1 

 2022 IL App (5th) 210263 

 NO. 5-21-0263 

 IN THE

 APPELLATE COURT OF ILLINOIS

 FIFTH DISTRICT

______________________________________________________________________________ 

RICHARD ALLEN, as Personal Representative ) Appeal from the 

and Executor of the Estate of Barbara L. Sisson, ) Circuit Court of 

Deceased, ) Madison County. 

 ) 

Plaintiff-Appellee, ) 

 ) 

v. ) No. 20-L-1278 

 ) 

MISSOURI BAPTIST MEDICAL CENTER, ) Honorable 

 ) Sarah D. Smith, 

Defendant-Appellant. ) Judge, presiding. 

______________________________________________________________________________ 

JUSTICE MOORE delivered the judgment of the court, with opinion. 

Justice Welch concurred in the judgment and opinion. 

 Justice Cates specially concurred, with opinion. 

 OPINION

¶ 1 The defendant, Missouri Baptist Medical Center (Missouri Baptist), appeals, pursuant to 

Illinois Supreme Court Rule 306(a)(3) (eff. Oct. 1, 2020), the August 6, 2021, order of the circuit 

court of Madison County, which denied its motion to dismiss based on a lack of personal 

jurisdiction. For the following reasons, we reverse. 

¶ 2 I. BACKGROUND

¶ 3 On September 4, 2020, the plaintiff, Richard Allen, as personal representative and executor 

of the estate of Barbara L. Sisson, deceased, filed a complaint alleging medical negligence and 

wrongful death against numerous physicians, health care groups, and hospitals, including the 

NOTICE

Decision filed 10/21/22. The 

text of this decision may be 

changed or corrected prior to 

the filing of a Petition for 

Rehearing or the disposition of 

the same.
2 

appellant here, Missouri Baptist, in Madison County, Illinois.

1 On October 29, 2020, Missouri 

Baptist of St. Louis, Missouri, filed its motion to dismiss for lack of personal jurisdiction. On

August 6, 2021, the circuit court denied the motion to dismiss, finding “sufficient minimum 

contacts occurred with the State of Illinois that makes specific jurisdiction over this matter 

appropriate.” This timely appeal then followed. The facts necessary to our disposition of this 

matter are taken from the various filings of the parties and are as follows.

¶ 4 At all times relevant to this lawsuit, the decedent and her husband were residents of Illinois. 

The plaintiff alleges in his complaint the following general facts. Another defendant, Richard H. 

Wikiera, D.O. (Dr. Wikiera), an Illinois defendant with no association or affiliation with Missouri 

Baptist, performed on Barbara Sisson (Barbara) what is commonly referred to as gallbladder 

surgery on September 4, 2018, in Madison County, Illinois, at Anderson Hospital. The following 

morning, on September 5, Barbara developed a subsequent issue or complication which required 

additional care. Dr. Wikiera “contacted” Dr. Aliperti, “a physician who specializes in 

Gastroenterology and Internal Medicine, with privileges at the Missouri Baptist facility,” and 

arranged a transfer of Barbara for further care at Missouri Baptist. Barbara was then transferred to 

Missouri Baptist, where she underwent further surgery and care. Unfortunately, Barbara’s 

condition further declined, and she died on September 26, 2018. Barbara did not leave the Missouri 

Baptist facility from her September 5 transfer through her death on September 26. 

1

We note that on September 4, 2020, the plaintiff, along with his son, Donald Sisson, as the 

surviving son of Barbara Sisson, deceased, also filed a medical negligence action stemming from these 

events in the State of Missouri. In that action, only Dr. Aliperti, Midwest Therapeutic Endoscopy 

Consultants, and Missouri Baptist were named as defendants. That action was later dismissed so the plaintiff 

could pursue an action in the State of Illinois. Because neither the filing of that action nor its dismissal has 

any bearing on the outcome of this appeal, we decline to discuss it further and only reference the Illinois 

lawsuit relevant to this appeal.
3 

¶ 5 Relevant to the issue on appeal, the plaintiff alleged in his complaint that “[Missouri 

Baptist] purposely directs its activities to Illinois facilities and patients, and it agreed to a request 

by the Illinois defendants to accept [Barbara] as a patient.” He further alleged, “[a]t all times 

relevant, [Missouri Baptist], a corporation, was engaged in the business of providing medical care 

and accepting referrals of patients in Madison County, Illinois by and through its officers, agents, 

employees and representatives.”

¶ 6 Following the plaintiff’s filing of the complaint, Missouri Baptist, on October 29, 2020, 

entered a special and limited appearance for the limited and sole purpose of challenging the circuit 

court’s personal jurisdiction over it. At the same time, Missouri Baptist also filed its motion to 

dismiss for lack of personal jurisdiction. 

¶ 7 In its motion to dismiss, Missouri Baptist argued that the plaintiff failed to meet its burden 

of demonstrating that Missouri Baptist had sufficient contacts with Illinois to be subject to personal 

jurisdiction in an Illinois court. Missouri Baptist specifically stated that the plaintiff failed to allege 

that it provided care or treatment to the decedent within Illinois or that it committed a tortious act 

against the decedent within Illinois. Additionally, Missouri Baptist attached an affidavit from its 

manager for patient safety and risk management, Maggie Lange, which attested that (1) Missouri 

Baptist is a “nonprofit corporation registered with and licensed by the State of Missouri,” 

“maintains its principal place of business in St. Louis County, State of Missouri,” and “does not 

maintain any business in the State of Illinois,” (2) the decedent was treated at Missouri Baptist 

from September 5, 2018, to September 26, 2018, (3) the decedent’s treatment “was provided 

exclusively in the State of Missouri,” and (4) none of Missouri Baptist’s employees provided any 

health care services to the decedent in the State of Illinois. 
4 

¶ 8 Missouri Baptist’s motion to dismiss argued that the provisions of sections 2-209(a) and 

(b) of the Code of Civil Procedure (Code) (735 ILCS 5/2-209(a), (b) (West 2020)) are not present 

in this matter. Thus, Missouri Baptist argued that only the due process considerations set forth in 

section 2-209(c) of the Code (id. § 2-209(c)) and the determination of whether general or specific 

personal jurisdiction exists were before the circuit court. Missouri Baptist asserted that specific 

personal jurisdiction did not exist because the alleged negligent conduct of Missouri Baptist 

against Barbara did not arise from any conduct or actions taken by it within Illinois. It further 

argued that because it is not incorporated in Illinois, does not have its principal place of business 

in Illinois, and does not have a permanent or systematic relationship with Illinois such that it could 

be considered “at home” in Illinois, general jurisdiction also did not exist. 

