Opinion ID: 791276
Heading Depth: 2
Heading Rank: 2

Heading: Darnell's Uncontrolled Diabetes Made Him a Direct Threat to Workplace Safety

Text: 15 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 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. 16 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. 17 Darnell, however, claims there is no proof that a harmful episode is likely to happen. This court has recognized that 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. 18 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. 19 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, 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. 20 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, an employee 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. 21 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 treating his diabetes and taking care of himself that was the very reason Thermafiber deemed him unsafe.