Hospital Dr. Susoni, Inc.

National Labor Relations Board - Board Decisions

May 15, 2002

337 N.L.R.B. 537 (N.L.R.B. 2002)

HOSPITAL DR. SUSONI, INC. 537
Hospital Dr. Susoni, Inc. and Unidad Laboral de En­
fermeras(os) y Empleados de la Salud. Cases
24–CA–8204 and 24–CA–8524
May 15, 2002
DECISION AND ORDER
BY CHAIRMAN HURTGEN AND MEMBERS LIEBMAN
AND BARTLETT
On December 27, 2001, Administrative Law Judge
William G. Kocol issued the attached decision. The
General Counsel and Charging Party each filed excep­
tions and supporting briefs, and the Respondent filed an
answering brief.
The National Labor Relations Board has delegated its
authority in this proceeding to a three-member panel.
The Board has considered the decision and the record
in light of the exceptions and briefs and has decided to
affirm the judge’s rulings, findings,1 and conclusions and
to adopt the recommended Order.
ORDER
The recommended Order of the administrative law
judge is adopted and the complaint is dismissed.
Robert J. Debonis, Marisol Ramos Fernandez , and Miguel
Nieves Mojica, Esqs., for the General Counsel.
Tristan Reyes-Gilestra and Pedro Manzano Yates, Esqs. (Fid­
dler, Gonzalez & Rodriguez) of San Juan, Puerto Rico, for
Respondent .
Harold E. Hopkins Jr., Esq., for the Union.
DECISION
STATEMENT OF THE CASE
WILLIAM G. KOCOL, Administrative Law Judge. This case
was tried in San Juan, Puerto Rico, on October 16–19, 2001.
The charge, and the amended, second amended, and third
amended charges in Case 24–CA–8204 were filed January 27,
March 10, April 14, and June 30, 1999,1 respectively; the
charge in Case 24–CA–8524 was filed on January 7, 2000. An
order consolidating cases, third amended complaint and notice
of hearing (the complaint) was issued June 29, 2001. At the
hearing major sections of the complaint were settled by an in-
formal settlement agreement signed by all parties.2 The re­
maining portions in the complaint allege that Hospital Dr. Su­
soni, Inc. (Respondent) violated Section 8(a)(1) of the Act by
maintaining photographs of employees engaged in union activ-
1 The Board’s established policy is not to overrule an administrative
law judge’s credibility resolutions unless the clear preponderance of all
the relevant evidence convinces us that they are incorrect. Standard
Dry Wall Products, 91 NLRB 544 (1950), enfd. 188 F.2d 362 (3d Cir.
1951). We have examined the record and find no basis for reversing
the findings.
1 All dates are in 1999, unless otherwise indicated.
2 The settled case numbers have been deleted from the caption of
this case.
ity and violated Section 8(a)(3) and (1) by terminating employ­
ees Jose Santiago and Maritza Ramos. Respondent filed a
timely answer that admitted the allegations in the complaint
concerning jurisdiction, interstate commerce, labor organization
status, and agency status of named individuals; it denied the
substantive allegations.
On the entire record, including my observation of the de­
meanor of the witnesses, and after considering the briefs filed
by the General Counsel and Respondent, I make the following
FINDINGS OF FACT
I. JURISDICTION
Respondent, a corporation, operates an acute care hospital in
Arecibo, Puerto Rico, where it annually derives gross revenues
in excess of $250,000 and purchases and receives goods valued
in excess of $50,000 directly from points located outside the
Commonwealth of Puerto Rico. Respondent admits and I find
that it is an employer engaged in commerce within the meaning
of Section 2(2), (6), and (7) of the Act and that the Unidad de
Efermeras(os) y Empleados de la Salud (the Union) is a labor
organization within the meaning of Section 2(5) of the Act.
II. ALLEGED UNFAIR LABOR PRACTICES
A. Background
As indicated, Respondent operates an acute care hospital.
Julia Velez was the hospital administrator and Migdalia Ortiz
Mestre was human resources director at the times relevant in
this proceeding. Two elections were held among Respondent’s
employees in January. Although the record is not clear, it ap­
pears that one unit involved service and maintenance and tech­
nical employees. The election for this unit was held on January
15 and the Union lost. The Union filed objections to the elec­
tion and a hearing was held on the objections at some time not
specified in the record. The second election was held on Janu­
ary 20 for a unit of registered nurses. The Union apparently
won that election.
B. Santiago’s Discharge and a Related 8(a)(1) Allegation
Jose Santiago Batista worked for Respondent as a registered
nurse since about 1988. Santiago distributed authorization
cards and literature for the Union to fellow employees in the
parking areas and at the main entrance to Respondent’s facility.
