Want v. Express Scripts, Inc.
862 F. Supp. 2d 14
D.D.C.2012Background
- Plaintiff Jerome Want, proceeding pro se, sues Express Scripts, Inc. in D.D.C. for $2 million plus $1B punitive damages over alleged failed prescription processing.
- Express Scripts is a pharmacy benefit manager that contracts with retail pharmacies to dispense medications.
- Plaintiff’s 10-count complaint alleges malpractice, negligence, lack of good faith, failure to perform, fraud, malfeasance, breach of contract, HIPAA violation, discrimination, and reckless endangerment.
- Plaintiff’s responses add factual detail: (a) two failed processing incidents in 2011; (b) multiple calls requesting physician fax of refill forms; (c) Pfizer letter alleging a contract via Pfizer Connection to Care.
- Court grants 12(b)(6) motion, applying Maryland law for torts and Missouri law for contract, and dismisses claims for lack of viable legal theories or facts supporting them.
- Court notes no credible injury or duty relationship; the Pfizer letter is not a contract; HIPAA private right of action does not exist; many counts are not viable under applicable law.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether plaintiff states a plausible malpractice claim | Want asserts a duty and breach by defendant. | No physician-patient duty between Want and Express Scripts. | Counts 1/2 not stated; dismissed |
| Whether plaintiff states a plausible fraud claim | Misrepresentation by defendant about processing delays. | Fraud lacks particularity and reliance not shown. | Count 5 dismissed for lack of particularity |
| Whether plaintiff states a plausible breach of contract claim | Pfizer letter creates contract binding defendant. | Letter insufficient to form contract terms. | Count 7 dismissed; no contract shown |
| Whether plaintiff states a claim for discrimination | Discriminatory conduct by gender/age. | Suits under Title VII/ADEA not shown against plaintiff’s employer. | Count 9 dismissed; no federal discrimination claim shown |
| Whether HIPAA private right of action exists | HIPAA rights apply to plaintiff. | No private HIPAA cause of action; only parens patriae action possible. | Count 8 dismissed; no private right of action |
Key Cases Cited
- Alexander v. Wash. Gas Light Co., 481 F. Supp. 2d 16 (D.D.C. 2006) (tort facts required; Maryland contract choice analysis)
- Ashcroft v. Iqbal, 556 U.S. 662 (Supreme Court 2009) (pleading standard; plausibility required)
- Twombly v. Bell Atl. Corp., 550 U.S. 544 (S. Ct. 2007) (facial plausibility required; naked allegations not enough)
- Richardson v. U.S., 193 F.3d 545 (D.C. Cir. 1999) (liberal pro se construction of filings; read together)
- Horridge v. St. Mary’s County Dep’t of Soc. Services, 854 A.2d 1232 (Md. 2004) (elements of negligence; duty, breach, causation, damages)
- State v. Copes, 927 A.2d 426 (Md. 2007) (duty and standard of care in malpractice context)
- Ellerin v. Fairfax Sav., F.S.B., 652 A.2d 1117 (Md. 1995) (fraud elements; intent to deceive)
- Keveney v. Missouri Military Academy, 304 S.W.3d 98 (Mo. 2010) (contract breach requires evidence of contract)