Labor & Employment Law Daily Wrap Up, RETALITATION—E.D. Mo.: Greek neurosurgery resident advances FMLA retaliation claims against two supervisors, (Sep 28, 2026)

By Nicholas Kaster, J.D.

Because the court would not consider factual allegations not raised in the complaint, it dismissed FMLA retaliation and Title VII claims against the hospital.

An FMLA retaliation claim brought by a Greek national neurosurgery resident against two supervisors survived a motion to dismiss. A federal district court in Missouri held that the complaint alleged facts from which a person could infer that the supervisors were acting in the interest of their employer when they interfered with the employee’s FMLA rights. The court also allowed the employee’s claims under the Missouri Whistleblower Protection Act against the hospital employer to go forward. However, the court dismissed FMLA retaliation claims against the hospital and Title VII discrimination claims against the hospital and the two supervisors (Alexopoulos v. SSM Health St. Louis University Hospital, No. 4:25-cv-00988-MAL (E.D. Mo. Sept. 23, 2026)).

The employee was a neurosurgery resident who worked at SSM Health St. Louis University Hospital (SSM-SLUH). In 2018, the employee—a Greek national—was granted a J-1 visa sponsorship for up to nine years to allow him to complete the neurosurgery residency program. The employee’s J-1 visa was strictly bound to the program.

Vulnerability exploited. He alleged that the hospital and two supervisors exploited this vulnerability by coercing him into accepting excessive work at his workplace, threatening him with termination that would jeopardize his immigration status, and inflicting punitive measures such as extra duties and extended hours for making complaints about patient safety and working conditions.

FMLA request. In June 2024, the employee received news that his widowed mother had been found bedridden and required 24-hour care, following the recent death of his father. Under duress, he submitted his involuntary resignation email, but upon learning that the FMLA does not require managerial approval, he rescinded his resignation and submitted an FMLA request to care for his ailing mother. About a month later, the employee was involuntarily dismissed from the program while on FMLA leave. He has not been able to secure employment in the United States and is also prevented from working abroad, as hospitals require certification of his training and work experience over the past six years.

The employee brought suit against his hospital employer and the two physician supervisors alleging FMLA retaliation, Title VII discrimination, discrimination, retaliation, and harassment in violation of the Missouri Human Rights Act (MHRA), and violation of the Missouri Whistleblower Protection Act. The hospital and supervisors moved to dismiss the claims.

Joint employers. A plaintiff may bring FMLA and Title VII claims only against an employer. The employer’s residency contract showed that he was employed by SSM Health Care Group (SSMHCG), not SSM-SLUH. The employee, however, argued that the two entities operated as joint employers because the residency program was operated through the hospital’s facilities, under its management and policies, and subject to its human resources and compliance structure. SSM-SLUH and its affiliated entities jointly administered payroll, benefits, training, and leave policies, and the employee’s work was supervised by physicians and administrators employed interchangeably across the entities. But these allegations did not appear in the employee’s complaint. Because the complaint did not state these facts, he failed to demonstrate a joint employer theory.

The employee argued that the two entities operated as an integrated enterprise because the entities shared personnel systems, facilities, and administrative infrastructure, reported through the same senior management structures within SSM Health, had overlapping directors and executives, there was centralized control over labor relations, and operated under the SSM Health corporate umbrella, sharing tax identification, benefit plans, and funding streams. However, none of these allegations appeared in the complaint. Because the court would not consider factual allegations not raised in the complaint, the employee failed to plead an integrated enterprise theory. Accordingly, the court dismissed the FMLA retaliation and Title VII claims against SSM-SLUH.

Claims against supervisors. The court dismissed the Title VII claim against the two supervisors because Title VII does not impose liability on co-workers or supervisors, who the complaint did not allege to be “employers” in the typical dictionary-definition sense of the word. But the court denied the motion to dismiss the FMLA claim against the supervisors.

