MEMORANDUM OPINION
Plаintiffs Jeanetta and James Hartley originally sued defendants John Dombrowski, M.D. (“Dr. Dombrowski”), John Dombrowski, M.D., PC (“Dombrowski, PC”), and Massachusetts Avenue Surgery Center, LLC (“MASC”), for medical malpractice as a result of the allegedly negligent implantation of a spinal cord modulator in Mrs. Hartley’s lumbar area when she was a patient at MASC on March 5, 2007. 1 The motions before the Court are (1) plaintiffs’ Motion to Amend the Complaint to add informed consent and post-surgery malpractice claims; (2) Dr. Dombrowski and Dombrowski, PC’s Motion to Dismiss for failure to comply with Maryland’s statutory pre-filing requirements for mаlpractice claims; (3) Dr. Dombrowski and Dombrowski, PC’s Motion to Transfer pursuant to 28 U.S.C. § 1404(a); and (4) MASC’s Motion to Dismiss for lack of personal jurisdiction. As explained herein, the Court will grant plaintiffs’ Motion to Amend and grant in part Dr. Dombrowski and Dombrowski, PC’s Motion to Dismiss. It will deny Dr. Dombrowski and Dombrowski, PC’s Motion to Transfer and deny as moot MASC’s Motion to Dismiss.
BACKGROUND
Plaintiffs, residents of Pennsylvania, allege that Mrs. Hartley received negligent medical treatment from Dr. Dombrowski, a physician licensed in Maryland and the District of Columbia; Dombrowski, PC, a professional corporation doing business in the District; and MASC, a Maryland corporation that does business in Maryland and is owned by physicians practicing in Maryland, Virginia, and the District. (Amended Complaint [“Am. Compl.”] at 2.) According to plaintiffs, Mrs. Hartley was referred to Dr. Dombrowski by her pain management physician as a candidate for implantation of a spinal cord modulator to treat her chronic pain.
(Id.
¶ 1.) After being informed that the procedure was low risk, Mrs. Hartley agreed to have the modulator temporarily implanted in her lumbar area for a trial period.
(Id.
¶ 2.) Dr. Dombrowski scheduled the procedure to occur at MASC, a surgery centеr that he had an ownership interest in, without offering Mrs. Hartley any alternative locations.
(Id.
¶ 4.) The temporary modulator was implanted on January 23, 2007, but it failed to reduce Mrs. Hartley’s pain.
(Id.
¶ 5.) On January 31, 2007, Mrs. Hartley met with Dr. Dombrowski at his District office, where he adjusted the device in hopes of improving its pain management.
(Id.
¶ 6.) These adjustments were not effective, and Mrs. Hartley repeatedly telephoned Dr. Dombrowski’s office to tell him so. However, he assured her that the de
On March 5, 2007, Dr. Dombrowski implanted a permanent spinal cord modulator in Mrs. Hartley’s lumbar area. (Complaint [“Compl.”] ¶ 1.) The operation took place in Bethesda, Maryland at MASC and was performed with the assistance of MASC employees. (Id.) Following the operation, Mrs. Hartley complained of difficulty walking and pain in her back and lower extremities. (Id. ¶ 2.) Nevertheless, Dr. Dombrowski did not attempt to diagnose her ailments, and MASC employees discharged her without alerting any physicians to her condition or obtaining physician approval. (Id. ¶¶ 3-4,14.)
The following day, plаintiffs telephoned Dr. Dombrowski’s office to inform him that Mrs. Hartley could not lift her left foot and was numb in her buttocks, reproductive, and perineal areas. (Compl. ¶ 6.) In response, Dr. Dombrowski prescribed a steroidal medication, but it did not result in any improvement. (Id. ¶¶ 6-7.) Plaintiffs then conferred with physicians in Pennsylvania, one of whom telephoned Dr. Dombrowski on March 12, 2007, to discuss Mrs. Hartley’s condition. Two days after that conversation, Dr. Dombrowski removed the spinal cord modulator. (Id. ¶¶ 7-9.) However, even after the device was removed, the neurological damage to Mrs. Hartley’s lumbar area and lower extremities persisted. Mrs. Hartley was diagnosed with permanent neurological damage in those areas. (Id. ¶¶ 10-11.)
