Chmura v. Monongalia Health System

Filing 41

MEMORANDUM OPINION AND ORDER GRANTING DEFENDANTS MOTION FOR SUMMARY JUDGMENT DKT. NO. 25 AND DISMISSING CASE WITH PREJUDICE. The Clerk is directed to issue a separate judgment order in this matter. Signed by Senior Judge Irene M. Keeley on 8/9/19. (mh)

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF WEST VIRGINIA
GEORGETTE CHMURA,
Plaintiff,
v.

CIVIL ACTION NO. 1:17CV222
(Judge Keeley)

MONONGALIA HEALTH SYSTEM,
Defendant.
MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
SUMMARY JUDGMENT [DKT. NO. 25] AND DISMISSING CASE WITH PREJUDICE
The plaintiff, registered nurse Georgette Chmura (“Chmura”),
was terminated from her employment at Monongalia General Hospital
(“Mon General”), a subsidiary of the defendant, Monongalia Health
System

(“Mon

Health”),

after

failing

to

obtain

a

mandatory

influenza vaccination. Chmura alleges that by terminating her
employment Mon Health discriminated against her on the basis of her
alleged disability, a latex allergy, in violation of the Americans
with Disabilities Act (ADA). Pending before the Court is Mon
Health’s motion for summary judgment. For the reasons that follow,
the Court GRANTS Mon Health’s motion (Dkt. No. 25), and DISMISSES
the case WITH PREJUDICE.1

1

Because, as a matter of law, Chmura’s sole claim fails as a matter
of law under the ADA, the Court need not reach the issue of whether
Mon General and Mon Health are integrated employers. Accordingly,
the Court will refer to each entity as reflected by the record
before it.

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
SUMMARY JUDGMENT [DKT. NO. 25] AND DISMISSING CASE WITH PREJUDICE
I. BACKGROUND
A.

Chmura’s Employment
Vaccination Program

History

and

Mon

General’s

Influenza

Beginning in January 2007 Chmura was employed by Mon General
as a per diem registered nurse (Dkt. No. 26-1 at 6-7). Chmura
maintained that job title throughout the duration of her employment
with Mon General, working approximately two to three days per week.
Id. at 7, 9.
Sometime

in

2015,

Mon

General

implemented

a

mandatory

Influenza Vaccination Program. See Dkt. No. 26-2 (“Flu Vaccination
Policy”); see also Dkt. No. 26-1 at 11. The stated purpose of the
Flu Vaccination Policy was “to provide information to [Mon Health]
Healthcare

Workers

(HCW)

regarding

the

requirements

for

all

employees, medical staff, allied health staff, residents, contract
employees, and volunteers providing services on any [Mon Health]
premises to be immunized against influenza” (Dkt. No. 26-2 at 1).
Chmura testified during her deposition that the Policy was designed
to “reduce [the] risk” of influenza to patients and staff members
(Dkt. No. 26-1 at 11-12).
According to the Flu Vaccination Policy, any healthcare worker
having a medical contraindication that prevented him or her from
obtaining

the

influenza

vaccination
2

“must

submit

a

Medical

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
SUMMARY JUDGMENT [DKT. NO. 25] AND DISMISSING CASE WITH PREJUDICE
Exemption

Form

in

its

entirety

to

[the]

Employee

Health

[Department]” (Dkt. No. 26-2 at 1). The Medical Exemption Form
“require[d] complete documentation” from the healthcare worker’s
physician, and an exemption request was subject to approval by the
Chair

of

the

Infection

Prevention

Committee

and

the

Vice

President/Medical Director. Id. A healthcare worker receiving an
approved medical exemption “[was] required to wear a mask at all
times

while

at

work

per

annually

established

vaccination

deadlines.” Id. Further, healthcare workers “[failing] to receive
the influenza vaccination or obtain an approved exemption by the
date determined annually, [were] considered as not meeting the
conditions of employment and . . . considered to have resigned
their employment.” Id. at 2.
During her employment with Mon General, Chmura had reviewed
the Flu Vaccination Policy and understood that it applied to her
(Dkt. No. 26-1 at 10, 17).
B.