He did this for about half an hour both before and after his shift
during the period of time between October 1998, until his ter­
mination. Almost all employees and supervisors used the en-
trance to the hospital at which Santiago distributed the union
literature. In or about November 1998, Migdalia Ortiz, Re­
spondent’s director of human resources,3 asked Santiago to
come to her office; there she told him that she knew that unions
were not prohibited but employees were not to hand out litera­
ture during working hours.4 Santiago also held union meetings
in his home and attended union meetings at the homes of other
3 Santiago described this person as Migdalia “Rios,” chief of human
resources. From context I conclude that he was referring to Migdalia
Ortiz.
4 The General Counsel does not allege that this conversation is
unlawful.
337 NLRB No. 82
538 DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD
employees, including alleged discriminatee Maritza Ramos.
These meetings occurred in late 1998 and early 1999.
As indicated above, the complaint alleges that Respondent
violated Section 8(a)(1) of the Act by maintaining photographs
of employees engaged in union activity. In support of this alle­
gation Santiago testified that on the day of the election, after he
voted, he met Union Representative Jose Castillo in front of the
front entrance to Respondent’s facility. While speaking to
Castillo about the election, Santiago noticed someone standing
above on the bridge of the hospital with a camera about 35–40
feet from them. Santiago and Castillo then both waved their
hands to the person with the camera. The General Counsel and
the Union did not call Castillo to corroborate Santiago’s testi­
mony, nor did they explain their failure to do so. Santiago
testified that about 3 days later he had to go to the office of
Julia Velez, Respondent’s hospital administrator. Velez was
not present on that occasion and while waiting for her Santiago
saw in Velez’ office a tripod with an easel. Santiago testified
that on the easel he saw seven to eight photographs of different
employees, including one of Maritza Ramos. That photo
showed Ramos handing out authorization cards to employees.
Some of the other employees that Santiago recognized were
among those active in the Union’s organizing drive; others he
was unable to state whether or not they were involved in the
campaign. He saw a photo of an employee handing out union
literature; he also saw a photograph of himself and Castillo
waving as they had done 3 days earlier after the election.
Velez, who was no longer employed by Respondent at the
time of the hearing, did not testify. Migdalia Ortiz Mestre was
director of human resources; at the time of the hearing she was
no longer working for Respondent. She testified that she vis­
ited Velez’ office on an almost daily basis while she was still
working for Respondent. She further testified that it is not
possible to see into Velez’ office from the area outside the of­
fice. Ortiz also testified that she never saw any bulletin board
in Velez’ office.
In resolving this allegation of the complaint, I first credit
Ortiz’ testimony that one cannot see into Velez’ office from the
waiting area outside. Her testimony in this regard was detailed
and convincing and although it was capable of being challenged
by other evidence, it was unrebutted. It follows from this find­
ing that Santiago must have been in Velez’ office, or at least
not in the waiting area, in order to see into the office. Yet
Santiago did not explain how he came to be in or near the office
of the hospital administrator instead of waiting for her in the
waiting area. It strikes me as unlikely that Velez would have
photographs of employees engaged in union activity displayed
in her office and yet allowed employees to have access to her
office. I also note that the General Counsel did not attempt to
corroborate Santiago’s testimony either by calling Castillo as a
witness or by subpoenaing the photographs.5 Moreover, as
explained below, I have determined that Santiago’s testimony
was not credible in other respects. Under these circumstances I
5 In his brief the General Counsel faults Respondent for failing to
call Velez’ secretary as a witness. However, the General Counsel has
failed to show that the secretary is an agent rather than an employee of
Respondent. Thus, no adverse inference is proper.
am unable to credit Santiago’s testimony concerning this alle­
gation of the complaint. I have taken into account the fact that
Velez did not deny Santiago’s testimony. However, Velez was
no longer employed by Respondent at the time of the hearing,
and thus no adverse inference can be made concerning her fail­
ure to appear. In any event the burden remains on the General
Counsel to present credible evidence to support the allegation.
I conclude that he has failed to do so and I will dismiss this
allegation of the complaint.
I return now to the events that lead to Santiago’s discharge.
Respondent contends that it fired Santiago because he did not
renew his professional license. Respondent’s rules require
nurses, among others, to maintain their professional licenses in
order to continue to be employed in that profession. Puerto
Rico law requires that registered nurses renew their licenses
every 3 years by taking courses totaling a certain number of
credit hours. Respondent’s policy allows employees to first use
accumulated vacation time to take the courses and renew their
license. If the employee has still failed to renew the license
after using vacation time, Respondent will place the employee
on leave without pay for a period of time to give the employee
another chance to obtain the license.
Respondent advised Santiago several times in 1998 that he
had to renew his license again. From November 2 to 27, 1998,
Respondent granted Santiago’s request for vacation so that he
could take the courses necessary to obtain his license. On De­
cember 3, 1998, Respondent notified Santiago in writing that he
still had not renewed his license, that his regular vacation time
had been exhausted, and that he would be placed on leave
without pay from November 30 to December 29, 1998, in order
to complete the necessary courses. On February 24, Respon­
dent notified Santiago in writing that his license was about to
expire and that he had not yet obtained a renewal. The written
notice warned that Santiago would be terminated if he failed to
do so.
