, Docket No. 86-5, pp. 10-11. In case of immediate suspension, the resident is entitled to due process. See, Docket No. 86-5, p.12.

D. Incident with Dr. Hevia

Dr. Yorlene Hevia was an emergency medicine resident at Hospital Episcopal San Lucas Ponce. See, Dr. Hevia's SUMF (Docket No. 80), ¶¶ 3-4; "Plaintiff's Position as to Dr. Yorlenis Hevia's Statement of Uncontested Material Facts and the Plaintiff's Statement of Uncontested Material Facts" ("SCMF 3")(Docket No. 105), p. 1 (admitting Dr. Hevia's SUMF 80), ¶¶ 3-4).²⁰ She started her training along with plaintiff in 2012. See, Dr. Hevia's SUMF (Docket No. 80), ¶¶ 3-4. By October 2014, she was chief resident of the emergency medicine residency program, and plaintiff's superior. See, Dr. Hevia's SUMF (Docket No. 80) ¶ 8; SCMF 3 (Docket No. 105), p. 1 (admitting Dr. Hevia's SUMF ¶ 8)).

On October 7, 2014, while plaintiff was presenting a patient to an internal medicine resident, Dr. Hevia raised her voice and interrupted him, telling plaintiff that he was presenting the patient incorrectly, and the patient needed emergency dialysis treatment. See, Dr. Hevia's SUMF (Docket No. 80) ¶¶ 9-11; SCMF 3 (Docket No. 105), p. 1 (admitting Dr. Hevia's SUMF ¶¶ 10-11)).²¹ After this incident, plaintiff spoke to Dr. Eric López, and told him that if Dr. Hevia had been a man, he would have punched her in the face. See, Dr. Hevia's SUMF (Docket No. 80) ¶ 13; Docket No. 80-1, pp. 16-17.²²

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