S.H., a minor, by her guardian ad litem, Chantal Holt; WILLIAM KENNETH HOLT; CHANTAL HOLT, Plaintiffs-Appellees, v. UNITED STATES OF AMERICA, Defendant-Appellant.
No. 15-15000
UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT
April 10, 2017
D.C. No. 2:11-cv-01963-MCE-DAD
Before: Carlos F. Lucero, Susan P. Graber, and Andrew D. Hurwitz, Circuit Judges. Opinion by Judge Lucero; Concurrence by Judge Graber
OPINION
Appeal from the United States District Court for the Eastern District of California Morrison C. England, Jr., District Judge, Presiding
Argued and Submitted December 15, 2016 San Francisco, California
Filed April 10, 2017
* The Honorable Carlos F. Lucero, United States Circuit Judge for the U.S. Court of Appeals for the Tenth Circuit, sitting by designation.
SUMMARY**
Federal Tort Claims Act
The panel vacated the district court‘s judgment in favor of plaintiffs who brought a Federal Tort Claims Act (“FTCA“) action against the United States; held that the plaintiffs’ claims arose in Spain and therefore were barred by the FTCA‘s foreign country exception; and remanded with instructions to dismiss for lack of subject matter jurisdiction.
Plaintiff S.H. was born prematurely while her family was stationed at a United States Air Force base in Spain, and as a consequence of her premature birth, S.H. suffered a permanent brain injury that led to a diagnosis of cerebral palsy after she returned to the United States.
The FTCA generally waives the United States’ sovereign immunity from suits in torts, but the waiver is subject to certain exceptions. Under the foreign country exception, the FTCA‘s waiver of immunity does not apply to any claim arising in a foreign country.
The panel held that an injury is suffered where the harm first impinges upon the body, even if it is later diagnosed elsewhere. The panel concluded that the brain injury S.H. suffered at or near the time of her birth impinged upon her body in Spain; thus, that was where the plaintiffs’ claims arose. The panel further held that S.H.‘s cerebral palsy was derivative of the harm she sustained at birth.
COUNSEL
John Samuel Koppel (argued) and Mark B. Stern, Attorneys, Appellate Staff; Benjamin B. Wagner, United States Attorney; Benjamin C. Mizer, Principal Deputy Assistant Attorney General; Civil Division, United States Department of Justice, Washington, D.C.; for Defendant-Appellant.
Steven B. Stevens (argued), Steven B. Stevens APC, Los Angeles, California; Martin M. Berman, Law Offices of Martin M. Berman, Palm Springs, California; for Plaintiffs-Appellees.
OPINION
LUCERO, Circuit Judge:
In Sosa v. Alvarez-Machain, 542 U.S. 692 (2004), the Supreme Court held that the foreign country exception to the Federal Tort Claims Act (“FTCA“) “bars all claims based on any injury suffered in a foreign country.” Id. at 712. The Court left unanswered, however, the issue currently before us: How to determine where an injury is “suffered.” We hold that an injury is suffered where the harm first “impinge[s]” upon the body, even if it is later diagnosed elsewhere. See Restatement (First) Conflict of Laws § 377, n.1 (1934).
I
A
Mr. Holt is a Master Sergeant in the USAF. He and his wife have four children. In 2004, when the family was stationed at Edwards Air Force Base in California, Mr. Holt was informed that he was being transferred to the USAF Air Base at Rota Naval Station in Spain. Shortly thereafter, a pregnancy test at the Edwards Air Force Base medical clinic confirmed that Mrs. Holt was pregnant with their third child.
In March 2005, when Mrs. Holt was approximately twenty weeks pregnant, the family relocated to Spain. There, Mrs. Holt was treated by Dr. Dennis Szurkus, a specialist in obstetrics and gynecology at Naval Hospital Rota. During an ultrasound appointment on May 11, 2005, Dr. Szurkus determined that Mrs. Holt was exhibiting signs of preterm labor and had her transferred by ambulance to an off-base hospital—Puerto Real Hospital—where she underwent an emergency cesarean section. S.H. was born on May 12, at approximately 31 weeks gestation. She had difficulty eating and breathing and was kept in the neonatal intensive care unit for seventeen days.