On March 3, 2010, plaintiffs sued the three defendants for medical malpractice, res ipsa loquitur, and loss of consortium for negligently operating on and discharging Mrs. Hartley. (Compl. ¶¶ 12-22.) In response, Dr. Dombrowski and Dombrowski, PC have moved to dismiss the complaint because plaintiffs had not complied with the pre-filing requirements set forth in Maryland’s Health Care Malpractice Claims Act, Md.Code Ann., Cts. & Jud. Proc. §§ 3-2A-01 to 09 (“Maryland’s Act”). (Defs. Dr. Dombrowski and Dombrowski, PC’s Mot. to Dismiss [“Dombrowski Mot. to Dismiss”] at 1.) Plaintiffs oppose this motion, or, in the alternative, they request that the action be stayed for 150 days while plaintiffs complete these pre-filing requirements. (Pis.’ Mem. in Opp’n. to Dombrowski Mot. to Dismiss [“Pis.’ Opp’n.”] at 7.) Defendants have also moved to transfer the case to the Southern Division of the United States District Court for the District of Maryland pursuant to 28 U.S.C. § 1404(a). (Defs. Dr. Dombrowski and Dombrowski, PC’s Mot. to Transfer at 1.) Finally, defendant MASC has moved to dismiss for lack of personal jurisdiction under Federal Rule of Civil Procedure 12(b)(2). (Mem. P. & A. in Supp. of Def. MASC’s Mot. to Dismiss at 1.)
On July 21, 2010, plaintiffs moved to amend their original complaint. Plaintiffs sought to add a claim against Dr. Dombrowski and Dombrowski, PC for lack of informed consent. (Am. Compl. ¶¶ 22-24.) In support of this claim, plaintiffs’ Amended Complaint alleges that Dr. Dombrowski never informed Mrs. Hartley that the procedure could leave her lower extremities paralyzed, and that the only warnings she received were in the Informed Consent Form that was given to her on the day of the surgery along with numerous other documents.
(Id.
¶¶ 9-10.) Plaintiffs also sought to add a claim for post-surgical malpractice against Dr. Dombrowski and Dombrowski, PC for prescribing steroidal medication to treat Mrs. Hartlеy’s numbness and paralysis.
(Id.
¶¶ 29-31.)
2
Dr.
ANALYSIS
I. MOTION TO AMEND
Under District law, the statute of limitations for medical malpractice and informed consent claims is three years. 3 D.C.Code § 12-301(8). As more than three years have lapsed since the surgery took place, plaintiffs proposеd informed consent claim is time barred. Thus, the Court must evaluate whether the claim relates back to plaintiffs’ original complaint, which alleged negligence in operating on Mrs. Hartley and discharging her from the MASC.
An amendment to a complaint that raises otherwise time barred claims may yet be timely if the amendment “relates back” to the date of the original complaint under Federal Rule of Civil Procedure 15(c).
Jones v. Bernanke,
Other courts that have examined whether an informed consent claim relates back to claims of surgical negligence are split on the issue.
See, e.g., Wagner v. Georgetown Univ. Med. Ctr.,
By contrast, those courts that find relation back generally view the surgery as a whole as the “occurrence” out of which both the malpractice and informed consent claims arose.
See, e.g., Wagner,
The Court prefers the latter approach as it recognizes that defendants in these cases are, as a practical matter, on notice of plaintiffs’ new informed consent claims even if the original complaints did not allege the specific facts of the claims. Here, defendants knew from the original complaint that plaintiffs sought to recover damages for injuries caused by defendants’ medical treatment of Mrs. Hartlеy. (Compl. at 1.) “Reasonably prudent” defendants would expect that plaintiffs might assert other theories of recovery for those injuries, including that Mrs. Hartley did not give informed consent to the surgery that caused them.
