S.M. v. UNITED STATES OF AMERICA et al, No. 1:2013cv05702 - Document 67 (D.N.J. 2016)

Court Description: OPINION. Signed by Judge Joseph H. Rodriguez on 12/20/2016. (TH, )
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S.M. v. UNITED STATES OF AMERICA et al Doc. 67 UNITED STATES DISTRICT COURT DISTRICT OF NEW J ERSEY S.M., by and through her Guardian Ad Litem , GABRIELLE MOORE, : : Plaintiffs, v. Hon. J oseph H. Rodriguez Civil Action No. 13-570 2 : OPINION UNITED STATES OF AMERICA, et al., : Defendants. : This m atter is before the Court on m otion of Defendant the United States of America to dism iss the case for lack of subject matter jurisdiction or, alternatively, for partial sum m ary judgm ent under the Federal Tort Claim s Act (“FTCA”) and New J ersey Charitable Im m unities Act (“NJ CIA’). [Doc. 57.] This Court previously allowed for discovery to be taken to resolve the issues at hand. Plaintiff S.M., by and through her Guardian ad Litem, Gabrielle Moore, has opposed the m otion. Oral argum ent was heard on November 30 , 20 16, and the record of that proceeding is incorporated here. For the reasons placed on the record that day, and those that follow, the m otion will be denied in part and granted in part. Background This is a wrongful birth m edical m alpractice case that stems from Plaintiff Moore’s treatm ent at CompleteCare Health Network a/ k/ a 1 Dockets.Justia.com Com pleteCare Obstetrics a/ k/ a Vineland Wom en’s Health Center (hereinafter “Com pleteCare”) from November 20 10 through May 20 11. Plaintiff alleges employees of Com pleteCare, a federally qualified health center (“FQHC”), deviated from the standard of care when they failed to tim ely offer Plaintiff proper prenatal screening for Down Syndrome, thereby depriving Plaintiff of necessary inform ation to m ake a fully inform ed decision as to whether or not to continue her pregnancy. S.M. was born with Down syndrom e on May 17, 20 11. The United States, answering for Defendant, argues that the Court has no jurisdiction to hear this suit because Com peteCare, a corporation with IRS section 50 1(c)(3) status which serves the underprivileged population of Vineland, qualifies as a “charitable organization” under the New J ersey Charitable Imm unity Act (“NJ CIA”), N.J . Stat. Ann. § 2A:53A7(a), and is therefore absolutely or partially im m une from liability. Alternatively, Defendant seeks partial sum m ary judgment and asks the Court to find that Com peteCare is a qualified entity under N.J . Stat. Ann. § 2A:53A-8, which caps recovery against “nonprofit hospitals” at $ 250 ,0 0 0 . 2 Applicable Standards A m otion to dism iss for lack of subject m atter jurisdiction under Fed. R. Civ. P. 12(b)(1) m ust be granted if the court lacks subject m atter jurisdiction to hear a claim . In re Schering Plough Corp. Intron/ Tem odar Consumer Class Action, 678 F.3d 235, 243 (3d Cir. 20 12). When a defendant files a motion under Rule 12(b)(1), the plaintiff bears the burden of establishing subject m atter jurisdiction for the sake of rem aining in federal court. Gould Elec., Inc. v. United States, 220 F.3d 169, 178 (3d Cir. 20 0 0 ). The Court applies this standard to the issue of im munity. See Young v. United States, 152 F. Supp. 3d 337, 344 (D.N.J . 20 15). A m otion to dism iss pursuant to Federal Rule of Civil Procedure 12(b)(1) m ay involve either a facial challenge to subject m atter jurisdiction or a factual challenge to the jurisdictional allegations. Gould Elec., 220 F.3d at 176. If the defendant’s attack is facial—i.e., “asserting that the com plaint, on its face, does not allege sufficient grounds to establish subject m atter jurisdiction”—a court m ust accept all allegations in the com plaint as true. Taliaferro v. Darby Twp. Zoning Bd., 458 F.3d 181, 188 (3d Cir. 20 0 6). Alternatively, a defendant m ay “challenge a federal court’s jurisdiction by factually attacking the plaintiff's jurisdictional allegations as set forth in the com plaint.” Mortensen v. First Fed. Sav. & Loan Ass’n, 549 F.2d 884, 891 3 (3d Cir. 1977). A factual challenge attacks the existence of a court’s subject m atter jurisdiction apart from any of the pleadings and, when considering such a challenge, a presum ption of truthfulness does not attach to a plaintiff's allegations.” Id.; see also Martinez v. U.S. Post Office, 875 F. Supp. 10 67, 10 70 (D.N.J . 