Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca10-94-04209/USCOURTS-ca10-94-04209-0/pdf.json

Nature of Suit Code: 442
Nature of Suit: Civil Rights Employment
Cause of Action: 

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.. 

PUBLISH 

UNITED STATES COURT OF APPEALS 

TENTH CIRCUIT 

SHARLENE K. WATSON, ) 

) 

Plaintiff-Appellant, ) 

) 

v. ) 

) 

UNIVERSITY OF UTAH MEDICAL CENTER, ) 

DALE GUNNELL, DIRECTOR OF UNIVER- ) 

SITY OF UTAH MEDICAL CENTER; ) 

EVELYN HARTIGAN, INDIVIDUALLY AND ) 

AS ADMINISTRATIVE DIRECTOR OF ) 

NURSING; WILLIAM DUNCAN, INDIVIDU- ) 

ALLY AND AS EMPLOYEE OF HUMAN ) 

RESOURCE; SALLY HEARD, INDIVIDUALLY) 

AND AS HEAD NURSE OF LABOR AND ) 

DELIVERY; DONNA HARLAND, INDIVIDU- ) 

ALLY AND AS DIRECTOR OF NURSING; ) 

HEIDI KLENK; WILLIAM T. EVANS; ) 

ROBERT STEED; DAVID ROBINSON, ) 

DIRECTOR OF DIVISION OF OCCUPA- ) 

TIONAL AND PROFESSIONAL LICENSING, ) 

) 

Defendants-Appellees. ) 

FILED 

United States Court or A~~=::~ 

Tenth Circuit 

JAN 1 D 1995 

PATRICK FISli~:ti. ~~er~t 

No. 94-4209 

Appeal from the United States District Court 

for the District of Utah 

(D.C. No. 92-CV-460) 

Blake S. Atkin of Atkin v. Lilja, Salt Lake City, Utah, for 

Plaintiff-Appellant. 

Elizabeth King, Assistant Attorney General (Jan Graham, Attorney 

General, with her on the brief), Salt Lake City, Utah, for 

Defendants-Appellees. 

Appellate Case: 94-4209 Document: 01019287509 Date Filed: 01/19/1996 Page: 1 
Before MOORE and LOGAN, Circuit Judges, and COOK, District Judge.* 

LOGAN, Circuit Judge. 

Plaintiff Sharlene K. Watson appeals the district court's 

grant of summary judgment in favor of defendants University of 

Utah Medical Center (Medical Center) and several Medical Center 

employees, most of whom she sued in both their official and individual capacities, in her suit brought under 42 U.S.C. § 1983.1 

Her amended complaint alleged that these defendants violated her 

due process rights under the Fifth and Fourteenth Amendments when 

they participated in disciplinary action taken against her as an 

employee of the Medical Center. Reading her complaint liberally, 

plaintiff asserted defendants deprived her of her liberty interest 

in practicing her profession as a nurse and her property rights in 

* The Honorable H. Dale Cook, Senior United States District 

Judge, United States District Court for the Northern District of 

Oklahoma, sitting by designation. 

1 The complaint names as defendants Robert Steed, Utah Department 

of Commerce, Division of Occupational and Professional Licensing, 

(DOPL) and David Robinson, Director of Division of Occupational 

and Professional Licensing. The district court found that DOPL 

was entitled to Eleventh Amendment immunity from damages. The 

district court also found that the issuance of a letter from the 

DOPL mooted the other claims against DOPL and DOPL officials Steed 

and Robinson in their official and individual capacities. 

Although the DOPL is mentioned as an appellee a few times in 

plaintiff's appellate briefs no argument is made against the DOPL 

defendants, and we do not consider claims against them as part of 

this appeal. 

The complaint also listed claims under Utah common law. The 

district court declined to exercise jurisdiction over plaintiff's 

state law claims, dismissing them without prejudice. No argument 

is made on appeal with respect to the state law claims. 

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' 

her public employment and in her nursing license, all without due 

process of law. 

On appeal plaintiff argues the district judge erred in ruling 

that (1) the Medical Center and defendants, insofar as they were 

sued in their official capacities, are entitled to immunity under 

the Eleventh Amendment; and (2) the individual defendants are 

entitled to qualified immunity insofar as they were sued as individuals. 