Wagner,
Given that the original complaint should have put defendants on notice of plaintiffs’ informed consent claim, relation back is not precluded by the fact that plaintiffs will have to prove different facts to recover on this claim. Such a reading of Rule 15(c)(1)(B) would “prohibit relation back even where plaintiff alleged an additional specific act of negligence during the operation itself, unless the newly alleged act was related to the previously alleged specific acts.”
Neeriemer, 477
P.2d at 749. Rather, notice is the issue underlying the Rule 15(c)(1)(B) inquiry.
Meijer,
The Court also finds that plaintiffs newly аdded medical malpractice claim based on Dr. Dombrowski’s post-surgery prescription of steroidal medication relates back to the original complaint. That complaint specifically alleged that Dr. Dombrowski had prescribed steroidal medication to treat Mrs. Hartley’s post-operative paralysis and numbness. (Compl. ¶ 6.) The Amended Complaint merely asserts a new claim for malpractice based on that conduct. This is precisely the sort of amendment contemplated by Rule 15(c), which provides for relation back where the amended pleading as
II. MOTION TO DISMISS FOR FAILURE TO COMPLY WITH MARYLAND’S ACT
Dr. Dombrowski and Dombrowski, PC have moved to dismiss plaintiffs’ complaint because plaintiffs failed to comply with the pre-filing requirements for medical malpractice claims set forth in Maryland’s Act. (Dombrowski Mot. to Dismiss at 1). Maryland’s Act provides that as a precondition to filing suit, medical malpractice claims alleging damages in excess of a specified jurisdictional amount (i.e., $30,-000) 4 must be submitted for arbitration, along with a certificate from a qualified expert attesting to the alleged malpractice. Md.Code Ann., Cts. & Jud. Proc. §§ 3-2A-01 to 09. The Act also places a cap on non-economic damages. Id. at § 11-108. It is uncontested that plaintiffs have not complied with the Maryland Act’s preconditions. (See Pis.’ Opp’n. at 7.) Plaintiffs, however, argue that District law, rather than Maryland law, applies. (Id. at 6.) The District requires only that plaintiffs send a Notice of Intent to Sue to defendants at least 90 days prior to filing suit. D.C.Code Ann. § 16-2802(a). The Court must resolve this dispute by reference to D.C.’s choicе of law rules.
A. Choice of Law
When determining the applicable law in a diversity case, a federal court applies the choice of law rules of the forum state.
Bledsoe v. Crowley,
The governmental policies underlying the malpractice laws in Maryland and in the District differ significantly. Maryland’s Act is aimed at reducing the cost of malpractice insurance and overall health care costs for Maryland residents. Specifically, in making arbitration a precondition to filing suit, “[t]he goal ... was to establish a mechanism to screen malpractice claims prior to the filing of suit.... [T]his would reduce the cost of defense by ferreting out unmeritorious claims which, in turn, would lower the cost of malpractice insurance and, potentially, overall health care costs.”
Group Health
Assoc.
v. Blumenthal,
1. Informed Consent: Dr. Dombrowski and Dombrowski, PC
Plaintiffs claim that Dr. Dombrowski and Dombrowski, PC failed to timely advise Mrs. Hartley of the risks of having a spinal cord modulator implanted in her lumbar area, and that she would not have undergone the procedure had she been so advised. (Am. Compl. ¶¶ 22-24.) Both Maryland and the District have an interest in applying their laws to this claim because these defendants do business in both jurisdictions. Thus, large malpractice liability would affect insurance and health care costs in Maryland, while a cap on damages would prevent the District from holding its practitioners fully liable for their negligencе. As both jurisdictions’ policies are implicated, the Court turns to the other choice of law factors.
The negligent conduct at issue occurred in both the District and Maryland. In the District, Dr. Dombrowski failed to inform Mrs. Hartley of the risks of implantation at their pre-operation consultations, including the one at which Mrs. Hartley agreed to have the modulator permanently implanted. (Am. Compl. ¶¶8-9.) Nor did he adequately disclose these risks on the day of the surgery, which took place in Maryland. (Am. Compl. ¶ 10.) Plaintiffs’ injuries were suffered predominantly in Pennsylvania, where plaintiffs residе.
