Title: Roe No. 1 v. Children's Hosp. Med. Ctr.

State: massachusetts

Issuer: Massachusetts Supreme Court

Document:

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SJC-11533 
 
ROBERT ROE No. 1 & others1  vs.  CHILDREN'S HOSPITAL MEDICAL 
CENTER & others.2 
 
 
 
Suffolk.     April 8, 2014. - October 1, 2014. 
 
Present:  Spina, Cordy, Botsford, Gants, Duffly, & Lenk, JJ. 
 
 
Child Abuse.  Negligence, Hospital, Employer, Duty to prevent 
harm.  Practice, Civil, Complaint, Amendment of complaint, 
Dismissal. 
 
 
 
 
Civil action commenced in the Superior Court Department on 
March 28, 2011. 
 
 
A motion to dismiss was heard by Merita A. Hopkins, J. 
 
 
The Supreme Judicial Court granted an application for 
direct appellate review. 
 
 
 
Mark F. Itzkowitz (Carmen L. Durso with him) for the 
plaintiffs. 
 
Gail M. Ryan (John P. Ryan with her) for Children's 
Hospital Medical Center. 
 
The following submitted briefs for amici curiae: 
 
John J. Barter for Professional Liability Foundation, Ltd. 
                                                          
 
 
1 Robert Roe Nos. 2-11. 
 
 
2 Michael Moe Nos. 1-10. 
2 
 
 
Darrell L. Heckman, of Ohio, & Ninamary Buba Maginnis, of 
Kentucky, for National Center for Victims of Crime. 
 
J. Michael Conley, Jeffrey S. Beeler, Thomas R. Murphy, & 
Kimberly A. Alley for Massachusetts Academy of Trial Attorneys. 
 
 
 
CORDY, J.  This case requires us to decide whether a 
Massachusetts hospital employer owes a legally cognizable duty 
of care to future patients of a doctor who has left the 
hospital's employ and resumed practicing medicine in the employ 
of a different hospital in another State.  We conclude that such 
a duty is not cognizable in the circumstances presented here, 
where the hospital does not have the type of special 
relationship either with its former employee, or with any of his 
prospective patients, that would create such a duty.  
Consequently, we affirm the judgment entered in the Superior 
Court dismissing the complaint for failing to state a claim on 
which relief may be granted. 
 
1.  Background.  We recite the relevant facts as drawn from 
the plaintiffs' complaint, which we assume to be true for the 
purposes of our review.  Nader v. Citron, 372 Mass. 96, 98 
(1977). 
 
The defendant, Children's Hospital Medical Center 
(Children's Hospital), is a fully licensed hospital located in 
Boston.  In 1966 it hired Melvin Levine as a pediatric 
physician.  Levine held that position until leaving Children's 
3 
 
Hospital's employ in 1985.3  On leaving Children's Hospital, 
Levine relocated to North Carolina, where he obtained a license 
to practice medicine and became employed as a pediatrician at 
the University of North Carolina School of Medicine (UNC).  
Twenty-four years later, in 2009, amid allegations that he had 
performed medically unnecessary genital examinations on a number 
of his patients at UNC, Levine signed a consent order 
surrendering his license to practice medicine in North Carolina 
and agreeing not to practice medicine in any other jurisdiction. 
 
In 2011, the plaintiffs, eleven former patients of Levine 
at UNC, brought this suit against Children's Hospital in the 
Superior Court.  Essentially, they allege that Children's 
Hospital failed to properly train, supervise, or discipline 
Levine during his employment at Children's Hospital; knew or 
should have known that Levine was conducting inappropriate 
genital examinations of minors during that employment; and 
failed to report Levine's conduct to various licensing 
authorities and UNC.  Further, they allege that, as a 
consequence of this negligence on the part of Children's 
                                                          
 
 
3 The reasons for the departure of Melvin Levine from 
Children's Hospital and Medical Center (Children's Hospital) are 
not in the record, and the plaintiffs have not alleged that 
Levine's departure was the product of complaints against him or 
that it was anything other than voluntary. 
4 
 
Hospital, Levine was able to continue his abuse of patients, 
including the plaintiffs, during his employment at UNC.4 
 