I 

Plaintiff was working as a labor and delivery nurse on February 22, 1992, when she participated in the birth of a baby at 

the Medical Center. Although a medical doctor, David Dowling, was 

present plaintiff delivered the baby. The Medical Center had a 

policy that nurses could deliver only "in emergency situations 

(precipitous deliveries)." App. 80. The parties dispute whether 

that condition was met here. Plaintiff's version is that she knew 

that Dr. Dowling had been vomiting earlier in the evening, that he 

arrived just before the birth, and that he requested that she deliver the baby under his supervision. One of the defendants, 

nurse Heidi Klenk, was present at the birth; she stated that the 

delivery was not imminent when the doctor entered the room, but 

that plaintiff told the doctor it was her baby to deliver. Dr. 

Dowling gave somewhat different accounts of the delivery on different occasions but essentially stated that he did, in one or two 

words, ask plaintiff to perform the delivery. He also stated that 

although he had been ill that evening he could have delivered the 

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baby, but that plaintiff could well have believed he was asking 

her to deliver the baby because he was too ill to do so. 

A few days after the delivery, Klenk informed defendant Donna 

Harland, director of nursing, and defendant Sally Heard, head 

nurse of labor and delivery, that she believed plaintiff had acted 

improperly in delivering the baby. Shortly thereafter, Heard, 

Harland, and defendant William Duncan, Medical Center Human 

Resource Director, met with plaintiff to discuss the allegedly 

improper delivery. Plaintiff asserts Duncan and Heard told her 

they would make an example of her because they did not want nurses 

delivering babies. Plaintiff responded with her version of the 

events and asked that they speak with two other employees present 

during the delivery, Dr. Dowling and nurse Tyra Robinson, to 

determine what occurred. Duncan and Heard agreed to do so. At 

this meeting they informed plaintiff that if she had delivered a 

baby against Medical Center policy her employment could be terminated. 

On March 2, 1992, plaintiff met with Duncan, Heard and Harland a second time and presented, along with her own recounting, 

four coworkers as witnesses. Dr. Dowling was not present, however, and plaintiff contends that Dowling's supervisors discouraged his attendance. Further, plaintiff asserts that one of her 

coworkers, nurse Robinson, was harassed in the meeting and told to 

leave. After a five-hour meeting, Duncan and Harland notified 

plaintiff that she would be placed on administrative leave without 

pay and that the matter would be referred to the state Division of 

Professional Licensing (DOPL) for investigation. 

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Plaintiff asserts that she then requested from defendant 

Evelyn Hartigan, Associate Administrator/Associate Dean of the 

College of Nursing, an appointment to protest the outcome under 

Medical Center employee grievance procedures. Hartigan cancelled 

the meeting; plaintiff states that Hartigan called her and told 

her she had nothing to grieve. 

DOPL investigated. Apparently at first it found no violation; then it changed its decision and thereafter changed its 

decision again. In May 1992, plaintiff filed this suit.2 The 

record shows the Medical Center took no further action concerning 

plaintiff's employment; she apparently remained on unpaid administrative leave. Plaintiff did not actively seek another job until October 1992, and found employment in December 1992.3 

Defendants moved for summary judgment. The district court 

ruled that the Medical Center was entitled to Eleventh Amendment 

immunity. The court rejected the individual defendants' claims to 

absolute immunity, based on their assertion that they acted in an 

adjudicatory capacity when they determined whether plaintiff was 

subject to disciplinary action for violating hospital policy. The 

court ruled, however, that the individual defendants were entitled 

to qualified immunity, because plaintiff failed to meet her burden 

2 Plaintiff's suit included a request for temporary restraining 

order, preliminary injunction and permanent injunction requiring 

that DOPL take no action other than to dismiss the Medical Center's complaint to the DOPL. The DOPL took no action after the 

suit was filed until it agreed to send a letter essentially stating that no action would be taken on plaintiff's nursing license. 

3 Plaintiff states that she delayed looking for work, in part 

because she expected to resume employment at the Medical Center, 

and in part because she had a baby in August 1992. 

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of establishing that at the time she was placed on leave without 

pay defendants' actions violated clearly established law. 

On appeal, we review the district court's grant of summary 

judgment de novo, applying the legal standard of Fed. R. Civ. P. 

