Chambers v. The Moses H. Cone Mem'l Hosp. , 259 N.C. App. 8 ( 2018 )

IN THE COURT OF APPEALS OF NORTH CAROLINA
No. COA17-686
Filed: 17 April 2018
Guilford County, No. 12 CVS 6126
CHRISTOPHER CHAMBERS, on behalf of himself and all others similarly situated,
Plaintiff,
v.
THE MOSES H. CONE MEMORIAL HOSPITAL; THE MOSES H. CONE
MEMORIAL HOSPITAL OPERATING CORPORATION d/b/a MOSES CONE
HEALTH SYSTEM and d/b/a CONE HEALTH; and DOES 1 through 25, inclusive,
Defendants.
Appeal by plaintiff from order entered 16 March 2017 by Chief Business Court
Judge James L. Gale in Guilford County Superior Court. Heard in the Court of
Appeals 30 January 2018.
Higgins Benjamin, PLLC, by John F. Bloss, and Barry L. Kramer Law Offices,
by Barry L. Kramer, Esq., admitted pro hac vice, for plaintiff-appellant.
Womble Carlyle Sandridge & Rice, LLP, by Philip J. Mohr and Brent F. Powell,
for defendant-appellees The Moses Cone Memorial Hospital and The Moses
Cone Memorial Hospital Corporation.
BRYANT, Judge.
Where the sole representative in a class action lacked a genuine personal
interest in the outcome of the case and the unifying interests of the class was not
temporary or unlikely to be resolved before the claim was heard, we affirm the trial
court’s dismissal of the class action complaint.
CHAMBERS V. THE MOSES H. CONE MEM’L HOSPITAL
Opinion of the Court
On 23 August 2011, before receiving treatment for an emergency procedure at
Moses H. Cone Memorial Hospital (hereinafter “Moses Cone”), Christopher
Chambers (hereinafter “Chambers”) signed Moses Cone’s Patient Consent form. The
form stated “I understand that I am financially responsible for, guarantee and agree
to pay in full, in accordance with the regular rates and terms of [Moses Cone] at the
time of patient’s treatment, for charges for all services provided to me by [Moses
Cone] . . . .” (Emphasis added). Moses Cone billed Chambers $14,578.14 for services
rendered and materials provided during his stay at the hospital. When the bill went
uncollected, Moses Cone sued Chambers and his wife in Guilford County District
Court.
Chambers filed a class action complaint against Moses Cone in Guilford
County Superior Court. Chambers alleged that Moses Cone charged inflated prices
for emergency care services provided to uninsured patients. Within the hospital
industry, a hospital’s list of gross billing rates for products and services is referred to
as a “chargemaster” list. However, these rates can be negotiated by insurance
companies, managed care organizations, and uninsured patients seeking elective
treatments. Chambers alleged that uninsured patients seeking emergency care
procedures were charged the chargemaster price for products and services.
Chambers argued that the Moses Cone emergency room Patient Consent Form’s
reference to “regular rates and terms” could not be made certain and were, therefore,
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CHAMBERS V. THE MOSES H. CONE MEM’L HOSPITAL
Opinion of the Court
governed by contract principles allowing Moses Cone to recover no more than
“reasonable value” for its services and materials. Chambers contended that the
reasonable value of the services he received was less than one-half of the amount
Moses Cone charged. Chambers sought relief from Moses Cone under several
theories, including: breach of contract, breach of covenant of good faith and fair
dealing, constructive trust, declaratory judgment, restitution, and injunction.
Moses Cone answered Chambers’s class action complaint and counter claimed
against Chambers and his wife,1 as well as the putative class, seeking relief for
unrecovered balances for the cost of services rendered.
On 1 April 2016, Chambers filed an amended class action complaint seeking
only a declaratory judgment that Moses Cone’s Patient Consent form, obligating a
patient to pay Moses Cone “in accordance with the regular rates and terms” applicable
at the time of the patient’s treatment, entitled Moses Cone to no more than the
reasonable value of the treatment or services provided. Moses Cone subsequently
dismissed with prejudice its counterclaims against Chambers and his wife and also
dismissed its district court action against Chambers and his wife. Moses Cone then
moved to dismiss Chambers’s amended class action complaint with prejudice on the
basis of Rule 12(b)(1).
1 N.C. Baptist Hosps. v. Harris, 319 N.C. 347, 349, 354 S.E.2d 471, 472 (1987) (“It is well settled
that ‘doctrine of necessaries’ applies to necessary medical expenses.” (citation omitted)); id. at 353, 354
S.E.2d at 474 (“hold[ing] that a wife is liable for the necessary medical expenses provided for her
husband”).
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CHAMBERS V. THE MOSES H. CONE MEM’L HOSPITAL
Opinion of the Court
In an order entered 16 March 2017, the trial court dismissed Chambers’s
amended complaint on the basis of mootness: There was no longer a controversy
between the parties, and the case did not fit within an exception that allowed a moot
claim to proceed. Chambers appeals.
