North Brevard County Hospital District v. C.R. Bard

Court of Appeals for the Tenth Circuit·Decided December 31, 2025·No. 24-4039·Published

Opinion

FILED

United States Court of Appeals Tenth Circuit

PUBLISH

December 31, 2025

UNITED STATES COURT OF APPEALS Christopher M. Wolpert

FOR THE TENTH CIRCUIT Clerk of Court

NORTH BREVARD COUNTY HOSPITAL DISTRICT, d/b/a Parrish Medical Center,

Plaintiff - Appellant, v. No. 24-4039

C.R. BARD, INC.; BARD ACCESS SYSTEMS, INC.,

Defendants - Appellees.

Appeal from the United States District Court for the District of Utah

(D.C. No. 2:22-CV-00144-RJS)

R. Stephen Berry of Berry Law PLLC, Washington, D.C. (Brent O. Hatch of Hatch Law Group PC, Salt Lake City, Utah; Velvel Freedman, Edward Normand, and Richard Cipolla of Freedman Normand Friedland LLP, New York, New York, with him on the briefs), for Plaintiff-Appellant.

Brian P. Quinn of O’Melveny & Myers LLP, Washington, D.C. (Andrew J. Frackman and Colleen Powers, New York, New York; Sergei Zaslavsky and Emily Murphy of O’Melveny & Myers LLP, Washington, D.C.; Andrew G. Deiss and Corey D. Riley of Deiss Law PC, Salt Lake City, Utah, with him on the briefs), for Defendants-Appellees.

Before HARTZ, EID, and FEDERICO, Circuit Judges.

FEDERICO, Circuit Judge.

North Brevard County Hospital, doing business as Parrish Medical Center, filed an antitrust class action complaint against C.R. Bard, a medical device manufacturer. 1 Parrish alleged that Bard engaged in unlawful tying of products and monopolization in violation of the Sherman Act and the Clayton Act. The district court dismissed Parrish’s tying claim for lack of antitrust standing and denied class certification for Parrish’s monopolization claim. Exercising jurisdiction under 28 U.S.C. § 1291, we affirm the dismissal of Parrish’s tying claim and dismiss Parrish’s appeal from the denial of class certification.

I

Bard produces a range of medical devices, including a type of catheter known as a peripherally inserted central catheter (PICC). PICCs are used to administer fluids into the bloodstream by passing through a patient’s arm vein and into a vein near the heart. It is important that a PICC be precisely placed within the patient’s body. Traditionally, this was done using separate chest x-rays and fluoroscopy. Today, doctors generally use a

1 According to the complaint, Bard Access Systems, the other named

Defendant-Appellee, is a subsidiary and division of C.R. Bard. We therefore refer to the Defendants-Appellees as one entity “Bard” for the purposes of this opinion, just as the parties do.

tip-location system (TLS) that automatically reports the PICC’s location through a combination of ultra-sound, magnetic tracking, and electrocardiography.

Parrish alleges that Bard is a leader in the TLS market and controls 70 percent market share. It also alleges that Bard has used its commanding position in the TLS market to manipulate the PICC market. Bard PICCs are sold with a proprietary tool known as a stylet that is required to integrate the PICC with a Bard TLS. If a hospital wanted to use another brand of PICC, it could not use a Bard TLS to determine the PICC’s location unless the hospital also purchased a Bard PICC to use the stylet.

In simple terms, Parrish alleges that using one Bard product effectively forces hospitals to buy the other. This is known as “tying,” and, under certain circumstances, it may be a violation of federal antitrust law. While Parrish did not buy Bard’s TLS (the alleged tying product), it claims that Bard’s practices have allowed it to monopolize the PICC market (the

alleged tied product), 2 suppressing competition and harming all buyers whether or not they purchase PICCs in conjunction with TLSs. As a result of this purported tying between PICCs and TLSs, Parrish alleges that hospitals pay 9.7 to 34.5 percent higher prices for PICCs than they would in a competitive market.

II

In March 2020, Parrish filed suit against Bard. 3 Parrish’s complaint contained two claims: illegal per se tying of separate products under Section 1 of the Sherman Act and illegal monopolization under Section 2 of the Sherman Act. See 15 U.S.C. §§ 1, 2. Parrish sought to certify a class

2 This opinion will repeatedly distinguish between tying products and

tied products. As a simple illustration to help keep them straight in mind, think of a balloon tied to a birthday cake. The buyer really wants the cake, which is the best in town. But the baker will only sell cakes on the condition that the buyer also buys her balloons, which are a separate cost. So, the balloon tags along, tied to the cake. The cake is the tying product – the product that the consumer really wants. The balloon is the tied product – the product that the consumer doesn’t want but must buy to access the cake. This arrangement raises the overall cost to the buyer.

Sometimes, the tie-in is explicit, like a contract that includes a term requiring the purchase of the tied product. Other times, it is more subtle, as alleged here, when the seller requires the purchase of one product in order to use and operate another product. See Daniel A. Crane, Tying Law for the Digital Age, 99 Notre Dame L. Rev. 821, 847, 851–56 (2024) (providing historic examples of tying arrangements).

3 Parrish originally filed in the District Court for the Northern District of New York. In February 2022, its case was transferred to the District of Utah, where Bard’s PICC business is headquartered.

comprised of hospitals, hospital systems, and clinics that had purchased Bard PICCs, and requested damages and injunctive relief for this class under the remedial provisions of the Clayton Act. See 15 U.S.C. §§ 15, 26.

Parrish filed a motion for class certification, while Bard filed a motion for judgment on the pleadings. In November 2022, after hearing oral argument, the district court granted Bard’s motion with respect to Parrish’s tying claim. The district court found that Parrish did not have antitrust standing to bring its claim for illegal tying because Parrish did not allege that it also purchased Bard’s TLS (the alleged tying product), and so Parrish did not show that it was forced to buy Bard’s PICCs (the alleged tied product).

The district court allowed Parrish’s monopolization claim to proceed.

In response, Parrish filed a renewed motion for class certification. The district court, however, denied this motion. It found that Parrish’s proposed class failed to meet the required elements for class certification, and that its pleadings were insufficient to establish a basis for either a damages class or an injunctive class.

Parrish petitioned for permission from this court to appeal the district court’s order denying class certification. See Fed. R. Civ. P. 23(f) (“A court of appeals may permit an appeal from an order granting or denying class- action certification[.]”) This petition was denied. As a result, Parrish then

moved for the district court to dismiss its monopolization claim with prejudice so that Parrish could appeal the entry of final judgment, which the district court granted. Parrish then appealed. On appeal, Bard filed a motion to dismiss the appeal from the district court’s class certification order, arguing that Parrish’s voluntary dismissal of the underlying monopolization claim forecloses our jurisdiction over the class certification order. 4

III

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