Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_11-cv-01541/USCOURTS-azd-2_11-cv-01541-0/pdf.json

Nature of Suit Code: 362
Nature of Suit: Medical Malpractice
Cause of Action: 28:1441 Petition for Removal- Medical Malpractice

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 The parties’ request for oral argument will be denied because the parties have fully

briefed the issues and oral argument will not aid in the Court’s decision. See Partridge v. Reich,

141 F.3d 920, 926 (9th Cir. 1998); Lake at Las Vegas Investors Group, Inc. v. Pacific Malibu

Development Corp., 933 F.2d 724, 729 (9th Cir. 1991).

WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Gerard Hefferon,

Plaintiff, 

vs.

Henry Perez, DDS, P.C., a California

professional corporation, et al.,

Defendants. 

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CIV 11-1541-PHX-MHB

ORDER

Pending before the Court is Defendants’ Motion to Dismiss for lack of personal

jurisdiction pursuant to Fed.R.Civ.P. 12(b)(2) (Doc. 7). After considering the arguments raised

by the parties in their briefing, the Court now issues the following ruling.1

BACKGROUND

This is a dental malpractice action asserted by Plaintiff Gerard Hefferon against

Defendants Henry Perez, DDS and entity, Henry Perez, DDS, P.C. Hefferon originally filed

his Complaint in the Maricopa County Superior Court on June 1, 2011, alleging negligence and

unjust enrichment. Specifically, Hefferon alleges that Perez was negligent in performing dental

treatment on him, which has resulted in injuries and damages. The matter was subsequently

removed to this Court on August 5, 2011.

Case 2:11-cv-01541-MHB Document 18 Filed 11/29/11 Page 1 of 9
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Perez is a California resident who is licensed to practice dentistry in California. He has

been in private practice for more than 28 years, all in California, and operates his practice –

through Perez P.C., a California professional corporation with its only place of business in

California – out of a single office located in Oxnard, California.

Perez met Hefferon in mid-2007 at a dental health conference in San Diego, California.

At the conference, Hefferon apparently expressed dissatisfaction with the dental treatment he

was receiving in Arizona, and one of the speakers at the conference suggested that he have

Perez look at his case. Several months later, Hefferon flew to Perez’s office in California to

discuss treatment.

Over the next year-and-a-half, Perez provided dental treatment to Hefferon in his

California office on at least ten occasions. During that time, Perez also made follow-up

telephone calls to Hefferon from California to Arizona concerning Hefferon’s diagnosis and

treatment.

At one point during the year-and-a-half of treatment, Perez flew to Arizona to visit

Hefferon’s chiropractic offices. During the visit, Hefferon removed his retainer, and Perez

made an adjustment to the retainer to alleviate Hefferon’s discomfort until his next scheduled

appointment in California. According to Hefferon, Perez spent “at least thirty” minutes

adjusting the retainer.

Prior to filing an answer, Defendants filed the instant Motion to Dismiss for lack of

personal jurisdiction on August 12, 2011. Hefferon filed a Response on September 19, 2011,

and Defendants filed their Reply on October 3, 2011.

STANDARD OF REVIEW

To establish personal jurisdiction, the plaintiff must show that: (1) the forum state’s long

arm statute confers jurisdiction over the non-resident defendant and (2) the exercise of

jurisdiction comports with the principles of due process. See Omeluk v. Langsten Slip &

Batbyggeri A/S, 52 F.3d 267, 269 (9th Cir. 1995). Arizona’s long arm statute confers

jurisdiction to the maximum extent allowed by the Due Process Clause of the United States

Constitution. See Ariz.R.Civ.P. 4.2(a); Doe v. Am. Nat’l Red Cross, 112 F.3d 1048, 1050 (9th

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Cir. 1997). Therefore, the issue before the Court is whether the exercise of jurisdiction over

Defendants accords with due process. See Omeluk, 52 F.3d at 269.

The Due Process Clause requires that a nonresident defendant have “certain minimum

contacts with [the forum] such that the maintenance of the suit does not offend ‘traditional

notions of fair play and substantial justice.’” Int’l Shoe Co. v. Washington, 326 U.S. 310, 316

(1945) (citations omitted). There are two types of personal jurisdiction: general and specific.

