In the

United States Court of Appeals

For the Seventh Circuit

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No. 04-2170

BRENT DARNELL,

Plaintiff-Appellant,

v.

THERMAFIBER, INCORPORATED,

Defendant-Appellee.

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Appeal from the United States District Court for the

Northern District of Indiana, South Bend Division.

No. 02 C 663—Robert L. Miller, Jr., Chief Judge.

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ARGUED DECEMBER 9, 2004—DECIDED JULY 29, 2005

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Before FLAUM, Chief Judge, and BAUER and WILLIAMS,

Circuit Judges.

BAUER, Circuit Judge. Plaintiff-Appellant Brent Darnell

sued defendant-appellee Thermafiber, Inc., alleging discrimination in violation of Title I of the Americans with

Disabilities Act (“ADA”), 42 U.S.C. §§ 12101 et seq. The

district court granted Thermafiber’s motion for summary

judgment. We affirm.
2 No. 04-2170

I. Background

Thermafiber manufactures mineral wool insulation at its

plant in Wabash, Indiana. This process involves melting

rock and blast furnace slag in a furnace at temperatures of

over 2,600 degrees Fahrenheit. Upon leaving the furnace,

the molten material drops onto fast-rotating wheels where

it is cooled and spun to create rock fibers. These fibers are

then glued, formed into boards, and cured in ovens at

temperatures of 600 degrees Fahrenheit. Once the boards

are cooled, they pass through a series of saws and highspeed blades. Operators then retrieve the insulation pieces

from the conveyor and lift them onto another conveyor for

shrink wrapping.

In late October 2000, Thermafiber hired Darnell through

a temporary employment agency. Darnell is a Type I diabetic who is insulin-dependent. Before starting the job,

Darnell was required to pass a pre-employment physical.

Thermafiber contracts with a Wabash medical practice,

Family Physicians Associated, to perform these exams. On

October 31, 2000, nurse practitioner Lynn Wicker conducted

the physical and reported to Thermafiber that Darnell was

capable of performing the requirements of the job. Darnell

began work shortly thereafter.

In early May 2001, Darnell left Thermafiber to work

outside the state. Up until that time, he did not have any

debilitating episodes at Thermafiber related to his diabetes.

He returned to Indiana several months later and applied for

a full-time position with Thermafiber in August 2001. He

was offered a position contingent upon his passing another

pre-employment physical. On August 9, 2001, Darnell

returned to Family Physicians Associated, where Dr. James

McCann conducted the physical. His exam consisted of a

urine glucose test and interview. Dr. McCann, whose practice includes 180 diabetes patients, determined from the

results of the test and interview that Darnell’s diabetes was
No. 04-2170 3

not under control; as a result, he felt there was no need to

conduct further tests or review Darnell’s medical chart. Dr.

McCann reported to Thermafiber that Darnell was not

capable of performing the physical requirements of the job

because of his “uncontrolled diabetes mellitus.” Darnell

soon thereafter learned from Thermafiber that it was

rescinding its offer of employment because he had not

passed the physical.

Darnell filed a charge with the Equal Employment

Opportunity Commission, claiming he had suffered discrimination in violation of the ADA. The EEOC issued a right

to sue letter, and Darnell filed suit in the district court. After discovery, Thermafiber moved for summary judgment,

contending that Darnell’s uncontrolled diabetes would pose

a significant safety risk at the plant. The district court

granted the motion.

II. Discussion

Darnell argues that summary judgment was inappropriate because Thermafiber did not demonstrate that his “uncontrolled” diabetes made him a direct threat to safety at

the plant. He also claims that it was unreasonable for

Thermafiber to rely upon Dr. McCann’s opinion because Dr.

McCann failed to perform an adequate, individualized

assessment of his ability to perform the job.

We review the district court’s grant of summary judgment

de novo. Roger v. Yellow Freight Systems, Inc., 21 F.3d 146,

148 (7th Cir. 1994). Summary judgment is appropriate

“when there is no genuine issue as to any material fact

and the moving party is entitled to judgment as a matter of

law.” Cameron v. Frances Slocum Bank & Trust Co., 824

F.2d 570, 573 (7th Cir. 1987) (citing FED. R. CIV. P. 56(c)).

