Bastidas v. Good Samaritan Hospital LP et al

Filing 209

ORDER ON DEFENDANTS' MOTION FOR SUMMARY JUDGMENT 176 . (Illston, Susan) (Filed on 11/21/2016)

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1 2 3 4 UNITED STATES DISTRICT COURT 5 NORTHERN DISTRICT OF CALIFORNIA 6 7 J. AUGUSTO BASTIDAS, Case No. 13-cv-04388-SI Plaintiff, 8 v. ORDER ON DEFENDANTS' MOTION FOR SUMMARY JUDGMENT 9 GOOD SAMARITAN HOSPITAL LP, et al., 11 United States District Court Northern District of California 10 Defendants. Re: Dkt. No. 176 12 13 This dispute arises out of a medical peer review following defendant Good Samaritan 14 Hospital‟s suspension of plaintiff‟s surgical privileges. Plaintiff initially filed this suit alleging 15 discrimination and disparate treatment based on race. After substantial motion practice and four 16 amended complaints, plaintiff now alleges two claims of retaliation under 42 U.S.C. § 1981. 17 Plaintiff claims that defendants retaliated against him for filing and prosecuting this lawsuit by: (1) 18 unreasonably and intentionally delaying with finalizing and implementing plaintiff‟s surgical 19 proctoring program; and (2) unreasonably and intentionally delaying an update to the National 20 Practitioner Data Bank with details of plaintiff‟s limited suspension. 21 On November 4, 2016, the Court held a hearing on defendants‟ motion for summary 22 judgment. After careful consideration of the papers submitted, for the reasons articulated in open 23 court, the Court finds that there are genuine disputes of material fact as to plaintiff‟s retaliation 24 claims against the hospital defendants. 25 evidence of retaliatory acts by the individual defendants, Dr. Wilbur and Dr. Schwartz. The Court 26 hereby DENIES defendants‟ motion as to the hospital entities and GRANTS the motion as to the 27 individual defendants. 28 The Court further finds that the record contains no 1 BACKGROUND 2 Plaintiff is a Colombian-born general surgeon sub-specializing in oncology surgery and 3 advanced cancer treatments at Good Samaritan Hospital (“GSH”). Plaintiff began working at 4 GSH in 2004. In 2009, plaintiff lost a patient shortly after performing a complicated surgical 5 procedure, known as a “Whipple.” GSH immediately suspended plaintiff‟s surgical privileges, 6 which prompted GSH‟s filing of an “Adverse Action Report” with the National Practitioner Data 7 Bank (“NPDB”) explaining plaintiff‟s “indefinite,” “summary or emergency” suspension. Decl. 8 Bastidas, Ex. C, NPDB report (Dkt. No. 185-6). Plaintiff‟s suspension began a years-long peer 9 review and administrative appeal process, finally completed in early 2013 when the GSH Board of 10 Trustees issued its final decision. See Decl. Wong, Ex. 7, Board final action (Dkt. No. 174-4). United States District Court Northern District of California 11 Pursuant to the Board‟s final decision, the GSH Medical Executive Committee (“MEC”) 12 presented plaintiff with a Focused Professional Practice Evaluation (“FPPE”), a surgical 13 proctoring program through which plaintiff could eventually regain his full surgical privileges at 14 GSH. Roughly two months later, on August 1, 2013, plaintiff responded by letter, stating his 15 belief that the FPPE was more restrictive than required by the final Board decision. Id., Ex. 12, 16 letter from plaintiff to Tilles (Dkt. No. 174-8). Plaintiff asked the GSH Chief of Staff to “review 17 this issue and clarify” and stated that he was “happy to meet . . . to finalize a FPPE.” Id. At this 18 point, neither party progressed the issue for well over a year. 19 Plaintiff filed this lawsuit on September 20, 2013. Dkt. No. 1. On December 16, 2014, for 20 the first time since filing the lawsuit, plaintiff renewed his requests for a revised FPPE and update 21 to the NPDB. Decl. Bastidas ¶ 91, Ex. L, plaintiff email to GSH staff (Dkt. No. 186-8). Plaintiff 22 stated that the GSH Medical Staff had “yet to respond to [his] request to initiate [his] FPPE.” Id. 23 Plaintiff requested a status update on the FPPE process and asked GSH to “submit an appropriate 24 amendment ASAP” to the NPDB since he “remain[ed] listed as an „incompetent‟ physician . . . 