PEDRO LUGO v. INOVA HEALTH CARE SERVICES
No. 1:24-cv-700 (PTG/WEF)
IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF VIRGINIA Alexandria Division
March 25, 2025
MEMORANDUM OPINION AND ORDER
This matter is before the Court on Defendant INOVA Health Care Services’ Motion to Dismiss for Failure to State a Claim (Dkt. 21). In this action, Plaintiff Pedro Lugo, individually and on behalf of similarly situated individuals, sues INOVA for actions relating to the misuse and disclosure of Plaintiff‘s and other potential class action members’ personally identifiable information (“PII“) and protected health information (“PHI“). Dkt. 1 (“Compl.“) 1. Plaintiff brings claims for breach of an implied-in-fact contract, unjust enrichment, and a violation of the Electronic Communications Privacy Act (“ECPA“). Id. ¶¶ 126-169. On October 3, 2024, the Court heard oral argument on Defendant‘s Motion to Dismiss. Dkt. 32. For the reasons stated below, the Court grants Defendant‘s Motion to Dismiss as it relates to the breach of implied contract and unjust enrichment claims, and the Court denies Defendant‘s Motion to Dismiss as it relates to Plaintiff‘s ECPA claim.
A. Factual Background
At this stage, the following facts from the Complaint are accepted as true:1
INOVA is a non-profit hospital organized under the laws of Virginia and headquartered in Falls Church, Virginia. Id. ¶ 13. It is one of the largest health care providers in the DC metro area and provides over two million patients visits annually. Id. ¶ 13, 15. INOVA utilizes websites and its Patient Portal to connect patients to its services. Id. ¶ 16. Plaintiff was a patient at INOVA and used its websites and MyChart Patient Portal. Id. ¶ 14.
INOVA implemented software tracking pixels on its website and Patient Portal. More specifically, Google and Facebook, also known as Meta, use “pixels” to create profiles and data points on individuals to target them with more effective advertising. Id. ¶¶ 24, 34-36. Google and Facebook tracking pixels are integrated into INOVA‘s website and Patient Portal. Id. ¶¶ 28, 46. Pixel codes track a user‘s interaction with websites and apps including when a user visits the site or app, what webpage he visits, what he clicks on, and what he types. Id. ¶¶ 28, 36. These pixels collect identifiable information such as IP addresses, User IDs, and Client IDs. Id. ¶¶ 28, 46. In this case, with the use of the pixels, INOVA intercepted and transmitted a variety of private information including: (1) individuals’ status as a medical patient; (2) individuals’ communications with INOVA through its website and Patient Portal; and (3) details regarding individuals’ medical appointments, location of treatments, specific medical providers, specific medical conditions and treatments, and related information. Id. ¶ 20.
INOVA used pixels on its website and Patient Portal without users’ consent. Id. ¶ 53. In July 2023, the Department of Health and Human Services, along with the Federal Trade Commission, warned INOVA and other hospital systems and telehealth providers that pixels and other tracking technologies could be sending information protected by the Health Insurance Portability and Accountability Act (“HIPAA“) to third parties. Id. ¶¶ 55-58. INOVA never disclosed to Plaintiff or other putative class members that INOVA was sharing confidential communications with third parties. Id. ¶ 65.
INOVA provides patients a Notice of Privacy Practices that explains INOVA‘s legal duties regarding patients’ private health information. Id. ¶ 68. The privacy notice does not discuss disclosure of information to Google and Facebook. Id. Plaintiff claims that INOVA violated HIPAA and the Virginia Health Records Privacy Act (“VHRPA“) by disclosing patients’ protected information through pixels. Id. ¶¶ 79, 166.
On April 29, 2024, Plaintiff filed his Complaint. Dkt. 1. On July 1, 2024, INOVA filed its Motion to Dismiss. Dkt. 21. On July 29, 2024, Plaintiff filed his opposition. Dkt. 29. On August 12, 2024, INOVA filed its reply. Dkt. 31. On October 3, 2024, the Court held a hearing on this matter. Dkt. 32. On October 10, 2024, Plaintiff filed a Notice of Supplemental Authority. Dkt. 33.
