City of Warren Police and Fire Retirement System, and Janice Stewart v. Tenet Healthcare Corporation ( 2020 )


Menu:
  • AFFIRMED; Opinion Filed September 28, 2020
    In The
    Court of Appeals
    Fifth District of Texas at Dallas
    No. 05-19-00260-CV
    CITY OF WARREN POLICE AND FIRE RETIREMENT SYSTEM AND
    JANICE STEWART, Appellants
    V.
    TENET HEALTHCARE CORPORATION, JAMES A. UNRUH, RONALD
    A. RITTENMEYER, BRENDA J. GAINES, KAREN M. GARRISON,
    RICHARD R. PETTINGILL, J. ROBERT KERREY, EDWARD A.
    KANGAS, FREDA C. LEWIS-HALL, TAMMY ROMO, MATTHEW J.
    RIPPERGER, RANDOLPH C. SIMPSON, TREVOR FETTER, DANIEL
    CANCELMI, R. SCOTT RAMSEY, J. MCDONALD WILLIAMS, JOHN
    ELLIS BUSH, AND BIGGS C. PORTER, Appellees
    On Appeal from the 14th Judicial District Court
    Dallas County, Texas
    Trial Court Cause No. DC-16-15118
    MEMORANDUM OPINION
    Before Justices Molberg, Carlyle, and Browning1
    Opinion by Justice Carlyle
    In this shareholder derivative action, appellants—two Tenet Healthcare
    Corporation shareholders—asserted claims for breach of fiduciary duty, corporate
    1
    The Honorable David L. Bridges, Justice, participated in the submission of this appeal; however, he
    did not participate in the issuance of this opinion due to his death on July 25, 2020. Justice Browning has
    substituted for Justice Bridges and has reviewed the record and the briefs in this cause.
    waste, unjust enrichment, and gross mismanagement against appellees, who are
    current and former Tenet directors and officers.2 Appellees filed special exceptions
    based on appellants’ alleged failure to adequately plead that a pre-suit litigation
    demand on Tenet’s board of directors was excused as futile. The trial court granted
    appellees’ special exceptions and, after appellants declined to replead, dismissed the
    action with prejudice.
    In two issues on appeal, appellants contend they sufficiently pleaded demand
    futility and the trial court erred by granting appellees’ special exceptions and
    dismissing the petition. We affirm in this memorandum opinion. See TEX. R. APP. P.
    47.4.
    Background
    Tenet, a Nevada corporation, operates hospitals and outpatient centers
    throughout the United States. At the time of the complained-of events, Tenet
    operated about 77 hospitals and 183 outpatient centers nationwide. Its board of
    directors (the Board) consisted of fourteen members elected annually by its
    shareholders.
    According to appellants’ February 2017 live petition, (1) in June 2006, Tenet
    “entered into a $900 million settlement with the United States to resolve the
    Company’s False Claims Act liability for engaging in alleged unlawful Medicare
    2
    Nominal defendant Tenet Healthcare Corporation is also an appellee.
    –2–
    billing practices”; (2) as part of the 2006 settlement, Tenet “agreed to a Corporate
    Integrity Agreement (‘CIA’) with the Department of Health and Human Services’
    Office of the Inspector General to ensure that all Tenet facilities complied with
    Medicare and Medicaid program requirements,” including the “federal False Claims
    Act and Anti-Kickback Statute”; and (3) the CIA required, among other things, that
    “Tenet strengthen its policies, procedures and controls for contracts with referral
    sources to ensure compliance with the Anti-Kickback Statute.”
    Appellants further alleged that from 2000 “until at least 2013,” four Tenet
    hospitals in Georgia and South Carolina “systematically paid healthcare kickbacks
    and bribes to Hispanic Medical Management d/b/a Clinica de la Mama (‘Clinica’)
    in return for Clinica’s agreement to send patients, mostly undocumented Hispanic
    women, to Tenet facilities for medical services related to labor and delivery that
    were paid for by the Medicaid and Medicare programs.” The petition stated that
    “although undocumented pregnant women are not eligible for regular Medicaid
    coverage,” Tenet benefitted from those referrals because undocumented patients
    “can qualify for emergency medical assistance when they deliver their babies” and
    Tenet hospitals “included the Medicaid-ineligible women when seeking additional
    Medicaid funds intended to support hospitals that treat a large number of low-income
    patients.” According to the petition, Tenet “unlawfully obtained more than $145
    million in Medicaid and Medicare program funds as a result of [that] patient referral
    scheme” and, on October 3, 2016, (1) “was forced to pay $513 million to resolve its
    –3–
    federal False Claims Act and Anti-Kickback Statute liability for defrauding the
    United States and paying bribes to Clinica in exchange for patient referrals” and
    (2) “entered into an onerous Non-Prosecution Agreement (‘NPA’)” with the U.S.