1995). Regarding the applicability of the $ 250 ,0 0 0 cap on damages, the Court applies a summ ary judgm ent standard. “Sum m ary judgm ent is proper if there is no genuine issue of material fact and if, viewing the facts in the light m ost favorable to the non-m oving party, the m oving party is entitled to judgm ent as a m atter of law.” Pearson v. Component Tech. Corp., 247 F.3d 471, 482 n.1 (3d Cir. 20 0 1) (citing Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986)); accord Fed. R. Civ. P. 56 (a). Thus, the Court will enter sum m ary judgm ent in favor of a m ovant who shows that it is entitled to judgm ent as a matter of law, and supports the showing that there is no genuine dispute as to any m aterial fact by “citing to particular parts of m aterials in the record, including depositions, documents, electronically stored inform ation, affidavits or declarations, stipulations . . . adm issions, interrogatory answers, or other m aterials.” Fed. R. Civ. P. 56 (c)(1)(A). An issue is “genuine” if supported by evidence such that a reasonable jury could return a verdict in the nonmoving party’s favor. Anderson v. 4 Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). A fact is “material” if, under the governing substantive law, a dispute about the fact m ight affect the outcom e of the suit. Id. In determ ining whether a genuine issue of m aterial fact exists, the court m ust view the facts and all reasonable inferences drawn from those facts in the light m ost favorable to the nonm oving party. Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986). Initially, the m oving party has the burden of dem onstrating the absence of a genuine issue of m aterial fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). Once the m oving party has m et this burden, the nonm oving party must identify, by affidavits or otherwise, specific facts showing that there is a genuine issue for trial. Id.; Maidenbaum v. Bally’s Park Place, Inc., 870 F. Supp. 1254, 1258 (D.N.J . 1994). Thus, to withstand a properly supported m otion for sum mary judgment, the nonm oving party m ust identify specific facts and affirm ative evidence that contradict those offered by the m oving party. Andersen, 477 U.S. at 256-57. “A nonm oving party m ay not ‘rest upon m ere allegations, general denials or . . . vague statements . . . .’” Trap Rock Indus., Inc. v. Local 825, Int’l Union of Operating Eng’rs, 982 F.2d 884, 890 (3d Cir. 1992) (quoting Quiroga v. Hasbro, Inc., 934 F.2d 497, 50 0 (3d Cir. 1991)). Indeed, 5 the plain language of Rule 56(c) m andates the entry of sum m ary judgment, after adequate time for discovery and upon m otion, against a party who fails to m ake a showing sufficient to establish the existence of an elem ent essential to that party’s case, and on which that party will bear the burden of proof at trial. Celotex, 477 U.S. at 322. That is, the movant can support the assertion that a fact cannot be genuinely disputed by showing that “an adverse party cannot produce adm issible evidence to support the [alleged dispute of] fact.” Fed. R. Civ. P. 56(c)(1)(B); accord Fed. R. Civ. P. 56(c)(2). In deciding the m erits of a party’s m otion for sum m ary judgm ent, the court’s role is not to evaluate the evidence and decide the truth of the m atter, but to determ ine whether there is a genuine issue for trial. Anderson, 477 U.S. at 249. Credibility determ inations are the province of the factfinder. Big Apple BMW, Inc. v. BMW of N. Am ., Inc., 974 F.2d 1358, 1363 (3d Cir. 1992). Analysis Because Com pleteCare is a FQHC, CompleteCare and its J ohn Doe em ployees nam ed in this suit are deemed employees of the United States Public Health Service (“PHS”) for purposes of the FTCA, 28 U.S.C. §§ 1346(b), 2671-80 , and the United States therefore answers for the actions of Com pleteCare. See Lom ando v. United States, 667 F.3d 363, 371-72 (3d Cir. 20 11) (“[A]n action against the United States under the FTCA is the 6 exclusive remedy for persons alleging ‘personal injury, including death, resulting from the perform ance of m edical . . . or related functions’ by Public Health Service employees acting within the scope of their em ploym ent.’ 42 U.S.C. § 233(a); see also 42 U.S.C. § 233(g)(1)(A) (reiterating subsection 233(a)’s exclusivity clause).”). As such, “the United States is entitled to assert ‘any defenses available to a sim ilarly-placed private em ployer answering for the alleged torts of its employee.’” Dupont v. United States, --- F. Supp. 3d ---, No. 15-3752, 20 16 WL 3457150 , at *5 (D.N.J . J une 23, 20 16) (quoting Lom ando, 667 F.3d at 376). One such defense m ay be found in the NJ CIA, enacted to protect against the diversion of charitable funds from the purpose for which they were donated, to encourage private philanthropic activity to ensure the continued provision of services that benefit the general welfare, and to relieve the government of the burden of providing those services. Ryan v. Holy Trinity Evangelical Church, 815 A.2d 419, 425-26 (N.J . 