Howe v. Hull

Brief Fact Summary. Howe (Plaintiff) was the personal representative for decedent, Charon, and brought suit against Dr. Hull (Defendant) for discrimination associated with the transfer of decedent to another hospital.

Synopsis of Rule of Law. Even if the person’s disability was only one of many reasons for the discrimination, the statutory exception to the common-law no-duty rule created in the Americans with Disabilities Act applies.

Facts. Howe (Plaintiff) was travelling with Charon through Ohio at the time Charon started taking “Floxin,” a new prescription antibiotic.  Charon apparently had an allergic reaction to the medication and got fever, headache, nausea, joint pain, and redness of the skin.  Charon went to the emergency room of Fremont Memorial Hospital (FMH) to be treated and was initially diagnosed with toxic epidermal necrolysis (TEN), a serious, rare and frequently lethal skin condition.  The doctor who examined him first was planning to admit him to FMH, but when the supervising doctor found that Charon was infected with the human immunodeficiency virus (HIV), he ordered that Charon be transferred to the Medical College of Ohio (MCO).  Testimony revealed that when MCO was called and asked to accept transfer of Charon there had been no discussion regarding a diagnosis of TEN.  The only discussion about Charon’s transfer regarded his status as HIV positive.  Before he was transferred, the examining doctor basically admitted the transfer had been based on discrimination.  Dr. Hull (Defendant) was the doctor in charge of admissions that day and told the examining doctor that, “if you get an AIDS patient in the hospital, you will never get him out.”  When Charon arrived at MCO, he was diagnosed with a simple allergic reaction, was treated, and released from the hospital.  Charon’s personal representative, Plaintiff, brought a discrimination action against Hull (Defendant) claiming violations of the Americans with Disabilities Act (ADA) and the Federal Rehabilitation Act of 1973 9FRA).  Hull (Defendant) moved for summary judgment and this hearing followed.

Issue. Even if the person’s disability was only one of many reasons for the discrimination, does the statutory exception to the common-law no-duty rule created in the Americans with Disabilities Act apply?

Held. (Potter, J.)  Yes.  Even if the person’s disability was only one of many reasons for the discrimination, the statutory exception to the common-law no-duty rule created in the Americans with Disabilities Act applies.  Under the ADA, there are three elements to establish a prima facie case of discrimination: (1) the plaintiff must have a disability, (2) there must be discrimination against the plaintiff by the defendant, and (3) the discrimination must be based upon the disability.  In contrast, a prima facie case of discrimination under the FRA requires: (1) the plaintiff to have a disability, (2) the plaintiff must have been otherwise qualified to participate in the denied program, (3) the discrimination must have solely been based on the disability, and (4) the program must have received federal funding.  Two distinctions exist in the requirements for these two provisions.  First, the FRA requires that the denied program or services that were denied were receiving federal funding.  Second, the FRA requires that the discrimination be solely based upon the disability, whereas the ADA does not.  Under the facts of this case, a fact-finder could reasonably believe that the diagnosis of TEN, a rare disease process, was not the full story and that the only reason Charon was transferred was because of his HIV status.  Because there is ample evidence to establish a prima facie case for both the ADA and FRA claims to survive a motion for judgment, the motion is denied.

Discussion. In this case, the examining physician, Dr. Reardon, basically admitted to Charon that the transfer was related to his HIV status.  Dr. Reardon stated to Charon, “I’m sure you’ve dealt with this before …”  Plaintiff asked, “What’s that, discrimination?”  Dr. Reardon responded, “You have to understand, this is a small community, and the admitting doctor does not feel comfortable admitting [Charon].”  It may be more difficult in other cases to prove discrimination was involved in the medical decision because of the complexity of a patient’s condition.  Therefore, in cases where a disease process involves multiple body systems, the court may find itself deferring to the practitioners providing a defense, even if the motives of that provider are questionable.  In addition, Titles II and III of the ADA, which cover access to professional offices of healthcare providers and access to government programs, contains an exception in cases where a person with a disability poses a direct threat to the health or safety of others.  A direct threat is defined as a significant risk to the health or safety of others that cannot be eliminated or satisfactorily reduced by reasonable adjustments.