Bristol-Myers Squibb Company v. Clare Connors, 979 F.3d 732

Hawaii Attorney General sued Bristol-Myers Squibb and Sanofi entities in state court (2014) under Hawaii’s consumer-protection statute for allegedly concealing that Plavix is less effective in persons with a certain genetic variation common in Hawaii.
Two private law firms led the investigation and litigate the state case on a contingency-fee basis, but the action was filed in the name of the State and seeks civil penalties, injunctive relief, and damages.
Nearly six years into the state litigation, the pharmaceutical companies filed a federal suit seeking an injunction, alleging First Amendment violations and challenging the state action.
The State moved to dismiss under Younger abstention; the district court granted the motion.
On appeal, the Ninth Circuit reviewed de novo and considered whether the state suit is a quasi-criminal civil enforcement proceeding within Younger/Sprint.
The Ninth Circuit affirmed: the state enforcement action is the type of civil enforcement proceeding that warrants Younger abstention; challenges based on private counsel, case-specific inquiry, and First Amendment interests did not overcome abstention.

Issue	Bristol-Myers' Argument	Hawaii/Connors' Argument	Held
Whether Younger abstention applies to the state suit	Younger does not apply because the action is not a state-initiated civil enforcement proceeding	The suit is a civil enforcement action brought by the State and Younger applies	Younger applies; state suit is a civil enforcement proceeding warranting abstention
Whether the State is a real party in interest when private counsel prosecutes the case	Use of private counsel makes the State only a nominal plaintiff, so Younger should not apply	Litigation was brought by the Attorney General in sovereign capacity; choice of counsel does not change that	State is a genuine sovereign party; use of outside counsel does not defeat Younger
Whether courts must perform a case-specific, rigorous inquiry into the state action’s character	Court should scrutinize the specific facts (investigation by private firms, profit motive) before applying Younger	Younger focuses on the general class of proceedings; no case-specific checklist required	No heightened case-specific inquiry; classify by the general class of proceedings
Whether First Amendment claims or extraordinary circumstances defeat Younger	First Amendment chilling from high penalties requires heightened review and injunction	First Amendment claims alone do not negate Younger absent narrow extraordinary circumstances	First Amendment concerns insufficient to overcome Younger; no bad-faith/harassment exception shown

Younger v. Harris, 401 U.S. 37 (1971) (establishes federal abstention from interfering with pending state criminal prosecutions and related comity principles)
Sprint Communications, Inc. v. Jacobs, 571 U.S. 69 (2013) (limits Younger to three categories, including certain civil enforcement proceedings akin to criminal prosecutions)
New Orleans Pub. Serv., Inc. v. Council of New Orleans, 491 U.S. 350 (1989) (extends Younger to certain civil enforcement proceedings)
Huffman v. Pursue, Ltd., 420 U.S. 592 (1975) (abstention principles where federal relief would interfere with pending state proceedings)
Middlesex County Ethics Comm. v. Garden State Bar Ass'n, 457 U.S. 423 (1982) (focus on the importance of the generic class of state proceedings for Younger analysis)
Colorado River Water Conservation Dist. v. United States, 424 U.S. 800 (1976) (federal courts generally obliged to exercise jurisdiction except in limited abstention doctrines)
Trainor v. Hernandez, 431 U.S. 434 (1977) (actions brought by a State in its sovereign capacity are distinct and implicate Younger principles)