6
(Compl. at 2.) The localities of the parties do not clearly favor either Maryland or the District. Plaintiffs reside in Pennsylvania, Dr. Dombrowski is licensed in both Maryland and the District, and Dombrowski, PC, does business in Maryland and the District through Dr. Dombrowski. Finally, the center of the parties’ relationship favors neither jurisdiction. While both the temporary and permanent modulators were implanted in Maryland, the consultations leading up to the surgery, the decision to go forward with permanent implan
In sum, governmental interest analysis does not favor either Maryland or the District. Where the interests of both jurisdictions are equally weighty, the law of the forum state shall apply.
Stutsman,
2. Medical Malpractice:
Dr. Dombrowski and Dombrowski, PC
Plaintiffs claim that Dr. Dombrowski and Dombrowski, PC committed medical malpractice while implanting the spinal cord modulator. (Am. Compl. ¶¶ 26-28.) For the reasons explained above, both Maryland and the District have an interest in applying their laws to this claim. And, as above, the place of the injury, the localities of the parties, and the center of the relationship do not favor еither jurisdiction. However, the negligent conduct underlying this claim occurred entirely in Maryland, as that is where the surgery took place.
7
(Compl. ¶ 1.) This factor tips the scales decidedly in favor of Maryland, as “ ![t]he state where the defendant’s conduct occurs has the dominant interest in regulating it.’ ”
Bledsoe,
3. Res Ipsa Loquitur: Dr. Dombrowski, Dombrowski, PC, and MASC
Plaintiffs claim that under the doctrine of
res ipsa loquitur,
all three defendants were either individually or collectively negligent during the device implantation, thereby causing Mrs. Hartley’s injuries. (Am. Compl. ¶¶ 36-40.) Again, both Maryland and the District’s policy interests are implicated by this claim. But with respect to defendant MASC, Maryland’s interest clearly outwеighs the District’s, as MASC is a Maryland corporation that conducts business in Maryland (Mem. P. & A. in Supp. of Def. MASC’s Mot. to Dismiss at 2), and therefore, the effects of large malpractice liability would be felt
The analysis of the four Restatement factors is similar to the Restatement analysis above, with the localities of the parties more strongly favoring Maryland due to MASC. Thus, the Court finds that Maryland law applies to plaintiffs’ res ipsa loquitur claim.
4. Medical Malpractice: MASC
Plaintiffs claim that MASC committed medical malpractice by discharging Mrs. Hartley after the operation without first seeking physician approval. (Am. Compl. ¶¶ 33-35.) Maryland clearly has the greater interest in this claim as it concerns a Maryland corporation, the negligent conduct occurred in Maryland, the injury was suffered in Pennsylvania and arguably also in Maryland (see supra note 6), and the parties’ localities are in Maryland and Pennsylvania. Thus, Maryland law applies to this claim.
5. Medical Malpractice:
Dr. Dombrowski and Dombrowski, PC
Plaintiffs allege that Dr. Dombrowski and Dombrowski, PC committed medical malpractice by prescribing Mrs. Hartley steroidal medication in response to her complaints of numbness and paralysis post-operation. (Am. Compl. ¶¶ 29-32.) The choice of law analysis for this claim is the same as for the informed consent claim against these defendants, except that here, the negligent conduct occurred in the District. Thus, this “dominant interest” tips the scales in favor of the District, and District law applies to this claim.
Bledsoe,
6. Loss of Consortium: Dr. Dombrowski, Dombrowski, PC, and MASC
Finally, plaintiffs allegе that all three defendants are liable for Mr. Hartley’s loss of consortium due to Mrs. Hartley’s condition. (Am. Compl. ¶¶ 41-42.) For loss of consortium claims, the District applies the law of the state where the marriage is domiciled.