56(c). Summary judgment is appropriate if the record shows 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." Wolf v. 

Prudential Ins. Co. of Am., 50 F.3d 793, 796 (lOth Cir. 1995). In 

applying this standard, "we examine the factual record and reasonable inferences therefrom in the light most favorable to the party 

opposing summary judgment." Id. 

II 

We first address the issue of the Medical Center's immunity 

from liability under the Eleventh Amendment. The Eleventh Amendment bars a suit for damages against a state in federal court, 

absent a waiver of immunity by the state. Edelman v. Jordan, 415 

U.S. 651, 663 (1974). Congress did not abrogate state Eleventh 

Amendment immunity when it enacted § 1983, Ouern v. Jordan, 440 

U.S. 332, 341 (1979); however, that immunity extends only to the 

states and governmental entities that are "arms of the state." 

Arnbus v. Granite Bd. of Educ., 995 F.2d 992, 994 (lOth Cir. 1993) 

(en bane). The arm-of-the-state doctrine bestows immunity on 

entities created by state governments that operate as alter egos 

or instrumentalities of the states. Mascheroni v. Board of 

Regents of the Univ. of Cal., 28 F.3d 1554, 1559 (lOth Cir. 1994). 

To make the determination whether an entity is an arm of the 

state we engage in two general inquiries. "[T]he court first 

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examines the degree of autonomy given to the agency, as determined 

by the characterization of the agency by state law and the extent 

of guidance and control exercised by the state. Second, the court 

examines the extent of financing the agency receives independent 

of the state treasury and its ability to provide for its own financing." Haldeman v. State of Wyo. Farm Loan Bd., 32 F.3d 409, 

473 (lOth Cir. 1994); see also Mascheroni, 28 F.3d at 1559. "The 

governmental entity is immune from suit if the money judgment 

sought is to be satisfied out of the state treasury." Haldeman, 

32 F.3d at 473. 

Our cases have consistently found state universities are arms 

of the state. See Mascheroni, 28 F.3d at 1559 (University of 

California); Seibert v. State of Okla., 867 F.2d 591, 594 (lOth 

Cir. 1989) (University of Oklahoma); Prebble v. Brodrick, 535 F.2d 

605, 610 (lOth Cir. 1976) (University of Wyoming); Brennan v. 

University of Kan., 451 F.2d 1287, 1290 (lOth Cir. 1971) (University of Kansas and University of Kansas Press); see also Korgich v. Regents of N.M. Sch. of Mines, 582 F.2d 549, 551-52 (lOth 

Cir. 1978) (New Mexico School of Mines). 

Turning to the University of Utah we note the Utah legislature established a State Board of Regents which has the "power to 

govern the state system of higher education consistent with state 

law," and is vested with the "control, management, and supervision" of the University. Utah Code Ann. §§ 53B-l-101(2), 

(103) (2). Fifteen of the sixteen members of the Board of Regents 

are appointed by the governor with the consent of the state senate, id. §§ 53B-l-104(1), and the Board of Regents appoints the 

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president of the University of Utah, id. § 53B-2-102. The University of Utah has a Board of Trustees with ten members--eight 

appointed by the governor--which is responsible for many administrative functions of the University. See id. §§ 53B-2-103, 

104(1). The University holds all of its real and personal property as a trustee of the State Board of Regents. See id. § 53B20-101. Pharmaceutical & Diagnostic Servs. v. University of Utah, 

801 F. Supp. 508 (D. Utah 1990), in finding the University of Utah 

is an arm of the state, relied on some of these provisions, as 

well as the Utah Supreme Court's determination that 11 (t]he university is clearly a state institution. 11 See id. at 512 (citing 

University of Utah v. Board of Examiners, 295 P.2d 348 (Utah 

1956}). We are satisfied that the University is not autonomous 

but rather is a state-controlled entity. 

We move then to the second area of inquiry: the degree of 

state funding and the University's ability to issue bonds and 

raise taxes, i.e., the likelihood that a judgment against the 

University might be paid from state funds. See Ambus, 995 F.2d at 

996. Like the school district in Ambus, the University participates in the Utah Risk Management Fund which provides, in part, 

insurance against money judgments. See Utah Code Ann. § 63A-4-

103. However, school districts are subject to special provisions 

under the Act, see id., § 63A-4-204, and the statute makes a clear 

distinction between state agencies and public school districts, 

which are treated as state agencies for purposes of the Risk Management Fund. The language of the risk management statute, id. 

