Gardner v. Delta Dental Plan of N.M., 20-cv-01271-DHU-LF

CourtUnited States District Courts. 10th Circuit. District of New Mexico
PartiesDR. WILLIAM C. GARDNER, DDS, dba DR. WILLIAM C. GARDNER, DDS, P.A., Plaintiff, v. DELTA DENTAL PLAN OF NEW MEXICO, INC., DELTA DENTAL PLAN OF MICHIGAN, INC., EDWARD J. LOPEZ, JR., as an Individual and in his capacity as CEO, JESUS C. GALVAN, DDS, as an individual and in his capacity as CFO, and JASON LOUIS SNIDER, as an individual and in his capacity as manager, Defendants.
Docket Number20-cv-01271-DHU-LF
Decision Date08 March 2023



DELTA DENTAL PLAN OF NEW MEXICO, INC., DELTA DENTAL PLAN OF MICHIGAN, INC., EDWARD J. LOPEZ, JR., as an Individual and in his capacity as CEO, JESUS C. GALVAN, DDS, as an individual and in his capacity as CFO, and JASON LOUIS SNIDER, as an individual and in his capacity as manager, Defendants.

No. 20-cv-01271-DHU-LF

United States District Court, D. New Mexico

March 8, 2023



This matter is before the Court on Defendants Delta Dental Plan of New Mexico, Inc., Delta Dental Plan of Michigan, Inc., Jesus C. Galvan, DDS, and Jason Louis Snider's (“Defendants”) Joint Motion to Dismiss Civil Complaint for Money Damages as Res Judicata (“Motion to Dismiss”) (Doc. 62). Plaintiff William C. Gardner, DDS responded (Doc. 75) and Defendants replied (Doc. 84). After considering the briefs, applicable law, and being otherwise fully informed, the Court concludes that Defendants' Motion to Dismiss (Doc. 62) will be GRANTED.

This matter is also before the Court on Delta Dental Plan of Michigan, Delta Dental Plan of New Mexico, Jesus C. Galvan, DDS, and Jason Louis Snider's Motion to Dismiss Pursuant to Rule 12(b)(6) (Doc. 65), which is DENIED as MOOT in light of the Court's granting of the res judicata Motion to Dismiss.



Plaintiff is a dentist residing in Albuquerque, New Mexico. Doc. 33 at 2 (Second Amended Complaint for Money Damages in a Civil Action).[1] Plaintiff brought this action against Delta Dental Plan of New Mexico (“DDNM”) and Delta Dental Plan of Michigan (“DDMI”), both of which are state-license insurers of dental services provided to policyholders in the states of New Mexico and Michigan, respectively. Id. Plaintiff also brought this case against Edward J. Lopez, Jr., the former Chief Executive Officer for DDNM;[2] Jesus C. Galvan, the Chief Financial Officer for DDNM; and Jason Louis Snider, who is in a “managerial capacity” for DDMI. Id. at 2-3.

Plaintiff began practicing as a dentist in New Mexico in 1996. Id. at 3. Plaintiff was an “in network” Delta Dental Plan Premier Provider until 2014. Id. In 2012, Defendant Galvan “contacted Plaintiff and demanded that Plaintiff waive payment for services Plaintiff had provided to a patient that made a complaint to DDNM indicating that he was dissatisfied with the work that Dr. Gardner had performed.” Id. Plaintiff refused. Id. Defendant Galvan told Plaintiff, “[I]f you don't do what I tell you I will kick you off the network. I have done it before, and I will do it again.” Id. at 4. After this incident, Plaintiff was placed on the “Focus Review” program, which required Plaintiff to provide additional clinical documentation to DDNM in order to receive payment for his dental services. Id.

In 2014, after DDNM stopped paying Plaintiff's claims for work he performed for patients


contract with DDNM, Plaintiff filed suit against DDNM in New Mexico State District Court, case number D-202-CV-2014-02082.[3] Id. at 5. After Plaintiff filed the State Case, DDNM began soliciting complaints from his patients in a campaign to destroy Plaintiffs dental practice and reputation.” Id. Six complaints were filed against Plaintiff before the New Mexico Dental Board. Id. at 6.

DDNM continued to retaliate against Plaintiff. Id. In 2014, the Delta Dental Board voted Plaintiff out of the Delta Dental Premier Network without grounds. Id. This caused Plaintiff “significant financial and reputational harm.” Id. In 2016, Defendant Lopez and others acting at his direction issued a press release about Plaintiff, which included protected health information about Plaintiff's patients. Id. at 7. Many of Plaintiff's patients stopped using his services after this negative press coverage, causing him financial harm. Id. at 7-8. Other patients continued to see Plaintiff for dental services. Id. at 8. Defendant Lopez also called 911 and made a false police report against Plaintiff alleging that DDNM was afraid that “Plaintiff might come into his large five story office complex and perform an ‘Orlando Style Shooting.'" Id.

In 2018, Plaintiff's dental license was suspended for 60 plus days. Id. at 8-9. Because Plaintiff's license was suspended, DDNM removed Plaintiff from their list of providers and other provider lists for other networks. Id. at 9. Plaintiff did not know his license was suspended so he continued to practice during the suspension, and Plaintiff has been unable to collect payment for work performed during this period. Id. In 2019, DDNM facilitated filing another complaint with the New Mexico Board of Dentistry. Id. Plaintiff's license was revoked on January 1, 2020. Id.


