Case Title: Doherty v. Merck & Co., Inc.

Citation: 

Docket Number: 2017 ME 19

State: maine

Court: Maine Supreme Court

Date: 2017-01-26T00:00:00Z

Document:
MAINE SUPREME JUDICIAL COURT 
Reporter of Decisions 
Decision: 
2017 ME 19 
Docket: 
Fed-16-14 
Argued: 
September 8, 2016 
Decided: 
January 26, 2017 
 
Panel: 
 SAUFLEY, C.J., and ALEXANDER, MEAD, GORMAN,* JABAR, and HUMPHREY, JJ. 
Majority: 
 SAUFLEY, C.J., and ALEXANDER, MEAD, GORMAN, JABAR, and HUMPHREY, JJ. 
Concurrence: 
 SAUFLEY, C.J., and ALEXANDER and GORMAN, JJ. 
 
KAYLA DOHERTY 
 
v. 
 
MERCK & CO., INC., et al. 
 
 
MEAD, J. 
[¶1]  After Kayla Doherty gave birth to a healthy son in June 2014, she 
filed a complaint against Merck & Co., Inc., and the United States in the 
United States District Court for the District of Maine, alleging that in 
February 2012, at a community health center for which the United States was 
responsible, a physician negligently failed, as a result of Merck’s defective 
applicator, to insert into her arm an implant manufactured by Merck that was 
designed to prevent pregnancy for at least three years.  Pursuant to 
                                         
*  Although not available at oral argument, Justice Gorman participated in the development of this 
opinion.  See M.R. App. P. 12(a) (“A qualified justice may participate in a decision even though not 
present at oral argument.”). 
  
 
2 
4 M.R.S. § 57 (2016) and M.R. App. P. 25, the federal court (Hornby, J.) has 
certified three questions of state law to us: 
1.  Does the protection of Maine’s Wrongful Birth statute, 
24 M.R.S.A. § 2931, extend to the defendant Merck & Co., Inc., as a 
drug manufacturer and distributor? 
 
2.  If not, does the Law Court’s decision in Macomber v. Dillman, 
505 A.2d 810 (Me. 1986), which concerned a failed sterilization by 
a health care provider, apply to the plaintiff Kayla Doherty’s claim 
against Merck as a drug manufacturer and distributor? 
 
3.  Does Maine’s Wrongful Birth statute prohibit all recovery for 
Doherty against both defendants (Merck if it is covered by the 
statute, see question one, supra) because of the nature of the 
procedure she underwent?  Or does the statute allow Doherty to 
proceed with her claims but limit the recoverable damages to her 
expenses incurred for the procedure and pregnancy, pain and 
suffering connected with the pregnancy, and loss of earnings 
during pregnancy? 
 
 
[¶2]  We answer the first question in the affirmative.  Accordingly, we 
decline to answer the second question.  In answer to the third question, 
pursuant to 24 M.R.S. § 2931 (2016) Doherty may not recover any damages on 
her claims against either defendant. 
I.  BACKGROUND 
 
[¶3]  The United States District Court denied without prejudice the 
defendants’ motion to dismiss Doherty’s complaint.  The court stated in its 
certification to us that “the following factual allegations are properly pleaded.  
 
3 
The plaintiff’s factual allegations are therefore taken as true for the purpose of 
testing the defendants’ argument that Maine law allows no recovery to the 
plaintiff even if her allegations are proven.”  See Miller v. Town of Wenham, 
833 F.3d 46, 51 (1st Cir. 2016) (stating that in reviewing the dismissal of a claim 
pursuant to Fed. R. Civ. P. 12(b)(6), the federal courts “accept as true all 
well-pled facts alleged in the complaint and draw all reasonable inferences in 
the plaintiff’s favor” (alteration and quotation marks omitted)). 
 
