RED WING, Minn. — A Mayo Clinic Health System nurse anesthetist and two former medical staffers are suing the regional hospital and clinic network, alleging breach of contract and retaliation after raising concerns over proposed staffing changes for employees trained to administer sedation and insert breathing tubes.

The plaintiffs claim they spoke out against attempts by Mayo Clinic Health System to end round-the-clock coverage in Lake City by a certified registered nurse anesthetist, or CRNA, as well as a failure to provide trained backup providers to assist with deep sedation in the Cannon Falls emergency department, according to the employment lawsuit filed Nov. 12 in Goodhue County District Court.

The suit follows a similar civil action in 2017 by a Lake City doctor who sued the health system for alleged defamation after criticizing plans to reduce off-hour emergency services — including CRNA coverage — and replace ER physicians with nurse practitioners and physician assistants. The case was settled confidentially in 2018.

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Mayo Clinic Health System in a statement noted the 24/7 CRNA staffing model remains in place in Lake City, and that proposed changes would be consistent with other similarly sized Mayo Clinic Health System hospitals.

According to the statement:

“Our staffing models are designed to ensure safe, effective care for all patients. Despite our many attempts to resolve this issue through discussions with the three employees, they and their attorney chose to move this into the legal system. It is unfortunate that the plaintiff’s attorney is now attempting to leverage media to influence the outcome before the case goes to court.”

It continued: “While we cannot discuss the details of this pending litigation or respond to specific allegations, we want to assure our patients and the community that they have and continue to receive safe, high-quality care at Mayo Clinic Health System in Lake City and in Cannon Falls.”

Civil complaint

Plaintiffs Mark Swenson and Jacob Ricks were hired in 2012 as certified registered nurse anesthetists at Mayo Clinic Health System in Lake City. Their contracts required they each be on call 24 hours per day for 26 weeks of the year, and be available to respond to the facility within 20 minutes.

According to the civil complaint, Swenson and Ricks learned in 2015 of plans to remove them from on-call CRNA coverage in Lake City and switch to providing regional coverage. After expressing concern that cutting continuous CRNA coverage in Lake City would jeopardize patient safety, Swenson claims an administrator told him, “We’re going to have to accept some losses then.”

Swenson and Ricks said they persisted in raising concerns for three years to Mayo Clinic Health System management, culminating in a 2018 complaint by Ricks to a Mayo Clinic ethics officer.

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Meanwhile the third plaintiff, nurse practitioner Heidi Harms, said she repeatedly reported to management that eliminating continuous CRNA coverage in Lake City would put patients at risk, and a lack of qualified professionals to assist with deep sedation in Cannon Falls violates care standards, according to the complaint.

In a phone interview Friday, Ricks said the lawsuit is not intended as a slight against nurse practitioners or physician assistants.

“No one person can be expected to do everything in these small hospitals,” Ricks said. “A solo ER provider can easily become overwhelmed in an emergency situation, and they need to have the appropriate support staff available to assist them. That’s what this is about.”

The plaintiffs claim they faced retaliation from management starting in 2018, including additional work hours without additional compensation for Swenson and Ricks that, according to the complaint, was intended to force their resignations.

Swenson resigned from Mayo Clinic Health System effective Oct. 11, followed by Harms on Oct. 28. Ricks continues to be employed by Mayo Clinic Health System.

They seek damages including compensation for back pay and legal fees.

Mayo Clinic Health System has locations in Minnesota, Wisconsin and Iowa, and operates in partnership with Rochester-based Mayo Clinic. The Mayo Clinic Health System in Lake City emergency department recently underwent a $1.1 million renovation.