¶ 9 The plaintiff, in his response, contended that the allegations within the complaint—alleging 

that Missouri Baptist knowingly accepted an Illinois resident as a patient from an Illinois 

physician, purposefully directed its activities towards Illinois facilities to accept their Illinois 

patients, and routinely accepted Illinois patients to its facility—were sufficient to confer specific 

personal jurisdiction. 

¶ 10 On August 6, 2021, the circuit court entered an order denying Missouri Baptist’s motion 

to dismiss. In its order, the circuit court found that Missouri Baptist was “a non-resident defendant, 

and therefore Illinois law requires that the defendant have certain minimum contacts with the State 

of Illinois in order for a court to have jurisdiction.” The court then noted that the plaintiff had 

alleged “various affirmative acts on behalf of [Missouri Baptist], many of which involve the 

transfer and referral of the patient” and that “[Barbara] would not have been a patient at [Missouri 

Baptist] but for defendant’s granting the request of an Illinois medical provider and [Missouri 

Baptist’s] affirmative acceptance of her transfer.” Finally, the circuit court held that “based on the 
5 

continued and routine transfer and acceptance of patients from Illinois by [Missouri Baptist] 

retention of personal jurisdiction over this case would not defy notions of fair play and justice”; 

therefore, the circuit court found that “sufficient minimum contacts occurred with the State of 

Illinois that makes specific jurisdiction over this matter appropriate.”

¶ 11 A timely petition for leave to appeal followed from Missouri Baptist, and on March 2, 

2022, this court granted leave to appeal under Rule 306(a)(3). 

¶ 12 II. ANALYSIS

¶ 13 The sole question presented before this court is whether Missouri Baptist had sufficient 

minimum contacts with the State of Illinois for an Illinois court to exercise personal jurisdiction 

over it. We begin our analysis with a brief discussion of the relevant Illinois law applicable to this 

matter as previously outlined by this court in Unterreiner v. Pernikoff, 2011 IL App (5th) 110006, 

¶ 5: 

“Before an Illinois court may exercise jurisdiction over a nonresident defendant, that court 

must ensure its exercise of jurisdiction ‘comports with “traditional notions of fair play and 

substantial justice.” ’ Culligan International Co. v. Wallace, Ross, & Sims, 273 Ill. App. 

3d 230, 231 (1995) (quoting International Shoe Co. v. Washington, 326 U.S. 310, 316

(1945)). To so ensure, the court must consider three criteria:

 ‘(1) whether the nonresident defendant had “minimum contacts” with the forum 

State such that it had “fair warning” that it may be required to defend there;

(2) whether the action arose out of or relates to the defendant’s contacts with the 

forum; and (3) whether it is reasonable to require the defendant to litigate in the 

forum State.’ Culligan, 273 Ill. App. 3d at 231 (citing Burger King Corp. v. 

Rudzewicz, 471 U.S. 462, 472-78 (1985)). 
6 

‘The determination as to what constitutes sufficient minimum contacts depends upon the 

facts of each case.’ Ballard v. Fred E. Rawlins, M.D., Inc., 101 Ill. App. 3d 601, 603 (1981). 

However, for sufficient minimum contacts to exist, ‘[t]he defendant must have voluntarily 

invoked the protections and benefits of the laws of the state’ in question. Muffo v. Forsyth, 

37 Ill. App. 3d 6, 9 (1976). A plaintiff may not ‘lure’ a nonresident defendant into a 

jurisdiction, and the mere ‘unilateral action of the plaintiff in seeking and obtaining the 

service of the defendant cannot serve to satisfy the jurisdictional requirement’ of minimum 

contacts. Muffo, 37 Ill. App. 3d at 9. When a defendant contests the existence of personal 

jurisdiction, the plaintiff bears the burden of proving its presence. Ballard, 101 Ill. App. 3d 

at 604. If the trial court has based its decision about personal jurisdiction solely on 

documentary evidence, as the court did here, our review of that decision is de novo. Kostal 

v. Pinkus Dermatopathology Laboratory, P.C., 357 Ill. App. 3d 381, 383 (2005).” 

¶ 14 The issue set before this court is a narrow one. At no time during this litigation has the 

plaintiff contended that the circuit court had general personal jurisdiction over Missouri Baptist in 

this matter. The plaintiff, in his response to Missouri Baptist’s motion to dismiss, only argued that 

specific personal jurisdiction existed. The circuit court, in its August 6, 2021, order, found 

“sufficient minimum contacts occurred with the State of Illinois that makes specific jurisdiction 

over this matter appropriate.” The circuit court’s order did not address whether general personal 

jurisdiction was present. On appeal, the plaintiff asserts that because “[t]he Circuit Court did not 

find that Illinois has general jurisdiction over Missouri Baptist” and his “response below focused 

on specific jurisdiction,” “there is no need for this Court’s involvement on [the general jurisdiction]

issue.” In light of the foregoing, we find that the issue of general personal jurisdiction is not 

properly before us and—as the issue has not been raised by the plaintiff at any stage of this 
7 

litigation, including this appeal—it is forfeited for purposes of this appeal. See Ill. S. Ct. R. 

341(h)(7) (eff. Oct. 1, 2020) (argument must contain the contentions of the appellant, the reasons 

therefor, and the citation of authorities; points not argued in an opening brief are forfeited). Thus, 

we turn our attention to whether the circuit court’s finding of specific jurisdiction over Missouri 

Baptist was proper. 

¶ 15 First, both parties agree that the Illinois long arm statute is applicable to determining 

jurisdiction in this matter, and specifically only subsection (c), which is commonly referred to as 

the “catch-all provision.” 735 ILCS 5/2-209(c) (West 2020). The “ ‘catch-all provision,’ broadly 

provides that a court ‘may also exercise jurisdiction on any other basis now or hereafter permitted 

by the Illinois Constitution and the Constitution of the United States.’ ” Russell v. SNFA, 2013 IL 

113909, ¶ 30 (quoting 735 ILCS 5/2-209(c) (West 2002)). “Thus, when, as here, a plaintiff argues 

that personal jurisdiction is proper under subsection (c) of the Illinois long-arm statute, the sole 

issue before the court is whether the nonresident defendant’s connection or contact with Illinois is 

sufficient to satisfy federal and Illinois due process.” Id. Accordingly, “ ‘[s]pecific jurisdiction 

requires a showing that the defendant purposefully directed its activities at the forum state and the 

cause of action arose out of or relates to the defendant’s contacts with the forum state.’ ” Linder v. 

