Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-4_13-cv-01224/USCOURTS-azd-4_13-cv-01224-0/pdf.json

Nature of Suit Code: 555
Nature of Suit: Prisoner - Prison Condition
Cause of Action: 28:1331 Federal Question: Bivens Act

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The action was originally filed in the United States District for the Southern District

of Indiana. The assigned judge severed the allegations involving conduct that occurred in

Arizona from the allegations involving conduct that occurred in Indiana, opened this action

against the Arizona defendants, and transferred this action to the District of Arizona.

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In its Answer Defendant Northwest Hospital, L.L.C., dba Northwest Medical Center,

states it was improperly identified as Northwestern Hospital in the First Amended Complaint.

WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

BOBBY JOE MANN, 

Plaintiff, 

vs.

UNITED STATES OF AMERICA, et al.,

Defendants. 

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No. CV 13-1224-TUC-CKJ

ORDER

Plaintiff Bobby Joe Mann (“Mann”) filed this pro se action1

 against the United States

of America (“USA” or “the government”), Gary L. Henderson (“Henderson”), Gary L.

Henderson, MD PC (“GLH PC”), and Northwestern Hospital (“NH”).2

 NH has filed a

Motion to Compel and Motion to Stay Action (Doc. 22) seeking an order by the Court

requiring Mann to obtain and serve a preliminary expert opinion affidavit pursuant to AR.S.

§ 12-2603 and staying the action until such time as Mann produces a preliminary expert

affidavit. Defendants Henderson, GLH PC, and USA have filed Joinders in this motion

(Docs. 23 and 28). No response to the motion has been filed. 

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Unless otherwise stated, the facts are taken from Mann’s First Amended Complaint

(“FAC”).

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I. Factual and Procedural Background3

Mann alleges he was transferred to the United States Penitentiary in Tucson, Arizona,

for follow-up medical care and the repair of a ventral hernia. Defendant USA contracted with

Henderson, NH , and GLH PC to provide medical evaluation, care, and surgical repair of the

ventral hernia. In May 2011, Henderson advised Mann that it was medically necessary to

correct the ventral hernia, that it could only be corrected surgically, that the surgery could

be performed safely in the operating room at NH, and that the procedure was minor and did

not have any inherent or attendant risks to Mann.

In December 2011, Mann underwent surgery to repair the ventral hernia and was

under the care of Henderson, GLH PC, NH, and other employees of NH. Henderson inserted

a subfacial mesh during the surgery and stated that he had repaired the ventral hernia. Mann

was discharged from NH four days later and was returned to the custody of the Bureau of

Prisons (“BOP”). Two days later, Mann “incurred a catastrophic failure at the site of the

abdominal surgery, including but not limited to a delamination and detachment of the

subfacial mesh, and the opening of the wound site.” FAC, Doc. 13, p. 7.

In Count One, Mann asserts the government, through its employees, was negligent and

guilty of malpractice because it failed to “ensure adequate precautions and adopt proper

hospital, surgical, after-care, and contract medical services” and failed to properly treat or

provide acceptable medical care after the catastrophic failure at the surgical site. 

In Count Two, Mann contends Henderson was negligent and guilty of malpractice

because he failed to exercise the care and precautions required to prevent Mann’s injuries,

lacked the required knowledge and surgical skill, failed to consult with others to acquire the

knowledge necessary to avoid Mann’s injuries, failed to adequately inform Plaintiff of the

dangers of the surgery, and “in general[,] acted with negligence, imprudence, and a lack of

expertise under the circumstances.” FAC, Doc. 13, p. 7.

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Erie R. Co. v. Tompkins, 304 U.S. 64, 58 S.Ct. 817, 82 L.Ed. 1188 (1938).

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In Count Three, Mann alleges NH was negligent and guilty of malpractice because

it failed to “ensure adequate precautions and adopt proper hospital, surgical and operating

procedures[.]” FAC, Doc. 13, p. 8.

In Count Four, Mann asserts GLH PC was negligent and guilty of malpractice because

it failed to “ensure adequate protections and adopt proper practices in the employment,

retention, qualification and operation of a medical corporation[.]” FAC, Doc. 13, p. 8.

