Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca10-07-01498/USCOURTS-ca10-07-01498-0/pdf.json

Parties Involved:
Margaret Frueh
Appellee
Lisa M. Rohrbough
Appellant
University of Colorado Hospital Authority
Appellee

Document Text:

FILED

United States Court of Appeals

Tenth Circuit

February 19, 2010

Elisabeth A. Shumaker

Clerk of Court

PUBLISH

UNITED STATES COURT OF APPEALS

TENTH CIRCUIT

LISA M. ROHRBOUGH,

Plaintiff-Appellant,

v. No. 07-1498

UNIVERSITY OF COLORADO

HOSPITAL AUTHORITY, a body

corporate and political subdivision of

the State of Colorado; and

MARGARET FRUEH, individually

and in her official capacity,

Defendants-Appellees.

APPEAL FROM THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF COLORADO

(D.C. NO. 1:06-CV-00995-REB-MJW)

David A. Lane, Killmer, Lane & Newman, LLP, Denver, Colorado, for Appellant.

Thomas S. Rice (Gillian M. Fahlsing with him on the brief), Senter Goldfarb &

Rice, L.L.C., Denver, Colorado, for Appellees.

Before MURPHY, EBEL, and HARTZ, Circuit Judges.

MURPHY, Circuit Judge.

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I. Introduction

Plaintiff Lisa M. Rohrbough filed suit pursuant to 42 U.S.C. § 1983,

alleging her former employer, the University of Colorado Hospital Authority (the

“Hospital”), and her former manager, Margaret Frueh, fired her in retaliation for

exercising her First Amendment rights. Rohrbough appeals the district court’s

grant of summary judgment. The district court concluded Rohrbough’s speech

was unprotected because it was made pursuant to Rohrbough’s official duties as a

“Transplant Coordinator” in the Hospital’s Heart Transplant Unit. Exercising

jurisdiction under 28 U.S.C. § 1291, we AFFIRM. 

II. Background

Rohrbough worked for the Hospital from November 9, 1992, until June 1,

2004, when the Hospital terminated her employment. During the final five years

of her employment, Rohrbough served as the “Transplant Coordinator” in the

Hospital’s Heart Transplant Unit. In 2002, she became concerned about patient

care in the Unit due to what she perceived to be a “staffing crisis.” Specifically,

Rohrbough believed the staffing problems were affecting the quality of care the

Hospital’s patients received because labs and other medical tests were performed

“extremely late” and charts were not reviewed in a timely fashion. Rohrbough

raised her concerns with a number of hospital employees “[b]ecause [she] wanted

the patient care issues that were causing patient negative outcomes to be

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addressed, and [because she] believed everyone needed to be held accountable for

their action or inaction.” 

First, Rohrbough raised her concerns to Nurses Nancy Ireland and Linda

Stepien, and Karin Keller, her day-to-day supervisor. These conversations took

place both inside and outside the workplace. She next raised her concerns with

Margaret Frueh, her manager, and Dr. JoAnn Lindenfeld, the director of the

Hospital’s Heart Transplant Unit. Rohrbough also discussed the staffing issues

during an appeal of her 2002 performance evaluation with Colleen Goode, vice

president of patient services and the Hospital’s chief nursing officer, and Joyce

Cashman, the Hospital’s executive vice president. Still frustrated by the

Hospital’s lack of response, she took her concerns to Dennis Brimhall, the

president of the Hospital. Rohrbough thought it appropriate to meet with

Brimhall given that her concerns were “related to [her] employment because they

were patient care issues.” 

Brimhall informed Rohrbough she had the option of meeting with someone

from the Hospital’s Risk Management Unit. Rohrbough subsequently met with

Susan West of the Hospital’s Risk Management Unit. West informed her of the

Hospital’s incident reporting system and welcomed Rohrbough to create incident

reports covering the instances of substandard care she observed. Indeed, Hospital

policies required all employees to write incident reports whenever they

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encountered unsafe conditions, errors, and near misses. After meeting with West,

Rohrbough composed eleven such reports.

While her performance evaluation appeal was pending, Rohrbough learned

of a possible heart transplant misallocation and cover-up at the Hospital. She

reported information regarding this alleged missallocation and cover-up to the

United Network for Organ Sharing (“UNOS”), an entity established by Congress

to administer organ transplants. As Transplant Coordinator, Rohrbough was

responsible for contacting UNOS to place patients on transplant lists, removing

patients from transplants lists, and providing information about a particular

transplant. In this particular instance, however, Rohrbough testified she called

UNOS because her impression was that Dr. Lindenfeld was not going to be

truthful in her report to UNOS. She contacted the UNOS representative from her

home, identified herself as the Hospital’s Transplant Coordinator, and described

her basis for believing a heart had been misallocated at the Hospital. She also

discussed the alleged heart misallocation with a reporter from the Denver

Westword, a print weekly.

