Facts
- Prestige Institute for Plastic Surgery performed surgery on a patient insured under a health plan administered by Aetna, which pre-authorized the operations [lines="12-18"].
- Prestige submitted a bill of $100,000 for the surgery, but Aetna paid only $1,775.37, leaving a significant balance [lines="58-66"].
- Aetna later declined payment for a second surgery, also pre-authorized, which Prestige billed at $22,179.82 [lines="78-86"].
- Prestige claimed it was proceeding both as an assignee concerning the medical services rendered and on its own behalf for the unpaid charges [lines="88-90"].
- Defendants filed a motion to dismiss all claims in the complaint, which included several state law claims and ERISA-based claims [lines="19-24"].
Issues
- Whether Aetna is a proper defendant when it allegedly does not administer the plan [lines="234-236"].
- Whether ERISA preempts the state law claims brought by Prestige, including the claim for promissory estoppel [lines="598-600"].
- Whether Prestige has standing to pursue ERISA claims as a healthcare provider, given the anti-assignment provision in the health plan [lines="378-384"].
Holdings
- The court held that Aetna is not a proper defendant as it is merely a parent company and not the claims administrator of the health plan, so claims against it must be dismissed [lines="282-284"].
- The court found that Prestige's promissory estoppel claim, among others, is preempted by ERISA as it relates to a wrongful denial of benefits under an ERISA plan [lines="842-844"].
- Prestige lacks standing to pursue its ERISA claims due to the anti-assignment clause in the plan, which renders any assignment from the patient ineffective [lines="385-387"].
OPINION
MARIANA PARDO v. TOMAS INFERNUSO DVM, P.C., doing business as Animal Surgical Center; TOMAS INFERNUSO in his individual and professional capacities
Case 2:24-cv-00190-NCM-ST
UNITED STATES DISTRICT COURT EASTERN DISTRICT OF NEW YORK
September 24, 2024
Document 55
NATASHA C. MERLE
PageID #: 666
24-cv-00190 (NCM) (ST)
NATASHA C. MERLE, United States District Judge:
Before the Court is defendants’ partial Motion to Dismiss, ECF No. 38,1 plaintiff‘s retaliation claims, counts II, IV, and V of plaintiff‘s amended complaint, ECF No. 19 (“AC“), with prejudice pursuant to
BACKGROUND
Plaintiff Dr. Mariana Pardo is a veterinarian who was employed as the Emergency and Critical Care Medical Director at defendant ASC from September 2022 to May 2023. AC ¶¶ 1, 8, 36, 121. Prior to her employment at ASC, Dr. Pardo was an emergency veterinarian at another practice in New York. AC ¶ 28. Dr. Pardo has also served as an Intensive Care Unit (“ICU“) Head Veterinary Technician, completed internships and a residency in emergency and critical care, and published articles regarding veterinary practice and diversity and inclusion in the profession. AC ¶¶ 24-26.
Defendant Dr. Tomas Infernuso is ASC‘s founder, owner, and medical director. AC ¶ 10. In 2021, Dr. Infernuso began recruiting Dr. Pardo to develop an Emergency Room (“ER“) and ICU at ASC. AC ¶¶ 27-35. In July 2022, Dr. Pardo agreed to join ASC as the Veterinary Critical Care Specialist. AC ¶ 35. In that role, she “was tasked with setting up standard protocols” for ASC‘s ER, “recruiting employees, creating staff schedules[,] and marketing the emergency care practice.” AC ¶ 37. Dr. Pardo‘s duties at ASC also included: treating patients, hiring and onboarding doctors and staff, establishing training and protocols, reviewing and organizing invoices and sales, “addressing performance reviews” with employees, and contributing to marketing efforts. AC ¶¶ 39-41.
Plaintiff‘s complaint describes several instances of alleged unlawful conduct at ASC “from the outset” of her employment. AC ¶ 45. Specifically, Dr. Pardo alleges that defendants tasked unlicensed staff with administering medicine in violation of state law, AC ¶ 50; did not properly maintain drug records in violation of state law, AC ¶¶ 60-62; failed to meet “general standards of care for veterinarians,” AC ¶ 65; “used highly offensive and inappropriate language” with staff regarding euthanasia decisions, AC ¶ 91; “made insensitive and discriminatory comments about [an employee‘s] body and
Plaintiff alleges that she “promptly escalated” to Dr. Infernuso and ASC‘s Director of Human Resources (“HR“), William Welsh, several of her concerns about unlawful and unethical practices during her time at ASC. AC ¶¶ 46, 116. Plaintiff further alleges that defendants responded to her complaints with overt hostility and, ultimately, termination. AC ¶¶ 47, 48.