25 and that item continue[d] to prevent [him] from obtaining privileges at any new institutions.” Id. 26 Having heard nothing, plaintiff followed up again on April 28, 2015 by certified letter to Dr. 27 Blumenfeld, now acting as GSH Chief of Staff, and reiterated the same concerns about the FPPE 28 and NPDB. Decl. Wong, Ex. 17, plaintiff letter to Blumenfeld (Dkt. No. 175-1). Again, plaintiff 2 1 received no response. 2 Plaintiff noticed the depositions of the GSH Medical Staff on June 2, 2015, including as 3 topics, “actions taken by the [MEC] with regard to the proctoring of Plaintiff,” actions taken in 4 response to plaintiff‟s August 1, 2013 letter objecting to the FPPE and his follow-up 5 communications on December 16, 2014 and April 28, 2015, and actions related to updating the 6 NPDB. Decl. Bastidas ¶ 94. One week later, Dr. Blumenfeld, GSH Chief of Staff, called plaintiff 7 to let him know that the MEC was working on a proposed FPPE and that the two should meet to 8 discuss NPDB reporting. See Decl. Bastidas ¶ 95 & Ex. N, email from plaintiff to Blumenfeld 9 memorializing conversation (Dkt. No. 186-12). Over several weeks following the phone conversation, plaintiff and defendants exchanged letters and emails, eventually leading to an 11 United States District Court Northern District of California 10 agreed FPPE. Decl. Bastidas ¶ 97; see also Decl. Wong, Exs. 19-21. Plaintiff signed the FPPE on 12 August 26, 2015, which appointed Dr. Harris from UCSF as his proctor and included optional 13 intra-operative observation at the election of the Chief of Staff. Decl. Wong, Ex. 28 (Dkt. No. 14 175-10). 15 Around the time that the parties executed plaintiff‟s FPPE, discussions also progressed 16 regarding the NPDB update. On August 24, 2015, Dr. Blumenfeld sent plaintiff a letter about 17 plaintiff‟s requested NPDB updates. Decl. Bastidas ¶ 99 & Ex. O, letter from Blumenfeld to 18 plaintiff (Dkt. No. 186-14). The letter set forth agreed-upon language for an NPDB revision, 19 describing plaintiff‟s suspension and proctoring program, and stated that the NPDB update would 20 be filed the same week. Id. By the end of August 2015, the parties had signed plaintiff‟s 21 proctoring program and agreed to the content of the NPDB revision. 22 agreement, the parties did not finalize either for several more months. Despite the apparent 23 Mary Ann Rodriguez, now GSH‟s Director of Medical Staff Services, states that between 24 late August and mid-December of 2015, she did not realize that filing the NPDB update was her 25 responsibility. Decl. Rodriguez (Dkt. No. 173-6) ¶¶ 7-8.1 Rodriguez states that she could not find 26 1 27 28 Plaintiff objects to certain portions of the Rodriguez Declaration, claiming the information is either inadmissible hearsay or that the declarant lacks personal knowledge with respect to certain statements. See Dkt. No. 193. This order need not address these objections because, even taking this evidence into account, defendants‟ motion will be denied. Accordingly, 3 1 log-in credentials for the data bank, so she called the NPDB and waited “a couple of weeks” for 2 her log-in information. Id. ¶ 10. She then tried to submit the report, but the submission required a 3 payment and she did not have access to a hospital credit card. Id. ¶¶ 11-12. Rodriguez filed 4 plaintiff‟s “Revision to Action Report” with the NPDB on January 28, 2016, approximately five 5 months after Dr. Blumenfeld told plaintiff it would be filed. Id. ¶ 12; Wong Decl., Ex. 35, 6 Revision to Action Report (Dkt. No. 177-6). After reaching an agreed FPPE in August 2015, the parties continued to experience delays 8 with the implementation of plaintiff‟s proctoring. Over the next several months, plaintiff followed 9 up with GSH administration regularly about submitting cases to his proctor. Plaintiff wrote 10 directly to the Board on December 14, 2015 requesting a status update, stating that he had been 11 United States District Court Northern District of California 7 waiting to have Dr. Harris review certain patients that plaintiff wanted to schedule for surgery. 