Court of Appeals of Missouri, Southern District, Second Division
SHANTI S. YERRA, M.D., Respondent,
MERCY CLINIC SPRINGFIELD COMMUNITIES, f/k/a ST. JOHNS HEALTH SYSTEM, INC., Appellant.
FROM THE CIRCUIT COURT OF GREENE COUNTY Honorable Michael J.
E. SCOTT, J.
Shanti Yerra successfully sued Mercy Clinic for wrongful
discharge on a whistleblower theory. Mercy appeals, urging in
part that Dr. Yerra failed to make a submissible
case. We agree, reverse the judgment, and remand
with directions to enter judgment in Mercy's favor.
an at-will employee can be discharged for any reason or no
reason. Fleshner v. Pepose Vision Inst., P.C., 304
S.W.3d 81, 92 (Mo. banc 2010). A "very narrowly
drawn" public-policy exception, often called the
wrongful-discharge doctrine (Margiotta v. Christian Hosp.
NE NW, 315 S.W.3d 342, 346 (Mo. banc 2010)), applies to
both at-will and contract employees. Keveney v. Missouri
Military Acad., 304 S.W.3d 98, 103 (Mo. banc
context, a public-policy claim "must be based on a
constitutional provision, a statute, a regulation based on a
statute or a rule promulgated by a governmental body."
Margiotta, 315 S.W.3d at 346. "Absent such
explicit authority, the wrongful discharge claim fails as a
matter of law." Id. "Moreover, not every
statute or regulation gives rise to an at-will wrongful
termination action." Id. "A vague or
general statute, regulation, or rule cannot be successfully
pled under the at-will wrongful termination theory, because
it would force the court to decide on its own what public
policy requires." Id.
said, "a plaintiff need not rely on an employer's
direct violation of a statute or regulation."
Fleshner, 304 S.W.3d at 96. "Instead, the
public policy must be reflected by a constitutional
provision, statute, regulation promulgated pursuant to
statute, or a rule created by a governmental body."
Id. The pertinent inquiry is whether the cited
authority "clearly prohibits the conduct at issue in the
action." Margiotta, 315 S.W.3d at 347.
to these parameters, Missouri's public-policy exception
protects an employee who reports legal violations or
wrongdoing to superiors or third parties
("whistleblowing") or refuses to perform an illegal
act. Id. at 346, 347; Fleshner, 304 S.W.3d
at 92. An employee terminated for either reason has a
common-law tort action for wrongful discharge.
Fleshner, 304 S.W.3d at 92.
summarize, a whistleblower plaintiff must demonstrate that:
(1) she reported serious misconduct that constituted a
violation of the law and of well-established and
clearly-mandated public policy; (2) her employer discharged
her; and (3) her report causally contributed to the
discharge. Van Kirk v. Burns & McDonnell Eng'g
Co., Inc., 484 S.W.3d 840, 844-45 (Mo.App. 2016).
the public-policy exception affords no "protected status
for making complaints about acts or omission he merely
believes to be violations of the law or public policy."
Margiotta, 315 S.W.3d at 348. To merely cite a
statute, regulation, etc., without demonstrating how
the reported conduct violated it cannot form the basis for a
wrongful-discharge action. Id.
is essential that a reported act did violate public
policy, not merely that the plaintiff so believed, even if
her belief was reasonable. Newsome v. Kansas
City, Missouri Sch. Dist., 520 S.W.3d 769, 779 (Mo.
banc 2017). Whether a reported act violated public policy is
a legal question for the trial court in determining whether
the plaintiff has made a prima facie case.
In other words, only after the circuit court decides an act
constitutes a violation of public policy as
"reflected by a constitutional provision,
statute, regulation promulgated pursuant to statute, or a
rule created by a governmental body, "
Fleshner, 304 S.W.3d at 96, may the circuit court
then submit an instruction to the jury based on the act.
Yerra worked for Mercy as an internal medicine physician. She
treated a patient in her 60's who had been hospitalized
several times over several weeks for heart issues and other
conditions. The patient's condition stabilized and Dr.
Yerra referred her to a surgeon, Dr. Cavagnol, for gall
Cavagnol accepted the referral, admitted the patient, and
asked a cardiologist to confirm that the patient could
tolerate anesthesia and surgery. Dr. Yerra learned of the
planned cardiac consult and canceled it, deeming it
unnecessary given her prior evaluation of the patient.
Cavagnol re-ordered the consult and a cardiologist cleared
the patient for surgery. When Dr. Yerra learned of this, she
called Mercy's Medical Staff Services, where her
complaint was summarized and emailed to several
Dr. Yerra called me this afternoon around 2:30. I made no
statements to her except to request the patient's medical
record number. When Dr. Yerra was finished with her comments,
I told her I would convey the message that follows:
Dr. Yerra admitted a patient (Medicare) for surgery by Dr.
Cavagnol. Dr. Yerra's documentation did not indicate a
need for a cardiology consult but Dr. Cavagnol called for one
anyway which was inappropriate and resulted in unnecessary
cost. Dr. Yerra said there was no difference in what she
documented and what Dr. Cochran documented. She said again,
Dr. Cavagnol's action was inappropriate, resulted in
unnecessary cost and was disrespectful to her-she will not
tolerate it. She will report this to Medicare if it
continues. "This type of care sucks!" "If we
are an [Accountable Care Organization], these things should
investigation concluded that the cardiology consult was
appropriate, within the standard of care, and not an
unnecessary cost. But issues were discerned regarding Dr.
Yerra, who had been put on several improvement plans
previously. A new improvement plan was devised for her, but
after further events, including an intensive care incident,
Mercy terminated Dr. Yerra's employment.
Yerra sued, citing RSMo §§ 334.100 & 197.285 as
public-policy sources for her claim that Mercy wrongfully
discharged her for reporting the cardiology consult obtained
by Dr. Cavagnol. At trial, the court agreed to give the