See Perkins v. Benguet Consol. Mining Co., 342 U.S. 437, 445 (1952). General jurisdiction

exists where a non-resident defendant engages in substantial, continuous or systematic activities

within the forum. See id. When a court has general jurisdiction over a defendant, the defendant

may be hailed into that court for any claim, even one that does not arise from the defendant’s

contacts with that jurisdiction. See Helicopteros Nacionales de Colombia, S.A. v. Hall, 466

U.S. 408, 416 (1984). However, when a defendant’s contact with the forum does not rise to the

level required for general jurisdiction, a court may have specific jurisdiction over a claim when

the claim arises from the defendant’s activities within that forum. See Shute v. Carnival Cruise

Lines, 897 F.2d 377, 381 (9th Cir. 1990), rev’d on other grounds, 499 U.S. 585 (1991).

Where an evidentiary hearing is not held, dismissal for lack of personal jurisdiction is

appropriate only if the plaintiff has not made a prima facie showing of personal jurisdiction.

See Fields v. Sedgwick Associated Risks, Ltd., 796 F.2d 299, 300 (9th Cir. 1986).

“[U]ncontroverted allegations in [the plaintiff’s] complaint must be taken as true, and ‘conflicts

between the facts contained in the parties’ affidavits must be resolved in [the plaintiff’s] favor

for purposes of deciding whether a prima facie case for personal jurisdiction exists.’” Am.

Telephone & Telegraph Co. v. Compagnie Bruxelles Lambert, 94 F.3d 586, 588 (9th Cir. 1996)

(quoting WNS, Inc. v. Farrow, 884 F.2d 200, 203 (5th Cir. 1989)). However, a court may not

assume the truth of allegations in a pleading that are contradicted by affidavit. See Data Disc,

Inc. v. Systems Tech. Assoc., 557 F.2d 1280, 1284 (9th Cir. 1977). If the plaintiff is able to meet

its prima facie burden, the movant can nevertheless continue to challenge personal jurisdiction

either at a pretrial evidentiary hearing or at trial itself. See Metropolitan Life Ins. Co. v. Neaves,

912 F.2d 1062, 1064 n.1 (9th Cir. 1990).

Case 2:11-cv-01541-MHB Document 18 Filed 11/29/11 Page 3 of 9
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DISCUSSION

In their pleadings, the parties agree that this Court does not have general jurisdiction over

Defendants. Thus, the dispute before the Court is whether the Court has specific jurisdiction

over Defendants.

The Ninth Circuit applies a three-part test to determine if the exercise of specific

jurisdiction over a non-resident defendant is appropriate. First, the defendant must purposefully

direct his activities towards the forum or its residents, or he must purposefully avail “himself

of the privilege of conducting activities in the forum, thereby invoking the benefits and

protections of its laws.” Boschetto v. Hansing, 539 F.3d 1011, 1016 (9th Cir. 2008). Second,

“the claim must be one which arises out of or relates to the defendant’s forum-related

activities.” Id. Finally, the exercise of jurisdiction must be reasonable. See id. The plaintiff

must prove the first two prongs, in which case the defendant must come forward with

compelling evidence that the exercise of jurisdiction would be unreasonable. See id. “If any

of the three requirements is not satisfied, jurisdiction in the forum would deprive the defendant

of due process of law.” Omeluk, 52 F.3d at 270.

A. Purposeful Availment or Direction

“The purposeful availment requirement ensures that a nonresident defendant will not be

haled into court based upon ‘random, fortuitous or attenuated’ contacts with the forum state.”

Panavision Int’l, L.P. v. Toeppen, 141 F.3d 1316, 1320 (9th Cir. 1998) (quoting Burger King

Corp. v. Rudzewicz, 471 U.S. 462, 475 (1985)). The phrase “purposeful availment” includes

both purposeful availment and purposeful direction, which are distinct concepts. See

Schwarzenegger v. Fred Martin Motor Co., 374 F.3d 797, 802 (9th Cir. 2004). While a

purposeful availment analysis is used in suits sounding in contract, a purposeful direction

analysis is used in suits sounding in tort. See id. Here, the underlying action is characterized

as a tort. Purposeful direction is therefore the proper analytical framework in this case.

The Ninth Circuit “evaluates purposeful direction using the three-part ‘Calder-effects’

test, taken from the Supreme Court’s decision in Calder v. Jones, 465 U.S. 783, 104 S.Ct. 1482,

79 L.Ed.2d 804 (1984).” Brayton Purcell LLP v. Recordon & Recordon, 606 F.3d 1124, 1128

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(9th Cir. 2010). “Under this test, ‘the defendant allegedly must have (1) committed an

intentional act, (2) expressly aimed at the forum state, (3) causing harm that the defendant

knows is likely to be suffered in the forum state.’” Id. (quoting Yahoo! Inc. v. La Ligue Contre

Le Racisme Et L’Antisemitisme, 433 F.3d 1199, 1206 (9th Cir. 2006) (en banc)).