12 Decl. Bastidas, Ex. P, letter to Board (Dkt. No. 186-16). 13 While plaintiff sought to have his proctoring program fully implemented, plaintiff ran for 14 election as Chair of GSH‟s Department of Surgery. On October 27, 2015, the MEC wrote plaintiff 15 and informed him that because of the practice restrictions in place under plaintiff‟s suspension, 16 plaintiff was not in “good standing” and therefore ineligible to run for Chair of Surgery under the 17 Medical Staff Bylaws. Decl. Bastidas ¶ 122 & Ex. S, letter from Chief of Staff to plaintiff (Dkt. 18 No. 187-4) at 1. The MEC removed plaintiff from the ballot. Plaintiff disputed the MEC‟s 19 interpretation of the Bylaws. Decl. Bastidas ¶ 123; id., Ex. S, email from plaintiff to MEC 20 members (Dkt. No. 187-4) at 2. On November 16, 2015, the MEC responded to plaintiff by letter. 21 Decl. Bastidas ¶ 124 & Ex. T, letter from MEC to plaintiff (Dkt. No. 187-6). The MEC stated that 22 after meeting on the issue, it had determined that the Bylaws were not clear about plaintiff‟s 23 eligibility to run and that because of the ambiguity, it would send out new ballots including 24 plaintiff‟s name. Id. The MEC noted, however, that in the course of reviewing the Bylaws, it had 25 determined that members of medical staff committees must be in good standing, and that 26 accordingly, plaintiff could no longer serve on the hospital‟s Cancer Care Committee. Id. After 27 28 plaintiff‟s objections to this declaration are OVERRULED. 4 1 the MEC added plaintiff‟s name to the new Chair of Surgery ballot, plaintiff‟s voting peers elected 2 him as Chair. Decl. Bastidas ¶¶ 125-26, id. Exs. U, V, memo and new ballot for election, letter 3 from MEC to plaintiff (Dkt. Nos. 187-8, 187-10). On December 21, 2015, the MEC wrote 4 plaintiff again to explain that under the Bylaws, election results are subject to ratification by the 5 MEC. Decl. Bastidas ¶ 127 & Ex. V, letter from MEC to plaintiff (Dkt. No. 187-10). The MEC 6 stated that ratification required a majority vote and, after discussing the election in a closed 7 session, plaintiff‟s election had narrowly fallen short of ratification; plaintiff “therefore [could not] 8 serve in that position.” Id. 9 Before, during, and after the election proceedings, GSH claims to have experienced significant delays in getting Dr. Harris, a UCSF doctor, the necessary temporary privileges to act 11 United States District Court Northern District of California 10 as plaintiff‟s proctor at GSH. See Decl. Abrams (Dkt. No. 173-5) ¶¶ 7-12.2 GSH, UCSF, and Dr. 12 Harris needed to negotiate and agree to a professional services contract for Dr. Harris‟s proctoring 13 arrangement. See id. ¶¶ 8-9. Gregory Abrams, who oversaw this process, describes that it 14 dragged out over many months from late 2015 to mid-2016, and involved extensive coordination 15 between GSH, UCSF, GSH‟s parent company, the hospital‟s credentialing arm, and others. See 16 id. ¶¶ 7-25; see also Supp. Decl. Wong, Ex. 60, excerpts from Hinsdale deposition (Dkt. 196-10) 17 at 26. Plaintiff states that he has only been able to submit cases to Dr. Harris for review since late 18 July 2016. Decl. Bastidas (Dkt. No. 184-6) ¶ 115. 19 LEGAL STANDARD 20 21 Summary judgment is proper “if the movant shows that there is no genuine dispute as to 22 any material fact and the movant is entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a). 