Nonetheless, Santiago’s license expired on February 28; he
lacked 10–12 credit hours. He claimed that he had already
taken the courses necessary to obtain those credit hours but a
hurricane caused computer problems that resulted in the late
transmission of this information.6 Yet Santiago testified that he
took the necessary courses during his two periods of leave.
Santiago testified that he decided to take additional courses just
in case the certificates from the earlier courses did not arrive.
He testified that he told his supervisors, including Ortiz, that
the certificates were about to arrive, that they were late, and
that he had enrolled in other courses in case he had to take them
if the other certificates failed to arrive on time. He claimed that
he was told that the fact that he had enrolled in classes did not
guarantee that he was going to take them. Ortiz testified that in
March she asked Santiago why he had not renewed his license.
Santiago said that it was due to neglect on his part. He ex­
plained to Ortiz that he had a part-time job distributing news-
papers and that did not allow him time to take the needed
courses and that he made $14 per hour at that job, which was
more than he made working for Respondent. According to
6 The parties stipulated that Hurricane Georges hit the island of
Puerto Rico on September 18, 1998.
HOSPITAL DR. SUSONI, INC. 539
Ortiz, Santiago said that he was applying for a “heavy” driver’s
license and that would allow him to earn more money. Santi­
ago said that he was planning to take some courses and that he
had some agreement with another supervisor. Ortiz told him
that the policy was that he would be dismissed if he did not
have his license renewed. Santiago also told Ortiz that he had
planned to take some courses but that they were cancelled be-
cause of the hurricane. He showed Ortiz a program of courses
to be given in the future but gave no indication that he had reg­
istered for them.
Respondent’s counsel asked Santiago whether he was work­
ing elsewhere at the same time he was working for Respondent
in late 1998 and early 1999. He answered, “no”. Respondent’s
counsel then asked whether he was involved in the distribution
of a newspaper in Arecibo. Santiago again answered, “no”,
explaining that he did 1 week’s work but it was suspended be-
cause he had to work 11 p.m. to 7 a.m. shifts. Santiago then
testified that he worked for the newspaper before his termina­
tion and for about 6 months afterwards. Santiago then admitted
that he worked for the newspaper from June to December 1998,
and also from January to March. He explained that the news-
paper, a weekly publication, would call him when one of its
regular distributors did not show up for work. Santiago would
then distribute the newspapers to businesses on a designated
route. This process could take a day or two. When asked how
doing this work affected his ability to take the courses needed
to renew his license, Santiago testified that it did not affect him
because he already had taken the courses and was waiting for
the certificates. He denied that he was planning to obtain a
“heavy“ drivers license. However, he admitted that he told
Ortiz that he was working for the newspaper and that if he
worked fulltime for the newspaper he would be making good
money.
On March 2, Ortiz sent Santiago a memorandum that indi­
cated that they had met on March 1 and discussed the expira­
tion of his license. The memorandum advised Santiago that
effective March 3 he was terminated because he had failed to
renew his license. After his termination, the Union submitted
copies of courses that he had taken, but no license was submit­
ted. Santiago testified that about a month and a half after he
was fired, the certificates arrived and his license was renewed,
but he admitted that he did not submit the documents necessary
for the renewal to Respondent until June 22. After he was
fired, Santiago took the three courses needed to renew his li­
cense. He explained that after he was fired he had a lot of time
on his hands. He also explained that the courses could be used
for his next renewal. The General Counsel presented no docu­
mentary evidence to support any of Santiago’s testimony on
this matter, particularly evidence that the certificates from the
earlier courses finally arrived and based thereon his license was
renewed.
I now address the matter of credibility raised by the conflict­
ing testimony set forth above. I credit Ortiz’ version of the
pretermination conversation over Santiago’s. First, Santiago
was not fully forthcoming about the details of his conversation
with Ortiz; rather, important details had to be pried from him
on cross-examination. He also initially denied having worked
extensively on another job and only admitted that fact when
Respondent’s counsel revealed that he knew of Santiago’s work
for the newspaper. Also, Santiago’s testimony does not with-
stand scrutiny. For example, he testified that he completed his
course work before he began working for the newspaper, yet he
also admitted that he worked for the newspaper as early as June
1998. In light of the stipulation that the hurricane struck on
September 18, 1998, there is no explanation as to what ac­
counted for the delay in transmitting the certificates prior to the
time of the hurricane for the courses he allegedly took prior to
June. I also do not credit Santiago’s explanation concerning
why he was unable to renew his license. Importantly, the Gen­
eral Counsel failed to produce any documentary evidence to
support Santiago’s testimony that he had in fact taken all the
necessary courses in time to obtain the certificates and renew
his license. Moreover, Santiago’s testimony that the hurricane
delayed the transmission of the certificates rings hollow, espe­
cially in the absence of corroborating testimony from the course
givers that this was the case. When Santiago finally admitted
that he had been working for the newspapers, the inherent
probabilities based on the record as a whole point to the likeli­
hood that his outside work was the reason he failed to renew his
license. Significantly, there is no evidence that at the time he
was granted vacation time and leave without pay that he told
his supervisors that he had already taken the courses and thus
did not need the time off. Under all these circumstances, and
also based on my observation of the relative demeanor of the
witnesses, I do not credit Santiago’s testimony set forth above.
