Faulkner v. Lucille Packard Salter Children's Hospital

Background

Bethan Faulkner, a registered nurse with a Doctor in Nursing Practice, worked for nearly ten years at Lucile Salter Packard Children’s Hospital at Stanford. She became the interim patient care manager of the neonatal intensive care unit in December 2018 and the permanent patient care manager in June 2019. She supervised more than 150 nurses. The hospital terminated her employment on November 11, 2020.

After summary judgment, two claims remained: wrongful discharge in violation of public policy and retaliation under California Health and Safety Code section 1278.5, the state’s medical-whistleblower statute. The parties stipulated the wrongful-discharge claim, meaning the jury would decide it, while the court would decide the section 1278.5 claim. After a seven-day trial, the jury found for the hospital, answering “No” to whether Faulkner proved that her report or complaint about unsafe patient care was a substantial motivating reason for her discharge.

Legal Standard

Section 1278.5 generally prohibits a health facility from discriminating or retaliating against a patient, employee, medical staff member, or other health care worker for presenting a grievance, complaint, or report concerning the quality of patient care, services, or conditions. To establish an initial case under the statute, a plaintiff must show that she made a complaint to the hospital or medical staff, that the complaint concerned the quality of patient care, and that the hospital retaliated against her for making it.

The statute also creates a rebuttable presumption of retaliation when the adverse action occurs within 120 days after the employee files a grievance or complaint. A rebuttable presumption shifts the burden of producing evidence unless the opposing party provides evidence countering the presumption.

Court’s Analysis

The court did not decide whether the jury’s finding on the wrongful-discharge claim legally controlled the section 1278.5 claim. Instead, it independently found that Faulkner had not presented enough evidence to prevail on the statutory claim.

The court found that Faulkner’s complaints largely concerned her treatment by Dr. Lisa Bain, a doctor in the neonatal intensive care unit, rather than patient safety. The only formal complaint during the relevant period was a September 2020 iCare report. That report focused on Dr. Bain’s unprofessional behavior toward Faulkner, described Faulkner’s efforts to address that behavior, and classified the matter as “Professional Conduct” with “No Patient Involved.” Although the report briefly referred to the effect of Dr. Bain’s conduct on patient safety, the court found that reference insufficient to make the complaint one about the quality of patient care.

The court reached a similar conclusion about a 28-page timeline Faulkner prepared for human-resources personnel. The timeline primarily described Dr. Bain’s allegedly unprofessional or bullying conduct toward Faulkner and, to some extent, Dr. Alexis Davis’s conduct. The court found that the timeline did not adequately notify the hospital that Faulkner was making a complaint about the quality of patient care. The court also found that the behavior Faulkner described began when she first became interim manager, before the alleged protected complaints, and therefore could not have been retaliation for those complaints based on her own chronology.

The court also rejected Faulkner’s reliance on a November 2, 2020 email about the hospital’s Aquadex trial program for very sick babies with kidney failure. The court found that the email concerned staffing and the logistics of operating the Aquadex machine, not a complaint about the quality of patient care. The court further stated that there was no trial evidence supporting counsel’s argument that the hospital viewed the Aquadex program as a major source of revenue.

Because the court found that Faulkner had not presented a qualifying patient-care complaint, it concluded that she was not entitled to the statutory presumption of retaliation. The court nevertheless stated that, even if the presumption applied, the hospital rebutted it with sufficient evidence that Faulkner was terminated for performance-related reasons rather than medical whistleblowing. That evidence included concerns about her management priorities, negative feedback from colleagues, and testimony that she undermined a new evidence-based neonatal line setup intended to reduce infection risk. The court acknowledged that the hospital’s termination process lacked expected progressive discipline and that the termination letter appeared hastily written and contained inaccuracies, but it still found the evidence insufficient to establish a statutory violation.

Disposition

The court found that Faulkner failed to meet her burden on her Health and Safety Code section 1278.5 claim. The court also denied Faulkner’s request to present additional evidence. The court explained that the parties had agreed the claim would be tried to the court using the same evidence presented to the jury, and it declined to reopen the evidence after Faulkner had rested and the parties had completed additional examination and closing argument.