Andrews-Clarke v. Lucent Technologies, Inc.

157 F. Supp. 2d 93, 2001 U.S. Dist. LEXIS 23291, 2001 WL 909013
CourtDistrict Court, D. Massachusetts
DecidedJuly 27, 2001
DocketCIV. A.01-10055-PBS
StatusPublished
Cited by33 cases

This text of 157 F. Supp. 2d 93 (Andrews-Clarke v. Lucent Technologies, Inc.) is published on Counsel Stack Legal Research, covering District Court, D. Massachusetts primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Andrews-Clarke v. Lucent Technologies, Inc., 157 F. Supp. 2d 93, 2001 U.S. Dist. LEXIS 23291, 2001 WL 909013 (D. Mass. 2001).

Opinion

ORDER

SARIS, District Judge.

After a review of the objections, I adopt the report and recommendation and order the action to be dismissed.

REPORT AND RECOMMENDATION ON DEFENDANTS’ MOTIONS TO DISMISS

DEIN, United States Magistrate Judge.

I. INTRODUCTION

The plaintiff Diane Andrews-Clarke brings this action individually, as Adminis-tratrix of the Estate of her deceased husband Richard J. Clarke, and as next friend of their minor children, seeking to recover damages for her husband’s death which allegedly was the result of the defendants’ refusal to authorize appropriate medical and psychiatric treatment during Mr. Clarke’s repeated hospitalizations for alcoholism in 1994. The defendants are Lu-cent Technologies (formerly known as AT & T) (“AT & T”); Travelers Insurance Company (formerly known as MetraHealth Insurance and United Healthcare Insurance Company) (“Travelers”) and TAO, Inc. (now known as Green Spring Health Services, Inc.) (“TAO”). 1

Each defendant has moved to dismiss the Complaint pursuant to Fed.R.Civ.P. 12(b)(6) for failure to state a claim upon which relief can be granted. (See Docket *96 Nos. 2, 6, 8). For the reasons detailed below, this court recommends to the district court judge to whom this case is assigned that the motions to dismiss be ALLOWED as this action is barred by the doctrine of res judicata, the claims raised are preempted by the Employee Retirement Income Security Act of 1974, 29 U.S.C.A. § 1001 et seq. (“ERISA”), and the plaintiff has not alleged any viable ERISA claims.

II. STATEMENT OF FACTS

When ruling on a motion to dismiss, the court must accept as true all well-pleaded facts, and the plaintiff is to be given the benefit of all reasonable inferences. See Cooperman v. Individual, Inc., 171 F.3d 43, 46 (1st Cir.1999); Dartmouth Review v. Dartmouth Coll., 889 F.2d 13, 16 (1st Cir.1989). Applying this standard to the instant case, the relevant facts are as follows:

Diane Andrews-Clarke (“Andrews-Clarke”) an employee of AT & T, maintained a health insurance policy with Travelers through her AT & T employee benefit plan. (See Complaint (“Compl.”) at ¶¶ 12, 13 and Ex. C). 2 TAO, a utilization review company, contracted with AT & T to provide utilization review services for AT & T’s employee health benefit plan. 3 (Id. at ¶¶ 11, 69). Andrews-Clarke’s husband Richard Clarke (“Clarke”), and her children were named beneficiaries of the insurance policy. (Id. at ¶¶ 14, 15).

The allegations in the current complaint arise from the alleged failure of the defendants to authorize adequate medical and psychiatric treatment for Clarke prior to his suicide on November 12, 1994. (See Compl. Intro.) The plaintiff contends that Clarke was entitled to, and wrongfully denied, in-patient hospital care for detoxification and rehabilitation under the terms of AT & T’s employee benefit plan, and that this failure to obtain the necessary treatment resulted in Clarke’s tragic death. (Id. at ¶¶ 18, 29, 46, 58, 60-66; Ex. C).

Procedural Background

The plaintiff filed her first suit in 1996 in state court against, inter alia, Travelers and TAO. 4 The defendants promptly removed the case to federal court, where they filed motions to dismiss on the grounds that the claims were preempted by ERISA. See Andrews-Clarke v. Trav *97 elers Ins. Co., 984 F.Supp. 49 (D.Mass.1997) (“Andrews-Clarke I”). In Andrews-Clarke I, like the instant case, the complaint alleged that Clarke’s “death was the direct and foreseeable result of the improper refusal of Traveler’s and its agent (TAO) to authorize appropriate medical and psychological treatment during Clarke’s repeated hospitalization for alcoholism in 1994.” Id. at 52. The factual allegations of the first complaint are virtually identical to the allegations of the present complaint.

After reviewing the factual allegations of the complaint in detail, the District Court (by Young, J.) allowed the motions to dismiss, but clearly was outraged by the ruling. In an eloquent and passionate decision, Judge Young wrote:

This case, thus, becomes yet another illustration of the glaring need for Congress to amend ERISA to account for the changing realities of the modern health care system. Enacted to safeguard the interests of employees and their beneficiaries, ERISA has evolved into a shield of immunity that protects health insurers, utilization review providers, and other managed care entities from potential liability for the consequences of their wrongful denial of health benefits.

Id. at 53. Although clearly loathe to do so, by his decision dated October 30, 1997, Judge Young dismissed all the claims raised against Travelers and TAO in plaintiffs proposed second amended complaint after finding that the state law claims were either preempted by ERISA or did not confer a private right of action. Id. at 53-56. The court also determined that none of the plaintiffs claims stated a cause of action under ERISA. Id. at 55-56. The counts against Travelers and TAO in the proposed second amended complaint included medical malpractice claims for negligent failure to diagnose and failure to administer appropriate treatment; wrongful death; breach of contract for failure to approve medically necessary treatment; loss of spousal and parental consortium; intentional infliction of emotional distress; negligent infliction of emotional distress; violations of Mass. Gen. Laws ch. 175, § 47B; violations of Mass. Gen. Laws ch. 176D, § 3; and violations of Mass. Gen. Laws ch. 93A. Id. at 53-56, n. 22, 23.

The plaintiff had attempted to add AT & T as a defendant in the proposed second amended complaint which formed the basis of Judge Young’s ruling. 5 She subsequently sought leave to add AT & T in a third amended complaint pursuant to a motion filed in August, 1998, almost a year after Judge Young’s decision dismissing the action. The motion to amend was denied, and the plaintiff then moved for reconsideration of that denial. In an Order dated February 9, 1999 the Court (by Saris, J.) found that either the motion to add AT &

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Bluebook (online)
157 F. Supp. 2d 93, 2001 U.S. Dist. LEXIS 23291, 2001 WL 909013, Counsel Stack Legal Research, https://law.counselstack.com/opinion/andrews-clarke-v-lucent-technologies-inc-mad-2001.