Cardio-Medical Assoc. v. Crozer-Chester Med. Ctr.
| Decision Date | 15 November 1982 |
| Docket Number | Civ. A. No. 81-3050. |
| Citation | 552 F. Supp. 1170 |
| Parties | CARDIO-MEDICAL ASSOCIATES, LTD. and Thomas J. McBride, M.D. and Paul T. Cass, M.D. and C. Richard Schott, M.D. and Michael B. Goodkin, M.D., Plaintiffs, v. CROZER-CHESTER MEDICAL CENTER and James H. Loucks, M.D., Michael C. Boyd, William J. Breece, John F. Cramp, Esquire, Daniel R. Curran, Mary E. Dale, Conrad A. Etzel, M.D., Jeremiah A. Hartley, Joseph R. Layton, Reverend David A. MacQueen, Peter L. Miller, William B. Mitchell, Jr., Clarence R. Moll, Ph.D., J. Harold Perrine, Malcolm B. Petrikin, Esquire, and Bertram M. Speare, individually and as members of the Crozer-Chester Medical Center Board of Directors and James Clark, M.D., Chief of Department of Medicine of Crozer-Chester Medical Center and Daniel J. MARINO, M.D., R. David Mishalove, M.D., Joel A. Krackow, M.D., Adrian S. Weyn, M.D., Peter Lavine, M.D., Michael Yow, M.D., and Ancil Jones, M.D. c/a Cardiology Associates of Delaware County. |
| Court | U.S. District Court — Eastern District of Pennsylvania |
COPYRIGHT MATERIAL OMITTED
COPYRIGHT MATERIAL OMITTED
Howard Richard and Lynn B. Schoenfeld, Media, Pa., and David Berger, Philadelphia, Pa., for plaintiff.
John W. Wellman, Media, Pa., and H. Robert Halper, Washington, D.C., for Crozer-Chester.
H. Robert Fiebach, Philadelphia, Pa., for Cardiology Assoc.
TABLE OF CONTENTS
I. Preliminary Statement ..................... 1173
II. Standards Under Which Defendants'
Motion Must be Decided ............................ 1175
A. Rule 12(b)(1) ............................ 1175
B. Review of Standards Developed
in Previous Opinion ...................... 1175
1. Pleading Standards .................. 1175
2. Substantive Sherman Act
Standards ........................... 1176
C. Analytic Framework ....................... 1180
1. Each Case Turns on Its Own
Facts ............................... 1180
2. Considerations Bearing on the
Tripartite Jurisdictional Test ...... 1181
a. Nature of the alleged
restraint .................... 1181
b. Nature of the plaintiff ...... 1183
III. Application of Legal Standards to Plaintiffs'
Sherman Act Allegations ....... 1184
A. Introductory Statement ................... 1184
B. "In Commerce" Theory ..................... 1185
C. "Affecting Commerce" Theory .............. 1186
1. Treatment of Out-of-State
Patients by Plaintiffs .............. 1187
2. Interstate Flow of Revenues to
Plaintiffs .......................... 1190
3. Use of Medical Equipment and
Medical Supplies by Plaintiffs ...... 1192
4. Use of Automobiles, Gasoline, and
Other Equipment by Plaintiffs ....... 1194
5. Prescriptions of Drugs and
Medicines by Plaintiffs ............. 1195
6. Dissuasion of Out-of-State
Physicians From Associating
with Plaintiffs ..................... 1197
7. Inflating of Fees for Cardiology
Services ............................ 1198
8. Diminished Interstate Investments
in Plaintiffs' Pension Portfolio .... 1200
9. Curtailment of Plaintiffs' Practice
in Connection with a New Jersey
Clinic .............................. 1201
10. Lessening of Use of Out-of-State
Continuing Education ................ 1201
11. Summary ............................. 1202
D. Consistency with Prior Precedent .......... 1202
IV. Conclusion ................ 1205
Plaintiff Cardio-Medical Associates, Ltd., and its four physician members, brought this antitrust action against Crozer-Chester Medical Center (hereinafter referred to as "CCMC"), members of the CCMC Board of Directors, and the Chief of the Department of Medicine at CCMC (hereinafter referred to as "the CCMC defendants"), as well as several individual doctors practicing cardiology under the name of Cardiology Associates of Delaware County (hereinafter referred to as "Cardiology Associates"). Plaintiffs allege that the denial to them of certain specialized staff privileges in cardiology at CCMC violates both sections 1 and 2 of the Sherman Act, 15 U.S.C. ?? 1, 2 (1976), and section 4 of the Clayton Act, 15 U.S.C. ? 15 (1976).
Plaintiffs originally filed this action on July 30, 1981. In their original complaint, plaintiffs alleged that the denial to them of such privileges resulted from an unlawful conspiracy by defendants that restrained trade in violation of sections 1 and 2 of the Sherman Act. Plaintiffs also alleged that defendants' conduct violated plaintiffs' fourteenth amendment rights and, therefore, constituted a deprivation of a constitutionally protected property or liberty interest within the meaning of 42 U.S.C. ? 1983 (1976). Pursuant to rule 12(c), the CCMC defendants, later joined by Cardiology Associates, filed a motion for judgment on the pleadings on the grounds that plaintiffs had failed to state a claim for relief or establish that this court had subject matter jurisdiction with respect to either count of the original complaint.
