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Greene v. Fayette Medical Center

United States District Court, N.D. Alabama, Western Division

September 18, 2017

DEIRDRE GREENE, Plaintiff,
v.
FAYETTE MEDICAL CENTER, Defendant.

          MEMORANDUM OF OPINION

          L. SCOTT COOGLER UNITED STATES DISTRICT JUDGE.

         I. Introduction

         Plaintiff Deirdre Greene ("Greene") brings this action against her former employer, Fayette Medical Center ("FMC"), alleging that she suffered discrimination on the basis of her gender in violation of Title VII of the Civil Rights Act of 1964, 42 U.S.C. § 2000e et seq. (Title VII). Before this Court is FMC's Motion for Summary Judgement and Supplemental Motion for Summary Judgment. (Docs. 19, 48, & 49.) For the reasons explained herein, FMC's motions are due to be granted.

         II. Factual Background

         Greene began working at FMC, which is part of the DCH Health System ("DCH"), in July 1992 upon her completion of radiology school and was continuously employed by FMC until her termination in March 2014. During her employment at FMC, Greene worked as a radiology technician conducting MRI scans and similar procedures.

         A. Greene's Knowledge of FMC and HIPAA Privacy Procedure

         Greene received regular training on FMC privacy policies and HIPAA confidentiality requirements. Greene certified that she understood FMC's Confidentiality Acknowledgement & Agreement Forms (the "Confidentiality Forms") once a year from 2008 to 2014. (See Doc. 20 at 85-98.) The purpose of the Confidentiality Forms was to inform FMC employees of their "personal and professional responsibilities regarding confidential information and receive an acknowledgment of understanding." See, e.g., Id. at 85. The Confidentiality Forms also advised employees that as part of their jobs they were being given access to "Protected Health Information" ("PHI") governed by the Health Insurance Portability and Accountability Act ("HIPAA") security regulations. Id. The confidential information as defined under the Confidentiality Forms included "[m]edical and certain other personal information about patients." Id. Access to the confidential information should be limited to "legitimate medical need" using the "minimum necessary access." Id. The Confidentiality Forms also clarified that "failure to comply with my confidentiality obligation may result in disciplinary action or termination of my employment/educational affiliation by the DCH Health System and its affiliates." Id. at 86. Greene stated that she fully understood the policy reflected in the Confidentiality Forms and FMC's HIPAA policy. (Greene Depo. at 53-64.)

         Greene also underwent computer-based training on "HIPAA Privacy and Confidentiality." (Doc. 21 at 1.) The training module took the form of a fifty-slide PowerPoint that repeatedly stresses protection of patient confidentiality and HIPAA compliance. The training module warned trainees that they have an obligation to protect "Protected Health Information" ("PHI") from those who "don't 'need to know.'" (Doc. 21 at 7.) PHI is defined non-exhaustively on the following slide to include written and verbal information about physical and mental health, as well as information specific to an individual such as address, date of birth, and social security number. Id. The training module stresses repeatedly that violation of these policies may result in the employee's termination. Id. at 3, 6, 11, 15, & 24. Specifically, "[d]isclosing PHI to another person without authorization will result in termination." Id. at 11 (emphasis added).

         Greene was also aware of the policies about disclosure of patient information contained in the training module. The training module makes clear employees should not allow relatives into a room when a patient's PHI is read unless given consent by the patient. Id. at 10, 14. In regards to a minor's PHI, the slides inform trainees that Alabama law requires minors over the age of fourteen to consent to the release of their PHI to anyone, including their parents or guardians. (Doc. 21 at 21.) Greene stated in her deposition that she understood the protections that patients and specifically minors received under HIPAA as presented in the training module. (Greene Depo. at 76-79.)

         B. MRI Procedure at FMC

         The Radiology Department is located in FMC in several adjacent rooms. The MRI area of the Radiology Department consists of two connected rooms, a control room and a scan room, which are divided by a large plate glass window so the radiology tech sitting in the control room can monitor patients in the scan room. The control room contains a desk with computers and monitors. The door leading out of the control room to a patient waiting area is always locked and displays an "Authorized Personnel Only" sign.

         When a patient is to receive an MRI, the radiology tech receives a message on the computers located in the control room with the patient's identifying information. The radiology tech leaves the control room to the adjacent waiting room and calls a patient into the control room. The radiology tech then interviews the patient in the control room about her personal and medical information. When the interview is complete, the tech walks the patient into the scan room where the MRI machine is located and then returns to the control room. The radiology tech then conducts MRI scans by using the computer in the control room while supervising the patient through the two-way window.

         When the MRI machine scans a patient, the images of the scan appear on the monitor in the control room. The radiology tech reviews the images as they appear on the screen to ensure they are usable. After the MRI is complete, the radiology tech discharges the patient and sends the MRI scans to a radiologist for review.