More specifically, the plaintiffs allege that, in 1967, the 
mother of a minor male patient informed Children's Hospital that 
Levine had sexually abused her son during an examination,5 and 
that the plaintiffs are "informed and believe" that other 
patients may have made similar complaints to Children's Hospital 
during the term of Levine's employment.  Further to this 
allegation, the complaint identifies litigation initiated in 
Massachusetts by former patients treated by Levine when he 
worked at Children's Hospital -- litigation brought after Levine 
left Children's Hospital's employ.  For example, in 1988, a 
patient identified as John Doe No. 6 filed suit against Levine 
in the United States District Court for the District of 
Massachusetts, alleging that Levine repeatedly performed 
medically unnecessary examinations of his genitals between 1978 
and 1984; and, in 1993, a former patient identified as John Doe 
                                                          
 
 
4 The plaintiffs' complaint alleges the following legal 
theories:  count I alleges that Children's Hospital was 
negligent in failing to take any action to prevent Levine from 
abusing them; count II alleges a conspiracy between Children's 
Hospital and unknown individuals to conceal and prevent the 
disclosure of Levine's sexual abuse of his patients; and count 
III alleges that Children's Hospital intentionally and 
fraudulently concealed and prevented the disclosure of Levine's 
sexual abuse of his pediatric patients. 
 
 
5 Children's Hospital denies that any such report was filed, 
but for the purposes of our review we take the factual 
allegations set forth in the complaint as true. 
5 
 
No. 7 complained of similar abuse to the Board of Registration 
in Medicine (board).6  The complaint also references four 
additional suits that were filed in the Superior Court in 2005, 
2006, 2008, and 2011, alleging substantially the same type of 
conduct by Levine during his employment at Children's Hospital. 
 
In July, 2011, Children's Hospital moved to dismiss the 
plaintiffs' complaint pursuant to Mass. R. Civ. P. 12 (b) (6), 
365 Mass. 754 (1974), for failure to state a claim.  Children's 
Hospital argued, among other things, that it did not owe any 
cognizable duty of care to the plaintiffs, as the alleged abuse 
happened after Levine left its employ and during his work for an 
unrelated hospital in another State.  In response, the 
plaintiffs moved to amend their complaint in August, 2011, to 
add a paragraph alleging that Children's Hospital owed them a 
duty of care because it had a "special relationship" with 
Levine, and it knew or should have known that he posed a 
foreseeable risk of harm to future patients.  Children's 
Hospital opposed the motion, arguing that the proposed amended 
complaint would still not state a claim on which relief could be 
granted. 
                                                          
 
 
6 Children's Hospital was not a party to the Federal lawsuit 
brought by John Doe No. 6, and after a jury trial, a directed 
verdict was entered in favor of Levine, resulting in the suit's 
dismissal.  According to Children's Hospital, the complaint 
filed by John Doe No. 7 with the Board of Registration in 
Medicine (board) was dismissed after an investigation had been 
completed by board investigators. 
6 
 
 
In July, 2012, a Superior Court judge, in a detailed 
memorandum of decision and order, allowed Children's Hospital's 
motion to dismiss and denied the plaintiffs' motion to amend.  
She concluded that Children's Hospital did not owe a recognized 
duty of care to the plaintiffs -- victims of abuse at a hospital 
in North Carolina -- given that the alleged abuse occurred after 
Levine left Children's Hospital's employ.  The judge added that 
public policy did not dictate the creation of a duty to the 
plaintiffs that would expose an employer to liability for future 
potential abuse on unknown persons by a former employee anywhere 
in the country.  As a result, she denied the motion for leave to 
amend, as the proposed amendment would not "cure the defect in 
the original complaint:  the lack of a cognizable legal duty to 
these particular plaintiffs."  The plaintiffs timely appealed 
the judge's decision, and we granted their application for 
direct appellate review. 
 
2.  Discussion.  The only issue on appeal is whether 
Children's Hospital owed a duty of reasonable care to the 
plaintiffs requiring it to take affirmative action to protect 
them from Levine, including informing UNC or other appropriate 
authorities of allegations of sexual abuse made against him.  
Our review of the judge's decision to dismiss the claim pursuant 
to Mass. R. Civ. P. 12 (b) (6) is de novo.  Dartmouth v. Greater 
New Bedford Regional Vocational Tech. High Sch. Dist., 461 Mass. 
7 
 
366, 373 (2012).  On review, "a plaintiff's obligation to 
provide the 'grounds' of his 'entitle[ment] to relief' requires 
more than labels and conclusions . . . .  Factual allegations 
must be enough to raise a right to relief above the speculative 
level . . . [based] on the assumption that all the allegations 
in the complaint are true (even if doubtful in fact) . . . ."  
Iannacchino v. Ford Motor Co., 451 Mass. 623, 636 (2008), 
quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 554-555 
(2007). 
 