The General Counsel recognizes that Santiago could not con­
tinue to work as a nurse after his license had expired. How-
ever, the General Counsel contends that Respondent should
have allowed Santiago to work in other positions that did not
require a license. In support of this contention, Santiago testi­
fied that other employees who were unable to renew their li­
censes on time were allowed to work in other areas of the hos­
pital that did not require a license; this allowed them to con­
tinue to work while they attempted to renew their license. He
specifically mentioned Iris Toledo, Marilyn Maldonado, Made-
line De La Rosa, Zulma Rios, and Daisy Sanchez. Santiago
also testified that near the end of February he told Toledo, the
supervisor in the emergency room, that he had heard of a va­
cant position in quality control in the records room. He said
that he was interested in that position. Toledo replied that she
had no knowledge of the position but that she would find out
whether it was available. Toledo never got back to Santiago on
the matter. However, the General Counsel has failed to show
that there were any vacancies at the time Santiago’s license
expired.7
Ortiz gave the names of many other employees that have
been terminated because they failed to renew their professional
licenses. She testified that Respondent does not have a policy
7 In his brief the General Counsel contends that the unrebutted testi­
mony shows that there was an open position. However, it is the Gen­
eral Counsel’s burden to present reliable and credible evidence to prove
the existence of the vacancy. Santiago’s testimony that he told a super-
visor that he had heard that a vacancy existed is at least double hearsay.
Moreover, the General Counsel failed to establish a foundation for
Santiago’s knowledge. I conclude this testimony falls far short of
showing the existence of a vacancy.
540 DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD
of automatically transferring such employees to positions that
did not require licenses. She explained that De La Rosa was
unable to pass the exam to obtain her license. However, there
was an opening in a position that did not require a license and
she asked to be placed there and she was. Ortiz explained that
Sanchez was a registered nurse who asked to be transferred to
the position of coordinator of pre-admissions when that va­
cancy occurred. Thereafter her license expired, but her new
position did not require one. She, in any event, renewed her
license. Ortiz testified that she did not know a Zulma Rios, but
did know Zulma Gonzalez and Lourdes Rios. Gonzalez failed
to pass her exam and was terminated. Rios also failed to pass
her exam, but there was an opening in a position that did not
require a license and she took that position. Ortiz testified that
Teresa Maldonado had failed to present her license and Re­
spondent followed its policy and placed her on vacation. Dur­
ing vacation she was able to obtain the license and thus was
allowed to continue to work.
I once again credit Ortiz’ testimony over that of Santiago.
Her testimony was more detailed, her demeanor was confident,
and she was in a position to have more knowledge of the facts.
The shifting burden analysis set forth in Wright Line8 gov­
erns the determination of whether Respondent violated Section
8(a)(3) and (1) of the Act by discriminating against Santiago.
The Board has restated that analysis as follows:
Under Wright Line, the General Counsel must make a prima
facie showing that the employee’s protected union activity
was a motivating factor in the decision to discharge him.
Once this is established, the burden shifts to the employer to
demonstrate that it would have taken the same action even in
absence of the protected union activity.7/ An employer cannot
simply present a legitimate reason for its actions but must per­
suade by a preponderance of the evidence that the same action
would have taken place even in the absence of the protected
conduct.8/ Furthermore, if an employer does not assert any
business reason, other than one found to be pretextual by the
judge, then the employer has not shown that it would have
fired the employee for a lawful, nondiscriminatory reason.9/
_______________________________
7/ NLRB v. Transportation Management Corp., 462 U.S. 393,

400 (1983).

8/See GSX Corp. v. NLRB, 918 F. 2d 1351, 1357 (8th Cir.

1990) (“By asserting a legitimate reason for its decision and

showing by a preponderance of the evidence that the legiti­

mate reason would have brought about the same result even

without the Illegal motivation, an employer can establish an

affirmative defense to the discrimination charge.”)

9/ See Aero Metal Forms, 310 NLRB 397, 399 fn. 14 (1993).

T & J Trucking Co., 316 NLRB 771 (1995). This was fur­
ther clarified in Manno Electric, 321 NLRB 278 (1996).
