George Matheis, Jr. v. CSL Plasma Inc ( 2019 )


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  •                                         PRECEDENTIAL
    UNITED STATES COURT OF APPEALS
    FOR THE THIRD CIRCUIT
    ________________
    Nos. 18-3415 & 18-3501
    ________________
    GEORGE F. MATHEIS, JR.,
    Appellant/Cross-Appellee
    v.
    CSL PLASMA, INC.,
    Appellee/ Cross-Appellant
    ________________
    Appeal from the United States District Court
    for the Middle District of Pennsylvania
    (D.C. Civil Action No. 1-17-cv-00785)
    District Judge: Honorable Sylvia H. Rambo
    ________________
    Argued June 18, 2019
    Before: AMBRO, RESTREPO, and FISHER, Circuit Judges
    (Opinion filed August 30, 2019)
    Rees Griffiths
    Zachary E. Nahass (Argued)
    CGA Law Firm
    135 North George Street
    York, PA 17401
    Counsel for Appellant
    Bruce J. Douglas (Argued)
    Ogletree Deakins Nash Smoak & Stewart
    225 South Sixth Street, Suite 1800
    Minneapolis, MN 55402
    Donald D. Gamburg
    Rachel C. Stone
    Ogletree Deakins Nash Smoak & Stewart
    1735 Market Street, Suite 3000
    Philadelphia, PA 19103
    Counsel for Appellee
    Lauri A. Mazzuchetti
    Kelley Drye & Warren
    One Jefferson Road, 2nd Floor
    Parsippany, NJ 07054
    John T. Delacourt (Argued)
    Joshua Penrod
    Plasma Protein Therapeutics Association
    3050 K Street, NW, Suite 400
    Washington, DC 20007
    Counsel for Amicus Appellee/Cross Amicus Appellant
    The Plasma Protein Therapeutics Association
    2
    ________________
    OPINION OF THE COURT
    ________________
    AMBRO, Circuit Judge
    Congress, when it passed the Americans with
    Disabilities Act (“ADA”), found that “physical or mental
    disabilities in no way diminish a person’s right to fully
    participate in all aspects of society, yet many people with
    physical or mental disabilities have been precluded from doing
    so because of discrimination.” 42 U.S.C. § 12101(a)(1). The
    remedy for this finding was “to provide a clear and
    comprehensive national mandate for the elimination of
    discrimination against individuals with disabilities.” 42 U.S.C.
    § 12101(b)(1). But is it discrimination for an establishment, in
    the name of safety, to bar everyone who uses a psychiatric
    service animal, including someone who safely participated
    more than four score times without assistance?
    George Matheis, a retired police officer who has
    successfully managed a diagnosis of post-traumatic stress
    disorder (“PTSD”), routinely and safely donated plasma
    roughly 90 times in an 11-month period at CSL Plasma, Inc.’s
    plasma donation facility. CSL barred him from making further
    donations when he brought his new service dog, Odin, to the
    facility the next time. It reasoned that it has a policy to bar any
    individual who is prescribed daily more than two separate
    anxiety medications or who uses a service animal to manage
    anxiety.1 In its view, these people are categorically unsafe to
    donate plasma. The company required Matheis to provide a
    1
    The parties agree the two anxiety medications rule is not
    relevant to this appeal.
    3
    letter from his doctor stating he had no need for a service
    animal before it would screen him for further plasma donation.
    He sued, lost, and appeals to us.
    We have two issues. We determine first whether plasma
    donation centers—facilities where members of the public have
    their plasma extracted in exchange for money—are subject to
    the ADA’s prohibition on unreasonable discrimination. This
    turns on whether these facilities are “service establishments”
    under 42 U.S.C. § 12181(7)(F), which has produced a circuit
    split between the Tenth and Fifth Circuits. We conclude, like
    the District Court here, that the Tenth Circuit got it right: the
    ADA applies to plasma donation centers.
    So we next consider the question posed initially,
    whether CSL violated the ADA by imposing a blanket ban on
    prospective donors who use a psychiatric service animal. Here
    we part with the District Court. Public accommodations like
    CSL must permit disabled individuals to use service animals
    unless they can show a regulatory exception applies. CSL has
    failed to provide evidence to satisfy the relevant exception
    here—that any safety rule “be based on actual risks and not on
    mere speculation, stereotypes, or generalizations about
    individuals with disabilities.” 28 C.F.R. § 36.301(B). Thus we
    reverse the grant of summary judgment and remand.