Chmura’s 2015 Vaccination Exemption Request
In October 2015, Chmura submitted a Medical Exemption Form

completed by her primary care physician, Dr. Janice Allen (“Dr.
Allen”) (Dkt. No. 26-3 at 2). The 2015 Medical Exemption Form
provided three boxes that could be checked by a healthcare worker’s
physician,

each

of

which

referenced
3

certain

recognized

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
SUMMARY JUDGMENT [DKT. NO. 25] AND DISMISSING CASE WITH PREJUDICE
contraindications to the influenza vaccination. The Form directed
the physician to certify that the healthcare worker “should not be
immunized for influenza for the following reasons (Please check all
that apply):
‘

History of previous allergic reaction and documented
allergy testing to indicate an immediate hypersensitivity
reaction to the influenza vaccine or a component of the
vaccine. Please attach supporting DOCUMENTATION or
MEDICAL RECORDS.

‘

History of Guillain-Barre Syndrome within six weeks of
receiving a previous vaccine. Please provide and attach
a detailed narrative that describes the event.

‘

Other – Please provide this information in a separate
narrative that describe the exception in detail (these
requests will be reviewed on a case-by-case basis).”

Id. at 2 (emphasis in original). On Chmura’s 2015 Medical Exemption
Form, Dr. Allen checked the box next to “Other,” and noted “severe
Latex allergy. Patient concerned Latex in vial or needle.” Id.
Chmura testified in her deposition that, along with her
completed Medical Exemption Form, she provided Mon General with a
September 12, 2014 letter from Lisa Donahue, Patient Safety Officer
at University of Pittsburgh Medical Center Shadyside (“Donahue”)
(Dkt. No. 26-1 at 18-19).2 In Donahue’s words, “the purpose of this
2

Although the September 12, 2014 letter is signed by Donahue and
displays her letterhead, the parties sometime refer to the letter
as being written by Dr. Hrebinko, Chmura’s treating surgeon at
UPMC. Donahue’s letter indicates that a courtesy copy was
4

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
SUMMARY JUDGMENT [DKT. NO. 25] AND DISMISSING CASE WITH PREJUDICE
letter [wa]s to confirm that during . . . [a hospital] stay
beginning

September

4,

2014,

[Chmura]

experienced

low

blood

pressure requiring medication during surgery from the use of latex
gloves” (Dkt. No. 26-4). The only supporting documentation Chmura
provided with her 2015 exemption request was Donahue’s letter
recounting her reaction to latex (Dkt. No. 26-1 at 22).
In an email dated November 9, 2015, S. Nicole Linger, Employee
Health & Wellness Manager for Mon General (“Linger”), informed
Chmura that her “request for a medical exemption to the vaccine
ha[d] been denied” (Dkt. No. 26-5) (emphasis in original). Linger’s
email also advised Chmura that, “[i]f you fail to receive the
influenza vaccination by [November 13, 2015], you have failed to
meet [Mon Health] conditions of employment and your actions will be
considered a resignation of employment” (Dkt. No. 26-5).
The following day, November 10, 2015, Linger sent an email to
Dr. Dino Delaportas (“Dr. Delaportas”), stating that Chmura “was
just in my office and would like to talk to you about her flu
exemption . . . She has a Latex allergy.” See Dkt. No. 26-6. On the
same date, Linger or another employee indicated in a handwritten
note that she had “called [Chmura] and told her that Delaportas
states

he’s

not

changing

his

mind

on

latex.”

provided to Dr. Hrebinko. See Dkt. No. 26-4.
5

Id.

Chmura’s

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
SUMMARY JUDGMENT [DKT. NO. 25] AND DISMISSING CASE WITH PREJUDICE
deposition

testimony

confirms

that

she

never

spoke

to

Dr.

Delaportas following the denial of her 2015 exemption request but
understood her request had been denied due to the availability of
latex-free influenza vaccines (Dkt. No. 26-1 at 22).
Three days after the denial of her exemption request, on
November 12, 2015, Chmura received an intramuscular injection of
Afluria®, a latex-free influenza vaccine (“Afluria”), at a Rite Aid
pharmacy (Dkt. No. 26-7). Approximately two months after receiving
Afluria, on January 19, 2016, Chmura completed a Vaccine Adverse
Event Reporting System (VAERS) form, in which she reported that the
vaccine had caused itching on her arm and wrist and redness on her
hands and neck (Dkt. No. 26-8).
C.

