A Marin County supermarket clerk who urinated on herself at the checkout counter after her supervisor refused to let her take a bathroom break is entitled to a $200,000 damage award, a state appeals court has ruled.

The woman, identified only as A.M., had returned to work at an Albertson's Inc. store in Fairfax in 2004 after undergoing cancer treatment that left her mouth dry and required her to drink water constantly. The store told her to let the managers know when she needed a bathroom break and they would cover for her.

The arrangement worked for more than a year. Then in February 2005, a new supervisor who had never worked with A.M. was on duty one night and turned down three of her requests for a break, saying the supervisor was busy.

After the supervisor hung up the in-store phone, A.M. urinated while standing at the check stand.

She cleaned herself in the bathroom and drove home in tears, contemplating suicide, the court said. Emotionally fragile from her childhood in war-torn El Salvador, her cancer and past experiences as a crime victim, she left her job soon afterward and was committed to a psychiatric hospital for several days, the court said. She returned to work in August 2005.

A Marin County Superior Court jury found in June 2008 that Albertson's had failed to provide a reasonable accommodation for A.M.'s disability and awarded her $12,000 for lost wages, $40,000 for medical expenses and $148,000 for emotional distress.

Albertson's appealed the verdict, arguing that it had accommodated A.M. for more than a year and that she should have told the supervisor about her medical condition or simply gone to the bathroom without permission.

But the First District Court of Appeal in San Francisco said the jury had been entitled to find that Albertson's was at fault for not informing the supervisor about A.M.'s condition and need for bathroom breaks.

Although an employer may have accommodated a disabled worker's needs over an extended period, "a single failure to make reasonable accommodation can have tragic consequences," Justice Timothy Reardon said in the 3-0 ruling.

The court initially upheld A.M.'s damages last month and published its ruling as a statewide precedent last week.

Lawyers for Albertson's were unavailable for comment. The company could appeal the ruling to the state Supreme Court.

The ruling can be viewed at links.sfgate.com/ZILF.