[¶4]  Doherty’s complaint alleges that on January 26, 2012, she visited a 
federally-supported health care center in Albion to inquire about birth control 
options.  She saw a physician, who recommended the use of an implantable 
drug manufactured by Merck consisting of a single, four-centimeter-long rod 
inserted under the skin of the inner side of the patient’s upper arm with a 
syringe-like applicator.  The drug, which is designed to be effective for at least 
three years unless the rod is removed sooner by a physician, works by 
inhibiting ovulation.  Merck knew, or should have known, that the applicator 
had a history of failed insertion attempts occurring when, unbeknownst to the 
treating physician, the rod would remain stuck in the applicator following the 
procedure. 
 
4 
 
[¶5]  On February 28, 2012, the physician who recommended the drug to 
Doherty carried out the implantation procedure, but failed to check her arm to 
see if it was successful.  A pregnancy test at the health care center on 
October 16, 2013, confirmed that Doherty was pregnant.  An examination and 
subsequent ultrasound examination failed to locate the rod in either of 
Doherty’s arms.  A nurse later told Doherty that the physician “believes it was 
never inserted.” 
[¶6]  On June 9, 2014, Doherty gave birth to a healthy boy following a long 
and painful delivery.  In connection with her pregnancy, Doherty suffered 
nausea, mental and physical pain and suffering, insomnia, swelling, and weight 
gain.  She also incurred expenses, and she lost wages as a result of missing work 
for medical appointments.  Following the birth of her son, Doherty received 
mental health counseling and suffered emotional distress as a result of being 
unprepared to raise a child as a single mother. 
 
[¶7]  Doherty filed suit against Merck on theories of strict product 
liability, breach of warranty, negligence, and negligent misrepresentation; and 
against the United States for the negligence of the physician, and for the 
physician’s failure to obtain her informed consent.  The complaint also asked 
the federal court to declare that 24 M.R.S. § 2931 is unconstitutional, both 
 
5 
facially and as applied.  Merck and the United States moved to dismiss the 
complaint on the grounds that (1) pursuant to 24 M.R.S. § 2931(1), the birth of 
a healthy child is not a “legally recognizable injury” for which Doherty may 
recover damages; and (2) pursuant to 24 M.R.S. § 2931(2), Doherty did not 
undergo a “failed sterilization procedure” that would invoke the statute’s 
exception and allow her to recover limited damages.  The court denied the 
motions pending our answers to the three certified questions. 
II.  DISCUSSION 
A. 
Acceptance of the Certified Questions 
 
[¶8]  A threshold issue is whether we will agree to consider the certified 
questions.  See Bankr. Estate of Everest v. Bank of Am., N.A., 2015 ME 19, ¶ 13, 
111 A.3d 655 (“Title 4 M.R.S. § 57 authorizes, but does not require, us to 
consider a certified question of state law posed by a federal court in certain 
circumstances.” (quotation marks omitted)).  In resolving that issue,  
[w]e may consider the merits of a certified question from the 
United States District Court and, in our discretion, provide an 
answer if (1) there is no dispute as to the material facts at issue; 
(2) there is no clear controlling precedent; and (3) our answer, in 
at least one alternative, would be determinative of the case. 
 
 
We have stated that wherever reasonably possible, the state 
court of last resort should be given [the] opportunity to decide 
state law issues on which there are no state precedents which are 
controlling or clearly indicative of the developmental course of the 
 
6 
state law because this approach (1) tends to avoid the uncertainty 
and inconsistency in the exposition of state law caused when 
federal courts render decisions of state law which have an interim 
effectiveness until the issues are finally settled by the state court of 
last resort; and (2) minimizes the potential for state-federal 
tensions arising from actual, or fancied, federal court efforts to 
influence the development of state law. 
 
Id. ¶¶ 13-14 (alterations, citation, and quotation marks omitted). 
 
[¶9]  Here there is no dispute as to the facts to be accepted as true at this 
stage of the case; no clear controlling precedent that would answer the 
questions; and one alternative that would be determinative of the case, in that 
the federal court stated in its certification that “a decision by the Law Court that 
no recovery is available to the plaintiff under Maine law even if all her factual 
allegations are true . . . would be determinative of the cause and would end the 
lawsuit now.”  Therefore, we agree to consider the certified questions. 
B. 
Scope of 24 M.R.S. § 2931 
 
[¶10]  Maine’s “wrongful birth” statute provides, in part: 
§ 2931.  Wrongful birth; wrongful life 
 
1.  Intent.  It is the intent of the Legislature that the birth of a 
normal, healthy child does not constitute a legally recognizable 
injury and that it is contrary to public policy to award damages for 
the birth or rearing of a healthy child. 
 