    Department of Justice and the U.S. Attorney’s Office for the Northern District of
    Georgia.3
    The petition contended that “[a]s Tenet’s directors and top officers,”4
    appellees owed Tenet and its shareholders “a fiduciary duty of loyalty to direct the
    operations of the Company and its subsidiaries and hospitals in conformity with the
    laws applicable to its business,” but “breached their fiduciary duties of legal
    compliance and candor by acting disloyally towards Tenet.” Specifically, “[w]hile
    under [appellees’] stewardship, Tenet adopted billing and contract review policies,
    procedures and controls, and/or deployed such policies, procedures and controls,
    such that multiple Tenet hospitals regularly paid kickbacks to prenatal care clinic
    3
    Appellants’ petition quoted portions of the NPA’s “Statement of Facts” in support of the petition’s
    factual allegations.
    4
    According to the petition, Mr. Unruh “has been a director of Tenet since 2004”; Mr. Rittenmeyer “has
    been a director of Tenet since 2010”; Ms. Gaines “has been a director of Tenet since March 2005”; Ms.
    Garrison “has been a director of Tenet since March 2005”; Mr. Pettingill “has been a director of Tenet since
    March 2004”; Mr. Kerrey “served as a director of Tenet since November 2012 (he previously served as a
    director from March 2001 to March 2012 as well)”; Mr. Kangas “has been a director of Tenet since April
    2003”; Ms. Lewis-Hall “has been a director of Tenet since December 2014”; Ms. Romo “has been a director
    of Tenet since March 2015”; Mr. Ripperger “has been a director of Tenet since January 2016”; Mr. Simpson
    “has been a director of Tenet since January 2016”; Mr. Fetter “has been Tenet’s CEO since September
    2003” and “has been a director of Tenet since 2003”; Mr. Cancelmi “has been Tenet’s CFO since September
    2012”; Mr. Ramsey “has been Tenet’s CAO, Vice President and Controller since September 2012”; Mr.
    Williams “served as a director of Tenet from March 2005 to May 2010”; Mr. Bush “served as a director of
    Tenet from April 2007 to December 2014”; and Mr. Porter “served as Tenet’s CFO from June 2006 to
    March 2012.” The petition also described the required duties of the Board’s Audit Committee and
    Compliance Committee and alleged that seven of the defendants had served on at least one of those two
    committees during the relevant time period.
    –4–
    operators in exchange for patient referrals with impunity” and “issued materially
    false and misleading” financial reports that (1) “misrepresented that Tenet had
    effective internal controls for legal compliance when, in fact, it did not,” and
    (2) failed to disclose that Tenet had “obtained millions of dollars in revenues by
    defrauding the United States and paying bribes and kickback in exchange for patient
    referrals” and “improperly recorded the unlawful payments as legitimate expenses
    in Tenet’s consolidated financial statements and financial reports.” The petition
    stated,
    As a result of their access to and review of internal corporate
    documents, or conversations and connections with other corporate
    officers, employees, and directors and attendance at management
    and/or Board meetings, each of the defendants knew, or was reckless in
    not knowing, the adverse, material, non-public facts about Tenet’s
    patient referral kickback scheme and/or the false and misleading
    consolidated financial results and financial statements complained of
    herein.
    Appellants alleged appellees “collectively pocketed well over $100 million in
    salaries, fees, stock and other incentive-based compensation not justified in light of
    the serious breaches of fiduciary duty and violations of federal law that have
    occurred during their watch.” Thus, appellants asserted, a majority of Tenet’s
    directors are “disabled from considering a demand” and “[a]ccordingly, a pre-suit
    demand on the Tenet Board to commence, let alone vigorously prosecute, this action
    is a useless and futile act, and is therefore excused.”
    –5–
    Appellees filed a brief in support of their special exceptions5 in which they
    asserted, among other things, (1) “[a]ccording to the government’s factual recitation
    on which the Petition relies,” employees of four Tenet hospitals in Georgia and
    South Carolina “created contractual agreements with Clinica as a ‘pretextual
    mechanism’ to make illegal payments in exchange for patient referrals, ‘concealed
    material facts from Tenet lawyers and outside counsel because they knew that the
    agreements would not be approved if the true nature of the Clinica arrangements
    were disclosed to the lawyers,’ and facilitated payments to Clinica ‘in violation of
    then-existing company policies and controls governing the disbursement of monies
    to referral sources,’” and (2) “[w]hen this misconduct came to light, Tenet
    cooperated with the government in its investigation, disclosed the investigation to
    its shareholders, and resolved the matter by, among other things, paying a monetary
    settlement and enhancing its controls, policies, and monitoring procedures.”
    Appellees contended appellants’ effort to adequately plead demand futility
    failed because appellants did not “plead particularized facts giving rise to an
    inference that any member of the Board faces a substantial likelihood of personal
    liability for intentional misconduct, fraud, or a knowing violation of law.”
