Case Title: Chambers v. Moses H. Cone Memorial Hospital

Citation: 

Docket Number: 147PA18

State: north-carolina

Court: North Carolina Supreme Court

Date: 2020-06-05T00:00:00Z

Document:
IN THE SUPREME COURT OF NORTH CAROLINA 
No. 147PA18 
Filed 5 June 2020 
CHRISTOPHER CHAMBERS, on behalf of himself and all others similarly 
situated 
 
 
v. 
THE MOSES H. CONE MEMORIAL HOSPITAL; THE MOSES H. CONE 
MEMORIAL HOSPITAL OPERATING CORPORATION d/b/a MOSES CONE 
HEALTH SYSTEM and d/b/a CONE HEALTH; and DOES 1 through 25, inclusive 
 
On discretionary review pursuant to N.C.G.S. § 7A-31 of a unanimous decision 
of the Court of Appeals, 259 N.C. App. 8, 814 S.E.2d 864 (2018), affirming an order 
entered on 16 March 2017 by Judge James L. Gale, Chief Business Court Judge, in 
Superior Court, Guilford County.  Heard in the Supreme Court on 18 November 2019 
in session in the Old Guilford County Courthouse in the City of Greensboro, pursuant 
to section 18B.8 of Chapter 57 of the 2017 North Carolina Session Laws. 
 
Higgins Benjamin, PLLC, by John F. Bloss, for plaintiff-appellant. 
 
Womble Bond Dickinson, LLP, by Philip J. Mohr and Brent F. Powell, for 
defendant-appellees The Moses H. Cone Memorial Hospital and The Moses H. 
Cone Memorial Hospital Operating Corporation. 
 
Patterson Harkavy LLP, by Burton Craige; and Carol L. Brooke, Jack 
Holtzman, and Clermont F. Ripley for North Carolina Justice Center, Center 
for Responsible Lending, and North Carolina Advocates for Justice, amicus 
curiae. 
 
Joshua H. Stein, Attorney General, by Ryan Y. Park, Deputy Solicitor General, 
Daniel T. Wilkes, Assistant Attorney General, and Matthew C. Burke, Solicitor 
General Fellow, for the State of North Carolina, amicus curiae. 
 
Linwood Jones for North Carolina Healthcare Association, amicus curiae. 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
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EARLS, Justice. 
 
 
Christopher Chambers and his wife were sued in May 2012 by The Moses H. 
Cone Memorial Hospital Operating Corporation seeking collection of $14,358.14 plus 
interest, allegedly owed for emergency room services. Around the same time, 
Christopher Chambers filed a class action complaint against The Moses H. Cone 
Memorial Hospital and The Moses H. Cone Memorial Hospital Operating Corporation 
(Moses Cone) seeking a declaratory judgment that the contract he signed as an 
uninsured patient needing emergency medical treatment entitled Moses Cone to 
recover no more than the reasonable value of the services it provided. We must now 
decide whether Moses Cone’s subsequent, unilateral action dismissing its claims 
against Chambers and his wife and ceasing all other attempts to collect the debt, 
prior to certification of the class in Chambers’s declaratory judgment action, renders 
the entire class action moot.  Following the logic of the Third Circuit Court of Appeals 
decision in Richardson v. Bledsoe, 829 F.3d 273 (3d Cir. 2016), we hold that the 
relation back doctrine “may be applied to relate a now-moot individual claim back to 
the date of the class action complaint” when the event that moots the plaintiff’s claim 
occurs before the plaintiff has had a fair opportunity to seek class certification and 
provided that the plaintiff has not unduly delayed in litigating the motion for class 
certification.  Id. at 285.  Therefore, “when ‘satisfaction of the plaintiff’s individual 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
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claim [occurs] before the court can reasonably be expected to rule on the class 
certification motion,’ the plaintiff’s stake in the litigation is not extinguished,” and 
the case is not moot. Id. (quoting Lucero v. Bureau of Collection Recovery, Inc., 639 
F.3d 1239, 1250 (10th Cir. 2011)).   
I. 
Factual Background 
On or about 23 August 2011, Chambers was treated at Moses Cone’s 
emergency room where he underwent an emergency appendectomy.  He was 
uninsured at the time. In his complaint, Chambers alleged that the $14,358.14 he 
was charged by Moses Cone (separate from independent physicians’ and other non-
hospital charges) was “far more than the payment amount required from the vast 
majority” of Moses Cone’s patients receiving similar services, and he alleged that the 
bill was grossly excessive, out of proportion to Moses Cone’s actual cost, and much 
greater than the reasonable value of such services. 
Chambers sought to bring this action on behalf of a class, defined as follows: 
All individuals (or their guardians or representatives) who 
within four years of the date of the filing of the Complaint 
in this action and through the date that the Court certifies 
the action as a class action (a) received emergency care 
medical treatment at Moses H. Cone Memorial Hospital or 
another Cone Health Hospital; (b) whose bills were not 
paid in whole or part by commercial insurance or a 
governmental healthcare program; and (c) who were not 
granted a full discount or waiver under Defendants’ charity 
care policies or otherwise had their bills permanently 
waived or written off in full by Defendants. 
 
According to Moses Cone’s standard contract in force at the time Chambers had his 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
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appendectomy, the patient was obligated to pay the Moses Cone’s bill “in accordance 
with the regular rates and terms of Cone Health.”  Chambers contended he expected 
to pay the same as other emergency care patients who sign the same contract but 
that, as an uninsured patient, he was charged 100% of Moses Cone’s Chargemaster 
rates, which he alleges are artificial, grossly inflated rates.   
Chambers initially filed suit on 11 May 2012.  Moses Cone filed an answer and 
counterclaim on 3 August 2012 denying all class allegations, asserting seventeen 
affirmative defenses, bringing counterclaims against Chambers and his wife seeking 
compensatory damages and attorneys’ fees, and asking the trial court to consolidate 
the action with Moses Cone’s original lawsuit seeking payment of the $14,358.14 bill.  
Shortly after Moses Cone filed its answer and counterclaim, Robin D. Hayes sought 
to intervene as a plaintiff, individually and as a class representative.  More than a 
year later, on 27 September 2013, the trial court ordered that “further consideration 
of the [m]otion [to intervene] should be delayed until after the Court rules on 
Plaintiff’s motion for class certification.”  On 2 July 2014, the case was assigned to a 
new judge and thereafter a status conference was held “at which the parties agreed 
to . . . stay further proceedings in this case until the Court issued an opinion on related 
matters in Hefner v. Mission Hosp., Inc., No. 12 CVS 3088.”  The plaintiff’s claims in 
Hefner eventually were ruled moot when the defendant hospital in that case 
“unequivocally bound itself to seek no payment” of its bill from the plaintiff.  This 
case then was reactivated, and Chambers filed an Amended Class Action Complaint.  
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
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Moses Cone then dismissed its claims for the remainder of its bill and on the following 
day, filed a motion to dismiss the case.  The trial court granted the motion to dismiss 
on 16 March 2017 and, citing Hefner, noted that “[s]imilar to the hospital defendant 
in Hefner, Moses Cone has voluntarily dismissed with prejudice its collection action 
against Chambers, meaning that Moses Cone has no right to recover any additional 
payments from Chambers.”  In addition, the trial court went on to deny Hayes’ motion 
to intervene, leaving no plaintiff to maintain the class action claims. 
Chambers filed a notice of appeal, and the Court of Appeals affirmed the trial 
court’s order dismissing the case.  Chambers v. Moses H. Cone Mem’l Hosp., 259 N.C. 
App. 8, 13, 814 S.E.2d 864, 869 (2018).  The Court of Appeals concluded that because 
Chambers’ bill was permanently waived, he was no longer a member of the proposed 
class and, therefore, it was appropriate to apply the general rule that an appeal 
presenting a question that has become moot will be dismissed.  Id. at 12, 814 S.E.2d 
at 868.  Because the class had not yet been certified and the sole class representative 
no longer had “a genuine personal interest in the outcome of the case,” the Court of 
Appeals concluded that it “need not determine if the class action is now moot based 
on the conduct of Moses Cone or the public interest.”  Id. at 13, 814 S.E.2d at 868. 
This Court granted discretionary review pursuant to N.C.G.S. § 7A-31 (2019). 
Chambers’ original class action complaint alleged that uninsured patients 
receiving emergency medical care at Moses H. Cone Memorial Hospital or another 
Cone Health hospital who were charged 100% of the hospital’s Chargemaster rates 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
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numbered “at least hundreds, if not thousands, of persons.”  Chambers further 
alleged (1) that there were questions of law and fact common to the class, which 
predominate over any questions affecting only individual class members; (2) that he 
will fairly and adequately represent the interests of the class; and (3) that a class 
action is the superior method for the fair and efficient adjudication of the claims. The 
complaint asserted the following: 
Most losses are modest in relation to the expense and 
burden of individual prosecution of the litigation 
necessitated by the Defendants’ wrongful conduct.  It 
would be virtually impossible for the Class members to 
efficiently redress their wrongs individually.  Even if all 
Class members could afford such individual litigation 
themselves, the court system would benefit from a class 
action.  Individualized litigation would present the 
potential for inconsistent or contradictory judgments.  
Individualized litigation would also magnify the delay and 
expense to all parties and the court system presented by 
the issues of the case. 
 