A.W. Chesterton Co., 2020 IL App (5th) 200101, ¶ 11 (quoting Russell, 2013 IL 113909, ¶ 40, and 

citing Burger King Corp. v. Rudzewicz, 471 U.S. 462, 472 (1985)).

¶ 16 “It is settled that the plaintiff has the burden to establish a prima facie basis to exercise 

personal jurisdiction over a nonresident defendant.” Russell, 2013 IL 113909, ¶ 28. In the case at 

bar, the plaintiff’s basis for the existence of specific jurisdiction is that Missouri Baptist “purposely 

directed its activity” towards Illinois when “it agreed to a request by the Illinois defendants to 

accept [Barbara] as a patient” and through its “accepting referrals of patients in Madison County, 
8 

Illinois.” The plaintiff did not allege any other contacts with Illinois outside of its acceptance of 

Illinois residentsto its facility. There are no allegations that Missouri Baptist advertised or solicited 

Illinois residents, that it had any agreements with Illinois health care providers or facilities for 

transfers of patients, or that it facilitated the transfer of the patient from Illinois to Missouri. All 

the parties agree that Missouri Baptist did not provide any medical care to Barbara while she was 

in Illinois; instead, all of the medical treatment she was provided by Missouri Baptist occurred in 

Missouri following her transfer. Following Missouri Baptist’s challenging of personal jurisdiction, 

the plaintiff did not offer any supplemental evidence to support his claims or highlight any 

additional contacts with Illinois. No affidavits or other evidence relating to the issue of specific 

jurisdiction was set forth. Further, the plaintiff failed to request an opportunity to conduct limited 

discovery on the jurisdictional issue and no discovery on the issue was completed by the parties.

The plaintiff instead chose to stand on the allegations contained in his complaint, both at the circuit 

court level and here on appeal, contending that they are sufficient to establish specific personal 

jurisdiction over Missouri Baptist. Thus, while there may be other contacts that Missouri Baptist 

has with Illinois, we must consider only that which the plaintiff has alleged in his pleadings. Based 

upon the case law as articulated below, we find that the allegation that Missouri Baptist accepted 

an Illinois patient and that it “routinely” accepts patients from Madison County is not sufficient 

for the plaintiff to meet his prima facie case supporting specific personal jurisdiction. 

¶ 17 The United States Supreme Court in Burger King Corp., 471 U.S. 462, noted that “a 

potential nonresident defendant should be able to ‘reasonably anticipate’ being drawn into 

litigation in the foreign forum.” Russell, 2013 IL 113909, ¶ 42. In Burger King Corp., the Court 

went on to explain: 
9 

“ ‘The unilateral activity of those who claim some relationship with a nonresident 

defendant cannot satisfy the requirement of contact with the forum State. The application 

of that rule will vary with the quality and nature of the defendant’s activity, but it is 

essential in each case that there be some act by which the defendant purposefully avails 

itself of the privilege of conducting activities within the forum State, thus invoking the 

benefits and protections of its laws.’ ” Burger King Corp., 471 U.S. at 474-75 (quoting 

Hanson v. Denckla, 357 U.S. 235, 253 (1958)). 

“The Court further explained that requiring a showing of ‘purposeful availment’ within the forum 

state protects a nonresident defendant from being haled into a jurisdiction based on random or 

attenuated contacts or the unilateral activity of a third party.” Russell, 2013 IL 113909, ¶ 42 (citing 

Burger King Corp., 471 U.S. at 475). Specific jurisdiction can be exercised with due process only 

where the defendant’s activities in the state “ ‘give rise to the liabilities sued on.’ ” Daimler AG v. 

Bauman, 571 U.S. 117, 138 (2014) (quoting International Shoe Co. v. Washington, 326 U.S. 310, 

317 (1945)). 

¶ 18 We are therefore tasked with deciding whether Missouri Baptist’s “routine” acceptance of 

patients from Illinois, and its subsequent acceptance of the transfer of Barbara, was sufficient to 

create minimum contacts with Illinois to give rise to specific jurisdiction. There are numerous 

cases within Illinois that have addressed jurisdictional issues as it relates to Illinois residents and 

out-of-state health care providers. Unfortunately, none of these cases is specifically on point with 

the facts set before us; however, we do find them to be instructive when taken together for the 

purposes of this decision. 

“In Muffo v. Forsyth, 37 Ill. App. 3d 6, 9 (1976), this court held that when an Illinois 

resident seeks out treatment from a nonresident provider, the mere fact that the nonresident 
10 

provider is aware that the Illinois resident ‘would likely fill’ the provider’s prescription in 

Illinois is not sufficient to invest personal jurisdiction over the nonresident. That is because 

the Illinois resident ‘was the motivating force for the relationship’ and, having sought 

treatment in Missouri, could reasonably be required ‘to return to Missouri to prosecute any 

actions arising out of that treatment.’ Muffo, 37 Ill. App. 3d at 10. Thus, for sufficient 

minimum contacts to exist, ‘[t]he defendant must have voluntarily invoked the protections 

and benefits of the laws of the state’ in question. Muffo, 37 Ill. App. 3d at 9. A plaintiff 

may not ‘lure’ a nonresident defendant into a jurisdiction, and the mere ‘unilateral action 

of the plaintiff in seeking and obtaining the service of the defendant cannot serve to satisfy 

the jurisdictional requirement’ of minimum contacts. Muffo, 37 Ill. App. 3d at 9. 

