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Outside Article Court Upholds Denial Of Student Nurse's Service Dog

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By: BridgeTower Media Newswires//March 13, 2023

By Correy E. Stephenson
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A hospital did not violate the Americans with Disabilities Act by withdrawing its accommodation of allowing a service dog to accompany a student nurse intern on her rounds, according to a ruling from the Eastern District of Michigan, granting the defendant's motion for summary judgment.

Hurley Medical Center had granted Mia Bennett's request for accommodation to bring her service dog, Pistol, with her on her clinical nursing rotation, but withdrew it after a patient and staff member had severe allergic reactions.

"No reasonable jury could dispute that Hurley did conduct an individualized assessment and reasonably concluded that Pistol, who would have accompanied Bennett to every patient on her rounds with doctors and nurses, was a direct threat to the health and safety of all the patients and staff on 7E and 9E," U.S. District Court Judge Paul D. Borman wrote.

The opinion is Bennett v. Hurley Medical Center (MiLW 02-106419, 38 pages).

Grand Blanc attorney Michael W. Edmunds of Gault Davison, who represented the hospital, said the court reached the correct decision after considering the rights of the various parties.

"The hospital has to balance the rights of disabled people with the rights of its patients and can't sacrifice patient care," he said. "[The hospital] isn't anti-dog; in fact, it started out accommodating the plaintiff but a bunch of people had allergic reactions."

Nicholas Roumel of Nacht Law in Ann Arbor, who represented the student nurse intern, did not respond to a request for comment by deadline.

Rescinded accommodation

In 2017, Mia Bennett, a nursing student at the University of Michigan – Flint, was diagnosed with "Generalized Anxiety Disorder with a history of panic attacks."

Bennett contends that Pistol, her Pembroke Welsh Corgi dog, helps to minimize the attacks. She primarily trained the dog by herself to detect a rise in her anxious behaviors and signal her to take medication to stop a panic attack.

As a UM-Flint nursing student, Bennett was required to complete clinical training rotations that complement her coursework at nearby hospitals each semester. She was set to begin at Hurley Medical Center in the fall of 2020, following doctors and nurses making their rounds of patients' rooms for four hours a week on Wednesdays, for six weeks.

Bennett was scheduled to intern on floor 7E, where patient conditions include infectious diseases, congestive heart failure, vascular and postsurgical patients and the designated unit for renal patients, many of whom are immunocompromised, as well as 9E, which has an oncology unit.

Two weeks before her rotation began, Bennett emailed Hurley's human resources department to apply for an accommodation that would allow her to bring Pistol on her rotation. The request was approved, with a note that the use of Pistol needed to comply with Hurley's Standard Practices.

The first day Bennett brought Pistol to start her rotation, a nurse with severe dog allergies had to be sent home — and missed an additional day of work — after having a reaction, requiring the entire nursing staff on the floor to be reshuffled.
A patient also had an allergic reaction to Pistol without the dog even entering his room.

Hurley then reevaluated Bennett's accommodation. The hospital considered putting Pistol in a lycra body suit to minimize allergic reactions or crating the dog during patient care timeframes with the opportunity for Bennett to take necessary breaks as needed.
Bennett ultimately finished her rotation at Hurley without Pistol and without suffering any panic attacks.

She then sued the hospital, asserting claims under the Americans with Disabilities Act, or ADA, the Rehabilitation Act and Michigan's Persons with Disabilities Civil Rights Act, or PWDCRA.

Hurley moved for summary judgment.

Direct threat to health and safety

Bennett alleged that Hurley intentionally discriminated against her and denied her a reasonable accommodation in violation of the ADA.

Borman disagreed.

Bennett abandoned her claim of intentional discrimination under the ADA, the judge said, and summary judgment was appropriate on the reasonable accommodation claim because Pistol was a direct threat to health and safety.

The ADA's regulations state that they "do[] not require a public entity to permit an individual to participate in or benefit from the services, programs, or activities of that public entity when that individual poses a direct threat to the health or safety of others."

Bennett maintained that it should not be difficult to accommodate a student nurse with a service animal and that safety requirements must be based on actual risks, not mere speculation.

Hurley countered that Pistol caused actual allergic reactions in staff and patients, and that many of the patients on 7E were post-surgical or unconscious, had not been screened for dog allergies and could not be moved because other parts of the hospital were not equipped to deal with their medical needs.

Borman had little difficulty concluding Hurley established that Pistol was a direct threat to the health and safety of patients and staff.

"Hurley barred Pistol from future presence on 7E and 9E only after he actually caused allergic reactions; it did not act based purely on speculation or generalizations," the judge wrote.

The hospital conducted a proper individualized assessment before excluding Pistol as a direct threat and offered to allow Pistol to stay in a crate on the eighth floor. While not satisfactory to Bennett, this demonstrated that Hurley assessed whether a modification could mitigate the risk Pistol posed without fully excluding him, Borman pointed out.

"The evidence shows that Pistol at the very least carried allergens," the judge said. "In less than a day, Pistol triggered an allergic reaction in [a nurse] that was so strong that she sought medical care and was out for two days, and he also triggered a reaction in a patient with dog allergies who did not even see Pistol."

Also, "Pistol's disbursement of allergens was especially dangerous on 7E, because some of its patients are immunocompromised and needed to stay on that floor for their care," Borman continued. "Pistol's allergens would have been similarly dangerous to the patients on 9E, which is an '[o]ncology medical unit.' And even if Hurley could have rearranged staff schedules to find a team of nurses without dog allergies, doing so would have disrupted continuity of care by the assigned nurses, further endangering patients."

The court also found that Hurley did not obstruct the interactive process.

Bennett claimed Hurley revoked her accommodation without consulting her and never responded to an email about trying to find a "shed defender," a lycra body suit for Pistol that would minimize the likelihood of an allergic reaction to him.
"Neither allegation shows that Hurley acted obstructively or in bad faith," the judge wrote. Hurley had multiple phone calls with Bennett after it revoked permission for Pistol to go on rounds before it sent an official letter and continued conversations after that.

"Perhaps more importantly, in that withdrawal email, [the human resources representative] emphasized that Hurley 'remain[ed] open to continue dialogue on th[e] matter' but 'at th[at] time Hurley w[ould] not permit [Pistol] to accompany [Bennett] on 7E or 9E,'" Borman said. "This language made it clear that Hurley was keeping the interactive process open."

As the parties agreed that Bennett's Rehabilitation Act and PWDCRA claims should be resolved consistently with her ADA claims, the court granted summary judgment on all of her claims.
 
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