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§ 63A-4-103, refers to the Board of Regents and its higher education institutions as state agencies, and requires that when the 

Board of Regents authorizes the higher education institutions to 

purchase their own insurance, it "shall ensure that the state is 

named as an additional insured on any of those policies." This 

suggests that the state might be responsible for funding a judgment against the University of Utah. Further, although the University may "handle its own financial affairs" under the general 

supervision of the Board, id. § 53B-7-101(9), the budget of the 

University is controlled to a large degree by the State Board of 

Regents, the legislature and the governor. See id. § 53B-7-101. 

It does appear that any judgment against the University might be 

satisfied, at least indirectly, from state resources. 

Although we are satisfied that the University is an arm of 

the state, the more difficult question is whether the University 

of Utah Medical Center has that status. Plaintiff contends that 

the Medical Center is a separate and distinct entity that is "more 

akin to the private hospitals with which it competes." Appellant's Brief at 7. She points out that a small fraction (less 

than five percent) of the Medical Center's operating income comes 

from the state, and states that "any judgment obtained against the 

Medical Center in this case could easily come from patient revenues rather than from any state coffers." Id. She also asserts 

that, in Condemarin v. University Hospital, 775 P.2d 348, 366 

(Utah 1989), the Utah Supreme Court found that the Medical Center 

is not an arm of the state. She quotes Justice Stewart's observations in Condemarin that the Medical Center is "essentially 

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supported by non-state funds" and that the hospital is "practically [] self-supporting." See Condemarin, 775 P.2d at 373-74. 

The holding of Condemarin, however, is that Utah statutes 

limiting tort recovery are unconstitutional as applied to the 

Medical Center. This holding rested in part upon the reasoning 

that 

The problem with Utah's Governmental Immunity Act is 

that is has created limited liability under the screen 

of governmental immunity for activities which were traditionally subject to the deterrent effects of tort 

liability. Furthermore, notwithstanding the fact tha~ 

it is a government-owned health care facility, the 

[Medical Center], in its patient care programs, virtually operates in the public sector, competing with other 

private, nonprofit entities, as well as with for-profit 

hospitals. In the area of patient service, it is not in 

the business of establishing government policy. For 

that reason, the common law exception existed to prevent 

governmental immunity from barring medical malpractice 

actions in Utah, and for that reason, the deterrence 

factor in the balancing analysis this Court should apply 

weighs in favor of liability, not limitation. 

Id. at 365 (footnote omitted) . Plaintiff cites Condemarin for the 

proposition that the Medical Center did not demonstrate that 

"requiring the hospital to shoulder the full cost of liability 

will have a substantial effect on the state's treasury." Id. at 

374. That statement appears in Justice Stewart's separate opinion, 

and is not the question we must answer. Although plaintiff states 

that Condemarin found that the Medical Center is not an arm or 

alter ego of the state, we do not read Condemarin as so holding. 

In fact, the majority in Condemarin stated that "[the Medical 

Center] is a government-owned health care facility." Id. at 365. 

Our review of the record supports the conclusion that the 

Medical Center is an integral part of the University of Utah. The 

Medical Center is governed by the University Board of Trustees, 

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and its annual budget is subject to approval by the University 

Board and the State Board of Regents. The Bylaws of the Medical 

Center, Article I, provide that the Medical Center is a "component 

organization" of the University of Utah. Supp. App., Bylaws at 1. 

The Medical Center Board is "created by, and subject to the 

authority of the President of the University and the Institutional 

Council," and members are "appointed by the president of the University with approval by the Institutional Council." Id., Bylaws, 

Arts. III and IV. Finally, the University president and Institutional Council retain authority to grant final approval for the 

long range plan of the Medical Center, the annual budget and 

appropriations request, major construction, capital financing, 

fund raising programs, and University policies, procedures, rules, 

and regulations "relating to or affecting" the Medical Center. 

Id., Art. V. Further, the Chief Operating Officer of the Medical 

Center reports directly to the University Vice President for 

Health Sciences. Id., Art. VII. 

