Opinion ID: 202767
Heading Depth: 3
Heading Rank: 2

Heading: Whether the Hospital Met Its Burden

Text: 27 The Hospital also argues that even if the General Counsel met his burden under Wright Line, substantial evidence does not support the Board's conclusion that the Hospital had not met its burden of showing it would have suspended Garcia and later terminated his employment in the absence of his union activity. 4 The Hospital argued to the Board that two incidents would have led to the suspension even if Garcia had not been a union delegate: Garcia's absence from the emergency room with the narcotics key and Garcia's making an announcement deemed inappropriate by the Hospital over the emergency room loudspeaker. 28 The Board justifiably found that the Hospital had not met its burden and that the true reason for suspending Garcia was Garcia's union activity. 5 As the Board noted, the Human Resources Director herself referred to the narcotics-key incident as a minor offense and testified that she had not disciplined Garcia for it. Hosp. Cristo Redentor, 347 N.L.R.B. No. 65, at 4. There also was evidence that other employees had similarly left the emergency room with the narcotics key, but no evidence that they had been similarly disciplined. As both the ALJ and the Board stated, Garcia was faced with a Hobson's choice among several undesirable alternatives when he left with the key in order to take patient samples to the lab when no one else was able to do so. Id. at 4, 23. 29 The Hospital contends that Garcia should have left the narcotics key in the emergency room when he went to the lab. That may be so, and it may even have been reasonable for the Hospital to treat the incident as a serious one. But the evidence in the record indicates that the Hospital did not treat such incidents as serious infractions. The issue is not whether Garcia should have handled the situation differently. 30 As for the loudspeaker episode, the ALJ characterized the announcement as a brief outburst by a frustrated Garcia, who was using undiplomatic means to get more staffing assistance in a severely understaffed emergency room. Id. at 22-23. As the ALJ and the Board indicated, the record is devoid of evidence, save for the suspension letter itself, that Garcia actually made objectionable remarks over the loudspeaker. Id. at 5, 23. Even assuming that the Hospital's characterization of the episode is correct, the record does not show that Garcia would have been suspended absent his union activities. The suspension letter notes that the loudspeaker incident was the third time that there had been a problem with Garcia's attitude, and that because the available corrective measures had been exhausted, Garcia was being suspended. 6 However, at least one of the prior two incidents involved union-related activities. The Board's conclusion that the Hospital would not have suspended Garcia save for his union activities is thus supported by substantial evidence. 31 The Board also supportably found that the Hospital had not met its burden of showing it would have terminated Garcia's employment regardless of union activity. The Hospital's termination letter gave three reasons for discharging Garcia: the October 6 incident in which he left the hospital to attend to a family emergency, the incidents resulting in his suspension, and the improper diagnosis of a patient on October 18. Our earlier holding that substantial evidence supports the Board's findings as to the incidents resulting in Garcia's suspension eliminate them as a legitimate basis for termination. 32 As the ALJ recognized, the evidence indicates that Garcia spoke with his supervisor before leaving the Hospital on October 6. Id. at 15-16. The supervisor's testimony indicated that she understood that Garcia had an emergency and needed to leave the Hospital, and that after she was unable to find the appropriate authorization form, she accepted instead a note from Garcia explaining his reason for leaving. 33 Likewise, the ALJ's finding that the October 18 incident did not warrant dismissal is supported by the record. On October 18, 2001, a young girl arrived at the emergency room after having fainted. The Hospital claims that Garcia told the girl's mother that the girl likely had tried to commit suicide. In fact, the girl had taken several Panadol tablets for a headache from having not eaten and had then fainted because she had not had enough to eat. In the termination letter, this episode was characterized as a breach of the Hospital's privacy and confidentiality policy. As the ALJ indicated, there is no evidence that Garcia revealed confidential information. Id. at 23. 34 The Hospital has now recharacterized the violation as more general improper handling of patient care. Regardless, the only evidence in the record is that Garcia assumed based on the information provided to him that the girl had attempted to commit suicide, and that in informing the mother of the procedures that her daughter would undergo, Garcia indicated that if necessary the daughter would be subject to the protocol for dealing with cases of attempted suicide. There is no evidence to support the Hospital's suggestion that Garcia diagnosed the patient, and in fact Garcia directly denied having done so and indicated that he had told the mother that the physician would be the one to make the diagnosis. 35 The Hospital also presents an after-the-fact justification for the suspension and discharge. It now says that the suspension and discharge were justified by an admitted medical records mistake by Garcia. On March 12, 2001, Garcia made a mistake recording a medication dosage onto a patient's chart. When he corrected the mistake, he deviated from Hospital protocol, which required him to strike through the erroneous order, write Omit, and initial and date the strike-through before noting the correct order. Instead, Garcia simply wrote the correct order on top of the incorrect order. 36 The Hospital characterizes the episode as an attempt to evade responsibility for a medical mistake, in which the incorrect dosage actually was administered to the patient. 7 The record does not support such an argument. As the ALJ noted, the correct dosage was written over the incorrect dosage without any apparent attempt to conceal the change. Moreover, this error in correcting a record was not a reason proffered by the Hospital in either the suspension letter or the termination letter. The Hospital's volte face on the grounds for suspension and termination undermines its argument. See E.C. Waste, 359 F.3d at 44 ([A]n employer's shifting explanations for discharging an employee may themselves serve either to ground or to reinforce a finding of pretext.); see also Santiago-Ramos v. Centennial P.R. Wireless Corp., 217 F.3d 46, 56 (1st Cir. 2000). The ALJ was justified in finding that the recording error was at most a minor records protocol error that did not justify suspension or dismissal. 37 The sum, it is true, may be greater than the total of its parts. A series of incidents none of which individually would warrant dismissal in total may nonetheless justify it. But that argument cannot plausibly be made by the Hospital here. The after-the-fact justification offered by the Hospital only further supports the Board's conclusion that the Hospital's proffered reasons for the suspension and discharge were pretext. 38 The Board's finding that the Hospital engaged in unfair labor practices is supported by substantial evidence.