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Castrillon v. St. Vincent Hosp. & Health Care Ctr., Inc.

United States District Court, S.D. Indiana, Indianapolis Division

September 29, 2014


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For Sharon Castrillon, Plaintiff: Benjamin C. Ellis, Kevin W. Betz, Sandra L. Blevins, BETZ & BLEVINS, Indianapolis, IN USA.

For St. Vincent Hospital And Health Care Center, Inc., Defendant: Craig M. Williams, Jarrod Alvin Malone, John Patrick Ryan, Jr., HALL, RENDER, KILLIAN, HEATH & LYMAN, PC, Indianapolis, IN USA.

For Steven Gerke, Maria Espinoza, Defendants: Alan L. McLaughlin, LITTLER MENDELSON PC, Indianapolis, IN; Emily L. Connor, LITTLER MENDELSON, Indianapolis, IN USA.

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Hon. William T. Lawrence, United States District Judge.

This cause is before the Court on the motion for summary judgment filed by Defendant St. Vincent Hospital and Health Care Center, Inc., (" St. Vincent" ) (found at Dkt. Nos. 197 and 207), the motion for partial summary judgment filed by Defendants Steven Gerke and Maria Espinoza (Dkt. No. 199), and two motions for leave to file surreplies filed by Plaintiff Sharon Castrillon (Dtk. Nos. 246 and 251). The motions are fully briefed and the Court, being duly advised, rules as follows.


The facts of record, viewed in the light most favorable to the Plaintiff, as the non-moving party, are as follow.

Dr. Castrillon began working as a first-year resident in the Internal Medicine Residency Program at St. Vincent on July

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1, 2008. Defendant Gerke, as the Assistant Director of the Internal Medicine Residency Program and the Medical Director of St. Vincent's Internal Medical Clinic, was one of Dr. Castrillon's supervisors. Dr. Gerke found Dr. Castrillon attractive when he interviewed her for the residency position and first told her of his attraction when he went to her house in June 2008, before she began working at St. Vincent.

In July 2008, St. Vincent determined that Dr. Castrillon and another first year resident needed to repeat their cardiology rotation due to a lack of medical knowledge and unsuccessful overall performance. Dr. Castrillon successfully repeated that rotation.

In August 2008, Dr. Castrillon participated in an international rotation that Dr. Gerke supervised. During the trip, Dr. Gerke became upset when she talked to another man, chased her through the hotel, and banged on the door of her room while yelling for her; her roommate answered the door and told him she was not available to speak to him.

From September 2008 to December 2008 or January 2009, Dr. Gerke and Dr. Castrillon had a sexual relationship. At the time, Dr. Gerke also was dating Defendant Maria Espinoza (now Gerke; for the sake of clarity she will be referred to as " Maria" in this Entry), who worked at St. Vincent as an interpreter in the internal medicine clinic. On more than one occasion, Dr. Castrillon attempted to end her relationship with Dr. Gerke; in fact, Dr. Gerke contacted her sister twice asking for her help in wooing Dr. Castrillon back, telling her, for example, that he loved Dr. Castrillon " more than she knows . . . I want very much for all of her dreams to come true, and I feel TRULY and UNCONTROLLABLY, compelled to try and make them come true myself. But the situation is very complicated, and I just want to do what is right for everyone." In December 2008 or January 2009, Dr. Castrillon ended her intimate relationship with Dr. Gerke for good and asked him to stop calling her, sending her love letters, and contacting her family. She then worked to avoid him by, for example, completing her patient notes at home rather than at the hospital. For a period of time she tried to block his calls, but realized that was infeasible because, as her supervisor, he had to be able to reach her for work purposes. Dr. Gerke sent her approximately three love letters after she ended the relationship; she received the last one in " maybe July 2009."

In October 2008, Dr. Castrillon met twice with Dr. Craig Wilson, who was the director of St. Vincent's internal medicine residency program, about an issue with her punctuality. Dr. Castrillon reported that she was having some health issues (a neck fracture) that had caused her tardiness. Dr. Wilson believed that to be a successful intervention with Dr. Castrillon.