23 The moving party bears the initial burden of demonstrating the absence of a genuine issue of 24 material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). The moving party, however, 25 26 27 28 2 Plaintiff objects to the admissibility of the Abrams Declaration in whole and in part. Dkt. No. 184-8. This order need not address these objections because, even taking this evidence into account, defendants‟ motion will be denied. Accordingly, plaintiff‟s objections to this declaration are OVERRULED. 5 1 has no burden to disprove matters on which the nonmoving party will have the burden of proof at 2 trial. Id. at 325. The moving party need only demonstrate to the Court that there is an absence of 3 evidence to support the non-moving party‟s case. Id. Once the moving party has met its burden, the burden shifts to the nonmoving party to “set 5 forth, by affidavit or as otherwise provided in Rule 56, „specific facts showing that there is a 6 genuine issue for trial.‟” T.W. Elec. Serv., Inc. v. Pac. Elec. Contractors Ass’n, 809 F.2d 626, 630 7 (9th Cir. 1987) (citing Celotex, 477 U.S. at 324). To carry this burden, the non-moving party must 8 “do more than simply show that there is some metaphysical doubt as to the material facts.” 9 Matsushita Elec. Indus. Co., Ltd. v. Zenith Radio Corp., 475 U.S. 574, 586 (1986). “The mere 10 existence of a scintilla of evidence . . . will be insufficient; there must be evidence on which the 11 United States District Court Northern District of California 4 jury could reasonably find for the [non-moving party].” Anderson v. Liberty Lobby, Inc., 477 U.S. 12 242, 252 (1986). 13 In deciding a summary judgment motion, the Court must view the evidence in the light 14 most favorable to the non-moving party and draw all justifiable inferences in its favor. Id. at 255. 15 However, conclusory, speculative testimony in affidavits and moving papers is insufficient to raise 16 genuine issues of fact and defeat summary judgment. Thornhill Publ’g Co., Inc. v. GTE Corp., 17 594 F.2d 730, 738 (9th Cir. 1979). 18 19 20 DISCUSSION The Supreme Court has interpreted 42 U.S.C. § 1981 to encompass retaliation claims, even 21 though section 1981 does not include an express retaliation provision. 22 Humphries, 553 U.S. 442, 446 (2008). A plaintiff alleging retaliation under section 1981 may 23 either proceed by producing direct or circumstantial evidence showing that a discriminatory reason 24 more likely than not motivated the employer, or may apply the burden-shifting framework set 25 forth by the Supreme Court in McDonnell Douglas Corp. v. Green, 411 U.S. 792, 802 (1973). 26 Surrell v. Cal. Water Serv. Co., 518 F.3d 1097, 1105 (9th Cir. 2008). Here, both parties apply the 27 McDonnell Douglas framework. See Mot. (Dkt. No. 176) at 9; Opp‟n (Dkt. No. 184) at 17. 28 CBOCS W., Inc. v. The McDonnell Douglas framework utilizes a three-step analysis. The first step requires 6 the plaintiff to demonstrate a prima facie case of retaliation. Bergene v. Salt River Project Agric. 2 Improvement & Power Dist., 272 F.3d 1136, 1140-41 (9th Cir. 2001) (citation omitted). If the 3 plaintiff succeeds, he has established a rebuttable presumption of retaliation. See Texas Dep’t of 4 Cmty. Affairs v. Burdine, 450 U.S. 248, 254 (1981). 