Applying this framework, I have concluded above that Santi­
ago engaged in extensive union activity. I also conclude that
Respondent was aware of this activity. I base this conclusion
not only on the discussion that Santiago had with Ortiz about
8 251 NLRB 1083 (1980), enfd. 662 F.2d 899 (1st Cir. 1981), cert.
denied 455 U.S. 989 (1982).
the Union, but also on the open and public nature of Santiago’s
union activities in front of Respondent’s facility. The General
Counsel has thereby established the elements of union activity
and knowledge by the employer of that activity. However, I
have not credited the testimony offered by the General Counsel
to show that Respondent had antiunion animus. Nor can I con­
clude that the reason asserted by Respondent for Santiago’s
discharge was a pretext to disguise an unlawful reason. To the
contrary, I conclude that Santiago was terminated because he
failed to renew his professional license. While Respondent had
a policy of allowing employees who failed to renew their li­
censes to transfer into other positions, this policy applied only
when there were openings available; here the General Counsel
failed to show that any such opening existed at the time that
Santiago’s license lapsed. Under these circumstances, I con­
clude that the General Counsel has failed to meet his burden
under Wright Line and I shall dismiss this allegation of the
complaint.9
C. Ramos’ Discharge
Maritza Ramos Aquino worked as a registered nurse in the
hospital OBG maternity ward from September 1994 until her
termination on June 21, 1999. Ramos assisted the Union in its
organizing campaign by attending meetings, one of which was
held at her home. She also distributed union literature during
her break and lunch times near the front entrance to the hospi­
tal. Ramos was an observer for the Union at the election on
January 20, and appeared at the election site on January 15 to
be available to serve as an observer for the Union at that elec­
tion too. However, because she was not a member of that unit
she was not selected. Ramos also appeared at the hearing held
on the union's objections to the first election, but her testimony
was not required. Respondent’s supervisors saw Ramos there.
On July 4, Ramos worked the 11 p.m. to 7 a.m. shift in the
delivery room. She arrived, as she normally did, about 15 min­
utes prior to the start of the shift so that she could count the
narcotics. After Ramos counted the narcotics, the nurse on the
earlier shift, Sandra Cardona, gave Ramos an update on the
number and condition of the patients in the area. One of the
patients who had not yet been admitted was a woman who was
diagnosed as being 38 weeks pregnant, with asthma, fever, and
fetal tachycardia. The patient had been examined and admitted
by Dr. Edwin Candelario, who made the diagnosis. Among
other things, he concluded that because the fetus had tachycar-
dia10 a fetal monitor11 should be placed on the patient. Al-
9 In his brief the General Counsel argues that Ortiz’ testimony shows
that Respondent had a policy of that required it to suspend Santiago for
10 days before he was fired. I am not at all sure that Ortiz’ testimony
must be read in such a fashion. It appears to deal with normal progres­
sive disciplinary matters. Importantly, there is no evidence that the
other employees who were fired for failure to renew their licenses were
first suspended for 10 days.
10 Tachycardia is a medical condition of having an accelerated heart
rate. The normal fetal heart rate is between 120 and 160 beats per
minute. Fetal tachycardia is a heart rate of more that 160 heartbeats per
minute sustained for over 10 minutes. Among the causes of fetal tachy­
cardia is maternal fever. Fetal tachycardia is not a disease; it is an
indication that other things may be occurring to the fetus. However,
fetal tachycardia may progress to the point that insufficient oxygen gets
HOSPITAL DR. SUSONI, INC. 541
though the patient was not in labor Dr. Candelario admitted her
to the delivery room. At the time Ramos began working, the
patient already had a fetal monitor on her. According to
Ramos’ notes, the fetal monitor indicated that the fetal heart
rate was between 160 and 170 beats per minute. At about 1:50
a.m., Ramos removed the fetal monitor. At that time, the re-
cords showed that the fetal heart rate was 180 beats per minute
and the patient was showing regular contractions every 3 min­
utes. This was an indication that the patient might be going
into labor. There is a dispute concerning what the protocol is
for removing the fetal monitor. Ramos testified that the normal
practice is to remove the monitor after 30 minutes unless the
doctor has ordered that it stay there for a longer period of time.
Dr. Candelario testified that if a patient has fetal tachycardia the
rule is that the fetal monitor remains in place until the doctor
orders its removal. He explained that the fetal monitor is re-
moved after 30 minutes only when a patient is being adminis­
tered a nonstress test, a circumstance not present for the patient
in question. Dr. Candelario was present when Ramos began
working. In the written orders left by Dr. Candelario there was
no indication as to how long the fetal monitor was to remain on
the patient. Dr. Jose Rodriguez Gomez was president of the
board of directors for about 3–4 years. He was medical director
for about 10–15 years and director of obstetrics and gynecology
for over 25 years. He occupied the latter position from 1974
until 1999 or 2000 when he was dismissed from that position.
