Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca13-15-02019/USCOURTS-ca13-15-02019-0/pdf.json

Nature of Suit Code: 830
Nature of Suit: Patent
Cause of Action: 

---

United States Court of Appeals 

for the Federal Circuit ______________________ 

MEDGRAPH, INC.,

Plaintiff-Appellant

v.

MEDTRONIC, INC.,

Defendant-Appellee

______________________ 

2015-2019

______________________ 

Appeal from the United States District Court for the 

Western District of New York in No. 6:09-cv-06610-DGLMWP, Judge David G. Larimer.

______________________ 

Decided: December 13, 2016

______________________ 

DARIUSH KEYHANI, Meredith & Keyhani, PLLC, New 

York, NY, argued for plaintiff-appellant. 

WAYNE M. BARSKY, Gibson, Dunn & Crutcher LLP, 

Los Angeles, CA, argued for defendant-appellee. Also 

represented by KATHERINE QUINN DOMINGUEZ, New York, 

NY. 

______________________ 

Before LOURIE, PLAGER, and TARANTO, Circuit Judges.

Case: 15-2019 Document: 74-2 Page: 1 Filed: 12/13/2016
2 MEDGRAPH, INC. v. MEDTRONIC, INC. 

LOURIE, Circuit Judge. 

Medgraph, Inc. (“Medgraph”) appeals from the decision of the United States District Court for the Western 

District of New York, dismissing with prejudice Medgraph’s claims of infringement of U.S. Patent 5,974,124 

(“the ’124 patent”) and U.S. Patent 6,122,351 (“the ’351 

patent”) (collectively, the “asserted patents”) against 

Medtronic, Inc. (“Medtronic”). See Medgraph, Inc. v. 

Medtronic, Inc., 111 F. Supp. 3d 346, 348 (W.D.N.Y. 2015)

(“Decision”). For the reasons that follow, we affirm.

BACKGROUND

Medgraph owns by assignment the asserted patents, 

directed to a method for improving and facilitating diagnosis and treatment of patients, whereby data relating to 

“medically important variable[s],” for example, blood 

sugar levels of a diabetic patient, measured from a patient’s body, are uploaded onto a computer and transmitted to a central storage device, from which they can be 

accessed remotely by medical professionals treating the 

patient. See, e.g., ’124 patent col. 3 ll. 35–46. 

Claims 1–15 of the ’124 patent are method claims. 

Claim 1 is representative and reads as follows:

1. A method for improving and facilitating 

diagnosis and treatment of patients having 

medical conditions requiring long-term profiles 

of specific variables, said method including the 

steps of 

using at least one measuring device, periodically 

taking a measurement of at least one medically important variable that has been identified 

for a patient from a body of said patient; 

ensuring said patient is separated from said at 

least one measuring device after taking each 

said measurement; 

Case: 15-2019 Document: 74-2 Page: 2 Filed: 12/13/2016
MEDGRAPH, INC. v. MEDTRONIC, INC. 3

inputting said at least one medically important 

variable as raw data into a primary computer 

system after said step of ensuring said patient 

is separated and recording said raw data in a 

mass storage device integrated with said primary computer system; 

compiling said raw data as data for said patient 

using the primary computer system, said data 

representing a history of values for said at 

least one medically important variable for said 

patient; 

receiving a request for data of one of said patients from by [sic] a medical practitioner that 

is treating said one of said patients; and

outputting requested data for said one of said 

patients in the form of at least one of a chart 

and a graph to said medical practitioner; 

said step of inputting comprising one of 

transferring said raw data to a remote computer comprising an ordinary general purpose personal computer, then transferring 

said raw data to said primary computer; 

telephoning an automatic telephone interface 

and employing one of speech recognition and 

touch-tone recognition software to input said 

raw data into said primary computer; and 

telephoning a live receptionist, speaking the 

raw data to said live receptionist for entry into said primary computer.

Id. col. 7 ll. 13–50. 

The ’351 patent, which is a continuation-in-part of the 

’124 patent, sets forth a single, similar claim, with differences that are not relevant to this appeal. 