Chmura’s 2016 Vaccination Exemption Request
The following year, in October 2016, Chmura met with Lisa

Pifer, an Employee Health Nurse at Mon Health (“Pifer”), to discuss
her 2016 influenza vaccination status. See Dkt. No. 26-9. During
that meeting, Chmura provided Pifer with copies of her completed
VAERS

form

and

an

observation

note

from

George

Anderson

(“Anderson”), the Rite Aid pharmacist who had administered the
Afluria vaccine to her (Dkt. No. 26-7). Anderson’s note stated, in
full, “Patient showed severe anxiety & nervousness due to latex
allergy. Observed pt for over a half hour & showed anxiousness &
6

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
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itching. I did not observe any rash or breathing issues, but
patient was itching midsection & various other parts of the body.”
Id. Chmura testified in her deposition that Anderson’s report
accurately described her 2015 reaction to the Afluria vaccine (Dkt.
No. 26-1 at 24).
In an October 12, 2016 email memorializing her conversation
with Chmura, Pifer reported that she had advised Chmura to “have
her

doctor

fill

out

a

medical

exemption

form

with

as

much

supporting documentation as possible.” Id. In the same email, Pifer
wrote that Chmura “said she would not take the flu shot this year.”
(Dkt. No. 26-9).
A few weeks following her conversation with Pifer, Chmura
submitted a Medical Exemption Form completed by her new primary
care physician, Dr. Maria Gauna (“Dr. Gauna”) (Dkt. No. 26-11).
Like the 2015 version of the Medical Exemption Form, the 2016 Form
provided three boxes that could be checked by Chmura’s physician:
The above person should not be immunized for influenza
for the following reasons (Please check all that apply):
‘

History of previous allergic reaction and
documented allergy testing to indicate an
immediate hypersensitivity reaction to the
influenza vaccine or a component of the
vaccine.

‘

History of Guillain-Barre Syndrome within six
weeks of receiving a previous vaccine.
7

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
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‘

Other – (these requests will be reviewed on a
case-by-case basis).”

Please attach supporting DOCUMENTATION or MEDICAL RECORDS
for your request.
Id. (emphasis in original).
On Chmura’s 2016 Medical Exemption Form, Dr. Gauna checked the
boxes next to “History of previous allergic reaction and documented
allergy testing” and “Other.” Beside the box marked “Other,” Dr.
Guana wrote that she had “advised [Chmura] to wear a mask all the
time during flu season.” Id. Although Dr. Gauna checked the box
indicating a “History of previous allergic reaction and documented
allergy testing to indicate an immediate hypersensitivity reaction
to the influenza vaccine or a component of the vaccine,” Dr. Gauna
did not attach any supporting documentation regarding a previous
allergic reaction or documented allergy testing. See id.
On November 8, 2016, Chmura was informed via email and letter
from Kristan Rogers, Director of Corporate Education and Employee
Health & Wellness (“Rogers”), that her “request for a medical
exemption to the vaccine ha[d] been denied” (Dkt. No. 26-12 at 2)
(emphasis in original); see also Dkt. No. 26-11 (indicating that
Chmura’s medical exemption request had been denied on 11/7/16).
Rogers’

letter

further

stated,
8

“if

you

fail

to

receive

the

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
SUMMARY JUDGMENT [DKT. NO. 25] AND DISMISSING CASE WITH PREJUDICE
influenza vaccination by [November 18, 2016], you have failed to
meet [Mon Health] conditions of employment and your actions will be
considered a resignation of employment” (Dkt. No. 26-12 at 2).
Following the denial of her 2016 exemption request, Chmura
submitted a one-paragraph letter from Dr. Gauna, dated November 15,
2016, which stated, in relevant part, that “[i]t is medically
necessary that Mrs. Chmura dose [sic] not get the influenza vaccine
due to hypersensitivity to a component in the influenza vaccine. If
you have any questions please feel free to contact my office.”
(Dkt. No. 26-14). See also Dkt. No. 26-1 at 30. Dr. Gauna did not
indicate the component of the influenza vaccine to which Chmura was
hypersensitive, nor did she provide any documented allergy testing
or other medical records supporting her conclusion. Id. In her
deposition, Chmura confirmed that Dr. Guana did not perform allergy
testing or any other type of medical testing to determine whether
she is hypersensitive to any component of the influenza vaccine
(Dkt. No. 26-1 at 26, 31, 34).
Following receipt of Dr. Guana’s letter, Dr. Brian Hawthorne,
then the Vice President and Medical Director of Mon General (“Dr.
Hawthorne”), contacted Dr. Guana to discuss her opinion (Dkt. No.
26-15 at 1-2). According to Dr. Hawthorne, Dr. Gauna confirmed that
Chmura had reported a latex allergy to her, but that she never
9