20 0 3). The NJ CIA bars negligence claim s against a nonprofit corporation organized exclusively for religious, charitable, or educational purposes. It provides, in pertinent part: No nonprofit corporation, society or association organized exclusively for religious, charitable or educational purposes or its trustees, directors, officers, em ployees, agents, servants or volunteers shall, except as is hereinafter set forth, be liable to 7 respond in dam ages to any person who shall suffer dam age from the negligence of any agent or servant of such corporation, society or association, where such person is a beneficiary, to whatever degree, of the works of such nonprofit corporation, society or association; provided, however, that such im m unity from liability shall not extend to any person who shall suffer dam age from the negligence of such corporation, society, or association or of its agents or servants where such person is one unconcerned in and unrelated to and outside of the benefactions of such corporation, society or association. Nothing in this subsection shall be deem ed to grant im m unity to any health care provider, in the practice of his profession, who is a com pensated employee, agent or servant of any nonprofit corporation, society, or association organized exclusively for religious, charitable or educational purposes. N.J . Stat. Ann. § 2A:53A-7(a). That is, the NJ CIA provides com plete im m unity to an entity from tort liability when it (1) was form ed as a nonprofit corporation, society, or association; (2) is organized exclusively for religious, charitable, or educational purposes; and (3) was advancing those purposes “at the tim e of the injury to plaintiff who was then a beneficiary of the charitable works.” Bieker v. Cm ty. House of Moorestown, 177 A.2d 37, 42 (N.J . 20 0 1). The Act is “deemed to be remedial and shall be liberally construed so as to afford im m unity to the said corporations, societies and associations from liability as provided herein in furtherance of the public policy for the protection of nonprofit corporations, societies and associations organized for religious, charitable, educational or hospital purposes.” N.J . Stat. Ann. § 2A:53A-10 . 8 “Although the overarching character of all three categories [of N.J . Stat. Ann. § 2A:53A-7(a)] is eleem osynary, they are actually quite distinct. Two are specific as to subject m atter (educational and religious), and one is a generic catchall term (charitable). Both ‘educational’ and ‘religious’ have a lim ited and com m only understood meaning. On the contrary, ‘charitable’ is a m ore complex notion that defies precise definition.” Ryan, 815 A.2d at 424-25. When a charitable purpose is claim ed, therefore, the court m ust conduct a factual analysis beyond the benevolent acts of “the entity seeking to clothe itself in the veil of charitable im m unity to discover its aim s, its origins, and its method of operation in order to determ ine whether its dom inant m otive is charity or some other form of enterprise.” Parker v. St. Stephen’s Urban Dev. Corp., 579 A.2d 360 , 364 (N.J . Super. Ct. App. Div. 1990 ) (also recognizing that an entity’s non-profit and/ or tax-exempt status is irrelevant to the determ ination of whether that entity is organized exclusively for a charitable purpose). “Courts conducting this inquiry have looked to an organization’s funding, charter, daily operations, relationships to other entities, and the extent to which an organization lessens a burden on the government.” Nazzaro v. United States, 30 4 F. Supp. 2d 60 5, 611 (D.N.J . 20 0 4). 