In the months following S.H.‘s birth, the Holts saw several doctors in Spain regarding her medical issues and expressed concern that S.H. was not developing like her two older siblings, both of whom were also born preterm. Doctors told the Holts that S.H. had strabismus, poor head control, low tone in her abdominal muscles, and significant motor and developmental delays. S.H. also experienced seizure-like symptoms, for which she was prescribed phenobarbital. When she was approximately five months old,
At around nine months of age, S.H. was evaluated by a neurologist, Dr. Lisa Smith, who found that S.H. had abnormally brisk reflexes and a mild increase in dynamic tone in her lower extremities. Dr. Smith did not rule out cerebral palsy at that time but declined to render a diagnosis. Two other doctors in Spain did conclude that S.H. had cerebral palsy.1
The family returned to the United States in mid-2006. Late that year, S.H. was diagnosed with tetraplegia of all four extremities. At the age of two, while living in South Carolina, S.H. was definitively diagnosed with cerebral palsy. It is undisputed that S.H.‘s premature birth was the cause of her cerebral palsy.
B
In June 2006, while the Holts were still in Spain, they filed an administrative claim seeking damages from the government for S.H.‘s “catastrophic neurological injuries, seizures, learning deficits, physical limitations,” and “cerebral palsy.” They alleged that these injuries resulted from the negligent approval of Mrs. Holt‘s command-sponsored travel overseas. The administrative claim was denied.
II
We review a district court‘s findings of fact following a bench trial for clear error. Kohler v. Presidio Int‘l, Inc., 782 F.3d 1064, 1068 (9th Cir. 2015). However, “[w]hether the United States is immune from liability in a FTCA action is a question of federal law subject to de novo review.” Montes v. United States, 37 F.3d 1347, 1351 (9th Cir. 1994) (italics omitted).
The FTCA generally waives the United States’ sovereign immunity from suits in tort, “render[ing] the Government liable in tort as a private individual would be under like circumstances.” Richards v. United States, 369 U.S. 1, 6 (1962); see also
In Sosa, the Supreme Court held that the foreign country exception “bars all claims based on any injury suffered in a
The question at the center of this appeal is where S.H.‘s injury was “suffered” for the purposes of the foreign country exception. Id. at 712. The Sosa opinion offers various
The district court concluded that state accrual law should determine where an injury is suffered. Relying on California law, it held that S.H.‘s cerebral palsy occurred in the United States because it was not until the Holts arrived in South Carolina that doctors could identify S.H.‘s symptoms as cerebral palsy. But as we have previously noted, “[q]uestions of interpretation under the [FTCA‘s] exclusion provisions are controlled by federal law.” Ramirez v. United States, 567 F.2d 854, 856 (9th Cir. 1977); accord United States v. Neustadt, 366 U.S. 696, 706 (1961) (“[W]hether [a] claim is outside the intended scope of the Federal Tort Claims Act . . . depends solely upon what Congress meant by the language it used . . . .“). The district court acknowledged this principle as a general matter but concluded that because California law governed the United States’ liability under
To determine where the Holts’ claims arose for the purposes of the foreign country exception, we must therefore look to governing choice-of-law principles at the time Congress enacted the FTCA. And, as the Supreme Court held in Sosa, we must apply lex loci delicti. Id. The Restatement (First) of Conflict of Laws, upon which the Supreme Court relied in Sosa, provides that “[t]he place of wrong is . . . where the last event necessary to make an actor liable for an alleged tort takes place.” § 377. The Restatement illustrates application of this rule when an individual “sustains bodily harm” as follows:
Such a force is first set in motion by some human being. It is quite immaterial in what state he set the force in motion. It must alone or in cooperation with other forces harm the body of another. The person harmed may thereafter go into another state and die from the injury or suffer other loss therefrom. The place where this last event happens is also immaterial. The question is only where did the force impinge upon his body.