2.  Birth of healthy child; claim for damages prohibited.  No 
person may maintain a claim for relief or receive an award for 
damages based on the claim that the birth and rearing of a healthy 
 
7 
child resulted in damages to him.  A person may maintain a claim 
for relief based on a failed sterilization procedure resulting in the 
birth of a healthy child and receive an award of damages for the 
hospital and medical expenses incurred for the sterilization 
procedures and pregnancy, the pain and suffering connected with 
the pregnancy and the loss of earnings by the mother during 
pregnancy. 
 
. . . . 
 
24 M.R.S. § 2931(1)-(2). 
[¶11]  The first certified question asks whether section 2931 applies to 
Merck.  We have often said that “[i]n interpreting a statute, we seek to effectuate 
the intent of the Legislature, which is ordinarily gleaned from the plain 
language of the statute.  We will not look beyond the plain language of the 
statute if it is unambiguous.”  State v. Knight, 2016 ME 123, ¶ 9, 145 A.3d 1046. 
(citation and quotation marks omitted). 
[¶12]  Section 2931 is not at all ambiguous in that it bars a specific legal 
claim regardless of the party that the claim is brought against: “No person may 
maintain a claim for relief or receive an award for damages based on the claim 
that the birth and rearing of a healthy child resulted in damages to him.”  
24 M.R.S. § 2931(2).  Consistent with the Legislature’s stated public policy—
“the birth of a normal, healthy child does not constitute a legally recognizable 
injury,” 24 M.R.S. § 2931(1)—the statute addresses only the basis for the claim, 
 
8 
not the identity of the defendant.  In the case of a legislative public policy 
decision, 
[w]hen it is clear that the Legislature enacted specific legislation to 
remedy an existing problem, social or otherwise, such statutory 
enactment must be construed so as to promote the policy 
consideration which brought about the Legislature’s action. . . . 
We must look to the end which our Legislators sought in the 
enactment of the law and approve a construction which will not 
nullify its purpose. 
 
Waddell v. Briggs, 381 A.2d 1132, 1135 (Me. 1978). 
[¶13]  Here, Doherty claims that she is entitled to damages resulting from 
injuries that she suffered when the failure of Merck’s product resulted in a 
non-remarkable pregnancy leading to the birth of her healthy child.  That is 
precisely the claim barred by the very clear language of the statute.  Doherty’s 
argument that the statute applies to the physician who treated her but not to 
Merck disregards the statute’s declaration that the birth of a healthy child is not 
a legally recognizable injury ab initio; therefore, it is not actionable against any 
defendant.  As a result, unless the “failed sterilization procedure” exception 
contained in section 2931(2) and discussed infra applies, Doherty may not 
recover damages against either Merck or the United States for the birth and 
expense of raising her healthy child.1 
                                         
1  In her brief Doherty argues that not all claims, and by implication not all damages, are barred by 
the statute.  She does not specify the damages that would conceivably remain once all damages for 
 
9 
[¶14]  For these reasons, we answer the first certified question in the 
affirmative. 
C. 
Scope of Macomber v. Dillman 
 
[¶15]  The second certified question asks whether our holding in 
Macomber v. Dillman, 505 A.2d 810 (Me. 1986), a case involving a failed tubal 
ligation procedure resulting in the birth of a healthy child, id. at 812, is 
applicable to Merck.  Because the federal court conditioned the second question 
upon a negative answer to the first question, and we have answered that 
question in the affirmative, we do not answer the second question.2 
                                         