         C. The March Incident

         On March 5, 2014 Greene was scheduled to work in the MRI control room of the Radiology Department. (Greene Depo. at 139.) At approximately 10:00 a.m. Greene saw the name of a minor patient who was to receive an MRI. (Greene Depo. at 140.) Greene went to the waiting room and called the minor patient who was with her mother to go to the control room. The minor patient's mother stood up to accompany her daughter, but Greene told her that she could not come because there was no room in the scan room for the minor patient's mother to wait during the MRI scan. (Greene Depo. at 143-44.) Greene and the minor patient entered the control room, and Greene began to go over the minor patient's history form with her. (Greene Depo. at 147-48.)

         Greene states she had finished going through the minor patient's history form and was about to input the information into the computer, when there was a knock at the control room door. (Greene Depo. at 147-48.) Greene opened the door, and allowed her daughter, age 17, and niece, age 15, to enter into the control room without asking the minor patient's consent to do so. Greene had been expecting her daughter to come to the FMC that day, because her daughter had communicated to her mother that she had a headache and was leaving school. (Greene Depo. at 153-56; 183.) Upon their arrival at FMC, Greene's daughter and niece had asked John Files ("Files"), Greene's supervisor, where they could find their mother. (Greene Daughter Depo. at 30-31.) Files had told the girls to check in the MRI room. Id. Files did not accompany Greene's daughter and niece to the room. (Greene Daughter Depo. at 31-32.)

         Greene's daughter and niece went to the same school as the minor patient and the three children recognized and spoke to each other in the control room. (Greene Depo. at 151-52; 170-71.) Greene has given conflicting answers whether she asked the minor patient about PHI after Greene's daughter and niece entered the control room. (Greene Interrog. ¶ 5 (Q: "Describe where you were standing as well as where the minor patient was located when your daughter and niece walked into the MRI room. State ... exactly what words were exchanged between all people in the room." A: "I asked the patient if she had ever had an MRI before and she said no."); Greene Depo. at 150 (Q: "So right now you're saying you can't recall if you [asked any questions of the minor patient once your daughter and niece entered the scan room]? A: "Not to my knowledge." Q: "So you don't remember if you did or not?" A: "I do not.").)

         Greene led the minor patient into the scan room and then returned to the control room to carry out the MRI. Greene's daughter and niece were present during the minor patient's MRI and were able to see the procedure through the window separating the scan and control room. (Greene Depo. at 173-76.) As the minor patient received her MRI, scans taken from the MRI appeared for Greene's review in the control room where her daughter and niece were present. (Greene Depo. at 176.) Greene admits that the presence of her daughter and niece before and during the minor patient's MRI violated DCH policy and HIPAA, (Greene Depo. at 181), and that she did not ask for the minor patient's consent before allowing her daughter and niece into the control room or any time during the procedure. (Greene Depo. at 185.)

         After the completion of the MRI and the minor patient's discharge, Plaintiff's supervisor Files entered the control room to tell Greene that there was "a big problem" because the minor patient's mother had complained about the way the MRI was conducted to FMC's administration. (Greene Depo. at 195.) Files told Greene that she would need to speak with JoAnn Nichols ("Nichols"), Assistant Administrator, Head of Compliance for FMC about the incident. (Greene Depo. 196-97.) Greene spoke with Nichols before 12:00 p.m. that same day in Nichols' office. Nichols' report on the March Incident was submitted to DCH Human Resources and to the HIPAA Compliance Office for DCH on the same day. (Doc. 21 Def.'s Ex. 24.) Two days later on Friday March 7, 2014, Mildred Black, a representative of DCH's Compliance Department, and Files interviewed Greene about the March Incident. (Greene Depo. at 204-05.) Following the interview Files told Greene that he would contact her to schedule another meeting to occur on the following Monday about the March Incident. (Greene Depo. at 206.) According to Files, the March Incident was the only incident in his sixteen years at FMC where a complaint was raised in the Radiology Department about a HIPAA violation. (Files Depo. at 15.)

         On Monday March 10, 2014, Greene went to DCH to discuss the incident and investigation with Mildred Black, the in-house general counsel, a representative of Human Resources, and Files. At that meeting they told Greene that her employment was terminated because she had violated HIPAA. (Greene Depo. at 207.) Greene's termination notice, effective March 10, 2014, indicated she was fired for "inappropriate behavior" defined as "PHI Privacy Breach."(Doc. 21 Def.'s Ex. 25.) Following Greene's termination, DCH reported the privacy breach to the Office of Civil Rights, Department of Human Health and Human Services, but the office took no action on the violation. (See Doc. 21 Def. 's Ex. 31.)

         D. Additional Facts Relating To FMC Radiology Department

         The parties agree that it was a regular practice for the Radiology Department employees' children to be present at the hospital. Greene and Greene's daughter also allege that during the same time period children were allowed in areas where confidential PHI was displayed on computer screens and procedures were being performed on patients. (Greene Depo. at 220, 225; Greene Daughter Depo. at 60-68.) They give no specific instances or proof of this conduct, but Greene states slightly more specifically that Files performed MRIs with his children present in the control room. (Greene Depo. at 224-25.) Greene's daughter states that Files and one other employee allowed children into the ...


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