LEGAL STANDARD
When deciding a motion to dismiss, a district court must “accept[] all factual claims in the complaint as true, and draw[] all reasonable inferences in the plaintiff‘s favor.” Lotes Co. v. Hon Hai Precision Indus. Co., 753 F.3d 395, 403 (2d Cir. 2014).2 Factual disputes are typically not the subject of the Court‘s analysis, as Rule 12 motions “probe the legal, not the factual, sufficiency of a complaint.” Plastic Surgery Grp., P.C. v. United Healthcare Ins. Co. of N.Y., Inc., 64 F. Supp. 3d 459, 468-69 (E.D.N.Y. 2014). That is, “the issue” on a motion to dismiss “is not whether a plaintiff will ultimately prevail,” but instead whether a plaintiff is “entitled to offer evidence to support the claims.” Sikhs for Just. v. Nath, 893 F. Supp. 2d 598, 615 (S.D.N.Y. 2012). Accordingly, “[d]ismissal is inappropriate unless it appears beyond doubt that the plaintiff can prove
In order to survive a motion to dismiss pursuant to
Defendants move to dismiss each of plaintiff‘s retaliation claims for failure to state a claim. For the reasons stated below, the Court finds that plaintiff has adequately alleged retaliation in violation of Title VII, the NYSHRL, and Section 740.
DISCUSSION
Courts in this circuit generally consider state and federal retaliation claims “in tandem” because “New York courts rely on federal law when determining claims under the New York Human Rights Law.” Reed v. A.W. Lawrence & Co., 95 F.3d 1170, 1177 (2d Cir. 1996); see also Kelly v. Howard I. Shapiro & Assocs. Consulting Eng‘rs, P.C., 716 F.3d 10, 14 (2d Cir. 2013) (“The standards for evaluating . . . retaliation claims are identical under Title VII and the NYSHRL.“); see also Thacker v. HSBC Bank USA, N.A., No. 22-cv-07120, 2023 WL 3061336, at *7 (S.D.N.Y. Apr. 24, 2023) (“assum[ing] without deciding” that the Title VII standard applies to Section 740 claims).
However, these elements are “relaxed” at the pleading stage. Littlejohn v. City of New York, 795 F.3d 297, 307, 316 (2d Cir. 2015); see also Duplan v. City of New York, 888 F.3d 612, 626 (2d Cir. 2018). In order to survive a motion to dismiss a retaliation claim, a plaintiff must “plausibly allege that: (1) defendants discriminated—or took an adverse employment action—against [plaintiff], (2) because [plaintiff] has opposed any unlawful employment practice.” Vega v. Hempstead Union Free Sch. Dist., 801 F.3d 72, 90 (2d Cir. 2015).
To satisfy the requirement that plaintiff engaged in protected activity by opposing an employer‘s practice, a plaintiff need only allege “a good faith, reasonable belief that the underlying employment practice was unlawful,” whether or not it actually was unlawful. Zann Kwan, 737 F.3d at 843.
I. Protected Activity
Federal law prohibiting retaliation in the workplace operates to “prevent[] an employer from interfering (through retaliation) with an employee‘s efforts to secure or advance enforcement of [a statute‘s] basic guarantees.” Burlington N. & Santa Fe Ry. Co. v. White, 548 U.S. 53, 63 (2006). While anti-discrimination law seeks “to prevent injury to individuals based on who they are, i.e., their status,” anti-retaliation law seeks “to prevent harm to individuals based on what they do, i.e., their conduct.” Id. The conduct protected by anti-retaliation law is defined by the underlying statutes’ prohibitions—here, discrimination pursuant to Title VII and the NYSHRL, and unlawful or dangerous conduct pursuant to NYLL Section 740. See Duplan, 888 F.3d at 625 (equating protected activity with “oppos[ing] any unlawful employment practice“).
A. Title VII & NYSHRL Claims
Defendants contend that plaintiff‘s Title VII and NYSHRL claims should be dismissed for failure to state a claim because plaintiff has not sufficiently alleged that she engaged in “protected activity” leading up to the alleged retaliation. Mot. at 20.3 In response, plaintiff points to her allegations that she “supported, and advocated for, an employee who was being discriminated against due to his disabilities,” Opp‘n at 24, and “complain[ed] about the lack of” pregnancy-related accommodations, Opp‘n at 26, as sufficient to constitute protected activity under federal and state discrimination laws. For the reasons stated below, the Court finds plaintiff‘s allegations sufficient to state a claim for retaliation under Title VII and the NYSHRL.
