Lead Opinion
Appellant, a California resident, filed a medical malpractice suit in Federal District Court for the Central District of California. Jurisdiction was based on diversity. The two appellee doctors live and practice medicine in Arizona, and appellee hospital is located and licensed in Arizona. The district court dismissed the case for lack of personal jurisdiction as to all appellees. Appellant appeals, arguing that under California’s long-arm statute аppellees had sufficient contacts with the state to support personal jurisdiction.
Appellee Parker Community Hospital is an Arizona corporation having its principal place of business in Parker, Arizona. The town is located in a sparsely populated desert region near the Arizona/Calif ornia border. A bridge connects Parker with California. Appellee doctors Merchent and Meyer are Arizona citizens and are licensed to practice mеdicine there, but not in California.
During October-November of 1981, appellees treated appellant for an ulcer. Appellant was subsequently transferred to a California hospital on November 13, 1981, at the instigation of Dr. Merchent. Appellees were not responsible for any of appellant’s treatment there.
The district court, in granting appellees’ F.R.Civ.P. 12(b)(2) motion to dismiss for lack of personal jurisdiction, included in its findings of fact that (1) a small percentage of the hospital’s employees are residents of California — in 1981 sixteen of eighty-seven were California residents; (2) appellees each maintained a listing in the white pages of the 1982 Parker telephone directory, which was distributed in that area of California lying adjacent to Arizona; (3) the hospital also maintained a yellow pages listing in that directory; (4) during a four month period in 1981, approximately 26% of the hospital’s patients were California residents who travelled to Arizona for treatment; (5) Dr. Meyer sees approximately 120 patients per week, of whom about 12% are California residents; (6) the doctor appellees applied for and were issued California Medi-Cal numbers; (7) the doctor appellees have treated a small number of patients covered under the Medi-Cal program and have received reimbursement either directly or indirectly from the State of California for those patients.
ISSUE
Do sufficient contacts exist between appelleеs and the State of California to support assertion of personal jurisdiction over appellees by a district court sitting in California?
DISCUSSION
1. Standard of Review
Even though the trial court did enter findings of fact, the facts are undisputed and therefore we review the court’s holding that the exercise of personal jurisdiction is inconsistent with due process de novo as a matter of law. See World-Wide Volkswagen Corp. v. Woodson,
2. In Personam Jurisdiction
The district court’s determination of personal jurisdiction is made by examination of the forum state’s law. Hunt v. Erie Ins. Group,
Where a defendant has “substantial” or “continuous and systematic” contаcts with the state, a state court may have general personal jurisdiction, even if the cause of action is unrelated to the defendant’s forum activities. Data Disc,
Lacking sufficient contacts to support general jurisdiction, appellees may still be subject to limited personal jurisdiction following “an evaluation of the nature and quality of the defendant’s contacts in relation to the cause of action.” Data Disc,
A court judging minimum contacts must focus on the relationship between the defendant, the forum, and the litigation. Shaffer v. Heitner,
(A) Actions by which appellees purposefully availed themselves of the privilege of conducting activities in California.
If appellees have so “purposefully availed” themselves, they should reasonably foresee being haled into California courts. See World-Wide Volkswagen,
Appellee doctors applied for and received Medi-Cal numbers from the State of California. A Medi-Cal number permits a health care provider to receive reimbursement from the state for serviсes rendered to eligible California residents. See County v. Lackner,
Appellee argues that holding a Medi-Cal number should not be considered a relevant “contact” because the hospital does not make money on Medi-Cal patients. Even assuming arguendo the hospital’s lack of profit, our focus is on whether appellees purposefully took some action by which they invoked the protection of California law. Appellee doctors purposefully applied for a Medi-Cal number. Appellees invoked the protection of California law by placing themselves within the statutory safeguards provided health care providers seeking to settle grievances or complaints regarding unpaid Medi-Cal fees. See Cal.Welf. & Inst.Code § 14104.5 (West 1980). Under 14104.5, upon exhausting administrative remedies appellees may enter California courts to sue the state for monies owed. Id.; see, e.g., Royal Conval. Hosp., Inc. v. State Bd. of Control,
Moreover, appellees each maintained a white pages listing in the Parker phone directory and the hospital maintained a yellow pages listing. Although a telephone listing, without further solicitation, is not
Appellees rely on Wright v. Yackley,
In the case of personal services focus must be on the place where the services are rendered, since this is the place of the ... patient's ... need. The need is personal and the services rendered are in response to the dimensions of that personal need. Thеy are directed to no place but to the needy person herself. It is in the very nature of such services that their consequences will be felt wherever the person may choose to go. However, the idea that tortious rendition of such services is a portable tort which can be deemed to have been committed wherever the consequences foreseeably were felt is wholly inconsistent with the public interest in having services of this sort generally available.