The Medical Center clearly is not autonomous from the University or the state. The bothersome question is whether a judgment against the Medical Center would come from the state treasury. It is undisputed that the Medical Center receives most of 

its budget from patient billing and only a small amount of its 

funding, somewhere between 3.5 and 5%, comes from state appropriations. Although, unlike local school boards, it cannot raise 

taxes or issue bonds without approval of the state, the Medical 

Center can increase patient billings, thus reducing the likelihood that any judgment will be paid from state funds. The only 

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definite statement concerning monies to satisfy a judgment appears 

in the Risk Management Fund manager's statement: The bulk of any 

judgment would be paid from the state Risk Management Fund, 

although twenty-five percent of a back wages award would come from 

the University. See IV R. doc. 121. The funding issue makes this 

a close case, but on balance we agree with the district court's 

determination that the University of Utah Medical Center, as a 

part of the University of Utah, is an arm of the state entitled to 

Eleventh Amendment immunity. The district court thus correctly 

found that the Medical Center and the individual defendants sued 

in their official capacities are entitled to the state's immunity. 

See Brennan, 451 F.2d at 1290-91. 

III 

We turn now to the issue whether the district erred in finding that the individual defendants are entitled to qualified 

immunity. "[G]overnrnent officials performing discretionary functions, generally are shielded from liability for civil damages 

insofar as their conduct does not violate clearly established 

statutory or constitutional rights of which a reasonable person 

would have known." Harlow v. Fitzgerald, 457 U.S. 800, 818 

(1982). Qualified immunity protects defendants not only from 

liability but also from suit. Id. 

Once the defendant raises the defense of qualified immunity, 

"the plaintiff then has the burden to show with particularity 

facts and law establishing the inference that the defendants violated a constitutional right." Walter v. Morton, 33 

1242 (lOth Cir. 1994). "This burden is quite heavy 

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F .3d 1240, 

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Appellate Case: 94-4209 Document: 01019287509 Date Filed: 01/19/1996 Page: 12 
plaintiff must do more than simply allege the violation of a general legal precept. The plaintiff must 'instead demonstrate a 

substantial correspondence between the conduct in question and 

prior law allegedly establishing that the defendant's actions were 

clearly prohibited.'" Jantz v. Muci, 976 F.2d 623, 627 (lOth Cir. 

1992) (quoting Harlow, 457 U.S. at 818), cert. denied, 113 S. Ct. 

2445 (1993). "The contours of the right must be sufficiently 

clear that a reasonable official would understand that what he is 

doing violates that right." Id. (quoting Anderson v. Creighton, 

483 U.S. 635, 640 (1987)). Only if plaintiff makes that threshold 

showing does the burden shift to defendants to show that no material facts remain in dispute that would defeat defendant's claim 

of qualified immunity. Id. The district court found that 

"plaintiff's general claims of being denied property and liberty 

interests without due process are insufficient to satisfy her 

shifted burden of establishing that defendants' alleged actions 

violated clearly established law at the time of her being placed 

on administrative leave without pay."4 App. 17. 

"To assess whether an individual was denied procedural due 

process, 'courts must engage in a two-step inquiry: (1) did the 

individual possess a protected interest such that the due process 

protections were applicable; and, if so, then (2) was the individual afforded an appropriate level of process.'" Hatfield v. 

4 The district court stated that despite plaintiff's allegations 

that defendants acted with malice this is not a case in which 

defendant's subjective intent is an element of the claim. App. 17 

(quoting Harlow, 457 U.S. at 817) ("bare allegations of malice" do 

not defeat qualified immunity) . 

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Board of County Comm'rs, 52 F.3d 858, 862 (lOth Cir. 1995) (quoting Farthing v. City of Shawnee, 39 F.3d 1131, 1135 (lOth Cir. 

1994)); see also Cleveland Bd. of Educ. v. Loudermill, 470 U.S. 

532, 541 (1985). In asserting a procedural due process violation, 

a plaintiff must first demonstrate that she had a protected property or liberty interest. Plaintiff asserts, as we read her complaint and pleadings, deprivation of process in regard to three 

separate protected interests. We address each in turn. 

A 

First, plaintiff appears to contend she had a property 

interest in her continued public employment at the Medical Center. 

