OPINION
A foreign medical lab appeals a district court order denying its motion to dismiss for lack of personal jurisdiction. We agree with the district court that Minnesota may properly exercise jurisdiction over the foreign defendant where it has had numerous contacts with Minnesota through an intermediary.
FACTS
Joan Bergherr (Bergherr) died at the age of 33 from cervical cancer. Her husband sued the attending doctor (Sommer) for failing to diagnose her illness. MetPath, Inc. (MetPath) and Dallas Pathology Associates, Inc. (DPA), medical labs that had examined cells taken from Bergherr’s cervix, were later joined for allegedly fаiling to interpret properly her pap smear slides.
Over a 14-year period, Bergherr had a total of 10 pap smears taken by Sommer. For each smear, he would send slides with cells taken from her cervix to MetPath in Illinois for examination. MetPath is a nationwide reference laboratory which оften “offloads” specimens to other labs for testing.
In 1988, MetPath and DPA, a Texas corporation, entered into an agreement by which MetPath would offload pap smear slides to DPA. DPA solicited this business from Met-Path. DPA has no other contacts with Minnesota. It owns no property, conducts no business, and has no оffices in Minnesota.
MetPath estimates that, in 1988, it shipped approximately 1,100 pap smears daily from Illinois and nearby states to DPA for analysis. Roughly 110 were from Minnesota. That number increased over the next few years. DPA charged MetPath $4.50 per slide until 1991, when it began charging $6.25. DPA received thousands of dollars every week from its analysis of pap smears from Minnesota. MetPath would send the specimens to DPA along with the MetPath requisition slip filled out by the requesting doctor. As the slip contained the patient’s name and the address of the doctor, DPA knew which slides were from Minnesota.
DPA received and analyzed pap smеars from Bergherr during the years 1989, 1990, and 1991. DPA’s report to Sommer indicated that there had been some “atypical changes” and suggested various treatments. Plaintiff amended his complaint to include DPA after experts determined that these specimens were even more abnormal than DPA reported to Sommer. DPA moved for dismissal for lack of personal jurisdiction, and the district court denied its motion.
ISSUE
Does DPA have sufficient minimum contacts with Minnesota to permit Minnesota courts constitutionally to exercise personal jurisdiction over it?
*20 ANALYSIS
Determining whether personal jurisdiction exists is a question of law and this court need not defer to the trial court’s decision.
Stanek v. A.P.I., Inc.,
(d) Commits any act outside Minnesota causing injury or property damage in Minnesota, subject to the following exceptions when no jurisdiction shall be fоund: (1)Minnesota has no substantial interest in providing a forum; or (2) the burden placed on the defendant by being brought under the state’s jurisdiction would violate fairness and substantial justice.
Since this statute is to have the maximum territorial effect allowed under the due process clause of the federal constitution, the real inquiry in determining the permissibility of an exercise of jurisdiction is whether it meets constitutional muster.
Rostad v. On-Deck, Inc.,
“Due process requires that a defendant have minimum contacts with a jurisdiction before being required to defend a lawsuit in that jurisdiction.”
Id.
(citing
International Shoe Co. v. Washington,
(1) The quantity of contacts with the forum state;
(2) The nature and quality of the contacts;
(3) The source and connection of the cause of action with these contacts;
(4) The interest of the state providing a forum; and
(5) The convenience of the parties.
National City Bank v. Ceresota Mill Ltd. Partnership,
1. Quantity of Contacts
It is undisputed that DPA has no direct contacts with Minnesota. The lack of direct contacts, however, does not necessarily preclude a state from exercising personal jurisdiction over a nonresident defendant.
Helten v. Arthur J. Evers Corp.,
The trial court applied the stream-of-commerce theory to the present case, which involves the sale of services rather than the sale of goods, stating, “there are many similarities which are anаlogous as well as instructive.” DPA argues that the stream-of-commerce theory cannot be applied in the present ease and asserts that the only occasion to apply the theory is in product liability cases.
DPA cites several eases in which it claims Minnesota courts have consistеntly indicated that the stream-of-commerce theory is proper
only
in product liability cases. These cases state that Minnesota has adopted the theory in product liability cases. They do not
expressly
limit the application of the theory to that context. All of these cases involved a product of some kind, so it is not surprising that they referred to the stream-of-commerce theory as applying in the product liability context.
See Rostad,
Although Minnesota courts have never directly applied the stream-of-commerce theory to a case involving services, the analysis has been used to establish jurisdiction in
*21
contexts other than product liability.