    I. Factual Background
    CSL owns and operates a plasma donation facility in
    York, Pennsylvania. Its business is collecting human blood
    plasma from the public and selling it to third parties. It screens
    prospective donors for known health risks, extracts plasma
    from qualifying individuals, freezes it, and then ships it to
    manufacturing plants to be made into medicines. The donation
    process is intense; each session lasts as long as two hours, and
    donors, who give blood as often as twice a week, must each
    4
    time pass an individualized screening process. This process
    includes a check of the donor’s blood pressure and protein
    levels, along with questions to see how the donor is feeling and
    to check that he or she has not engaged in risky activities. CSL
    pays its donors as much as several hundred dollars a month for
    their plasma.
    Matheis was involved in a deadly shooting incident
    while on duty as a SWAT officer with his police department in
    2000. After that incident, he had problems socializing and was
    soon diagnosed with PTSD. His condition sometimes causes
    him to suffer panic attacks when exposed to crowded or
    confined spaces, altercations, or helicopter noise. He retired
    from the police force in 2007 to become a small business
    owner.
    In 2016, Matheis decided to donate plasma to raise extra
    money. As noted, he did so approximately 90 times during that
    year at the CSL facility in York. These went off without a
    hitch, and CSL paid Matheis between $250-300 a month for
    his donations.
    In October 2016, Matheis’s eldest daughter enlisted in
    the Navy. Seeing the stress that her leaving caused her father,
    she bought him a dog, Odin, to help him cope with her absence.
    Odin was trained as a service dog for Matheis soon thereafter.
    During Odin’s initial training, Matheis brought him to
    CSL to introduce him to the facility. Immediately on entering
    the building, his phlebotomist (someone trained to draw blood
    from patients or donors) told him he could not have a dog on
    the premises. Matheis did not undergo CSL’s individualized
    assessment to determine if he could safely donate that day;
    instead his phlebotomist referred him to the CSL nurses’
    station. There he explained that Odin was a service animal that
    helped him manage his PTSD. The nurse referred him to a CSL
    5
    manger, who explained that, under its policies, CSL permitted
    service animals for the blind but not for anxiety. Matheis again
    explained that Odin helped him manage his PTSD, a disability
    under the ADA. After a phone call, the manager told him he
    could not donate. Matheis offered to leave Odin in his car and
    donate without him. The manager rejected this, stating he
    could not donate until he brought back a letter from his
    healthcare provider saying he could safely donate without
    Odin. Matheis left CSL and has not returned to donate plasma
    since.
    CSL’s concern is not related to any health concerns that
    dogs like Odin pose; rather it has concluded that using a service
    animal for anxiety means that the donor’s condition is too
    severe to undergo safely the donation process.
    Matheis filed suit alleging discrimination for a failure to
    accommodate his condition. To establish his claim, he must
    show that (1) he is disabled, (2) CSL is a “public
    accommodation” under Title III of the ADA, and (3) it
    unlawfully discriminated against him on the basis of his
    disability by (a) failing to make a reasonable modification that
    was (b) necessary to accommodate his disability. See PGA
    Tour, Inc. v. Martin, 
    532 U.S. 661
    , 683 n.38 (2001); Berardelli
    v. Allied Servs. Inst. of Rehab. Med., 
    900 F.3d 104
    , 123 (3d Cir.
    2018).
    CSL does not dispute that Matheis is disabled or that
    Odin is a trained service animal. Thus this appeal hinges on
    the two issues noted above: whether the ADA applies to CSL;
    and, if so, whether its conduct was unlawful discrimination
    under the ADA. It moved for summary judgment contending
    that it was not subject to the ADA or, alternatively, that its
    policy—barring all individuals who use service animals for
    anxiety—was reasonable. See Defendant’s Mot. for Summ. J.
    6
    at 12–19, Matheis v. CSL Plasma, Inc., No. 1:17-cv-00785-
    SHR, 
    346 F. Supp. 3d 723
    , 734 (M.D. Pa. 2018) (ECF No. 27).