Furthermore, the fact that plaintiff facilitated the conversation between Dr. Infernuso and the employee does not at this stage transform Dr. Pardo‘s opposition to defendants’ practices into an avenue “merely to convey others’ complaints.”
Plaintiff also alleges that after being informed of her pregnancy, Dr. Infernuso “used [that information] as an opportunity to be vindictive.” AC ¶ 109. In particular, she alleges that Dr. Infernuso changed plaintiff‘s work schedule and requirements in ways that worked against her “need for pregnancy accommodations,” as communicated to both Dr. Infernuso and Mr. Welsh. AC ¶¶ 112-16. Title VII prohibits pregnancy-based discrimination in the workplace. Romero v. St. Vincent‘s Servs., Inc., No. 22-cv-01476, 2023 WL 3477161, at *1 (2d Cir. May 16, 2023) (“In 1978, Congress amended Title VII and specified that the term ‘because of sex’ prohibits discrimination ‘on the basis of pregnancy, childbirth, or related medical conditions.’
Given these state and federal prohibitions of discrimination based on disability and pregnancy, coupled with plaintiff‘s experience in the field of diversity and inclusion in the veterinary profession, the Court can reasonably infer from the complaint that plaintiff had a good-faith and reasonable belief that the conduct she complained about at ASC was unlawful. Accordingly, the Court finds that plaintiff has sufficiently alleged protected activity under Title VII and the NYSHRL.
B. NYLL Section 740 Claim
Defendants seek to dismiss plaintiff‘s Section 740 claim5 on the grounds that plaintiff fails to allege retaliation based on complaints of a danger to public safety or any law, rule, or regulation. Mot. at 12-13. In opposition, plaintiff contends that her amended complaint demonstrates her reasonable belief that defendants were violating several
Section 740 of the NYLL, otherwise known as New York‘s “whistleblower law,” provides additional state law protection against retaliation for employees reporting misconduct. Thacker, 2023 WL 3061336, at *6. Specifically, it prohibits any employer from taking “any retaliatory action” because an employee “discloses, or threatens to disclose” a practice the employee “reasonably believes is in violation of [a] law, rule or regulation” or otherwise poses “a substantial and specific danger to the public health or safety.”
Therefore, to state a Section 740 claim, a plaintiff must allege (a) retaliation (b) based on (c) threatened or actual disclosure of her employer‘s activity that she “reasonably believed either (1) violated a law, rule, or regulation, or (2) posed a substantial and specific
Here, plaintiff has detailed several instances that, taken as true, support a reasonable belief that defendants were violating New York laws governing education and controlled substances. Indeed, plaintiff has alleged that defendants violated three specific laws:
Also, contrary to defendants’ argument, Oral Arg. Tr. 31:1-16, this specificity in the complaint does not work to undermine plaintiffs Section 740 claim in light of the fact that she was not required to identify any such laws. Komorek, 2024 WL 1484249, at *6. To the extent it has merit and is not simply a factual dispute, defendants’ contention that plaintiff failed to allege a reasonable belief because she did not act “immediately” to “investigate, correct, or report” those violations, Reply at 8, is contradicted by plaintiff‘s allegations that she addressed several concerns with Dr. Infernuso “immediately.” See, e.g., AC ¶ 62.
Plaintiff has also sufficiently alleged that she reasonably believed defendants’ mishandling of fentanyl—a highly addictive and dangerous opioid—posed a danger to
The Court can reasonably infer that the administration by unlicensed staff of a drug “known for its high potential for addiction and overdose,” United States v. Brooks, 685 F. Supp. 3d 476, 479 (E.D. Mich. 2023), may pose a threat to public health. This is especially true here, where plaintiff has alleged multiple examples that, taken together, suggest a recurring practice at ASC with the potential to pose a danger to the public at large. See Villarreal v. Montefiore Med. Ctr., No. 20-cv-00012, 2020 WL 5518382, at *3 (S.D.N.Y. Sept. 14, 2020) (noting that specific instance of patient neglect “attributable” to a “lack of training and discipline” could “pose[] § 740‘s requisite threat to the health or safety of the public at large,” in part if it was “ongoing or liable to recur“). Plaintiff may ultimately be required to more clearly connect the practices of allowing unlicensed staff to administer fentanyl and engaging in improper record keeping with threats to public health and safety, but she has satisfied her burden to allege that she reasonably believed defendants’ conduct posed a public health concern.
