Sakellis v. Cedars-Sinai Med. Ctr.
| Decision Date | 12 August 2021 |
| Docket Number | B300417 |
| Court | California Court of Appeals Court of Appeals |
| Parties | HELENE SAKELLIS, Plaintiff and Appellant, v. CEDARS-SINAI MEDICAL CENTER, Defendant and Respondent. |
NOT TO BE PUBLISHED
APPEAL from a judgment of the Superior Court of Los Angeles County No. BC653918 Dennis Landin, Judge. Reversed and remanded with directions.
Shegerian & Associates, Carney R. Shegerian and Mahru Madjidi, for Plaintiff and Appellant.
Proskauer Rose, Anthony J. Oncidi, Pietro A. Deserio, and Cole D. Lewis, for Defendant and Respondent.
Plaintiff Helene Sakellis (plaintiff) sued her former employer Cedars-Sinai Medical Center (Cedars), alleging her termination was motivated by age discrimination and retaliation for raising concerns about patient care and demanding a lunch break. The trial court granted Cedars' summary judgment motion, finding plaintiff was terminated for failing to adhere to policies concerning timekeeping and updating patient charts. We consider whether plaintiff identifies issues of material fact requiring resolution at trial.
In 1992, plaintiff began working for Cedars as a clinical nurse in the labor and delivery unit. Beginning in 2010, and at all times relevant to this appeal, plaintiff worked in Cedars' mother-baby unit (also referred to as the postpartum unit). Plaintiff asked to be transferred to the postpartum unit because, among other things, she wanted to work with the postpartum unit's manager, Anna Greif (Greif), and she believed the postpartum unit would be less stressful than other assignments.[1]
Plaintiff's performance evaluations for the fiscal years ending 2010 through 2015 uniformly praised her skills as a clinician. She was also commended for her bedside manner. One evaluator emphasized plaintiff was “often one of the nurses [the evaluator] select[ed] for difficult patients or patients where service recovery [was] needed.” Colleagues “sometimes... criticized [plaintiff] for spending too much time in the room” with patients, but patients rated her highly.
One area in which plaintiff did not always meet or exceed expectations, however, was promptly documenting the care she provided. In 2011 and 2012, plaintiff received four “performance counseling” memoranda for instances in which she did not timely update patient charts.[2] Two of these memoranda indicated plaintiff's delay resulted in inaccurate reporting of the time at which treatment was administered. Although plaintiff's 2013 performance evaluation stated she demonstrated “much improvement in documenting in real time, ” her 2014 evaluation indicated that “[a]n opportunity for [plaintiff] would be to always chart in real time-preferably at the bedside and not wait to chart at the end of the shift.”
Another recurring theme in plaintiff's performance evaluations between 2010 and 2015 was praise for her strong advocacy for patient care, though tempered by suggestions that she adopt a more diplomatic manner when interacting with colleagues. For example, in 2010, plaintiff's performance evaluation noted she “finds it difficult to deal with people that are not motivated, ” but emphasized she “has patient satisfaction on the top of her priority list” and was “[n]o doubt... a big part of why we are doing so well.” In 2011, plaintiff was described as a “stickler about paying attention to detail and reminding nurses when something falls short, ” and the evaluator encouraged her to find ways to “improv[e] her crucial conversations with the ancillary staff while continuing to raise the bar for excellence without resentment.” In 2012, plaintiff's evaluator noted she was “never afraid to report something up the chain of command” and emphasized that interactions with colleagues “could go smoother” and urged “tolerance[ ] and acceptance that everyone is not the same and that it is hard to hear about the error of your ways....” In 2013, the evaluator indicated plaintiff has “a strong voice which she sure knows how to use.” In 2014, the evaluator noted “a couple instances” of “behaviors that were unbecoming of a [Cedars] employee” and urged plaintiff to “discuss any type of concerns... regarding patients or staff in a private setting and not at the nursing station....” In 2015, the evaluator stated that although plaintiff's “intentions and rationale on an issue or safety concern is often justified, her delivery is not well received....”