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
SUMMARY JUDGMENT [DKT. NO. 25] AND DISMISSING CASE WITH PREJUDICE
performed any allergy testing to identify the root of the alleged
allergy. Id. at 2. Significantly, Dr. Gauna further advised Dr.
Hawthorne that, in her opinion, there was no medical reason why
Chmura could not receive a latex-free vaccination. Id. Chmura
testified in her deposition that she “wouldn’t have any reason to
doubt” that Dr. Guana so advised Dr. Hawthorne (Dkt. No. 26-1 at
36-37). She further testified that, she “didn’t have any medical
evidence” from Dr. Guana that she “had a hypersensitivity to any
other component of the vaccine other than latex.” Id. at 31.
Following Dr. Hawthorne’s conversation with Dr. Gauna, Mon
General denied Chmura’s renewed 2016 exemption request “due to the
availability of numerous latex-free influenza vaccination options”
(Dkt. No. 26-15 at 2). Rogers notified Chmura of the denial via
email and in a letter dated November 18, 2016 (Dkt. No. 26-16)
(informing Chmura that her renewed “request for a medical exemption
to the vaccine ha[d] been denied”)(emphasis in original). As had
the first denial letter, the second letter stated, “if you fail to
receive the influenza vaccination by [November 18, 2016], you have
failed to meet [Mon Health] conditions of employment and your
actions will be considered a resignation of employment.” Id.
On the same date, Chmura’s direct supervisor, Susan Konya,
Director of Clinical Resources (“Konya”), notified Chmura via
10

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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
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letter that, effective immediately, her employment was suspended
due to her “failure to comply with the [Flu Vaccine] Policy by
either receiving a flu vaccine or obtaining an exemption” (Dkt. No.
26-17). Konya’s letter warned Chmura that if she “still ha[d] not
complied with the Policy by November 23, 2016, at 5pm [she] would
be considered to have resigned [her] employment.” Id. Thereafter,
on November 23, 2016, Konya notified Chmura that as Mon General had
not received proof that she had received an influenza vaccine, it
considered her continued non-compliance with the Flu Vaccination
Policy to constitute a voluntary resignation of her employment,
effective immediately (Dkt. No. 26-18).
On December 21, 2017, Chmura filed suit against Mon Health
(Dkt. No. 1), alleging a single claim of discrimination under the
ADA. Following the close of discovery in the case, Mon Health filed
a motion for summary judgment (Dkt. No. 25), which is now fully
briefed and ripe for disposition.
II. STANDARD OF REVIEW
Summary

judgment

is

appropriate

only

“if

the

pleadings,

depositions, answers to interrogatories, and admissions on file,
together with the affidavits, if any, show that there is no genuine
issue as to any material fact and that the moving party is entitled
to judgment as a matter of law.” Fed.R.Civ.P. 56(c). When ruling on
11

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a motion for summary judgment, the Court reviews all the evidence
“in the light most favorable” to the nonmoving party. Providence
Square Assocs., L.L.C. v. G.D.F., Inc., 211 F.3d 846, 850 (4th Cir.
2000). “Summary judgment cannot be granted merely because the court
believes that the movant will prevail if the action is tried on the
merits.” Jacobs v. N.C. Admin. Office of the Courts, 780 F.3d 562,
568 (4th Cir. 2015) (citation omitted). The Court must therefore
avoid weighing the evidence or determining its truth and limit its
inquiry solely to a determination of whether genuine issues of
triable fact exist. Anderson v. Liberty Lobby, Inc., 477 U.S. 242,
249 (1986).
The moving party bears the initial burden of informing the
Court