II. Legal Standard
In order to survive a motion to dismiss brought under
When reviewing a motion brought under
III. Analysis
A. Breach of Implied Contract Claim
Plaintiff alleges that by providing his information to INOVA, the parties entered into an implied-in-fact contract wherein INOVA agreed to safeguard the private information that Plaintiff provided. Compl. ¶ 127. INOVA contends that Plaintiff‘s breach of implied contract claim must be dismissed because Plaintiff failed to allege consideration or mutual assent—required elements of an implied contract. Dkt. 22 at 21-23.
An “implied-in-fact-contract is a true contract, containing all of the elements that construct an enforceable agreement.” Nossen v. Hoy, 750 F. Supp. 740, 744 (E.D. Va. 1990). An implied-in-fact contract “differs from an actual contract in that the parties have not reduced it to a writing or to an oral agreement; rather, the court infers the implied-in-fact agreement from the course of conduct of the parties.” Id. Just as with an actual contract, for an implied-in-fact contract to be valid there must be consideration and mutuality of assent between the parties. Spectra-4, LLP v. Uniwest Com. Realty, Inc., 772 S.E.2d 290, 295 (Va. 2015).
“[C]onsideration is, in effect, the price bargained for and paid for a promise. It may be in the form of a benefit to the party promising or a detriment to the party to whom the promise is made.” Reynolds v. USAA Life Ins. Co., 678 F. Supp. 3d 736, 746 (E.D. Va. 2023) (alteration in original) (quoting Smith v. Mountjoy, 694 S.E.2d 598, 602 (Va. 2010)). “[A] party‘s agreement to
Plaintiff claims the parties exchanged valuable consideration in the form of a mutual exchange of promises. Dkt. 29 at 14-15. Plaintiff alleges that he and INOVA “entered into an implied contract pursuant to which Inova Health agreed to safeguard and not disclose [his] Private Information without consent.” Compl. ¶ 127. Accordingly, the alleged exchange consisted of Plaintiff promising to provide his private information to INOVA, and INOVA promising to safeguard that information. Courts applying Virginia law have found that a mutual exchange of promises can constitute consideration for an express contract. Price v. Taylor, 466 S.E.2d 87, 88-89 (Va. 1996) (finding that mutual promises constituted consideration for a written land sale contract); see also Reynolds, 678 F. Supp. 3d at 746-47 (finding the mutual exchange of oral promises to cancel a written life insurance policy, followed by a written confirmation of the cancellation, was valuable consideration). Plaintiff has offered no authority that suggests the mutual exchange of promises is sufficient consideration in an implied-in-fact contract, like the one at issue here.
Even if it was sufficient, to the extent Plaintiff attempts to offer INOVA‘s privacy notice as evidence of bargained for consideration, Plaintiff‘s claim for a breach of an implied-in-fact contract must fail. INOVA argues, and Plaintiff concedes in his Complaint, that the privacy notice “explains [INOVA‘s] legal duties under HIPAA.” Compl. ¶ 68; Dkt. 22 at 21-22. Thus, the privacy notice is not any more than a recitation of INOVA‘s legal obligations. Such a recitation is insufficient to show consideration. See Bojorquez-Moreno, 92 F. Supp. 3d at 468. Therefore, Plaintiff has not properly alleged that he exchanged bargained for consideration with INOVA, a
Even if Plaintiff had adequately pled facts showing bargained-for consideration, Plaintiff also fails to establish mutual assent to contract terms. “Mutual assent by the parties to the terms of a contract is crucial to the contract‘s validity.” AB Staffing Sols., LLC v. Asefi Cap., Inc., No. 3:22-cv-32, 2022 WL 16555707, at *9 (E.D. Va. Oct. 31, 2022) (quoting Wells v. Weston, 326 S.E.2d 672, 676 (Va. 1985)). “[T]o form an enforceable contract in Virginia, ‘there must be mutual assent of the contracting parties to terms reasonably certain under the circumstances.‘” Id. (quoting Allen v. Aetna Cas. & Sur. Co., 281 S.E.2d 818, 820 (Va. 1981)). In an express contract, “[m]utual assent is determined ‘exclusively from those expressions of [the parties‘] intentions which are communicated between them.‘” Moorman v. Blackstock, Inc., 661 S.E.2d 404, 409 (Va. 2008) (quoting Lucy v. Zehmer, 84 S.E.2d 516, 522 (Va. 1954) (alteration in original)). With an implied-in-fact contract, however, “agreement is arrived at by a consideration of [the parties‘] acts and conduct.” City of Norfolk v. Norfolk Cnty., 91 S.E. 820, 821 (Va. 1917) (quoting 2 Ruling Case Law § 6 (William Mark McKinney & Burdett Alberto Rich eds., 1914); see also Spectra-4, LLP, 772 S.E.2d at 295 (citing City of Norfolk, 91 S.E. at 821-22) (“With implied-in-fact contracts, the parties’ conduct must... establish what the terms of the contract are.“). Because conduct, and not express communication, creates an implied-in-fact contract, custom plays a large role in determining what actions imply a contract between parties. Here, Plaintiff does not allege facts to show that custom dictates that the exchange of Plaintiff‘s private information for health services creates an implied-in-fact contract between the parties.