    The District Court ruled that the ADA covered CSL, but
    that the company did not unlawfully discriminate because it
    had a legitimate, non-discriminatory reason for refusing to
    allow Matheis to donate plasma, a concern that he had severe
    anxiety. Matheis v. CSL Plasma, Inc., 
    346 F. Supp. 3d 723
    ,
    734 (M.D. Pa. 2018). The Court buttressed what it recognized
    as a “necessary, yet counterintuitive,” conclusion, 
    id. at 735,
    by stressing CSL would let Matheis donate with Odin once he
    cleared it with a doctor. 
    Id. at 737
    (“CSL stated that it would
    admit Plaintiff if he provided it with a note from a psychologist
    stating that he could donate safely with Odin accompanying
    him.”) (emphasis added). But CSL’s stance is that Matheis
    may not donate until he can safely donate without Odin.
    Matheis appeals the ruling, while CSL cross-appeals
    contending it is not subject to the ADA at all. The Plasma
    Protein Therapeutics Association also filed an amicus brief and
    participated in oral argument, arguing that Title III of the ADA
    does not apply to plasma donation centers like CSL.
    II. Jurisdiction and Standard of Review
    The District Court had jurisdiction per 28 U.S.C.
    §§ 1331 and 1343(a)(4). Its grant of summary judgment was a
    final order, and so we have jurisdiction under 28 U.S.C.
    § 1291.
    We review de novo a grant of summary judgment.
    Metro Transp. Co. v. N. Star Reinsurance Co., 
    912 F.2d 672
    ,
    678 (3d Cir. 1990). We apply the same test the District Court
    would use. Dwyer v. Cappell, 
    762 F.3d 275
    , 279 (3d Cir.
    2014). Under this test, reviewing the facts in the light most
    favorable to the non-mover, we grant summary judgment “if
    7
    the movant shows that there is no genuine dispute as to any
    material fact and the movant is entitled to judgment as a matter
    of law.” Fed. R. Civ. P. 56(a).
    III. Discussion
    A. Does the ADA apply to plasma donation centers?
    The ADA is divided into three titles of regulation—
    Title I (employers), Title II (governments), and Title III (public
    accommodations). Title III states that “[n]o individual shall be
    discriminated against on the basis of disability in the full and
    equal enjoyment of the goods, services, facilities, privileges,
    advantages, or accommodations of any place of public
    accommodation . . . .” 42 U.S.C. § 12182. It reflects the
    ADA’s “comprehensive character,” 
    Martin, 532 U.S. at 675
    (quotation omitted), and defines “public accommodation” to
    include, in relevant part:
    a laundromat, dry-cleaner, bank, barber shop,
    beauty shop, travel service, shoe repair service,
    funeral parlor, gas station, office of an
    accountant or lawyer, pharmacy, insurance
    office, professional office of a health care
    provider,    hospital,    or    other     service
    establishment;
    ....
    42 U.S.C. § 12181(7)(F) (emphasis added). Our focus narrows
    to whether a plasma donation facility is an “other service
    establishment.”
    This question has already produced a circuit split. In
    Levorsen v. Octapharma Plasma, Inc., 
    828 F.3d 1227
    , 1229
    (10th Cir. 2016), a divided panel held that plasma donation
    centers were subject to the ADA as service establishments.
    8
    The Court relied on a broad, common definition of “service”
    and “establishment”—“conduct or performance that assists or
    benefits someone or something” and a “place of business,”
    respectively. 
    Id. at 1231
    (quoting Webster’s Third New
    International Dictionary 778, 2075 (2002)). It reasoned that
    giving the term “service establishment” the ordinary meaning
    of its components yielded neither ambiguity nor an irrational
    result. Plasma donation centers “are ‘place[s] of business.’ . . .
    And they ‘assist[] or benefit[]’ those who wish to provide
    plasma for medical use—whether for altruistic reasons or for
    pecuniary gain—by supplying the trained personnel and
    medical equipment necessary to accomplish that goal.” 
    Id. at 1234
    (same) (alterations supplied in opinion).
    The Fifth Circuit in Silguero v. CSL Plasma, Inc., 
    907 F.3d 323
    (5th Cir. 2018), viewed things differently. It made
    two base observations—the donor is not benefited by donating,
    and each of the listed service establishments provides services
    to the public in exchange for money. These features did not
    apply to plasma donation services. 
    Id. at 329.