In February 2004, Rohrbough received a performance evaluation that

indicated she had failed to meet Hospital standards. In March 2004, several of

Rohrbough’s coworkers approached the Hospital’s human resources department to

express concerns about Rohrbough’s poor job performance and her negative

impact on the work environment. In response, Rohrbough was placed on

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administrative leave. She was reinstated, but failed to improve her performance. 

As a result, Frueh terminated Rohrbough’s employment on June 1, 2004. In

explaining her decision to terminate Rohrbough, Frueh testified that “[a]t no time

during Ms. Rohrbough’s employment at the Hospital did I have knowledge of her

reports to UNOS regarding the alleged ‘heart-switch cover-up.’ . . . Therefore, I

could not have disciplined Ms. Rohrbough for this alleged reporting.” 

Rohrbough filed suit against the Hospital and Frueh, in both her individual

and official capacity, alleging the Hospital impermissibly retaliated against her

for exercising First Amendment rights. Rohrbough specifically alleges her speech

relating to the Hospital’s staffing crisis, the heart misallocation, and incident

reports were protected under the First Amendment. The Hospital moved for

summary judgment, arguing that all of Rohrbough’s speech was made pursuant to

her official responsibilities and therefore unprotected under Garcetti. 

The district court entered summary judgment in favor of the Hospital. It

held that under the standards developed in the wake of Garcetti, it was “clear that

all the speech for which plaintiff was allegedly retaliated against [fell] squarely

within the scope of her official duties.” The district court held Rohrbough’s

complaints about inadequate staffing “by her own admission, directly related to

her concerns about patient safety and welfare” and fell squarely within her

“overarching job responsibility as a nurse” to ensure those concerns were met. 

Similarly, the district court held the occurrence reports were also written pursuant

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to Rohrbough’s “broader, official duties as a nurse to safeguard patient welfare.” 

Finally, with respect to her communications with UNOS, the district court held

this speech was a “natural, foreseeable outgrowth” of Rohrbough’s official duty

to contact UNOS to place patients on the transplant list or to change a patient’s

status on that list. As a result, the district court held that none of the speech

activities on which Rohrbough’s claim was based were “subject to protection

under the First Amendment in the wake of Garcetti.” On appeal, Rohrbough

argues the district court erred in determining she spoke pursuant to her official

duties as the Hospital’s Transplant Coordinator. 

III. Analysis

A. Standard of Review

“We review the district court's grant of summary judgment for the

[defendants] de novo, applying the same legal standard as the district court.”

Shero v. City of Grove, Okla., 510 F.3d 1196, 1200 (10th Cir. 2007). Summary

judgment is proper when “the pleadings, the discovery and disclosure materials on

file, and any affidavits show that there is no genuine issue as to any material fact

and that the movant is entitled to judgment as a matter of law.” FED. R. CIV. P.

56(c)(2). “Furthermore, because this case involves the First Amendment, we have

an obligation to make an independent examination of the whole record in order to

make sure that the judgment does not constitute a forbidden intrusion on the field

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of free expression.” Brammer-Hoelter v. Twin Peaks Charter Acad., 492 F.3d

1192, 1201 (10th Cir. 2007) (quotation omitted). 

B. Freedom of Speech Retaliation Claim

In Garcetti v. Ceballos, the Supreme Court reaffirmed that “the First

Amendment protects a public employee’s right, in certain circumstances, to speak

as a citizen addressing matters of public concern.” 547 U.S. 410, 417 (2006). 

The Court recognized the inherent tension between an employee’s right to free

speech and the government employer’s right to exercise “a significant degree of

control over their employees’ words and actions,” and concluded “while the First

Amendment invests public employees with certain rights, it does not empower

them to constitutionalize the employee grievance.” Id. at 418, 420 (quotation

omitted). 

To balance these competing interests, this court employs the inquiry set out

in Pickering v. Bd. of Educ., 391 U.S. 563 (1968), and modified by Garcetti. 