He was also removed from his position as medical director at
some point prior to July 1, 1996. While he was director of
obstetrics and gynecology, he was responsible, along with other
doctors, for setting the proper protocol to be used in the de­
partment. At the time of the hearing he was an attending physi­
cian at the hospital and occupied no supervisory position with
Respondent.12 Dr. Rodriguez testified that the proper protocol
concerning the use of fetal monitors was that for nonstress tests,
the fetal monitor remains in place for one-half hour or whatever
specific time the doctor orders, and then is removed. If a doc-
tor is using the fetal monitor throughout labor then the doctor
must specify that the fetal monitor is to remain in place. He
testified that such an order either had to be in writing or, if by
telephone, the order would be entered on the patient’s records
and signed by the doctor within 12–24 hours thereafter. Dr.
Rodriguez explained that verbal orders can be given to nurses,
who then should write the verbal order on the patient’s records.
However, those circumstances should be limited to instances
where the doctor is unavailable to make written orders. The
doctor should later confirm the verbal order by placing his sig­
nature next to order. Practical nurse Sandra Nunez worked
with Ramos on July 4. She testified that the protocol is for the
fetal monitor to be removed from a patient not in active labor
after one-half hour unless there are doctor’s orders to the con­
trary. I conclude, based on the testimony of Ramos, Nunez,
to the brain of the fetus. This in turn may cause brain damage and
learning disabilities that become apparent as the baby matures.
11 The fetal monitor is designed to measure the vital signs of a fetus,
particularly the heartbeat. It emits tracings that maybe read by the
doctor or nurse.
12 He also owned one share of Respondent’s stock.
and Dr. Rodriguez, that the protocol existing in the hospital
permitted nurses to remove the fetal monitor after one-half hour
unless ordered otherwise by the doctor. I conclude that Dr.
Candelario’s testimony to the contrary was not supported by a
sufficient foundation to show that it was, in fact, the policy at
the hospital as opposed to what Dr. Candelario believed the
policy should be.
There is also a dispute concerning whether Dr. Candelario
issued verbal orders to Ramos concerning the fetal monitor.
Dr. Candelario testified that he instructed the nurse on the ear­
lier shift to place the fetal monitor on the patient, but that he did
not rely on the nurse to present the patient to the nurses on the
next shift. He testified that he directly told Ramos that the
patient had acute asthma and fetal tachycardia and that he
wanted the fetal monitor to remain in place. Ramos testified
that he said nothing to her that morning. Nunez was present
before the start of the shift with Ramos and Dr. Candelario; she
did not see Dr. Candelario talk to Ramos that day before he left.
I conclude that Dr. Candelario did not personally give any ver­
bal orders to Ramos on July 4. I base this conclusion not only
on my observation of the relative demeanor of the witnesses,
but also on the fact that Ramos’ testimony was corroborated to
a degree by Nunez. I also consider it unlikely that Dr. Cande­
lario would issue a verbal order that the fetal monitor remain in
place until otherwise ordered when his written orders contained
no such instruction.
Ramos also had the patient transferred out of the delivery
room. She testified that her outstanding instructions were that
patients with contagious conditions but who are not in active
labor should not be admitted to the delivery room for fear that
the contagious conditions could be spread to other patients.
She included patients with a fever in that group. Ramos testi­
fied that she explained the condition of the patient to Carmen
Alicia Gutierrez Llanos, the supervisory nurse, and that
Gutierrez then instructed that the patient should be moved to
another room.13 Gutierrez told Ramos the room to which the
patient should be moved. Dr. Rodriguez also testified that a
pregnant patient with a fever who is not in active labor should
be removed from the delivery to avoid infections of other pa­
tients. Nunez physically transferred the patient to the other
location. She testified that patients with a fever are not kept in
the delivery room because that was a sterile area. She also
testified that Gutierrez instructed Ramos to transfer the patient
out of the delivery room. Dr. Candelario, however, explained
that he admitted the patient to the delivery room because the
patient would be under a higher level of monitoring there than
in other areas of the hospital. He further testified that the pa­
tient’s fever was likely caused by dehydration and therefore
there was no concern for harm to other patients in the delivery
room. He testified that if the nurse felt that the patient had an
infectious disease the nurse should have contacted him. He
13 Gutierrez, on the other hand, testified that Ramos did not tell her
that the patient had a fetal monitor in place and that if Ramos had done
so she would not have approved the transfer. However, Gutierrez ad­
mitted that she observed the fetal monitor on the patient earlier when
she assisted implanting an intravenous device on the patient. I con­
clude that Gutierrez’ test imony in this regard is an after-the-fact excuse
that it not credible.
542 DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD
described the errors attributed to Ramos as placing the patient
and fetus at risk. I conclude, based on the testimony of Ramos,
Dr. Rodriguez, and Nunez that the practice at the hospital was
to have patients with a fever removed from the delivery room
for fear that they might harm other patients there. Dr. Cande­
lario’s testimony that the patient was not contagious was based
on a medical diagnosis that he did not share with Ramos. Nor
is there any indication in his written orders that the patient
should remain in the delivery room notwithstanding her fever.