However, before these allegations could be tested at the class certification stage, 
Moses Cone sought to end the litigation by dismissing its claims against Chambers 
and suspending its attempts to collect the debt it alleged was owed by Chambers and 
his wife for the emergency appendectomy. 
II. 
Class Action Context 
Class action lawsuits have long been a feature of our justice system.  The class 
action lawsuit originated in the middle ages.  See Shaw v. Toshiba Am. Info. Sys., 
91 F. Supp. 2d 942, 948 (E.D. Tex. 2000) (tracing the history of class actions).  “In 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
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order to facilitate the adjudication of disputes involving common questions and 
multiple parties in a single action, the English Court of Chancery developed the bill 
of peace.” 7A Charles Alan Wright, Arthur R. Miller & Mary K. Kane, Federal Practice 
and Procedure: Civil § 1751 (3d ed. 1986).  The English bill of peace became the basis 
for class actions in the United States, including North Carolina’s early class action 
decisions in the late 1800’s.  See Bronson v. Wilmington N.C. Life Ins. Co., 85 N.C. 
411, 414 (1881) (describing the class action mechanism as a feature of civil procedure, 
citing Joseph Story’s treatise on English equity jurisprudence).   
Thus, it is well-established that class actions can be an efficient and fair way 
to resolve in one case disputes that may affect a large number of people.  Maffei v. 
Alert Cable TV of N.C., Inc., 316 N.C. 615, 620, 342 S.E.2d 867, 871 (1986); see also 
Crow v. Citicorp Acceptance Co., 319 N.C. 274, 284, 354 S.E.2d 459, 466 (1987) 
(stating that class actions serve many purposes, including “preventing a multiplicity 
of suits or inconsistent results”); Fisher v. Flue-Cured Tobacco Coop. Stabilization 
Corp., 369 N.C. 202, 216, 794 S.E.2d 699, 710 (2016) (same).  By consolidating 
numerous individual claims with common factual and legal issues into a single 
proceeding, “the class-action device saves the resources of both the courts and the 
parties.”  Gen. Tel. Co. v. Falcon, 457 U.S. 147, 155 (1982).  Moreover, courts have 
also recognized the deterrent effect of class action lawsuits, which hold defendants 
accountable for conduct that may be unlawful and widespread but difficult to address 
when the conduct does not harm any single individual enough to make it economically 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
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expedient to bring a lawsuit.  See Deposit Guar. Nat’l Bank v. Roper, 445 U.S. 326, 
338 (1980); see also Amchem Prods., Inc. v. Windsor, 521 U.S. 591, 617 (1997) 
(explaining that the class action mechanism was designed to overcome the problem 
that small recoveries do not provide incentive for any single individual to bring an 
action to vindicate his or her rights); James Grimmelmann, Future Conduct and the 
Limits of Class-Action Settlements, 91 N.C. L. Rev. 387, 421–22 (2013) (explaining 
the deterrent effect of class action lawsuits on other potential defendants in similar 
situations).   
One potential obstacle to the efficient and equitable administration of the class 
action procedure occurs when defendants settle the claims of individual plaintiffs 
prior to class certification and contend that therefore the entire case has become 
moot. The U.S. Supreme Court described the problem as follows: 
Requiring multiple plaintiffs to bring separate actions, 
which effectively could be “picked off” by a defendant’s 
tender of judgment before an affirmative ruling on class 
certification could be obtained, obviously would frustrate 
the objectives of class actions; moreover it would invite 
waste of judicial resources by stimulating successive suits 
brought by others claiming aggrievement. 
 
Roper, 445 U.S. at 339.  Under federal law, where a named plaintiff’s individual claim 
is mooted after the plaintiff-class has already been certified, it does not moot the 
entire case.  See Sosna v. Iowa, 419 U.S. 393, 401–02 (1975).  Similarly, even where 
class certification has been denied, a named plaintiff whose individual claim is moot 
retains the right to appeal the denial of class certification.  See Roper, 445 U.S. at 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
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339–40; U.S. Parole Comm’n v. Geraghty, 445 U.S. 388, 404 (1980).  The question 
raised in this case is whether the unilateral action by Moses Cone to moot the named 
plaintiff’s individual claim renders the entire case moot when there has been no 
discovery or ruling on plaintiff’s motion for class certification.  The U.S. Supreme 
Court has not directly resolved this question. 
 