Plaintiff also argues that INOVA‘s privacy notice constitutes mutual assent to the obligations INOVA laid out in that document. Dkt. 29 at 14. However, Plaintiff does not allege
Plaintiff additionally argues that INOVA‘s Employee Code of Conduct establishes mutual assent. The Code of Conduct instructs employees to not disclose patient specific information and uphold confidentiality. Compl. ¶¶ 68-69. The Code of Conduct, however, cannot establish mutual assent between Plaintiff and INOVA because Plaintiff is not an employee of INOVA. Accordingly, Plaintiff fails to allege mutual assent between the parties to an implied contract.
Because Plaintiff does not allege facts sufficient to prove consideration or mutual assent, Plaintiff fails to allege that an implied-in-fact contract existed between himself and INOVA. Therefore, the Court dismisses Plaintiff‘s claim for breach of an implied-in-fact contract.
B. Unjust Enrichment Claim
As an alternative to Plaintiff‘s breach of implied contract claim, Plaintiff brings a claim for unjust enrichment. Compl. ¶ 133. Plaintiff argues that INOVA was unjustly enriched when it received a benefit from collecting Plaintiff‘s data without compensating Plaintiff. Id. ¶¶ 135-36. INOVA contends that Plaintiff‘s unjust enrichment claim must be dismissed because Plaintiff has not shown that INOVA should have reasonably expected to pay Plaintiff or that Plaintiff was the one who conferred a benefit on INOVA. Dkt. 22 at 25-29.
“A plaintiff asserting unjust enrichment must demonstrate the following three elements: ‘(1) he conferred a benefit on [the defendant]; (2) [the defendant] knew of the benefit
Plaintiff alleges that he conferred a benefit on INOVA by providing “valuable Private Information” that INOVA “distributed without authorization and proper compensation.” Compl. ¶ 135. Further, Plaintiff alleges that INOVA “used this information for its own gain, providing Inova . . . with economic, tangible, and other benefits, including substantial monetary compensation.” Id. However, Plaintiff has not alleged facts showing that Plaintiff, or other potential class members, compensated INOVA. Instead, Plaintiff alleged that INOVA was “compensated by Facebook, Google, and other third parties in the form of enhanced advertising services and more cost-efficient marketing on their platforms.” Compl. ¶ 87. Defendant contends that this forecloses Plaintiff from alleging the first element of the unjust enrichment claim. Dkt. 22 at 28.
In support of his unjust enrichment claim, Plaintiff cites In re Capital One Consumer Data Security Breach Litigation, 488 F. Supp. 3d 374 (E.D. Va. 2020). The In re Capital One plaintiffs alleged that they provided personal information to Capital One and Amazon and that Amazon received a benefit from this information because Amazon charged Capital One to use Amazon servers to store the plaintiffs’ information. Id. at 412-13. The court maintained plaintiffs’ unjust enrichment claim at the motion to dismiss stage, finding that Amazon “profited from its storage and retention of [p]laintiffs’ PII” and “[r]etaining these profits without adequately securing [plaintiffs‘] data would be ‘unjust.‘” Id. at 413. Plaintiff argues his unjust enrichment claim should not be dismissed because like Amazon in In re Capital One, INOVA retained an undue benefit
INOVA argues that In re Capital One is inapplicable because it stems from a data breach. Dkt. 31 at 13. INOVA instead points to In re Hackman wherein the court dismissed the plaintiffs’ unjust enrichment claim against the defendant-bank. In re Hackman, 534 B.R. 867, 878-79 (Bankr. E.D. Va. 2015). In In re Hackman, the defendant-bank was allegedly enriched due to third-party embezzling funds into an account with the defendant-bank. There, the court granted the defendant-bank‘s motion to dismiss finding (1) the enrichment was “too attenuated from the nature of the wrong” and (2) the plaintiffs did not confer the benefit. Id. However, this Court is persuaded that In re Capital One is more analogous than In re Hackman because both In re Capital One and the instant matter involve situations wherein entities retained the plaintiff‘s personal information and received a benefit as a result. Taking Plaintiff‘s allegations as true, Plaintiff has plausibly stated facts to show he conferred a benefit on INOVA by providing INOVA with his personal data for which INOVA was later compensated by Google and Facebook. Accordingly, Plaintiff has alleged facts to satisfy the first prong of an unjust enrichment claim.