In assessing the matter, we construe all facts and inferences in the light most favorable to Darnell, the non-moving
4 No. 04-2170

party. Webb v. Clyde L. Choate Mental Health & Dev. Ctr.,

230 F.3d 991, 997 (7th Cir. 2000).

The ADA prohibits an employer from discriminating

against a qualified individual with a disability. See 42

U.S.C. § 12112(a); Bekker v. Humana Health Plan, Inc., 229

F.3d 662, 669 (7th Cir. 2000). A “qualified individual with

a disability” is a person “who, with or without reasonable

accommodation, can perform the essential functions of the

employment position that such individual holds or desires.”

42 U.S.C. § 12111(8). An individual is not qualified if he

presents a “direct threat” to his own health and safety or

that of others. See Bekker, 229 F.3d at 670. The determination that he poses a direct threat must be premised upon “a

reasonable medical judgment that relies on the most current medical knowledge and/or the best available objective

evidence, and upon an expressly individualized assessment

of the individual’s present ability to safely perform the

essential functions of the job.” Chevron U.S.A. Inc. v.

Echazabal, 536 U.S. 73, 86 (2002) (citing 29 C.F.R.

§ 1630.2(r) (internal quotations omitted)). The assessment

should take into account: (1) the duration of the risk, (2) the

nature and severity of the potential harm, (3) the likelihood

that the potential harm will occur, and (4) the imminence

of the potential harm. 29 C.F.R. § 1630.2(r); see also

Chevron, 536 U.S. at 86; Emerson v. N. States Power Co.,

256 F.3d 506, 514 (7th Cir. 2001).

A. Thermafiber Reasonably Relied on Dr. McCann’s

Opinion

Darnell contends that Dr. McCann failed to perform an

individualized assessment of his diabetic condition and

abilities that was supported by objective, medical evidence.

Rather, he claims the assessment was based on stereotypes

and insufficient data—the results of a single urine glucose

test—which should have been supplemented by more
No. 04-2170 5

reliable blood tests. Therefore, Darnell argues, it was

unreasonable of Thermafiber to rely upon Dr. McCann’s

opinion when it rescinded the offer of employment.

We disagree with Darnell’s position. First, his claim that

the information he revealed during the interview does not

constitute reliable, medical evidence is inaccurate. This

court has recognized that testimonial evidence can provide

sufficient support for a direct threat finding under the ADA.

See Bekker, 229 F.3d at 668 (finding that employee and

patient reports that a physician smelled of alcohol constituted sufficient evidence that she posed a direct threat to

patients); see also Turco v. Hoechst Celanese Corp., 101 F.3d

1090, 1093-94 (5th Cir. 1996) (finding that defendant’s

testimony confirmed that his diabetes made him a safety

risk). During the interview, Dr. McCann asked Darnell

about his physical complaints, his health as it related to his

diabetes, and whether he experienced episodes of low blood

sugar. McCann Dep. at 11. Darnell related a history of poor

compliance and failure to seek medical attention; he

admitted “his blood sugar levels were too high, he hadn’t

checked in with a doctor in a number of months . . . [and]

last anyone seen it was not good.” Id. at 32. These admissions were corroborated by the results from his urine

glucose test. When Dr. McCann suggested that he better

control his diabetes, Darnell angrily responded that his

sugar levels were “good enough.” Id. at 33. Dr. McCann was

“shocked” by Darnell’s disinterest in regulating his condition. Id. at 49. Under these circumstances, additional

testing was unnecessary because the results could not have

refuted the fact that Darnell was unmotivated to control his

diabetes.

Darnell argues that, at a minimum, Dr. McCann should

have consulted his medical chart before drawing his conclusion. Generally speaking, familiarity with a patient’s

medical history is highly important, but here the information could not have controverted Darnell’s admitted non-
6 No. 04-2170

compliance. Moreover, had Dr. McCann checked Darnell’s

medical charts, the information would have more or less

borne out that, historically, his glucose levels were unpredictable as a result of his failure to regulate his condition.