Defendants do not dispute that when Perez flew to Arizona and made an adjustment to

Hefferon’s retainer to alleviate discomfort – such activity was purposefully directed at Arizona

and, therefore, meets the first prong of the specific jurisdiction test. Defendants, however,

dispute that the dental treatment and telephone calls performed in California satisfy the

“purposeful direction” prong claiming that said conduct fails to meet the Calder-effects test.

The Court agrees.

Express aiming, the second element of the test, “depends, to a significant degree, on the

specific type of tort or other wrongful conduct at issue.” Schwarzenegger, 374 F.3d at 807.

Allegations of “untargeted negligence” are not enough to satisfy this element. See id. at 806-07.

Thus, even if the out-of-state dental treatment qualifies as an “intentional act” that caused harm

that Defendants “knew” was likely to be suffered in Arizona, Hefferon cannot establish that

such treatment was expressly aimed at Arizona because his claims rest on allegations of mere

negligence. Therefore, there is no basis for finding that Defendants purposefully directed any

out-of-state activity at Arizona, whether through the treatment itself or the telephone calls that

were incidental to that treatment.

This conclusion is supported by the decisions of numerous courts, including the Ninth

Circuit, which hold that rendering medical or dental services in one state does not subject the

provider of those services to personal jurisdiction in the patient’s state, even when the doctor

or dentist knows that the patient is a resident of another state and, thus, that the consequences

of their services will be felt in that state. See, e.g., Wright v. Yackley, 459 F.2d 287, 289-90

(9th Cir. 1972) (affirming dismissal of a medical-malpractice action for lack of personal

jurisdiction where the defendant provided the allegedly negligent medical services outside the

forum state, and stating: “[T]he idea that tortious rendition of such services is a portable tort

which can be deemed to have been committed wherever the consequences foreseeably were felt

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is wholly inconsistent with the public interest in having services of this sort generally

available.”); Jackson v. Shepard, 609 F.Supp. 205, 207 (D. Ariz. 1985) (dismissing medicalmalpractice action for lack of personal jurisdiction where the alleged injury-causing event

occurred in California); Jackson v. Wileman, 468 F.Supp. 822, 825 (W.D. Ky. 1979) (holding

that Kentucky resident who traveled to Ohio for dental services could not maintain action in

Kentucky, since the jurisdictional focus is on the place where the services were rendered rather

than where the consequences of such services would be felt).

This principle holds true even when the out-of-state doctor or dentist makes telephone

calls to the forum state that are incidental to the out-of-state services. See, e.g., Wright, 459

F.2d at 288-90 (affirming dismissal of a medical-malpractice action for lack of personal

jurisdiction where the defendant, a South Dakota doctor, mailed to the plaintiff, an Idaho

resident, copies of prescriptions stemming from the defendant’s treatment of plaintiff in South

Dakota); Kennedy v. Ziesmann, 526 F.Supp. 1328, 1330 (E.D. Ky. (holding that telephone calls

incidental to medical treatment that the plaintiff received outside the forum were insufficient

to establish personal jurisdiction); Prince v. Urban, 57 Cal.Rptr.2d 181, 182 (“[W]here, as here,

the out-of-state doctor’s contact with the forum state consists of nothing more than telephonic

follow up on services rendered in the doctor’s own state, it is unreasonable for the patient’s

home state to exercise personal jurisdiction over the physician.”).

In sum, the only possible activity that satisfies the “purposeful direction” prong of the

specific-jurisdiction test is Perez’s adjustment to Hefferon’s retainer.

B. Arises Out Of

The Ninth Circuit utilizes “a ‘but for’ test to determine whether a particular claim arises

out of forum-related activities and thereby satisfies the second requirement for specific

jurisdiction.” Ballard v. Savage, 65 F.3d 1495, 1500 (9th Cir. 1995). That is, a claim arises out

of a forum-related activity only if the claim would not exist but for the forum-related activity.

See id.; Bancroft & Masters, Inc. v. Augusta Nat’l Inc., 223 F.3d 1082, 1088 (9th Cir. 2000)

(“[T]he contacts constituting purposeful [direction] must be the ones that give rise to the current

suit.”).