The court held that the supervisors were “employers” as the FMLA defines the term in 29 U.S.C. § 2611(4)(A)(ii)(I)—as persons who act “in the interest of an employer.” The complaint alleged facts from which a person could infer that the supervisors were acting in the interest of their employer when they interfered with the employee’s FMLA rights. The complaint stated that one supervisor was the Program Director of Neurosurgery and that he oversaw training of residents such as the employee. The complaint further stated that the other supervisor was the Division Director of Neurosurgery. Both worked at SLU Hospital, which is where the employee worked as a neurosurgery resident. These are positions of power that imply that their decisions and actions were taken “in the interest of [their] employer,” said the court.

In response, the supervisors argued that they could not be held liable under the FMLA because the employee did not allege that either had any authority over his leave, made decisions regarding his FMLA eligibility, or otherwise interfered with his rights under the statute. The court found this argument unpersuasive. Maybe the complaint failed to use those exact words, said the court, but the gist of the complaint was that the two supervisors were involved in such decisions and interfered (directly or indirectly) with his rights under the statute.

Additionally, said the court, this argument failed because it reads liability requirements into FMLA discrimination that do not exist. An employer is “any person who acts, directly or indirectly, in the interest of an employer.” Such employers may not “interfere with, restrain, or deny the exercise of” FMLA rights. The complaint alleged interference with FMLA rights by the supervisors. The court said it was unaware of any Eighth Circuit or Supreme Court precedent requiring more. Therefore, the court denied dismissal of this claim against the two supervisors.

MHRA claims. The employee’s claim under the MHRA for discrimination was based on his ethnicity, ancestry, and national origin. However, the employee failed to obtain a right-to-sue letter from the Missouri Commission on Human Rights (MCHR). The employee asked the court to equitably waive this requirement because he believed MCHR’s refusal to issue a letter was legal error. The court, however, found no Missouri case law supporting the proposition that the requirement to obtain a right to sue letter may be equitably waived. Accordingly, the court dismissed the MHRA claims against the hospital.

Missouri Whistleblower Protection Act claims. Under the Whistleblower Protection Act (WPA), employers are prohibited from discharging an individual for reporting to the proper authorities an unlawful act or serious misconduct of his employer. The hospital argued that the court should dismiss the WPA claims against SSM-SLUH because SSM Health Care Group and its subsidiaries are religious organizations exempt from liability under the statute.

The court acknowledged that the WPA expressly excludes from the definition of “employer” corporations and associations owned or operated by religious or sectarian organizations. But the complaint did not state whether SSM-SLUH is owned or operated by religious or sectarian organizations. To make the case that SSM-SLUH is a religious organization, the hospital pointed to two documents: (1) a Declaration by the Holy See that SSMI Health ministries is a public juridic person; and (2) a section of the Official Catholic Directory, which it argued confirmed the Catholic Church’s declaration that SSM-SLUH is a religious organization operated by the Catholic Church.

The court declined to dismiss the WPA claims because the hospital failed to demonstrate that the court may take notice of these exhibits without converting the motion to one for summary judgment. First, the exhibits “are not obviously embraced by the pleadings,” said the court, because the documents were not referenced in the complaint.

Additionally, said the court, the hospital offered no explanation for why the Holy See Decree and the excerpt from The Official Catholic Directory are public records in that there were indicia of reliability. The court said it had no way to assess the indicia of reliability for these documents. Thus, it declined to take judicial notice of the exhibits. Accordingly, the court declined to dismiss the WPA claims against SSM-SLUH.

Finally, the court dismissed the MHRA and WPA claims against the two supervisors. Because the MHRA and WPA explicitly exclude individuals employed by an employer from their definitions of “employer,” the supervisors could not be held liable under these statutes.

The case is No. 4:25-cv-00988-MAL.

Judge: Lanahan, M.

Attorneys: Alan Grady Crone (Barrett & Farahany) for Georgios Alexopoulos. Amy L. Blaisdell (UB Greensfelder) for SSM Health St. Louis University Hospital, Philippe Mercier and Jeroen Coppens.

Companies: SSM Health St. Louis University Hospital

Cases: Retaliation CoverageLiability Discharge Discrimination NationalOrigin EmployeeLeave Immigration StateLawClaims Whistleblowers MissouriNews