"To recover for negligence, a plaintiff must show 'the 
existence of an act or omission in violation of a . . . duty 
owed to the plaintiff[s] by the defendant."  Cottam v. CVS 
Pharmacy, 436 Mass. 316, 320 (2002), quoting Dinsky v. 
Framingham, 386 Mass. 801, 804 (1982).  "Whether a defendant 
owes a plaintiff a duty of reasonable care is a question of law 
that is decided 'by reference to existing social values and 
customs and appropriate social policy.'"  Coombes v. Florio, 450 
Mass. 182, 187 (2007), quoting Cremins v. Clancy, 415 Mass. 289, 
292 (1993).  "If no such duty exists, a claim of negligence 
cannot be brought."  Remy v. MacDonald, 440 Mass. 675, 677 
(2004). 
 
As a general rule, all persons have a duty to exercise 
reasonable care in their own conduct to avoid harming others 
where the risk of harm is foreseeable to the actor.  Id.  That 
8 
 
duty does not typically extend to controlling the conduct of a 
third party -- here, Levine -- unless a "special relationship" 
exists between the party posing a risk to others and the party 
who can prevent that harm from occurring by taking action.  Lev 
v. Beverly Enters.-Mass., Inc., 457 Mass. 234, 242 (2010). 
 
We have recognized the relationship between an employer and 
employee as a type of special relationship "that potentially 
would give rise to a duty of care [to third parties] . . . when 
'the employment facilitates the employee's causing harm'" to 
them (citation omitted).  Lev, 457 Mass. at 243-244.  See 
Restatement (Third) of Torts:  Liability for Physical and 
Emotional Harm § 41 (2012) ("Duty to Third Parties Based on 
Special Relationship with Person Posing Risks").7  In such 
circumstances, employers are responsible for exercising 
reasonable care to ensure that their employees do not cause 
                                                          
 
 
7 The Restatement identifies four types of special 
relationships giving rise to a duty of reasonable care with 
regard to risks posed by a third party that arise within the 
scope of the relationship:  "(1) a parent with dependent 
children; (2) a custodian with those in custody; (3) an employer 
with employees when the employment facilitates the employee's 
causing harm to third parties; and (4) a mental-health 
professional with patients."  Restatement (Third) of Torts:  
Liability for Physical and Emotional Harm § 41(a) (2012). 
 
 
"Employment facilitates harm to others when the employment 
provides the employee access to physical locations, such as the 
place of employment, or to instrumentalities, such as a 
concealed weapon that a police officer is required to carry 
while off duty, or other means by which to cause harm that would 
otherwise not be available to the employee."  Id. at § 41 
comment e. 
9 
 
foreseeable harm to a foreseeable class of plaintiffs.  For 
example, an employer whose employees have contact with members 
of the public in the course of conducting the employer's 
business has a duty to exercise reasonable care in selecting and 
supervising its employees.  See Coughlin v. Titus & Bean 
Graphics, Inc., 54 Mass. App. Ct. 633, 639 (2002). 
 
While there is little doubt that Children's Hospital had a 
duty to supervise and monitor Levine's conduct while he was 
employed as a physician there, and owed a duty of reasonable 
care to his minor patients to prevent foreseeable harm to them, 
that is not this case.  We have never recognized or imposed a 
duty on an employer to prevent the future behavior of a former 
employee, with respect to unknown customers and clients of 
unknown future employers.  While the responsibilities of medical 
providers to vulnerable patients might extend beyond those of 
other service-providing employers, the geographic and temporal 
breadth of the duty the plaintiffs seek to impose reaches too 
far, and would potentially expose the employer to liability to 
an essentially limitless class of unknown parties for acts 
committed long after the employer had any ability to supervise, 
monitor, or discipline the former employee's conduct.  We 
decline to create such uncertainties for medical providers in 
10 
 
the Commonwealth by creating such a duty, and are not aware of 
any other jurisdiction that has done so.8 
 
