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Link for Translation of this Kaiser Papers page from Google Translation Service McCLELLAN v. PATEL, (Or. 2006) ANA MARIA McCLELLAN, as Personal Representative of the Estate of IAN MURILLO MCCLELLAN, a deceased child, Plaintiff, v. JAYANT MUKUNDRAY PATEL, M.D.; NORTHWEST
PERMANENTE, P.C., an Oregon corporation; KAISER FOUNDATION HOSPITALS, a
California corporation; KAISER HEALTH PLAN OF THE NORTHWEST; OREGON
HEALTH SCIENCES UNIVERSITY; and THE OREGON BOARD OF MEDICAL EXAMINERS,
by and through the STATE OF OREGON, Defendants.
Civil No. 06-392-AA. United States District Court, D. Oregon. July 16, 2006 David K. Miller, Robert Beatty-Walters, Miller & Wagner, Portland, Oregon, Attorneys for plaintiff. John E. Hart, Troy S. Bundy, Hoffman, Hart & Wagner, LLP, Portland, Oregon, Attorneys for Kaiser defendants. Donald Bowerman, Bowerman & Boutin, LLP, Oregon City, Oregon, Attorney for defendant Oregon Health Sciences University. OPINION AND ORDER Page 2 ANN AIKEN, District Judge Pursuant to 28 U.S.C. § 1447, plaintiff moves to remand this action to state court on the grounds that this court lacks subject matter jurisdiction. Plaintiff's motion is granted. BACKGROUND This is a medical
malpractice case brought in state court under state common law theories
of negligence against defendants in connection with the provision of
surgical care to a 3 ½ year old boy in February 1999. The surgery at issue was performed by defendant Jayant M. Patel.
Defendants Kaiser filed a Notice of Removal on March 20, 2006. The defendant that initially filed the Notice of Removal, Kaiser Foundation Health Plan of the Northwest (KFHP), has since been dismissed from this lawsuit. Further, consent to removal has been obtained from all remaining defendants. Defendants allege that plaintiff's claims are preempted under the Employee Retirement Income Security Act (ERISA), 29 U.S.C. § 1144(a). DISCUSSION Pursuant to 28
U.S.C. § 1441, "any civil action brought in a State court of which
the district courts of the United States have original jurisdiction,
may be removed by the defendant or other defendants, to the district
court of the United States[.]" Removal is proper only where the federal
court would have had subject matter jurisdiction over the matter if the
plaintiff had originally filed the action in federal court. The existence of federal
jurisdiction ordinarily depends on the facts as they exist when the
complaint is filed. Newman-Green, Inc. v. Alfonzo-Larrain, 490 U.S.
826, 830 (1989) (internal citation omitted).
Defendants assert
that plaintiff's claims are not limited to malpractice claims against
defendant Patel. Defendants argue that plaintiff's claims fall into
"two distinct categories: 1) claims challenging the medical decisions
of Dr. Patel, and 2) claims challenging the administrative decisions of
the Kaiser defendants." Defendant Kaiser's Memo in Response, p. 2.
Defendants assert that it is plaintiff's "administrative negligence
claims" that trigger ERISA preemption and this court's resulting
jurisdiction. Id.
Specifically,
Kaiser defendants allege that plaintiff makes the following
"administrative negligence" claims: Ian McClellan died following
abdominal surgery performed by defendant Jayant Patel, M.D.
Complaint, 1. The Kaiser defendants were "jointly engaged in the
practice of medicine and the delivery of other healthcare services. Id.
at 5. The collective defendants granted Dr. Patel surgical
privileges and held Dr. Patel out to the public and plaintiff as a
competent physician, specially skilled in performing abdominal surgery
on children. Id. Defendant Patel was hired by the Kaiser defendants in
1989, and the Kaiser defendants were aware of at least eight medical
malpractice lawsuits, some of which involved wrongful death cases and
Dr. Patel's care. Id. at 11. In 1997, the Kaiser defendants began
conducting an internal review of approximately 80 potential malpractice
incidents involving Dr. Patel. As a result of that internal review,
plaintiff alleges the Kaiser defendants restricted defendant Patel's
surgical privileges in the summer of 1998, limiting his ability to
perform certain abdominal procedures as well as placing other
requirements on defendant Patel. Id. at 14.
Plaintiff further
alleges that the Kaiser defendants failed to inform the Oregon Board of
Medical Examiners and defendant Oregon Health Sciences University
(OHSU) about defendant Patel and his "malpractice history." Further,
plaintiff alleges that: "Despite Dr. Patel's malpractice history and
the restrictions defendant Kaiser placed on his surgical privileges,
Dr. Patel was nevertheless elevated to a position of leadership in
defendant Kaiser's pediatric surgical service. Id. at 17.
Finally, plaintiff
has alleged against the Kaiser defendants in particular, that those
defendants were negligent "in allowing Dr. Patel to operate on children
in light of the malpractice incidents that caused defendant Kaiser to
restrict his surgical privileges and put him on a professional
improvement plan approximately six months earlier;" "in failing to
report Dr. Patel's malpractice incidents between 1991 and 2005 to the
Oregon Board of Medical Examiners as required by ORS 742.400(2);" and
"in failing to have an adequate system in place between 1991 and 1999
to identify physicians and surgeons with surgical complication rates
outside the expected range."