Case: 15-2019 Document: 74-2 Page: 3 Filed: 12/13/2016
4 MEDGRAPH, INC. v. MEDTRONIC, INC. 

Claim 16 of the ’124 patent is the corresponding system claim, and reads in relevant part: 

16. A system for improving and facilitating 

diagnosis and treatment of patients having 

medical conditions requiring long-term profiles 

of at least one predetermined medically important variable, comprising . . . 

means for inputting said at least one predetermined medically important variable as raw 

data into a primary computer comprising 

software and hardware enabling said primary 

computer system to operate as at least one of a 

web server, a dial-up host, a network server, 

and a telephone answering and data collection 

device whereby raw data can be communicated 

from a remote computer proximate a patient 

comprising an ordinary general purpose personal computer and from an ordinary telephone wherein data is transmitted as one of 

spoken data and touch-tone data; . . . 

means to transmit said requested data in the 

form of at least one of a chart and graph generated from said data from said primary computer to a remote computer proximate said 

practitioner whereby said primary computer is 

one of a web server, a dial-up host, and a network server and means to transmit said requested data by facsimile through a faxmodem integrated with said primary computer . . . . 

’124 patent col. 10 ll. 24–40, 53–60 (emphases added). 

Medtronic manufactures and markets a variety of integrated diabetes management solutions, including the 

CareLink® Therapy Management System for Diabetes, 

which integrates CareLink Personal Therapy ManageCase: 15-2019 Document: 74-2 Page: 4 Filed: 12/13/2016
MEDGRAPH, INC. v. MEDTRONIC, INC. 5

ment Software (“CareLink Personal”) for patients and 

CareLink Pro Diabetes Therapy Management Software 

(“CareLink Pro”) for healthcare professionals (collectively,

the “CareLink System”). The CareLink System allows 

patients to upload data relating to management of their 

diabetes, including blood glucose readings, to Medtronic’s 

central computer server, where the data are collected and 

stored in a database so that the patients can keep an 

online record of the information, and/or share the information remotely with a healthcare provider.

In December 2009, Medgraph sued Medtronic in the 

United States District Court for the Western District of 

New York, alleging infringement of all claims of the ’124 

patent. In October 2010, Medgraph filed an amended 

complaint to assert that Medtronic also infringed claim 1 

of the ’351 patent. This appeal arises in part from the fact 

that Medgraph’s suit coincided with a multi-year process 

of judicial reconsideration by this court sitting en banc 

and by the Supreme Court of the relevant governing law, 

in a series of five appellate decisions, which the parties 

refer to as “the Akamai cases.” 

A year after Medgraph’s complaint was filed, this 

court issued Akamai I, where we held that direct infringement of a method claim requires a single party to 

perform every step of the claimed method and that there

can only be joint infringement where the acts of another 

are attributable to the accused infringer through either 

an agency relationship or a contractual obligation. Akamai Techs., Inc. v. Limelight Networks, Inc., 629 F.3d 

1311, 1318–19 (Fed. Cir. 2010) (“Akamai I”). 

In August 2012, Medtronic filed a motion for summary judgment of noninfringement of all claims of the 

asserted patents, based on, inter alia, the grounds that: 

(1) the CareLink System does not infringe any of the 

method claims of the asserted patents because those 

claims require performance of certain steps by patients 

Case: 15-2019 Document: 74-2 Page: 5 Filed: 12/13/2016
6 MEDGRAPH, INC. v. MEDTRONIC, INC. 

and doctors in addition to those performed by Medtronic;

and (2) the CareLink System does not infringe claim 16 of 

the ’124 patent because that claim, if properly construed, 

requires a system that includes both telephonic and 

computer (e.g., Internet) communication. 