“the birth and rearing of a healthy child,” 24 M.R.S. § 2931(2) (2016), are excluded.  In any event, that 
the Legislature in section 2931(2) created a very specific category of damages—“the hospital and 
medical expenses incurred for the sterilization procedures and pregnancy, the pain and suffering 
connected with the pregnancy and the loss of earnings by the mother during pregnancy”—that are 
available in a very specific and limited circumstance, namely when “a failed sterilization procedure 
result[s] in the birth of a healthy child,” means, employing well-recognized principles of statutory 
construction, that those are the only damages that may be awarded as a result of claims arising from 
the birth of a healthy child.  See Musk v. Nelson, 647 A.2d 1198, 1201 (Me. 1994) (“[A] well-settled 
rule of statutory interpretation states that express mention of one concept implies the exclusion of 
others not listed.”); Lee v. Massie, 447 A.2d 65, 68 (Me. 1982) (“[T]he maxim[] expressio unius est 
exclusio alterius . . . is regarded as well recognized in Maine.” (quotation marks omitted)).  We said as 
much in Thibeault v. Larson: “As expressed in [24 M.R.S. § 2931] subsections (1) and (2), the birth of 
a healthy child is not a legally cognizable injury and an action may only be maintained for limited 
damages if the healthy child is born as a result of a failed sterilization.”  666 A.2d 112, 115 (Me. 1995) 
(emphases added). 
 
2  We note, in any event, that because the Legislature has occupied the field on this issue in enacting 
section 2931, Macomber no longer has any independent jurisprudential vitality. 
 
10 
D. 
The “Failed Sterilization Procedure” Exception 
 
[¶16]  The third certified question asks if the single exception to the 
statute’s blanket prohibition against claims based on the birth of a healthy child 
is applicable on these facts.  The relevant section provides: 
No person may maintain a claim for relief or receive an award for 
damages based on the claim that the birth and rearing of a healthy 
child resulted in damages to him.  A person may maintain a claim 
for relief based on a failed sterilization procedure resulting in the 
birth of a healthy child and receive an award of damages for the 
hospital and medical expenses incurred for the sterilization 
procedures and pregnancy, the pain and suffering connected with 
the pregnancy and the loss of earnings by the mother during 
pregnancy. 
 
24 M.R.S. § 2931(2). 
 
[¶17]  The term “sterilization procedure” is not defined in the Maine 
Health Security Act, 24 M.R.S. §§ 2501-2988 (2016), where section 2931 is 
located.  Doherty argues that the exception should apply here because Merck’s 
implantable, long-term drug is “synonymous with sterilization,” and therefore 
“the only reasonable interpretation of [section 2931] is that the term 
‘sterilization procedure’ . . . applies to any long-lasting effort to render a woman 
infertile.”  We disagree, and conclude that the Legislature intended 
“sterilization procedure” to include medical or surgical procedures that alter 
the body’s anatomy for the purpose of permanently ending the possibility of 
 
11 
procreation.  The term does not include temporary pharmaceutical 
intervention in the reproductive process, such as the implant Doherty sought, 
nor does it include physical intervention, such as an intrauterine device, that is 
designed to be reversible without permanently altering the body’s 
reproductive organs.  These are methods of contraception, and in section 2931 
the Legislature explicitly made an exception to its prohibition against 
recovering damages for the birth of a healthy child only for “sterilization.”  
24 M.R.S. § 2931(2). 
 
[¶18] 
 
Our 
construction 
is 
supported 
by 
the 
Legislature’s 
near-contemporaneous definition of the term “sterilization procedure[]” in 
title 34-B.  In the Due Process in Sterilization Act of 1982, 34-B M.R.S. 
§§ 7001-7017 (2016), the effective date of which predated the enactment of 
section 2931 by two years, the Legislature stated that it “finds and declares that 
sterilization procedures are generally irreversible and represent potentially 
permanent and highly significant consequences for the patient involved.”  
34-B M.R.S. § 7002 (emphases added) (enacted by P.L. 1983, ch. 459, § 7 
(effective Jan. 15, 1984)).  The Act goes on to define “[s]terilization” as 
“a medical or surgical procedure, the purpose of which is to render an individual 
 
