Last week, the Sixth Circuit affirmed an employer’s summary judgment dismissing claims of retaliation and violations of the ADA when the hospital employer required a physician to submit to a forensic psychiatric exam and drug test as a condition of reinstatement from a suspension. Robitaille v. Trinity Health Grand Rapids, No. 25-2154 (6th Cir. July 20, 2026). The Court agreed that the numerous reports of the physician’s unprofessional, erratic and paranoid behavior and his safety-sensitive job duties justified the suspension and fitness-for-duty request and the subsequent refusal to renew his employment agreement when he refused to submit to the exam. It also rejected his argument that his previously stated objections to the employer’s data safety protocols actually motivated the request and non-renewal of this agreement and that his refusal to submit was protected conduct.
According to the Court’s opinion, the plaintiff anesthesiologist
was hired in 2022 on a three-year contract.
In December 2023, the computer system experienced an outage and he
expressed concerns and agitation about the need for additional safety
protocols. Thus began repeated concerns being expressed to
the chain of command about his unprofessional and erratic behavior. The Practitioners Committee eventual sent him
“letters requesting explanations for certain patient-care choices, including
multiple instances in which he refused to provide care.” He summarily referred to patient files after
the first few inquiries, but then stopped responding. “Based on this pattern of conduct, and after
an unsuccessful meeting with [him], [the Department Chair] summarily suspended [his]
clinical privileges in February 2024.” The
following month, the Executive Committee reviewed the suspension and the Chair’s
report, “based on his “disruptive behavior adversely affecting the effective
operation of the Hospital.” . . . The Executive Committee conditioned any
reconsideration of the suspension on [the plaintiff] completing a
fitness-for-duty examination that included both drug testing and a forensic
psychiatric evaluation.” The plaintiff submitted
to and passed the drug test, but refused to submit to the psychiatric
examination. When his contract expired,
the employer decided to not renew it.
Litigation ensued.
Under the ADA, a covered employer
may not “require a medical examination” of an employee unless it is both
“job-related and consistent with business necessity.” . . .
The statutory standard authorizing
medical examinations can be met by performance- or safety-based issues. On the
performance side, an examination is proper if an employer has “a reasonable
basis” to believe that the employee is “unable to perform the essential
functions of [his] job . . . . Thus, when an employee’s “aberrant behavior”
affects his “job performance,” an employer may be justified in “ordering a
mental examination.” . . . . On the
safety side, requests are proper if the employer has a “reasonable basis” to
believe that the employee “pose[s] a direct threat to [his] own safety or the
safety of others.” . . . . Safety-based
concerns carry particular weight in high-stress environments—like
hospitals—where “employees are in positions where they can do tremendous harm
if they act irrationally.” . . . In such settings, employers “may be justified
in requesting a psychological exam on slighter evidence than in other types of
workplaces.”
. . .
The clinical shortcomings [the
Department Chair] presented—[the plaintiff’s] hesitation to perform routine
tasks, avoidance of higher-risk patients, and inability to handle the standard
caseload—could all cause a reasonable person to question whether [he] was
“still capable of performing his job.” .
. . Likewise, [his] reported “aberrant
behavior”—including paranoid ideation and excessive risk-aversion—noticeably
impaired his job performance by causing inefficiencies and delays. . . . . Because [he] practiced anesthesiology,
these performance concerns were inextricably linked with patient safety.
Administering life-threatening anesthetic agents is inherently high-stakes work
where a single careless or “irrational[]” decision by [him] could “do
tremendous harm” to patients in his care. . . .
The combination of documented
performance shortfalls and behavioral red flags thus gave the Executive
Committee reasonable grounds to question both whether [the plaintiff] was
“still capable of performing his job,” .
. . , and whether he “posed a direct threat” to patient safety, . . . . Given the nature of these concerns,
the Executive Committee reasonably sought to rule out underlying impairments
related to substance abuse or mental health that could be hindering [his]
fitness to practice. The decision to require the medical examination was
therefore both “job-related and consistent with business necessity.” . . .
The Court rejected the plaintiff’s argument that the district
court had inappropriately believed the truth of the allegations against him.” Rather,
it correctly identified that “the relevant question is whether the [Executive
Committee] had a ‘reasonable belief’ that a medical exam was warranted.” . . . And it explained that “the underlying truth of
[the Chair’s] claim does not impact whether the [Executive Committee] was
reasonable in relying on it.””
The Court also rejected the plaintiff’s argument that the
report and examination request was pretext for discrimination or
retaliation. “For starters, our decision
in Sullivan adopted the objective-evidence standard for ADA
medical-examination claims and held that “there is no need to assess an
employer’s intent in ordering a fitness-for-duty examination.””
The Court also rejected the plaintiff’s argument that all of
this was pretext as retaliation for his concerns with the computer safety protocols
because he failed to address the subsequent months of multiple reports about
his behavior and performance issues and his refusal to respond to them or to
cooperate with the investigation by the Practitioners Committee. “Those issues,
as mentioned, provided an intervening, non-retaliatory basis for the Executive
Committee to order the medical examination.”
The plaintiff also argued that his refusal to submit to the
fitness-for-duty examination was protected conduct under the ADA. The Court rejected that argument as well. The employer’s “request did not violate the
ADA, and [he] offers no other arguments that his opposition was reasonable and
grounded in good faith. . . . [His] argument that he engaged in protected
activity therefore fails.”
NOTICE: This summary is designed merely to inform and alert
you of recent legal developments. It does not constitute legal advice and does
not apply to any particular situation because different facts could lead to
different results. Information here can change or be amended without notice.
Readers should not act upon this information without legal advice. If you have
any questions about anything you have read, you should consult with or retain
an employment attorney.