Two days after Medtronic filed its motion, this court 

issued Akamai II, an en banc decision, in which we overruled and vacated the panel decision in Akamai I. Akamai Techs., Inc. v. Limelight Networks, Inc., 692 F.3d 

1301, 1306 (Fed. Cir. 2012) (en banc) (per curiam) (“Akamai II”). In Akamai II, we left direct infringement standards in place without reconsidering them, but provided an 

independent inducement basis for divided infringement 

liability. Akamai II, 692 F.3d at 1317–18. As a result of 

that decision, Medtronic filed an amended motion for 

summary judgment, taking Akamai II into account. 

Medgraph submits on appeal that, “in response to Akamai 

II, [it] was compelled to forego its claim of direct infringement and rely, instead, upon a claim for indirect 

infringement under a theory of inducement.” Appellant’s

Br. 10. 

After the district court held a hearing on Medtronic’s 

summary judgment motion, the Supreme Court issued 

Akamai III, reversing Akamai II on the issue of induced 

infringement and remanding the case to this court for 

possible reconsideration of the standard of divided direct

infringement. Limelight Networks, Inc. v. Akamai Techs., 

Inc., 134 S. Ct. 2111, 2120 (2014) (“Akamai III”). The 

parties filed supplemental briefs to discuss the effect of 

Akamai III on Medtronic’s motion for summary judgment. 

The district court awaited a decision from this court

on remand from Akamai III before ruling on Medtronic’s

motion. On May 13, 2015, a divided panel of this court 

issued Akamai IV, where we again rejected direct infringement liability for Limelight—as had the initial 

panel in Akamai I—reasoning that Limelight did not 

Case: 15-2019 Document: 74-2 Page: 6 Filed: 12/13/2016
MEDGRAPH, INC. v. MEDTRONIC, INC. 7

“direct or control” its customers to perform the claimed 

steps, that its customers were not agents of or contractually obligated to Limelight, and that Limelight’s customers were not acting in a “joint enterprise” with Limelight 

whereby each member could be charged with the acts of 

the others. Akamai Techs., Inc v. Limelight Networks, 

Inc., 786 F.3d 899, 915 (Fed. Cir. 2015) (“Akamai IV”). 

On June 29, 2015, the district court in this case issued 

a decision granting summary judgment of no infringement, applying the law on direct infringement liability as 

it then stood. In its decision, the district court noted that 

the legal standard governing direct infringement after 

Akamai IV was the same as under Akamai II, which had 

caused Medgraph to withdraw its claim of direct infringement because “more than one person, i.e., the patient or doctor, neither of whom is an agent of or under 

contractual obligation to Medtronic, is required to perform 

all of the steps of the method claims . . . .” Decision, 111 

F. Supp. 3d at 356 (internal quotation marks omitted). 

Thus, the district court concluded that there was no 

infringement because there had not been any “showing 

that Medtronic itself directly infringed the method claims 

or that it acted as a ‘mastermind’ by controlling or directing anyone else’s direct infringement.” Id. (citing Akamai 

IV, 786 F.3d at 904). The district court then entered final 

judgment of noninfringement on July 2, 2015. 

Shortly after the district court’s entry of final judgment, this court issued Akamai V, an en banc decision

where we broadened the circumstances in which others’ 

acts may be attributed to an accused infringer in cases of 

divided infringement. Akamai Techs., Inc. v. Limelight 

Networks, Inc., 797 F.3d 1020, 1023 (Fed. Cir. 2015) (en 

banc) (per curiam) (“Akamai V”). We held that, in addition to an agency or contractual relationship, attribution

is proper “when an alleged infringer conditions participation in an activity or receipt of a benefit upon performance 

of a step or steps of a patented method and establishes 

Case: 15-2019 Document: 74-2 Page: 7 Filed: 12/13/2016
8 MEDGRAPH, INC. v. MEDTRONIC, INC. 

the manner or timing of that performance.” Id. Stated 

otherwise, an actor who is implicated in that way in all of 

the claimed steps it does not itself perform may be liable 

as a direct infringer.

Medgraph timely appealed to this court. We have jurisdiction pursuant to 28 U.S.C. § 1295(a)(1).