Brammer-Hoelter, 492 F.3d at 1202. The Garcetti/Pickering inquiry comprises

five steps: 

(1) whether the speech was made pursuant to an employee’s official

duties; (2) whether the speech was on a matter of public concern; (3)

whether the government’s interests, as employer, in promoting the

efficiency of the public service are sufficient to outweigh the

plaintiff’s free speech interests; (4) whether the protected speech was

a motivating factor in the adverse employment action; and (5)

whether the defendant would have reached the same employment

decision in the absence of the protected conduct. 

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Dixon v. Kirkpatrick, 553 F.3d 1294, 1302 (10th Cir. 2009). 

The first three steps of the Garcetti/Pickering analysis are issues of law “to

be resolved by the district court, while the last two are ordinarily for the trier of

fact.” Brammer-Hoelter, 492 F.3d at 1203; see also Thomas v. City of Blanchard,

548 F.3d 1317, 1322 & 1326 (10th Cir. 2008) (describing step one of the

Garcetti/Pickering inquiry as a question of whether speech is constitutionally

protected and therefore one of law, not fact); Hesse v. Town of Jackson, Wyo.,

541 F.3d 1240, 1249 (10th Cir. 2008) (“The determination of whether a public

employee speaks pursuant to official duties is a matter of law.”). Nevertheless,

these cases review disputed facts relevant to step one of the Garcetti/Pickering

analysis in the light most favorable to the non-moving party at the summary

judgment stage. See, e.g., Brammer-Hoelter, 492 F.3d at 1204 (“[V]iewing the

evidence in the light most favorable to them, Plaintiffs’ speech regarding some of

the matters was not made pursuant to their official duties.”); Hesse, 541 F.3d at

1249 (viewing the facts in the light most favorable to the Plaintiff to conclude as

a matter of law that Plaintiff’s speech was made pursuant to his official

employment duties); Green v. Board of County Comm’rs, 472 F.3d 794, 799 (10th

Cir. 2007) (same). Accordingly, this court will view any disputed facts relevant

to the issue of whether Rohrbough spoke pursuant to her official duties in the

light most favorable to her in making its determination under the first prong of

the Garcetti/Pickering analysis. 

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The Garcetti Court did not have the opportunity to articulate “a

comprehensive framework for defining the scope of an employee’s duties,”

because the parties did not dispute the presence of the factor. 547 U.S. at 424. 

The Tenth Circuit’s decisions addressing the first step of the Garcetti/Pickering

analysis “have taken a broad view of the meaning of speech that is pursuant to an

employee’s official duties.” Thomas, 548 F.3d at 1324 (quotations omitted); see

also Casey v. W. Las Vegas Indep. Sch. Dist., 473 F.3d 1323, 1331 (10th Cir.

2007) (referring to the first prong of the Garcetti/Pickering analysis as a “heavy

barrier”). These decisions, however, have not developed a set of bright line rules

to determine when an employee speaks pursuant to her official duties for the

purposes of Garcetti/Pickering. Rather, in line with the Court’s admonition in

Garcetti that “[t]he proper inquiry was a practical one,” 547 U.S. at 424, the

Tenth Circuit has taken a case-by-case approach, looking both to the content of

the speech, as well as the employee’s chosen audience, to determine whether the

speech is made pursuant to an employee’s official duties. 

In general, the court has focused on whether the speech activity “stemmed

from and [was of] the type . . . that [the employee] was paid to do,” Green, 472

F.3d at 801, and has highlighted that the ultimate question in determining whether

speech falls within an employee’s official duties is “whether the employee speaks

as a citizen or instead as a government employee,” Brammer-Hoelter, 492 F.3d at

1203. As examples of protected government employee speech, Green listed

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“communicating with newspapers or . . . legislators or performing some similar

activity afforded citizens.” 472 F.3d at 800; see also Garcetti, 547 U.S. at 423

(listing “writing a letter to a local newspaper” and “discussing politics with a coworker” as examples of such speech). The Garcetti decision also suggested that a

government employee’s speech is not protected when there is “no relevant

analogue to speech by citizens who are not government employees.” Id. at 424.

Regarding the content of an employee’s speech, the Tenth Circuit has

recognized that not all speech “about the subject matter of an employee’s work

[is] necessarily made pursuant to the employee’s official duties.” BrammerHoelter, 492 F.3d at 1204. The court has also noted that speech pursuant to the

employee’s duty to report a particular activity is usually within that employee’s

official duties under Garcetti/Pickering. See, e.g., Casey, 473 F.3d at 1329

(holding that speech made pursuant to an employee’s duty to report to her

employer regarding the legality of the employer’s operations was within the scope

of her official duties). 