______________________________________________
On appeal, Chambers argues that the trial court erred by concluding that
Moses Cone’s dismissal of its counterclaims defeated Chambers’s right to continue
prosecuting the putative class action. We disagree.
Rule 23 of our Rules of Civil Procedure provides that “[i]f persons constituting
a class are so numerous as to make it impracticable to bring them all before the court,
such of them, one or more, as will fairly insure the adequate representation of all
may, on behalf of all, sue or be sued.” N.C. Gen. Stat. § 1A-1, Rule 23(a) (2017).
[P]rerequisites for bringing a class action . . . [include] that
. . . the named representatives must establish that they will
fairly and adequately represent the interests of all
members of the class; [and] . . . the named representatives
must have a genuine personal interest, not a mere
technical interest, in the outcome of the case . . . .
Faulkenbury v. Teachers' & State Emps' Ret. Sys. of N.C., 345 N.C. 683, 697, 483
S.E.2d 422, 431 (1997); see also Crow v. Citicorp Acceptance Co., 319 N.C. 274, 282–
83, 354 S.E.2d 459, 465 (1987); Harrison v. Wal-Mart Stores, Inc., 170 N.C. App. 545,
548, 613 S.E.2d 322, 325–26 (2005).
The party seeking to bring a class action under Rule 23(a)
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Opinion of the Court
has the burden of showing that the prerequisites to
utilizing the class action procedure are present. . . .
The named representatives also must establish that they
will fairly and adequately represent the interests of all
members of the class. This prerequisite is a requirement of
due process. See Hansberry v. Lee, 311 U.S. 32, 45, 85 L.
Ed. 22, 29 (1940) (discussing F. R. Civ. P. 23).
Crow, 319 N.C. at 282, 354 S.E.2d at 465.
“Although North Carolina courts are not bound by the ‘case or controversy’
requirement of the United States Constitution with respect to the jurisdiction of
federal courts, similar ‘standing’ requirements apply ‘to refer generally to a party’s
right to have a court decide the merits of a dispute.’ ” Meadows v. Iredell Cty., 187
N.C. App. 785, 787, 653 S.E.2d 925, 927–28 (2007) (citation omitted). “As is obvious
from the wording of [Rule 23], one who is not a member of the represented class may
not bring a class action representing that class.” Id. at 788, 653 S.E.2d at 928(citation omitted); see also id. at 789, 653 S.E.2d at 929 (affirming a trial court’s
dismissal of a class action in part because “[the] plaintiffs were not suitable to
represent the proposed class”); Laborers’ Int’l Union of N. Am., AFL-CIO v. Case
Farms, Inc., 127 N.C. App. 312, 315, 488 S.E.2d 633, 635 (1997) (“[Rule 23] does not
grant or deny standing to parties. Rather than providing a basis for standing, this
statute allows a party who is entitled to sue to bring suit on behalf of itself and other
parties in the form of a class action.” (citation omitted)).
Here, per the Amended Class Action Complaint,
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CHAMBERS V. THE MOSES H. CONE MEM’L HOSPITAL
Opinion of the Court
[Chambers] [brought] this action on behalf of himself and
a class of all persons similarly situated, as defined as
follows:
All individuals (or their guardians or
representatives) who within four years of the date of
the filing of the Complaint in this action and through
the date that the [c]ourt certifies the action as a class
action (a) received emergency care medical
treatment at [Moses Cone] . . . ; (b) whose bills were
not paid in whole or in part by commercial insurance
or a governmental healthcare program; and (c) who
were not granted a full discount or waiver under
[Moses Cone’s] charity policies or otherwise had
their bills permanently waived or written off in full
by [Moses Cone].
Chambers alleged that on 23 August 2011 he went to the emergency room at
Moses Cone for an emergency medical procedure; at the time, he was uninsured.
Chambers was subject to Moses Cone’s standard contract terms and provisions, which
stated that he was obligated to pay the hospital’s bill “in accordance with the regular
rates and terms of [Moses Cone].” The total payment billed to Chambers after his
discharge was $14,458.14 and “upon information and belief such amount was based
on 100% of the hospital’s Chargemaster rates. [Moses Cone] [has] not written off,
discounted or adjusted said billing.” Chambers alleged that his claims “are typical of
the claims of the [proposed] Class” and that “[he] is a member of the [proposed] Class
as defined.” Furthermore, Chambers alleged that he “will fairly and adequately
represent and protect the interest of the Class. He shares the same interests as all
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CHAMBERS V. THE MOSES H. CONE MEM’L HOSPITAL
Opinion of the Court
Class members in having the Contract interpreted and in preventing [Moses Cone]
from pursuing collection of accounts based on billing at its Chargemaster rates.”