Mann alleges that as a result of Defendants’ negligence, he is “left with serious and

permanent diastasis of the abdominal wall,” has severe damage to his abdominal area, and

his motor function has been critically impaired. Mann claims he has suffered permanent

disfigurement, has been totally impeded in the enjoyment of normal pursuits and activities,

and has suffered mental anguish.

Answers have been filed by Defendants. Docs. 19, 20, and 27.

NH filed a Motion to Compel and Motion to Stay Action (Doc. 22) seeking an order

by the Court requiring Mann to obtain and serve a preliminary expert opinion affidavit

pursuant to AR.S. § 12-2603 and staying the action until such time as Mann produces a

preliminary expert affidavit. Defendants Henderson, GLH PC, and USA have filed Joinders

to this motion. No response to the motion has been filed. 

II. Failure to File a Response 

Mann has not responded to the Motion to Compel. This failure alone may be deemed

consent to the granting of the motion. LRCiv. 7.2(i). 

III. Motion to Compel (Doc. 22)

As an initial matter, this Court must determine whether the Erie4

 doctrine and

subsequent United States Supreme Court precedent bar reliance on Arizona’s preliminary

expert affidavit statutes.

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A. Erie R. Co. v. Tompkins

In the landmark decision Erie R. Co. v. Tompkins, 304 U.S. 64, 58 S.Ct. 817, 82 L.Ed.

1188 (1938), the United States Supreme Court overturned the doctrine of Swift v. Tyson, 16

Pet. 1, 10 L.Ed. 865 (1942). The Erie court held that “[e]xcept in matters governed by the

Federal Constitution or by acts of Congress, the law to be applied in any case is the law of

the state.” Id. at 78, 58 S.Ct. at 822.

In Hanna v. Plummer, the Court addressed the Erie doctrine in consideration of

whether “service of process [is] to be made in the manner prescribed by state law of that set

forth in Rule 4(d)(1) of the Federal Rules of Civil Procedure” where federal jurisdiction of

a civil case is based on diversity of citizenship. Hanna v. Plumer, 380 U.S. 460, 461, 85

S.Ct. 1136, 1138, 14 L.Ed.2d 8 (1965). The Hanna court reiterated that where there is no

Federal Rule on point, Erie dictates the enforcement of state law. Id. at 470, 85 S.Ct. at

1143. Hanna focused on the “twin aims of the Erie rule: discouragement of forum-shopping

and avoidance of inequitable administration of the laws.” Id. at 468, 85 S.Ct. at 1142. Thus,

even though application of the Federal Rule would result in a different outcome than its state

law counterpart, when there is a Federal Rule on point, it must control. Id. at 473-74, 85

S.Ct. at 1145. Erie and its progeny specifically addressed the application of state law where

federal jurisdiction was based upon diversity of citizenship.

“The first question must [] be whether the scope of the Federal Rule in fact is

sufficiently broad to control the issue before the Court.” Walker v. Armco Steel Corp., 446

U.S. 740, 749-50, 100 S.Ct. 1978, 1985, 64 L.Ed.2d 639 (1980).

B. A.R.S. § 12-2603

The Arizona legislature declared the purpose of A.R.S. § 12-2603 “is to curtail the

filing of frivolous lawsuits against health care professionals and the filing of frivolous

nonparty at fault designations by health care professionals.” Laws 2004, Ch. 4 § 2. As such,

the legislature evinced support of a policy to curtail rising medical costs related to

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“From 1976 to 1989, Arizona medical malpractice claimants were obliged to submit their

claims to medical liability review panels before advancing beyond the complaint in the superior

court.” Hunter Contracting Co., Inc. v. Superior Court, 190 Ariz. 318, 323, 947 P.2d 892, 897 (Ct.

App. 1997) (citing A.R.S. § 12-567 (Supp. 1976-77) (repealed by Laws 1989, ch. 289, § 1). Prior

versions of the current statute mandated submission of a preliminary expert witness affidavit early

in the litigation. Consistently, the legislative intent has been to screen for non-meritorious claims

early in the litigation in an effort to reduce increasing medical costs.

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malpractice insurance and litigation.5

Section 12-2603 requires that a party asserting a claim against a health care

professional “shall certify in a written statement that is filed and served with the claim or the

designation of nonparty at fault whether or not expert opinion testimony is necessary to prove

the health care professional’s standard of care or liability for the claim.” A.R.S. § 12-

2603(A). In cases where a party certifies an expert is needed, the preliminary expert opinion

affidavit shall contain the following:

1. The expert’s qualifications to express an opinion on the health

care professional’s standard of care or liability for the claim.