In addition, the court has not foreclosed unauthorized speech or speech “not

explicitly required as part of [an employee’s] day-to-day job” from being within

the scope of that employee’s official duties under Garcetti/Pickering. Green, 472

F.3d at 800-01; see also Brammer-Hoelter, 492 F.3d at 1203 (holding that speech

could be considered within the scope of an employee’s official duty even if “the

speech concerns an unusual aspect of an employee’s job that is not part of his

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everyday functions”). To the contrary, Green emphasized the employee’s

unauthorized speech at issue “inescapably invoke[d] Garcetti’s admonishment

that [a] government employee’s First Amendment rights do ‘not invest them with

a right to perform their jobs however they see fit.’” 472 F.3d at 801 (quoting

Garcetti, 547 U.S. at 422). In this vein, Green also noted that protecting

unauthorized speech would result in “‘judicial oversight of communications

between and among government employees and their superiors in the course of

official business’ and ‘displacement of managerial discretion by judicial

supervision.’” Id. (quoting Garcetti, 547 U.S. at 423). 

Regarding the employee’s chosen audience, or chosen method of

disseminating speech, the court has similarly refrained from establishing per se

rules for determining whether speech is made pursuant to an employee’s official

duties. For example, in Brammer-Hoelter, the speech regarding the budgeting of

teacher salaries and staffing levels was not within the scope of the plaintiffs’

official duties in part because the speech occurred outside the school, after hours,

and with “ordinary citizens and parents.” 492 F.3d at 1205. Similarly, the court

has observed that speech directed at an individual or entity outside of an

employee’s chain of command is often outside of an employee’s official duties. 

See, e.g., Thomas, 548 F.3d at 1325 (protecting speech based upon the employee’s

threat to go “outside of his usual chain of command . . . and not merely to his

supervisors or to the state housing inspector”); Casey, 473 F.3d at 1332-33

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(protecting speech directed to the New Mexico Attorney General because the

employee had no responsibility to report to that entity regarding potential

violations of the Open Meetings Act). 

By contrast, speech directed at an individual or entity within a employee’s

chain of command is often found to be pursuant to that employee’s official duties

under Garcetti/Pickering. See, e.g., Casey, 473 F.3d at 1329-32 (leaving

unprotected speech directed at a federal authority due to plaintiff’s responsibility

to independently report to that authority); Green, 472 F.3d at 800-01 (leaving

unprotected speech directed at third parties regarding drug testing policies

because the plaintiff “had the responsibility for communicating with clients and

with third parties regarding testing.”). But an employee’s decision to go outside

of their ordinary chain of command does not necessarily insulate their speech. 

Rather, as noted above, the proper focus is ultimately still whether the speech

“stemmed from and [was of] the type . . . that [the employee] was paid to do,”

regardless of the exact role of the individual or entity to which the employee has

chosen to speak. Green, 472 F.3d at 798. 

In this case, Rohrbough alleges she was retaliated against because of her

communications regarding the Hospital’s alleged staffing crisis, the alleged

instances of substandard care, and the alleged heart transplant misallocation. 

Rohrbough’s communications with other Hospital employees regarding the

alleged staffing crisis, the alleged instances of substandard care, and the alleged

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heart misallocation all fall squarely within the scope of her official duties under

the first prong of the Garcetti/Pickering analysis. 

1. The Alleged Staffing Crisis

Rohrbough’s communications with other Hospital employees regarding the

alleged staffing crisis were made pursuant to her official duties. Her own

admissions about why she was concerned about the alleged staffing crisis, as well

as other undisputed facts about her job at the Hospital, demonstrate this speech

was within the scope of her official duties as Transplant Coordinator in the

Hospital’s Heart Transplant Unit. Rohrbough admits she had the conversations

about the staffing crisis because the staffing crisis affected her ability to do her

job and provide appropriate patient care. Furthermore, she directed her speech

toward other hospital employees such as Karin Keller, her day-to-day supervisor,

Margaret Frueh, her manager, and Dr. Lindenfeld, the director of the Transplant

Unit.

Rohrbough correctly points out that a government employee’s speech

regarding staffing, although work-related, may fall outside the employee’s official

duties. See Brammer-Hoelter, 492 F.3d at 1204-05 (concluding that plaintiffs’

speech regarding staffing levels was not made pursuant to their official duties). 