In similar circumstances, the Supreme Court of Wisconsin 
declined to find a special relationship giving rise to a duty of 
care in Hornback v. Archdiocese of Milwaukee, 313 Wis. 2d 294 
(2008).  In that case, the plaintiffs, who grew up in Kentucky, 
alleged that their former teacher sexually abused children 
between 1964 and 1966 while employed by various schools in 
Wisconsin that were operated by the Diocese of Madison 
(diocese).  Id. at 302.  The teacher then accepted a position in 
another State, Kentucky, where he allegedly abused the plaintiff 
students.  Id.  The plaintiffs brought suit against the diocese, 
claiming that it knew or should have known of the teacher's 
conduct and was negligent in failing to affirmatively warn other 
schools or authorities of the teacher's history of sexual abuse.  
Id. at 302-303.  The court affirmed the dismissal of the 
                                                          
 
 
8 Even when we impose new duties based on relationships, we 
are careful not to recognize duties that would expose the person 
having the relationship to endless liability and litigation from 
innumerable people for failing to act in ways that arguably 
might have prevented some future harm.  Compare Jupin v. Kask, 
447 Mass. 141, 152 (2006) (recognition of duty of property owner 
to secure gun from person known to have history of violence and 
mental instability would not expose property owners to endless 
litigation and liability), with Remy v. MacDonald, 440 Mass. 
675, 677-678 (2004) (imposing liability on pregnant woman not to 
harm fetus negligently would present unlimited number of 
circumstances where liability could attach). 
11 
 
complaint,9 id. at 328, concluding that the diocese did not owe 
the plaintiffs a duty of care, reasoning that "[t]here is no 
state in which employers are recognized as being negligent for 
failing to seek out, find, and warn future employers of sexually 
dangerous former employees."  Id. at 319.  The court went on to 
state that the "plaintiffs appear to interpret Wisconsin's duty 
of ordinary care as creating automatic negligence and liability 
for any person even tangentially connected in a causal chain of 
injury, with little concern about the relationship among those 
sued, or how many years have passed between causal events. . . .  
There must be limits.  We draw one here."  Id. at 327-328. 
 
The plaintiffs here have not alleged that Children's 
Hospital affirmatively misrepresented Levine's employment 
history in response to reference or professional qualification 
inquiries from UNC or any other authority, or that any such 
inquiries were even made.10  Rather, the duty the plaintiffs seek 
                                                          
 
 
9 There were two defendants in the case, the Archdiocese of 
Milwaukee (archdiocese) and the Diocese of Madison (diocese).  
The trial court dismissed the complaint against both defendants 
on statute of limitations grounds, a decision that the Appeals 
Court of Wisconsin affirmed.  See Hornback v. Archdiocese of 
Milwaukee, 313 Wis. 2d 294, 304 (2008).  The Supreme Court of 
Wisconsin also affirmed the dismissal against the diocese, but 
on duty of care grounds.  Id. at 319.  An equally divided 
Supreme Court affirmed the dismissal of the case against the 
archdiocese on statute of limitations grounds.  Id. at 328. 
 
 
10 We leave open the question what, if any, duty Children's 
Hospital might have with respect to inquiries made of it by 
12 
 
to impose is one that would obligate Children's Hospital to seek 
out Levine's future employers in order to warn them of past 
allegations of abuse made against him.  It is unclear what level 
of knowledge on the part of an employer would trigger such an 
obligation.  For example, if Children's Hospital received a 
complaint about Levine (or any other doctor), investigated that 
complaint, and determined it to be unsupported, would it still 
be obliged to seek out potential future employers and disclose 
the complaint to them in order to avoid liability?  Such a duty 
would place an onerous burden on employers, obligating them to 
track former employees and warn their future employers or, 
perhaps, even the customers of such future employers.  While the 
protection of children from sexual abuse is of great importance, 
an employer's duty to prevent such harm cannot extend to a duty 
to prevent the actions of a former employee later employed by an 
unrelated entity in another State in the decades following his 
departure from the employer's employ. 
 