DISCUSSION

On appeal, Medgraph argues that: (1) given the 

change in controlling law, the district court’s decision 

should be vacated and remanded for proceedings in accordance with Akamai V; and (2) the district court’s 

finding of noninfringement of system claim 16 was in 

error because the court improperly construed the claim. 

We discuss each issue in turn. 

I.

We first consider whether the district court’s grant of 

summary judgment of noninfringement of the asserted

method claims should be vacated and remanded in light of 

Akamai V. We review the district court’s grant of summary judgment under the law of the regional circuit in 

which the court sits, here, the Second Circuit. Classen 

Immunotherapies, Inc. v. Elan Pharm., Inc., 786 F.3d 892, 

896 (Fed. Cir. 2015). The Second Circuit reviews a grant 

of summary judgment without deference, construing the 

evidence in the light most favorable to the nonmovant and 

drawing all reasonable inferences in that party’s favor. 

Kuebel v. Black & Decker Inc., 643 F.3d 352, 358 (2d Cir.

2011). Summary judgment may only be granted when no 

“reasonable jury could return a verdict for the nonmoving 

party.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 

(1986). 

Medgraph argues that the district court’s grant of 

summary judgment of noninfringement was based “solely” 

on Akamai IV, which limited attribution of liability for 

divided direct infringement to agency and contractual 

Case: 15-2019 Document: 74-2 Page: 8 Filed: 12/13/2016
MEDGRAPH, INC. v. MEDTRONIC, INC. 9

relationships. Appellant’s Br. 14. Medgraph asserts that, 

because Akamai V broadened the scope for attributing 

third party actions to an accused infringer, the district 

court did not conduct the relevant inquiries under Akamai 

V and the evidence of record would need to be developed. 

Thus, in effect, Medgraph argues that Medtronic conditions the patients’ and/or doctors’ participation in the 

CareLink System, or receipt of the benefit to the patients 

and doctors of remote access to patient information, upon 

their performance of the claimed method steps and establishes the manner or timing of that performance. 

Medtronic responds that, under any of the Akamai

cases, proof of direct infringement required Medgraph to 

show that some entity or group of entities performed all of 

the claimed steps, a burden that Medgraph never met. 

Medtronic maintains that Medgraph never produced

evidence of, inter alia, the steps that are performed by the 

patient and doctor. Thus, argues Medtronic, the outcome 

would remain unchanged if we were to remand this case, 

because the only relevant inquiry occasioned by the 

change in law from Akamai IV to V is the relationship

between the accused infringer (itself) and the third parties (patients and doctors) that would allow for attribution, and this inquiry is unnecessary in the absence of 

evidence of patients and doctors performing the claimed 

steps. 

We agree with Medtronic that a remand is unnecessary in this case. Ordinarily, when the governing legal 

standards change during an appeal, remand is an appropriate action. See, e.g., Mankes v. Vivid Seats Ltd., 822 

F.3d 1302, 1310 (Fed. Cir. 2016). However, in this case,

Medgraph has not pointed to any evidence that would 

permit attribution of patient- and doctor-performed steps 

to Medtronic under the sole standard of Akamai V invoked by Medgraph. See Appellant’s Br. 25–26. A finding 

of direct infringement requires that “all steps of the claim 

are performed by or attributable to a single entity.” 

Case: 15-2019 Document: 74-2 Page: 9 Filed: 12/13/2016
10 MEDGRAPH, INC. v. MEDTRONIC, INC. 

Akamai IV, 786 F.3d at 904. That rule was unaffected by 

Akamai V, which reiterated the rule while broadening the 

circumstances under which attribution may be proper. 

797 F.3d at 1023. Under the Akamai V standard invoked 

by Medgraph, the evidence would have to allow a finding 

that Medtronic “conditions participation in an activity or 

receipt of a benefit upon performance of a step or steps of 

a patented method and establishes the manner and 

timing of performance.” Id. Medgraph has not identified 

any basis on which it could meet that standard. 