On January 23, 2009, Dr. Castrillon was placed on a remediation plan because she scored below the 10th percentile on a national exam (the " ITE exam" ) which put her in the category of academically at-risk. Dr. Castrillon believes she was at a disadvantage in taking this exam because, unlike other residents, she was not given time off from her rotations to take it, but rather was required to take it at home while she was working the night shift of the emergency medicine rotation.

In an evaluation dated February 24, 2009, Dr. Stephen Knaus noted that he was " troubled by some professionalism concerns, including repeated tardiness and poor follow-up on some patient care issues." Dr. Castrillon does not believe she was tardy during her rotation with Dr.

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Knaus except for once when she drove into a snowbank.

In March 2009, Dr. Gerke reported, in writing, to Dr. Wilson, who was his supervisor, that Dr. Castrillon had " been persistently negligent in completing her clinic notes on time for several months." In his letter, Dr. Gerke noted that he had addressed the issue of incomplete clinic notes with Dr. Castrillon twice by e-mail (once in November 2008 and again in February 2009) and admitted in his letter to Dr. Wilson that he " may have complicated the problem by not calling for discipline before now." He stated that he was " [r]eluctantly . . . forced to conclude that [Dr. Castrillon] is not willing to make a professional commitment to [her patients'] care, or her own education." He recommended that she be removed from service until her notes were completed, that she be required to complete all of her notes by 7:00 a.m. on the day following each office visit, and that she be placed on academic probation if she were unable to comply with those terms. Dr. Gerke's policy as expressed to Dr. Castrillon had been that clinic notes were considered complete as long as the relevant information was entered, even if the note was left " open" in the system to permit further editing. After Dr. Castrillon ended their relationship, Dr. Gerke began defining any note left open after 48 hours as untimely, even if the relevant information had been entered.

Dr. Wilson met with Dr. Gerke to discuss Dr. Castrillon on March 16, 2009. That same day, Dr. Wilson placed Dr. Castrillon on academic probation, noting " a persistent trend of tardiness" and " a persistent habit of not completing [her] outpatient notes in a timely manner." The letter informing Dr. Castrillon of the terms of her probation provided that her promotion to second-year residency status (" PGY-2" ) would be " contingent upon successful remediation of the above concerns." At that time, Dr. Castrillon had been tardy only twice during her residency; once in September when she overslept due to pain medication she was taking for a neck fracture, and again in January when her car slid into a snowbank. She had addressed those incidents with her relevant supervisors when they occurred and believed the issues had been resolved.

During her period of probation, Dr. Castrillon was not informed of any further issues with tardiness or the timeliness of her clinic notes.

On March 21, 2009, five days after putting Dr. Castrillon on probation, Dr. Wilson stated in an email to his supervisor, Dr. Robert Lubitz, St. Vincent's Vice President of Academic Affairs and Research, that he needed to discuss with him a " sensitive issue" regarding Dr. Gerke and Dr. Castrillon and that he might not renew Dr. Castrillon's contract. He similarly emailed Dr. Lannie Caition, another administrator in the residency program, about a " messy situation" involving Drs. Castrillon and Gerke. Dr. Wilson testified at his deposition that the " messy situation" referred to the fact that he had received an unusual phone call from Maria Espinoza reporting to him that she had overheard Dr. Castrillon call Dr. Gerke an asshole during an argument.

On March 25, 2009, Dr. Wilson notified Dr. Gerke that his employment contract would not be renewed. This followed an incident in which Dr. Gerke berated St. Vincent information technology staff regarding a computer issue. The nonrenewal letter from St. Vincent states that " despite multiple attempts at counseling, you [Dr. Gerke] are failing to uphold our core value of reverence by continuing to demonstrate behaviors that are inconsistent with the above requests [to 'represent our Department calmly and professionally,' to

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'not bypass the established chains of command when attempting to resolve conflict,' and to 'allow me to review external communications prior to their release by you']." The meeting notes produced by St. Vincent reflect that the specific concerns relating to Dr. Gerke's nonrenewal included " [c]oncerns raised by residents regarding temper and overaggressive attempts to discipline residents -- verbally demeaning to residents who have not completed administrative tasks, sometimes without confirming beforehand whether the accusations are accurate." Dr. Gerke testified that this characterization of his performance was not accurate. Despite the issues identified as supporting the decision not to renew Dr. Gerke's contract, Dr. Lubitz recommended him for another position within the St. Vincent network and Dr. Wilson, on his own initiative, wrote a positive recommendation letter for Dr. Gerke to assist him in finding another position. Dr. Gerke continued to work at the hospital until June 23, 2009.