2. The factual basis for each claim against a health care

professional.

3. The health care professional’s acts, errors or omissions that the

expert considers to be a violation of the applicable standard of care resulting

in liability.

4. The manner in which the health care professional’s acts, errors

or omissions caused or contributed to the damages or other relief sought by the

claimant.

A.R.S. § 12-2603(B). If the claimant certifies that expert witness testimony is not required,

the health care professional may move for a court order requiring service of a preliminary

expert opinion affidavit. A.R.S. § 12-2603(D). Section 12-2603(D) further provides that:

[i]n the motion, the claimant, the health care professional or the designated

nonparty at fault shall identify the following:

1. The claim for which it believes expert testimony is needed.

2. The prima facie elements of the claim.

3. The legal or factual basis for its contention that expert opinion

testimony is required to establish the standard of care or liability

for the claim.

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A.R.S.§ 12-2603(D). An “expert” is defined as “a person who is qualified by knowledge,

skill, experience, training or education to express an opinion regarding a licensed health care

professional’s standard of care or liability for the claim.” A.R.S. § 12-2603(H)(2).

“After considering the motion and any response, the court shall determine whether the

claimant . . . shall comply with this section.” A.R.S. § 12-2603(E). Moreover, “[t]he court

on its own motion or the motion of the health care professional . . ., shall dismiss the claim

against the health care professional . . . without prejudice if the claimant . . . fails to file and

serve a preliminary expert opinion affidavit after . . . the court has ordered the claimant . . .

to file and serve an affidavit.” A.R.S. § 12-2603(F).

C. Federal Rules of Civil Procedure

Fed.R.Civ.P. 11 provides:

By presenting to the court a pleading, written motion, or other paper – whether

by signing, filing, submitting, or later advocating it – an attorney or

unrepresented party certifies that to the best of the person’s knowledge,

information, and belief, formed after an inquiry reasonable under the

circumstances:

(1) it is not being presented for any improper purpose, such as to harass, cause

unnecessary delay, or needlessly increase the cost of litigation;

(2) the claims, defenses, and other legal contentions are warranted by existing

law or by a nonfrivolous argument for extending, modifying, or reversing

existing law or for establishing new law;

(3) the factual contentions have evidentiary support or, if specifically so

identified, will likely have evidentiary support after a reasonable opportunity

for further investigation or discovery; and

(4) the denials of factual contentions are warranted on the evidence or, if

specifically so identified, are reasonably based on belief or a lack of

information.

Fed.R.Civ.P. 11(b). This rule further allows for the court, either on its own initiative or on

motion for sanctions by a party, to impose sanctions sufficient to deter repetition of the

conduct. Fed.R.Civ.P. 11(c). “[T]he central purpose of Rule 11 is to deter baseless filings

in district court and thus, consistent with the Rules Enabling Act’s grant of authority,

streamline the administration and procedure of the federal courts.” Cooter & Gell v.

Hartmarx Corp., 496 U.S. 384, 393, 110 S.Ct. 2447, 2454, 110 L.Ed.2d 359 (1990) (citations

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The Federal Rules of Civil Procedure also provide a mechanism for sanctions due to

discovery violations. See Fed.R.Civ.P. 37. The Court does not consider the applicability of this

Rule in the instant case, because A.R.S. § 12-2603 mandates early disclosure of a preliminary expert

affidavit. Thus, although discovery sanctions are potentially available to litigants, they do not arise

until much later in the course of litigation.

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omitted).

Fed.R.Civ.P. 26 governs discovery in civil litigation. The primary purpose for the

discovery rules is to promote full disclosure of all facts to aid in fair, prompt and inexpensive

disposition of lawsuits. Woldum v. Roverud Const. Inc., 43 F.R.D. 420 (D. Iowa 1968).

Expert testimony must be disclosed pursuant to Rule 26(a)(2), Federal Rules of Civil

Procedure. Parties must only disclose the “identity of any [expert] witness it may use at trial

to present evidence.” Fed.R.Civ.P. 26(a)(2)(A). The time for such disclosure shall occur “at

the times and in the sequence that the court orders.” Fed.R.Civ.P. 26(a)(2)(C). Absent a

court order or stipulation, the disclosure must occur “(i) at least 90 days before the date set

for trial or for the case to be ready for trial; or (ii) if the evidence is intended solely to

contradict or rebut evidence on the same subject matter identified by another party under

Rule 26(a)(2)(B), within 30 days after the other party’s disclosure.” Id.

