This article from Vital Law discusses a physician’s failed attempt to show he was discharged because of an ADA claim violation. Hospital’s adherence to substance abuse policy forecloses inference that prior substance abuse disorder caused discharge due to an ADA claim.
A hospital did not violate the Americans with Disabilities Act (ADA) when it terminated its medical director of anesthesia following a certified positive drug test, a federal court in Indiana determined. Granting the hospital’s motion for summary judgment and denying the physician’s cross-motion, the court concluded that the record lacked evidence from which a factfinder could determine that disability was a but-for cause of the termination. No reasonable jury, the court concluded, could find that the physician was discharged because of his prior substance abuse disorder rather than pursuant to the hospital’s substance abuse policy (Carter v. The Health and Hospital Corporation of Johnson County, No. 1:23-cv-01048-SEB-MKK (S.D. Ind. Feb. 11, 2026)).
The physician was hired in October 2020 as medical director of anesthesia and a practicing anesthesiologist at Johnson Memorial Hospital. During the hiring process, the physician disclosed that he had received treatment approximately seven years earlier for a substance abuse disorder and had remained sober since that time.
In September 2021, the hospital conducted a department-wide audit of controlled substances after identifying discrepancies between the amounts of narcotics anesthesia providers had withdrawn from the automated dispensing system and the amounts documented as administered to patients or properly wasted.
The audit caused the hospital to drug test the doctor. The physician’s test was reported as “non-negative” and was sent for confirmation. Confirmatory testing detected hydromorphone above the screening cutoff level.
The hospital’s substance abuse policy provided that drug tests were to be reviewed by a medical review officer, defined as a licensed physician designated by hospital administration with appropriate medical training to evaluate positive test results and determine whether there was a legitimate medical explanation. If the medical review officer determined that no legitimate explanation existed beyond unauthorized drug use, the policy stated that employees with verified positive test results would be discharged. [R&A Comment – We discuss the importance of a medial review officer in your drug testing program here.]
The physician did not dispute the accuracy of the laboratory findings themselves but instead challenged the medical review officer’s interpretation of those findings.
The physician filed suit after receiving a right-to-sue notice from the EEOC, alleging that the hospital terminated him because of his prior substance abuse disorder in violation of the ADA. He argued that the hospital’s reliance on the certified positive drug test was a pretext for discrimination, while the hospital maintained that it acted pursuant to its substance abuse policy following the medical review officer’s final determination. In assessing the physician’s ADA claim, the court explained that the central inquiry was whether the evidence would allow a reasonable factfinder to conclude that disability caused the termination.
The court found that, even assuming the prior substance abuse disorder qualified as a disability and that the physician was otherwise qualified for his position, there was no evidence that the termination occurred because of that disability.
James P. Randisi, President of Randisi & Associates, Inc., has been helping employers protect their clients, workforce and reputation through implementation of employment screening and drug testing programs since 1999. This post does not constitute legal advice. Randisi & Associates, Inc. is not a law firm. Always contact competent employment legal counsel. To learn more about the rights of employees who test positive for marijuana, Mr. Randisi can be contacted by phone at 410.336.0287 or Email: info@randisiandassociates.com or the website at Randisiandassociates.com