The question whether a plaintiff had a protected property interest 

is determined by state law. Casias v. City of Raton, 738 F.2d 

392, 394 (lOth Cir. 1984). Under Utah law, "any employment contract which has no specified term of duration is an at-will relationship," Berube v. Fashion Centre. Ltd., 771 P.2d 1033, 1044 

(Utah 1989), and such employment may be terminated at any time by 

the employer. Brehany v. Nordstrom. Inc., 812 P.2d 49, 53 (Utah 

1991) . An employee may rebut this presumption of at-will employment by showing that "the parties expressly or impliedly intended 

a specified term or agreed to terminate the relationship for cause 

alone." Berube, 771 P.2d at 1044. 

In the instant case, plaintiff does not contend that she had 

a contract for a specific term. She refers to an employee handbook that provides for a grievance procedure for employees. Under 

Utah law an employment manual or handbook that provides employees 

cannot be fired except for cause can rebut the presumption of 

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employment at will. See Johnson v. Morton Thiokol, Inc., 818 P.2d 

997, 1000-01 (Utah 1991). 

The problem here is that plaintiff did not produce evidence 

of what the employment manual said in this regard, nor did she 

provide a copy of the grievance procedure. She points to statements by defendants that they knew she was entitled to a grievance 

procedure. But those statements do not provide any information as 

to what the grievance procedure involved. She identifies no Utah 

statutes on which a property interest might be grounded. Cf. 

Ambus, 975 F.2d 1555, 1562 (lOth Cir. 1992), modified and aff'd en 

bane, 995 F.2d 997 (lOth Cir. 1993) (tenured teacher's property 

interest in continued employment created by Utah statute on termination of school employees and professional agreement) . 

Plaintiff did not meet her burden to establish a property 

interest in continued employment. See Conway v. Smith, 853 F.2d 

789, 793-94 (lOth Cir. 1988) (plaintiff failed to produce manual 

that might have established termination procedures; did not meet 

burden to show property interest in continued employment) . 

Because plaintiff failed to make a showing that she had a protected property interest in continued employment, she failed to 

meet her burden to show defendants violated a clearly established 

right. Thus, defendants are entitled to qualified immunity as to 

this claim. 

B 

As to plaintiff's allegations that defendants denied her due 

process with regard to her property right to her nursing license, 

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she has not shown enough: DOPL took no action to revoke or suspend her license. See Phelps v. Wichita Eagle-Beacon, 886 F.2d 

1262, 1269 (lOth Cir. 1989) (discussing fact that plaintiff did 

not lose status as lawyer; thus failed to state a deprivation of 

liberty or property interest). Further, in a typical due process 

case in which an employment status decision is not dependent on a 

DOPL determination, hospital officials/employers would be free to 

ask DOPL for clarification of their initial determination. This 

is especially so because the Medical Center had previously been 

investigated by DOPL for reports of nurses delivering babies. See 

II R. doc. 70. 

c 

Plaintiff also asserted that her liberty interests were implicated by defendants' actions surrounding the decision to place 

her on administrative leave without pay. We have recognized that 

"[w]hen a public employer takes action to terminate an employee 

based upon a public statement of unfounded charges of dishonesty 

or immorality that might seriously damage the employee's standing 

or associations in the community and foreclose the employee's 

freedom to take advantage of future employment opportunities, a 

claim for relief is created." Melton v. City of Oklahoma City, 

928 F.2d 920, 927 (lOth Cir.) (en bane), cert. denied, 502 U.S. 

906 (1991). 

Once plaintiff has identified a clearly established right, we 

examine whether she has come forward with the necessary factual 

allegations, Ramirez v. Oklahoma Dep't of Mental Health, 41 F.3d 

584, 593 (lOth Cir. 1994), to establish that defendants violated 

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that right. Plaintiff asserts that defendants infringed her liberty interest in her professional reputation and ability to obtain 

future employment by charges they made after they placed her on 

administrative leave. In order to show that defendants infringed 

on her liberty interest, plaintiff must show several elements. 

First, to be actionable, the statements must impugn the 

good name, reputation, honor, or integrity of the 

employee. Board of Regents v. Roth, 408 U.S. at 573. 

