I. Introduction
Plaintiff Lisa M. Rohrbough filed suit pursuant to 42 U.S.C. § 1983, alleging her former employer, the University of Colorado Hospital Authority (the “Hospital”), and her former manager, Margaret Frueh, fired her in retaliation for exercising her First Amendment rights. Rohrbough appeals the district court’s grant of summary judgment. The district court concluded Rohrbough’s speech was unprotected because it was made pursuant to Rohrbough’s official duties as a “Transplant Coordinator” in the Hospital’s Heart Transplant Unit. Exercising jurisdiction under 28 U.S.C. § 1291, we AFFIRM.
II. Background
Rohrbough worked for the Hospital from November 9, 1992, until June 1, 2004, when the Hospital terminated her employment. During the final five years of her employment, Rohrbough served as the “Transplant Coordinator” in the Hospital’s Heart Transplant Unit. In 2002, she became concerned about patient care in the Unit due to what she perceived to be a “staffing crisis.” Specifically, Rohrbough believed the staffing problems were affecting the quality of care the Hospital’s patients received because labs and other medical tests were performed “extremely late” and charts were not reviewed in a timely fashion. Rohrbough raised her concerns with a number of hospital employees “[bjecause [she] wanted the patient care issues that were causing patient negative outcomes to be addressed, and [because she] believed everyone needed to be held accountable for their action or inaction.”
First, Rohrbough raised her concerns to Nurses Nancy Ireland and Linda Stepien, and Karin Keller, her day-to-day supervisor. These conversations took place both inside and outside the workplace. She next raised her concerns with Margaret Frueh, her manager, and Dr. JoAnn Lindenfeld, the director of the Hospital’s Heart Transplant Unit. Rohrbough also discussed the staffing issues during an appeal of her 2002 performance evaluation with Colleen Goode, vice president of patient services and the Hospital’s chief nursing officer, and Joyce Cashman, the Hospital’s executive vice president. Still frustrated by the Hospital’s lack of response, she took her concerns to Dennis Brimhall, the president of the Hospital. Rohrbough thought it appropriate to meet with Brimhall given that her concerns were “related to [her] employment because they were patient care issues.”
While her performance evaluation appeal was pending, Rohrbough learned of a possible heart transplant misallocation and cover-up at the Hospital. She reported information regarding this alleged misallocation and cover-up to the United Network for Organ Sharing (“UNOS”), an entity established by Congress to administer organ transplants. As Transplant Coordinator, Rohrbough was responsible for contacting UNOS to place patients on transplant lists, removing patients from transplants lists, and providing information about a particular transplant. In this particular instance, however, Rohrbough testified she called UNOS because her impression was that Dr. Lindenfeld was not going to be truthful in her report to UNOS. She contacted the UNOS representative from her home, identified herself as the Hospital’s Transplant Coordinator, and described her basis for believing a heart had been misallocated at the Hospital. She also discussed the alleged heart misallocation with a reporter from the Denver Westward, a print weekly.
In February 2004, Rohrbough received a performance evaluation that indicated she had failed to meet Hospital standards. In March 2004, several of Rohrbough’s coworkers approached the Hospital’s human resources department to express concerns about Rohrbough’s poor job performance and her negative impact on the work environment. In response, Rohrbough was placed on administrative leave. She was reinstated, but failed to improve her performance. As a result, Frueh terminated Rohrbough’s employment on June 1, 2004. In explaining her decision to terminate Rohrbough, Frueh testified that “[a]t no time during Ms. Rohrbough’s employment at the Hospital did I have knowledge of her reports to UNOS regarding the alleged ‘heart-switch cover-up.’ ... Therefore, I could not have disciplined Ms. Rohrbough for this alleged reporting.”
Rohrbough filed suit against the Hospital and Frueh, in both her individual and official capacity, alleging the Hospital impermissibly retaliated against her for exercising First Amendment rights. Rohrbough specifically alleges her speech relating to the Hospital’s staffing crisis, the heart misallocation, and incident reports were protected under the First Amendment. The Hospital moved for summary judgment, arguing that all of Rohrbough’s speech was made pursuant to her official responsibilities and therefore unprotected under Garcetti.