In Campbell-Ewald Co. v. Gomez, 136 S. Ct. 663 (2016), the defendant made 
an offer of judgment to satisfy the named plaintiff’s individual claim prior to class 
certification, which was not accepted by the plaintiff, and then the defendant moved 
to dismiss the case on mootness grounds.  The U.S. Supreme Court held that the 
plaintiff’s class action complaint “was not effaced by [the defendant’s] unaccepted 
offer to satisfy his individual claim.”  Id. at 670.  Thus, “an unaccepted settlement 
offer or offer of judgment does not moot a plaintiff’s case.”  Id. at 672.  However, “[t]he 
Supreme Court, therefore, did not need to reach the arguably more difficult question: 
whether a named plaintiff who did in fact lack a personal stake in the outcome of the 
litigation could continue to seek class certification even though his claim became moot 
before filing a motion for class certification.”  Richardson, 829 F.3d at 282.  Here, we 
must decide an issue expressly left open in Campbell-Ewald.  See Campbell-Ewald 
Co., 136 S. Ct. at 672 (“We need not, and do not, now decide whether the result would 
be different if a defendant deposits the full amount of the plaintiff’s individual claim 
in an account payable to the plaintiff, and the court then enters judgment for the 
plaintiff in that amount.”). 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
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Ten federal circuit courts of appeals have reached this arguably more difficult 
question.  Eight of those ten circuits have ruled that when a defendant acts to moot 
the claims of individual named plaintiffs before the court has ruled on a class 
certification motion, the entire action is not yet moot, and the named plaintiff retains 
the representative capacity to pursue class certification and a ruling on the merits.1  
This exception to mootness has been adopted by federal courts because “[i]n recent 
years, this stratagem [of picking off the named plaintiff] has become a popular way 
                                            
1 The Second, Third, Fifth, Sixth, Seventh, Ninth, Tenth, and Eleventh circuits have 
some form of a pick off exception to mootness in the class action context.  See Unan v. Lyon, 
853 F.3d 279, 285–86 (6th Cir. 2017) (claims were not moot where government was “picking 
off” named plaintiffs, retroactively determining them to be eligible for comprehensive 
Medicaid coverage shortly after lawsuit was filed); Richardson v. Bledsoe, 829 F.3d at 284–
86 (reviewing federal circuit court precedent and based in part “upon consideration of the 
well-reasoned approaches of our sister circuits, [ ] reaffirm[ing] the validity of the picking off 
exception”); Wilson v. Gordon, 822 F.3d 934, 947–51 (6th Cir. 2016), reh’g en banc denied 
Wilson v. Gordon, No. 14-6191, 2016 U.S. App. LEXIS 15697 (6th Cir. Aug. 1, 2016) (evidence 
was sufficient for trial court “to conclude that ‘picking off’ exception applies in this case”); 
Chapman v. First Index, Inc., 796 F.3d 783, 787 (7th Cir. 2015) (rejecting a claim of mootness 
because following recent Supreme Court cases, “no one thinks (or should think) that a 
defendant’s offer to have the court enter a consent decree renders the litigation moot and 
thus prevents the injunction’s entry”); Fontenot v. McCraw, 777 F.3d 741, 751 (5th Cir. 2015) 
(pick off exception to mootness applies where class certification motion has been filed even if 
it has not yet been ruled on); Stein v. Buccaneers Ltd. P’ship, 772 F.3d 698, 705–07 (11th Cir. 
2014) (exception to mootness in class actions applies even where plaintiffs’ individual claims 
become moot before plaintiffs move to certify a class); Pitts v. Terrible Herbst, Inc., 653 F.3d 
1081, 1091 (9th Cir. 2011) (even where plaintiff’s claim is not inherently transitory, class 
certification relates back to the date the case was filed, and the case does not become moot 
because “a claim transitory by its very nature and one transitory by virtue of the defendant’s 
litigation strategy share the reality that both claims would evade review”); Lucero v. Bureau 
of Collection Recovery, Inc., 639 F.3d 1239, 1249–50 (10th Cir. 2011) (exception to mootness 
applies where defendant seeks to moot individual claim prior to ruling on class certification); 
Comer v. Cisneros, 37 F.3d 775, 799 (2d Cir. 1994) (when claims of the named plaintiffs 
become moot prior to class certification, the case is not moot if circumstances suggest class 
certification may relate back to filing of the complaint). 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
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to try to thwart class actions.” Bais Yaakov of Spring Valley v. ACT, Inc., 798 F.3d 
46, 48 (1st Cir. 2015). Even the two circuits that do not explicitly adopt a “pick off” 
exception to mootness leave open the door to permit a plaintiff whose claims are moot 
to continue as a class representative under either a “capable of repetition, yet evading 
review” theory,2 or when the class certification motion was pending but not ruled on 
at the time that the plaintiff’s claim became moot.3  The Fourth Circuit Court of 
Appeals has not yet addressed this issue, but several federal district courts have 
applied precedent from other circuits to find a “pick off” exception to mootness in 
putative class action cases.  See, e.g., Reyna v. Fiott, No. 1:17-cv-01192, 2018 U.S. 
Dist. LEXIS 123949, at *8 (E.D. Va. Mar. 20, 2018) (holding case not moot, applying 
relation back doctrine to pick off exception in immigrant detention case following 
                                            
2 The Eighth Circuit has held that where the defendant acts to moot a named 
plaintiff’s claim in a putative class action, the claim is capable of repetition, yet evading 
review.  See, e.g., Inmates of Lincoln Intake & Det. Facility by Windes v. Boosalis, 705 F.2d 
1021, 1023 (8th Cir. 1983) (“[A] court may address on appeal the issue of whether the district 
court ruled properly on the class certification issue, even though the named plaintiff’s claim 
became moot prior to the district court’s consideration of the issue.”); Owens v. Heckler, 753 
F.2d 675, 677 (8th Cir. 1985) (holding that the class action could proceed even though the 
plaintiff’s individual claim had become moot). 
3 In Cruz v. Farquharson, 252 F.3d 530 (1st Cir. 2001), the court held that “[d]espite 
the fact that a case is brought as a putative class action, it ordinarily must be dismissed as 
moot if no decision on class certification has occurred by the time that the individual claims 
of all named plaintiffs have been fully resolved.”  Id. at 533.  However, Cruz left open the 
question of whether mooting the named plaintiff’s claim also moots the entire action if the 
class certification motion has been filed but not yet ruled on.  Id. at 534 n.3; see also Bais 
Yaakov of Spring Valley v. ACT, Inc., 798 F.3d 46, 51 (1st Cir. 2015) (“Cruz also left open the 
possibility that a putative class action may not be moot if a motion for certification was 
pending when the plaintiff's individual claims became moot . . . .”).   
 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
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Richardson), aff’d, Reyna v. Hott, 921 F.3d 204 (4th Cir. 2019);  In re Monitronics 
Int’l, Inc., Tel. Consumer Prot. Act. Litig., No. 1:13-MD-2493-JPB-MJA, 2016 U.S. 
Dist. LEXIS 191414, at *13 (N.D. W. Va. June 27, 2016) (“[A] complete settlement 
offer made before the plaintiff files a motion for class certification does not moot the 
putative class action provided that the plaintiff move for class certification within a 
reasonable time after discovery.”); Kensington Physical Therapy, Inc. v. Jackson 
Therapy Partners, LLC, 974 F. Supp. 2d 856, 864 (D. Md. 2013) (“[A] complete 
settlement offer made before class certification does not moot the putative class 
claims.”); Shifflett v. Kozlowski, No. 92-0072-H, 1993 U.S. Dist. LEXIS 997, at *10 
(W.D. Va. Jan. 25, 1993) (“[E]ven if the named plaintiffs’ claims become moot before 
a class has been certified, the district court may nonetheless certify a class and the 
action may be maintained as a class action.”).  While this federal case law is not 
binding precedent for this Court, it is instructive to observe the weight of precedent 
in the federal class action context. 
 