The speech protected by Brammer-Hoelter, however, occurred after hours in

groups including ordinary citizens and parents and concerned aspects of school

administration over which the plaintiffs had no supervisory responsibility and no

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duty to report. Id. at 1205. Unlike the plaintiffs in Brammer-Hoelter, however,

Rohrbough spoke only to Hospital employees and only about matters within the

scope of her duties as a nurse and Transplant Coordinator. See id. at 1204

(holding “[n]early all” of the communications at issue were unprotected because

they fell within the scope of the plaintiffs’ “inherent duty as teachers to ensure

they had adequate materials to educate their students”). Thus, Rohrbough’s

complaints to her coworkers and supervisors about the Hospital’s alleged staffing

crisis were similarly made pursuant to her official duties under

Garcetti/Pickering.

2. The Occurrence Reports

The undisputed facts also establish that Rohrbough’s eleven Occurrence

Reports were generated pursuant to her official duties. She wrote these reports at

the behest of Susan West of the Hospital’s Risk Management Unit. Furthermore,

Hospital policies required that all employees, including Rohrbough, create

Occurrence Reports to report unsafe conditions, errors, and near misses. 

Rohrbough’s reporting about the conditions affecting her ability to fulfill her

duties as Transplant Coordinator at the Hospital undoubtedly was an activity that

“stemmed from and [was of] the type . . . that she was paid to do.” Green, 472

F.3d at 801. 

Rohrbough nevertheless argues the communications in these reports were

not within the scope of her official duties because drafting them was not

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something she was “actually expected to do.” Rohrbough relies on Garcetti’s

focus on “the duties an employee actually is expected to perform,” 547 U.S. at

424-25, and notes Brammer-Hoelter expressly held that employers may not rely

upon generalized grievance policies to characterize “official duties,” 492 F.3d at

1204. 

These arguments misconceive the thrust of the analysis in Tenth Circuit

case law. First, as noted above, employee speech “not explicitly required as part

of [an employee’s] day-to-day job” may nevertheless fall within the scope of that

employee’s official duties. Green, 472 F.3d at 800-01. Indeed, BrammerHoelter, the case upon which Rohrbough relies, held that speech could be

considered within the scope of an employee’s official duty even if “the speech

concerns an unusual aspect of an employee’s job that is not part of his everyday

functions.” 492 F.3d at 1203. Brammer-Hoelter’s statement that a generalized

grievance policy does not free an employer to retaliate against any grieving

employee certainly does not also mean that every grievance necessarily falls

outside the scope of that employee’s official duties. 492 F.3d at 1204. Rather,

Brammer-Hoelter specifically held that “[n]early all” of the plaintiffs’ grievances

were unprotected because they were made “pursuant to their duties as teachers.” 

Id. at 1204. 

Rohrbough’s Occurrence Reports were similarly made pursuant to her

duties as Transplant Coordinator. Her reports documented the eleven instances of

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substandard care she observed while fulfilling her job responsibilities. They

detailed several cases in which Rohrbough felt the Heart Transplant Unit’s

patients had received inadequate care following medication changes, lab results,

and other medical tests. Like the teachers’ complaints about the school’s

curriculum and pedagogy in Brammer-Hoelter, these reports were all made

pursuant to Rohrbough’s official duties as Transplant Coordinator within the

Hospital’s Heart Transplant Unit. Her assertions that her immediate supervisors

did not order her to write the reports and that other nurses did not write similar

reports does not change the analysis. 

3. The Alleged Heart Misallocation

Finally, Rohrbough’s claim that she was retaliated against for her speech

regarding the alleged heart misallocation also fails as a matter of law. On appeal,

she argues her communications with UNOS, the Colorado State Board of Nursing,

and the Westword newspaper reporter about the alleged organ misallocation at the

Hospital were all protected under the First Amendment. An examination of the

record, however, reveals that Rohrbough failed to raise her communications with

the Colorado State Board of Nursing and the Westword reporter in the district

court. Her allegations regarding the “Heart Switch Cover up” appear in

paragraphs 18-31 of her complaint. Those paragraphs state that Rohrbough

initially directed her concerns to the following individuals: (1) Dr. Ronald Zolty,

an attending physician in the Heart Transplant Division; (2) Dr. JoAnn

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Lindenfeld, the Division’s director; (3) Karin Keller, Rohrbough’s supervisor; (4)

Nancy Ireland, a nurse within the Division; (5) Joyce Cashman, the Hospital’s

executive vice president; and (6) Colleen Goode, the Hospital’s vice president of

patient services and chief nursing officer. 