Doe 1-22 v. Roman Catholic Bishop,
DPA asserts that the Minnesota Supreme Court expressly declined to extend jurisdiction to services under the stream-of-commerce theory in
Real Properties, Inc. v. Mission Ins. Co.,
The primary basis for the court’s decision was Holman’s minimal contacts with Minnesota. Holman had no direct contaсts with Minnesota and his five or six indirect contacts through the Minnesota moving firm were “fortuitous and attenuated.” Id. at 668. The court held that Holman’s 18 contacts with Minnesota as an agent of United over a 15-year period were insufficient because they did not “demonstrate a continuous pattern of business sufficient tо make it fair and reasonable to subject Holman to Minnesota’s jurisdiction for a cause of action arising out of a transaction unrelated to these * * * contacts.” Id. at 669.
DPA points to a footnote in which the court rejected the argument that Holman should be compared to a manufacturеr under the stream-of-commerce theory. The court stated, “[t]here are * * * structural differences between a manufacturer of a product with a distribution system and, as here, the provider of a service who
sometimes
participates in a national carrier network.”
Id.,
n. 3 (emphasis added). Although the court did refer to the difference between a manufacturer and a service provider, the court’s focus remained on the frequency of the contacts. The court went on to point out in the footnote that Holman did not have the “ ‘plethora of indirect contacts’ ” that existed in
Rostad. Real Properties,
DPA cites
Considine v. West Point Dairy Prods., Inc.,
*22
An examination of the reasoning underlying the stream-of-commerce theory further supports its application to the present case. In
Rostad)
The
Rostad
court adopted the United States Supreme Court’s reasoning that it is not unreasonable to subject to suit a manufacturer or distributor who places its products into the stream of commerce, expecting that consumers in the forum state will purchase them.
Rostad,
due process does not extend so far as to permit a manufacturer to insulate itself from the reach of the forum state * * * by using an intermediary or by professing ignorance of the ultimate destination of a product.
Id. at 721 (citations omitted).
Applying the principles of the stream-of-commerce theory to the present case, DPA’s numerous indirect contacts with Minnesota sufficiently satisfy the due process сlause. Like the bat weight manufacturer, DPA has had no direct contacts with Minnesota, but has provided its service thousands of times to Minnesota residents through MetPath.
To hold that DPA is not subject to Minnesota jurisdiction because it had no direct contact would mean that DPA could only be sued in Texas and Illinois, a cоncept the Rostad court found unacceptable in the product liability context. Id. Like the manufacturer of a product, DPA similarly should not be allowed to insulate itself from Minnesota’s reach by its use of an intermediary — in this ease MetPath. Therefore, we hold that DPA’s systematic provision of numerous services to Minnesotans through MetPath establishes sufficient contacts to justify jurisdiction.
2. Nature and Quality of Contacts
In reviewing the nature and quality of contacts, the focus is on whether the nonresident “purposefully availed” itself of the benefits and protections of Minnesota law.
Dent-Air, Inc. v. Beech Mountain Air Serv.,
DPA argues that it did not purposefully avail itself of the benefits and protection of Minnesota law because it did not solicit business directly from Minnesota. DPA correctly points out that a nonresident defendant’s solicitation of business in a forum state satisfies the purposeful availment requirement.
See Hanson v. John Blue Co.,
The two cases cited by DPA are distinguishable and do not support its claim that it has not purposefully availed itself to Minnesota. In
Simmons v. Montana,
Similarly, in
Grange Ins. Assoc. v. Washington,
3. Other Factors Supporting Jurisdiction
The remaining factors to be considered in determining whether minimum contacts exist also support jurisdiction in the present case.
See National City Bank,
DECISION
Minnesota may properly exercise jurisdiction over a foreign defendant who commits an act outside Minnesota which causes injury in Minnesota as long as it does not violate fairness and substantial justice. Minn.Stat. § 543.19, subd. 1(d)(2) (1992). If, as alleged, DPA misinterpreted the pap smears, thereby contributing to Bergherr’s death, that was an act causing injury in Minnesota. Considering the volume of business and amount of revenue DPA received for the services it performed for Minnesota residents, it is not unfair or unjust to expect DPA to defend in Minnesota.
Affirmed.
Notes
Retired judge of the district court, serving as judge of the Minnesota Court of Appeals by appointment pursuant to Minn. Const, art. VI, § 10.