    The dissent in Levorsen took a similar line. It followed
    ejusdem generis, a canon of statutory interpretation that
    interprets a last, general term by looking to the preceding
    examples. From these the dissenting judge proposed the
    following definition: a service establishment “offer[s] the
    public a ‘service’ (1) in the form of (a) expertise (e.g., barbers,
    beauticians. . ., and hospitals) or (b) specialized equipment
    (e.g., laundromats and gas stations), (2) for use in achieving
    some desired end, (3) in exchange for monetary
    compensation.” 
    Levorsen, 828 F.3d at 1235
    (Holmes, J.,
    dissenting). He concluded that plasma donation centers could
    not qualify as service establishments because donors do not
    pay money for the service and (confusingly) because the
    donation centers do not offer their services in order to benefit
    the public.
    9
    [T]o the extent that plasma-donation centers
    provide services to the public—such as those
    services identified by Mr. Levorsen and the
    United States—they do not do so for
    the public’s use in achieving a desired end;
    instead, they provide them for the centers’ use in
    achieving a desired end. More specifically,
    plasma-donation centers provide the public with
    the expertise associated with blood [extraction] .
    . . so that the centers can sell the plasma to their
    customers in the pharmaceutical industry (i.e.,
    the desired end)—not so that they can assist the
    public to achieve some desired end.
    
    Id. at 1243
    (emphases in original).
    We align with the majority in the Tenth Circuit. First,
    at least here no support exists for the Fifth Circuit’s statement
    that donors “do not benefit” from the act of donating. The
    record is unequivocal that Matheis and other donors receive
    money, a clear benefit, to donate plasma.
    Second, Judge Holmes’s attempt in his dissent to
    distinguish this benefit on the basis of the secondary profit
    motive of plasma facilities is unpersuasive. A bank, one of the
    listed examples in § 12181(7)(F), is an obvious example of a
    service establishment that uses the fruits of its public-facing
    services for subsequent profit. Not only does it provide the
    means and expertise to hold safely the public’s money, it also
    may provide interest or other benefits (including cash or
    rewards) to convince customers to entrust them with their
    savings. That a bank subsequently invests, trades, or loans this
    money to third parties does not make it any less a service
    establishment with respect to the public.
    10
    Moreover, any emphasis on the direction of monetary
    compensation is, to us, unhelpful. Businesses that offer
    services to the public convey something of economic value in
    return for something else of economic value. The value
    received by the service provider and given by the customer is
    often money, but it need not be. Money is one proxy for
    economic value, and economic value is fungible.
    The bank example shows we should not arbitrarily
    narrow the scope of “service establishments” to entities that
    receive compensation from customers in the form of money.
    Banks and their customers exchange sources of economic
    value that do not always fit into a simple “money for service”
    model. As noted, customers often receive money from banks
    for using the bank’s service. Banks are hardly the only
    example of companies that pay the public to use their services.
    Amicus Plasma Protein Therapeutics Association conceded at
    oral argument that a pawnshop is a service establishment under
    Title III. It pays money in exchange for people’s possessions.
    So too, as the District Court noted, is a recycling center a
    service establishment; it compensates consumers in exchange
    for their waste and has been held subject to the ADA. 
    Matheis, 346 F. Supp. 3d at 734
    n.9 (citing Estrada v. S. St. Prop., LLC,
    No. 17-cv-259, 
    2017 WL 3461290
    , *3 (C.D. Cal. Aug. 11,
    2017)). These examples underscore a simple fact: providing
    services means providing something of economic value to the
    public; it does not matter whether it is paid for with money or
    something else of value.
    Hence we conclude that a plasma donation center is a
    service establishment under the ADA. It offers a service to the
    public, the extracting of plasma for money, with the plasma
    then used by the center in its business of supplying a vital
    product to healthcare providers. That both the center and
    members of the public derive economic value from the center’s
    provision and public’s use of a commercial service does not
    11
    divorce the center from the other listed examples in
    § 12181(7)(F). Indeed this is an irreducible feature of a market
    system.
    B. Did CSL discriminate against Matheis?
    We next turn to whether CSL violated the ADA when it
    barred Matheis from donating plasma.
    i.       Legal standard
    The statute requires that public accommodations not
    discriminate on the basis of disability. Discrimination
    includes:
    a failure to make reasonable modifications in
    policies, practices, or procedures, when such
    modifications are necessary to afford such
    goods,     services,     facilities, privileges,
    advantages, or accommodations to individuals
    with disabilities, unless the entity can
    demonstrate that making such modifications
    would fundamentally alter the nature of such
    goods, services, [etc.].
