U.S. ex rel. Saldivar v. Fresenius Medical Care Holdings, Inc.
906 F. Supp. 2d 1264
N.D. Ga.2012Background
- Relator Saldivar, California resident, worked for Fresenius from 2007 to 2009, alleging False Claims Act violations.
- Fresenius is a national dialysis provider seeking government reimbursement for treatments and medications, including Zemplar and Epogen.
- Relator alleges Fresenius billed for overfill volumes received for free, creating false claims to Medicare/Medicaid.
- Relator observed overfill percentages and discrepancies between administered doses and inventory; corporate reports highlighted overfill goals.
- Relator raised concerns, was suspended, then terminated in 2009; Relator filed suit January 24, 2011, alleging Counts 1–4 FCA claims and state-law equivalents.
- Fresenius moved to dismiss (public disclosure bar, original source, Rule 9(b), and state-law issues); court issued partial grant/partial denial.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Public disclosure bar applicability | Allegations not barred because disclosures do not reveal wrongdoing by Fresenius. | Bar applies where disclosures exist and relate to the same defendant; public disclosures mandate dismissal. | Public disclosure bar does not apply at this stage. |
| Original source exception viability | Relator had direct, independent knowledge and provided information to government pre-filing. | Relator not an original source; information publicly disclosed exists. | Relator may qualify as an original source; denial of dismissal on jurisdictional grounds. |
| Rule 9(b) failure to plead fraud with particularity | Relator's employment role and firsthand observations provide indicia of reliability. | Insufficient detail to plead false claims with particularity. | Relator's allegations plausibly allege fraud with sufficient indicia; claim survives. |
| State-law FCA claims viability | States other than CA/NV plausibly implicated; employment scope nationwide. | Insufficient procedure and geographic basis; service requirements not met; overbroad scope. | Dismissed all state-law claims except possibly CA and NV; procedural compliance fatal. |
Key Cases Cited
- U.S. ex rel. Walker v. R&F Props. of Lake County, Inc., 433 F.3d 1349 (11th Cir.2005) (three FCA elements; claims must be presented with knowledge of false claim)
- Hopper v. Solvay Pharm., Inc., 588 F.3d 1318 (11th Cir.2009) (heightened Rule 9(b) pleading for FCA claims; fraud specifics required)
- Matheny v. Medco Health Solutions, Inc., 671 F.3d 1217 (11th Cir.2012) (allows general pleading of scienter where appropriate reliability shown)
- Clausen v. Lab. Corp. of Am., 290 F.3d 1301 (11th Cir.2002) (Rule 9(b) relaxed when facts are peculiarly within defendant's knowledge)
- Bell Atl. Corp. v. Twombly, 550 U.S. 544 (2007) (claims must be plausible on their face)
- Rockwell Int’l Corp. v. U.S., 549 U.S. 457 (2007) (original source requires independent knowledge of information; public disclosures do not bar all claims)
- Cooper v. Blue Cross & Blue Shield of Florida, Inc., 19 F.3d 562 (11th Cir.1994) (public disclosure bar and original source framework)