Long v. Sears Roebuck & Co.,
B. Dismissal of Claims Governed by Maryland Law
The Court has found that Maryland law applies to three of plaintiffs’ six
III. MOTION TO TRANSFER
Dr. Dombrowski and Dombrowski, PC have moved to transfer the case to the Southern Division of the United States District Court for the District of Maryland pursuant to 28 U.S.C. § 1404(a). (Defs. Dr. Dombrowski and Dombrowski, PC’s Mot. to Transfer at 1.) This statute allows a district court to transfer a case to another district where the case might have been brought “[f]or the conveniеnce of parties and witnesses, in the interest of justice.” 28 U.S.C. § 1404(a). In deciding whether to transfer, a court is to consider several private and public interest factors. The private interest factors include (1) the plaintiffs choice of forum, (2) the defendant’s choice of forum, (3) where the claim arose, (4) the convenience of the parties, (5) the convenience of the witnesses, particularly if important witnesses may actually be unavailable to give live trial testimony in one of the districts, and (6) the ease of access to sources of proof.
Montgomery v. STG Intern., Inc.,
Given the proximity of Maryland to the District, public, rather than private, interest factors predominate.
See Medlantic Long Term Care Corp. v. Smith,
IV. Motion to Dismiss for Lack of Personal Jurisdiction
As all claims against MASC have been dismissed, the Court will deny MASC’s Motion to Dismiss for lack of personal jurisdiction as moot. 10
CONCLUSION
The Court will grant plaintiffs’ Motion to Amend and it will grant in part Dr. Dombrowski and Dombrowski, PC’s Motion to Dismiss. As a result, all claims against MASC shall be dismissed. The remaining claims against Dr. Dombrowski and Dombrowski, PC for informed consent, medical malpractice for the post-surgery prescription of steroidal medication, and loss of consortium shall remain in this Court, which will apply District law to the informed consent and medical malpractice claims, and Pennsylvania law to the loss of consortium claim.
Notes
. Mr. Hartley's claim is for loss of consortium.
. Plaintiffs seek $5,000,000 for each claim alleged in their original and amended com
. The District's choice of law rules treat statutes of limitations as procedural rather than as substantive, and thus, the District’s statute of limitations applies in this case.
A.I. Trade Fin., Inc. v. Petra Int’l. Banking Corp.,
. The jurisdictional amоunt is the limit of the Maryland District Court's concurrent jurisdiction with Maryland trial courts of general jurisdiction, Md.Code Ann., Cts. & Jud. Proc. § 3-2A-02(a)(l), which is currently $30,000. Id. §§ 4-401(1), -402(d)(l)(i).
. Plaintiffs advance another District interest. They argue that because a significant number of the physicians who own MASC practice in the District, they will “undoubtedly” refer patients seeking medical care in the District to MASC. Therefore, plaintiffs argue, the District has an interest in ensuring that these patients receive competent medical care without getting "hauled off” to Maryland where they lose the protection of District law. (Pls.’ Opp'n. at 3-4.) Even assuming
arguendo
that such referrаls “undoubtedly" occur, this interest would not be materially undermined by the application of Maryland law. There is no suggestion that Maryland provides less competent health care than the District, or that Maryland does not protect its patients. To the contrary, "Maryland law does not prevent a defendant from being adjudged liable for substantial damages.”
Groover,
. Arguably, a small portion of the injury was also suffered in Maryland, where Mrs. Hartley experienced numbness and paralysis prior to being discharged. (Compl. ¶¶ 2-4.)
. Plaintiffs argue that the location of the conduct was "fortuitous” as Dr. Dombrowski, and not Mrs. Hartley, selected it. (Pls.' Opp'n. at 6.) However, this does not make the location fortuitous.
See, e.g., Ott v. Kaiser-Georgetown Cmty. Health Plan, Inc.,
. Plaintiffs argue that because a significant number of MASC's physician-owners have offices in the District, MASC conducts business in the District. (Am. Compl. at 2) Assuming arguendo that this is true, plaintiffs do not dispute that MASC’s principal place of business is in Maryland.
. Note that plaintiff’s choice of forum would receive even more deference if it were their home forum.
Robinson,
. Although plaintiffs' loss of consortium claim remains, there remain no underlying claims of negligence against MASC. Thus, there can be no loss of consortium claim against MASC as a spouse may only recover for loss of consortium against a defendant who has tortiously caused injury to the other spouse. See 21 George L. Blum, Standard Pennsylvania Practice % 116:31 (2d ed.).