    42 U.S.C. § 12182(b)(2)(A)(ii) (emphases added).
    A company regulated under Title III may be held liable
    for failing to accommodate. This is “a standard that turn[s] on
    (1) whether the requested accommodation to the program was
    ‘reasonable’; (2) whether it was necessary ‘to assure
    meaningful access’; and (3) whether it would represent ‘a
    fundamental alteration in the nature of [the]
    program.’” 
    Berardelli, 900 F.3d at 115
    (quoting Alexander v.
    Choate, 
    469 U.S. 287
    (1985)). The plaintiff bears the initial
    burden of establishing that the desired accommodation is
    reasonable and necessary, while the defendant bears the burden
    12
    of showing that it would fundamentally alter the nature of the
    program. 
    Id. at 124;
    see J.D. by Doherty v. Colonial
    Williamsburg Found., 
    925 F.3d 663
    , 671 (4th Cir. 2019).
    CSL does not contend that permitting Odin to
    accompany Matheis would fundamentally alter the nature of its
    service. Nor does it dispute Matheis’s evidence showing that
    Odin is a necessary accommodation (indeed, CSL’s policy
    assumes that Odin is a necessary accommodation and bars
    Matheis outright for it). The only question is whether his use
    of Odin is reasonable.
    Title III entities are required by regulation to “modify
    policies, practices, or procedures to permit the use of a service
    animal by an individual with a disability.” 28 C.F.R. § 36.302.
    In other words, use of a service animal by a disabled individual
    “is reasonable under the ADA as a matter of law” so long as no
    Department of Justice-promulgated regulation supersedes this
    general rule. 
    Berardelli, 900 F.3d at 119
    (vacating a jury
    verdict for a school district that denied one of its students with
    epilepsy use of her service dog).2 The service-animal
    regulations satisfy Matheis’s initial burden to show an
    accommodation is reasonable; CSL must establish that an
    exception to those regulations applies. 
    Id. at 124.
    This burden differs significantly from the test the
    District Court seems to have applied when it concluded CSL’s
    denial was not based on a “discriminatory animus.” It
    borrowed the employment discrimination framework from
    McDonnell Douglas Corp. v. Green, 
    411 U.S. 792
    (1973).
    2
    Though Berardelli involved the reasonableness of service
    animals under the Title II regulations (Part 35), the approach
    here is identical, as those animal service regulations use
    “materially identical language” as the regulations under the
    Title III regulations (Part 36). 
    Id. at 118–19.
    13
    That framework involves burden shifting: a plaintiff must
    establish a prima facie case of discrimination; when he does,
    the burden shifts to the employer to articulate some legitimate,
    nondiscriminatory reason for the adverse action against the
    employee. If the employer does so, the employee may attempt
    to show the reason is a pretext to hide discrimination. See, e.g.,
    Walton v. Mental Health Ass’n. of Se. Pennsylvania, 
    168 F.3d 661
    , 668 (3d Cir. 1999).
    Because a plaintiff need not show intentional
    discrimination to demonstrate a violation of Title III of the
    ADA, Lentini v. Calif. Ctr. for the Arts, Escondido, 
    370 F.3d 837
    , 846-47 (9th Cir. 2004), we reject using McDonnell
    Douglas in this context, and instead follow the Berardelli
    framework for ADA claims against a public accommodation.
    Thus we must determine whether CSL has established
    exceptions that permit a plasma donation center to deny a
    disabled individual’s use of a service animal. If none apply,
    Matheis’s use of Odin is a reasonable accommodation, and his
    claim succeeds.
    ii.       Regulatory exceptions
    In Berardelli we concluded that a small group of
    regulatory exceptions, both within the animal service
    regulations and listed elsewhere in Part 35, formed the
    exclusive bases for a government entity to deny a service
    animal who is a necessary accommodation for a disabled
    person:
    [The regulations] specify the limited
    circumstances in which it would be unreasonable
    to require these actors to allow the use of service
    animals: if granting access would . . . pose a
    “direct threat” to the health or safety of
    others, 
    id. §§ 35.139,
    36.208, or if the animal is
    14
    either “out of control” or “not housebroken,”[] 
    id. §§ 35.136(b)(1)–(2),
    36.302(c)(2)(i)–(ii) . . . .
