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Dewitt v. Proctor Hospital

February 27, 2008

PHILLIS DEWITT, PLAINTIFF-APPELLANT,
v.
PROCTOR HOSPITAL, AN ILLINOIS NOT-FOR-PROFIT CORPORATION, DEFENDANT-APPELLEE.



Appeal from the United States District Court for the Central District of Illinois. No. 06 C 1181-Joe Billy McDade, Judge.

The opinion of the court was delivered by: Evans, Circuit Judge

ARGUED NOVEMBER 29, 2007

Before CUDAHY, POSNER, and EVANS, Circuit Judges.

After she was fired from her job as a registered nurse at Proctor Hospital, 47-year-old Phillis Dewitt sued, alleging "association discrimination" under the Americans with Disabilities Act (ADA) as well as age and gender discrimination. The district court entered summary judgment in favor of Proctor. The court also denied Dewitt's motion for leave to amend her complaint to add a claim of ERISA retaliation. Today we resolve Dewitt's appeal from those decisions.

In September 2001, Proctor, a hospital in Peoria, Illinois, hired Dewitt to work as a nurse on an "as-needed" basis. Proctor apparently liked how Dewitt did her job because the following month she was promoted to the permanent position of second-shift clinical manager. In that role, Dewitt supervised nurses and other Proctor staff members.

Three years into the job, Dewitt switched to the first-shift clinical manager slot. In the summer of 2005, she switched to a part-time schedule, sharing the responsibilities of second-shift clinical manager with a co-worker.

Dewitt, it appears (for we must assume the facts to be as she presents them at this stage of the proceedings), was a valuable employee. In her last evaluation, her supervisor, Mary Jane Davis, described her as an "outstanding clinical manager [who] consistently goes the extra mile." But things were not quite as rosy as they appeared.

Dewitt and her husband, Anthony, were covered under Proctor's health insurance plan. Throughout Dewitt's tenure at Proctor, Anthony suffered from prostate cancer and received expensive medical care. His covered medical expenses were paid by Proctor, which was partially self-insured. It paid for members' covered medical costs up to $250,000 per year. Anything above this "stop-loss" figure was covered by a policy issued by the Standard Security Life Insurance Company of New York.

Dewitt was able to maintain health insurance coverage for herself and Anthony even during her short part-time stint, since Proctor credited Dewitt with "hospital approved absence" (unpaid time), allowing her to reach the minimum number of hours necessary to qualify for benefits.

Since Proctor was self-insured, it took a keen interest in the medical claims submitted by its employees. Each quarter, in fact, Progressive Benefits Services, the administrator of Proctor's medical plan, prepared a "stop-loss report" for Linda K. Buck, Proctor's vice-president of human resources. The report identified all employees whose recent medical claims exceeded $25,000.

The stop-loss reports highlighted Dewitt's expenses. Although Dewitt was not listed on reports for 2001 and 2002 (indicating that her family's medical expenses, particularly those of her husband, were less than $25,000), during the next three years Anthony underwent costly medical procedures. In 2003, the Dewitts' medical claims for Anthony were $71,684. In 2004, the figure jumped to $177,826. In the first eight months of 2005, the expenses were $67,281.50.

In September 2004, Davis confronted Dewitt about Anthony's high medical claims. Specifically, she asked what treatment Anthony was receiving, and Dewitt responded that he was undergoing chemotherapy and radiation. Davis asked Dewitt if she had considered hospice care for her husband; Dewitt responded that Anthony's doctor considered less expensive hospice care placement to be premature. Davis explained that a committee was reviewing Anthony's medical expenses, which she described as unusually high.

In February 2005, Davis again pulled Dewitt aside to ask about Anthony's treatment. Dewitt informed her that Anthony's situation had not changed.

In May 2005, Davis organized a meeting for Proctor's clinical managers. She informed the employees that Proctor faced financial troubles, which, according to Davis, ...


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