The second prong of an unjust enrichment claim requires the plaintiff demonstrate that the defendant “knew of the benefit and should reasonably have expected to repay [the plaintiff].” Rosetta Stone Ltd., 676 F.3d at 166 (alteration in original). In Rosetta Stone, Google allegedly engaged in the unauthorized sale of Rosetta Stone trademarks via a program through which companies could “purchase” words to optimize Google searches. Id. at 151-52, 156-57. Rosetta Stone argued that Google was unjustly enriched through the improper sale of Rosetta Stone trademarks to other companies. Id. at 152. The Fourth Circuit dismissed Rosetta Stone‘s claim finding that Rosetta Stone did not allege that Google pays any other mark holder for the sale of
Rosetta Stone is instructive. Like that plaintiff, here, Plaintiff makes no allegation that INOVA should have reasonably expected to pay Plaintiff for his information that was allegedly disclosed via pixels. Plaintiff does not allege that INOVA, or other health care providers, pay other users for the same type of information. Nor does Plaintiff allege any facts to suggest that Plaintiff should have reasonably expected to be paid for his information. Therefore, Plaintiff fails to allege sufficient facts to set out the second prong of an unjust enrichment claim. As such, the Court will grant INOVA‘s Motion with respect to Plaintiff‘s unjust enrichment claim.
C. Electronic Communications Privacy Act Claim
The ECPA “prohibits intentionally intercepting any electronic communication.” Ctr. L. & Consulting, LLC v. Axiom Res. Mgmt., Inc., 456 F. Supp. 3d 765, 769 (E.D. Va. 2020) (citing
The ECPA, however, includes an exception to liability. The “party exception” provides that a “party” to an electronic communication cannot be held liable for an interception of that communication.
The party exception does not apply when a party intercepts electronic communication “for the purpose of committing” a crime or tort in violation of state or federal law.
Plaintiff alleged that INOVA‘s interception and disclosure of personal data were part of the criminal act of violating HIPAA and the VHRPA. Compl. ¶¶ 158-59, 165. INOVA argues that because neither HIPAA nor the VHRPA create a private right of action, a plaintiff should be precluded from using HIPAA or VHRPA violations to invoke the crime-tort exception to the ECPA.
Plaintiff alleges that INOVA disclosed individuals’ “(1) status as medical patients; (2) communications with Inova Health through its websites and Patient Portal; and (3) information about their medical appointments, location of treatments, specific medical providers, specific medical conditions and treatments, and related information.” Compl. ¶ 20. This information “relates to the provision of health care” to Plaintiff.
The VHRPA prohibits the disclosure of an individual‘s heath records without their permission or legal authorization.
2. A Commercial Purpose and the Crime-Tort Exception
INOVA has argued that because there was a commercial purpose behind the collection and disclosure of Plaintiff‘s private health information, irrespective of any intent to violate HIPAA or the VHRPA, the crime-tort exception does not apply. Dkt. 22 at 14-17.