Likewise, in Ballard v. Fred E. Rawlins, M.D., Inc., 101 Ill. App. 3d 601, 605

(1981), we held that even when a nonresident provider calls prescriptions in to an Illinois 

pharmacy, the mere fact that the nonresident provider asked the Illinois resident for the 

name of a pharmacy close to where the Illinois resident lived, ‘such [pharmacy] being in 

Illinois, is an insufficient basis for subjecting the [nonresident provider] to the jurisdiction 

of Illinois.’ Building upon our reasoning in Muffo and Ballard, the appellate court held in 

Veeninga v. Alt, 111 Ill. App. 3d 775, 779 (1982), that the ‘unilateral activity’ of an Illinois 

resident ‘in seeking and obtaining medical services outside of Illinois’ led to the alleged 

damages to that resident and that, accordingly, the nonresident provider ‘was not amenable 

to the jurisdiction of Illinois courts.’ That was true in Veeninga even though the Illinois 

resident’s prescriptions had been filled in Illinois, he had injected himself with the 

prescribed drugs in Illinois, and the allegation in his complaint was that the prescription 
11 

drugs were unnecessary and had been negligently prescribed to him. 111 Ill. App. 3d at 

776.” Unterreiner, 2011 IL App (5th) 110006, ¶¶ 7-8. 

¶ 19 The plaintiff argues that many of the cases, such as those discussed above, cannot be relied 

upon because they were decided prior to the amendment of section 2-209 that extended the longarm jurisdiction to the full extent allowed by due process of law. However, numerous cases 

following those decisions have also relied upon the analysis of those cases and reiterate the analysis 

derived from those decisions. Thus, while not necessarily binding upon this court, they remain 

instructive and the logic behind their analysis remains intact.

¶ 20 In Unterreiner, 2011 IL App (5th) 110006, the plaintiff, an Illinois resident, traveled to 

Missouri for her medical appointments with the defendant health care providers. After some initial

blood work, the Missouri health care provider phoned the plaintiff at her home in Illinois, 

instructed her to take some medication, and asked her to return to their Missouri offices for followup. Id. ¶ 3. This court found personal jurisdiction could not rest on a phone conversation. Id. ¶ 9. 

The defendants operated their medical offices exclusively in Missouri, were licensed only in 

Missouri, never advertised for clients in Illinois, and never owned or leased any real or personal 

property in Illinois. Id. The plaintiff unilaterally sought out the defendants and traveled to Missouri 

to receive treatment from them. Id. Thus, we found that the fact that the defendants provided advice 

to her over a phone call while she was in Illinois could not equate to the defendants having 

“voluntarily invoked the protections and benefits of the laws of the State” of Illinois. (Internal 

quotation marks omitted.) Id.

¶ 21 Also, in Sabados v. Planned Parenthood of Greater Indiana, 378 Ill. App. 3d 243, 245

(2007), an Illinois patient brought a medical negligence action against Planned Parenthood of 

Greater Indiana (PPI), which prescribed birth control pills for her, alleging injuries from a blood 
12 

clot sustained after she returned to Illinois. PPI was located in Indiana and did not maintain an 

office in Illinois. Id. at 251. It also conducted treatment and business exclusively in Indiana. Id.

The appellate court found that minimum contacts were lacking to have jurisdiction over PPI in

Illinois because the only contacts with Illinois were telephone book advertisements, which the 

court found amounted “to mere solicitation.” Id.

¶ 22 The list of cases above is by no means exhaustive, but taken together, they outline that 

where a patient initiates contact with an out-of-state facility, which does not have offices or 

conduct services within Illinois, personal jurisdiction generally will not exist without further 

contacts or activities by the out-of-state defendant with Illinois. See also Green v. United States, 

No. 14-CV-119-NJR-DGW, 2016 WL 6248281 (S.D. Ill. Oct. 26, 2016) (no jurisdiction over 

Missouri health care providers who had telephone contact with a correctional facility regarding 

plaintiff inmate’s office note); Clemens v. Greenberg, 2022 IL App (1st) 201129 (brief phone call 

between Wisconsin doctor who had treated patient for infection in Wisconsin and emergency room

(ER) physician in Illinois, in which physician informed the doctor of patient’s deep vein 

thrombosis and how he would treat patient, did not create minimum contacts with Illinois sufficient 

to satisfy due process and subject doctor and hospital to specific personal jurisdiction under 

Illinois’s long-arm statute, in patient’s medical malpractice action; where call was initiated by 

patient’s mother and ER physician, doctor’s participation was extremely limited, and doctor did 

not provide any input into treatment plan).

¶ 23 The plaintiff and the circuit court distinguished the cases cited above with the present case 

by arguing/finding that Barbara did not “unilaterally” select the out-of-state health care provider. 

It is the plaintiff’s and the circuit court’s contention that Missouri Baptist’s acceptance of the 

transfer of an out-of-state patient destroyed the unilateral nature of the contact between the parties, 
13 

rendering the analysis of these cases inapplicable. Plaintiff argues that Barbara “did not travel to 

Missouri; she was transferred there, after Missouri Baptist chose to accept the transfer. She did not 

show up on its doorstep.” We disagree. This court fails to find a significant difference between a 

patient “traveling” on her own and the “transfer” of a patient orchestrated by her health care 

provider. In both cases, the out-of-state health care provider has not reached into Illinois, but the 

patient, whether by her own travel or a phone call from her physician acting on her behalf, has 

reached out into the out-of-state forum for treatment. There is no allegation that Missouri Baptist 

initiated the contact between the parties; in fact, it is clear from the plaintiff’s pleadings that 

Barbara, through her physician, initiated the contact. Further, Missouri Baptist did not come to 

Illinois to treat Barbara. They required that she come to Missouri to be treated. The mere 

acceptance of the transfer of an out-of-state patient, alone, does not give rise to specific jurisdiction 

over the health care provider in the home state of that patient. It is a leap to find that a patient 

showing up on the doorstep of a hospital, on her own accord, and the hospital accepting her as a 

patient constitutes “unilateral” activity, but that a patient’s physician calling a hospital and getting 

the acceptance prior to the travel to the facility does not. In both cases, the out-of-state patient is 

initiating the contact and, in both cases, the out-of-state defendant is accepting the defendant for 

treatment at its location out of state. It is important that we reiterate that we are only considering 

the allegations as contained within the plaintiff’s complaint in this matter; thus, we are only 

considering whether the acceptance of the transfer of a patient alone, as alleged in this case, is 

sufficient. We are not holding that the acceptance of a patient cannot be considered alongside other 

contacts that could then be sufficient to give grounds for specific jurisdiction. 