Both parties’ experts also agreed that Dr. McCann’s

opinion that Darnell’s diabetes was uncontrolled was

reasonable and supported by the evidence. Thermafiber’s

expert, Dr. John Cavanaugh, a board-certified endocrinologist and diabetes specialist, testified that the information

Dr. McCann considered supported the reasonable medical

conclusion that Darnell had failed to control his disease.

Cavanaugh Dep. at 80. In his view, if an insulin-dependent

diabetic tells a physician he is not complying with proper

diabetes treatment, the physician does not “need to have

that written somewhere”—in other words, does not need to

have test results confirming high blood sugar or glucose

fluctuations—to determine the patient is “noncompliant.”

Id. at 82. When Darnell’s expert and treating physician, Dr.

John Levine, was asked at his deposition whether Darnell’s

diabetes was uncontrolled, he conceded: “That would be a

fair statement.” Levine Dep. at 50. That Dr. Levine appears

to have used the term in that context as being synonymous

with “poorly compliant” changes nothing. With both experts

in accord on this issue, we believe that Dr. McCann’s

assessment was a reasonable medical judgment supported

by the evidence. Therefore, Thermafiber reasonably relied

upon that assessment.

B. Darnell’s Uncontrolled Diabetes Made Him a

Direct Threat to Workplace Safety

Darnell next argues there was no evidence that his noncompliance was likely to cause substantial injury, apart

from generalizations about diabetics and Thermafiber’s

work environment. We disagree. It is uncontested that blood

sugar levels can fluctuate dramatically when diabetes goes
No. 04-2170 7

unregulated. As Dr. Levine himself testified, this can cause

unconsciousness, confusion, and impaired judgment. Levine

Dep. at 23. Were Darnell to experience such symptoms at

Thermafiber, the injury to himself or others could be great.

Thermafiber employees are required to climb tall ladders,

operate dangerous machinery—including saws, balers,

conveyors, exhaust fans, ovens, and recycling machinery—and help lift 80-pound pieces of fiber board. The

dangers posed by this environment figured prominently in

Dr. McCann’s assessment. He testified that “[t]here’s a lot

of very hot equipment around there. There are hydraulic

lifts and somebody has to be acutely aware of their body

100% of the time to work in a factory like Thermafiber, and

I would definitely be concerned about his level of control, he

would not be alert as he should be.” McCann Dep. at 51. Dr.

Cavanaugh agreed that the heavy machinery inside the

plant increased the risk that a diabetes-related injury

would be serious. Cavanaugh Dep. at 37-38.

Darnell asserts that ominous predictions about falls from

heights and injuries by heavy equipment cannot support an

employer’s assertion that a diabetic is a direct threat under

the ADA. He relies on EEOC v. Chrysler, 917 F. Supp. 1164,

1171-72 (E.D. Mich. 1996), rev’d, 172 F.3d 48 (6th Cir. 1998)

(reversed on grounds that record contained insufficient

evidence to support the holding that the employer regarded

the plaintiff as disabled), for this proposition. However, the

plaintiff in Chrysler sought out regular care, kept his

diabetes under good control, and was not insulin-dependent.

Darnell, by contrast, admitted that his sugar levels were too

high, that he does not adequately monitor his diabetes, and

is insulin-dependent. It is precisely his noncompliance, poor

judgment, and admittedly high glucose levels that make it

likely he would eventually experience a diabetic episode at

Thermafiber.

