Egypt v. United States

Background

Cleopatra Egypt, proceeding without a lawyer, sued the United States under the Federal Tort Claims Act (FTCA), a law that permits certain tort claims against the federal government. The claims arose from dental services provided by the Institute for Family Health, a federally qualified health center. Egypt alleged that she received inadequate care involving dentures and Teeth Nos. 12 and 15, that the Institute and its personnel failed to follow up after a December 23, 2020 visit, and that she later experienced pain, infections, root-canal problems, and extractions.

Egypt’s second amended complaint asserted claims that the court interpreted as including medical negligence or malpractice, negligent supervision, alleged abandonment by the Institute, Dr. Demetra Atsaves, and Dr. Robert Schiller, and breach of an implied contract. The Government moved to dismiss under Federal Rule of Civil Procedure 12(b)(1), for lack of subject-matter jurisdiction, and Rule 12(b)(6), for failure to state a legally sufficient claim.

Claims Based on Mount Sinai Dentists

Egypt alleged that Dr. Deborah Tirsun failed to take requested X-rays during the December 23, 2020 visit and that Dr. Sherman failed to supervise her. The court considered the record concerning a residency agreement between the Institute and Mount Sinai Hospital and the Icahn School of Medicine at Mount Sinai. That agreement stated that Mount Sinai’s attending and resident dentists were independent contractors, not Institute employees or agents, and that Mount Sinai controlled the residency program and supervision of its dentists.

The court applied the Federal Tort Claims Act’s distinction between federal employees and independent contractors. It concluded that Dr. Tirsun and Dr. Sherman were Mount Sinai employees and independent contractors rather than federal employees or covered contract employees of the Institute. Because the FTCA did not waive the Government’s immunity for claims based on their conduct, the court recommended dismissing those claims for lack of subject-matter jurisdiction.

Institute’s Supervision of Mount Sinai

Egypt also alleged that the Institute negligently failed to supervise the care provided by Mount Sinai. The court applied the FTCA’s discretionary-function exception, which preserves government immunity for certain decisions involving judgment and policy. It concluded that the Institute had discretion under the governing federal health-center statutes to provide preventive dental services through contracts and had exercised that discretion by delegating the services and supervision to Mount Sinai.

The court therefore recommended dismissing the negligent-supervision claim concerning the Institute’s delegation of supervision to Mount Sinai for lack of subject-matter jurisdiction.

Breach of Contract

Egypt alleged that the Institute breached an implied financial contract by failing to follow its mission and provide high-quality care. She sought $250,000 in damages in the second amended complaint.

The court explained that the Tucker Act gives the United States Court of Federal Claims exclusive jurisdiction over contract claims against the United States exceeding $10,000. Because Egypt’s demand exceeded that amount, the court recommended dismissing the contract claim under Rule 12(b)(1). The court did not decide whether Egypt had actually stated a valid contract claim. It also noted that federal law, rather than New York law, would govern the contract claim against the federal government.

The court recommended allowing Egypt to amend the contract claim if she chose to abandon any demand for more than $10,000. The recommendation did not state that the contract claim was dismissed with prejudice or without prejudice.

Negligence and Medical-Malpractice Claims Against the Institute and Dr. Schiller

The Government argued that Egypt had not plausibly alleged that the Institute’s or Dr. Schiller’s conduct proximately caused her injuries. The court agreed that Egypt had not plausibly connected Dr. Atsaves’s alleged abandonment to the treatment provided by Dr. Tirsun, because Dr. Atsaves did not supervise the December 23, 2020 visit. The court also concluded that later injuries resulting from treatment by outside providers, including root canals and extractions, were separated from the Institute’s and Dr. Schiller’s conduct by later medical treatment.

However, the court found that Egypt plausibly alleged pain and suffering caused by delays in treatment before she received care from outside providers. In particular, she alleged that she reported pain and requested treatment in July 2021, but that the Institute and Dr. Schiller did not timely follow up. The court therefore recommended denying the Government’s motion to dismiss the negligence and medical-malpractice claims based on the Institute’s and Dr. Schiller’s conduct.

Recommendation and Procedure

Judge Stewart D. Aaron recommended that the Government’s motion to dismiss be GRANTED IN PART and DENIED IN PART. Specifically, he recommended dismissing the second amended complaint as to all claims except the FTCA claims based on the conduct of the Institute and Dr. Schiller. He also recommended granting Egypt leave to amend the breach-of-contract claim to eliminate any monetary relief above $10,000.

This document was a report and recommendation by a magistrate judge to District Judge Jessica G. L. Clarke, not the final ruling by the district court. The parties were given fourteen days after service to object, and the document stated that failing to object would waive objections and prevent appellate review.