¶ 24 Additionally, we must keep in mind that not only must there be contact with Illinois, but 

specific jurisdiction can be exercised with due process only where the defendant’s activities in the 
14 

state “ ‘give rise to the liabilities sued on.’ ” Daimler AG, 571 U.S. at 138 (quoting International 

Shoe Co., 326 U.S. at 317). Here, that would mean we would need to find that Missouri Baptist’s 

act of accepting the transfer of Barbara “gave rise” to her injuries. The plaintiff attempts to put 

forth a “but-for” theory of causation, arguing that but for Missouri Baptist’s acceptance and her 

subsequent transfer to their facility, the harm would have never occurred. However, we find this 

is insufficient to give Illinois specific jurisdiction over Missouri Baptist. 

¶ 25 “Although the United States Supreme Court has not clarified what is meant by ‘arising out 

of’ or ‘related to’ in the context of a jurisdiction question [citation], several courts have determined 

that the applicable standard is lenient or flexible.” Russell, 2013 IL 113909, ¶ 83 (citing Myers v. 

Casino Queen, Inc., 689 F.3d 904, 913 (8th Cir. 2012)). Despite this lenient standard, we decline 

to go so far as to say that the acceptance of a patient by a hospital caused or led to the death of a 

patient. Generally, broad “but-for” arguments are insufficient. “Because ‘ “but for” events can be 

very remote, *** due process demands something like a “proximate cause” nexus.’ ” Harlow v. 

Children’s Hospital, 432 F.3d 50, 61 (1st Cir. 2005) (quoting Cambridge Literary Properties, Ltd. 

v. W. Goebel Porzellanfabrik, 295 F.3d 59, 65 (1st Cir. 2002)). “A ‘but for’ requirement *** has 

in itself no limiting principle; it literally embraces every event that hindsight can logically identify 

in the causative chain.” Nowak v. Tak How Investments, Ltd., 94 F.3d 708, 715 (1st Cir. 1996). 

Therefore, “although proximate causation is not a per se requirement of specific jurisdiction, its 

presence or absence is still important.” Harlow, 432 F.3d at 61. 

¶ 26 Here, the location of the alleged tortious conduct, medical malpractice, occurred in

Missouri, not Illinois. There are no allegations that an issue occurred in the transfer or that the 

acceptance resulted in delayed treatment. The plaintiff has put forth no evidence that Missouri 

Baptist purposefully induced Barbara to leave Illinois to come to Missouri or that Missouri Baptist 
15 

induced Barbara’s Illinois physician to refer her to Missouri Baptist. Therefore, the subsequent 

alleged medical negligence of a health care provider, without more, does not “arise out of” the 

acceptance of the transfer of patient. 

¶ 27 Furthermore, the plaintiff, and the circuit court decision, imply that Missouri Baptist’s 

alleged “routine” acceptance of patients from Madison County, Illinois, is a basis for specific 

jurisdiction. This is not entirely correct. 

“In order for a court to exercise specific jurisdiction over a claim, there must be an 

‘affiliation between the forum and the underlying controversy, principally, [an] activity or 

an occurrence that takes place in the forum State.’ [Citation.] When there is no such 

connection, specific jurisdiction is lacking regardless of the extent of a defendant’s 

unconnected activities in the State.” Bristol-Myers Squibb Co. v. Superior Court of 

California, 582 U.S. ___, ___, 137 S. Ct. 1773, 1781 (2017) (quoting Goodyear Dunlop 

Tires Operations, S.A. v. Brown, 564 U.S. 915, 919 (2011)). 

Here, it appears that the plaintiff and the circuit court conflate to an extent the often-blurry line 

between specific and general jurisdiction. As discussed above, the acceptance of a patient alone is 

not grounds for specific jurisdiction. However, the number of patients a health care facility sees 

could be evidence of business activity within a state, such that a plaintiff could argue that the state 

is “at home” for purposes of general jurisdiction, especially when paired with other activities such 

as marketing, sales, advertising, etc. However, in our examination of specific jurisdiction, the 

acceptance of other individuals unrelated to the lawsuit is not relevant unless it demonstrates 

activity that would be directed at Illinois residents or the injured party or that the defendant is 

availing itself of Illinois laws or protections. This delineation is also evidenced in some of the 

aforementioned cases. Here, the plaintiff put forth only the allegations contained in the complaint, 
16 

and there was no evidence presented that Missouri Baptist directed advertising, outreach efforts, 

or anything of this nature into Illinois to seek out or acquire Illinois residents as patients. Like the 

cases cited above, the relationship between Missouri Baptist and Barbara began with an unsolicited 

and unilateral phone call from Barbara’s Illinois physician to Missouri Baptist. While it is true that 

Missouri Baptist accepted an Illinois resident as a patient, it did so at its Missouri facility. This is 

simply not a case of Missouri Baptist doing anything that might be construed as availing itself of 

the benefits or protections of Illinois laws.

¶ 28 Furthermore, we briefly turn to the case Kostal v. Pinkus Dermatopathology Laboratory, 

P.C., 357 Ill. App. 3d 381 (2005), which provides an example of when a defendant has availed 

itself of Illinois laws sufficient to support personal jurisdiction. In Kostal, the out-of-state

defendant was a national diagnostic lab company based in Michigan, whose physicians provided 

diagnostic services in Michigan through the mail to Illinois patients. The Kostal court noted that

the services “[were fundamentally interstate in nature from the inception of the relationship.” 

(Internal quotation marks omitted.) Id. at 397. The court also noted that special jurisdictional rules 

exist with respect to physicians “to ensure that jurisdiction is asserted only when that physician 

has purposefully availed himself of the privileges of conducting activities in the patient’s state.” 

Id. at 390. Generally, “the tortious rendition of medical services outside the forum state is not a 

portable tort that would subject an out-of-state doctor to jurisdiction in the forum.” Id. at 392 (citing 

Wright v. Yackley, 459 F.2d 287 (9th Cir. 1972)). Thus, because the plaintiff did not travel out of 

the State of Illinois to receive medical care and because defendants purposefully directed activities 

to Illinois through their mail-based diagnostic services, the exercise of personal jurisdiction over 

the defendants comported with due process requirements. Id. at 397-98. 
17 

¶ 29 The present matter stands in stark contrast to Kostal. Here, Barbara physically traveled to 

Missouri for medical treatment. No treatment was rendered by Missouri Baptist in Illinois. There 

are no allegations that Missouri Baptist solicited, advertised to, or targeted the plaintiff or any other 

Illinois resident. There are no allegations that Missouri Baptist had any ongoing relationship with 

the Illinois physician who referred Barbara to them. The only contact with Illinois is Missouri 

Baptist’s acceptance of the transfer of an Illinois resident to its facility. Ultimately, the mere fact 

that the reputation and expertise of an institution lead to referrals from out of state cannot be 

enough to establish specific jurisdiction. 

