351 S.W.3d 707
Mo. Ct. App.2011Background
- Henry supervised as RN III at Fulton State Hospital's Biggs Forensics Center; incident on Jan 20, 2008 involved restraining P.G. with a spit sock and head stabilization while others applied restraints; Henry held P.G.'s head for about six minutes during restraint and prepared to administer a sedative; video of the restraint captured the incident.
- Henry had prior training/awareness of head-holding policies; December 2007 Nurse Leadership Council minutes and January 2008 shift discussions discouraged head holding; PRO ACT refresher five days before the incident advised monitoring breathing, but no written policy foreclosed head-holding.
- Hospital policy 4.201 defined physical restraint and referenced PRO ACT principles; Henry attended PRO ACT refresher noting not to touch head, but instructor said no written policy existed; hospital management had expressed a preference to discourage head-holding but recognized some head contact might be necessary.
- Henry was dismissed April 29, 2008 by the appointing authority for alleged violations of policy and for physical abuse; the Department later sought to uphold the dismissal as for the good of the service and under DOR 2.205; the PAB upheld the dismissal, but the circuit court later vacated the PAB decision as unsupported by substantial evidence.
- The appeal centers on whether the PAB had substantial evidence to support the two bases for dismissal (good of the service and DOR 2.205), and whether the specific policy violations were proven; the court ultimately held the PAB decision unsupported by substantial evidence and vacated the dismissal.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether PAB’s dismissal for cause was supported by substantial evidence | Henry lacked proof of abuse or policy violations | Department proved willful policy violations and abuse | No; PAB decision not supported by substantial evidence |
| Whether Henry violated Fulton Hospital Policy 4.201 by head-holding | Oral admonition does not equal written policy | Oral directive constitutes policy | No; no substantial evidence of violation of 4.201 |
| Whether Fulton Nursing Policy VII-N.007 was violated | Video does not show prohibited conduct | Policy prohibited such restraint methods | No; evidence insufficient to prove violation of VII-N.007 |
| Whether DOR 2.205 grounds supported dismissal | No proof of physical abuse under policy | Disputed conduct constituted abuse | No; insufficient evidence of physical abuse under DOR 2.205 |
Key Cases Cited
- Lombardi, Inc. v. Smithfield, 11 A.3d 1180 (Del. 1989) (irreparable harm is the most important factor for a preliminary injunction)
- Hearth Admins., Corp v. City of New York, 394 F.3d 382 (2d. Cir. 2012) (public policy arguments rarely factor heavily into the outcome of a motion for preliminary injunction)
- Barzingus v. Wilheim, 306 F.3d 17 (10th Cir. 2010) (motion to compel arbitration standard is similar to summary judgment standard)