Due to her continuing concerns about the situation, Rohrbough then alleges

she called UNOS and spoke with a representative who was already investigating

the incident. Nowhere in her complaint does she allege that she contacted any

other individuals or outside entities, or that she was retaliated against for

engaging in such speech. In addition, Rohrbough completely failed to raise these

issues in her response to the Hospital’s motion to dismiss or in her subsequent

response to the Hospital’s motion for summary judgment. As a consequence, this

court will not consider the purported communications with the Colorado State

Board of Nursing and the Westword reporter as part of the allegedly protected

speech. Walker v. Mather (In re Walker), 959 F.2d 894, 896 (10th Cir. 1992)

(noting this circuit follows the general rule that “a federal appellate court does not

consider an issue not passed upon below” (quotation omitted)). 

Rohrbough’s communications with other Hospital employees regarding the

alleged heart misallocation and UNOS cover-up fall within the scope of her

official duties. The undisputed facts demonstrate Rohrbough’s responsibilities

included contacting UNOS to list a patient for an organ transplant and to change a

patient’s status. Her internal discussions about these duties certainly “stemmed

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from and were the type of activities that she was paid to do.” Green, 472 F.3d at

801. Indeed, Rohrbough testified that Goode, the Hospital’s chief nursing officer,

told her to “leave [the UNOS] problems with those within the hospital at a level

above myself.” Rohrbough also testified that Cashman, the Hospital’s executive

vice president, told her that her “only recourse was to take the problem to Dr.

Lindenfeld because she was in charge and was the director of the heart transplant

program.” Under the undisputed facts, Rohrbough’s internal discussions with Dr.

Zolty, Dr. Lindenfeld, Keller, Ireland, Cashman, and Goode about the UNOS

misallocation fell within the scope of her official duties under Garcetti/Pickering. 

Rohrbough’s additional reporting to UNOS, an outside agency that

Rohrbough was nevertheless required to maintain some official contacts with,

presents a closer question. This court, however, need not resolve the question of

whether this additional reporting fell within the scope of Rohrbough’s official

duties because her claim cannot survive the fourth prong of the Garcetti/Pickering

analysis. Step four looks to “whether the protected speech was a motivating

factor in the adverse employment action.” Dixon, 553 F.3d at 1302. Although

this step is ordinarily resolved by the trier of fact, see, e.g., Brammer-Hoelter,

492 F.3d at 1203, there simply is no evidence in the record from which a trier of

fact could reasonably conclude the UNOS speech was a motivating factor in

Rohrbough’s termination. 

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Rohrbough’s supervisor, Margaret Frueh, testified that she had no

knowledge of Rohrbough’s UNOS reporting prior to terminating Rohrbough. 

Specifically, Frueh testified that “[a]t no time during Ms. Rohrbough’s

employment at the Hospital did I have knowledge of her reports to UNOS

regarding the alleged ‘heart-switch cover-up.’” Against the weight of this

statement, Rohrbough simply argues that she has “presented enough evidence for

a reasonable jury to find that her speech was indeed the motivating factor in her

termination.” Specifically, she contends that Frueh’s credibility should be

determined by a jury and that discussions regarding the “heart transplant

continued through the spring and summer of 2003—just before her September

2003 performance evaluation.” 

The record certainly supports a conclusion that Rohrbough engaged in a

number of discussions with a variety of Hospital employees about the alleged

misallocation of the heart. This evidence might allow a jury to infer that Frueh

knew of Rohrbough’s involvement in the incident. However, there is no evidence

whatsoever that Rohrbough told Frueh, or any of her other superiors, of her

decision to report the incident to UNOS. Accordingly, she has failed to present

sufficient evidence for a reasonable trier of fact to find that her communications

with UNOS were a motivating factor in her termination.

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IV. Conclusion

For the foregoing reasons, all of Rohrbough’s claims fail as a matter of law. 

Her discussions with other Hospital employees about the alleged staffing crisis,

the alleged incidents of sub-standard care, and the alleged heart misallocation

were all within the scope of her official duties under the first prong of the

Garcetti/Pickering analysis. Furthermore, her reporting of the alleged heart

misallocation to UNOS cannot survive the fourth Garcetti/Pickering prong

because there is no evidence this speech was a motivating factor in Rohrbough’s

termination. Finally, this court will not consider Rohrbough’s claims based upon

her communications with the Colorado State Board of Nursing and the Westword

reporter because of her failure to present them below. Accordingly, the district

court’s grant of summary judgment for the Hospital is AFFIRMED. 

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