In her April 22, 2009, evaluation of Dr. Castrillon, Dr. Larissa Day expressed concerns with her professionalism as it related to " complete, timely changeover," which refers to the briefing regarding the status of patients that occurs at a shift change. Dr. Wilson had previously been made aware of complaints by other residents regarding Dr. Castrillon's failure to complete timely changeovers in September 2008.

By letter dated June 30, 2009, signed by Dr. Wilson, St. Vincent promoted Dr. Castrillon to her second year of residency, which began the following day. Dr. Wilson testified that this promotion occurred because he signed a form letter accidentally. On July 8, 2009, Dr. Castrillon and Kyle Defur, president of St. Vincent, signed her new contract and her promotion to PGY-2 was processed by the hospital.

Meanwhile, on July 3, 2009, Maria Espinoza learned of Dr. Gerke's affair with Dr. Castrillon when he left a letter he had written to her on his printer. Maria, who describes herself as being " hurt, distraught, [an] emotional wreck" at that time, began a campaign of revenge against Dr. Castrillon that lasted for more than a year. Maria sent Dr. Castrillon numerous admittedly " hateful" letters, some of which appeared to be from Dr. Gerke and others of which appeared to be from a fellow resident. Maria mailed some of the letters and put others in Dr. Castrillon's work mailbox. Maria also sent an anonymous letter to Dr. Wilson and Dr. Victor Collier asserting that Dr. Castrillon used marijuana and planned to seduce St. Vincent male faculty members. Dr. Gerke participated in sending the letter to Dr. Collier; after Maria saw Dr. Castrillon and Dr. Collier " near him a couple of times . . . really close," he and Maria believed he needed to be warned so he " wouldn't also get caught up in any kind of mess like we were in with her . . . [h]aving an affair with somebody at work and having to work with them still." Maria Gerke Dep. at 49, 55. Maria also posted negative comments about and ratings of Dr. Castrillon on professional ratings websites, posing as patients she had treated.

On July 16, 2009, Dr. Wilson emailed Dr. Lubitz and Joyce Dobson, St. Vincent's Manager of Medical Education and Chair of St. Vincent's Gradual Medical Education Committee (" GMEC" ), about the anonymous letter he received (that he referred to as " an accusation from one of her resident peers" ) that alleged that Dr. Castrillon used recreational drugs and planned to seduce male members of the St. Vincent faculty, including Dr. Wilson himself. He had already spoken to Kim Sykes-Joseph from the St. Vincent Human Resources

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Department about the anonymous accusations. His email read, in part:

Kim confirmed that a peer's accusation is insufficient to warrant a formal fitness for duty evaluation. I have provided her with a copy of our impairment policy. My opinion is that [Dr. Castrillon's] continued tardiness and delayed note completion represent impaired behavior by our residency standards as highlighted in our policy. Because of the nature of the allegations, and due to the fact that [Dr. Castrillon] is already on academic probation with repeated offenses, I would like to refer the case to both of you as representatives of the Graduate Medical Education committee, and would value the opportunity to discuss our options for remediation (or otherwise) with you and our HR representative. There is email documentation of inappropriate correspondence with faculty, the late attendance, as well as . . . documentation of note completion delays.

No investigation was conducted by Dr. Wilson or anyone else at St. Vincent regarding the anonymous letter or the accusations made therein.

By letter dated July 23, 2009, Dr. Wilson terminated Dr. Castrillon's employment. The letter noted that at the time she was placed on probation Dr. Castrillon had " provided assurance" that an " evaluation for medical and/or psychologic [sic] contributors to [her] impaired performance" was not necessary. It then identified two " substantial ...

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