of

the

basis

for

the

motion

and

of

establishing

the

nonexistence of genuine issues of fact. Celotex Corp. v. Catrett,
477 U.S. 317, 323 (1986). Once the moving party has made the
necessary showing, the non-moving party “must set forth specific
facts showing that there is a genuine issue for trial.” Anderson,
477 U.S. at 256 (internal quotation marks and citation omitted).
The “mere existence of a scintilla of evidence” favoring the nonmoving party will not prevent the entry of summary judgment; the
evidence

must

be

such

that

a

rational

trier

of

fact

reasonably find for the nonmoving party. Id. at 248–52.
12

could

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SUMMARY JUDGMENT [DKT. NO. 25] AND DISMISSING CASE WITH PREJUDICE
III. DISCUSSION
A.

Applicable Law
Under Title I of the ADA, covered entities, including private

employers,

are

prohibited

from

“discriminat[ing]

against

a

qualified individual on the basis of disability in regard to . . .
the hiring, advancement, or discharge of employees.” 42 U.S.C.
§ 12112(a); see also Summers v. Altarum Inst., Corp., 740 F.3d 325,
328 (4th Cir. 2014) (“The ADA makes it unlawful for covered
employers to ‘discriminate against a qualified individual on the
basis of disability.’”).
Disability discrimination may be proven through ordinary
principles

of

proof

or

through

the

burden-shifting

framework

established in McDonnell Douglas v. Green, 411 U.S. 792 (1973).
Jacobs v. N.C. Admin. Office of the Courts, 780 F.3d 562, 572 (4th
Cir. 2015) (citation omitted). To satisfy ordinary principles of
proof, the plaintiff must provide direct evidence of a purpose to
discriminate or circumstantial evidence of sufficiently probative
force to raise a genuine issue of material fact. Goldberg v. B.
Green & Co., 836 F.2d 845, 848 (4th Cir. 1988).
Here, the record reveals little, if any, direct or indirect
evidence of discriminatory motive, and the parties have confined
their arguments on summary judgment to whether Chmura has met her
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burden under the burden-shifting scheme established by McDonnell
Douglas.

Under

the

familiar

McDonnell

Douglas

framework,

the

plaintiff must first establish a prima facie case of disability
discrimination.

In

this

case,

Chmura

alleges

discriminatory

treatment in the form of wrongful discharge.3
In order to set forth a prima facie case of wrongful discharge
under the ADA, a plaintiff must establish, by a preponderance of
the evidence, that: “(1) [s]he was a qualified individual with a
disability; (2) [s]he was discharged; (3) [s]he was fulfilling
h[er] employer’s legitimate expectations at the time of discharge;
and (4) the circumstances of h[er] discharge raise a reasonable
inference of unlawful discrimination.” Reynolds v. Am. Nat’l Red
Cross, 701 F.3d 143, 150 (4th Cir. 2012) (citing Rohan v. Networks
Presentations LLC, 375 F.3d 266, 273 n. 9 (4th Cir. 2004) (internal
quotation marks omitted)).
If the plaintiff satisfies her initial burden of establishing
a prima facie case of disability discrimination, “a presumption of
illegal discrimination arises, and the burden of production shifts
to the employer” to show that its decision to terminate the

3

Chmura has not alleged a separate cause of action for failure to
accommodate under the ADA, which is a distinct cause of action with
different prima facie elements.
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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
SUMMARY JUDGMENT [DKT. NO. 25] AND DISMISSING CASE WITH PREJUDICE
plaintiff was based on a legitimate, non-discriminatory reason.
Hoyle v. Freightliner, LLC, 650 F.3d 321, 336 (4th Cir. 2011); see
Reeves v. Sanderson Plumbing Prods., Inc., 530 U.S. 133, 142
(2000). If the employer carries this burden of production, the
burden then shifts back to the plaintiff to demonstrate, by a
preponderance of the evidence, that the legitimate reason offered
by her employer is a pretext for disability discrimination. Id.
B.

