Riano v. McDonald, 833 F.3d 830

James Riano, a VA registered nurse, examined male patients for genital warts and admitted he sometimes manipulated their penises (including applying pressure at the base and using moisturizing cream) to induce firmness or erections; he also used crude slang terms during examinations.
An Office of Inspector General investigation gathered written responses and interviews from patients; some complained, others said they were comfortable; medical leadership concluded Riano’s technique and language were inappropriate and not standard.
Riano was terminated; he appealed and received an administrative hearing with counsel, live testimony from medical experts, written patient statements, and an investigator’s report; the appeals board denied live patient testimony and denied a proposed corpsman witness as irrelevant.
The appeals board affirmed the termination based on an objective medical judgment that Riano’s examination technique and crude language were professionally inappropriate; the district court affirmed.
On appeal to the Seventh Circuit, Riano argued the board’s refusal to allow live patient testimony and cross-examination violated his due‑process rights and that live testimony could have shown patient comfort or ulterior motives. The court reviewed whether additional procedural protections were constitutionally required.

Issue	Riano's Argument	Government's Argument	Held
Whether denying live patient testimony/cross‑examination violated due process	Live testimony would show some patients were comfortable and reveal motives of complainants, so the lack of live testimony prejudiced his defense	Board’s written records and medical testimony resolved the core issues; patient subjective views and cross‑examination were unnecessary	Denial did not violate due process because the board’s decision rested on objective professional judgments and Riano’s own admissions; live testimony would not have changed outcome
Whether evidence of Riano’s Navy corpsman training should have been admitted	Training and common corpsman practices would explain and justify his technique and language	Corpsman training is not equivalent to registered‑nurse standards and thus irrelevant to professional expectations as an RN	Board correctly excluded the corpsman witness as irrelevant; Riano failed to show the exclusion affected the board’s objective-based decision

Carmody v. Bd. of Trs. of the Univ. of Ill., 747 F.3d 470 (7th Cir. 2014) (public‑employee property interest supports due‑process protections)
Mathews v. Eldridge, 424 U.S. 319 (U.S. 1976) (Mathews balancing test for required procedures)
Ringquist v. Hampton, 582 F.2d 1138 (7th Cir. 1978) (no required live testimony when it would not advance defense theory)
Clancy v. Geithner, 559 F.3d 595 (7th Cir. 2009) (lack of hearing not a due‑process violation absent material factual disputes)
Wozniak v. Conry, 236 F.3d 888 (7th Cir. 2001) (evidentiary hearing required only for material factual disputes)
Cleveland Bd. of Educ. v. Loudermill, 470 U.S. 532 (U.S. 1985) (due‑process entitlement to a meaningful opportunity to be heard)
Green v. Bd. of Sch. Comm’rs, 716 F.2d 1191 (7th Cir. 1983) (admission of conduct may make cross‑examination of accusers immaterial)
McNeill v. Butz, 480 F.2d 314 (4th Cir. 1973) (cross‑examination required or not depending on whether disputed facts were material)
Mann v. Vogel, 707 F.3d 872 (7th Cir. 2013) (restating Mathews balancing framework for procedural due process)