Cossaboon v. Maine Medical Center

• Citation: 600 F.3d 25
• Decision Date: 25 March 2010
• Docket Number: No. 09-1550.,09-1550.
• Parties: Amanda COSSABOON, Plaintiff, Appellant, v. MAINE MEDICAL CENTER, Defendant, Appellee.
• Court: United States Courts of Appeals. United States Court of Appeals (1st Circuit)

600 F.3d 25

Amanda COSSABOON, Plaintiff, Appellant, v. MAINE MEDICAL CENTER, Defendant, Appellee.

No. 09-1550.

United States Court of Appeals, First Circuit.

Heard October 5, 2009.

Decided March 25, 2010.

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Matthew R. Serge, with whom Heather M. Burns, Upton & Hatfield, LLP was on brief, for appellant.

Gerald F. Petruccelli, with whom Petruccelli, Martin & Haddow, LLP was on brief, for appellee.

Before BOUDIN, STAHL and LIPEZ, Circuit Judges.

LIPEZ, Circuit Judge.

Plaintiff Amanda Cossaboon, individually and as mother and next friend of E.C., appeals from the district court's dismissal of her medical malpractice action against defendant Maine Medical Center (MMC) for lack of personal jurisdiction. Cossaboon contends that MMC purposefully established sufficient contacts with New Hampshire to permit the exercise of general personal jurisdiction in New Hampshire. We disagree and affirm.

I.

On June 3, 2008, Cossaboon, a New Hampshire resident, filed this medical malpractice action against MMC in New Hampshire Superior Court. Cossaboon alleged that on April 15, 2007, she gave birth to twin daughters at Portsmouth Hospital in New Hampshire. The twins were born prematurely, and E.C., upon referral from her New Hampshire physician, was transferred to the neonatal intensive care unit at MMC four hours after her birth. On May 1, 2007, an employee of MMC placed a hot, wet diaper on E.C.'s heel. The diaper burned E.C.'s heel, causing scarring and requiring additional medical services. Cossaboon alleged that MMC breached the standard of care by placing the hot diaper on E.C.'s foot, and sought compensation, individually and as mother and next friend of E.C., for the resulting injury and economic losses.

MMC removed the action to federal court on the basis of diversity of citizenship on June 30, 2008, and later moved to dismiss for lack of personal jurisdiction. Cossaboon opposed the motion to dismiss, contending that MMC was subject to both specific and general personal jurisdiction. After hearing argument from counsel, the district court granted MMC's motion to dismiss.

The court concluded that MMC was not subject to specific personal jurisdiction because Cossaboon's claim did not directly relate to or arise from MMC's activities in New Hampshire. Instead, the act from which the claim arose, the application of the hot diaper to E.C.'s heel, occurred in Maine nearly two weeks after E.C.'s transfer from Portsmouth Hospital to MMC. The court further determined that MMC was not subject to general personal jurisdiction because MMC had not purposefully established "continuous and systematic" contacts with New Hampshire. In light of its conclusion that MMC was not subject to either specific or general jurisdiction, the court found it unnecessary to reach the issue of whether New Hampshire's long-arm statute conferred jurisdiction over MMC.¹

Cossaboon filed this timely appeal, challenging only the district court's ruling that MMC is not subject to general personal jurisdiction.

II.

A. Jurisdictional Facts

For purposes of the general jurisdiction analysis, we "consider all of a defendant's contacts with the forum state prior to the filing of the lawsuit." Harlow v. Children's Hosp., 432 F.3d 50, 65 (1st Cir.2005). The relevant facts in this case are largely undisputed.

Cossaboon is a New Hampshire resident. MMC is a not-for-profit corporation organized in the state of Maine with its principal place of business in Portland, Maine. MMC does not hold any license from the state of New Hampshire, and does not own, lease, or occupy any real property in New Hampshire. It does not employ any physicians, nurses or other healthcare professionals who provide professional services in New Hampshire and does not require employees to hold medical licenses from New Hampshire.

