Opinion
8:01CV297.
March 12, 2002
MEMORANDUM AND ORDER
This matter is before the court on the objections, Filing No. 30, filed by defendant United Behavioral Health, to the findings of the magistrate, Filing No. 25. The pleadings and briefs raise questions regarding federal preemption versus the right of an individual to sue in state court for medical malpractice claims and resulting vicarious liability.
On or about June 30, 1999, plaintiff took her son to Jenny Edmundson Hospital because he was exhibiting suicidal thoughts. He was released, and on the next day attempted suicide. Plaintiff took her son back to the emergency room. Pursuant to the Health Maintenance Organization (HMO) plan covering plaintiff's son, he was transferred to Richard Young Hospital. He remained at Richard Young for four days, at which time he was released for outpatient treatment. He committed suicide on July 17, 1999.
Plaintiff filed her original complaint in Nebraska state court. He alleged negligence against defendant Dr. Jay Rich, defendant social worker Roy McGowan, and defendant Richard Young Hospital. He also alleged vicarious liability against defendants Richard Young Hospital and United Behavioral Health (UHB), on the basis that Dr. Rich and McGowan were allegedly employees/agents of these two defendants acting in the scope of their employment. Defendant UHB filed a notice of removal to federal court, alleging that this case is preempted under the Employee Retirement Income Security Act (ERISA), 29 U.S.C. § 1132(a). Defendants Richard Young Hospital, Methodist Health System and Dr. Rich claim that this court lacks subject matter jurisdiction over the case, and it should be remanded to state court. Defendant McGowan, while not filing a separate motion, has submitted a brief supporting that request. Plaintiff likewise requests that this case be remanded to state court.
The magistrate carefully reviewed the law in this case and determined that the cause of action as alleged by the plaintiff asserts purely state law claims. The magistrate determined that the plaintiff was not requesting relief from any adverse determination under the plan, nor was the plaintiff seeking reimbursement under the plan. Simply put, the magistrate determined that the plaintiff is seeking damages for purely state law medical malpractice causes of action and claims of vicarious liability as are connected to the malpractice.
Looking at the complaint as pleaded and also attempting to look outside of the corners of the complaint, I agree with the magistrate. This case is different from the Eighth Circuit cases that have determined that state court actions couched in state law claims could not prevail, when in reality the cause of action involved the administration of benefit determinations under an ERISA Plan. See Kuhl v. Lincoln Nat'l Health Plan, 999 F.2d 298 (8th Cir. 1993); Hull v. Fallon, 188 F.3d 939 (8th Cir. 1999).
In the case at hand, as found by the magistrate, the plaintiff alleges inappropriate treatments, assessments and inadequate care. There is no allegation that benefits were improperly denied. The allegations are qualitative in nature, not quantitative. Were the complaints in any way related to the administration of benefits, preemption would indeed apply in this case. See Corporate Health Ins., Inc. v. Texas Dept. of Ins., 215 F.3d 526, 534 (5th Cir. 2000). However, as stated in Corporate Health: "A suit for medical malpractice against a doctor is not preempted by ERISA simply because those services were arranged by an HMO and paid for by an ERISA plan. Likewise, the vicarious liability of the entities for whom the doctor acted as an agent is rooted in general principles of state agency law. Seen in this light, the Act simply codifies Texas's already-existing standards regarding medical care. These standards of care are at the heart of Texas's regulatory power." Id. at 535. The court in Corporate Health concluded that the statute allowing HMOs to be sued for physicians' negligence was not preempted by ERISA. See also, Dukes v. U.S. Healthcare, Inc., 57 F.3d 350, 358 (3rd Cir. 1995) (beneficiaries did not attack quantity of benefits due or rights under the plan but instead attacked quality of benefits received, thus complete preemption doctrine did not permit removal to federal court); Pegram v. Herdrich, 530 U.S. 211, 228 (2000) (in case dealing with fiduciary responsibilities, court notes treatment decisions do not fall within gambit of ERISA); Pryzbowski v. U.S. Healthcare, Inc., 245 F.3d 266, 273 (3rd Cir. 2001) (treatment decisions do not fall within the gambit of ERISA).
I have carefully reviewed the case law, the briefs, the record and the particular facts as pleaded in this case, and I agree with the findings and conclusions of the magistrate. The magistrate has carefully reviewed the law and has written a well- reasoned opinion in this case. Accordingly, I shall adopt his report and recommendation in its entirety and will order that this case be remanded to state court.
THEREFORE, IT IS ORDERED, ADJUDGED AND DECREED that:
1. The objections to the report and recommendation, Filing No. 30, are hereby overruled;
2. The findings and recommendations of the magistrate, Filing No. 25, are hereby adopted in their entirety; and
3. The motions to remand, Filing Nos. 14 and 23, are hereby granted.