Dr. Candelario explained that he left the hospital on July 4
because after he checked the fetal monitor he felt that the fetal
heart rate was within the acceptable range of variability and
there were signs of fetal wellbeing. He concluded that the pa­
tient and fetus were in stable condition. Between 5:30 a.m. and
6 a.m. the next day, Dr. Candelario called the hospital and dis­
covered that the patient had been transferred out of the delivery
room to the surgery ward and that the fetal monitor had been
removed. He then called the delivery room and spoke to a
nurse; that nurse then handed the telephone to Ramos, saying
that Dr. Candelario wanted a report concerning what happened
to the patient. After some expressions of anger as to why the
patient had been transferred, Dr. Candelario told Ramos that
they were going to make a report on the incident. Dr. Cande­
lario ordered that the fetal monitor again be placed on the pa­
tient and he immediately returned to the hospital. There he
examined the patient, and determined that the patient was about
to go into labor. He performed an emergency Caesarian sec­
tion on the patient. The patient and baby were released from
the hospital on July 8 in good condition.
Thereafter Dr. Candelario did prepare a report. In that report
Dr. Candelario stated that on July 4 he personally presented the
patient to Ramos and emphasized to her that the reason the
patient was in the delivery room was because of fetal tachycar­
dia. He described how he later called the hospital to inquire as
to the condition of the patient and discovered that the patient
had been transferred out of the delivery room because the pa­
tient had a fever and that may have posed a risk to other pa­
tients in the area. He also learned that the fetal monitor had
been removed. In the report Dr. Candelario explained that the
patient’s presence in the delivery room did not pose a risk to
other patients because once treatment began the patient’s tem­
perature lowered into the normal range. Dr. Candelario stated:
Mrs. Ramos’ action constitutes an unnecessary risk with a real
potential medical legal case, since any type of defect in the
development of this baby until he/she is 21 years old may be
related to this incident.
On July 9, Marili Diaz Gonzalez, associate director of nurs­
ing, sent a memorandum to Doris Aponte, Esq., director of
institutional programs. Diaz described how Ramos told her that
she had transferred the patient from the delivery room and that
Dr. Candelario was upset by that action. Ramos had explained
to her that she made the decision to transfer the patient because
the patient was not in labor and had a fever. Diaz noted that her
review of the patient’s medical file supported Ramos’ com­
ments. Diaz noted that she spoke with Dr. Candelario, who
expressed his concern that the transfer created an unnecessary
risk for the patient and the baby. Diaz also noted that she spoke
with another nurse on the shift, who confirmed that she knew of
the transfer and that she sent a licensed practical nurse to take
the patient out of the delivery room. Finally, Diaz indicated
that she spoke with the nurse in charge of the surgery room,
where the patient had been transferred.
Respondent did not contact Ramos about the incident until
the day she was terminated on July 21. On that day, Ramos
was summoned to the office of Marili Diaz. She was accompa­
nied by another employee who also had been an active union
supporter. Ramos testified that Diaz told her that she wanted to
go over the incident of July 4. As they were reviewing the
matter, Diaz received a call from Ortiz. Diaz told Ortiz that she
did not think that the matter was as easy as she thought it was.
Diaz then told Ramos to go to Ortiz’ office. Ramos testified
that once there, Ortiz made a general reference to the incident,
began to cry, and told Ramos that they did not need her ser­
vices. Ortiz testified that she participated in the decision to
discharge Ramos, and that Ramos was terminated because her
conduct at the hospital put patients’ lives at risk. Ortiz inter-
viewed Marili Diaz, Doris Aponte, and Julia Velez. She evalu­
ated reports that had been made concerning the matter and re-
viewed Ramos’ personnel file. She considered the reports
made by Marili Diaz, Dr. Candelario, and others. Ortiz testi­
fied that she met with Ramos and her union representative on
the day that Ramos was terminated. Ortiz told Ramos that the
hospital had done an extensive analysis of what had occurred
concerning the July 4 incident and that the hospital could not
allow such a situation to occur because it caused risks for the
patients. She asked Ramos whether she had received instruc­
tions from anyone to transfer the patient and Ramos answered
that she had not, that she had done the transfer because the
patient had a high fever. Ramos was told that she was termi-
nated.14 Ortiz testified that she did not recall anyone crying at
the meeting. To the extent that there is a conflict between the
testimony of Ramos and Ortiz concerning the content of the
discharge conversation, I credit Ortiz. Her testimony was more
detailed and her demeanor more confident. She did not strike
me as someone who would cry while performing her duties.
By way of background, sometime prior to the events of July
4, the hospital experienced a fetal death that occurred after a
fetal monitor was removed from a patient.