¶ 30 We acknowledge that with the advancement in technology, especially the ability to video 

conference, the way health care is delivered to patients is rapidly changing. Physician-patient 

interactions and medical treatment no longer always require in-person meetings like it previously 

did. Further, health care providers are consolidating and becoming larger and more regional in 

nature. As a result, we must reiterate that each case where the issue of personal jurisdiction arises, 

especially in the context of medical services, must be decided upon its own facts. 

¶ 31 Therefore, here, where we must consider only the allegations contained in the plaintiff’s 

complaint as alleged and where the plaintiff bears the burden of showing a prima facie case of 

specific personal jurisdiction, we find that the plaintiff has failed to meet his burden because

Missouri Baptist’s acceptance of an Illinois resident, alone, does not create sufficient minimum 

contacts with Illinois to create personal jurisdiction in Illinois courts.

¶ 32 III. CONCLUSION

¶ 33 For the foregoing reasons, we reverse the circuit court’s August 6, 2021, order denying the 

defendant’s motion to dismiss. 

¶ 34 Reversed. 
18 

¶ 35 JUSTICE CATES, specially concurring: 

¶ 36 I agree with the majority’s determination that the trial court erred when it denied Missouri 

Baptist’s motion to dismiss for lack of specific personal jurisdiction. I write separately because I 

do not agree fully with the majority’s jurisdictional analysis and discussion of case law. The only 

issue on appeal is whether the trial court erred in finding that it had specific personal jurisdiction 

over Missouri Baptist in this case. After reviewing the record, sparse as it is, I find that the plaintiff 

did not meet his burden to establish a prima facie basis for specific personal jurisdiction over 

Missouri Baptist under the particular facts presented herein. Accordingly, the trial court’s finding 

of specific jurisdiction cannot be sustained. 

¶ 37 In this case, the plaintiff’s decedent was transferred from a hospital in Madison County, 

Illinois, to Missouri Baptist in St. Louis, Missouri, where she later died. The plaintiff brought a 

medical negligence action against Missouri Baptist and several other defendants in the circuit court 

of Madison County. Missouri Baptist moved to dismiss the claims against it, arguing the Illinois 

circuit court did not have general or specific jurisdiction over it. The plaintiff filed a response in 

opposition to Missouri Baptist’s motion. Therein, the plaintiff addressed only specific 

jurisdiction.2 The trial court found there were “sufficient minimum contacts” with the State of 

Illinois to “make specific jurisdiction over this matter appropriate” and denied Missouri Baptist’s 

motion to dismiss on that basis.3 Missouri Baptist appealed. 

¶ 38 Under federal due process standards, a court may exercise specific jurisdiction over a 

nonresident defendant who has not consented to suit if the defendant has “purposefully directed” 

2

In the appellee’s brief, the plaintiff readily acknowledged that his arguments in the trial court 

focused solely on specific jurisdiction, and as such, there was “no need for this Court’s involvement” on 

the issue of general jurisdiction. 

3

Missouri Baptist also argued that it was not subject to general personal jurisdiction in Illinois, but 

the trial court did not reach that issue. Accordingly, that issue is reserved for another day. 
19 

his activities at residents of the forum and the litigation results from alleged injuries that “arise out 

of or relate to” those activities. (Internal quotation marks omitted.) Burger King Corp. v. 

Rudzewicz, 471 U.S. 462, 472 (1985). In Burger King Corp., the United States Supreme Court 

explained the rationale underlying this principle of due process: 

“A State generally has a ‘manifest interest’ in providing its residents with a convenient 

forum for redressing injuries inflicted by out-of-state actors. [Citations.] Moreover, where 

individuals ‘purposefully derive benefit’ from their interstate activities [citation], it may 

well be unfair to allow them to escape having to account in other States for consequences 

that arise proximately from such activities; the Due Process Clause may not readily be 

wielded as a territorial shield to avoid interstate obligations that have been voluntarily 

assumed. And because ‘modern transportation and communications have made it much 

less burdensome for a party sued to defend himself in a State where he engages in economic 

activity,’ it usually will not be unfair to subject him to the burdens of litigating in another 

forum for disputes relating to such activity. [Citation.]” Burger King Corp., 471 U.S. at 

473-74. 

¶ 39 The Supreme Court noted that, notwithstanding the aforementioned considerations, the 

“constitutional touchstone” is whether the defendant purposefully established “ ‘minimum 

contacts’ ” with the forum state. Burger King Corp., 471 U.S. at 474 (quoting International Shoe 

Co. v. Washington, 326 U.S. 310, 316 (1945)). While the application of the rule will vary with the 

quality and nature of the defendant’s activities, it is essential that “ ‘there be some act by which 

the defendant purposefully avails itself of the privilege of conducting activities within the forum 

State, thus invoking the benefits and protections of its laws.’ ” Burger King Corp., 471 U.S. at 475 

(quoting Hanson v. Denckla, 357 U.S. 235, 253 (1958)). This “purposeful availment” requirement 
20 

protects a nonresident defendant from being brought into a jurisdiction based on random or 

attenuated contacts or the unilateral activity of another person. Burger King Corp., 471 U.S. at 

475. Where, however, a nonresident defendant has “deliberately *** engaged in significant 

activities” within a forum or “created continuing obligations” between himself and residents of the 

forum, he has availed himself of the privileges of conducting business in that forum and of the 

benefits and protections of the forum’s laws. Under such circumstances, it is “presumptively not 

unreasonable to require him to submit to the burdens of litigation in that forum as well.” (Internal 

quotation marks omitted.) Burger King Corp., 471 U.S. at 475-76. Jurisdiction may not be avoided 

simply because the defendant did not physically enter the forum. Burger King Corp., 471 U.S. at 

476. 