On March 15, 1982, I issued an opinion and order granting defendants' motion for judgment on the pleadings. Cardio-Medical Associates, Ltd. v. Crozer-Chester Medical Center, 536 F.Supp. 1065 (E.D.Pa.1982). Count II of plaintiffs' original complaint, which alleged violations of the Constitution and section 1983, was dismissed with prejudice. Count I, however, which alleged that the actions of defendants violated the antitrust laws, was dismissed without prejudice and I granted plaintiffs sixty days to file an amended complaint.
On May 13, 1982, plaintiffs, with the assistance of new counsel, filed a thirty-eight page, sixty-five paragraph amended complaint. In fifty-five paragraphs of introductory allegations, plaintiffs attempt to plead jurisdiction and venue; the identity of the parties; the identification of relevant product markets; the alleged effects that defendants' activities have on interstate trade and commerce; and the activities allegedly constituting defendants' conspiracy, unreasonable restraint of trade, and group boycott of plaintiffs. Count I of plaintiffs' amended complaint then states their Sherman Act section 1 claim while Count II states their Sherman Act section 2 claim.
Thus, plaintiffs' amended complaint alleges, as did Count I of their original complaint, that defendants have prohibited plaintiffs from practicing certain cardiology procedures at CCMC in violation of sections 1 and 2 of the Sherman Act. On the basis of these allegations, plaintiffs seek permanent injunctive relief compelling defendants to permit plaintiffs to perform the specified procedures from which they allegedly have been wrongfully excluded. Plaintiffs also seek damages for the injuries allegedly sustained as a result of the denial of the opportunity to perform these procedures as well as attorneys' fees and costs.
Pursuant to rule 12(b)(1) of the Federal Rules of Civil Procedure, the CCMC defendants have moved to dismiss plaintiffs' amended complaint for lack of subject matter jurisdiction.1 Defendants' decision to proceed under rule 12(b)(1) as opposed to rule 12(b)(6) was dictated by my holding in the original Cardio-Medical opinion that "the Third Circuit uniformly approaches the interstate commerce issue as one of jurisdiction." Cardio-Medical, 536 F.Supp. at 1079 n. 15.
Under the applicable Third Circuit precedents, rule 12(b)(1) is the appropriate procedural vehicle for the testing of antitrust jurisdictional challenges. See, e.g., Mortensen v. First Federal Savings & Loan Ass'n, 549 F.2d 884 (3d Cir.1977); Doctors, Inc. v. Blue Cross of Greater Philadelphia, 490 F.2d 48 (3d Cir.1973); Daley v. St. Agnes Hospital, Inc., 490 F.Supp. 1309 (E.D. Pa.1980). The Third Circuit, however, has been emphatic in its identification of a "crucial distinction" between rule 12(b)(1) motions that attack a complaint on its face and rule 12(b)(1) motions that attack a complaint factually (i.e., through the introduction of materials outside the pleadings). Mortensen, 549 F.2d at 891.
Whenever the court treats a rule 12(b)(1) motion to dismiss as a facial challenge to the legal sufficiency of the pleading, it must afford the plaintiff the same safeguards as would be available to the plaintiff in a rule 12(b)(6) motion:
To continue reading
Request your trial
-
Weiss v. York Hosp.
...and adverse." The defendants' argument is premised primarily on a district court opinion, Cardio-Medical Associates v. Crozer-Chester Medical Center, 552 F.Supp. 1170 (E.D.Pa.1982). Since the time of oral argument in this case, however, this court reversed that district court's opinion and ......
-
MIAMI INTERN. REALTY CO. v. Town of Mt. Crested Butte, Civ. A. No. 83-K-25.
...activities of defendants and the effect on the relevant channel of interstate commerce. Cardio-Medical Assoc., Ltd. v. Crozer-Chester Med. Ctr., 552 F.Supp. 1170, 1176 (E.D.Pa.1982). The Tenth Circuit, in a somewhat different formulation, requires a plaintiff to "identify the relevant chann......
-
Weiss v. York Hosp.
...in order to establish jurisdiction. Pontius v. Children's Hospital, 552 F.Supp. 1352 (W.D.Pa.1982); Cardio-Medical Associates v. Crozer-Chester Medical Center, 552 F.Supp. 1170 (E.D.Pa.1982). We did not so hold in this case and the Court of Appeals affirmed. However, had we applied the same......
-
Cardio-Medical Associates, Ltd. v. Crozer-Chester Medical Center
...opinions, the district court granted both the motion to strike the demand for a jury trial, 95 F.R.D. 194, and the motion to dismiss, 552 F.Supp. 1170. Plaintiffs appeal from orders implementing those two decisions. II. Jurisdiction Under the Sherman Act Sections 1 and 2 of the Sherman Act ......