However, after Chambers amended the proposed class complaint on 1 April
2016 to assert only one cause of action—declaratory judgment as to the interpretation
of an open price term contained in Moses Cone’s Patient Consent form signed by self-
pay emergency care patients—and removed all other previous claims, such as breach
of contract, breach of covenant of good faith and fair dealing, constructive trust,
restitution, and injunction, Moses Cone ceased its efforts to collect Chambers’s
outstanding balance. On 18 May 2016, Moses Cone dismissed with prejudice all
counterclaims against Chambers and his wife filed in response to the proposed class
action complaint as well as the District Court action against Chambers and his wife
for recovery of Chambers’s $14,358.14 outstanding balance due Moses Cone. Thus,
Chambers no longer has an individual claim against Moses Cone, and neither
Chambers nor his wife is subject to suit by Moses Cone for recovery of the outstanding
balance owed for emergency medical services provided 23 August 2011. Chambers’s
bill has effectively been permanently waived or written off, and thus, Chambers is no
longer a member of the proposed class he seeks to represent. See Faulkenbury, 345
N.C. at 697, 483 S.E.2d at 431 (“[P]rerequisites for bringing a class action . . . [include]
that . . . the named representatives must establish that they will fairly and
adequately represent the interests of all members of the class; [and] . . . the named
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Opinion of the Court
representatives must have a genuine personal interest, not a mere technical interest,
in the outcome of the case . . . .”); Meadows, 187 N.C. App. at 788, 653 S.E.2d at 928(“As is obvious from the wording of [Rule 23], one who is not a member of the
represented class may not bring a class action representing that class.” (citation
omitted)). “The general rule is that an appeal presenting a question which has
become moot will be dismissed.” Thomas v. N.C. Dep't of Human Res., 124 N.C. App.
698, 705, 478 S.E.2d 816, 820 (1996), aff’d, 346 N.C. 268, 485 S.E.2d 295 (1997).
Chambers contends that there are at least three exceptions to the mootness
doctrine which preclude dismissal of his action: “cases in which termination of a class
representative’s claim does not moot the claims of the unnamed members of the
class,” id. at 706, 478 S.E.2d at 821 (quoting Simeon v. Hardin, 339 N.C. 358, 371,
451 S.E.2d 858, 867 (1994)), “a defendant’s voluntary cessation of a challenged
practice does not deprive a . . . court of its power to determine the legality of the
practice,” id. at 705, 478 S.E.2d at 820 (alteration in original) (quoting City of
Mesquite v. Aladdin's Castle, Inc., 455 U.S. 283, 289, 71 L. Ed. 2d 152, 159 (1982)),
and “the court has a ‘duty’ to address an otherwise moot case when the ‘question
involved is a matter of public interest,’ ” id. at 705, 478 S.E.2d at 821 (citing Matthews
v. Dept. of Transp., 35 N.C. App. 768, 770, 242 S.E.2d 653, 654 (1978)). We hold these
exceptions do not apply in the instant case.
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CHAMBERS V. THE MOSES H. CONE MEM’L HOSPITAL
Opinion of the Court
Where our Supreme Court stated in Simeon that it believed the case before it
belonged “to that narrow class of cases in which the termination of a class
representative’s claim does not moot the claims of the unnamed members of the
class,” Simeon, 339 N.C. at 371, 451 S.E.2d at 867 (citation omitted), the Court
acknowledged there that the named plaintiff’s challenged harm was “by nature
temporary, and it [was] most unlikely that any given individual could have his . . .
claim decided . . . before [his challenge was resolved].” Id. Here, Chambers does not
raise a challenge that is by nature temporary or likely to be resolved before the claim
could be heard. Therefore, this exception to the mootness doctrine is not applicable.
As to the remaining grounds raised as exceptions to the basis for holding
Chambers’s action moot, we note that each is an exception to holding the class action
moot. See Thomas, 124 N.C. App. at 705, 478 S.E.2d at 820 (“[A] defendant’s
voluntary cessation of a challenged practice does not deprive a . . . court of its power
to determine the legality of the practice.” (citation omitted)); id. at 705, 478 S.E.2d at
821 (“[T]he court has a ‘duty’ to address an otherwise moot case when the ‘question
involved is a matter of public interest.’ ” (citation omitted)). We need not determine
if the class action is now moot based on the conduct of Moses Cone or the public
interest. The proposed class has but one representative—Chambers. And the sole
class representative lacks a genuine personal interest in the outcome of the case. See
Faulkenbury, 345 N.C. at 697, 483 S.E.2d at 431 (requiring that a class representative
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CHAMBERS V. THE MOSES H. CONE MEM’L HOSPITAL
Opinion of the Court
have “a genuine personal interest . . . in the outcome of the case”). Furthermore,
Chambers has provided no authority which would allow the class action to proceed
despite his lack of individual standing as class representative. See N.C. Gen. Stat. §
1A-1, Rule 23(a) (“[O]ne or more, as will fairly insure the adequate representation of
all may, on behalf of all, sue or be sued.”). Accordingly, we affirm the trial court’s
dismissal of Chambers’s amended class action complaint.
AFFIRMED.
Judges DIETZ and BERGER concur.
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