5 persuasion,” then shifts to the defendant to articulate “some legitimate, nondiscriminatory reason” 6 for its adverse action against the plaintiff. Hawn v. Exec. Jet Mgmt., Inc., 615 F.3d 1151, 1155 7 (9th Cir. 2010) (citations and internal quotation marks omitted); see also Ray v. Henderson, 217 8 F.3d 1234, 1240 (9th Cir. 2000) (citation omitted). If the defendant puts forth a legitimate reason, 9 the presumption of unlawful discrimination “simply drops out of the picture.” St. Mary’s Honor 10 Ctr. v. Hicks, 509 U.S. 502, 511 (1993). The final burden then rests with the plaintiff to prove that 11 United States District Court Northern District of California 1 the defendant‟s proffered explanation is merely a pretext for retaliation. Bergene, 272 F.3d at 12 1140-41 (citation omitted); Ray, 217 F.3d at 1240 (citation omitted). “The burden of production, but not 13 As a general matter, the plaintiff in an employment discrimination action “need produce 14 very little evidence in order to overcome an employer's motion for summary judgment. This is 15 because „the ultimate question is one that can only be resolved through a searching inquiry—one 16 that is most appropriately conducted by a factfinder, upon a full record.‟” Chuang v. Univ. of Cal. 17 Davis, Bd. of Trs., 225 F.3d 1115, 1124 (9th Cir. 2000) (quoting Schnidrig v. Columbia Mach., 18 Inc., 80 F.3d 1406, 1410 (9th Cir. 1996)). 19 For the reasons set forth below, and for the reasons stated in open court, the Court 20 GRANTS defendants‟ motion as to Dr. Schwartz and Dr. Wilbur, and DENIES defendants‟ 21 motion as to the remaining defendants. 22 23 I. Prima Facie Case 24 In order to establish a prima facie case on summary judgment, “[t]he plaintiff need only 25 offer evidence which gives rise to an inference of unlawful discrimination.” Wallis v. J.R. Simplot 26 Co., 26 F.3d 885, 889 (9th Cir. 1994) (citing Yartzoff v. Thomas, 809 F.2d 1371, 1375 (9th Cir. 27 1987)); see id. (noting that the degree of proof necessary on summary judgment is “minimal”). To 28 make out a prima facie case of retaliation under the McDonnell Douglas framework, an employee 7 1 must show: (1) that he engaged in a protected activity; (2) that his employer subjected him to an 2 adverse employment action; and (3) that a causal link exists between the protected activity and the 3 adverse action. Ray, 217 F.3d at 1240.3 The parties do not dispute that plaintiff meets the first 4 requirement of his prima facie case: plaintiff engaged in a protected activity by filing and 5 prosecuting this discrimination lawsuit. Dkt. 1; Dkt. 39; Dkt. 60; Dkt. 83; Dkt. 140; Dkt. No. 176 6 at 9; Dkt. 190 at 18. The parties‟ arguments center on the second and third elements of plaintiff‟s 7 prima facie case: whether defendants subjected plaintiff to an adverse employment action, and 8 whether there is a causal link between plaintiff‟s prosecution of this lawsuit and the alleged 9 adverse employment actions. 10 United States District Court Northern District of California 11 A. Adverse Employment Action 12 Plaintiff alleges that defendants subjected him to two adverse employment actions in this 13 case, by: (1) failing to timely implement a surgical proctoring program for the plaintiff; and 14 (2) failing to timely file an update to the National Practitioner Data Bank regarding plaintiff‟s 15 suspension of privileges. 16 Fonseca v. Sysco Food Servs. of Ariz., Inc., 374 F.3d 840, 847 (9th Cir. 2004) (citations omitted). 17 Any action “reasonably likely to deter employees from engaging in protected activity” can be 18 considered an adverse employment action. Ray, 217 F.3d at 1243. An adverse action may include 19 a reduction in compensation, a warning letter or negative review or a limitation of the terms or 20 privileges of employment. Fonseca, 374 F.3d at 847; Chuang, 225 F.3d at 1125-26. The Ninth Circuit defines “adverse employment action” broadly. 21 A jury could reasonably find that the two adverse employment actions alleged here, failure 22 to timely implement plaintiff‟s proctoring program and failure to timely update the NPDB with 23 plaintiff‟s disciplinary status, would be reasonably likely to deter an employee from engaging in 24 protected activity. At minimum, the record demonstrates that successful implementation of an 25 approved proctoring program directly affected plaintiff‟s privileges to perform certain types of 26 3 27 28 While Ray addressed retaliation claims under Title VII, courts analyze section 1981 retaliation claims under the same framework. See Maduka v. Sunrise Hosp., 375 F.3d 909, 912 (9th Cir. 2004). 