At the time that E.C.'s injury occurred, MMC was registered to do business in New Hampshire as a foreign not-for-profit corporation, and had registered the trade name "Northern New England Poison Control Center." On its Application for Registration of a Foreign Nonprofit Corporation, MMC stated that the "principal purpose or purposes which it proposes to pursue in the transaction of business in New Hampshire" was "including but not limited to poison control center services." The Northern New England Poison Control Center (Poison Control Center) operates a poison hotline in Portland, Maine that accepts phone calls from New Hampshire, Maine and Vermont. All calls to the Poison Control Center are handled by MMC personnel in Portland; MMC provides no poison-related medical services other than at locations in Portland. At the time of E.C.'s injury, MMC employed one person in New Hampshire. That employee did not provide medical services in New Hampshire, but was employed to provide education and consultation services to healthcare providers, educators, first responders and others interested in the work of the Poison Control Center.²

MMC does not purchase advertisements in any New Hampshire-based newspapers, telephone directories or television or radio stations. MMC does issue periodic press releases to a range of media outlets, including two New Hampshire-based newspapers (Foster's Daily Democrat and the Portsmouth Herald) and a few regional and national news outlets that reach New Hampshire (such as The Boston Globe and New England Cable News). MMC has placed job listings in the regional trade publication HealthCare Review, which is produced in New Hampshire. MMC also advertises on radio and television stations whose signals may reach parts of New Hampshire, including WGME, a television station broadcast from southern Maine.

MMC operates a website that provides information about the hospital's services and staff. The website allows users to make online charitable donations to the hospital, complete patient pre-registration, register for classes and events, find a doctor, and apply for an employment position at the hospital. The website describes certain hospital services and programs, four of which mention that MMC serves patients from New Hampshire.

MMC participates in the Regional Emergency Medical Information System (REMIS), a twenty-four-hour communication center that facilitates transfers to MMC from other hospitals and caregivers. When a caregiver calls MMC with a request to transfer a patient, REMIS facilitates communications related to patient status, bed availability, and other information necessary for the transfer. Contacts regarding transfer to MMC are initiated by the patients' caregivers. MMC has no agreements with New Hampshire physicians under which patients are directed to MMC for medical services.

MMC has also entered into an agreement with Dartmouth Medical School in New Hampshire whereby medical students at Dartmouth may be placed at MMC for clinical training rotations. The agreement specifies that the Dartmouth students are present at MMC "in their learning capacity" and not as employees of MMC.

Finally, MMC treats patients from New Hampshire at its Portland hospital. In the approximately two years before Cossaboon filed suit, New Hampshire residents represented approximately 1.23% of all patients treated at MMC, whether admitted as in-patients or treated as out-patients (8,107 New Hampshire patients out of a total of 660,524 patients). In 2006 and 2007, New Hampshire residents admitted as in-patients at MMC represented 2.9% of all in-patient admissions to MMC. New Hampshire residents represented a somewhat higher percentage of patients admitted to the neonatal unit at MMC, approximately 8.8% of neonatal admissions in 2007.

A portion of MMC's revenue is derived from its treatment of New Hampshire residents. In the roughly two years prior to Cossaboon's suit, MMC received approximately $72,537,073 in payments for treatment of New Hampshire residents. These payments represented approximately 3.24% of MMC's total revenue for this period. MMC received $2,613,951 in payments from New Hampshire Medicaid,.001% of MMC's total revenue during this period.

B. Legal Background on Personal Jurisdiction

1. Standard of Review

Where, as here, the district court "held no evidentiary hearing but instead conducted only a prima facie review of the jurisdictional facts," we review de novo the district court's decision to dismiss for lack of personal jurisdiction. Harlow, 432 F.3d at 57 (quotation marks and citation omitted). In reviewing a decision made under the prima facie standard, we consider the plaintiff's allegations "so far as evidence supports them after preliminary jurisdictional discovery." Jet Wine & Spirits, Inc. v. Bacardi & Co., 298 F.3d 1, 4 (1st Cir. 2002); see United States v. Swiss Am. Bank, Ltd., 274 F.3d 610, 619 (1st Cir. 2001) (holding that the prima facie showing "must be based upon evidence of specific facts set forth in the record") (quotation marks and citation omitted). In addition, "we then add to the mix facts put forward by the defendants, to the extent that they are uncontradicted." Mass. Sch. of Law at Andover, Inc. v. Am. Bar Ass'n, 142 F.3d 26, 34 (1st Cir.1998). The plaintiff "ultimately bears the burden of persuading the court that jurisdiction exists." Id.

2. Due Process Requirements

Personal jurisdiction may be either general or specific. Harlow, 432 F.3d at 57. Specific jurisdiction "may only be relied upon where the cause of action arises directly out of, or relates to, the defendant's forum-based contacts." Pritzker v. Yari, 42 F.3d 53, 60 (1st Cir.1994) (internal quotation marks and citation omitted); see Glater v. Eli Lilly & Co., 744 F.2d 213, 215 (1st Cir.1984) (stating that specific jurisdiction is based on "the relationship among the defendant, the forum, and the litigation"). General jurisdiction, by contrast, "may be asserted in connection with suits not directly founded on that defendant's forum-based conduct...." Pritzker, 42 F.3d at 59 (...