Similarly, numerous state courts have also found an exception to mootness 
where a defendant acts to moot the claim of the named plaintiff prior to class 
certification.  See, e.g., Growden v. Good Shepherd Health Sys., 550 S.W.3d 716, 727 
(Tex. App. 2018) (applying an exception to mootness where defendant waived 
plaintiff’s medical bill prior to the court considering class certification); Frazier v. 
Castle Ford, Ltd., 59 A.3d 1016, 1024 (Md. 2013) (holding that providing individual 
relief to the putative class representative does not moot a class action if the individual 
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plaintiff has not had the opportunity for reasonable discovery and to seek class 
certification); Jones v. S. United Life Ins. Co., 392 So. 2d 822, 823 (Ala. 1981) (holding 
that when plaintiff’s individual case was mooted by defendant paying her claim prior 
to class certification, plaintiff was not thereby ousted as a proper class 
representative).   
Several cases from other state courts arise in factually similar circumstances.  
For example, in Growden, the plaintiff was charged hospital fees of $25,308.92 for a 
brief emergency room visit to treat her daughter, who was uninsured.  Growden, 550 
S.W.3d at 720.  The plaintiff’s complaint sought only declaratory relief on behalf of 
herself and others similarly situated.  Id. at 720–21.  After the lawsuit was filed, but 
before a ruling on class certification, the defendant hospital executed an affidavit 
stating that it waived and had written off the charges, and that it would make no 
further attempt to collect the plaintiff’s bills.  At the same time, the defendant sought 
dismissal of the lawsuit, which was granted by the trial court.  Id.  On appeal, the 
Court of Appeals of Texas held that while the plaintiff’s individual claim became moot 
when the hospital waived her bill, her class action claims were not mooted, applying 
a pick off exception to mootness.  Id. at 727.   
Another similar case involved a bank’s attempt to enforce a “due-on-
encumbrance” acceleration clause in a mortgage contract when the plaintiff-
homeowner took out a second lien on the home.  See La Sala v. Am. Sav. & Loan 
Ass’n, 5 Cal. 3d 864 (1971).  Upon receiving notice of the bank’s intent to accelerate 
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the mortgage unless the homeowner agreed to a waiver fee and an increase in the 
loan’s interest rate, the homeowner filed a class action complaint for declaratory 
relief.  Id. at 869–70.  Before any class was certified, the bank voluntarily waived its 
right to accelerate against the named plaintiffs and sought dismissal of the action for 
lack of a representative plaintiff.  Id. at 870.  While not explicitly calling this a pick 
off exception to mootness, the Supreme Court of California ruled that the plaintiffs 
could continue to pursue class action certification even though their individual claims 
had been resolved by the bank’s actions.  Id. at 871 (“Even if the named plaintiff 
receives all the benefits that he seeks in the complaint, such success does not divest 
him of the duty to continue the action for the benefit of others similarly situated.”). 
III. 
Richardson and the Relation Back Doctrine 
In Richardson, the Court recognized that Article III mootness doctrine in class 
action cases is more “flexible” than other federal justiciability requirements and that 
“ ‘[i]n the class action context, special mootness rules apply’ for determining at what 
point in time a named plaintiff must still have a personal stake in the litigation to 
continue seeking to represent a putative class action.”  Richardson, 829 F.3d at 278–
79 (quoting Brown v. Phila. Hous. Auth., 350 F.3d 338, 343 (3d Cir. 2003)).  Thus, 
class certification may, in certain circumstances, relate back to the filing of the 
complaint, permitting a named plaintiff to serve as a putative class representative, 
even though his individual claims are no longer justiciable.  Most commonly, this 
applies to claims that are “inherently transitory” or “capable of repetition, yet evading 
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review.”  See Cty. of Riverside v. McLaughlin, 500 U.S. 44, 52 (1991); Geraghty, 445 
U.S. at 398–99.  The facts in Richardson presented a different application of the 
relation back doctrine, which that court called “the picking off exception to mootness.”  
Richardson, 829 F.3d at 279.   
The plaintiff in Richardson was a former inmate at a federal penitentiary, USP 
Lewisburg, who sought relief for violations of his Fifth and Eighth Amendment rights 
and on behalf of dozens of other inmates who he alleged suffered similar 
unconstitutional treatment.  Richardson was transferred to another federal facility 
after his complaint was filed but before he moved for class certification.  “Richardson 
had standing to seek injunctive relief when he filed his amended complaint (as he 
was still housed . . . at USP Lewisburg), [so the court] must ask whether his claims 
for injunctive relief are now moot because he is no longer housed there.”  Id. at 278.  
Neither Richardson’s nor Chamber’s individual claims were inherently transitory.  
However, their individual claims became moot as a result of actions over which they 
had no control. 
Applying its own precedent in Weiss v. Regal Collections, 385 F.3d 337, 347–
48 (3d Cir. 2004) (applying relation back doctrine to produce “picking off” exception 
in debt collection context where the defendant made Rule 68 offer for full amount of 
potential recovery before the plaintiff moved for class certification), abrogated on 
other grounds by Campbell-Ewald Co., 136 S. Ct. 663, and after a careful review of 
similar cases across the country, the Richardson court held that the relation back 
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doctrine can be applied to relate a now-moot individual claim back to the date of the 
class action complaint where a would-be class representative is not given a fair 
opportunity to show that class certification is warranted and provided that the 
plaintiff has not unduly delayed seeking class certification.  Richardson, 829 F.3d at 
286.   
Thus, in applying this standard, a trial court must look to “two separate but 
related considerations.” Id.  First, it is necessary to examine whether the plaintiff 
was given a “fair opportunity” to show that class certification is appropriate. Id. at 
283 (citing Campbell-Ewald Co., 136 S. Ct. at 672 (“[A] would-be class representative 
with a live claim of her own must be accorded a fair opportunity to show that 
certification is warranted.”)). Second, a trial court must next consider whether the 
plaintiff submitted the issue of class certification to the trial court without “undue 
delay.” Id. at 287 (citing Weiss, 385 F.3d at 348). 
In Richardson, there was no showing of any purpose or design on the part of 
the defendant to intentionally relocate the plaintiff to another facility in order to moot 
the putative class action case.  Also, it was irrelevant to the analysis that the plaintiff 
there, as with Chambers here, had not actually filed a class certification motion prior 
to the event that mooted the plaintiff’s individual claim.  Applying the pick off 
exception, the court concluded that the case was not moot because only six weeks had 
passed between the filing of the amended class action complaint and Richardson’s 
transfer to another facility, the event that allegedly mooted his individual claim, and 
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because Richardson “could not be expected to have presented the class certification 
issue to the District Court within that amount of time.”  Richardson, 829 F.3d at 289.  
The Richardson court also noted that, in fairness, either party may raise the issue of 
class certification, concluding that “[n]othing in the plain language of Rule 23(c)(1)(A) 
[of the Federal Rules of Civil Procedure] either vests plaintiffs with the exclusive 
right to put the class certification issue before the district court or prohibits a 