    Subject to these exceptions, however, the
    regulations mandate that “[i]ndividuals with
    disabilities shall be permitted to be accompanied
    by their service animals in all areas of [a covered
    actor’s facilities] where . . . program participants
    . . . are allowed to go.” 
    Id. § 36.302(c)(7);
    see
    also 
    id. § 35.136(g).
    Id. at 119.
    
    As the citations to Part 36 indicate, identical regulations
    exist for Title III entities. None is relevant here. The closest
    fit is 28 C.F.R. § 36.208, which permits public
    accommodations to deny anyone who poses a “direct threat” to
    others. While CSL expresses concern that people like Matheis
    are a threat to staff and other donors, the “direct threat”
    exception requires “an individualized assessment” to
    determine “[t]he nature, duration, and severity of the risk; the
    probability that the potential injury will actually occur; and
    whether reasonable modifications of policies, practices, or
    procedures or the provision of auxiliary aids or services will
    mitigate the risk,” 28 C.F.R. § 36.208, an assessment CSL did
    not perform.
    That is not all that is relevant, however. The parties and
    the District Court each note the eligibility regulation for Title
    III public accommodations, 28 U.S.C. § 36.301, and it
    ultimately controls our inquiry. It states that “[a] public
    accommodation may impose legitimate safety requirements
    that are necessary for safe operation. Safety requirements must
    be based on actual risks and not on mere speculation,
    stereotypes, or generalizations about individuals with
    disabilities.” 28 U.S.C. § 36.301(b). The parties agree CSL’s
    15
    policy deferring donors who use multiple anxiety medications
    or a service animal is a safety rule, so it must pass muster under
    § 36.301(b).
    The parties and the District Court also note the blood
    transfusion regulation in 21 C.F.R. § 630.10, but this does not
    alleviate CSL’s burden under § 36.301(b). It states a donor is
    ineligible if the donation “could adversely affect the health of
    th[at] donor,” 21 C.F.R. § 630.10(a), but the facility “must
    determine the donor’s eligibility” by the specified procedures
    for individualized assessment, 21 C.F.R. § 630.10(d). The
    individualized assessment must check for
    factors that make the donor ineligible to donate.
    . . . Your assessment must include each of the
    following factors:
    (i) Symptoms of a recent or current illness;
    (ii) Certain     medical      treatments      or
    medications;
    ....
    21 C.F.R. § 630.10(e)(2). The regulation does not clarify
    which treatments are included among the “[c]ertain medical
    treatments.”
    CSL contends that it has complete discretion to
    determine what treatments, including use of service animals,
    show a donor may be harmed by donating. This overreads the
    blood transfusion regulation. It does not give plasma donation
    centers carte blanche to ignore U.S. law, which not only
    mandates that service animals be allowed, 28 C.F.R.
    § 36.302(c), but also specifies when public accommodations
    may adopt rules that exclude disabled individuals in the name
    of safety, 28 C.F.R. 36.301. Applied to our case, CSL may
    16
    consider a service animal among the list of “[c]ertain medical
    treatments” it can assess for eligible donating of plasma so long
    as it can show that the safety policy it adopts is based on “actual
    risk and not mere speculation, stereotypes, or generalizations
    about individuals with disabilities.”
    iii.       Is CSL’s policy a valid safety rule?
    Though CSL bears the burden to show its service animal
    policy is valid under § 36.301(b), the evidence it marshals on
    its behalf is unimpressive and not remotely adequate to confer
    summary judgment. It relies exclusively on a declaration from
    Dr. John Nelson, its divisional medical director, stating that
    “[d]onors with severe anxiety may be unable to follow
    directions, cause disturbances, impact the donation process . .
    .[,] putting staff at risk of getting stuck with the needle and
    other donors at risk of getting blood on them.” J.A. at 89. It
    also states that “[i]t is my professional medical opinion that
    donors with severe anxiety present serious health and safety
    risks to themselves, medical staff, and other donors.” 
    Id. at 90.
    The declaration’s lone statement addressing the use of a service
    animal is that
    CSL’s general policy is to defer a donor who
    requires more than two medications daily or a
    service animal for anxiety, until the need for
    medications or service animal decreases. . . . This
    policy is not directed to the use of a service dog,
    as CSL allows service dogs for vision-and
    hearing-impaired donors, but is based on the
    severity of the anxiety.