Plaintiff reported medical errors in May 2011, June 2011, May 2012, July 2012, and October 2015, as well as violations of patient privacy in November 2010 and September 2015.[3] Responses to plaintiff's concerns fell along a spectrum including silence, Greif telling plaintiff to communicate only with her regarding an alleged medical error, plaintiff being urged to present her concerns to a committee, and receiving a “Safety Star” award.
Plaintiff was placed on administrative leave in late May 2016 and terminated about a week later. As we shall discuss, the stated reason for plaintiff's termination was a claimed failure on May 22, 2016, to comply with Cedars' time records policy and previous warnings regarding timely completion of patient charts. Events occurring the previous day (May 21), however, provide important context for plaintiff's lawsuit.
On May 21, 2016, plaintiff was assigned to handle the discharge of three newborns, including “difficult” parents of a newborn who had already “fired” (i.e., requested they no longer be attended by) a different nurse. When the child's father complained the discharge process was taking too long, the charge nurse took over and completed the discharge around 1:30 p.m.[4]
After the three discharges were complete, the charge nurse asked plaintiff to handle another patient's admission to the postpartum unit. Plaintiff said she had been working without a break for six hours and requested coverage while she took her lunch. The charge nurse told plaintiff she was “here to work and if [she did not] want to work she should go home.”
Plaintiff responded by calling Wayne Millican (Millican), the hospital administrator on duty, and asked about her right to a meal break under the Labor Code. Millican told plaintiff he would contact the charge nurse. Plaintiff also called the labor and delivery unit and learned the new patient's transfer to the postpartum unit would not proceed until a labor and delivery nurse returned from her lunch break. After plaintiff discussed these two conversations with the charge nurse, she was given permission to take her lunch break.
Millican spoke to the charge nurse and several other postpartum nurses during plaintiff's break. The nurses told Millican plaintiff consistently left for breaks when it was her turn to admit a new patient. The charge nurse reiterated this complaint in an email to Millican.
The following day, plaintiff completed a 12-hour shift and clocked out of Cedars' timekeeping system at 7:57 p.m. The nurse who was taking over the care of plaintiff's patients reminded plaintiff that a patient had a cupcake for her, and plaintiff sat with the patient to eat the cupcake and watch television after she clocked out. Around 10:00 p.m., the nurse who took over for plaintiff noticed that no feedings had been recorded since the morning for the patient with whom plaintiff was sitting. Plaintiff told the nurse she had not yet finished her charting and then-between 10:14 p.m. and 10:29 p.m.-completed the chart entries for care provided earlier in the day. Plaintiff did not clock back in to the timekeeping system when she finished her chart entries for the day.
Cedars' time recording policy states that inaccurate time recording may result in termination. Nonetheless, plaintiff and a former colleague believed it is “common practice” for Cedars nurses to complete patient charts after clocking out. According to plaintiff, every one of the more than 100 nurses she knows completed charts after clocking out because overtime was discouraged. Plaintiff was not aware of anyone else having been disciplined for this practice.
At a meeting on May 26, 2016, Greif notified plaintiff she was being placed on administrative leave pending an investigation of the patient complaint from May 21, 2016. Greif also remarked that, thanks to plaintiff, breaks would now be assigned.[5] Plaintiff complained she was being punished for escalating the meal break dispute to Millican, but Greif “got in [her] face” and said she could not prove that. Although the written notice placing plaintiff on administrative leave mentioned only the patient complaint and not any concern about plaintiff working “off the clock, ” Greif told plaintiff she planned to review relevant database entries and if she found plaintiff made even one entry while plaintiff was off the clock, Greif could have her terminated.
The following day, plaintiff sent an email to Cedars' chief nursing executive, Linda Burns Bolton (Burns Bolton), asking whether she was aware plaintiff had been placed on administrative leave. Burns Bolton was not aware of this, and she asked the acting executive nursing director, Jane Swanson (Swanson), for more information. Swanson sent Burns Bolton an email stating Greif would be “investigating further, ” but issues known at the time included the patient complaint from May 21, 2016, and possible timekeeping issues.
About a week later, on June 1, 2016, Greif presented a written separation notice to plaintiff. The notice...
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