Second, the statements must be false. Codd v. Velger, 

429 U.S. 624, 628. Third, the statements must occur in 

the course of terminating the employee or must foreclose 

other employment opportunities. Paul [v. Davis, 424 

U.S. 693, 710 (1976)]. And fourth, the statements must 

be published. Bishop v. Wood, 426 U.S. 341, 348. These 

elements are not disjunctive, all must be satisfied to 

demonstrate deprivation of the liberty interest. See, 

~' Melton v. City of Oklahoma City, 928 F.2d 920 (en 

bane) (trial court erred in instructing jury to find 

either stigmatization or loss of employment opportunities), cert. denied, [502 U.S. 906 (1991)]. 

Workman v. Jordan, 32 F.3d 475, 481 (lOth Cir. 1994), cert. 

denied, 115 S. Ct. 1357 (1995) (some citations omitted). We turn 

now to whether plaintiff raised questions of fact as to each of 

these elements. 

Plaintiff produced evidence that her supervisors made public 

statements to the entire nursing staff not only that she had 

"illegally" delivered a baby but also that she lied about the 

incident. See App. 109-10. These public charges certainly impugn 

her honesty and integrity. Plaintiff also produced evidence that 

these charges were false. First, as to delivering the baby, the 

DOPL initially determined that plaintiff had done nothing wrong 

and eventually concluded that it would take no action. Further, 

as to plaintiff being "a liar," the record contains conflicting 

evidence as to what actually occurred in the delivery room. Nurse 

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Robinson's version, and to some extent Dr. Dowling's version, 

support the conclusion that plaintiff told the truth about the 

delivery; defendant Klenk's statements contradict plaintiff's 

version of events, and there is evidence that defendants published 

to others that Klenk's version was correct and plaintiff's version 

was false. Thus, plaintiff produced a question of material fact 

as to whether defendants' charges that plaintiff "illegally" 

delivered a baby and then lied about it were false. 

Next, plaintiff must show defendants made the statements in 

the course of terminating her employment. The allegedly false 

statements here were made after defendants placed plaintiff on 

administrative leave without pay, but we believe the jury could 

find plaintiff was constructively discharged. Plaintiff produced 

evidence that defendants agreed to abide by the DOPL decision but 

then attempted and apparently initially succeeded in getting the 

DOPL to change that decision when it was in favor of plaintiff. 

See infra footnote 6. When the DOPL finally changed its determination, after plaintiff filed this lawsuit, the Medical Center 

defendants never offered to reinstate plaintiff. Thus, although 

plaintiff initially was placed on leave without pay, if defendants 

never took any action to reinstate her, a jury could find that the 

alleged defamation "occurred in the course of the termination of 

employment." Melton, 928 F.2d at 926. 

Finally, plaintiff made a showing that defendants' actions 

foreclosed her future employment opportunities in her chosen field 

as a labor and delivery nurse. Although she was able to secure 

employment as a nurse, it was not as a labor and delivery nurse as 

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a result of dissemination of information concerning her troubles 

in the relatively close-knit hospital community in Salt Lake City. 

See App. 115; II R. doc. 70 (plaintiff's deposition). 

We believe plaintiff has set out a claim of a liberty 

deprivation--she has raised an issue of material fact whether "her 

dismissal resulted in the publication of information which was 

false and stigmatizing--information which had the general effect 

of curtailing her future freedom of choice or action." Asbil v. 

Housing Auth. of Choctaw Nation, 726 F.2d 1499, 1503 (lOth Cir. 

1984) . Thus, she has made a showing that she was entitled to 

notice and a due process hearing to clear her name. See Roth, 408 

U.S. at 573 n.12 ("The purpose of such notice and hearing is to 

provide the person an opportunity to clear [her] name."). 

The more difficult question is whether plaintiff has raised a 

question of material fact that defendants denied her that due 

process hearing. Defendants assert that, as a matter of law, the 

March 2 meeting provided all the procedural due process to which 

plaintiff was entitled. We disagree. The publication of the allegedly false and stigmatizing information--that plaintiff "illegally" delivered a baby and lied about it--occurred after the 

March 2 meeting. Therefore, plaintiff was entitled to a hearing 

after the publication, which was apparently on March 3, 1992. 

App. 109-10. 

Defendants, however, argue that plaintiff waived any further 

hearing because she did not file a grievance after the March 2 

meeting. 

filing a 

Plaintiff responds that defendants discouraged her from 

grievance, although defendants dispute this. See App. 