defendant from seeking early resolution of the class certification question.” Id. at 288 
(quoting Vinole v. Countrywide Home Loans, Inc., 571 F.3d 935, 939–40 (9th Cir. 
2009)). 
We previously have held that “Rule 23 [of the North Carolina Rules of Civil 
Procedure] should receive a liberal construction” to ensure that the class action 
mechanism remains a viable procedure when applicable.  Crow, 319 N.C. at 280, 354 
S.E.2d at 464 (quoting English v. Holden Beach Realty Corp., 41 N.C. App. 1, 9, 254 
S.E.2d 223, 230–31, disc. rev. denied, 297 N.C. 609, 257 S.E.2d 217 (1979)).  In state 
court, mootness is “a form of judicial restraint,” rather than a jurisdictional concern, 
as it is in federal court.  In re Peoples, 296 N.C. 109, 147, 250 S.E.2d 890, 912 (1978).  
In the class action context, where absent class members may have unresolved claims, 
any prudential concerns that may guide the exercise of that constraint are 
outweighed by the value of serving the multiple purposes of the class action 
procedure, including “ ‘the efficient resolution of the claims or liabilities of many 
individuals in a single action’ and ‘the elimination of repetitious litigation and 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
-18- 
possible inconsistent adjudications involving common questions, related events, or 
requests for similar relief.’ ”  Crow, 319 N.C. at 280, 354 S.E.2d at 464.  Therefore, it 
is appropriate to adopt the Richardson standard in these circumstances to allow 
relation back of the plaintiff’s claim to the date of the filing of the complaint for 
purposes of the justiciability analysis in class action cases under Rule 23 of the 
North Carolina Rules of Civil Procedure. 
Further support for this interpretation of North Carolina class action law 
comes from this Court’s prior decision in Reep v. Beck, 360 N.C. 34, 619 S.E.2d 497 
(2005).  There, we held that while it is not error as a matter of law to rule on a motion 
to dismiss prior to ruling on a class certification motion, “[t]his Court is confident 
that, in determining the sequence in which motions will be considered, North 
Carolina judges will continue to be mindful of longstanding exceptions to the 
mootness rule and other factors affecting traditional notions of justice and fair play.”  
Id. at 40, 619 S.E.2d at 501 (citing Simeon v. Hardin, 339 N.C. 358, 371, 451 S.E.2d 
858, 867 (1994); Cty. of Riverside, 500 U.S. at 52; 5 James Wm. Moore et al., Moore’s 
Federal Practice § 23.64[1][b] (3d ed. 2005)).  It is such a notion of justice and fair play 
that motivates the Court to adopt the pick off exception and allow the relation back 
of the plaintiff’s claim for justiciability purposes. 
Requiring that a named plaintiff have a fair opportunity to present the issue 
of class certification to the trial court ensures that class representatives will not be 
picked off at the dawn of the litigation before they have had a chance to engage in 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
-19- 
appropriate discovery and otherwise prepare to seek class certification from the trial 
court. It will prevent both a “race to pay off named plaintiffs” before they can pursue 
class certification and premature class certification determinations before the 
development of the factual record necessary for a trial court’s rigorous analysis of the 
issues involved in a class certification motion.  Richardson, 829 F.3d at 282, 288.  The 
question of what constitutes a fair opportunity in this context naturally will vary from 
case to case based on considerations such as the complexity of the case, the nature of 
discovery required to determine class certification, the stage at which the named 
plaintiff’s individual claims become moot, and other relevant factors.  
The Richardson test also provides fairness to the defendant by incorporating 
an important corollary to the fair opportunity requirement—that is the notion that 
the plaintiff must present the issue of class certification to the trial court without 
“undue delay.” Richardson, 829 F.3d at 287. In other words, a class representative, 
while taking advantage of the fair opportunity to seek class certification, cannot be 
dilatory and instead must “act[ ] diligently to pursue the class claims.” Stein v. 
Buccaneers Ltd. P’ship, 772 F.3d 698, 707 (11th Cir. 2014). In cases where the trial 
court finds the named plaintiff was, in fact, dilatory in seeking class certification, the 
pick off “exception should not apply and ‘courts [should] adhere to the general rule 
that the mooting of [the] named plaintiff’s claim prior to class certification moots the 
entire case.’ ” Richardson, 829 F.3d at 286 (first alteration in original) (quoting 
Lucero, 639 F.3d at 1249); see Stein, 772 F.3d at 707 (“A named plaintiff who does not 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
-20- 
act diligently may not have what it takes to adequately present the issues. But to act 
diligently, a named plaintiff need not file a class-certification motion with the 
complaint or prematurely; it is enough that the named plaintiff diligently takes any 
necessary discovery, complies with any applicable local rules and scheduling orders, 
and acts without undue delay.”).  The guiding principle underlying the adoption of a 
pick off exception is fairness to the putative class members. However, the defendant, 
too, must be shielded from vexatious or unfair litigation tactics. The Richardson test 
provides the appropriate balance between the interests of the respective parties in 
this regard.  
Moses Cone’s argument that the U.S. Supreme Court has rejected any 
exception to mootness in these circumstances is unavailing for several reasons.  First, 
the case Moses Cone relies on, Genesis Healthcare Corp. v. Symczyk, 569 U.S. 66 
(2013), emphasized that the Fair Labor Standards Act proceeding at issue in that 
case was “fundamentally different” from a Rule 23 class action. 569 U.S. at 74.  Unlike 
class certification under Rule 23, “conditional certification” under the FLSA “does not 
produce a class with an independent legal status, or join additional parties to the 
action.”  Id. at 75.  Therefore, conclusions about a plaintiff’s claim becoming moot 
before certification under the FLSA cannot be transplanted to the Rule 23 class action 
context.  Cf. United States v. Sanchez-Gomez, 138 S. Ct. 1532, 1539 (2018) (stating 
that cases in the class certification context are inapposite to FLSA actions “because 
‘Rule 23 actions are fundamentally different from collective actions under the FLSA’ 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
-21- 
” (quoting Genesis HealthCare, 569 U.S. at 74)).  The outcome in Genesis Healthcare 
turned on the unique implications of conditional certification under the FLSA, and is 
not controlling here. 
Second, the U.S. Supreme Court has noted that the question presented here is 
unresolved.  See Campbell-Ewald Co., 136 S. Ct. at 672 (noting “we . . . do not [ ] now 
decide” whether actually mooting the plaintiff’s claim before class certification would 
moot the entire case). In Campbell-Ewald, the Court left for another day the question 
of whether unilateral action by the defendant that satisfied the named plaintiff’s 
individual claim before class certification could moot the entire case.  Id.  Thus, the 
U.S. Supreme Court has not explicitly endorsed or rejected a pick off exception to 
mootness in class action cases.   
Finally, even if federal law were settled in this area, this Court is required to 
decide how mootness applies under state law to class actions brought under the 
North Carolina Rules of Civil Procedure.  See, e.g., Scarvey v. First Fed. Sav. and 
Loan Ass’n of Charlotte, 146 N.C. App. 33, 41, 552 S.E.2d 655, 660 (2001) (federal 
class action cases are not binding on the Court of Appeals).  Federal precedents are 
instructive and we are indeed following the Third Circuit’s lead in articulating the 
pick off exception, but ultimately federal precedent is not binding on how this Court 
should interpret North Carolina class action law. 
 