Id. at 289-90.
The Wright cоurt was concerned that the amount of contact between defendant and forum state [would be] determined by the chance occurrence of a resident of the forum state seeking treatment by the doctor while in the latter’s state. From the very nature of the average doctor’s localized practice, there is no systematic or continuing effort on the part of the doctor to provide services which are to be felt in the forum state, [citation omitted].
Id. at 290.
Bearing in mind that jurisdictional inquiry must be made on the facts of each case, we decline to apply Wright’s broad language here. Appellees do conduct continuing efforts to provide services in California, and have not shown any efforts on their part to discourage California patients. Appellees’ advertising and the circulation of telephone directories into California also distinguish this case from Wright and cases following it, see, e.g., Kennedy,
There is no evidence in the record suggesting that subjecting appellees to the jurisdiction of California courts will produce a “chilling effect” on appellees in treating California patients. Appellees have not made any showing that they
(B) Appellant’s claim must arise out of or result from appеllees’ forum-related activities:
As stated above, appellees' relevant contacts with California were the obtaining of a Medi-Cal number and the placing of a telephone listing (and for the hospital, a yellow pages advertisement) in a local phone directory distributed in the adjacent California area. Through directory solicitation and participation in a state health care program appellees were able to attract a substantial number of patients from California. Furthermore, appellees’ forum activities were enhanced by appellant’s California residence because that residence is the focus of appellees’ activities out of which the suit arises. Keeton, — U.S. at -,
(C) Exercise of jurisdiction must be reasonable:
This court analyzes several factors in determining the reasonableness of asserting jurisdiction: (1) the extent of purposeful interjection into the forum state; (2) the burden on the defendant of defending in the forum; (3) the extent of conflict with the sovereignty of defendant’s state; (4) the forum state’s interest in adjudicating the dispute; (5) the most efficient judicial resolution of the controversy; (6) the importance of the forum to plaintiff’s interest in convenient and effective relief; аnd (7) the existence of an alternative forum. Ins. Co. of North America v. Marina Salina Cruz,
(1) Extent of purposeful interjection:
Appellees did not treat appellant in California, although they did treat a substantial number of California residents, see Raffaele v. Compagnie Generate Maritime,
(2) Burden on defendant:
Appellees are unfamiliar with California law. Their insurance carrier, relevant witnesses and attorneys are located in Arizona. Appellees would suffer some inconvеnience in being haled before the courts of California, although California is not a “distant” forum, see World-Wide Volkswagen,
While choice of law is a separate inquiry from that of personal jurisdiction, see Keeton, — U.S. at-,
(3) Conflict with sovereignty of defendant’s state:
A court should normally refrain from exercising jurisdiction when another state has expressed a substantially stronger sovereignty interest and that state’s courts will take jurisdiction. Raffaele,
(4) Forum state’s interest:
California obviously has an interest in protecting its citizens against the tortious conduct of others, including medical malpractice. See Wright,
[T]he forum state’s natural interest in the protection of its citizens is here countered by an interest in their access to medical services wherever needed____ [A] state’s dominant interest on behalf of its citizens in such a case as this is not that they should be frеe from injury by out-of-state doctors, but rather that they should be able to secure adequate medical services to meet their needs wherever they may go____
Id. (emphasis supplied).