We have also recognized, on occasion, a "special 
relationship" between a defendant and prospective plaintiffs.  
See McGuiggan v. New England Tel. & Tel. Co., 398 Mass. 152, 162 
(1986) (social host has duty to potential class of victims to 
stop serving individual he reasonably should know is 
                                                                                                                                                                                           
prospective employers in the medical field with regard to abuse 
allegations arising out of the work of former employees. 
13 
 
intoxicated); Adamian v. Three Sons, Inc., 353 Mass. 498, 501 
(1968) (tavern owner has same duty).  See also Mullins v. Pine 
Manor College, 389 Mass. 47, 51 (1983) (college owed duty of 
care to students who were victims of rape where community of 
colleges had taken "steps to provide an adequate level of 
security on . . . campus").11  We have generally recognized such 
relationships only where the defendant could reasonably 
anticipate that his or her failure to take prompt action in 
circumstances that he or she controlled could result in harm to 
a clearly defined class of plaintiffs; for example, a tavern 
owner can reasonably be aware that his or her failure to stop 
serving an intoxicated person can lead to a predictable injury 
to other drivers on the neighboring roads. 
 
We decline to recognize a special relationship between 
Children's Hospital and the plaintiffs.  The potential class of 
plaintiffs who could claim a special relationship with 
Children's Hospital includes every potential patient in any 
State where Levine ever worked after he left its employ -- 
                                                          
 
 
11 As Children's Hospital points out, in Coombes v. Florio, 
450 Mass. 182, 190 (2007), we recognized a special relationship 
between doctor and patient giving rise to liability.  In that 
case, the patient injured the plaintiffs after his doctor 
neglected to exercise a duty to inform the patient about the 
side effects of prescribed medication.  Id. at 184-185, 190.  
While both Coombes and this case involve medical personnel, 
Coombes is inapposite given that the proposed relationship here 
arose from conduct occurring between an employer and its 
employee, not a doctor and his or her patient. 
14 
 
essentially, an unlimited and unknowable number of people.  The 
plaintiffs had virtually no relationship with or connection to 
Children's Hospital.  There are significant gaps both temporally 
and geographically between Levine's employment at Children's 
Hospital and the alleged abuse at UNC.  See Hornback, 313 Wis. 
2d at 318-319.  Indeed, the only connection between the 
plaintiffs and Children's Hospital is that their alleged abuser 
worked for Children's Hospital twenty-four years before their 
abuse was reported.  This is simply insufficient to support the 
existence of a special relationship between the parties giving 
rise to a duty of care. 
 
In support of their argument that Children's Hospital owed 
them a duty of care, the plaintiffs also argue that (1) the 
medical community has imposed a duty on itself to report alleged 
abuse in order to protect future patients from predatory 
physicians; (2) the general public has demonstrated, through the 
enactment of statutes and regulations, that such a duty exists, 
establishing a "community consensus"; and (3) public policy is 
served by the recognition of such a duty.  While we agree that 
there is a well-established community consensus in favor of 
protecting children from abuse, we disagree that such concerns 
create a duty under the circumstances presented in this case, 
but address the plaintiffs' points in turn. 
15 
 
 
First, a community may impose a duty of care on itself.  
See Mullins, 389 Mass. at 51.  The plaintiffs contend that the 
medical community has imposed on itself the duty to protect 
children from being abused.  As evidence, they point to the 
creation of the Federation of State Medical Boards (FSMB) and 
the National Board of Medical Examiners (NBME),12 which are 
organizations whose services are used by medical facilities to 
determine the fitness of applicants for licensure.  They also 
point to the 1958 version of the American Medical Association's 
"Principles of Medical Ethics," which called on physicians to 
"safeguard the public" against immoral physicians and "expose, 
without hesitation, illegal or unethical conduct of fellow 
members of the profession."  Finally, they draw our attention to 
a policy statement of the American Academy of Pediatrics (AAP), 
which recommends that medical facilities search State registries 
and contact former employers to determine whether an employee 
has a history of child abuse.  American Academy of Pediatrics, 
Policy Statement -- Protecting Children from Sexual Abuse by 
Health Care Providers, 128 Pediatrics 407, 411-412 (2011). 
                                                          
 
 
12 According to the trial judge's memorandum of decision, 
the Federation of State Medical Boards represents seventy 
medical boards in the United States and maintains a database of 
information regarding the licensing and discipline of physicians 
to be used by the public.  While it collects information from 
its member medical boards, it is unclear whether it solicits 
direct reports from medical institutions. 
16 
 
 
While we agree that the medical community has taken steps 
to protect children from sexual abuse, we are not persuaded that 
medical care facilities have undertaken a duty to protect 
unknowable future plaintiffs from harm by former employees.  The 
FSMB and NBME are licensing databases, and exist to allow 
medical institutions and licensing boards to research the 
histories of applicants.  Medical facilities are not required to 
report alleged abuse to them, and there is no penalty for a 
failure to do so.  The mere existence of the boards does not 
create a duty of care on Children's Hospital's part to the 
plaintiffs. 
 
