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Palacios v. Medstar Health, Inc.

United States District Court, District of Columbia

February 20, 2018

MEDSTAR HEALTH, INC. et al., Defendants.



         Ariana Palacios brought suit against MedStar Health and MedStar Georgetown Medical Center, Inc. alleging discrimination based on her gender identity after the hospital's Department of Plastic Surgery purportedly refused to provide her gender-affirming breast augmentation surgery. After the parties failed to reach an agreement in mediation, Palacios filed a motion seeking to amend her complaint to add additional claims related to a consultation she had with a MedStar Georgetown doctor regarding a different procedure, vocal feminization surgery. MedStar has opposed her motion. Based on the arguments presented by the parties in their briefing and at the hearing, the Court will allow Palacios to amend her federal Affordable Care Act claim but will deny leave to amend her D.C. Human Rights Act claim.

         I. Background

         According to her complaint, on May 4, 2015, Ariana Palacios-a twenty-seven year old transgender woman-telephoned the Department of Plastic Surgery at MedStar Georgetown Medical Center (“MedStar Georgetown”) seeking to make an appointment for breast augmentation surgery. Compl. ¶¶ 19-20. Palacios alleges that during the phone call, she was informed that the Department of Plastic Surgery was no longer accepting “trans patients.” Id. ¶ 21. A few days later, Palacios asserts that she and a friend went to the Department of Plastic Surgery in person and were again informed that the Department was not accepting any “trans patients.” Id. ¶ 22. Palacios claims she followed this visit up with a phone call to the office of the Chairman of the Department, during which she recounted her prior unsuccessful attempts to obtain an appointment for surgery. Id. ¶ 23. The assistant to whom she spoke allegedly said the Department would return her call within a week, but Palacios says she never received a response. Id.

         On August 26, 2015, Palacios filed a charge of discrimination with the D.C. Office of Human Rights related to her interactions with MedStar Georgetown's Department of Plastic Surgery. See Defs.' Opp'n Pl.'s Mot. Leave File Am. Compl. (“Defs.' Opp'n) Ex. A. In it, she alleged that the Department's refusal to schedule her breast augmentation surgery constituted discrimination based on gender identity in violation of D.C.'s anti-discrimination laws. Id. She similarly filed an administrative charge of discrimination against MedStar with the U.S. Department of Health and Human Service's (“HHS”) Office for Civil Rights, asserting that the hospital's actions violated the anti-discrimination provision in section 1557 of the Patient Protection and Affordable Care Act (“Affordable Care Act”) (codified at 42 U.S.C. § 18116). Pl.'s Mot. Leave File Am. Compl. (“Pl.'s Mot.”) at 2.

         According to Palacios's proposed amended complaint, after these charges were filed she met with MedStar Georgetown physician Shaum Sridharen, an otolaryngologist. Am. Compl. ¶ 32. During this meeting, Palacios says she sought to obtain a video recording of her vocal chords to provide to a surgeon in Boston who was scheduled to perform voice feminization surgery on her. Id. Palacios claims that when Dr. Sridharen learned of the nature of her procedure, he refused to provide her a copy of the video recording. Id. ¶ 34. Palacios subsequently amended her federal administrative charge to encompass the incident with Dr. Sridharen. Defs.' Opp'n Ex. B (letter of Nov. 12, 2015). There is no evidence that Palacios ever similarly amended her D.C. administrative charge.

         On May 10, 2017, Palacios withdrew her pending D.C. charge.[1] She then filed suit in this Court against MedStar Health, Inc. and MedStar Georgetown (collectively “MedStar”). Her complaint alleges that her interactions with the MedStar Georgetown Department of Plastic Surgery constituted discrimination on the basis of gender identity in violation of the D.C. Human Rights Act, D.C. Code § 2-1402.21, and in violation of section 1557 of the Affordable Care Act, 42 U.S.C. § 18116(a). Compl. ¶¶ 30, 42. The complaint as originally filed did not include any allegations concerning her interaction with Dr. Sridharen. After MedStar filed its answer, the parties agreed to undergo mediation, which proved unsuccessful. On November 17, 2017, Palacios filed a motion to amend her complaint, seeking to flesh out her allegations and add claims related to the Sridharen interaction. MedStar opposed her motion, and the Court held a hearing on January 30, 2018. The Court will now grant Palacios's motion in part and deny it in part.

         II. Legal Standard

         Under Federal Rule of Civil Procedure 15(a)(2), a plaintiff may file an amended complaint after an answer has been served only with the opposing party's consent or with leave of court. The Court “should freely give leave when justice so requires.” Id. Leave may be denied in cases involving “undue delay, bad faith or dilatory motive on the part of the movant, repeated failure to cure deficiencies by amendments previously allowed, undue prejudice to the opposing party by virtue of the allowance of the amendment, [and] futility of amendment.” Foman v. Davis, 371 U.S. 178, 182 (1962). In particular, if an amendment would not survive a motion to dismiss-such as where a claim sought to be added is barred by the statute of limitations-amendment is futile and should be denied. See, e.g., James Madison Ltd. by Hecht v. Ludwig, 82 F.3d 1085, 1099 (D.C. Cir. 1996). A defendant has the burden of showing why leave to file an amended complaint should be denied. See, e.g., Smith v. Café Asia, 598 F.Supp.2d 45, 48 (D.D.C. 2009).

         III. Analysis

         As Palacios's counsel clarified at the hearing, Palacios seeks to amend both her claim under the Affordable Care Act (the “section 1557 claim”) and her claim under the D.C. Human Rights Act (the “D.C. law claim”). Medstar argues that leave to amend should be denied because (1) the claims Palacios seeks to add are barred by the applicable statutes of limitations, and (2) Palacios acted with undue delay, bad faith, and dilatory motive in seeking to amend her complaint. See Defs.' Opp'n at 5, 11.

         A. Palacios's section 1557 claim

         1. Statute of Limitations

         Medstar first argues that the section 1557 claim that Palacios seeks to add is barred by the statute of limitations. In fact, counsel for Medstar suggested at the hearing that all of Palacios's section 1557 claims are barred by the statute of limitations. This is so, Medstar contends, because the one-year statute of limitations governing D.C. Human Rights Act claims applies to Palacios's section 1557 claims. See Defs.' Opp'n at 5. Palacios contends that the three-year statute of limitations governing D.C. personal injury claims applies instead. See Pl.'s Reply at 2-3. Neither side is correct. The Court finds that ...

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