D. Analysis

Although the Federal Rules of Civil Procedure provide a mechanism for the disclosure

of testifying expert witnesses and sanctions for frivolous claims,6

 the Arizona rule mandates

for early disclosure of a preliminary expert, who need not testify at trial, evidencing support

for a plaintiff’s medical malpractice claims. The Arizona state legislature has evinced a clear

policy to curtail “frivolous medical malpractice lawsuits by imposing a stricter standard of

pleading and setting deadlines for the early involvement of plaintiff’s expert witness.”

Gorney v. Meaney, 214 Ariz. 226, 229, 150 P.3d 799, 802 (Ct. App. 2007). Moreover, “a

statute that would completely bar recovery in a suit if brought in a State court bears on a

State created right vitally and not merely formally or negligibly.” Guaranty Trust Co. of New

York v. York, 326 U.S. 99, 110, 65 S.Ct. 1464, 1470, 89 L.Ed. 2079 (1945).

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A “[m]edical malpractice action or “cause of action for medical malpractice” is

defined as “an action for injury or death against a licensed health care provider based upon

such provider's alleged negligence, misconduct, errors or omissions, or breach of contract in

the rendering of health care, medical services, nursing services or other health-related

services . . .” A.R.S. § 12-561(2).

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Here, if Mann brought this medical malpractice claims in state court and was unable

to provide a preliminary expert affidavit pursuant to A.R.S. § 12-2603, his medical

malpractice claims would be dismissed.7

 If this Court does not apply A.R.S. § 12-2603,

Defendants would automatically have to participate in the discovery process. This result,

based solely on Mann’s choice of forum as to the malpractice claims, is inequitable.

Allowing such a procedure “would promote the choice of United States rather than of state

courts in order to gain the advantage of different laws.” York, 326 U.S. at 111, 65 S.Ct. at

1471. The states have a “systemic interest[] in . . . being able to develop coherent policies

governing medical malpractice liability.” Bledsoe v. Crowley, 849 F.2d 639, 646 (D.C. Cir.

1988) (J. Williams, concurring). Accordingly, “a state that seeks to reduce medical costs by

reducing the burden of malpractice liability must be able to assure providers that the state’s

rule will actually apply to all (or virtually all) cases.” Id. Moreover, courts have determined

Arizona’s expert affidavit requirements also apply in federal court where plaintiffs have sued

the federal government, i.e., where plaintiff did not have a choice of forum. See e.g., Mann

v. United States, 2012 WL 273690 (D. Ariz. 2012), Wright v. United States, 2008 WL

820557 *5-7 (D. Ariz. 2008). Therefore, because the Federal Rules are not sufficiently broad

to cover the issue before this Court, and in furtherance of the twin aims of Erie, A.R.S. § 12-

2603 is applicable to this cause of action.

IV. Preliminary Expert Affidavit

It is well-established law in Arizona that “[t]he general rule in a medical malpractice

case is that it is incumbent on the plaintiff to establish negligence on the part of a physician

or surgeon by expert medical testimony.” Tessitore v. McGilvra, 105 Ariz. 91, 93, 459 P.2d

716, 718 (1969). “Whether a physician breaches a duty by falling below the accepted

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Section 12-2604(A) provides in its entirety:

In an action alleging medical malpractice, a person shall not give expert testimony

on the appropriate standard of practice or care unless the person is licensed as a

health professional in this state or another state and the person meets the following

criteria:

1. If the party against whom or on whose behalf the testimony is offered is or claims

to be a specialist, specializes at the time of the occurrence that is the basis for the

action in the same specialty or claimed specialty as the party against whom or on

whose behalf the testimony is offered. If the party against whom or on whose behalf

the testimony is offered is or claims to be a specialist who is board certified, the

expert witness shall be a specialist who is board certified in that specialty or claimed

specialty.

2. During the year immediately preceding the occurrence giving rise to the lawsuit,

devoted a majority of the person's professional time to either or both of the

following:

(a) The active clinical practice of the same health profession as the defendant

and, if the defendant is or claims to be a specialist, in the same specialty or claimed

specialty.