Chmura’s Prima Facie Case
Under the McDonnell Douglas framework, the first step in the

Court’s analysis is to determine whether Chmura has put forth
sufficient prima facie evidence of disability discrimination to
survive summary judgment. Specifically at issue are the third and
fourth prongs of Chmura’s prima facie case.4 Mon Health first
argues that Chmura has failed to establish that she was fulfilling
Mon General’s legitimate expectations at the time of her discharge
because of her failure to receive the influenza vaccination or to
obtain an approved exemption to the Flu Vaccination Policy (Dkt.
No. 26 at 16-18). It further argues that Chmura has failed to
4

Because the parties did not address the issue on summary judgment,
the Court assumes, without deciding, that Chmura can establish the
first element of her prima facie case, that she is a qualified
individual with a disability under the ADA. With regard to the
second element, the parties do not dispute that Chmura was
discharged from her employment.
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present

any

evidence

of

a

reasonable

inference

of

unlawful

discrimination. Id. at 18-20.
While Mon Health contends that Chmura’s non-compliance with
the Flu Vaccination Policy requires a finding that she was not
meeting her employer’s legitimate expectations, such a finding
cannot be made without first considering whether Mon General’s
enforcement

of

the

Policy

was

discriminatory

under

the

circumstances. In other words, whether Chmura was meeting Mon
General’s legitimate expectations at the time of her discharge is
inextricably linked to the question of whether the circumstances of
her discharge, pursuant to the Policy, raise a reasonable inference
of discrimination. Accordingly, the Court will first consider the
fourth element of Chmura’s prima facie case, whether she has
presented sufficient evidence of a reasonable inference of unlawful
discrimination.
“An

inference

is

defined

as

a

conclusion

reached

by

considering other facts and deducing a logical consequence from
them, and the process of thought by which one moves from evidence
to proof.” Crawley v. Combs, No. 7:16-CV-00172, 2017 WL 780845, at
*2 (W.D. Va. Feb. 28, 2017), aff’d, 693 F. App’x 250 (4th Cir.
2017) (citations and internal quotation marks and alterations
omitted). “A reasonable inference is one that is within the range
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of reasonable probability.” Brown v. Rose’s Stores, Inc., 145 F.3d
1323 (4th Cir. 1998) (per curiam); see also Exergen Corp. v.
Wal-Mart Stores. Inc., 575 F.3d 1312, 1329 n.5 (Fed. Cir. 2009) (“A
reasonable inference is one that is plausible and that flows
logically from the facts alleged....”).
At the prima facie stage, the Court must carefully distinguish
between

evidence

that

allows

for

a

reasonable

inference

of

discrimination and evidence that gives rise to mere speculation and
conjecture. See Brown, 145 F.3d at 1323. Here, Chmura has failed to
establish that the circumstances surrounding her discharge give
rise to a reasonable inference of unlawful discrimination.
The parties do not dispute that, in November 2016, Chmura
failed to comply with Mon General’s Flu Vaccination Policy by
either receiving an influenza vaccination or obtaining an exemption
to the vaccination requirement. It is also undisputed that Chmura
requested medical exemptions to the Policy in 2015 and 2016, both
of which were denied. See Dkt. Nos. 26 at 7-11; 27 at 3-4; see also
Dkt. Nos. 26-5; 26-12; 26-16.
Further, the record reflects, and Chmura does not directly
dispute, that her 2015 medical exemption request was based solely
on her latex allergy. In support of her 2015 exemption request,
Chmura submitted only the Medical Exemption Form completed by Dr.
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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
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Allen and the patient safety letter signed by Donahue, see Dkt. No.
26-1 at 22, both of which indicate, at most, that Chmura has a
“severe latex allergy,” that she was “concerned [about] latex” in
flu vaccines, and that she had “experienced low blood pressure . .
. from the use of latex gloves” during a 2014 surgical procedure
(Dkt. Nos. 26-3 at 2; 26-4). Consistent with the documents provided
to Mon General in support of her request for an exemption, Chmura’s
2015 Medical Exemption Form reflects that her request was “denied”
because she “can take [a] Latex free” influenza vaccine (Dkt. No.
26-3 at 1). Moreover, Chmura agreed in her deposition that the
“basis”

of

her

2015

medical

exemption

request

“was

a

latex

allergy.” (Dkt. No. 26-1 at 22).
Chmura is decidedly less specific, however, about the asserted
basis or bases for her 2016 medical exemption request (Dkt. No. 263 at 2). As noted earlier, Dr. Guana completed Chmura’s 2016
Medical Exemption Form (Dkt. No. 26-11). Dr. Guana’s records
indicate that, on October 26, 2016, Chmura had an appointment as a
“new patient

. . . asking for a script for work to state unable to

get flu shot due to latex allergy . . . and severe reaction to
latex-free flu shot last time in 2015” (Dkt. No. 26-10 at 3).
During the appointment, Dr. Gauna completed Chmura’s 2016 Medical
Exemption Form, in which she indicated that Chmura had a “History
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of previous allergic reaction and documented allergy testing to
indicate an immediate hypersensitivity reaction to the influenza
vaccine or a component of the vaccine” (Dkt. No. 26-11) (emphasis
added).