The revocation was initially stayed, but then the stay was lifted in the revocation proceedings went forward. Id. at 10. Plaintiff did not receive notice of the Dental Board proceedings and his license was revoked on or about December 12, 2020. Id.

In this matter, Plaintiff brought seven causes of action against Defendants for: Breach of Contract, Conspiracy to Commit Breach of Contract, Unjust Enrichment, Wire Fraud and Mail Fraud, Tortious Interference, Defamation, and Racketeering. Id. at 11-15.

On May 6, 2021, Defendants filed a Joint Motion to Dismiss Civil Complaint for Money Damages as Res Judicata (Doc. 62). Defendants request the Court dismiss Plaintiff's Second Amended Complaint (Doc. 33) with prejudice pursuant to Fed.R.Civ.P. 12(b)(6). It is to this issue that the Court now turns.


Rule 12(b)(6) allows for the dismissal of a complaint where the plaintiff has failed to state a claim upon which relief can be granted. Fed.R.Civ.P. 12(b)(6). To survive a motion to dismiss, a plaintiff must allege facts that “raise a right to relief above the speculative level.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007) (citing 5 C. Wright & A. Miller, Federal Practice and Procedure § 1216, pp. 235-236 (3d ed.2004)). A complaint must contain “sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.' ” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Twombly, 550 U.S. at 570). To satisfy the plausibility standard, a plaintiff's allegations must show that defendant's liability is more than a “sheer possibility.” Id.

“The court's function on a Rule 12(b)(6) motion is not to weigh potential evidence that the parties might present at trial, but to assess whether the plaintiff's complaint alone is legally sufficient to state a claim for which relief may be granted.” Tal v. Hogan, 453 F.3d 1244, 1252 (10th Cir. 2006) (internal citation omitted). In considering dismissal under Rule 12(b)(6), the


Court will “assume the truth of the plaintiff's well-pleaded factual allegations and view them in the light most favorable to the plaintiff.” Ridge at Red Hawk, L.L.C. v. Schneider, 493 F.3d 1174, 1177 (10th Cir. 2007) (citing Beedle v. Wilson, 422 F.3d 1059, 1063 (10th Cir.2005)). A complaint will survive a Rule 12(b)(6) motion if it “contains ‘enough facts to state a claim to relief that is plausible on its face.' ” Id. (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007)).

A Rule 12(b)(6) motion is generally decided on the face of the pleadings themselves, and consideration of matters outside the pleadings generally converts a Rule 12(b)(6) motion into a motion for summary judgment. Utah Gospel Mission v. Salt Lake City Corp., 425 F.3d 1249, 1253 (10th Cir. 2005) (citing Fed.R.Civ.P. 12(b); Miller v. Glanz, 948 F.2d 1562, 1565 (10th Cir. 1991)). However, the Tenth Circuit has recognized that “facts subject to judicial notice may be considered in a Rule 12(b)(6) motion without converting the motion to dismiss into a motion for summary judgment.” Hogan, 453 F.3d at 1264-65 n.24 (citing See Grynberg v. Koch Gateway Pipeline Co., 390 F.3d 1276, 1278 n. 1 (10th Cir.2004)). “This includes another court's publicly filed records ‘concerning matters that bear directly upon the disposition of the case at hand.' ” Hodgson v. Farmington City, 675 Fed.Appx. 838, 840-41 (10th Cir. 2017) (quoting United States v. Ahidley, 486 F.3d 1184, 1192 n.5 (10th Cir. 2007)).

A. Res Judicata

“Under res judicata, a final judgment on the merits of an action precludes the parties or their privies from relitigating issues that were or could have been raised in that action.” Allen v. McCurry, 449 U.S. 90, 94 (1980). Res judicata promotes judicial economy by reducing unnecessary, duplicative litigation and promotes comity between separate jurisdictions by fostering reliance on existing adjudications. Id. 95-96 (citing Younger v. Harris, 401 U.S. 37, 43 -45, 91 S.Ct. 746, 750-51, 27 L.Ed.2d 669 (1971)).


“Res judicata is an affirmative defense, but may be raised in a motion to dismiss if the facts supporting the defense appear on the face of the complaint, or in documents subject to judicial notice, or if there is no factual dispute.” Navajo Nation v. Wells Fargo & Co., 344 F.Supp.3d 1292, 1302 (D.N.M. 2018) (citations omitted).

According to New Mexico law, “[r]es judicata is a judicially created doctrine designed to promote efficiency and finality by giving a litigant only one full and fair opportunity to litigate a claim and by precluding any later claim that could have, and should have, been brought as part of the earlier proceeding.” Potter v. Pierce, 2015-NMSC-002, ¶ 1, 342 P.3d 54.[4] “The underlying principle behind res judicata is to ‘relieve parties of the cost and vexation of multiple lawsuits, conserve judicial resources, and by preventing inconsistent decisions, encourage reliance on adjudication.'” Three Rivers Land Co., Inc. v. Maddux, 1982-NMSC-111, ¶ 21, 98 N.M. 690, overruled on other grounds, Universal Life Church, 1986-NMSC-068, ¶¶ 7-9 (quoting Allen v. McCurry, 449 U.S. 90, 94...

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