Similarly, the AAP's statement merely encourages hospitals 
to inquire whether a potential hire presents a risk of child 
abuse.  It does not create a legal duty of care.  Lev, 457 Mass. 
at 244-245 (employer's internal safety policy does not create 
legal duty where none already existed at law).  It also is not 
apparent that the statement even applies to these circumstances, 
as it does not include a duty to actively report alleged abuse.  
While the AAP's statement may be evidence of a consensus with 
respect to proper hiring and retention practices, and could 
potentially be used to prove UNC's negligence if it failed to 
exercise its due diligence in investigating Levine's fitness as 
a pediatrician, it does not support the plaintiffs' claim that 
the medical community has imposed on itself a duty that would 
17 
 
require Children's Hospital to report the allegations made 
against Levine in the absence of an inquiry by a prospective 
employer. 
 
The same is true of the plaintiffs' contention that the 
duty of care proposed has been incorporated into Massachusetts 
statutory law, evincing a consensus in the general public in 
support of the duty.  The plaintiffs refer us to G. L. c. 119, 
§ 51A, which requires physicians -- among other professionals -- 
to notify the Department of Children and Families (department) 
when they have "reasonable cause to believe" that a child has 
been abused;13 G. L. c. 111, § 53B, which requires hospitals to 
report disciplinary action taken against registered physicians 
to the board; and G. L. c. 112, § 5F, which requires health care 
providers to report to the board "any person who there is 
reasonable basis to believe" has engaged in the improper 
practice of medicine.14 
                                                          
 
 
13 General Laws c. 119, § 51A (a), requires that "[a] 
mandated reporter who, in his professional capacity, has 
reasonable cause to believe that a child is suffering physical 
or emotional injury resulting from:  (i) abuse inflicted upon 
him which causes harm or substantial risk of harm to the child's 
health or welfare, including sexual abuse . . . shall 
immediately communicate with the department orally and, within 
48 hours, shall file a written report with the department 
detailing the suspected abuse or neglect." 
 
 
14 The plaintiffs argue not that Children's Hospital 
violated these statutes, but that the statutes are indicative of 
the community consensus in favor of imposing their proposed duty 
of care. 
18 
 
 
As an initial matter, and as the judge correctly noted, the 
mere existence of a statute or regulation does not automatically 
give rise to a legal duty for the purpose of a negligence 
action.  See Lev, 457 Mass. at 245.  Rather, "[i]t is only where 
a duty of care exists that the violation of a statute, 
ordinance, regulation, or policy is relevant because it 
constitutes some evidence of a defendant's negligence."  Id.  
Certainly, all of the referenced statutes are generally intended 
to protect children in Massachusetts from abuse, and any 
evidence that Children's Hospital violated those statutes 
regarding Levine's conduct might be relevant in a tort action by 
patients alleged to have been abused by Levine while in 
Children's Hospital's employ.  That, however, is because 
Children's Hospital already has a legally cognizable duty to 
prevent harm to its own minor patients, not because the 
existence of the statutes created that duty. 
 
In any event, the statutes referenced by the plaintiffs do 
not support a conclusion that the public has come to the 
consensus that Children's Hospital owes a duty of care to the 
plaintiffs.  To be certain, they require that Children's 
Hospital report abuse to the department and the board in order 
to protect children in the care of Massachusetts hospitals and 
doctors.  They do not, however, create a duty to protect 
potential future plaintiffs in other States, or require 
19 
 
Children's Hospital affirmatively to alert prospective employers 
that Levine had been accused of sexual abuse.  We thus conclude 
that the plaintiffs' complaint does not state a claim on which 
relief may be granted.15 
 
3.  Conclusion.  We affirm the denial of the plaintiffs' 
motion to amend the complaint and the allowance of Children's 
Hospital's motion to dismiss the complaint. 
 
 
 
 
 
 
 
So ordered. 
                                                          
 
 
15 Because we conclude that the plaintiffs' complaint, even 
if amended as proposed, would not state a claim on which relief 
may be granted, we affirm the Superior Court's denial of the 
plaintiffs' motion to amend.  See Vakil v. Vakil, 450 Mass. 411, 
417 (2008) (motion to amend should be granted unless there 
appears to be good reason for denying motion such as futility of 
proposed amendment).