9 In addition to the absolute im m unity discussed, the NJ CIA caps the prospective liability of a nonprofit hospital “organized exclusively for hospital purposes” at $ 250 ,0 0 0 . Notwithstanding the provisions of [N.J . Stat. Ann. § 2A:53A– 7], any nonprofit corporation, society or association organized exclusively for hospital purposes shall be liable to respond in dam ages to such beneficiary who shall suffer dam age from the negligence of such corporation, society or association or of its agents or servants to an am ount not exceeding $ 250 ,0 0 0 , together with interest and costs of such suit[.] N.J . Stat. Ann. § 2A:53A-8. Accordingly, “[b]y the plain language of N.J . Stat. Ann. § 2A:53A– 7 and – 8, a hospital is subject to lim ited liability under section 8 if it is form ed as a nonprofit corporation, society, or association, is organized exclusively for hospital purposes, was prom oting those objectives and purposes at the tim e the plaintiff was injured, and the plaintiff was a beneficiary of the activities of the hospital.” Kuchera v. J ersey Shore Fam ily Health Ctr., 111 A.3d 84, 90 (N.J . 20 15) (also noting, at 92, that “hospitals now provide comprehensive services beyond acute inpatient care, and our conception of ‘hospital purposes’ needs to expand to reflect the m any health-related pursuits of the m odern hospital”). “The m ost prom inent distinction between nonprofit entities organized exclusively for charitable, religious, or educational purposes and nonprofits organized exclusively for hospital purposes is that the form er are 10 im m une from liability while the latter are subject to liability for negligence, albeit with a cap on its dam ages.” Kuchera, 111 A.3d at 89. “Put another way, if a nonprofit is organized ‘exclusively for hospital purposes,’ then no absolute im m unity can apply. Accordingly, if this Court determ ines that [Com pleteCare] is organized exclusively for hospital purposes, then the jurisdictional inquiry is concluded, even without determ ining the charitable status of [CompleteCare].” Young, 152 F. Supp. 3d at 347. Having thoroughly reviewed the record in this case, the Court is satisfied that CompleteCare is a nonprofit entity that is organized exclusively for hospital purposes, but its m ethod of operation does not indicate that its dom inant m otive is charity. The m ajority of Com pleteCare’s funding com es from government assistance, insurance, and patients. As such, im m unity would not apply to serve the purposes underlying com m on law. See Abdallah v. Occupational Ctr. of Hudson Cty., Inc., 798 A.2d 131, 134 (N.J . Super. Ct. App. Div. 20 0 2) (“[T]raditional analysis m ust take into account the organization’s source of funds as a critical elem ent of charitable status.). Com pleteCare’s Articles of Incorporation provide the following: The charitable purposes to which the Corporation shall be devoted are to prom ote the general health of the public, to provide health care and related services to the public, to receive grants and aid for the provision of health care and related 11 services, to contract with hospitals, professionals and other m edical service organizations for the provision of health care and related services to the public, and to conduct health education activities for the public. Edwards Decl. ¶ 5 and Ex. B. Its m ission statement is contained in the Bylaws: Our m ission is to provide the m ost accessible, culturally com petent and affordable highest quality health services to break down barriers to health care. And to work to prevent illness and injury am ong those m ost at risk by extending health prom otion and treatm ent to schools, neighborhoods and work places in the com munities we serve. Edwards Decl. ¶ 7 and Ex. C; see also Paul Decl. ¶ 3. It appears that the Bylaws effective during 20 10 and 20 11 are sim ilar. While Com pleteCare argues that this language evidences its charitable purpose, the Court finds, instead, that it docum ents that Com pleteCare is organized for hospital purposes. This determ ination is informed by the Kuchera Court: The m odern hospital in New J ersey . . . provides m edical care to those who can pay for the care and to those who cannot. In fact, every acute care hospital in this State is required to provide care to anyone who seeks care without regard to the ability to pay. N.J . Stat. Ann. § 26:2H– 18.64. The provision of charity care is a core function of a hospital. 