¶ 40 In keeping with these principles, an Illinois court may exercise specific personal 

jurisdiction over a nonresident defendant if the defendant has purposefully directed its activities at 

the forum and the action arises out of or relates to those activities. Russell v. SNFA, 2013 IL 

113909, ¶ 40 (citing Burger King Corp., 471 U.S. at 472). Specific personal jurisdiction is case 

specific. Aspen American Insurance Co. v. Interstate Warehousing, Inc., 2017 IL 121281, ¶ 14. 

The plaintiff has the burden to establish a prima facie basis upon which an Illinois court may 

exercise personal jurisdiction over a nonresident defendant. Russell, 2013 IL 113909, ¶ 28. 

¶ 41 Here, the plaintiff alleged that Missouri Baptist “purposely direct[ed] its activities to 

Illinois facilities and patients, and it agreed to a request by the Illinois defendants to accept 

[plaintiff’s decedent] as a patient.” The plaintiff further alleged that Missouri Baptist “was engaged 

in the business of providing medical care and accepting referrals of patients in Madison County, 

Illinois, by and through its officers, agents, employees and representatives.” When presented with 

Missouri Baptist’s challenge to personal jurisdiction, the plaintiff did not offer supporting 
21 

affidavits or other evidence to establish specific jurisdiction, nor did he request an opportunity to 

conduct limited discovery on that issue. Instead, the plaintiff argued that the unrebutted allegations 

in his complaint were sufficient to establish specific personal jurisdiction over Missouri Baptist. 

Contrary to the plaintiff’s contention, the complaint does not contain specific factual allegations 

establishing the nature and quality of Missouri Baptist’s relationship with the plaintiff’s decedent 

and Illinois or the existence, nature, and quality of the relationships among Missouri Baptist, Dr. 

Aliperti, and Dr. Wikiera. While there seems no dispute that Dr. Wikiera, an Illinois physician, 

contacted Dr. Aliperti, “a physician who specializes in Gastroenterology and Internal Medicine,” 

the plaintiff did not present any factual allegations, supporting affidavits, or other documentation 

describing the specific conversation between these two physicians pertaining to the plaintiff’s 

decedent or the details surrounding the referral and transfer of the decedent from an Illinois 

medical facility to Missouri Baptist. Significant questions regarding these matters remain 

unanswered. For example, was the transfer of the patient performed at the direction of Dr. Aliperti, 

and if so, what instructions did Dr. Aliperti give for the transfer? Were Dr. Aliperti and his 

employer, Midwest Therapeutic Endoscopy Consultants, LLC, agents of Missouri Baptist?

¶ 42 Additionally, Missouri Baptist presented an affidavit by Maggie Lange in support of its 

jurisdictional arguments. In the affidavit, Lange stated that Missouri Baptist did not maintain any 

business in Illinois. The plaintiff did not attempt to counter Lange’s assertion. Some limited 

discovery or investigation of these matters might have shed light on the quality, nature, and extent 

of Missouri Baptist’s contacts with Illinois and its residents.4

4

Here, for example, a click of the mouse could have produced the corporate standing of Midwest 

Therapeutic Endoscopy Consultants, LLC, revealing that it was an LLC registered to do business in Illinois, 

and that Dr. Aliperti was the named manager. See Corporation/LLC Search/Certificate of Good Standing, 

Ill. Sec’y of State, https://apps.ilsos.gov/corporatellc/corporatellccontroller (last visited Oct. 18, 2022) 

[https://perma.cc/49KN-ZVMJ]. Likewise, a view of the websites of Missouri Baptist and BJC HealthCare 

indicates that Missouri Baptist is part of the BJC HealthCare (BJC) system; that BJC does business through 
22 

¶ 43 To recap, the plaintiff did not present specific allegations or any supporting affidavits or 

documentation regarding the details surrounding the referral and transfer of the decedent from a 

health care facility in Illinois to a health care facility in Missouri. Additionally, the extent and 

quality of Missouri Baptist’s contacts with Illinois went undeveloped in this case. The plaintiff’s 

bare, conclusory allegations are not sufficient to make a prima facie showing that Missouri 

Baptist’s contacts with Illinois satisfied due process for purposes of specific personal jurisdiction 

in this case. For these reasons, I conclude that the trial court erred in finding that it had specific 

personal jurisdiction over Missouri Baptist and that the court’s decision must be reversed.

¶ 44 In the majority opinion, my colleagues state that the jurisdictional issue is narrow, and that 

this court is “tasked with deciding whether Missouri Baptist’s ‘routine’ acceptance of patients from 

Illinois, and its subsequent acceptance of the transfer of [the decedent], was sufficient to create 

minimum contacts with Illinois to give rise to specific jurisdiction.” Supra ¶ 18. The majority then 

considers a line of Illinois cases in which Illinois residents, acting unilaterally, made conscious 

decisions to travel outside of Illinois for medical treatment and thereafter were not permitted to 

prosecute actions against the nonresident medical providers in Illinois because there was no 

showing that the nonresident providers purposefully availed themselves of the privilege of 

conducting business in Illinois. Unterreiner v. Pernikoff, 2011 IL App (5th) 110006, ¶ 9; Veeninga 

its broad network of physicians and hospitals in Illinois, including Madison County; and that Dr. Aliperti 

is a part of the BJC network of physicians. See, e.g., Missouri Baptist Medical Center, BJC HealthCare, 

https://www.bjc.org/about-us/bjc-locations/missouri-baptist-medical-center (last visited Oct. 18, 2022) 

[https://perma.cc/RK57-U8X3]; Locations, BJC HealthCare, https://www.bjc.org/about-us/locations (last 

visited Oct. 18, 2022) [https://perma.cc/L4SC-X9YR]; Giuseppe Aliperti, MD, BJC HealthCare, https://

doctors.bjc.org/wlp2/doctors/info/akt003z6/giuseppe-aliperti-md (last visited Oct. 18, 2022) [https://

perma.cc/86RZ-R6UK]. 

The plaintiff could have requested that the trial court take judicial notice of the websites or domain 

locations of the individual and corporate defendants. See generally Innovative Garage Door Co. v. High 

Ranking Domains, LLC, 2012 IL App (2d) 120117, ¶ 4 n.1; People v. Clark, 406 Ill. App. 3d 622, 632 

(2010); Ill. R. Evid. 201(b) (eff. Jan. 1, 2011). 
23 

v. Alt, 111 Ill. App. 3d 775, 779 (1982); Ballard v. Fred E. Rawlins, M.D., Inc., 101 Ill. App. 3d 

601, 605 (1981); Muffo v. Forsyth, 37 Ill. App. 3d 6, 9 (1976). The majority acknowledges that 

these cases are not specifically on point on the facts, but nevertheless finds them instructive. Supra

¶ 18. I do not share this view. 