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61-62, 92-93, 102, 106-08. Plaintiff stated in her deposition 

that she actually made an appointment with Evelyn Hartigan to 

initiate a grievance but was told she had "no grounds for a 

grievance," id. at 107-08, and that defendant Duncan told her that 

"he had done it [told her story] for [her]." Id. at 102. Arguably at this point plaintiff had nothing to grieve because no 

final decision as to her job status had been made. Defendants had 

decided and plaintiff agreed--according to a March 23, 1992, letter from the assistant attorney general, see id. at 81; see also V 

R. 194, ex. BS--to allow the DOPL to conduct an investigation and 

to let her job status be determined by the result of DOPL's 

determination on the matter. Presumably, if DOPL declined to take 

action against plaintiff's nursing license, she would be returned 

to her job at the Medical Center and as a result her name would be 

cleared. If, on the other hand, DOPL initiated action to revoke 

or suspend her nursing license, plaintiff would have the type of 

hearing (with the right to representation, to present witnesses, 

etc.) that would satisfy our due process concerns. Thus, although 

plaintiff did not pursue a grievance procedure with the Medical 

Center, she agreed to a procedure by a third party state agency to 

serve the same purpose. 

Plaintiff alleges that defendants interfered with the DOPL 

process. Specifically, she asserts that after the DOPL investigator initially determined plaintiff had not violated nursing 

5 This exhibit is a letter from plaintiff's attorney to an 

assistant attorney general stating agreement that plaintiff "will 

be reinstated with full back pay if her license is not revoked by 

the nursing board." 

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practices, some of the defendants contacted DOPL personnel and 

exerted pressure to change that initial decision.6 Defendants 

assert that DOPL initially decided there was a violation justifying a prosecution to terminate her nursing license, but then 

decided there was not. These disputed issues of material fact 

cannot be resolved on summary judgment. The outcome of the DOPL 

investigation may have been prolonged by the fact that plaintiff 

herself filed this lawsuit before the DOPL made a written report 

or determination. Further, plaintiff failed to pursue the. grievance process at this point. But defendants had agreed to abide by 

the DOPL decision and then allegedly failed to do so when that 

decision was favorable to plaintiff. 

The question then becomes whether defendants' alleged actions 

violated a clearly established right of which they should have 

been aware. We believe they do. If Medical Center officials 

agreed to follow a specific avenue to resolve the status of 

plaintiff's employment, and then actively interfered with that 

6 Plaintiff's evidence of the defendants' actions to change the 

outcome of the DOPL investigation included (1) a letter from 

defendant Harland to VaLaine Pack, Nursing Consultant to DOPL, 

stating that the DOPL investigator had informed her that it is not 

a violation of state regulations for a nurse to deliver a baby "if 

the doctor tells her she can and is in the room," and that "[w]e 

at [the Medical Center] strongly disagree with this interpretation," App. 29; (2) a memorandum dated May 28, 1992, by defendant 

Harland indicating that she and defendants Hartigan and Heard met 

personally with Pack on May 4, 1992, to discuss and complain of 

the DOPL's "no violation" finding with respect to plaintiff, IV R. 

doc. 128, ex. B (Harland deposition ex. 18); and (3) a deposition 

of the DOPL investigator stating that after the initial decision 

not to take action against plaintiff's license, but to send an 

informal reprimand, a meeting was held in May 1992 including Pack, 

Steed and Robinson at which it was determined that such a letter 

would not be sent, III R. doc. 102, Godnick deposition. 

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• 

process, they violated plaintiff's right to procedural due process, a right clearly established at the time. See, ~, Melton, 

928 F.2d 920. Defendants are not entitled to qualified immunity 

on plaintiff's liberty claim. 

IV 

In summary, we AFFIRM the district court's summary judgment 

on the Eleventh Amendment immunity, and its grant of qualified 

immunity to the individual defendants on plaintiff's alleged 

property interests in continued employment and in her nursing 

license. We hold, however, that plaintiff has sufficiently met 

her burden to show that defendants' actions violated her liberty 

interests in the protection of her reputation and freedom to take 

advantage of other employment opportunities that summary judgment 

based on qualified immunity was improper on that issue. We 

therefore REVERSE that portion of the case and REMAND for further 

proceedings in accord with this opinion. 

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