Bennett v. Hurley Med. Ctr.

86 F.4th 314

Mia BENNETT, Plaintiff-Appellant, v. HURLEY MEDICAL CENTER, Defendant-Appellee.

No. 23-1162

United States Court of Appeals, Sixth Circuit

Argued: October 19, 2023

Decided and Filed: November 9, 2023

Appeal from the United States District Court for the Eastern District of Michigan at Detroit. No. 2:21-cv-10471—Paul D. Borman, District Judge.

ARGUED: Nicholas B. Roumel, NACHT & ROUMEL, P.C., Ann Arbor, Michigan, for Appellant. Michael W. Edmunds, GAULT DAVISON, PC, Grand Blanc, Michigan, for Appellee. ON BRIEF: Nicholas B. Roumel, NACHT & ROUMEL, P.C., Ann Arbor, Michigan, for Appellant. Michael W. Edmunds, GAULT DAVISON, PC, Grand Blanc, Michigan, for Appellee.

Before: SUTTON, Chief Judge; CLAY and LARSEN, Circuit Judges.

OPINION

CLAY, Circuit Judge.

Plaintiff Mia Bennett appeals the district court's grant of summary judgment in favor of Defendant Hurley Medical Center ("Hurley"). Plaintiff claims that Hurley violated her rights under Title II of the Americans with Disabilities Act ("ADA"), 42 U.S.C. § 12131 et seq.; Section 504 of the Rehabilitation Act, 29 U.S.C. § 794; and Michigan's Persons with Disabilities Civil Rights Act ("PWDCRA"), Mich. Comp. Laws § 37.1101 et seq., when it stopped permitting her service dog, Pistol, to accompany her while working as a student nurse. For the reasons set forth below, we AFFIRM the district court's grant of summary judgment.

I. BACKGROUND

A. Factual Background

In the fall of 2020, Plaintiff completed a clinical rotation at Hurley as a part of her education as a nursing student at University of Michigan-Flint ("UM-Flint"). She worked on floor 7 East ("7E") for four hours once a week for six weeks. Although student nurses on the rotation were assigned to two floors, 7E and 9 East ("9E"), Plaintiff could only work on 7E, the floor on which her UM-Flint faculty supervisor worked.

Before beginning the rotation, she requested that her service dog, Pistol, be permitted to accompany her on her rotation, and Hurley agreed. Pistol assists Plaintiff with her panic disorder, a condition that causes her to have intermittent panic attacks. For the attacks, she takes the medication Ativan as needed, which takes approximately five to ten minutes to become effective. Without this medication, Plaintiff's panic attacks can last over an hour, cause her to experience shortness of breath and chest tightness, and even make her feel as if she is "going to die." Bennett Depo., R. 14-2, Page ID #159-60.

Plaintiff trained Pistol to recognize the symptoms she exhibits just before a panic attack and to alert her to these symptoms so that she can take Ativan before an attack begins. She is able to take Ativan when the attacks begin, but, as Plaintiff testified in her deposition, when she is "physiologically worked up[,] it takes a little bit longer for [the Ativan] to work." Id. at Page ID #163. Plaintiff does not recognize the signs of a panic attack as well on her own as she does with Pistol, and, as she attested, by the time that she has recognized her symptoms, she "could be well on [her] way to a full-blown panic attack." Id. at Page ID #162-63.

1. Hurley's Service Animal Policy

Hurley's initial decision to allow Pistol in the hospital was informed by its written policy pertaining to service animals, titled "Hurley Medical Center Standard Practice: Service Animals" ("the Policy"). Hurley Service Animal Policy, R. 16-7, Page ID #517-521. It states that "[e]very attempt will be made to not separate or attempt to separate a Handler from her or his Service Animal." Id. at Page ID #518. A "Handler" is defined as a "person with a service or therapy animal," and is not explicitly restricted to patients or visitors to the hospital. Id., Page ID #517. However, other provisions of the Policy, including those discussing how Hurley responds to a dog who has caused an allergic reaction, appear to refer to a patient handler. The section of the Policy governing allergies states:

In the event that a patient or a Facility staff member is allergic to, or has a phobia about animals, the Facility shall further modify its policies, practices and procedures to permit a Service Animal to remain with a patient in an inpatient room by, for example, moving the patient to another comparable room, changing staff schedules, or using other nondiscriminatory methods so that the presence of the Service Animal would not pose a direct threat and would not require a fundamental alteration in the Facility's policies, practices, or procedures. Any patient or staff member with an allergy to animals shall provide verification within a reasonable time frame of request.

Id., Page ID #521.