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On this record, the Court finds that the claims arise from the diagnosis and treatment that

Hefferon received in California. Specifically, the record reflects that Perez initially evaluated

Hefferon in California; Perez recommended a treatment plan in California; Perez delivered and

fitted the retainer device in California; and Perez continued to treat Hefferon in California –

even after Perez’s alleged 30-minute adjustment to the retainer in Arizona. Any suggestion that

Hefferon’s claims would not exist but for the retainer adjustment in Arizona misses the mark.

The adjustment to the retainer appears merely incidental to the out-of-state diagnosis and

treatment, and is not the basis for the claims alleged in this lawsuit. And, Hefferon’s contention

that specific personal jurisdiction is established whenever in-state conduct is “directly related”

to the out-of-state conduct out of which the claims arise is unpersuasive. As previously noted,

the jurisdictional inquiry requires the Court to identify the conduct that was “purposefully

directed” at the forum state (in this case, the retainer adjustment in Arizona), and then to

determine whether the dispute arises out of that particular conduct. See Bancroft & Masters,

223 F.3d at 1088 (“[T]he contacts constituting purposeful [direction] must be the ones that give

rise to the current suit.”). It is the relationship between the “purposefully directed” conduct and

the claim that matters, not the relationship between the “purposefully directed” conduct and

other conduct. Accordingly, Hefferon has failed to establish that his claims arise out of any

forum-related activity and, thus, this Court lacks specific jurisdiction.

C. Reasonableness

Even if Hefferon was able to establish that his claims arise out of the only forum-related

activity in this case, personal jurisdiction would still not be proper, as the exercise of such

jurisdiction would be unreasonable. In determining whether the exercise of personal

jurisdiction is reasonable, courts consider and balance seven factors, none of which are alone

dispositive: (1) the extent of the defendant’s purposeful interjection into the forum state’s

affairs; (2) the burden on the defendant of defending in the forum; (3) the extent of conflict with

the sovereignty of the defendant’s state; (4) the forum state’s interest in adjudicating the dispute;

(5) the most efficient judicial resolution of the controversy; (6) the importance of the forum to

the plaintiff’s interest in obtaining convenient and effective relief; and (7) the existence of an

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alternative forum. See Harris Rutsky & Co. Ins. Serv., Inc. v. Bell & Clements Ltd., 328 F.3d

1122, 1132 (9th Cir. 2003) (citing Burger King Corp., 471 U.S. at 476-77).

As previously stated, Defendants only in-state conduct was the adjustment of Hefferon’s

retainer, which, according to Hefferon, lasted about 30 minutes. Arizona undoubtedly has little

interest in adjudicating disputes with so little connection to this state. Any negligent act that

can be alleged took place in California in association with the diagnosis and treatment of

Hefferon. The fact that Hefferon’s alleged injuries were suffered in Arizona is irrelevant. As

set forth by the Ninth Circuit in Wright, 459 F.2d at 289-90:

In the case of personal services[,] focus must be on the place where the services

are rendered, since this is the place of the receiver’s (here the patient’s) need.

The need is personal and the services rendered are in response to the dimensions

of that personal need. They are directed to no place but to the needy person

herself. It is in the very nature of such services that their consequences will be

felt wherever the person may choose to go. However, the idea that tortious

rendition of such services is a portable tort which can be deemed to have been

committed wherever the consequences foreseeably were felt is wholly

inconsistent with the public interest in having services of this sort generally

available. Medical services in particular should not be proscribed by the doctor’s

concerns as to where the patient may carry the consequences of his treatment and

in what distant lands he may be called upon to defend it. The traveling public

would be ill served were the treatment of local doctors confined to so much

aspirin as would get the patient into the next state. The scope of medical

treatment should be defined by the patient’s needs, as diagnosed by the doctor,

rather than by geography.

Thus, Hefferon’s claims do not arise out of the in-state retainer adjustment. But even if

they did, under these circumstances, it would be unreasonable to subject Defendants to the

personal jurisdiction of the courts of this state.

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CONCLUSION

Hefferon has not met his burden of showing that this dispute arises out of Perez’s in-state

adjustment to his retainer, the only conduct that was “purposefully directed” at Arizona.

Accordingly, the Court will grant Defendants’ Motion to Dismiss.

IT IS ORDERED that Defendants’ Motion to Dismiss for lack of personal jurisdiction

pursuant to Fed.R.Civ.P. 12(b)(2) (Doc. 7) is GRANTED.

DATED this 28th day of November, 2011.

Case 2:11-cv-01541-MHB Document 18 Filed 11/29/11 Page 9 of 9