Labor & Employment Law Daily Wrap Up, DISCRIMINATION—DISABILITY—M.D. Pa.: Fact issue as to whether ‘legally blind’ ENT physician posed safety risk to patients, (Dec 8, 2025)

By Kathleen Kapusta, J.D.

The doctor suffered from poor peripheral vision due to a retinal degenerative condition.

Finding medical evidence both supporting and diminishing a physician group’s assertion that an ENT physician who met the criteria for legal blindness posed a safety risk to patients that could not be mitigated through reasonable accommodation, a federal court in Pennsylvania denied summary judgment against his ADA claim. Allowing his breach of contract claim to also proceed to trial, the court found that while a reasonable jury could conclude the doctor materially breached his employment contract because he was unable to safely treat patients, he presented evidence he could do so and a fact issue existed as to whether the physicians group breached the contract by placing him on unpaid leave (Kao v. Mount Nittany Physicians Group, No. 4:24-CV-00101 (M.D. Pa. Dec. 5, 2025)).

In October 2020, the physicians group hired the doctor as an ENT and the parties entered into a Physician Employment Agreement (PEA). Two years later, the state entity responsible for investigating complaints concerning practitioners on behalf of the Pennsylvania Board of Medicine subpoenaed the physician group and related hospital (defendants) for the doctor’s personnel and credentials files.

Old eyes. During a subsequent investigation, a clinical coordinator reported that she had witnessed the doctor’s hands shaking numerous times and heard him state that his “old eyes can’t see well anymore.” The defendants then placed the doctor on leave while he obtained a note from his ophthalmologist and completed a functional capacity examination (FCE). The FCE results indicated the doctor had a sufficient functional capacity to return to work but his ophthalmologist stated that while the doctor had “excellent central vision,” his peripheral vision has been poor for many years due to a retinal degenerative condition. The ophthalmologist also told an otolaryngology physician with whom the defendants consulted that the doctor was considered legally blind due to his peripheral vision issues.

The defendants continued to investigate the doctor’s fitness to practice and another board-certified ophthalmologist stated that while he should not be driving, he should be able to perform his surgical procedures given his small operating field. He suggested, however, that the defendants review the doctor’s surgical privileges to eliminate procedures that required a larger field of vision.

Terminated. After additional consultations and meetings, the defendants determined that they could not accommodate the doctor and that his limitations posed a direct threat to patient safety. The doctor was placed on unpaid leave and ultimately terminated.

Direct threat. Moving for summary judgment on the doctor’s ADA claim, the defendants argued that he was not qualified for his position because he posed a direct threat to patient safety. They came to this conclusion, they asserted, after conducting an individualized assessment of his ability to safely treat patients. But based on the evidence in the record, said the court, a reasonable jury could conclude that the doctor did not pose a significant risk to the safety of patients and could have continued to perform the procedures he was already performing on patients.

That evidence included a letter from the doctor’s ophthalmologist stating that while the defendants should consult with “an actively practicing ENT surgeon” regarding whether he could safely practice, his vision had likely been “without change for 30-40 years, and he has been performing highly technical surgical procedures all these years with success.” In addition, the board-certified ophthalmologist who evaluated the doctor agreed that he should be able to perform his surgical procedures given his typically small operating field. There was also a letter from an otolaryngology physician who, after reviewing a list of procedures to determine if the doctor could continue to safely perform them, concluded that they fell “into to the category that the ophthalmologists have opined that [the doctor] should be able to continue to perform.”

The court acknowledged that there was also evidence from which a reasonable jury could conclude that the doctor could not safely continue to treat patients, including evidence his peripheral vision was well below what is considered normal in each eye as well as a written opinion from a board-certified otolaryngologist that given the doctor’s “level of disability, it would be difficult for any surgeon to meet quality standards and independently perform surgical procedures safely.”

Finding a genuine dispute of fact as to whether the doctor posed a significant risk to patients that could not be mitigated through reasonable accommodation, the court denied summary judgment against this claim.

Breach of contract. The doctor also asserted a breach of contract claim on which both parties moved for summary judgment. He contended that his contract with the physician group, the PEA, unambiguously stated that he could only be terminated upon his death or permanent disability, for cause, or with 60 days’ notice. The physician group, he asserted, placed him on unpaid medical leave prior before concluding he was permanently disabled and could not cease to pay him without providing him with 60-days’ notice of termination.

Letter. At issue was whether the physician group provided the doctor with 60 days’ notice to terminate him without cause. The doctor pointed to a February 2023 letter from the defendants to him stating that due to their determination he was “unable to perform the essential functions of [his] position,” he “will remain on continuous medical leave up to a maximum of six (6) months” and that he “may choose to continue [his] benefit elections during this six (six) month period.” This letter, he contended, constituted termination without cause and without the requisite notice.

For their part, the defendants pointed to the doctor’s testimony that in June 2023, while he was on unpaid leave, he received a letter providing him with 60 days’ notice of termination. Noting that the PEA did not address the issue of mandatory, unpaid leave or clearly state that the physician group was required to abide by the termination provisions prior to placing the doctor on leave, the court found he was not entitled to summary judgment on the issue of termination without notice because a reasonable jury could determine that he was not terminated when he was placed on mandatory, unpaid leave.

And while the doctor argued that the unpaid leave violated the PEA because it required the physician group to pay him the agreed upon salary, the physician group countered that it had no obligation to pay his salary because he “could not perform the essential functions of his position due to his medical condition” and the PEA required him to work “the required hours of a full time Otolaryngology Physician.”

Finding neither party was entitled to summary judgment, the court noted that the PEA not only stated that the doctor was required to work as a full-time otolaryngology physician and adequately treat patients, it also stated that the physician group could adjust his salary if there was a “material failure on [his] part to perform [his] duties under this Agreement.” While the defendants presented evidence from which a reasonable jury could conclude the doctor was unable to safely treat patients and thus perform his duties as an otolaryngology physician, there was also evidence from which a reasonable jury could conclude that he could continue safely treating patients. This genuine dispute of material fact, said the court, precluded summary judgment on this issue.

The case is No. 4:24-CV-00101.

Judge: Mehalchick, K.

Attorneys: Margaret Schuetz Coleman (O'Brien, Coleman & Wright) for Yi Kao. Karli Lubin Talmo (Ballard Spahr) for Mount Nittany Physicians Group.

Companies: Mount Nittany Physicians Group; Mount Nittany Medical Center

Cases: DisabilityDiscrimination Discrimination Discharge ContractClaims PennsylvaniaNews