Despite

documentation

the

or

Form’s

medical

directive

records,”

to
Dr.

“attach
Gauna

supporting

provided

no

documentation supporting Chmura’s purported history of a previous
reaction

to

the

influenza

vaccine.

Nor

did

she

provide

any

documented allergy testing indicating that Chmura had experienced
an immediate hypersensitivity reaction to the vaccine or one of its
components. See id. After concluding that Chmura failed to provide
medical

records

sufficient

to

demonstrate

a

documented

contraindication to a component of the influenza vaccine other than
latex, Mon General denied Chmura’s 2016 exemption request (Dkt.
Nos. 26-11; 26-12).
Dr. Guana’s subsequent November 2016 letter, in which she
opined,

without

further

explanation,

that

it

was

medically

necessary that Chmura not receive an influenza vaccine “due to a
hypersensitivity to a component in the . . . vaccine,” did not
specify the component of the influenza vaccine to which Chmura was
hypersensitive, nor did it reference any documented allergy testing
or other medical records to support her opinion (Dkt. No. 26-14).
Consequently, after receipt of the letter, Mon General, via Dr.
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Hawthorne, contacted Dr. Guana to discuss her medical opinions.
During that conversation, Dr. Guana admitted that she had not
performed any allergy testing before completing Chmura’s 2016
Medical Exemption Form and writing the letter in support of her
exemption request (Dkt. No. 26-15 at 2).
During

her

deposition,

Chmura

confirmed

that

she

never

provided any documents regarding allergy testing to Mon General at
the time she submitted her 2016 exemption request, because Dr.
Guana had never performed any type of medical testing to determine
whether

she

was,

in

fact,

hypersensitive

to

any

particular

component(s) of the vaccine (Dkt. Nos. 26-1 at 26, 31, 34). Chmura
therefore agreed that, as of the writing of Dr. Guana’s letter in
November 2016, she “didn’t have any medical evidence from Dr. Guana
or anyone else that [she] had a hypersensitivity to any . . .
component of the vaccine other than latex.” Id. at 31 (emphasis).
Finally, and most tellingly, Chmura also agreed that, because
Dr. Guana had not performed any medical testing, “Mon General [wa]s
not aware of any allergy to any component of the flu shot” other
than latex, when it denied her 2016 exemption request. Id. at 3435; see also id. at 26 (Chmura agreeing that, because she never
obtained medical testing to determine the component of the Afluria
vaccine to which she had allegedly reacted in November 2015, Mon
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General could not have known what caused the alleged reaction when
it considered her 2016 medical exemption request).5
Nonetheless, Chmura argues that a genuine dispute of material
fact exists “regarding Dr. Guana’s assessment of the true nature of
her disability” (Dkt. No. 27 at 11).

She contends that her 2016

Medical Exemption Form suggests that Dr. Guana “appears to have
believed that [she] suffered from an allergic reaction to another
element of the influenza vaccine.” Id. As discussed earlier, it is
Chmura who bears the burden to produce sufficient evidence from
which the Court can reasonably infer discrimination. An inference
“is not a suspicion or a guess.” Bickerstaff v. Vassar College, 196
F.3d 435, 448 (2d Cir. 1999).
The Court therefore will not endorse Chmura’s speculation
about what Dr. Guana “appears to have believed” about her reaction
to the Afluria vaccine, particularly given the undisputed evidence
that Dr. Guana could not have known which, if any, component of the
vaccine had caused Chmura’s reaction since she had performed no
medical testing. Chmura’s contention is also directly refuted by
5