The General Counsel presented the testimony of Dr. Rodri­
guez to establish antiunion animus by Respondent. Dr. Rodri­
guez testified concerning comments made during board of di­
rectors’ meetings concerning the Union and about remarks he
14 Ramos testified that after the July 4 incident she and the nursing
staff received training with respect to use of the fetal monitor. The
training was under the supervision of Supervisors Maribel Mendez and
Marili Diaz. After the close of the hearing Respondent filed a motion
requesting permission to submit document into evidence. The General
Counsel filed an opposition and Respondent filed a reply to the General
Counsel’s opposition. Those documents shall be received into evidence
as ALJ Exhs. 1–3, respectively. Respondent seeks permission to intro­
duce in evidence documents it says will show that Ramos received the
training on use of fetal monitors before the July 4 incident. I deny
Respondent’s motion. This evidence was available prior to the close of
the hearing and Respondent has failed to show good cause for its failure
to offer this evidence during the hearing.
HOSPITAL DR. SUSONI, INC. 543
made to Ramos about the Union. As to the latter, those re-
marks are not alleged to be unlawful. Dr. Rodriguez gave this
testimony is summary fashion, being unable to recall with
much precision what was actually said. In essence, he testified
that Ramos was concerned that she would suffer reprisals for
engaging in union activity, that he advised her to be sure to do
her job well, and that she should not engage in union activity
inside the hospital. When asked if he recalled if anything else
that was said Dr. Rodriguez answered “that’s all.” However,
after being shown a prior statement he then testified that he
recalled making other remarks to Ramos. Although I have
credited Dr. Rodriguez’ testimony in other respects, I am not
persuaded that his testimony on this matter is sufficiently reli­
able to be credited. Dr. Rodriguez was unable to give a very
precise time for these conversations and he appeared to testify
more about impressions than fact. I also take into account that
Dr. Rodriguez had been involuntarily removed from his posi­
tions of director of obstetrics and gynecology and medical di­
rector and was also involved as a plaintiff in a lawsuit against
Respondent. Dr. Rodriguez testified that the comments to
Ramos were made while he was still the medical director, yet
the more credible testimony of the current medical director
established that Dr. Rodriguez has not served in that position or
attended any board of directors meeting since July 1, 1996.
Lastly, his demeanor as a witness concerning this testimony
was not convincing. Under these circumstances I do not credit
his testimony concerning these conversations.
I again apply the Wright Line analysis to determine whether
Ramos’ discharge violated the Act. I have set forth above how
Ramos was openly involved in supporting the Union. It is also
clear that Respondent was aware that Ramos was an active
union supporter from her participation in the election process as
a union observer and by her appearance as a witness for the
Union at the postelection hearing. These factors support the
General Counsel’s case. However, I have not credited any of
the evidence that the General Counsel relies on to show that
Respondent harbored antiunion animus. This seriously weak-
ens his case. Nor does the timing of the discharge contribute to
the General Counsel’s case.
I turn now to examine whether the reasons asserted for
Ramos’ discharge were a pretext from which I can infer an
unlawful motive. Respondent asserts that Ramos was termi­
nated because she removed the fetal monitor from the patient
on July 4 and then had the patient transferred out of the deliv­
ery room.15 However, I have concluded that the procedure was
for the fetal monitor to be removed after one-half hour unless a
doctor orders that it should remain in place for a longer period
of time. I have further concluded that Dr. Candelario did not
give any instructions, either verbally or in writing, that the
monitor should remain in place for a longer period of time. I
have also concluded that Respondent’s practice was to remove
patients who had a fever from the delivery room if they were
not in active labor and that Dr. Candelario never made it clear
to Ramos that he wanted the patient to remain in the delivery
room notwithstanding her fever. So the facts show that Ramos
was acting in accordance with existing procedures yet she was
fired for doing so. However, that conclusion alone does not
necessarily compel a finding that the Ramos’ discharge was
motivated by antiunion animus. The entire case must be exam­
ined in determining whether such an inference can be made.
Here, there appears to be other reasons why Respondent might
have terminated Ramos notwithstanding her apparent compli­
ance with hospital policies. Under the facts of this case I de-
cline to infer that Ramos’ union activities were a motive in her
discharge. I note particularly the absence of any credible evi­
dence of antiunion animus. I conclude that the General Coun­
sel has failed to establish his initial burden under Wright Line.
I shall dismiss this allegation of the complaint.
On these findings of fact and conclusions of law and on the
entire record, I issue the following recommended16
ORDER
The complaint is dismissed.
15 In its brief Respondent argues that even if Dr. Candelario did not
give Ramos instructions that the fetal monitor should remain in place
Ramos should have known, based on the sustained fetal heart rate, to
seek medical authorization before removing the monitor. I reject this
contention because it was not given as a reason for Ramos’ discharge at
the time it occurred or at any time prior to the hearing.
16 If no exceptions are filed as provided by Sec. 102.46 of the
Board’s Rules and Regulations, the findings, conclusions, and recom­
mended Order shall, as provided in Sec. 102.48 of the Rules, be
adopted by the Board and all objections to them shall be deemed
waived for all purposes.