Darnell, however, claims there is no proof that a harmful

episode is likely to happen. This court has recognized that
8 No. 04-2170

where the plaintiff’s medical condition is uncontrolled, of an

unlimited duration, and capable of causing serious harm,

injury may be considered likely to occur. Bekker, 229 F.3d

at 668; see also Borgialli v. Thunder Basin Coal Co., 235

F.3d 1284, 1294 (10th Cir. 2000) (attributing greater weight

to the “nature and severity” of the potential harm than to

whether it is “likely” and “imminent” where a lapse in

safety could cause serious bodily injury for multiple individuals); Hutton v. Elf Atochem N. Am., Inc., 273 F.3d

884, 894-95 (9th Cir. 2001) (holding that a direct threat can

exist where the nature and severity of the potential harm

is catastrophic, though the likelihood that it will occur is

small) (citing Turco, 101 F.3d at 1094). Those conditions, as

we have discussed, are present here.

Furthermore, Dr. McCann and both parties’ medical

experts agreed that his continued noncompliance increased

the risk of injury on the job. Dr. McCann testified that

Darnell was “certainly at risk” of passing out and causing

severe harm to himself or others, McCann Dep. at 42, that

the risk was “significant,” id. at 51, and that he ascertained

“a very definite likelihood” that “harm could occur.” Id. at

42. Dr. Cavanaugh stated that it was “a reasonable medical

certainty that Darnell would pass out on the job . . . sooner

or later . . . .” Cavanaugh Dep. at 56. Dr. Levine testified

that Darnell’s noncompliance likely would increase his

blood sugar levels, and that increased blood sugar levels

might lead to mental confusion, impaired reasoning, and

impaired judgment. Levine Dep. at 20-24.

The likelihood that Darnell’s uncontrolled diabetes would

cause injury was magnified by the terrific heat within the

plant, which can reach 110 degrees. Dr. McCann testified

that if Darnell’s blood sugar level rose too high, he could

become dehydrated, “especially in very hot environments,

and that can certainly cause passing out at times.” McCann

Dep. at 19. He warned: “You get a diabetic, a poorly controlled diabetic with markedly elevated temperatures,
No. 04-2170 9

you’re looking . . . at a disaster.” Id. at 31. Darnell’s expert

confirmed that an insulin-dependent diabetic is more likely

to become dehydrated in high temperatures, and that this

can increase the likelihood that he will experience an

episode caused by high or low blood sugar. Levine Dep. at

24.

Darnell argues that the fact that he worked at the plant

for 10 months without experiencing an episode makes it

doubtful that an injury is likely to occur. However, a

defendant with a health condition who has experienced no

on-the-job episodes can still pose a direct threat to workplace safety. Bekker, 229 F.3d at 668; see also Branham v.

Snow, 392 F.3d 896, 908 (7th Cir. 2004) (reversing district

court’s direct threat finding where plaintiff had “exceptional

control over his blood glucose levels” and “full awareness of

all his reactions”). Darnell’s work history did not move Dr.

McCann to amend his conclusion that he would be “a

danger to himself and others.” McCann Dep. at 39.

Dr. Cavanaugh agreed and noted that Darnell’s history at

Thermafiber is not surprising given that “it’s a matter of

probability and . . . he was [not] there that long.”

Cavanaugh Dep. at 70. Darnell’s expert also rejected the

assumption that a diabetic who has never suffered from an

episode would not suffer such an event in the future. Levine

Dep. at 24. We conclude that Thermafiber produced sufficient evidence for the district court to conclude as a matter

of law that Darnell’s uncontrolled diabetes made him a

direct threat to his own safety and that of his co-workers,

his relatively brief work history notwithstanding.

As a final matter, Darnell argues that Thermafiber failed

to consider making reasonable accommodations for his

disability, such as allowing him to take additional food and

water breaks. This is inaccurate. Dr. McCann assumed that

Thermafiber would afford such opportunities in rendering

his assessment. McCann Dep. at 32. Moreover, it was

Darnell’s longstanding failure to exercise good judgment in
10 No. 04-2170

treating his diabetes and taking care of himself that was

the very reason Thermafiber deemed him unsafe.

III. Conclusion

For the reasons stated above, we AFFIRM the district

court’s grant of summary judgment.

A true Copy:

Teste: 

 ________________________________

Clerk of the United States Court of

Appeals for the Seventh Circuit 

USCA-02-C-0072—7-29-05