The district court entered summary judgment in favor of the Hospital. It held that under the standards developed in the wake of Garcetti, it was “clear that all the speech for which plaintiff was allegedly retaliated against [fell] squarely within the scope of her official duties.” The district court held Rohrbough’s complaints about inadequate staffing “by her own admission, directly related to her concerns about patient safety and welfare” and fell squarely within her “overarching job responsibility as a nurse” to ensure those concerns were met. Similarly, the district court held the occurrence reports were also written pur
III. Analysis
A. Standard of Review
“We review the district court’s grant of summary judgment for the [defendants] de novo, applying the same legal standard as the district court.” Shero v. City of Grove, Okla.,
B. Freedom of Speech Retaliation Claim
In Garcetti v. Ceballos, the Supreme Court reaffirmed that “the First Amendment protects a public employee’s right, in certain circumstances, to speak as a citizen addressing matters of public concern.”
To balance these competing interests, this court employs the inquiry set out in Pickering v. Bd. of Educ.,
(1) whether the speech was made pursuant to an employee’s official duties;
(2) whether the speech was on a matter of public concern; (3) whether the government’s interests, as employer, in promoting the efficiency of the public service are sufficient to outweigh the plaintiffs free speech interests; (4) whether the protected speech was a motivating factor in the adverse employment action; and (5) whether the defendant would have reached the same employment decision in the absence of the protected conduct.
Dixon v. Kirkpatrick,
The first three steps of the Garcetti/Pickering analysis are issues of law “to be resolved by the district court, while the last two are ordinarily for the trier of fact.” Brammer-Hoelter,
The Garcetti Court did not have the opportunity to articulate “a comprehensive framework for defining the scope of an employee’s duties,” because the parties did not dispute the presence of the factor.
In general, the court has focused on whether the speech activity “stemmed from and [was of] the type ... that [the employee] was paid to do,” Green,
Regarding the content of an employee’s speech, the Tenth Circuit has recognized that not all speech “about the subject matter of an employee’s work [is] necessarily made pursuant to the employee’s official duties.” Brammer-Hoelter,
In addition, the court has not foreclosed unauthorized speech or speech “not explicitly required as part of [an employee’s] day-to-day job” from being within the scope of that employee’s official duties under Garcetti/Pickering. Green,
Regarding the employee’s chosen audience, or chosen method of disseminating speech, the court has similarly refrained from establishing per se rules for determining whether speech is made pursuant to an employee’s official duties. For example, in Brammer-Hoelter, the speech regarding the budgeting of teacher salaries and staffing levels was not within the scope of the plaintiffs’ official duties in part because the speech occurred outside the school, after hours, and with “ordinary citizens and parents.”
By contrast, speech directed at an individual or entity within an employee’s chain of command is often found to be pursuant to that employee’s official duties under Garcetti/Pickering. See, e.g., Casey,
In this case, Rohrbough alleges she was retaliated against because of her communications regarding the Hospital’s alleged staffing crisis, the alleged instances
1. The Alleged Staffing Crisis
Rohrbough’s communications with other Hospital employees regarding the alleged staffing crisis were made pursuant to her official duties. Her own admissions about why she was concerned about the alleged staffing crisis, as well as other undisputed facts about her job at the Hospital, demonstrate this speech was within the scope of her official duties as Transplant Coordinator in the Hospital’s Heart Transplant Unit. Rohrbough admits she had the conversations about the staffing crisis because the staffing crisis affected her ability to do her job and provide appropriate patient care. Furthermore, she directed her speech toward other hospital employees such as Karin Keller, her day-to-day supervisor, Margaret Frueh, her manager, and Dr. Lindenfeld, the director of the Transplant Unit.
Rohrbough correctly points out that a government employee’s speech regarding staffing, although work-related, may fall outside the employee’s official duties. See Brammer-Hoelter,
2. The Occurrence Reports
The undisputed facts also establish that Rohrbough’s eleven Occurrence Reports were generated pursuant to her official duties. She wrote these reports at the behest of Susan West of the Hospital’s Risk Management Unit. Furthermore, Hospital policies required that all employees, including Rohrbough, create Occurrence Reports to report unsafe conditions, errors, and near misses. Rohrbough’s reporting about the conditions affecting her ability to fulfill her duties as Transplant Coordinator at the Hospital undoubtedly was an activity that “stemmed from and [was of] the type ... that she was paid to do.” Green,
Rohrbough nevertheless argues the communications in these reports were not within the scope of her official duties because drafting them was not something she was “actually expected to do.” Rohrbough relies on Garcetti’s focus on “the duties an employee actually is expected to perform,”
These arguments misconceive the thrust of the analysis in Tenth Circuit case
Rohrbough’s Occurrence Reports were similarly made pursuant to her duties as Transplant Coordinator. Her reports documented the eleven instances of substandard care she observed while fulfilling her job responsibilities. They detailed several cases in which Rohrbough felt the Heart Transplant Unit’s patients had received inadequate care following medication changes, lab results, and other medical tests. Like the teachers’ complaints about the school’s curriculum and pedagogy in Brammer-Hoelter, these reports were all made pursuant to Rohrbough’s official duties as Transplant Coordinator within the Hospital’s Heart Transplant Unit. Her assertions that her immediate supervisors did not order her to write the reports and that other nurses did not write similar reports does not change the analysis.