111 A.3d at 93. Com pleteCare’s daily operations also reflect those of a hospital: Com pleteCare provides a variety of health services to its patients, including prim ary care (fam ily m edicine, pediatrics, internal m edicine, obstetrics and gynecology, geriatrics); on-site 12 specialty care (podiatry, ophthalm ology, optometry, cardiology, derm atology, and other subspecialties); preventive care (fam ily planning, well-child services, dental services, and nutrition), related support and enabling health services, and additional health services as appropriate and necessary. Edwards Decl. ¶ 9; Edwards Dep. 20 :23 to 21:7; Paul Decl., Exs. A and B. Com pleteCare either provides these services directly or through established written arrangements and referrals. Edwards Decl. ¶ 6. As an FQHC, CompleteCare also offers a variety of healthrelated services to enhance patient outcom es: financial counseling (enrollm ent assistance in Medicaid and New J ersey Charity Care); transportation to/ from dental services for children through the Sm ile Sm art Program ; comm unity outreach, including health screenings and health education; a low-cost pharmacy program (340 B); and several school program s, including pregnancy prevention programs, health youth developm ent, learning support, substance abuse/ counseling, m ental health counseling, and em ploym ent counseling. Paul Decl. ¶ 5 and Exs. A and B; Paul Dep. 115:1 to 120 :24; 122:11 to 126:3. Sim ilar to traditional hospital functions, CompleteCare provides m edical coverage for its patient population 24 hours a day, 7 days a week. Edwards Decl. ¶ 10 . In 20 10 and 20 11, Com pleteCare provided in-patient admissions for its patients to the local regional hospitals South J ersey Hospital, Inc. (now Inspira Health Network) and Burdette Tom lin Health System (now Cape Regional). Edwards Dep. 185:9 to 187:2 and Exs. Edwards-4, -5. Lastly, Com pleteCare trains and supervises m edical residents. Edwards Dep. 189:21 to 190 :2 and Ex. Edwards-17. Effective J uly 1, 20 11, Com pleteCare and South J ersey Hospital (now Inspira) entered into a contractual agreement to allow South J ersey Hospital’s residents to rotate through Com pleteCare’s facilities. Edwards Dep. 187:12 to 188:14 and Ex. Edwards-17 (Agreem ent). The residents are prim arily 13 assigned to CompleteCare obstetrical sites. Edwards Dep. 189:3-10 . (Def. Br. p. 38-40 .) Although Plaintiff argues that Com pleteCare should not be afforded lim ited liability status, it would be “error to confine ‘hospital purposes’ to the ‘vintage conception of a hospital as a facility providing a site for physicians to provide acute and continuous inpatient care for their patients. Rather, to effect the legislative m andate that the [NJ ]CIA should be liberally construed to effectuate its purpose, we focus on the m any m edical pursuits of a m odern hospital in New J ersey.’” Young, 152 F. Supp. 3d at 349 (quoting Kuchera, 111 A.3d at 92). Rather, “The m odern hospital is now a place where members of the com m unity not only seek em ergency services but also preventative services, therapy, educational program s, and counseling. . . . [H]ospitals now provide com prehensive services beyond acute inpatient care, and our conception of ‘hospital purposes' needs to expand to reflect the m any health-related pursuits of the m odern hospital.” Kuchera, 111 A.3d at 92. Finally, regarding Plaintiff’s argument that Com pleteCare should not be regarded as a nonprofit entity under the NJ CIA, the Court finds that Com pleteCare is organized as a nonprofit corporation and has been granted nonprofit status by the IRS. See also Young v. United States, --- F.3d ---, 14 No. 12-cv-5215, 20 16 WL 3129613, at *5 (D.N.J . J une 2, 20 16) (“There is no dispute that CAMcare is tax exempt under I.R.C. § 50 1(c)(3) and classified as a publicly supported organization under I.R.C. §§ 50 9(a)(1) and 170 (b)(1)(A)(vi). Additionally, CAMcare’s governing docum ents refer to its 50 1(c)(3) status, explain that it is organized as a non-profit corporation, and further provide that its sources of incom e will be charitable contributions, governm ent and charitable grants, and fees for services provided. As such, CAMcare is a “non-profit corporation, society or association” within the m eaning of the NJ CIA.”). Co n clu s io n For these reasons, the Court will grant partial sum m ary judgm ent in Defendant’s favor, as it finds that Com pleteCare meets the criteria of N.J . Stat. Ann. § 2A:53A-8 and therefore is entitled to the statutory lim itation on dam ages under the NJ CIA. An Order will accom pany this Opinion. Dated: Decem ber 20 , 20 16 / s/ J oseph H. Rodriguez J OSEPH H. RODRIGUEZ U.S.D.J . 15