We again decline to find the Wright court’s language controlling. California’s interest in allowing its citizens to secure adequate medical treatment is apropos to the factual setting in Wright, where the South Dakota-based doctor’s only connection with Idaho was the mailing of a prescription made out four months earlier. Appellees here havе more significant contacts. Given those contacts, California has a manifest interest here in protecting its citizens from tortious injury by health care providers who solicit and derive a substantial number of patients and revenue from the state, exceeding the interest it has in seeing that its citizens secure adequate medical treatment wherever they travel. Cf. McGee v. Int’l Life Ins. Co.,
(5) Most efficient judicial resolution:
The court sitting in the place the injury occurred is ordinarily the most efficient
(6) Convenient and effective relief for plaintiff:
Appellant is a California resident, California courts are more accessible to him, and California has an interest in protecting its citizens. See World-Wide Volkswagen,
(7) Alternative forum:
Appellant may bring suit in Arizona.
While mindful of this court’s admonition that it may be unreasonable to subject an out-of-state defendant to jurisdiction where the allegedly tortious act is committed outside the forum state, Data Disc,
3. Conclusion
We are not unmindful of the recent decision of the United States Supreme Court in Helicopteros Nacionales de Colombia, S.A. v. Hall, — U.S.-,
Consequently, we conclude that, on the facts of this case, assertion of in person-am jurisdiction over appellees by a district court sitting in California does not offend due prоcess. Accordingly, the decision of the district court is hereby reversed and remanded for proceedings not inconsistent with this opinion.
REVERSED AND REMANDED.
Lead Opinion
OPINION AND ORDER ON PETITION FOR REHEARING
Due to an oversight on the part of our Clerk’s office, counsel for the appellee hospital were not notified of the time and place of oral argument. This oversight was not called to our attention until the hospital filed its petition for a rehearing on our opinion, Cubbage v. Merchent,
During the course of the argument, counsel for the hospital cited Ballard v. Fred E. Rawlins, Inc.,
The hospital next cites to NTN Bearing Corp.,
It does not offend traditional notions of fair play and substantial justice to require Scott, Inc. to come once more to Illinois to defend a suit based upon a contract under which it has so frequently and willingly come to Illinois. We conclude that our exercise of jurisdiction over defendant is proper.
Id. at 1277. In the final analysis, the ultimate decision of the court turned on the issue of venue, rather than on jurisdiction. See
The hospital also argues that under Guerrero v. Copper Queen Hospital,
Ada Carol Thompson v. Sun City Community Hospital,
In any event, the hospital’s theory that Arizona statutes would make its citizens, including the hospital, immune from liability under the California long-arm statute if, as we hold, the California long-arm statute gives jurisdiction to California courts under the facts and circumstances of this case is without merit. Neither the legislature nor the courts of Arizona can interfere with that jurisdiction. We have considered peripheral arguments made by the hospital’s counsel, but find them equally without merit.
What is said in Ballard in connection with the Illinois long-arm statute being coextensive with the jurisdiction permitted under the United States Constitution is destroyed by the same court’s decisions in Green v. Advance Ross Electronics Corp.,
After due consideration, the panеl votes to deny the petition for rehearing and Judges Hug and Boochever vote to deny the suggestion for a rehearing in banc. Judge Kilkenny recommends rejection of the suggestion for a rehearing in banc.
The full court has been advised of the suggestion for an in banc rehearing, and no judge of the court has requested a vote on the suggestion for rehearing in banc. FRAP 35(b).
Judge Hug continues to dissent for the reasons expressed in the dissent to the original opinion.
The petition for rehearing is denied and suggestion for a rehearing in banc is rejected.
Dissenting Opinion
dissenting:
I respectfully dissent. The treatment of which apрellant complains was rendered entirely in Arizona. For the reasons stated in Wright v. Yackley,
There was an insufficient showing, in my view, that the forum-related activities justified the assertion of personal jurisdiction in California. The telephone listings in the local Parker, Arizona telephone directory and the obtaining of a Medi-Cal number for billing purposes do not constitute a sufficient interjection by appellees into the state of California to warrant personal jurisdiction for a claim arising out of the medical treatment in Arizona. See World-Wide Volkswagen Corp. v. Woodson,