The evidence presented to the district court indisputably shows that Medtronic does not condition the use of, 

or receipt of a benefit from, the CareLink System on the 

performance of all of Medgraph’s method steps. For 

example, Medtronic does not deny users the ability to use 

CareLink Personal and CareLink Pro without performance of the claim step of ensuring detachment of the 

measuring device from the patient after each measurement. Nor does it offer an incentive for such detachment. 

Indeed, the evidence indicates that Medtronic benefits 

when patients use its continuous glucose monitoring 

device, which does not involve ensuring detachment after 

each measurement. J.A. 1947–48. The evidence also 

shows that Medtronic freely permits using the CareLink 

System without performing synchronization, and it denies 

no benefit to such users for their choices to do so. J.A. 

1499, 1503. Patients can freely choose to bring their 

devices to their physician’s office and have their data 

extracted locally there. J.A. 820–21, 967–68. Patients 

also can print or email reports and bring them to their 

medical practitioner. J.A. 907, 923. 

This evidence defeats application of the Akamai V 

standard that Medgraph invokes. Discovery was extensive in this case, and Medgraph has identified no avenue 

of discovery it was denied, or even that it chose not to 

pursue, that is relevant to applying that standard. Nor 

has it identified to this court any evidence that is in the 

Case: 15-2019 Document: 74-2 Page: 10 Filed: 12/13/2016
MEDGRAPH, INC. v. MEDTRONIC, INC. 11

record, or that it has reason to think exists, that would 

alter the conclusion required by the evidence of record. In 

these circumstances, we have been furnished no basis for 

viewing a remand for further proceedings as anything but 

a pointless prolonging of litigation.

The district court also correctly concluded that Medtronic was not liable under a theory of indirect infringement, because indirect infringement is predicated on 

direct infringement. That rule was also unaffected by 

Akamai V, so the outcome would, again, not change if we 

were to vacate and remand. 

We thus affirm the district court’s grant of summary 

judgment of noninfringement of the method claims of the 

asserted patents.

II. 

We next consider whether the district court erred in 

granting summary judgment of noninfringement of system claim 16 of the ’124 patent. Evaluation of summary 

judgment of noninfringement is a two-part inquiry: first, a 

court construes the scope and meaning of the asserted 

patent claims, and then compares the construed claims to 

the accused product or process. Abbott Labs. v. Sandoz, 

Inc., 566 F.3d 1282, 1288 (Fed. Cir. 2009). We review a 

district court’s ultimate claim constructions de novo and 

any underlying factual determinations involving extrinsic 

evidence for clear error. Teva Pharm. U.S.A., Inc. v. 

Sandoz, Inc., 135 S. Ct. 831, 841–42 (2015). Here, because the district court relied only on the intrinsic record 

to construe claim 16, we review the district court’s construction de novo. See Shire Dev., LLC v. Watson Pharm., 

Inc., 787 F.3d 1359, 1364, 1368 (Fed. Cir. 2015) (citing 

Teva, 135 S. Ct. at 840–42). 

Infringement is a question of fact. Absolute Software, 

Inc. v. Stealth Signal, Inc., 659 F.3d 1121, 1129–30 (Fed.

Cir. 2011). As such, a grant of summary judgment of 

Case: 15-2019 Document: 74-2 Page: 11 Filed: 12/13/2016
12 MEDGRAPH, INC. v. MEDTRONIC, INC. 

noninfringement is proper when no reasonable factfinder 

could find that the accused product contains every claim 

limitation or its equivalent. PC Connector Sols., LLC v. 

SmartDisk Corp., 406 F.3d 1359, 1364 (Fed. Cir. 2005); 

see Warner-Jenkinson Co. v. Hilton Davis Chem. Co., 520 

U.S. 17, 29, 39 n.8 (1997).

Medgraph argues that the district court erred in construing the claim limitation “and” to mean “and” instead 

of “or.” Under the district court’s construction, claim 16 

requires both computer (e.g., Internet) and telephone 

capabilities for receiving and transmitting data. Medgraph maintains that the written description supports a 

disjunctive construction because it repeatedly states that 

the invention transmits data either through “a common 

network, over telephone lines, or over the Internet.” See, 

e.g., ’124 patent col. 2 ll. 32–33 (emphasis added).