The Policy provides that service animals will generally be excluded from certain sterile areas, including "where a patient is immunosuppressed or in isolation," such as operating rooms or the post-anesthesia recovery unit. Id., Page ID #520. It further states that, a service animal will be

generally permitted in inpatient and outpatient areas unless an individualized assessment is made to exclude a Service Animal. This assessment shall be based on reasonable [judgment] that relies on current medical knowledge or on the best available objective evidence to ascertain: the nature, duration and severity of the risk; the probability that a potential injury will actually occur; and whether any reasonable modifications of policies, practices or procedures or the provision of auxiliary aids or services will mitigate the risk.¹

Id.

2. Pistol Causes Allergic Reactions

On the first day that Plaintiff brought Pistol to the hospital, one staff member and one patient reported experiencing allergic reactions. The staff member, Alexis Neal, obtained medical treatment after she suffered a severe allergic reaction from dog allergies. Neal's nurse manager believed that Neal had not seen Pistol before she suffered an allergic reaction because, when she approached the manager, she asked "is there a dog on the floor because I'm starting to have allergic reactions." Martin Depo., R. 14-4, Page ID #245. Neal left work for the rest of the day on September 9, 2020, and did not return until September 11, requiring the nurse manager for the floor to find a replacement for Neal, a unit clerk. Because the manager could not find another unit clerk to replace Neal on such short notice, she had to assign an assistant nursing manager to Neal's position, which meant that the assistant nursing manager had to primarily sit at the nurses' station and could not be "mobile" on the floor. Id. at Page ID #246. The nurse manager stated that this immobility caused a "burden on the unit." Id.

On the same day, another nurse reported that a patient had used the call system to ask whether there was a dog on 7E because the patient had begun to have an allergic reaction. Additionally, the nurse manager learned that another nurse, Tanesha Hippolyte, had severe dog allergies. Hippolyte was not working in the hospital the day that Plaintiff brought Pistol, but she was regularly assigned to 7E. However, the manager rescheduled Hippolyte so that she would no longer work on 7E for the duration of the Plaintiff's rotation. Hurley staff informed Plaintiff that there were individuals with dog allergies on 9E as well.

3. Hurley Reevaluates the Accommodation

After Hurley became aware that one patient and one employee had allergic reactions to Pistol, Hurley began to reevaluate Plaintiff's ability to have Pistol accompany her at all times in the hospital. When Summer Jenkins, the Hurley staff member charged with ADA compliance, informed Plaintiff that her accommodation would be reevaluated, Plaintiff offered to have Pistol wear a "Shed Defender," a type of body suit that covers dogs and minimizes the spread of allergens while Pistol was in the hospital. Bennett Depo., R. 14-2, Page ID #169. However, in a later email to Jenkins on September 15, 2020, Plaintiff stated that she had "inquired about the [S]hed [D]efender" but that the company had told her that "they would not fit [Pistol's] breed." Email, R. 14-9, Page ID #417. She told Jenkins that she was "looking for other options, or possibly seeing if [her] mom could alter it to fit" Pistol. Id. Plaintiff never informed Hurley whether she had successfully found those "other options."

Just a few hours later, Jenkins emailed Plaintiff back, revoking her ability to have Pistol with her at all times in the hospital. Specifically, Jenkins acknowledged that Pistol had already caused allergic reactions, and, because Hurley had confirmed that individuals with dog allergies were present on both floors 7E and 9E, Hurley could not permit Pistol to accompany Plaintiff on either floor.² Jenkins further stated that Hurley had "researched any options that would not pose a direct threat and would not require a fundamental alteration in the hospital's policies, practices, or procedures," and concluded that the reasonable accommodation it could provide moving forward would be to crate Pistol in the hospital and provide Plaintiff with "the opportunity to take necessary breaks" in order to be with Pistol. Email, R. 14-9, Page ID #418. Jenkins stated that the hospital remained "open to continued dialogue on this matter." Id. Jenkins stated in her deposition that the Shed Defender remained an available option from Hurley's perspective, but acknowledged that, by Plaintiff's own admission, she had not yet been able to obtain one to fit Pistol. At this point, time was of the essence because Plaintiff needed to appear for her rotation the following day, September 16, 2020.

Jenkins recalled that Plaintiff did not bring Pistol to the hospital with her at all on September 16, 2020. On September 17, 2020, Plaintiff responded to Jenkins' email stating that "[w]hile I appreciate the revised accommodation offer," of the crate, "it will not work for the proper utilization of the service dog." Email, R. 16-12, Page ID #585. Plaintiff did take Jenkins up on her offer of continued dialogue,...