12 
permanently incapable of procreation.”  34-B M.R.S. § 7003(9) (emphases 
added). 
[¶19]  This definition was known to the Legislature when it enacted 
section 2931 just two years later.  See Musk v. Nelson, 647 A.2d 1198, 1202 
(Me. 1994) (“The Legislature is presumed to be aware of the state of the law 
and decisions of this Court when it passes an act.”).  During that short time 
interval, the Legislature was aware that traditional methods of sterilization 
such as tubal ligation or vasectomy that are intended to be permanent may 
sometimes be reversed,3 yet it did not include a more expansive definition of 
“sterilization procedure” in section 2931.  Presumably, if the Legislature, 
mindful of its recent enactment in title 34-B, meant to include procedures—
such as the implant at issue here—that are intended to be reversible in the 
section 2931(2) exception, it would have said so, and not used the same term it 
had recently defined to mean procedures that are “generally irreversible,” and 
“the purpose of which is to render an individual permanently incapable of 
procreation.”  34-B M.R.S. §§ 7002, 7003(9).  In contrast to what the Legislature 
                                         
3  Indeed, when a court orders that a sterilization be performed, by statute it “shall be the most 
reversible procedure available at the time” unless the treating physician adjudges otherwise.  
34-B M.R.S. § 7013(6) (2016).  Nevertheless, the Legislature determined in defining “[s]terilization” 
as it did that the purpose of the procedure, even if it is potentially reversible, “is to render an 
individual permanently incapable of procreation.”  34-B M.R.S. § 7003(6) (2016). 
 
13 
explicitly defined to be a “sterilization procedure[],” the procedure that 
Doherty underwent was not “generally irreversible,” nor “potentially 
permanent,” nor intended to “render [her] permanently incapable of 
procreation.”  34-B M.R.S. §§ 7002, 7003(9). 
[¶20]  Other courts and authorities are in accord with our conclusion that 
sterilization is commonly understood to mean a procedure that is intended to 
be permanent.  See Semian v. Ledgemere Transp., Inc., 2014 ME 141, ¶¶ 8-9, 
106 A.3d 405 (stating that when a statute is “reasonably susceptible to different 
interpretations” the Law Court may “look to extrinsic information to determine 
the Legislature's intent” (quotation marks omitted)). 
[¶21]  In a 1942 case where the United States Supreme Court reviewed 
an Oklahoma compulsory sterilization statute, Justice Douglas emphasized the 
gravity of sterilization as a permanent procedure, writing, “We are dealing here 
with legislation which involves one of the basic civil rights of man. . . . There is 
no redemption for the individual whom the law touches.  Any experiment which 
the State conducts is to his irreparable injury.  He is forever deprived of a basic 
liberty.”  Skinner v. Oklahoma, 316 U.S. 535, 541 (1942). 
 
14 
[¶22]  Courts to the present day have continued to recognize the 
distinction between permanent sterilization and reversible contraception.4  
In 2010, the United States Court of Appeals for the Third Circuit, examining the 
question of whether the compelled insertion of an intrauterine device (IUD) 
constitutes sterilization for the purpose of asylum eligibility, concluded that 
“the term ‘involuntary sterilization’ by definition contemplates a permanent 
inhibition of reproductive capacity,” and noted that 
[i]ndeed, taken to its extreme, [the applicant’s] attempt to read the 
permanency out of "sterilization" would lead to such bizarre 
propositions as considering the use of any contraceptive . . . to be 
                                         