8 1 surgeries at GSH, surgeries that previously had formed a significant part of plaintiff‟s medical 2 practice at the hospital. Any delay in implementation served to prevent plaintiff from regaining 3 full surgical privileges. 4 genuine dispute of material fact as to whether defendants‟ failure to update the NPDB report 5 materially affected the terms, conditions, or privileges of plaintiff‟s employment, or otherwise 6 would be reasonably likely to deter an employee from engaging in protected activity. The report 7 on file, without revision until January 2016, stated that plaintiff had been suspended for 8 incompetence. The report was visible to other hospitals at which plaintiff may have sought 9 surgical privileges. Moreover, the record contains sufficient evidence demonstrating a 10 United States District Court Northern District of California 11 B. Causal Connection 12 To establish causation in this Circuit, a plaintiff may offer direct evidence of causation, or 13 circumstantial evidence from which causation can be inferred, such as an employer‟s “pattern of 14 antagonism following the protected conduct,” Porter v. Cal. Dep’t Corr., 419 F.3d 885, 895 (9th 15 Cir. 2005), or temporal proximity between the protected activity and the occurrence of the adverse 16 action. Pardi v. Kaiser Found. Hosp., 389 F.3d 840, 850 (9th Cir. 2004); Bell v. Clackamas Cnty., 17 341 F.3d 858, 865-66 (9th Cir. 2003); Yartzoff, 809 F.2d at 1376. In cases that rely solely on the 18 existence of temporal proximity, however, our Circuit has cautioned that a “specified time period 19 cannot be a mechanically applied criterion. A rule that any period over a certain time is per se too 20 long (or, conversely, a rule that any period under a certain time is per se short enough) would be 21 unrealistically simplistic.” Porter, 419 F.3d at 895 (citation and internal quotation marks omitted). 22 Defendants separately urge the Court to apply the heightened “but-for” causation standard 23 employed in Title VII cases to this action. See Univ. of Tex. Sw. Med. Ctr. v. Nassar, 133 S.Ct. 24 2517 (2013). Defendants admit that the Ninth Circuit has not explicitly extended Nassar to 25 section 1981 claims, but argue that the Ninth Circuit is “headed in that direction.”4 Mot. (Dkt. No. 26 4 27 28 The Ninth Circuit has consistently held that “[r]etaliation claims under Title VII and § 1981 share identical legal standards.” Williams v. Tucson Unified Sch. Dist., 316 F. App‟x 563, 564 (9th Cir. 2008) (citing Manatt v. Bank of Am., NA, 339 F.3d 792, 797 (9th Cir. 2003) (recognizing that “those legal principles guiding a court in a Title VII dispute apply with equal 9 1 176) at 14 n.6 (citing Bagley v. Bel-Aire Mech. Inc., 647 F. App‟x 797, 800 (2016) (unpublished 2 memorandum opinion)). Under this standard, a plaintiff must prove that “his or her protected 3 activity was a but-for cause of the alleged adverse action by the employer.” 133 S.Ct. at 2534. Although Nassar‟s applicability to section 1981 cases is questionable,5 the Court finds that 5 plaintiff has adduced sufficient evidence of causation under either standard to meet his “minimal” 6 burden of establishing a prima facie case at summary judgment. The record contains sufficient 7 circumstantial evidence of causation to raise a genuine dispute of material fact on both retaliation 8 claims. 