Moses Cone further contends that the pick off exception to mootness cannot be 
applied in this case because the trial court specifically found that there was no 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
-22- 
evidence that Moses Cone wrote off Chambers’ debt in order to prevent the trial court 
from ever reaching the question of whether a class should be certified.  Given the 
standard that we utilize here, defendant’s motive is not relevant to the inquiry.  The 
pick off exception to mootness that we have adopted does not rely on any finding of 
bad faith or improper motive on the part of any party.  It is perfectly reasonable that 
in order to minimize its exposure and limit its liability, a defendant would seek to 
end a class action lawsuit as quickly as possible before class certification.  The pick 
off exception is not a penalty for bad actions, it is simply necessary to protect the class 
action mechanism as a means of promoting judicial economy, fairness, deterrence, 
and efficiency in the determination of disputed claims, particularly where the amount 
in controversy in any particular case is small, but the number of potentially impacted 
plaintiffs is large. 
 
Further, in light of the Richardson standard, there is no required showing of a 
pattern of repeated picking off of numerous individual plaintiffs, time and again, 
before the pick off exception applies.  It was this type of evidence that the trial court 
held was missing in this case.  The trial court reasoned in its legal analysis of 
defendants’ motion to dismiss that 
[p]erhaps if Moses Cone were to continue to dismiss its 
collection actions against all patients who challenge the 
validity of the Contract, the Court could consider whether 
Moses Cone is taking action to evade judicial review of its 
Contract.  But at this time, the action does not fit within 
the narrow capable-of-repetition exception. 
 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
-23- 
However, where the pick off exception to mootness applies, rather than the capable 
of repetition, yet evading review exception, the question is whether the plaintiff had 
a reasonable opportunity to pursue class certification and did so without undue delay.  
The defendant’s actions in other cases is not relevant to that inquiry. 
 
The dissent’s proposed solution to the mootness problem, namely that other 
putative class members can now file their own new lawsuit, ignores the fact that the 
statute of limitations might continue to run against class members who, while 
Chambers’ claims were pending, would have no need to file separately.  Additionally, 
the dissent takes us to task for improperly legislating, but in fact, mootness is a court-
made doctrine and this Court previously has adopted several exceptions to mootness 
absent any action by the legislature.  See, e.g., N.C. State Bar v. Randolph, 325 N.C. 
699, 701, 386 S.E.2d 185, 186 (1989) (per curiam) (adopting the exception to mootness 
where a case involves “a question that involves a matter of public interest, is of 
general importance, and deserves prompt resolution” (citations omitted)); Simeon, 
339 N.C. at 371, 451 S.E.2d at 867 (adopting an exception to mootness where the 
“case belongs ‘to that narrow class of cases in which the termination of a class 
representative’s claim does not moot the claims of the unnamed members of the 
class’ ” and where “[t]he claim . . . is one that is distinctly ‘capable of repetition, yet 
evading review.’ ” (quoting Gerstein v. Pugh, 420 U.S. 103, 110 n. 11 (1974)); In re 
Hatley, 291 N.C. 693, 694, 231 S.E.2d 633, 634 (1977) (adopting the exception to 
mootness where “collateral legal consequences of an adverse nature can reasonably 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
-24- 
be expected to result therefrom” (citing Sibron v. New York, 392 U.S. 40, 57 (1968)). 
There still are countless ways that a class action matter may become moot after the 
original complaint is filed, depending on the nature of the case and the allegations of 
the complaint.  We have determined that the Richardson standard for evaluating 
whether an individual plaintiff’s claim should or should not relate back to the date 
the complaint was filed for the purpose of determining mootness, commonly called a 
pick off exception, is a fair balance of the rights of all parties. 
IV. 
Conclusion 
Accordingly, we conclude that a remand to the trial court to apply the 
appropriate legal standard is warranted.  See, e.g., Worley v. Moore, 370 N.C. 358, 
368, 807 S.E.2d 133, 140–41 (2017) (reversing and remanding for an application of 
the proper legal standard where the trial court applied an incorrect test).  Our holding 
today recognizes a narrow exception to the doctrine of mootness when a named 
plaintiff’s individual claim becomes moot before the plaintiff has had a fair 
opportunity to pursue class certification and has otherwise acted without undue delay 
regarding class certification.  In these limited circumstances, the named plaintiff’s 
claim relates back to the filing of the complaint for mootness purposes, and he retains 
the legal capacity to pursue class certification and class-wide relief, even though his 
individual claim may have been satisfied.4  The decision of the Court of Appeals is 
                                            
4 To be sure, even applying the relation back doctrine, obtaining class certification still 
requires Chambers to meet the stringent requirements of Rule 23 of the North Carolina Rules 
CHAMBERS V. MOSES H. CONE MEM’L HOSP.  
 
Opinion of the Court 
 
 
-25- 
reversed, and this case is remanded for further proceedings consistent with this 
opinion. 
 
REVERSED AND REMANDED. 
 
                                            
of Civil Procedure.  See generally Faulkenbury v. Teachers’ & State Emps. Ret. Sys. of N.C., 
345 N.C. 683, 697, 483 S.E.2d 422, 431 (1997) (describing prerequisites for bringing a class 
action). 
 
 
 
 
 
Justice NEWBY dissenting. 
The rule of law provides the consistency and predictability citizens need to plan 
their daily affairs. Under the rule of law, courts generally apply existing precedent 
and allow the citizens to make significant changes through their elected 
representatives in the legislature. When a court purports to act under its common-
law authority, but in doing so ignores the requirements of a controlling statute, it 
usurps a role for which it was not designed. Historically, this Court has recognized, 
as a matter of judicial restraint, that mootness renders a case nonjusticiable. And the 
General Assembly has declared that class representative plaintiffs must adequately 
represent the interests of the class. Today, the majority leaves behind both of these 
well-established legal principles. The majority adopts an exception to mootness that 
is neither supported by this Court’s precedent nor justified by the policy 
considerations the majority attempts to address.  It thus gives judicial life support to 
class action claims led by named plaintiffs who have no personal interest in the case 
and are in no position to adequately represent the interests of the rest of the class 
claimants. I respectfully dissent. 
Stated objectively, the procedural facts here do not justify the majority’s 
departure from our longstanding precedent. On 23 August 2011, the named plaintiff, 
Christopher Chambers, came to defendant hospital for emergency treatment. He, like 
every other patient, was given a form on which he was asked to agree to pay for the 
CHAMBERS V. MOSES H. CONE MEM’L HOSP. 
 
Newby, J., dissenting 
 
-2- 
 
hospital’s services in full. He was not asked whether he was insured, presumably 
because federal law restricts a hospital’s ability to consider the insurance status of a 
patient who needs emergency medical care. See, e.g., 42 U.S.C. § 1395dd (2011); 42 
C.F.R. § 489.24(d)(4). After Chambers left the hospital, the hospital billed him for the 
services based on the “Chargemaster,” a document commonly used by hospitals to 
standardize rates for various medical services. On 11 May 2012, Chambers filed his 
original class complaint against the hospital claiming, among other things, breach of 
contract and breach of the covenant of good faith and fair dealing. The hospital filed 
a counterclaim against Chambers for payment of its bill.1 The trial court dismissed 
some of Chambers’s claims, leaving only the contract-related claims intact. 
The attorneys representing the plaintiffs here had also filed a similar class 
action complaint in Hefner v. Mission Hospital Inc., No. 12 CVS 3088, 2015 NCBC 
LEXIS 115 (N.C. Super. Ct. Dec. 15, 2015). The parties agreed to allow the trial court 
to address those claims first because they appeared to be virtually identical to the 
ones filed in this case, and because the plaintiffs’ attorneys were the same.2 In Hefner, 
the trial court denied the plaintiff’s class action certification motion because the 
unique factual issues among the various individual plaintiffs’ claims made 
determination of liability on a class-wide basis inappropriate. After denying class 
                                            
1 The hospital sought to consolidate into the action against Chambers a separate 
collection action it had filed against him. 
2 Though the class action allegations in Hefner and this case present similar issues, 
the factual bases for the claims in Hefner are unrelated to the facts of this case. 
CHAMBERS V. MOSES H. CONE MEM’L HOSP. 
 