4  See, e.g., Huang v. Holder, 591 F.3d 124, 129-30 (2d Cir. 2010) (“The BIA’s [Board of Immigration 
Appeals] reasoning that sterilization makes one permanently incapable of having children, whereas 
an IUD is a temporary measure, is reasonable.”); Chen v. Holder, 313 F. App’x 625, 630 (4th Cir. 2009) 
(concluding, upon reviewing the BIA’s determination that “the sterilization procedure . . . leaves one 
incapable of having children . . . [and] IUD use should not be treated as the equivalent of sterilization,” 
that “we certainly cannot say that [the BIA’s] interpretation is unreasonable” (alteration and 
quotation marks omitted)); Gerber v. Hickman, 291 F.3d 617, 622 (9th Cir. 2002) (“Sterilization is 
intrusive, permanent, and irreparable.”); Peck v. Califano, 454 F. Supp. 484, 487-88 (D. Utah 1977) 
(“unlike other contraceptive or family planning measures, sterilization results in a permanent waiver 
of the fundamental right to procreate” (quotation marks omitted)); C.D.M. v. State, 627 P.2d 607, 612 
(Alaska 1981) (“Sterilization necessarily results in the permanent termination of the intensely 
personal right to procreate.”); Kennedy v. Kennedy, 845 N.W.2d 707, 714-15 (Iowa 2014) (citing 
C.D.M., 627 P.2d at 612, as well as a source describing sterilization as “the permanent physical 
deprivation of a fundamental constitutional right” (quotation marks omitted)); In re Moe, 432 N.E.2d 
712, 716 n.3 (Mass. 1982)  (“Sterilization is a surgical procedure that, in nearly all cases, renders a 
person permanently incapable of reproduction.”); In re Truesdell, 304 S.E.2d 793, 812 (N.C. Ct. App. 
1983) (“State action to compel a sterilization constitutes an irreversible certainty.  It would 
permanently and irrevocably deprive [the ward] of her procreative capacity.”); In re Terwilliger, 
450 A.2d 1376, 1382 (Pa. Super. Ct. 1982) (“sterilization necessarily results in the permanent 
termination of the intensely personal right of procreation” (italics omitted)); In re Guardianship of 
Eberhardy, 307 N.W.2d 881, 897 (Wis. 1981) (“[S]tate action to authorize sterilization constitutes an 
irreversible certainty.  It would permanently and irrevocably deprive [the ward] of her procreative 
capability.”); see also Conservatorship of Valerie N., 707 P.2d 760, 787 n.9, 788 (Cal. 1985) (Bird, C.J., 
dissenting) (“Other methods of contraception do not irreversibly prevent procreation, nor do they 
require the surgical destruction of any biological capacity for a nonmedical purpose. . . . [T]he 
majority fail[s] to weigh the impact of the irreversible deprivation of the right to procreate . . . .”). 
 
15 
“sterilization,” since all contraceptives inhibit reproduction.  At the 
risk of stating the obvious, the use of a contraceptive ordinarily 
would not amount to sterilization, since sterilization is permanent 
and irreparable and the use of a contraceptive—even an IUD, which 
is designed to remain in place until removed by a physician—is not. 
 
 Cheng v. Att’y Gen., 623 F.3d 175, 182-83, 187 & n.6 (3d Cir. 2010) (alterations, 
ellipsis and quotation marks omitted). 
[¶23] 
 
Beyond 
the 
widely-held 
view 
of 
numerous 
courts, 
Black’s Law Dictionary defines “sterilization” as “[t]he act of making (a person 
or other living thing) permanently unable to reproduce.”  Black’s Law 
Dictionary 1640 (10th ed. 2014) (emphasis added); see also Stedman’s Medical 
Dictionary 1475 (25th ed. 1990) (defining “sterilization” as “[t]he act or process 
by which an individual is rendered incapable of . . . reproduction, as by 
vasectomy, salpingectomy, or castration”); Richard Sloane, The Sloane-Dorland 
Annotated Medical-Legal Dictionary 670 (1987) (defining “sterilize” as “to 
render incapable of reproduction”); Webster’s Third New International 
Dictionary Unabridged 2238 (1986) (defining “sterilization” as “a procedure by 
which a human . . . is made incapable of reproduction”).  Contrary to Doherty’s 
assertion that the Black’s definition is unreliable because it dates to 1905, that 
the definition is of such long standing suggests that the Legislature would have 
been clear had it intended to expand the commonly-understood meaning—the 
 
16 
same meaning that it used in 34-B M.R.S. § 7003(9) in 1984—to encompass 
Doherty’s situation. 
 