To determine
whether plaintiff's claims fall within the scope of § 502(a)(1)(B)
of ERISA, 29 U.S.C. § 1132(a)(1)(B), the court must determine
whether those claims are "to recover benefits due . . . under the terms
of [the] plan, to enforce . . . rights under the terms of the plan, or
to clarify . . . rights to future benefits under the terms of the
plan." Id. I find nothing in plaintiff's complaint to indicate that
plaintiff is challenging her ERISA welfare plan's failure to provide
benefits due under the plan, nor does plaintiff ask the court to
enforce her rights under the terms of her plan or to clarify her right
to future benefits. Instead, plaintiff complains about the low quality
medical treatment her son received and argues that the defendants
should be held liable under agency and negligence principles. As the
court stated in Dukes v. U.S. Healthcare, Inc., 57 F.3d 350 (3rd Cir.
1995), "[w]e are confident that a claim about the quality of a benefit
received is not a claim under § 502(a)(1)(B) to "recover benefits
due . . . under the terms of [the] plan." Id. at 356.
It cannot be
disputed that anything in the legislative history, structure, or
purpose of ERISA suggests that Congress viewed § 502(a)(1)(B) as
creating a remedy for a participant injured by medical malpractice.
Instead, Congress sought to assure that promised benefits would be
available when plan participants had need of them and § 502 was
intended to provide each individual participant with a remedy in the
event that promises made by the plan were not kept. The Supreme Court
has noted that while quality standards and work place regulations in
the context of hospital services will indirectly affect the sorts of
benefits an ERISA plan can afford, those have traditionally been left
to the states, and there is no indication in ERISA that Congress chose
to displace general health care regulation by the states. N.Y. State
Conf. of Blue Shield Plans v. Travelers Ins. Co., 514 U.S. 645, 657-58
(1995).
The inquiry here
is whether plaintiff's claim rests upon the terms of the plan or
requires construction of the plan language; if so, the claim is
preempted by ERISA. Claims challenging the quality of a benefit, as
noted above in Dukes, are held not preempted by ERISA. In order to
determine whether ERISA preempts plaintiff's medical malpractice claim,
the court must determine whether the alleged negligent medical advice
was inextricable from its actions coordinating benefits and services
under the plan. See Roessert v. Health Net, 929 F.Supp. 343 (N.D.
Cal.1996) ("nothing in [defendant's] duty to administer benefits to
plaintiff required it to make medical judgments[,]" nor did plaintiff's
claims require reference to an ERISA plan to resolve them).
Defendants here
assert that plaintiff's claims allege "administrative" actions by
defendants, therefore ERISA preemption applies and removal to federal
court is proper. Plaintiff alleges that defendants were negligent for
several actions, including allegations that relate to the oversight and
retention of defendant Dr. Patel. Plaintiff alleges additional direct
negligence claims against these defendants that implicate the standards
of care for providing medical information to patients, as wells as
claims that defendants failed to report Dr. Patel's malpractice
incidents to the Oregon Board of Medical Examiners as required by Or.
Rev. Stat. 742.400(2), and failed to thoroughly and adequately
investigate Dr. Patel's prior history of discipline and fraudulent
conduct in the State of New York prior to granting him surgical
privileges. Complaint, 23. Similar to the court's analysis in
Dukes, however, I find that plaintiff's allegations allege common law
negligence directly related to the quality of care ultimately provided
to plaintiff's son. These claims do not implicate the administration
of, or necessitate the interpretation of, the benefits plan.
Further,
defendants fail to point this court to a plan-created right implicated
by plaintiff's state law medical malpractice claims. I find no
allegation by plaintiff that the defendants have withheld plan benefits
due, and nothing in the complaint resembles a request that the court
clarify a right to a future benefit. In fact, plaintiff's complaint
centers on past events.
The Ninth
Circuit's analysis and holding in Bui v. American Telephone and
Telegraph, 310 F.3d 1143 (9th Cir. 2002), relied on by both parties, is
instructive. There, plaintiff Bui sued his own employer and it was those claims that the court found preempted by
ERISA finding that plaintiff was claiming a denial of benefits under
the ERISA plan. Plaintiff's malpractice claims against healthcare
providers were not preempted by the court. The court did, however,
preempt plaintiff's negligence claim in the plan's retention of a
service provider, holding that the selection of service providers under
the benefits plan is a necessary part of the administration of an ERISA
plan. Here, plaintiff is not alleging that defendant Kaiser Foundation
Health Plan was negligent in contracting with defendants Northwest
Permanente, Kaiser Foundation Hospitals, or OHSU. Instead, plaintiff's
claim is against the hospital and Dr. Patel's employer for negligence
in credentialing Dr. Patel and allowing him to provide surgical
services to plaintiff's decedent. I find plaintiff's claims to be
similar to those in Dukes which were not preempted, than plaintiff's
claims in Bui. Plaintiff's claims relate to duties outside the proper
administration of the benefit plan. As plaintiff notes, any patient
treated at any hospital in the state of Oregon, regardless of whether
their benefits were provided under an ERISA plan, could bring a claim
against their hospital and the employer of their surgeon for negligence
in allowing that surgeon to practice.
In sum, since the
actions alleged by plaintiff do not require interpretation of the plan,
I find no reason to believe that state resolution of the disputed
medical decisions would affect the important uniformity of federal
ERISA law. Rather, plaintiff's complaint falls within the familiar
purview of state tort law. Therefore, the causes of action pled against
defendants do not come within the ambit of § 502(a)(1)(B) and this
court lacks jurisdiction to hear them.
CONCLUSION Plaintiff's motion to remand this action to state court (doc.12) is granted. Further, plaintiff's request for oral argument is denied as unnecessary.
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