National Union Fire Insurance Company of Pittsburgh, Pa. v. Surgalign Spine Technologies, Inc.

CourtDistrict Court, S.D. New York
DecidedFebruary 7, 2024
Docket1:22-cv-09870
StatusUnknown

This text of National Union Fire Insurance Company of Pittsburgh, Pa. v. Surgalign Spine Technologies, Inc. (National Union Fire Insurance Company of Pittsburgh, Pa. v. Surgalign Spine Technologies, Inc.) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
National Union Fire Insurance Company of Pittsburgh, Pa. v. Surgalign Spine Technologies, Inc., (S.D.N.Y. 2024).

Opinion

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK

NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA., as subrogee and assignee of Montefiore Medical Center, Plaintiff, Case No. 22-cv-09870 (JLR) -against- OPINION AND ORDER SURGALIGN SPINE TECHNOLOGIES, INC. and ORGANOGENESIS, INC., Defendants.

JENNIFER L. ROCHON, United States District Judge:

National Union Fire Insurance Company of Pittsburgh, Pa. (“National Union” or “Plaintiff”) brings this subrogation action against Surgalign Spine Technologies, Inc. (“Surgalign”) and Organogenesis, Inc. (“Organogenesis” and, together, “Defendants”), alleging fraud and other related violations of New York law. See generally ECF No. 13 (the “Amended Complaint” or “Am. Compl.”). Organogenesis moves to dismiss the claims brought against it in the Amended Complaint.1 See ECF No. 40 (“Br.”). For the reasons stated below, Organogenesis’s motion to dismiss is GRANTED. National Union is granted leave to amend to the extent that it can cure the pleading deficiencies discussed below.

1 Surgalign also moved to dismiss the Amended Complaint. See ECF No. 38 (“Surgalign Br.”). However, Surgalign filed for Chapter 11 bankruptcy on January 19, 2023, triggering an automatic stay of National Union’s claims against it under this action. See ECF No. 51; see also 11 U.S.C. § 362(a)(1). Because Surgalign’s bankruptcy proceedings remain pending, the stay as to Surgalign remains in effect and the Court holds Surgalign’s motion to dismiss in abeyance. BACKGROUND I. Factual Background The following allegations, taken from the Amended Complaint, are presumed true for purposes of resolving Organogenesis’s motion to dismiss, and the Court draws all reasonable inferences in favor of Plaintiff. See Int’l Code Council, Inc. v. UpCodes Inc., 43 F.4th 46, 53 (2d Cir. 2022). Both Defendants marketed and sold products for use in spinal surgeries: Surgalign

sold synthetic implants, and Organogenesis sold “tissue-based solutions.” Am. Compl. ¶ 1. One of Defendants’ customers was Montefiore Medical Center (“Montefiore”), which regularly uses implants during spinal surgeries. Id. ¶¶ 2, 9. Montefiore’s typical process for using and purchasing surgical implants, including Defendants’ products, operated in the following manner. Suppliers sold their implants to Montefiore on consignment, placing them in Montefiore’s operating-room supply area and billing the hospital on a “pay-as-you-use” basis. See id. ¶¶ 9, 14. When a surgeon opted to use an implant during a surgery, the operating room’s circulating nurse retrieved it from the supply area, then documented its use on the patient’s “Perioperative Record.” Id. ¶ 10. During such a

surgery, Montefiore recorded its use of surgical implants on an “Implant Tracking Log,” completing that form in triplicate and affixing “a unique serialized sticker associated with each individual implant to each page of the log.” Id. ¶ 11. After the surgery, one copy of the log was sent to Montefiore’s billing department, another copy went in the patient’s physical medical record, and a third copy went into a binder kept in the operating room. Id. Montefiore relied on this third copy to create a purchase order for any implants used during surgery. Id. ¶ 12. When Montefiore subsequently received an invoice from the supplier, it compared the invoice to its corresponding purchase order before issuing payment. Id. ¶ 13. “Between at least 2015 and 2020,” Defendants retained Rosemarie Mastrandrea (“Mastrandrea”) as a sales representative. Id. ¶ 2. Beyond marketing Defendants’ products to Montefiore, Mastrandrea was responsible for tracking and storing the products, moving them into Montefiore’s operating rooms, and invoicing Montefiore for their use. Id. ¶¶ 2, 15.