[¶24]  For these reasons, we conclude that the “failed sterilization 
procedure” exception is not applicable on the facts presented to us.  
Accordingly, our answer to the third certified question is that pursuant to 
section 2931, Doherty may not recover any damages on her claims against 
Merck or the United States.5 
The entry is: 
We answer the certified questions as follows: 
“We answer the first certified question in the 
affirmative.  Accordingly, we decline to answer 
the second certified question.  In answer to the 
third certified question, pursuant to 24 M.R.S. 
§ 2931 the plaintiff may not recover any 
damages 
on 
her 
claims 
against 
either 
defendant.” 
 
 
 
 
 
 
 
 
 
                                         
5  Doherty asserts that this result violates several provisions of the United States and Maine 
Constitutions. The United States District Court did not certify a question of the statute’s 
constitutionality to us, and we decline to address that issue before the federal court has done so in 
this federal case.  See M.R. App. P. 25(b) (“The certificate . . . shall contain . . . the question or questions 
of law to be answered.”). 
 
17 
SAUFLEY, C.J., with whom ALEXANDER and GORMAN, JJ., join, concurring. 
 
[¶25]  Although we concur with the Court’s answers, we write separately 
to make clear the very limited scope of the questions presented and our 
responses to those questions.  
[¶26]  The federal court has not asked us to determine whether the 
wrongful life statute goes beyond declaring that the birth and the life of a 
healthy child do not constitute damages, that is, legally recognizable injury.  
24 M.R.S. § 2931(1) (2016).  Nor has it asked us to determine whether, if the 
statute does go beyond the gender-neutral declaration that a child is not an 
“injury,” doing so constitutes an unconstitutional violation of a woman’s right 
to equal protection under the law.  Id. 
[¶27]  Moreover, in light of the questions presented, we are not required 
to consider whether a person may bring claims of ordinary medical malpractice 
for any negligent medical care provided to a person who sought medical care 
to avoid pregnancy as a result of a medical condition.  For example, a person 
who suffers from certain illnesses may be seriously or fatally harmed by a 
pregnancy.  In answering the questions presented, we are not required to 
consider whether a claim of medical malpractice for contraception failure may 
proceed in those circumstances.  Put another way, those injuries would be 
 
18 
factually distinct from the nature of the claim before the federal court related 
to the birth of an unanticipated but healthy child.  In the end, we are not asked 
to determine whether that type of harm to a person, unrelated to the child, falls 
outside of the statute’s limitation on negligence actions. 
[¶28]  Finally, although we cannot disagree with the Court’s careful 
parsing of the concepts of “sterilization,” particularly as used in other statutory 
contexts, it is clear from the lengths the Court goes to in attempting to 
distinguish various methods of permanent or semi-permanent contraception 
that medicine has outstripped the statutory definitions and that further 
attention to the language of 24 M.R.S. § 2931 (2016) is needed. 
[¶29]  In sum, we write to clarify that we do not opine on the 
constitutionality of the statute, and we do not opine on whether a person may 
maintain a claim for other types of injuries—unrelated to the existence of a 
healthy child—arising from allegations of medical malpractice in the context of 
a pregnancy. 
 
 
 
 
 
 
 
Laura H. White, Esq. (orally), Bergen & Parkinson, LLC, Kennebunk, for 
appellant Kayla Doherty 
 
Paul McDonald, Esq., (orally), and Daniel J. Mitchell, Bernstein Shur, Portland, 
and Thomas J. Yoo, Esq., Reed Smith LLP, Los Angeles, California, for appellee 
Merck & Co., Inc. 
 
19 
Thomas E. Delahanty II, United States Attorney, and Andrew K. Lizotte, Asst. 
U.S. Atty. (orally), Office of the United States Attorney, Portland, for appellee 
United States of America 
 
Janet T. Mills, Attorney General, and Susan P. Herman, Asst. Atty. Gen. (orally), 
Office of the Attorney General, Augusta, for appellee State of Maine 
 
 
United States District Court for the District of Maine docket number 1:15-cv-129-DBH 
FOR CLERK REFERENCE ONLY