Maschmeier v. United States

Background

Alexis Maschmeier and Mr. Maschmeier brought claims against the United States under the Federal Tort Claims Act (FTCA) and the Federally Supported Health Centers Assistance Act (FSHCAA). The FTCA permits certain state-law tort claims against the United States for injuries caused by negligent acts or omissions of federal employees acting within the scope of employment. The FSHCAA extends that protection to certain federally funded healthcare entities and their employees and contractors, subject to specified conditions.

In October 2019, Mrs. Maschmeier went to Mad River Community Hospital to deliver her child, Emma. Because of complications, Dr. Puttler performed a cesarean section, and Emma did not survive. Dr. Puttler later provided some post-operation care and saw Mrs. Maschmeier at five follow-up visits between October and December 2019. The Maschmeiers alleged that he encouraged them to become pregnant soon after the cesarean section without warning them about the risks. They also alleged that Dr. Hackett and other unidentified providers failed to give similar warnings before Mrs. Maschmeier’s second pregnancy and delivery, during which she suffered serious complications and significant blood loss. Mr. Maschmeier separately alleged emotional distress from witnessing his wife’s second cesarean section.

The Maschmeiers first presented an administrative tort claim to the Department of Health and Human Services (HHS) in September 2021. They then filed suit after HHS did not respond within six months. Their amended complaint added claims involving Dr. Hackett and other providers, as well as claims by Mr. Maschmeier. The United States moved to dismiss for lack of subject-matter jurisdiction and failure to state a claim, and moved to strike the request for prejudgment interest.

Dr. Puttler’s Follow-Up Care

The court treated the jurisdictional challenge as a factual challenge under Rule 12(b)(1), which allows dismissal for lack of subject-matter jurisdiction. The court considered evidence outside the complaint because the issue—whether Dr. Puttler acted within the scope of his contract—was separate from whether he gave inappropriate medical advice.

Dr. Puttler’s contract required him to invoice the federally funded healthcare entity, ODCHC, for out-of-hospital patient care; document ODCHC patient care in ODCHC’s record system; and provide services covered by ODCHC’s professional-liability provisions only when those services were within the project’s scope and recorded and billed by ODCHC. The evidence showed that Dr. Puttler’s invoices for October through December 2019 did not include the five follow-up visits, that he did not document those visits in ODCHC’s records, and that ODCHC did not bill Mrs. Maschmeier or her insurance for that out-of-hospital care.

The court rejected the Maschmeiers’ arguments that a zero-dollar visit history, charges for the cesarean delivery and an inpatient consultation, statements about Dr. Puttler’s understanding of the care, or Mrs. Maschmeier’s perception that he was acting as an ODCHC physician established contract coverage. The court concluded that Dr. Puttler did not comply with his contract and was not acting within the scope of his contract when he provided the follow-up care. Because the United States’ consent to suit under the FTCA and FSHCAA did not cover that conduct, the court held that it lacked subject-matter jurisdiction over those claims.

The court DISMISSED with prejudice all claims arising from Dr. Puttler’s follow-up visits. It DENIED the Maschmeiers’ request for discovery and a hearing because further discovery would be futile.

Claims Involving Dr. Hackett and Other Providers

The FTCA requires a claimant to first present the relevant allegations to the responsible federal agency. The court found that the Maschmeiers’ administrative claim addressed allegations against Dr. Puttler but did not address Dr. Hackett or the other ODCHC providers. HHS therefore had not been given an opportunity to evaluate those allegations.

The court concluded that it lacked jurisdiction over the claims involving Dr. Hackett and the other providers for failure to complete the required administrative process. It DISMISSED the remaining claims in the amended complaint without prejudice and GRANTED the Maschmeiers leave to amend.

Other Rulings and Disposition

The Maschmeiers agreed that their request for prejudgment interest was improper, so the court STRUCK that request. The court also ruled that the Doe defendants were not proper defendants in an FTCA action and DISMISSED them. It instructed the Maschmeiers to name only the United States as a defendant in any future amended complaint.

Because the court dismissed all claims on jurisdictional grounds, it did not reach the United States’ Rule 12(b)(6) argument that the negligent-infliction-of-emotional-distress claim failed to state a claim. The court stated that the United States could raise that argument again if the Maschmeiers filed a second amended complaint.

The court’s conclusion states that the United States’ motion to dismiss was GRANTED in part and DENIED in part as moot. The Maschmeiers were GRANTED leave to amend and given 30 days to file an amended complaint.