¶ 45 Specific jurisdiction depends on the particular and unique facts in each case. None of the 

cases cited above are analogous to the case before us.5 Each of these cases was decided on its own 

particular facts, and, unlike the present case, the jurisdictional facts were better developed in those 

cases. As noted above, there is scant information in the record regarding the activities of Missouri 

Baptist and its agents with respect to the “routine acceptance” of transfer patients and the 

subsequent acceptance and transfer of the decedent. Because the jurisdictional facts have not been 

developed in the case at bar, there are no meaningful points of comparison between this case and 

those cited in the majority opinion. It is like trying to compare an open box, with its contents 

displayed, and a closed container, sealed with conclusory allegations. 

¶ 46 The majority also discusses Kostal v. Pinkus Dermatopathology Laboratory, P.C., 357 Ill. 

App. 3d 381 (2005), as an example of a case in which nonresident defendants purposely directed 

activities at Illinois and availed themselves of Illinois law. Upon considering the quality and nature 

of the defendants’ activities with Illinois and its residents, the Kostal court determined that the 

defendants, by the very nature of their business model and practice, operated nationwide and that, 

5

In Unterreiner, the nonresident physicians’ solitary, follow-up phone call to the residence of their 

Illinois patient to adjust a prescription was insufficient to establish that the defendants had voluntarily 

invoked the protections and benefits and protections of the laws of Illinois. In Veeninga, Ballard, and Muffo, 

a nonresident physician called-in or wrote a prescription for a medication for an Illinois patient that was 

filled in Illinois, and that single phone call or contact was found to be an insufficient basis for exercising 

personal jurisdiction over the nonresident provider. It is also noteworthy that Veeninga, Ballard, and Muffo

were decided before the legislature amended the Illinois long-arm statute in 1989, adding a “catch-all” 

provision that allows a court to exercise jurisdiction on “any other basis *** permitted by the Illinois 

Constitution and the Constitution of the United States.” Ill. Rev. Stat. 1989, ch. 110, ¶ 2-209(c). 
24 

through their national operations, “affected a significant interest in Illinois—the health of one of 

its citizens.” Kostal, 357 Ill. App. 3d at 398. Again, unlike the case at bar, the Kostal court had the 

benefit of a record in which the jurisdictional facts regarding personal jurisdiction were developed.

¶ 47 Later in the opinion, the majority acknowledges the lack of development of jurisdictional 

facts in this record, but nevertheless finds that like the aforementioned cases, “the relationship 

between Missouri Baptist and [the decedent] began with an unsolicited and unilateral phone call” 

from the decedent’s physician to Missouri Baptist and that “[t]his is simply not a case of Missouri 

Baptist doing anything which might be construed as availing itself of the benefits or protections of 

Illinois laws.” Supra ¶ 27. I do not agree that those findings can be discerned from the current 

record. What is known is that a seriously ill patient was transferred from an Illinois health care 

facility to a Missouri hospital. Beyond that, as noted above, the plaintiff did not provide any 

allegations or information regarding the specific circumstances surrounding the patient transfer. 

As to Missouri Baptist, the facts regarding personal jurisdiction, specific and general alike, have 

not been developed in this case. 

¶ 48 Decades ago, the Supreme Court recognized that “modern transportation and 

communications” made it much less burdensome for a party to defend itself in a forum where it 

engaged in economic activities and, therefore, that it usually would not be unfair to subject that 

party to the burdens of litigating disputes related to its activities in that forum. (Internal quotation 

marks omitted.) Burger King Corp., 471 U.S. at 474. The “constitutional touchstone” of due 

process remains whether a nonresident defendant purposefully established “minimum contacts” 

within a forum, but advances in technology and transportation impact the nature and quality of a 

defendant’s activities and contacts with that forum. Burger King Corp., 471 U.S. at 474. The 

delivery of health care services has noticeably changed in the past several years due, in part, to 
25 

significant advances in communications technology. Increasingly, medical consultations and 

virtual health care services are being offered via telemedicine and the web. Medical providers, 

including local physicians, are able to reach out beyond state lines to establish relationships with, 

and meet obligations to, their out-of-state patients. Health care corporations routinely engage in 

mergers and acquisitions of regional health care facilities and, with intentionality, market their 

services to patients regionally. Whether an out-of-state provider is subject to personal jurisdiction 

in Illinois must be decided based on the unique facts presented in each case and in light of the 

continuing advances in “transportation and communications.” 

¶ 49 In sum, this case presents us with a single issue of specific jurisdiction, and the resolution 

of the issue depends upon the minimum contacts that Missouri Baptist, an out-of-state health care 

corporation, has with Illinois and one of its residents. The plaintiff did not present specific factual 

allegations or supporting documentation regarding the quality and nature of Missouri Baptist’s 

contacts and relationship with the decedent and the State of Illinois. Instead, the plaintiff relied on 

conclusory allegations in his complaint to support his claim of specific personal jurisdiction. 

Without sufficient support for his jurisdictional allegations, the plaintiff did not meet his burden 

to make a prima facie showing that Missouri Baptist purposely directed its activities to Illinois 

facilities and patients and, therefore, that its activities were not random, fortuitous, or attenuated. 

In light of the foregoing, the trial court’s finding that it had specific jurisdiction over Missouri 

Baptist cannot be sustained. Therefore, I agree the trial court’s decision must be reversed. 

¶ 50 For the reasons stated, I specially concur. 
26 

Allen v. Missouri Baptist Medical Center, 2022 IL App (5th) 210263 

Decision Under Review: Appeal from the Circuit Court of Madison County, No. 20-L1278; the Hon. Sarah D. Smith, Judge, presiding. 

Attorneys

for

Appellant:

Michael J. Nester, of Donovan Rose Nester, P.C., of Belleville, 

and Terrence J. O’Toole Jr., of Baker Sterchi Cowden & Rice 

LLC, of St. Louis, Missouri, for appellant. 

Attorneys

for

Appellee:

Roy C. Dripps, Charles W. Armbruster III, and Michael T. 

Blotevogel, of Armbruster Dripps Blotevogel, LLC, of 

Maryville, for appellee.