Newby, J., dissenting 
 
-3- 
 
certification the trial court dismissed Hefner’s individual claim as moot, finding there 
was no longer an actual controversy between the hospital and him because the 
hospital dismissed its counterclaim, binding itself not to seek payment from him. 
After the denial of class certification and dismissal in Hefner, Chambers filed 
an amended complaint on 1 April 2016, voluntarily dropping his contract-related 
claims against the hospital and seeking class action declaratory relief under a new 
theory. The amended complaint explained that Chambers was acting as a 
representative of all individuals who, within four years of the original complaint’s 
filing, received emergency care at the hospital, the cost of which was not covered by 
insurance, and who were not granted a discount or waiver by the hospital. The 
amended complaint asserted that this class of individuals “consists of at least 
hundreds, if not thousands, of persons.” After Chambers’s decision not to pursue his 
individual contract claims, the hospital dismissed with prejudice its counterclaim for 
payment from Chambers.3 Accordingly, Chambers was no longer a member of the 
class he purported to represent; he owed the hospital nothing. The hospital then 
moved to dismiss the class action for lack of subject matter jurisdiction because of 
mootness. 
The trial court found that Chambers’s claim for declaratory relief was moot 
because he had no individual interest in the action. In considering the then-
                                            
3 According to the hospital, its dismissal of its counterclaim for payment was in 
response to Chambers’s dropping of his individual contract claims. 
CHAMBERS V. MOSES H. CONE MEM’L HOSP. 
 
Newby, J., dissenting 
 
-4- 
 
recognized exceptions to mootness, the trial court found no evidence that the 
hospital’s billing practices were illegal, that any patient would be subject to the same 
billing terms in the future, or that the hospital would forgive the debt of any other 
patient in order to avoid judicial review of its billing practices. These facts are 
uncontested and therefore binding on appeal. The trial court then concluded that no 
exception to mootness applied. It also determined that because Chambers and the 
hospital both dismissed their breach of contract claims, “Chambers no longer has a 
live claim that warrants his representing an ongoing class.” The court dismissed his 
class claim for declaratory relief. 
On appeal, a unanimous panel of the Court of Appeals affirmed, applying the 
language of the class action rule and the longstanding precedent of this Court that 
parties must have a personal stake in the outcome of a case to adequately represent 
a class. Chambers successfully petitioned this Court for discretionary review. 
Rule 23 of the North Carolina Rules of Civil Procedure provides that “[i]f 
persons constituting a class are so numerous as to make it impracticable to bring 
them all before the court, such of them, one or more, as will fairly insure the adequate 
representation of all may, on behalf of all, sue or be sued.” N.C.G.S. § 1A-1, Rule 23(a) 
(2019) (emphasis added). This Court has therefore held that to bring a class action, a 
party must show (1) “the existence of a class”; (2) that “the named 
representatives . . . will fairly and adequately represent the interests of all members 
of the class”; and (3) “that the class members are so numerous that it is impractical 
CHAMBERS V. MOSES H. CONE MEM’L HOSP. 
 
Newby, J., dissenting 
 
-5- 
 
to bring them all before the court.” Crow v. Citicorp Acceptance Co., 319 N.C. 274, 
282–83, 354 S.E.2d 459, 465–66 (1987) (citations omitted). To satisfy the second 
requirement, the named plaintiff or plaintiffs must have a “genuine personal interest, 
not a mere technical interest, in the outcome of the action.” Id. at 283, 354 S.E.2d at 
465. 
Chambers does not have a genuine personal interest in the outcome of this 
case. Chambers chose to dismiss his contract claims, and the hospital then dismissed 
with prejudice its counterclaim against him for payment of its bill. Chambers 
therefore has no personal stake in seeing the hospital’s billing practices invalidated. 
The trial court thus appropriately found that Chambers’s claim was moot. 
Because there is no dispute that Chambers’s claim is moot, the central question 
in this case is whether any exception to mootness applies to his claim such that the 
class action can nonetheless proceed with him as the class representative. In other 
words, the question is whether Chambers will fairly and adequately represent all 
members of the class. Before today’s opinion, traditional exceptions to mootness have 
included when the defendant voluntarily ceases the challenged practice, see, e.g., City 
of Mesquite v. Aladdin’s Castle, Inc., 455 U.S. 283, 289, 102 S. Ct. 1070, 1074, 71 L. 
Ed. 2d 152, 159 (1982); when the issue presented in the case is “capable of repetition, 
yet evading review,” Simeon v. Hardin, 339 N.C. 358, 371, 451 S.E.2d 858, 867 (1994); 
and when the question involved is a matter of public interest, In re Hatley, 291 N.C. 
CHAMBERS V. MOSES H. CONE MEM’L HOSP. 
 
Newby, J., dissenting 
 
-6- 
 
693, 694, 231 S.E.2d 633, 634 (1977). None of these exceptions apply to this case.4 
The express language of Rule 23, and our precedent, requires that a named 
plaintiff must adequately represent the class. If a named plaintiff’s claim is moot, he 
does not adequately represent a class of individuals with claims that are not moot. 
Chambers’s claim here is moot, and no mootness exception applies. If the majority 
followed this Court’s precedent and adhered to the rationale of class actions, that 
would be the end of the matter. 
The majority, however, crafts a new exception to mootness, a “pick off” 
exception, and discards the well-established requirement that a named 
representative of a class must have a genuine personal interest in the outcome of the 
case.5 See Faulkenbury v. Teachers’ and State Emps.’ Ret. Sys. of N.C., 345 N.C. 683, 
                                            
4 First, the hospital has not voluntarily ceased its billing such that no indebted party 
could challenge the practice. Clearly there are other individuals who are able to challenge 
the practice, as the amended complaint states that there are “at least hundreds” of class 
members. Neither does this case present an issue that is capable of repetition, yet evading 
review. The hospital’s billing and collections practices against some of these alleged victims 
appears to be ongoing. Thus, it seems that numerous other individuals with active claims 
could represent the class now that Chambers’s claim is moot. Finally, this case does not 
involve a matter of public interest as the courts of this State have understood that exception. 
In this case, the parties most affected by the hospital’s billing practices are only those in the 
alleged class itself. Moreover, since the facts giving rise to this case occurred, the hospital 
has changed its billing practices, in accordance with federal law, to no longer reference a 
standard rate system like the one to which Chambers objects. 
 
5 This Court has the authority to develop the common law. But it does not have the 
authority to contravene statutory directives. Moreover, when the contemplated change is so 
drastic as to contravene a long-established and wide-reaching legal doctrine like mootness, 
this Court should allow the people to decide what sort of change, if any, is necessary and 
carry out that change through the legislature. 
CHAMBERS V. MOSES H. CONE MEM’L HOSP. 
 