    
    Id. These statements
    don’t get the job done. Indeed, they
    seem clearly speculative and to generalize widely about
    17
    individuals who use psychiatric service animals, all of whom
    CSL apparently views as people with “severe anxiety.” No
    medical justification or other scientific evidence undergirds
    CSL’s implicit conclusion that all those persons have “severe
    anxiety” and will put staff, other donors, or themselves at risk
    when donating plasma. This conclusion is not even stated; Dr.
    Nelson does not connect the dots by attesting that using a
    service animal indicates “severe anxiety.” This is clearly
    inadequate to show that CSL’s policy is based on actual risk
    and not based on speculation, stereotypes, or generalizations.
    CSL’s main retort is that Matheis cannot now challenge
    Dr. Nelson’s declaration because he failed to challenge its
    reliability before the District Court under Federal Rule of
    Evidence 702. (CSL Br. at 31.) Though Matheis did not move
    to exclude the declaration, this is not fatal; he argued before the
    District Court that the testimony fails to satisfy the safety rule
    regulation. See Plaintiff’s Br. in Opp’n to Def.’s Mot. for
    Summ. J. at 15–16, Matheis, No. 1:17-cv-00785-SHR, 346 F.
    Supp. 3d 723 (ECF No. 30). He can press this issue on appeal,
    as he does, without challenging Dr. Nelson’s reliability as a
    witness. (See Matheis Br. at 19, Reply at 8–9.)
    As a final Hail Mary, CSL argues it had other reasons
    for concluding Matheis had severe anxiety (which we assume
    for the sake of argument could support deferral for the reasons
    stated in the Nelson Declaration). Discovery revealed that
    Matheis had a panic attack after he was deferred from CSL (he
    confronted a homeless man while leaving the facility) and that
    some of his past panic attacks have been accompanied by
    violent symptoms. (See generally CSL Br. at 21–29.) It asserts
    that these facts show it reasonably required him to seek a
    doctor’s signoff that he was safe to donate without Odin.
    While we disagree, we note a predicate problem as well.
    CSL raises this issue for the first time on appeal. Before the
    18
    District Court it moved for summary judgment on two narrow
    grounds: (1) that CSL was not a public accommodation under
    Title III of the ADA; and (2) that its policy barring all anxiety
    patients who use a service animal to treat anxiety was a
    legitimate safety rule. See Defendant’s Mot. for Summ. J. at
    12–19, Matheis, No. 1:17-cv-00785-SHR, 
    346 F. Supp. 3d 723
    (ECF No. 27). We will not consider its new argument in favor
    of summary judgment. See Tri-M Grp., LLC v. Sharp, 
    638 F.3d 406
    , 416 (3d Cir. 2011) (“It is axiomatic that arguments
    asserted for the first time on appeal are deemed to be waived
    and consequently are not susceptible to review in this Court
    absent exceptional circumstances.”) (quotation omitted).3 As
    CSL’s two timely justifications for summary judgment fail, we
    reverse.
    IV. Conclusion
    CSL is a public accommodation under Title III of the
    ADA, and so it applies to CSL’s plasma donation center.
    Hence we affirm the District Court’s ruling on this issue.
    We reverse, however, its grant of summary judgment to
    CSL on whether it complied with the ADA. In doing so, we
    do not suggest that CSL would be wrong in the future to require
    a doctor’s note stating Matheis may safely donate with Odin.
    Indeed, had CSL adopted such a stance from the start, we might
    agree with how the District Court ruled. But CSL concedes
    that it will only consider Matheis as a potential donor when he
    provides a doctor’s note attesting he can safely donate without
    Odin. CSL’s lone justification is its service animal policy,
    which it does not support with evidence showing that policy is
    3
    To the extent CSL has attempted to justify Matheis’s deferral
    by pointing to his post-deferral panic attack that he experienced
    while leaving the donation facility, we do not see how an event
    that occurred after deferral could now be cited as a basis for it.
    19
    based on actual risk and not speculation, generalizations, or
    stereotypes. Moreover, CSL fails to explain why Matheis, who
    has managed his PTSD for nearly two decades and safely
    donated plasma roughly 90 times, should only be considered
    safe to donate when he renounces the new service animal that
    helps him better manage his PTSD.
    Thus we reverse and remand the District Court’s grant
    of summary judgment in favor of CSL. On remand, the Court
    may determine whether to permit CSL to move for summary
    judgment on other grounds, to hold trial, or to conclude on the
    facts presented that CSL violated the ADA.
    20