9 protracted delays continuing even after plaintiff reopened communications in December 2014; Dr. 10 Beaupre, GSH‟s CEO, allegedly ending an unrelated sit-down meeting with plaintiff in June 2015 11 United States District Court Northern District of California 4 after plaintiff refused to talk about the litigation; GSH‟s continuing struggles with implementation 12 of plaintiff‟s proctoring program in 2015 and 2016; delays with filing the agreed NPDB revision 13 in late 2015; plaintiff‟s removal from the Cancer Care Committee in 2015; and the MEC‟s 14 nullification of plaintiff‟s election as Chief of Surgery in 2015. The following items, at minimum, demonstrate a genuine dispute as to causation: 15 Considering all of the evidence in the light most favorable to plaintiff, the record 16 demonstrates a genuine dispute of material fact on the issue of causation. As such, the Court holds 17 that plaintiff has met his minimal burden to demonstrate a prima facie case at the summary 18 19 20 21 22 23 force in a § 1981 action”)). The Ninth Circuit recently extended Nassar‟s heightened “but-for” causation standard to ADA retaliation claims. T.B. ex rel. Brenneise v. San Diego Unified Sch. Dist., 795 F.3d 1067, 1088 (9th Cir. 2015). While the Ninth Circuit has not directly held that the Nassar standard applies in section 1981 cases, see Peterson v. Nat’l Sec. Technologies, 650 F. App‟x 476, 478 n.1 (9th Cir. 2016) (unpublished memorandum opinion), the Court observes that other circuits have applied Nassar‟s “but-for” causation standard to section 1981 retaliation claims. See, e.g., Zastrow v. Houston Auto Imports Greenway Ltd., 789 F.3d 553, 564 (5th Cir. 2015); Wright v St. Vincent Health Sys., 730 F.3d 732, 737-38, n.5 (8th Cir. 2013). . 24 5 25 26 27 28 The Supreme Court reached its holding in Nassar based, in part, on “Title VII‟s detailed structure[,]” as compared to other, more “broadly worded antidiscrimination statutes[.]” See 133 S. Ct. at 2532-33; see also id. at 2530 (dictum) (“Unlike Title IX, § 1981, § 1982, and the federalsector provisions of the ADEA, Title VII is a detailed statutory scheme.”); id. at 2532-33 (“[W]hile the Court has inferred a congressional intent to prohibit retaliation when confronted with broadly worded antidiscrimination statutes, Title VII‟s detailed structure makes that inference inappropriate here.”). The Court‟s decision appears to be limited to detailed statutory schemes like Title VII and the ADA. See id. at 2531. 10 1 judgment stage. 2 3 II. Legitimate, Nondiscriminatory Reason Under McDonnell Douglas, the burden now shifts to defendants. 4 The Court must determine whether defendants have shown legitimate, non-discriminatory reasons for the adverse 6 actions. 7 introduction of admissible evidence, reasons for the adverse actions “which, if believed by the trier 8 of fact, would support a finding that the employment action was not a result of unlawful 9 discrimination.” Noyes v. Kelly Servs., 488 F.3d 1163, 1169 (9th Cir. 2007) (citing Burdine, 450 10 U.S. at 255). Defendants offer several nondiscriminatory reasons for the delays with finalizing 11 United States District Court Northern District of California 5 and implementing plaintiff‟s proctoring program, and for delays with updating the NPDB. For 12 To meet their burden at this stage, defendants must clearly set forth, through the purposes of this order, the Court will assume that defendants‟ reasons are sufficient. 13 14 15 16 17 18 19 20 III. Pretext Because defendants have come forward with legitimate, nondiscriminatory reasons to explain the alleged adverse actions, the final burden rests with plaintiff to establish that defendants‟ proffered motives are merely a pretext for retaliation. At summary judgment, plaintiff must demonstrate that there is a genuine dispute of material fact as to the legitimacy of defendants‟ reasons for the delays. See Noyes, 488 F.3d at 1169. Pretext may be demonstrated by direct evidence showing the employer‟s discriminatory motive, or by circumstantial evidence that undermines the credibility of the employer‟s