It is undisputed that S.H.‘s cerebral palsy resulted from the brain injury she sustained in Spain as a consequence of her premature birth. The district court held that the Holts’ claims arose in the United States because that is where S.H.‘s cerebral palsy definitively manifested itself. In reaching that determination, the court distinguished between S.H.‘s brain injury and her cerebral palsy diagnosis, reasoning that because plaintiffs were suing to recover for the latter harm, and cerebral palsy is not a disease but rather a collection of symptoms, plaintiffs’ claims could not have arisen prior to those symptoms being present and diagnosable. But S.H.‘s premature birth caused appreciable injury while the Holts were in Spain, even if cerebral palsy was not definitively diagnosed in that country. Under lex loci delicti, as it was interpreted at the time of the FTCA‘s passage, the fact that a plaintiff suffers some “other loss” in a different jurisdiction is “immaterial.” Restatement (First) Conflict of Laws § 377, n.1. “The question is only where did the force impinge upon [her] body.” Id. The undisputed facts of this case indicate that the force—the brain injury S.H. suffered at or near the time of her birth—impinged upon her body in Spain; thus,
Our conclusion is consistent with the application of the foreign country exception by other federal courts. In Thompson v. Peace Corps, 159 F. Supp. 3d 56, 61 (D.D.C. 2016), the court held that the foreign country exception barred the plaintiff‘s FTCA claims, which were based on injuries she sustained as a result of taking an anti-malarial drug in Burkina Faso. Id. The court reasoned that although the plaintiff “complain[ed] of continuing side effects after her return home,” as well as “a permanent brain injury,” the court lacked jurisdiction because the “claims based on those injuries arose out of the administration of mefloquine in Burkina Faso.” Id. at 58, 61. Similarly, the District of Columbia Circuit has twice held that a district court lacked jurisdiction over a plaintiff‘s claims for emotional or
Like the injuries alleged in these cases, S.H.‘s cerebral palsy is derivative of the harm she sustained at birth. As the Holts recognize, cerebral palsy is not itself a disease, but rather a group of non-progressive motor conditions. It is therefore a description of symptoms manifesting from S.H.‘s brain injury, rather than a separate, compensable harm. Moreover, to hold that the Holts’ claims did not arise until cerebral palsy could be definitively diagnosed would enable plaintiffs in similar circumstances to avoid application of the foreign country exception, either by pleading their injuries in a particular way or by relocating to the United States before obtaining a diagnosis. Cf. Sosa, 542 U.S. at 702-03 (rejecting idea that “allegations of negligent medical care . . . can . . . be repackaged as headquarters claims based on . . . the offering of bad advice” in the United States, even though harm is suffered overseas, because the practice would “swallow the foreign country exception whole” (citations omitted)); Harbury, 522 F.3d at 423 (prohibiting plaintiffs
III
Because the Holts’ claims against the United States arose in Spain, the FTCA‘s foreign country exception bars their suit. Accordingly, the district court‘s order is VACATED, and we REMAND the case with instructions to dismiss for lack of subject matter jurisdiction.5 The parties shall bear their own costs on appeal.
GRABER, Circuit Judge, concurring in the result:
I concur in the result reached by the majority opinion. I write separately because, in my view, the timing and content of the administrative claim filed by Plaintiffs, while they were still in Spain, forecloses their claims under the Federal Tort Claims Act (“FTCA“).
The FTCA requires that a plaintiff exhaust administrative remedies:
An action shall not be instituted upon a claim against the United States for money damages for injury or loss of property or personal injury or death caused by the negligent or wrongful act or omission of any employee of the Government while acting within the scope of his office or employment, unless the claimant shall have first presented the claim to the appropriate Federal agency and his claim shall have been finally denied by the agency . . . .
Although an administrative claim need not be detailed to satisfy
S.H. was born in Spain, where the family continued to reside for more than an additional year before returning to the United States. While still in Spain, Plaintiffs filed an administrative claim seeking damages for, among other things, “catastrophic neurological injuries, seizures, learning deficits, [and] physical limitations” already suffered by S.H. as a result of her premature and difficult birth. The claim form also asserted, among other things, that “negligence on the part of medical healthcare providers, penultimately in Rota, Spain at USNaval Hospital, resulted in negligent failure to promptly recognize and treat [the mother‘s] abruptio placenta, causing catastrophic injuries,” and that care “at USNH Rota Spain failed to conform to the standard of medical and surgical care in the community.” It is clear that,
What this means is that Plaintiffs’ claims necessarily “arose” in Spain, because a claim cannot be “presented” to the appropriate agency under
This would be a tragic case in any event, but the fact that it is the foreign-country exception that ultimately bars relief makes it especially tragic, as it was the alleged negligence of the United States that led to Plaintiffs’ being in a foreign country in the first place. But only Congress is in a position to provide relief to Plaintiffs and those in similar situations.
