Howes v. Yankton Med. Clinic, P.C. — Aug. 2016 (Summary)

ANTITRUST

Howes v. Yankton Med. Clinic, P.C.
No. 4:15-CV-04177-KES (D.S.D. Aug. 17, 2016)

The Southern Division for the United States District Court for the District of South Dakota denied a medical clinic’s motion to dismiss a lawsuit filed by a deceased patient’s estate alleging federal antitrust claims of unlawful tying and monopolization.

The patient and his wife, who is the executrix of his estate, were involved in litigation that had been previously filed against the medical clinic involving widespread claims of malpractice due to the performance of unnecessary spine surgeries by an orthopedic surgeon at the clinic. The patient later began seeing a pulmonologist at the clinic for treatment of sleep apnea.  After the patient had to miss a follow-up appointment that was required by the insurance provider for continued use of a BiPAP machine, the pulmonologist’s office refused to reschedule his appointment unless they paid the entire outstanding balance, even though the patient’s wife showed the pulmonologist the patient’s Medicare card and informed him that they had an agreement for a monthly payment plan. Subsequently, the patient’s condition deteriorated from his stress over the lack of access to treatment, and he died.

The wife alleged that the pulmonologist’s refusal to treat the patient was an intimidation tactic in response to the couple’s involvement in the unnecessary spine surgery lawsuit against the clinic. The court denied the clinic’s motion to dismiss, finding that the executrix had sufficiently pled her antitrust claim. The executrix satisfied the interstate commerce element of the claim because several of the other plaintiffs in the unnecessary surgery case resided in other states and because the clinic accepted federal funding through Medicare.  With regard to showing antitrust injury, the court noted that due to the monopoly power of the clinic, the quantity of services available to the decedent in the relevant market was zero; therefore, antitrust standing was established by properly pleading that the clinic used its monopoly power to deny the decedent care so that the clinic could gain an improper advantage in the separate spine surgery litigation.