Defendants represented to Montefiore that Mastrandrea was their agent with respect to their products. Id. ¶ 15. “At all relevant times, Mastrandrea acted within the scope of her duties as [Defendants’] agent . . . and within the apparent authority granted by” Defendants. Id. ¶ 21. Hoping to increase Defendants’ sales and – by extension – her own sales commissions, Mastrandrea induced Montefiore into paying for products that were never used. Id. ¶¶ 16, 21. The details of the scheme were as follows. Mastrandrea created fake entries in Montefiore’s Implant Tracking Log, representing that Defendants’ products had been used during various surgeries when, in fact, they were not used. Id. ¶ 16. To create these entries, Mastrandrea conspired with Rowena Dellosa (“Dellosa”), a nurse manager at Montefiore for Perioperative Services, to place Defendants’ unique serialized sticker on the copy of the Implant Tracking Log

kept in the operating room. Id. ¶¶ 2, 17-18. Mastrandrea paid Dellosa kickbacks for her assistance. Id. ¶ 18. These fraudulent entries in the Implant Tracking Log induced Montefiore to issue purchase orders for Defendants’ products that, again, had not been used in any surgery. Id. ¶ 19. After Mastrandrea submitted invoices, Montefiore compared them to its corresponding purchase orders and subsequently issued payment to Defendants. Id. ¶ 20. After learning of the scheme, Montefiore confirmed the fraud by comparing its surgical records to the invoices received from Defendants. Id. ¶ 23. Ultimately, Montefiore paid Defendants over $3 million for products that had not been used. Id. Montefiore submitted a claim for this loss under its commercial crime insurance policy with National Union. Id. ¶ 24. National Union evaluated the claim, determined that it was covered under its policy, and ultimately reimbursed Montefiore $3,627,986. Id. In exchange for this insurance payment, Montefiore assigned to National Union its claims against Defendants. Id. II. Procedural History As Montefiore’s subrogee and assignee, National Union filed this action on November

18, 2022, against Surgalign and NuTech Spine, Inc. (“NuTech”) asserting causes of action under New York law against each defendant for common-law fraud, unjust enrichment, aiding and abetting a breach of fiduciary duty, and negligent supervision. See ECF No. 1 (“Compl.”) ¶¶ 26- 97. On January 27, 2023, National Union filed the operative Amended Complaint, which changed the name of one co-defendant to reflect NuTech’s merger into Organogenesis. See Am. Compl. ¶ 6. Organogenesis moved to dismiss the Amended Complaint on March 10, 2023. See Br. The motion is now fully briefed and presently before the Court. See ECF Nos. 43 (“Opp.”), 45 (“Reply”).2 LEGAL STANDARD To survive a motion to dismiss under Federal Rule of Civil Procedure (“Rule”) 12(b)(6),

“a complaint must contain sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)). But a court need not “accept as true a legal conclusion couched as a factual allegation.” Id. (quoting Twombly, 550 U.S. at 555). A complaint must allege “more than a sheer possibility that a defendant has acted unlawfully” and more than “facts that are ‘merely consistent with’ a defendant’s liability.” Id. (quoting Twombly, 550 U.S. at 557). “Threadbare recitals of the elements of a cause of action, supported by mere

2 Organogenesis adopts many of the arguments raised in Surgalign’s brief. See Br. at 1, 3, 6, 8-9. Therefore, where relevant, the Court addresses Surgalign’s arguments. See Surgalign Br. conclusory statements, do not suffice.” Id.

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National Union Fire Insurance Company of Pittsburgh, Pa. v. Surgalign Spine Technologies, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/national-union-fire-insurance-company-of-pittsburgh-pa-v-surgalign-spine-nysd-2024.