Natalie Slaughter v. Des Moines University College of Osteopathic Medicine
925 N.W.2d 793
Iowa2019Background
- Natalie Slaughter, a first-year medical student at Des Moines University (DMU), struggled academically in 2014–15, failing two required first-year courses and earning a cumulative GPA that supported dismissal under DMU policy.
- Slaughter began weekly counseling with DMU staff psychologist Dr. Emily Sanders in September 2014 for depression but did not consent to disclosure of therapy details to DMU faculty/administrators.
- DMU faculty (Academic Progress Committee, faculty advisor, CASE tutoring) repeatedly counseled and offered academic supports; Slaughter disclosed her depression to academic decision-makers on December 17, 2014.
- DMU offered accommodations/supports (extended pathways/5-year option, tutoring, counseling, permission to monitor lectures online), which Slaughter declined or did not pursue; she requested to keep electives while on probation and DMU refused per policy.
- Slaughter sued under the Iowa Civil Rights Act for disability discrimination, failure to accommodate, and retaliation; she abandoned discrimination and retaliation claims and appealed denial of a motion to impute therapist knowledge and grant of summary judgment on failure-to-accommodate.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Dr. Sanders’s confidential knowledge of Slaughter’s depression is imputed to DMU under agency law | Sanders was DMU-employed; her knowledge (from Sept. counseling) should be imputed to DMU, making DMU aware earlier | Statutory psychotherapist confidentiality (Iowa Code ch. 228) and HIPAA bar disclosure; privilege prevents imputing therapist knowledge | Not imputed: statutory confidentiality and duty not to disclose remove Sanders from agency-imputation rule; denial of imputation affirmed |
| Whether Iowa Code §622.10 bars using therapist communications outside litigation to impute knowledge | §622.10 forecloses disclosure/imputation | §622.10 is evidentiary; broader statutory confidentiality is §228.2 | Court declined to rely on §622.10 for imputation but relied on §228.2; §228.2/HIPAA prevent disclosure without consent |
| Whether DMU failed to reasonably accommodate Slaughter’s disability (elements: disability, notice, otherwise qualified, failure to accommodate) | Slaughter argued DMU did not engage in a good-faith interactive process and thus failed to identify reasonable accommodations (and that imputable earlier knowledge would matter) | DMU asserted it offered/attempted reasonable accommodations (counseling, tutoring, Extended Pathways, online lectures) and Slaughter identified no reasonable accommodation she requested that DMU refused | Summary judgment for DMU affirmed: undisputed facts show Slaughter identified no specific reasonable accommodation that would have enabled her to meet essential academic requirements |
| Whether the absence of a specific, refused accommodation or further interactive process precludes summary judgment | Slaughter contended interactive process could have yielded accommodations (e.g., medical leave) and that DMU’s failure to engage creates triable issue | DMU argued plaintiff must show a facially plausible accommodation and she did not; speculation insufficient to defeat summary judgment | Court held plaintiff must show a reasonable accommodation existed that would let her meet requirements; because she did not, summary judgment appropriate (majority). Dissent argued triable issues existed and Dr. Canby’s testimony suggested medical leave/remediation might have been possible |
Key Cases Cited
- John Q. Hammons Hotels, Inc. v. Acorn Window Sys., Inc., 394 F.3d 607 (8th Cir. 2005) (agency principle imputing employee knowledge to employer)
- Fagen v. Grand View Univ., 861 N.W.2d 825 (Iowa 2015) (psychotherapist privilege and confidentiality importance)
- Palmer Coll. of Chiropractic v. Davenport Civil Rights Comm’n, 850 N.W.2d 326 (Iowa 2014) (educational institutions’ duty to engage in individualized accommodation inquiry and deference to academic judgment)
- Regents of Univ. of Mich. v. Ewing, 474 U.S. 214 (U.S. 1985) (judicial deference to academic decisionmaking)
- Mershon v. St. Louis Univ., 442 F.3d 1069 (8th Cir. 2006) (elements for failure-to-accommodate claim in higher education)
- Dean v. Univ. at Buffalo Sch. of Med. & Biomed. Sci., 804 F.3d 178 (2d Cir. 2015) (distinguishable case where school denied a discrete leave and summary judgment was reversed)
- Stern v. Univ. of Osteopathic Med. & Health Scis., 220 F.3d 906 (8th Cir. 2000) (affirming summary judgment for medical school where student failed to identify reasonable accommodation)