Some courts have dismissed ECPA claims wherein the plaintiff alleged violations of HIPAA or state health privacy laws finding that the main purpose of the interception at issue was not to commit a statutory violation, but instead for commercial gain. These courts found that a commercial or marketing related motive is not criminal or tortious such that the crime-tort exception can be invoked. See e.g., Rodriguez v. FastMed Urgent Care, P.C., 2024 WL 3541582, at *6 (E.D.N.C. July 24, 2024); In re Meta Pixel Healthcare Litig., 647 F. Supp. 3d at 797; Roe v. Amgen Inc., 2024 WL 2873482, at *6 (C.D. Cal. June 5, 2024). However, other courts around the country have upheld ECPA claims using the crime-tort exception where the alleged criminal purpose for the interception was a violation of HIPAA or a state health privacy law, despite the healthcare provider having an additional commercial, marketing, or advertising purpose behind the interception. See e.g., Sweat, 2024 WL 3070184, at *3-4; Kurowski, 2023 WL 8544084, at *3; Kane, 2024 WL 1178340, at *7; Loyola Univ. Med. Ctr., 2024 WL 3338941, at *7; In re Grp. Health Plan Litig., 709 F. Supp. 3d at 719-20; Cooper v. Mount Sinai Health Sys., Inc., 742 F. Supp. 3d 369, 381-82 (S.D.N.Y. 2024); Aspen Dental Mgmt., Inc., 2024 WL 4119153, at *3;
Plaintiff alleged that INOVA used pixels to “increase the success of its profitability, advertising, and marketing.” Compl. ¶ 17; see also id. ¶ 86. According to Plaintiff, INOVA “intentionally intercepted the contents of Plaintiff‘s and the other Class Members’ electronic communications for the purpose of committing a tortious or criminal act in violation of the Constitution or laws of the United States or of any State.” Id. ¶ 155.
The Fourth Circuit has not determined whether the crime-tort exception applies when a health care provider‘s purpose for disclosing patients’ private information is commercial. INOVA asks this Court to follow the decision in Rodriguez v. FastMed Urgent Care, P.C., which dismissed an ECPA claim based on a HIPAA violation finding that FastMed disclosed patient information for commercial use, and not to commit a crime or tort. Rodriguez, 2024 WL 3541582, at *5-6. In support of this finding, the Eastern District of North Carolina cited to three cases that involve the ECPA, but do not involve the use of pixels to gather and disclose private health care information. Id. at *5 (citing In re Google Inc. Cookie Placement Consumer Priv. Litig., 806 F.3d 125, 145 (3d Cir. 2015); Caro, 618 F.3d at 99-101; Sussman v. Am. Broad. Cos., 186 F.3d 1200, 1202-03 (9th Cir. 1999)).
The Rodriguez court also cited to one case that involved a technology similar to the pixels alleged to be used in this case and similar facts to the case at issue, Kurowski v. Rush Sys. For Health, 659 F. Supp. 3d 931, 936-40 (N.D. Ill. 2023).3 In that iteration of Kurowski, the Northern
The Court declines to follow Rodriguez because its logic is based on three factually dissimilar cases and a previous iteration of Kurowski. Instead, the Court is persuaded that a plaintiff who has alleged the defendant engaged in a statutory violation, even if for a financial or commercial purpose, has stated a claim for relief under the ECPA and its crime tort exception. “[T]he mere existence of [a] lawful purpose alone does not ‘sanitize a[n interception] that was also made for an illegitimate purpose.‘” Cooper, 742 F. Supp. 3d at 378 (first quoting DoubleClick, 154 F. Supp. 2d at 514; and then quoting Sussman, 186 F.3d at 1202) (alteration in original). Indeed, many crimes and torts are committed for financial gain. Therefore, having a commercial purpose in addition to the purpose of violating HIPAA or the VHRPA, does not immunize INOVA from Plaintiff‘s ECPA claims.
IV. Conclusion
For these reasons, the Court grants Defendant‘s Motion to Dismiss as it relates to Count I (Breach of Implied Contract) and Count II (Unjust Enrichment) and the Court denies Defendant‘s Motion to Dismiss as it relates to Count III (Electronic Communication Privacy Act).
Accordingly, it is hereby
ORDERED that Defendant‘s Motion to Dismiss is GRANTED in part and DENIED in part; it is further
ORDERED that Defendant‘s Motion to Dismiss as to Count I and Count II is GRANTED; it is further
ORDERED that Plaintiff is GRANTED leave to amend his Complaint with respect to Counts I and II. Plaintiff shall file any amended complaint within twenty-one (21) days of this Order; it is further
Entered this 25th day of March, 2025
Alexandria, Virginia
Patricia Tolliver Giles
United States District Judge