(b) The instruction of students in an accredited health professional school or

accredited residency or clinical research program in the same health profession as the

defendant and, if the defendant is or claims to be a specialist, in an accredited health

professional school or accredited residency or clinical research program in the same

specialty or claimed specialty.

3. If the defendant is a general practitioner, the witness has devoted a majority of the

witness's professional time in the year preceding the occurrence giving rise to the

lawsuit to either or both of the following:

(a) Active clinical practice as a general practitioner.

(b) Instruction of students in an accredited health professional school or

accredited residency or clinical research program in the same health profession as the

defendant.

A.R.S. § 12-2604(A).

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standard of care is ordinarily shown by expert medical testimony.” Barrett v. Harris, 207

Ariz. 374, 380, 86 P.3d 954, 960 (Ct. App. 2004) (citations omitted). Moreover, Mann “must

prove the causal connection between an act or omission and the ultimate injury through

expert medical testimony.” Id. at 378, 86 P.3d at 958. Arizona law additionally requires that

an expert testifying regarding the standard of care must specialize in the same specialty as

the Defendant. A.R.S.§ 12-2604(A)(1)8

; See Seisinger v. Siebel, 220 Ariz. 85, 203 P.3d 483

(Ariz. 2009).

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Whether Defendants Henderson, GLH PC, and NH breached the applicable standards

of care in their treatment of Mann requires expert witness testimony. As such, the Court will

grant the Motion to Compel and will direct Mann to file and serve a preliminary expert

affidavit pursuant to A.R.S. § 12-2603 as to Defendants Henderson, GLH PC, and NH on or

before October 31, 2014.

V. Motion to Compel as to Defendant USA

In joining in the Motion to Compel, the government asserts A.R.S. § 12-2603 also

applies to Mann’s Federal Tort Claims Act (“FTCA”) against the government because Mann

alleges the government, through its agents, acted negligently in Arizona. As summarized by

the government, numerous decisions in this district have determined Arizona’s statutory

requirements regarding expert affidavits apply to FTCA claims. See USA’s Joinder, Doc.

28, p. 2, citing Mann, Merz v. United States, CV-12-551-TUC-FRZ (D. Ariz. 2014); Wright;

Jones v. Sanan, 2012WL715633, *3-4 (D. Ariz. 2012); Amor v. Arizona, 2010 WL 960379

(D. Ariz. 2010); Irwin v. Maricopa County Board of Supervisors, 2008 WL 3287037 (D.

Ariz. 2008). Other jurisdictions have similarly found state expert review statutes to apply

in federal proceedings. See e.g. Hill v. United States, 751 F.Supp. 909, 910 (D.Colo.1990);

Miville v. Abington Mem'l Hosp., 377 F.Supp.2d 488, 493 (E.D.Pa.2005); Ellingson v.

Walgreen Co., 78 F.Supp.2d 965, 968 (D.Minn.1999).

The Court finds the Arizona’s statutory expert affidavit requirements are applicable

to the FTCA claim in this case. Accordingly, the Court will grant the Motion to Compel and

will direct Mann to file and serve a preliminary expert affidavit pursuant to A.R.S. § 12-2603

as to Defendant USA or before October 31, 2014.

VI. Motion to Stay (Doc. 22)

Defendants request all proceedings be stayed pending receipt of Mann’s preliminary

expert affidavit pursuant to A.R.S. § 13-2603. Because medical malpractice claims may be

dismissed without prejudice if a plaintiff fails to file and serve a preliminary expert opinion

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affidavit after . . . the court has ordered the claimant . . . to file and serve an affidavit[,]”

A.R.S. § 12-2603(F), further proceedings pending the filing of such an affidavit is not

appropriate. The Court will grant the Motion to Stay.

Accordingly, IT IS HEREBY ORDERED that:

1. The Motion to Compel (Doc. 22) is GRANTED.

2. Mann shall file and serve his preliminary expert affidavit pursuant to A.R.S.

§ 12-2603 on or before October 31, 2014.

3. This matter is STAYED pending the filing of a preliminary expert affidavit by

Mann.

4. Should Mann fail to timely file and serve his preliminary expert affidavit this

case may be dismissed without further notice to Mann.

DATED this 26th day of August, 2014.

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