articulated 21 reasons. Noyes, 488 F.3d at 1170-71; Stegall v. Citadel Broad. Co., 350 F.3d 1061, 1066 (9th Cir. 22 23 24 25 26 27 2003). Circumstantial evidence must be “specific” and “substantial” in order to create a triable issue with respect to whether the employer intended to discriminate. Godwin v. Hunt Wesson, Inc., 150 F.3d 1217, 1222 (9th Cir. 1998); Vasquez v. Cnty. of L.A., 349 F.3d 634, 642 (9th Cir. 2003); see also Bradley v. Harcourt, Brace and Co., 104 F.3d 267, 270 (9th Cir. 1996) (citation and internal quotation marks omitted) (“To avoid summary judgment, [the plaintiff] must do more than establish a prima facie case and deny the credibility of the defendant‟s witnesses. She must 28 11 1 produce specific, substantial evidence of pretext.”). “All of the evidence as to pretext—whether 2 direct or indirect—is to be considered cumulatively.” Noyes, 488 F.3d at 1170 (citation and 3 internal quotation marks omitted). 4 The Court finds that plaintiff has met his burden to show genuine disputes of material fact 5 concerning pretext at the summary judgment stage. Plaintiff offers sufficient indirect evidence to 6 undermine the credibility of defendants‟ reasons. One such item is defendants‟ handling of the 7 2015 election for GSH‟s Chair of the Department of Surgery. Initially, plaintiff was listed on the 8 ballot, but the MEC decided to remove him because he was not in “good standing.” Plaintiff 9 objected, and the MEC eventually put his name back on the ballot. At the same time, however, 10 United States District Court Northern District of California 11 12 13 14 the MEC removed plaintiff from the Cancer Care Committee. The Chair of Surgery ballot proceeded and plaintiff‟s peers elected him. Afterwards, the MEC voted and declined to ratify plaintiff‟s election, nullifying the election results. Defendants argue that the MEC‟s decision to reject the election results could have been based on other issues with the plaintiff, such as behavioral complaints or surgical misconduct. Reply (Dkt. No. 196-3) at 10. At this stage of the proceedings, there are genuine issues of material fact that must be 15 16 17 resolved at trial. Based on the record, a reasonable fact finder could conclude that defendants‟ reasons for the extensive and protracted delays are unworthy of credence. The Court hereby DENIES the hospital defendants‟ motion for summary judgment as to liability. However, because 18 plaintiff has pointed to no evidence demonstrating personal responsibility on behalf of Dr. 19 Schwartz and Dr. Wilbur, the Court GRANTS summary judgment as to these individual 20 defendants. 21 22 IV. 23 Damages Defendants also move for summary judgment on plaintiff‟s damages, arguing that plaintiff 24 cannot prove that he actually suffered any harm from the retaliation claims in the fourth amended 25 complaint. Mot. (Dkt. No. 173-3) at 21-25; Reply (Dkt. No. 196-3) at 14-15. The Court finds that 26 27 genuine disputes of material fact exist regarding plaintiff‟s alleged damages. These issues are best reserved for decision by a jury on a full record. The Court hereby DENIES defendants‟ motion for 28 12 1 summary judgment as to damages. 2 CONCLUSION 3 4 For the foregoing reasons, the Court hereby DENIES defendants‟ motion for summary 5 judgment as to the hospital defendants and GRANTS defendants‟ motion as to the individual 6 defendants, Dr. Schwartz and Dr. Wilbur. The trial in this matter will be a clean slate. This order 7 does not establish anything for purposes of trial. 8 9 10 United States District Court Northern District of California 11 12 13 This order resolves Dkt. No. 176. IT IS SO ORDERED. Dated: November 21, 2016 ______________________________________ SUSAN ILLSTON United States District Judge 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 13

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