Patrick Santoro v. Tower Health

Court of Appeals for the Third Circuit·Decided August 28, 2026·No. 24-3173·Published

Opinion

UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT

No. 24-3173

PATRICK SANTORO; JESSICA LANDIS, Appellants

v.

TOWER HEALTH; META PLATFORMS, INC.

On Appeal from the U.S. District Court, E.D. Pa.

Judge John F. Murphy, No. 5:22-cv-04580

Before: HARDIMAN, FREEMAN, and CHUNG, Circuit Judges Argued: Oct. 21, 2025; Filed: Aug. 28, 2026

OPINION OF THE COURT

FREEMAN, Circuit Judge. Patrick Santoro and Jessica Landis brought a putative class action against healthcare provider Tower Health. They claim that Tower Health’s websites use a tracking code that intercepted and shared Plaintiffs’ personally identifying information, including their health conditions, treatments, and medications. The District Court dismissed their second amended complaint with prejudice, reasoning that (1) Plaintiffs did not adequately specify the nature of the personal health information the tracking pixels shared and (2) amendment would be futile. Plaintiffs moved for reconsideration, requesting leave to further amend their complaint. The District Court denied the motion on grounds of undue delay. For the reasons that follow, we will AFFIRM the District Court’s orders dismissing the Second Amended Complaint and denying the reconsideration motion.

I1

Tower Health is a regional healthcare provider that operates seven hospitals and 27 urgent care facilities, plus home healthcare services. It encourages its patients and the general public to access health information through its website.

In various notices and confidentiality agreements, Tower Health pledges to keep its patients’ health information private. Notwithstanding those representations, Tower Health installed Meta Pixel on its website. Meta Pixel is software code that captures information about website users’ characteristics (e.g., their IP addresses, device identifiers, and account numbers) and the content of their communications (e.g., the URLs, buttons, links, pages, and tabs the users view). Meta Pixel contemporaneously transmits this information to the technology company Meta, which uses it for commercial purposes, including selling targeted advertisements. Meta then forwards the information (along with a data analysis) to Tower Health, which uses the information for its own commercial purposes. Meta pays Tower Health for access to this information.

Santoro and Landis are Tower Health patients. Each of them has used Tower Health’s website to “engage in communications that included individually-identifiable health information about his [or her] past, present, or future health conditions, including requests for information about specific Tower Health providers and locations, and information about specific health conditions, treatments, and medications.” App. 56. Neither Plaintiff authorized Tower Health to share that individually-identifiable health information with Meta, nor did Tower Health disclose that it would do so. And neither Plaintiff authorized Tower Health or Meta to use that information for commercial purposes. Nonetheless, Tower Health’s deployment of Meta Pixel on its website captured

1 We accept the facts alleged in Plaintiffs’ Second Amended Complaint as true and construe them in the light most favorable to Plaintiffs. See Barclift v. Keystone Credit Servs., LLC, 93 F.4th 136, 141 (3d Cir. 2024).

Plaintiffs’ individually-identifiable health information and sent it to Meta to be used in the manner described above.

In 2022, Plaintiffs filed a putative class action against Tower Health and Meta for violations of a federal privacy statute and state tort laws. The claims against Meta were transferred to a different judicial district, and Tower Health moved to dismiss the complaint for failure to state a claim. Plaintiffs then amended their complaint as a matter of right, see Fed. R. Civ. P. 15(a)(1)(B), and Tower Health moved to dismiss the amended complaint. Plaintiffs obtained leave to amend again and filed their Second Amended Complaint (“SAC”). Tower Health’s third motion to dismiss followed.

In the SAC, Plaintiffs claimed that Tower Health violated the Electronic Communications Privacy Act (“ECPA”), 18 U.S.C. § 2510, et seq., by disclosing their individually-identifiable health information (and that of all putative class members) without notice or consent, in violation of the Health Insurance Portability and Accountability Act (“HIPAA”), 42 U.S.C. § 1320d, et seq. They also claimed that Tower Health’s disclosure of such information constitutes negligence and an intrusion upon their seclusion. All three of these claims were also raised in Plaintiffs’ original and first amended complaints.

During oral argument on the motion to dismiss the SAC, Tower Health argued that this was Plaintiffs’ “third shot” at pleading their claims and the allegations remained insufficient. App. 215. It pointed out that Plaintiffs did not allege what specific pages of Tower Health’s website they visited; whether they searched for anything and, if so, what search terms they entered; or whether they clicked on a button to go to the patient portal. The company argued that the District Court should dismiss the complaint with prejudice because Plaintiffs had twice amended their complaint without adding the specific allegations that each of Tower Health’s motions to dismiss contended were necessary.

When the District Court turned to Plaintiffs, it opened by saying, “Your biggest problem is the specificity of the pleadings, so let’s start there.” App. 239. Plaintiffs argued that further specifics were unnecessary; their allegation that Tower

Health disseminated their individually-identifiable health information was enough to support a violation of HIPAA and thus give rise to an ECPA violation. In response, the District Court said it would “show [Plaintiffs] [its] cards”: it was struggling to discern how to write an opinion permitting this case to go to discovery based on “hypothetical” information. App. 243. It said Plaintiffs needed to “paint a picture” of what information Meta received from Tower Health. App. 245. But, based on the allegations the SAC, the District Court would only able to write that “the allegation of what the information [Meta] got is . . . blah, blah, blah.” Id.

Plaintiffs disagreed, arguing that all individually-

identifiable health information is protected under the statute. After a lengthy exchange, Plaintiffs’ counsel told the District Court: “[I]f you’re inclined to insist that we need to say our plaintiffs looked for information about a torn ACL or a heart attack or a bunion, we’re able to do that and we’d like an opportunity to do that if Your Honor thinks that will advance the litigation or inform the claims in some way.” App. 259. But counsel, “again, emphasize[d]” that such amendment was unnecessary as a matter of law. Id.

The District Court immediately clarified that its concern was broader than Plaintiffs’ failure to allege the specific health conditions they looked into on Tower Health’s website. Rather, the District Court said the complaint lacked detail about “the scope of the information” Plaintiffs shared. Id. By way of example, the District Court said, “[I]t makes a difference whether we’re talking about someone who comes to the Tower Health website and, say, makes one click into the dermatology department” or “someone . . . who is a patient of Tower Health and goes into the dermatology department and reads a whole bunch of detailed information.” App. 259–60. Plaintiffs reiterated their disagreement, saying “HIPAA protects all information about medical conditions or treatment. So the one click is the same as 400 clicks.” App. 261.

Tower Health began its rebuttal argument by saying it was clear that the parties did not “have the facts to discuss here.” App. 263. The District Court responded, “I agree with you on that.” Id.

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