Medtronic responds that the district court correctly 

held that “and” means “and” because claim terms are to 

be given their plain and ordinary meaning. Additionally,

Medtronic argues, the written description teaches that 

the invention possesses both computer and telephonic 

capabilities, but only uses one at a time. See, e.g., id. col. 

6 ll. 32–41 (describing the “high-tech” and “low-tech” 

“utilization[s]” of the invention).

We agree with Medtronic that the district court correctly construed the claim. Although we have construed 

“and” to mean “or” when the specification so requires, see, 

e.g., Ortho-McNeil Pharm., Inc. v. Mylan Labs., Inc., 520 

F.3d 1358, 1361 (Fed. Cir. 2008) (“In light of . . . the 

specification, . . . this court sustains the trial court’s 

ruling that . . . claim 1’s use of and means or.”), those 

cases are distinct from the present case. For example, in 

Ortho-McNeil, we held that “and” meant “or” because “as 

used in [the] claim, and conjoins mutually exclusive 

possibilities.” 520 F.3d at 1362. Such is not the case

here. Telephone and computer capabilities are not mutuCase: 15-2019 Document: 74-2 Page: 12 Filed: 12/13/2016
MEDGRAPH, INC. v. MEDTRONIC, INC. 13

ally exclusive; the patents themselves teach that the 

invention may contain both, to serve a diverse set of 

customers. See, e.g., ’124 patent col. 5 ll. 26–28. Indeed, 

all cases cited by Medgraph, most of them district court 

cases that are not binding on this court, have a common 

theme that distinguishes them from this case: the specification compels a disjunctive construction for “and.” See, 

e.g., Merck & Co. v. Teva Pharm. USA, Inc., 228 F. Supp. 

2d 480, 493–94 (D. Del. 2002) (noting that a conjunctive 

construction would render tables in the written description meaningless), aff’d, 347 F.3d 1367 (Fed. Cir. 2003). 

In this case, in contrast, the written description can

be interpreted to support either construction. For example, the patent describes the “high-tech” and “low-tech”

versions of the invention as both “utilization[s]” of the 

invention and as “two systems.” See ’124 patent col. 6 ll. 

32–41. Likewise, the remainder of the written description 

contains portions that support a construction of “and” 

while others support a construction of “or.” Compare, e.g.,

id. col. 5 ll. 32–40 (explaining that “it is only for illustration purposes that FIG. 1 shows only one . . . telephone 

interface” even though “the primary computer may 

have . . . any number of telephone interfaces”) and id. 

fig.1 (showing only one dashed arrow, which suggests that 

all other arrows, including the one leading to telephone 

30, are not optional), with, e.g., id. col. 6 ll. 12–14 

(“[C]onnection 60 can include a direct network connection, 

a modem-to-modem connection, or an Internet connection.” (emphasis added)). 

 Because the written description does not compel a 

disjunctive construction for “and,” the claim term should 

be given its plain and ordinary meaning. Phillips v. AWH 

Corp., 415 F.3d 1303, 1312 (Fed. Cir. 2005) (en banc). We 

therefore conclude that the district court correctly construed the limitation “and” to mean “and,” rather than 

“or.”

Case: 15-2019 Document: 74-2 Page: 13 Filed: 12/13/2016
14 MEDGRAPH, INC. v. MEDTRONIC, INC. 

It is undisputed that Medtronic’s CareLink System is 

not capable of transmitting patient data by telephone. 

Because claim 16, as properly construed, requires that the

means for receiving and transmitting data include both 

computer and telephonic capabilities, we conclude that 

the district court correctly granted summary judgment of 

noninfringement of claim 16 of the ’124 patent. 

CONCLUSION

We have considered Medgraph’s remaining arguments 

but find them to be unpersuasive. For the foregoing 

reasons, we affirm the judgment of the district court. 

AFFIRMED

Case: 15-2019 Document: 74-2 Page: 14 Filed: 12/13/2016