3. The Alleged Heart Misallocation
Finally, Rohrbough’s claim that she was retaliated against for her speech regarding the alleged heart misallocation also fails as a matter of law. On appeal, she argues her communications with UNOS, the Colorado State Board of Nursing, and the Westword newspaper reporter about the alleged organ misallocation at the Hospital were all protected under the First Amendment. An examination of the record, however, reveals that Rohrbough failed to raise her communications with the Colorado State Board of Nursing and the West-word reporter in the district court. Her allegations regarding the “Heart Switch Cover up” appear in paragraphs 18-31 of her complaint. Those paragraphs state that Rohrbough initially directed her concerns to the following individuals: (1) Dr. Ronald Zolty, an attending physician in the Heart Transplant Division; (2) Dr. JoAnn Lindenfeld, the Division’s director; (3) Karin Keller, Rohrbough’s supervisor; (4) Nancy Ireland, a nurse within the Division; (5) Joyce Cashman, the Hospital’s executive vice president; and (6) Colleen Goode, the Hospital’s vice president of patient services and chief nursing officer.
Due to her continuing concerns about the situation, Rohrbough then alleges she called UNOS and spoke with a representative who was already investigating the incident. Nowhere in her complaint does she allege that she contacted any other individuals or outside entities, or that she was retaliated against for engaging in such speech. In addition, Rohrbough completely failed to raise these issues in her response to the Hospital’s motion to dismiss or in her subsequent response to the Hospital’s motion for summary judgment. As a consequence, this court will not consider the purported communications with the Colorado State Board of Nursing and the Westword reporter as part of the allegedly protected speech. Walker v. Mather (In re Walker),
Rohrbough’s communications with other Hospital employees regarding the alleged heart misallocation and UNOS cover-up fall within the scope of her official duties. The undisputed facts demonstrate Rohrbough’s responsibilities included contacting UNOS to list a patient for an organ transplant and to change a patient’s status. Her internal discussions about these duties certainly “stemmed from and were the type of activities that she was paid to do.” Green,
Rohrbough’s additional reporting to UNOS, an outside agency that Rohrbough was nevertheless required to maintain some official contacts with, presents a closer question. This court, however, need not resolve the question of whether this additional reporting fell within the scope of Rohrbough’s official duties because her claim cannot survive the fourth prong of the Garcetti/Pickering analysis. Step four looks to “whether the protected speech was a motivating factor. in the adverse employment action.” Dixon,
Rohrbough’s supervisor, Margaret Frueh, testified that she had no knowledge of Rohrbough’s UNOS reporting prior to terminating Rohrbough. Specifically, Frueh testified that “[a]t no time during Ms. Rohrbough’s employment at the Hospital did I have knowledge of her reports to UNOS regarding the alleged ‘heart-switch cover-up.’ ” Against the weight of this statement, Rohrbough simply argues that she has “presented enough evidence for a reasonable jury to find that her speech was indeed the motivating factor in her termination.” Specifically, she contends that Frueh’s credibility should be determined by a jury and that discussions regarding the “heart transplant continued through the spring and summer of 2003— just before her September 2003 performance evaluation.”
The record certainly supports a conclusion that Rohrbough engaged in a number of discussions with a variety of Hospital employees about the alleged misallocation of the heart. This evidence might allow a jury to infer that Frueh knew of Rohrbough’s involvement in the incident. However, there is no evidence whatsoever that Rohrbough told Frueh, or any of her other superiors, of her decision to report the incident to UNOS. Accordingly, she has failed to present sufficient evidence for a reasonable trier of fact to find that her communications with UNOS were a motivating factor in her termination.
IV. Conclusion
For the foregoing reasons, all of Rohrbough’s claims fail as a matter of law. Her discussions with other Hospital employees about the alleged staffing crisis, the alleged incidents of sub-standard care,