Accordingly, the Court finds that plaintiff has sufficiently stated protected activity under
II. Adverse Action
To state a retaliation claim, a plaintiff must also allege that she “was subjected to a retaliatory action, or a series of retaliatory actions, that were materially adverse.” Carr, 76 F.4th at 180. In the employment context, an action is adverse if it “well might have
Defendants do not challenge that plaintiff has alleged adverse actions. Oral Arg. Tr. 18:12-17. Indeed, plaintiff has alleged termination, a paradigmatic adverse employment action. AC ¶ 121. There is no question the idea of being fired might “dissuade” a reasonable employee from reporting discrimination under Title VII or conduct prohibited by Section 740. See Burlington, 548 U.S. at 57.
Plaintiff also alleges changes to her terms of employment. AC ¶¶ 76-78, 86. For example, plaintiff alleges that, in retaliation for her reports of misconduct, Dr. Infernuso later “decreased the amount of compensation” Dr. Pardo “expected to earn” at ASC, “suggested that her job duties would extend far beyond what she had understood” from prior negotiations, and indicated that her bonus would be contingent on “never before discussed performance indicators.” AC ¶¶ 85-89. A reasonable employee might be dissuaded from raising her concerns about discriminatory or otherwise unlawful conduct if those concerns would be met with indications that she would be required to work more for potentially less pay. See Thacker, 2023 WL 3061336, at *8 (noting that a “bonus reduction constitutes a . . . paradigmatic materially adverse change” that would satisfy “Section 740‘s threshold” for retaliation).
Accordingly, plaintiff has sufficiently alleged that the breakdown in her employment contract negotiations and her ultimate termination from ASC are both adverse actions that may support a retaliation claim pursuant to state and federal law.
III. Causation
Plaintiff has also sufficiently alleged that defendants engaged in retaliatory conduct because plaintiff opposed alleged discrimination under Title VII and the NYSHRL, as well as unlawful conduct under Section 740. To establish causation, a plaintiff must allege that the protected activity was a “but-for” cause of the retaliation. Vega, 801 F.3d at 90-91. Indeed, a plaintiff must allege that “the adverse action would not have occurred in the absence of the retaliatory motive.” Id. at 91.
Causation can be supported at the pleading stage with allegations of (i) “direct evidence of retaliatory animus” or (ii) indirect evidence of causation “through temporal proximity to the protected activity” or “a backdrop of continuing antagonism and frustration of [] professional ambitions.” Duplan, 888 F.3d at 625-26. Indirect support of causation can be established “by showing that the protected activity was closely followed in time by the adverse employment action.” Tafolla v. Heilig, 80 F.4th 111, 125-26 (2d Cir. 2023). Although the Second Circuit “has not drawn a bright line defining the outer limits beyond which a temporal relationship is too attenuated to establish causation,” it has found that “a period of several months,” including an eight-month gap, can support causation. Banks v. Gen. Motors, LLC, 81 F.4th 242, 277 (2d Cir. 2023) (citing Grant v. Bethlehem Steel Corp., 622 F.2d 43, 45-46 (2d Cir. 1980)).
Defendants terminated plaintiff in May 2023, roughly eight months after she joined ASC. See AC ¶ 121. More specifically, plaintiff‘s allegations describe a period of less than one month between her May termination and the April meeting regarding Dr. Infernuso‘s discriminatory comments based on another employee‘s actual or perceived disability, AC ¶¶ 97-101, and Dr. Pardo‘s April pregnancy announcement, AC ¶ 107. Furthermore, plaintiff‘s allegations suggest months of hostility in response to her voicing
Furthermore, plaintiff has alleged facts to support a causal link between her reports of misconduct and Dr. Infernuso‘s actual or suggested changes to her terms of employment, as discussed supra. Plaintiff provides two specific examples, one from January 2023 and another from mid-March 2023, regarding her reports to Dr. Infernuso about unlicensed staff administering medication. AC ¶¶ 54-56. These incidents coincided with the “early 2023” contract negotiation breakdown, AC ¶¶ 85-89, and occurred just a few months prior to her May termination, AC ¶ 121. These allegations are sufficient at the motion to dismiss stage to support the causal connection required to plead a Section 740 claim.
CONCLUSION
For the reasons stated above, the Court DENIES defendants’ Motion.
SO ORDERED.
/s/ Natasha C. Merle
NATASHA C. MERLE
United States District Judge
Dated: September 24, 2024
Brooklyn, New York