Chmura further testified that, as of the time of her deposition in
February 2019, Dr. Guana still had not performed any allergy
testing to determine whether Chmura has a hypersensitivity to a
component of the influenza vaccine other than latex. Chmura stated
that she had not yet obtained such testing “because I really
haven’t had the time.” (Dkt. No. 26-1 at 1).
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Dr. Gauna’s concession to Dr. Hawthorne that there was “no medical
reason” Chmura could not have received a latex-free vaccine (Dkt.
No. 26-15 at 2).
And so, while Chmura undoubtedly requested a medical exemption
to the Flu Vaccination Policy in both 2015 and 2016, the record
reflects that she never provided Mon General with sufficient
documentation to establish a contraindication to some component of
the influenza vaccination other than latex. Further, Mon General,
which had been aware of Chmura’s latex allergy since at least
October of 2015, had taken no adverse employment action against her
on the basis of her reported contraindication to latex. Rather, it
acknowledged that Chmura could satisfy its Policy by receiving any
one of the numerous latex-free influenza vaccinations available to
her, and continued to employ her for more than a year. Accordingly,
the undisputed evidence before the Court establishes that Chmura’s
termination, far from any unlawful disability discrimination by Mon
General, was the result of her own continued failure to comply with
the Flu Vaccination Policy in November 2016. Chmura failed either
to

obtain

a

latex-free

influenza

vaccination

or

to

provide

documentation sufficient to obtain a medical exemption based on a
recognized contraindication to the vaccine other than latex.
Thus, when the evidence is viewed in the light most favorable
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to Chmura, as it must be, the Court concludes that she has failed
to offer sufficient evidence of a reasonable inference of unlawful
discrimination so as to withstand summary judgment. Having failed
to demonstrate a reasonable inference of discrimination, Chmura has
failed to establish a prima facie case of wrongful discharge under
the ADA.
C.

Burden-Shifting Analysis
Given Chmura’s failure to establish a prima facie case, it is

not necessary to undertake the burden-shifting analysis under the
second step of McDonnell Douglas. Nonetheless, even had Chmura made
out

a

prima

facie

case,

Mon

Health

has

demonstrated

a

non-

discriminatory reason for terminating her employment. The stated
purpose of Mon Health’s Flu Vaccination Policy was “to provide
information . . . regarding the requirements for all . . .
employees . . . providing services on any [Mon Health] premises to
be immunized against influenza” (Dkt. No. 26-2 at 1). In her
deposition, Chmura agreed that the Policy was designed to protect
the safety of hospital patients and staff by reducing the risk of
influenza

infection

and

spread

(Dkt.

No.

26-1

at

11-12).

As

discussed at length, Chmura did not obtain an influenza vaccine in
November 2016 and, thus, failed to comply with the Policy. Mon
Health has therefore satisfied its relatively modest burden to
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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
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produce evidence of a legitimate, non-discriminatory reason for
terminating Chmura.
Moreover, for many of the same reasons that Chmura has failed
to demonstrate a reasonable inference of unlawful discrimination,
she also has failed to demonstrate that the legitimate reason for
her termination offered by Mon Health is a pretext for disability
discrimination. The only specific evidence Chmura cites for that
proposition

is

an

unsupported

assertion

that

Mon

Health

has

exempted at least one other employee from the Policy’s vaccination
requirement, “despite [the employee] not falling under any of
Defendant’s noted exceptions” (Dkt. No. 27 at 14). Chmura has
produced no evidence in support of this assertion. See id. (citing
to

transcript

pages

not

included

in

the

record

on

summary

judgment). Therefore, even when drawing all reasonable inferences
in her favor, the Court concludes that Chmura has failed to
demonstrate, by a preponderance of the evidence, that Mon Health’s
justification for her termination was pretextual.
IV. CONCLUSION
For the reasons discussed, the Court GRANTS Mon Health’s
motion for summary judgment (Dkt. No. 25), and DISMISSES this case
WITH PREJUDICE.
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MEMORANDUM OPINION AND ORDER GRANTING DEFENDANT’S MOTION FOR
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It is so ORDERED.
The Court

DIRECTS

the Clerk to transmit copies of this

Memorandum Opinion and Order to counsel of record and to enter a
separate judgment order.
DATED: August 9, 2019
/s/ Irene M. Keeley
IRENE M. KEELEY
UNITED STATES DISTRICT JUDGE

25