Newby, J., dissenting 
 
-7- 
 
697, 483 S.E.2d 422, 431 (1997). The majority’s broadly applicable exception 
effectively eliminates mootness in the class action context, but, ironically, the 
majority characterizes its holding as “narrow.” Expanding upon the reasoning of the 
Third Circuit in Richardson v. Bledsoe, 829 F.3d 273 (3d Cir. 2016), the majority holds 
that a class action is not moot “when the event that moots the [named] plaintiff’s 
claim occurs before the [named] plaintiff has had a fair opportunity to seek class 
certification and provided that the [named] plaintiff has not unduly delayed in 
litigating the motion for class certification.” 
This new rule, transplanted from federal law, is unworkable in this case.6 
Chambers originally filed a class complaint on 11 May 2012. Four years later, on 1 
April 2016, after it was clear that his alleged class claim was doomed to fail and was 
adversely affected by his personal claim, he filed an amended class complaint based 
on an entirely different legal theory and dropped his personal claim. How is a court 
to apply the majority’s test? In other words, when considering whether Chambers has 
had a “fair opportunity” to file a class certification motion and whether he has “unduly 
delayed” in bringing such a motion, is the key point in time when the 2012 complaint 
was filed, when the 2016 complaint was filed, or some other time? A court could not 
determine what sort of delay is “undue” after years of litigation has passed during 
which Chambers was permitted to completely change his legal theory. 
                                            
6 In general, given dissimilarities between state and federal civil procedural rules, this 
Court should hesitate to transplant whole cloth procedural principles from federal law. 
CHAMBERS V. MOSES H. CONE MEM’L HOSP. 
 
Newby, J., dissenting 
 
-8- 
 
For similar reasons, the new rule is manifestly unfair to defendants. The class 
Chambers purports to represent includes people who received care at the hospital 
within four years of the filing of the complaint. The complaint was originally filed on 
11 May 2012. Thus, his class action references events that happened as early as 2008. 
This passage of time raises issues about potential class members who are now 
immune from collection actions because of statutes of limitations and other 
considerations. Forcing the hospital to defend itself under such circumstances is 
unduly burdensome and unfair. The majority’s new rule is thus unworkable with such 
class action complaints that have been amended.  
The majority also claims that its new pick-off exception promotes “justice and 
fair play” to class claimants. It is unclear how that is so. It does not serve the interests 
of class claimants to allow actions to proceed with named plaintiffs who cannot satisfy 
the requirements that “the named representatives . . . will fairly and adequately 
represent the interests of all members of the class; [and] . . . have a genuine personal 
interest, not a mere technical interest, in the outcome of the case.” Faulkenbury, 345 
N.C. at 697, 483 S.E.2d at 431. Such named plaintiffs likely would not be poised to 
adequately vindicate the interests of the “at least hundreds, if not thousands,” of class 
members. Therefore, the majority’s new rule is unfair not only to defendants, but also 
to putative class members who need a named plaintiff who will fully vindicate their 
interests. To put it in terms of the majority’s new test, the delay in this case certainly 
would seem “undue” from the perspective of the members of the purported class 
CHAMBERS V. MOSES H. CONE MEM’L HOSP. 
 
Newby, J., dissenting 
 
-9- 
 
whose interests have taken the backseat while Chambers has spent years fighting to 
be the one who leads the class. 
The majority does not even discuss the traditional requirement of class actions 
that the named plaintiff must adequately represent the interests of class members. 
It merely makes a passing statement that even under its new rule class actions 
ultimately must still satisfy the requirements of Rule 23 to obtain certification. The 
majority thus apparently thinks that all of Rule 23’s requirements could be met even 
if the named plaintiff has no personal stake in the outcome of the case. Perhaps the 
implication is that when a named plaintiff has shown reasonable diligence to bring a 
class certification motion, that party has demonstrated some commitment to 
pursuing the interests of the class claimants as required by Rule 23(a).  
If that is the majority’s assumption, it is a misguided one. If the named plaintiff 
no longer has a personal interest in the outcome of the case, that party cannot fairly 
and adequately represent the interests of all class members. The named plaintiff’s 
interest is, to quote Faulkenbury, “mere[ly] technical.” 345 N.C. at 697, 483 S.E.2d at 
431. Particularly in cases like this one, in which hundreds of other parties may more 
adequately represent the class interests than a party who has no personal stake in 
the outcome, there is no policy justification for keeping the class action alive with the 
original named plaintiff as the class representative. 
Finally, the majority’s apparent concern, that a defendant could inhibit a class 
claim from ever reaching satisfactory resolution, is unwarranted. The majority claims 
CHAMBERS V. MOSES H. CONE MEM’L HOSP. 
 
Newby, J., dissenting 
 
-10- 
 
that its new rule “ensures that class representatives will not be picked off at the dawn 
of the litigation before they have had a chance to engage in appropriate discovery and 
otherwise prepare to seek class certification from the trial court.” The majority 
believes its rule “will prevent . . . a ‘race to pay off named plaintiffs’ before they can 
pursue class certification . . . .” (Quoting Richardson, 829 F.3d at 282).  
That concern is unfounded both in this case and as a general matter. In this 
case, the trial court specifically found there “is no record to support the argument” 
that the hospital intended to “pick off” Chambers. Indeed, it only dismissed its 
counterclaim against him after Chambers dismissed his individual contract claims. 
Thus, even if in theory some sort of “pick-off” exception should be created, the facts of 
this case do not warrant it here. Pending since 2012, this case does not present a good 
vehicle for the Court to create a new rule. 
In general, repeated “picking off” of named plaintiffs is not a strategy that 
defendants are likely to vigorously pursue. When a named plaintiff’s claim is mooted 
and the class action is therefore dismissed, the class action can be refiled with a new 
named plaintiff.7 For a defendant to fully resolve all claims against it, it either must 
settle the claims of a sufficient number of class members individually until no “class” 
remains, or it must eventually deal with the class as a whole. Thus, a defendant would 
likely have to settle many individual claims to make the issues raised by class action 
                                            
7 Again, that observation holds true in this case, in which Chambers has alleged that 
there are “at least hundreds, if not thousands,” of class members. Many of them may be 
available to pursue this case as a named representative. 
CHAMBERS V. MOSES H. CONE MEM’L HOSP. 
 
Newby, J., dissenting 
 
-11- 
 
finally disappear. This strategy often will be cost-prohibitive, and, even if a defendant 
can afford it, it will lead to most class members receiving a satisfactory resolution of 
their claims. 
Chambers independently dismissed his contract claims against the hospital. 
Only after that did the hospital dismiss its counterclaim against Chambers, 
rendering his claim moot and removing his personal stake in the case. Rather than 
resuscitating old class actions with inadequate representation, the best course is our 
historic one, which allows parties to find mutually beneficial paths forward, accepts 
any consequences to justiciability, and allows classes to regroup and return with 
proper representation. Not only could this encourage settlements that give relief to 
individual claimants, but it would also help ensure that the interests of those still in 
the class are vindicated by the attorneys dealing primarily with the named plaintiffs, 
who must have an active interest in the case. The majority’s expansive new path is 
both unnecessary and contrary to North Carolina law. I respectfully dissent.