Hospital Can Deny Service Dog Accommodation Due To Patient And Employee Safety Concerns

CATEGORY: Private Education Matters
CLIENT TYPE: Private Education
DATE: Dec 22, 2023

In fall of 2020, Mia Bennett, a nursing student at the University of Michigan-Flint completed a clinical rotation at Hurley Medical Center.  Before beginning her rotation, Bennett requested that her service dog, Pistol, be permitted to accompany her on her rotation, and the hospital agreed.  Pistol assists Bennett with her panic disorder, a condition that causes her to have intermittent panic attacks.  Bennett also takes medication as needed for her panic attacks, and Pistol is trained to recognize Bennett’s symptoms before the panic attack begins so she can take her medication. Bennett does not recognize the signs of a panic attack on her own.

On the first day that Pistol was at the hospital, one staff member and one patient reported experiencing allergic reactions.

The hospital revoked Bennett’s ability to have Pistol with her at all times in the hospital because Pistol had caused allergic reactions and the individuals with dog allergies were present on the only two floors that Bennett could work for her clinical rotation.  Relocating patient and staff members away from Bennett’s floor would be unworkable and directly compromise patient care.  For example, relocating nurses was difficult because nurses are union members and their collective bargaining agreements impose additional requirements when adjusting schedules.  Relocating staff more generally would also be onerous because the hospital was short-staffed during the COVID-19 pandemic.  Additionally, because certain nurses assigned to floors can perform medical care that nurses assigned to other floors cannot, moving certain nurses to a different floor could impact patient care.

The hospital also expressed concerns about exposing patients to dogs who are immunocompromised or unconscious.  The floor on which Bennett was placed had most of the hospital’s patients with kidney disease, many of whom were immunocompromised.

The hospital researched other options that would not cause a direct threat and would not require a fundamental alteration of the hospital’s policies.  The hospital concluded that it could crate Pistol and allow Bennett to take necessary breaks in order to be with Pistol.  Bennett declined this accommodation and finished her clinical rotation without Pistol and without experiencing any panic attacks.

Bennett filed suit under Title II of the Americans with Disabilities Act (ADA) alleging disability discrimination and failure to accommodate.

To establish a prima facie case of discrimination under the ADA, a plaintiff must show that: (1) she has a disability; (2) she is otherwise qualified; and (3) she was being excluded from participation in, denied the benefits of, or subjected to discrimination under the program because of her disability.

Bennett argued that the hospital intentionally discriminated against her when it prevented Pistol from accompanying her on rotation.  The Court of Appeals disagreed.  The Court said the hospital provided clear evidence that the decision was motivated by staff and patient complaints of allergic reactions, which were all related to Pistol rather than Bennett’s panic disorder.  One hospital staff member involved in the decision process did not know what specific medical condition Bennett had.  The Court therefore dismissed Bennett’s disability discrimination claim.

For Bennett’s failure to accommodate claim, the trial court concluded that Pistol posed a direct threat to the health and safety of employees and patients in the hospital, and that the hospital conducted a sufficiently individualized inquiry to make this assessment.  Bennett argued that the hospital made this conclusion on speculation rather than actual risks.  Bennett also argued that the hospital could have taken reasonable steps to separate Pistol from allergic patients and staff.

The Court of Appeals disagreed with Bennett.  The Court noted that Bennett could not have been moved to a different floor because there were only two floors that offered the nursing rotation for Bennett’s program.  The Court also concluded that there were employees on both of the two floors that had allergies.  The hospital provided proof that it did not screen patients for dog allergies, and unless the hospital implemented an entirely new allergy screening policy, the hospital would not know which patients would be at risk of a reaction.  Even if the hospital could determine who had a dog allergy, the hospital presented evidence that moving patients to different floors could be burdensome.  The hospital floors had staff and services available to treat specific medical needs.  The hospital also provided sufficient evidence that moving staff to different floors was difficult.

In sum, the Court of Appeals found ample evidence that the hospital reasonably considered Bennett’s accommodation and that Pistol posed a direct threat to the health and safety of patients.  The Court of Appeals upheld the trial court’s grant of summary judgment to the hospital.

Bennett v. Hurley Med. Ctr. (6th Cir. 2023) 86 F.4th 314.

Note: While the unique operations of a hospital are distinguishable from a school, this case illustrates the types of factors employers, including schools, must consider before denying a service dog accommodation.  An allergy or fear of dogs alone is typically not enough to justify denial of a service dog accommodation.

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