    Consequently, appellants “lack standing to bring claims on behalf of Tenet and this
    case cannot proceed.” Appellees also asserted “Plaintiffs’ failure to plead
    5
    About a month after appellees timely filed their answer and special exceptions, the trial court stayed
    this case pending resolution of a federal securities class action based on the same underlying allegations.
    One year later, the federal securities class action was dismissed with prejudice and this case resumed.
    –6–
    particularized facts on a director-by-director basis showing knowledge of the illegal
    payments to Clinica renders the Petition defective as a matter [of] law, and
    Defendants’ special exceptions can be granted on this basis alone.” Appellees relied
    primarily on two cases from this Court: In re Brick, 
    351 S.W.3d 601
    (Tex. App.—
    Dallas 2011, orig. proceeding), and Connolly v. Gasmire, 
    257 S.W.3d 831
    (Tex.
    App.—Dallas 2008, no pet.).
    Appellants filed an “Opposition” to appellees’ special exceptions, asserting in
    part (1) “[a]lthough not directly involving the Clinica kickback scheme, the CIA’s
    requirements directly addressed the same type of misconduct”; (2) Tenet’s
    “extensive internal controls,” i.e., “the specific duties and responsibilities required
    by the CIA that were implemented,” “would have uncovered the illegal kickbacks
    to Clinica and brought this information to management and the Board”; (3) the
    petition’s allegations “demonstrate that a majority of the directors on Tenet’s Board
    at the time the Petition was filed face a substantial likelihood of liability for
    consciously failing to stop the illegal bribes and kickback payments to Clinica”; and
    (4) “the size and duration of the Clinica kickback scheme also supports the
    reasonable inference that Defendants . . . had knowledge of the scheme.” The
    attachments to that document included the NPA’s Statement of Facts.
    In reply, appellees contended that “[e]ven setting aside Plaintiffs’ failure to
    plead on a director-by-director basis, Plaintiffs do not come close to pleading that
    any member of the Board knew of illegal conduct and allowed it to continue,” but
    –7–
    rather “ask [the trial court] to assume such knowledge” under theories rejected in
    Brick and Connolly.
    At the hearing on appellees’ special exceptions, appellants’ counsel argued in
    part (1) “this process that was enacted by the CIA and that the corporate Board at
    Tenet agreed to implement was implemented; it’s not even contested,” and (2) under
    Brick, “we can say that there are people on the Board committee and that that
    committee met at certain times and promised it would do so, certified in SEC filings
    that it had met its obligations under the 2006 CIA, and that is sufficient for pleading
    that each director gained knowledge through those meetings and through that
    process.”
    Following the hearing, the trial court signed an order granting appellees’
    special exceptions based on appellants “failing to meet the ‘demand futility’
    standards articulated by the Dallas Court of Appeals in In re Brick.” Appellants
    moved for limited discovery for the purpose of meeting the applicable pleading
    requirements, but the trial court denied that motion. Appellants then elected not to
    replead.
    Standard of review and applicable law
    We reverse a trial court’s ruling on special exceptions only if there has been
    an abuse of discretion. 6 
    Connolly, 257 S.W.3d at 838
    . “However, even under the
    6
    Though appellants contend abuse-of-discretion review is “inappropriate” here under “substantive
    Nevada law,” “[t]he standard of review is a procedural question to which we apply Texas law.” Gator
    –8–
    abuse of discretion standard, we review the trial court’s determination of legal
    questions de novo.” Gatten v. McCarley, 
    391 S.W.3d 669
    , 673 (Tex. App.—Dallas
    2013, no pet.); see also Downer v. Aquamarine Operators, Inc., 
    701 S.W.2d 238
    ,
    241–42 (Tex. 1985) (explaining trial court abuses its discretion when it fails to
    analyze or apply law correctly). If a trial court properly sustains special exceptions
    and the plaintiff does not amend the pleadings, the trial court does not err by
    dismissing the cause of action. 
    Connolly, 257 S.W.3d at 838
    .
    The parties do not dispute that Nevada law governs the substantive aspects of
    our demand futility analysis. See TEX. BUS. ORGS. CODE § 21.562(a) (in derivative
    proceeding brought in right of foreign corporation, requirement that shareholder
    make written demand is governed by law of jurisdiction where foreign corporation
    is incorporated). Under Nevada law, a corporation’s board of directors ordinarily
    “has full control over the affairs of the corporation,” including whether to take legal
    action on the corporation’s behalf. Shoen v. SAC Holding Corp., 
    137 P.3d 1171
    ,
    1178–79 (Nev. 2006), abrogated on other grounds by Chur v. Eighth Judicial Dist.
    Court in & for Cty. of Clark, 
    458 P.3d 336
    (Nev. 2020). Nonetheless, when the board
    fails to appropriately act, individual shareholders may file a derivative suit, which
    allows shareholders to “compel the corporation to sue” and to thus pursue litigation
    on the corporation’s behalf against the corporation’s board of directors and officers.
    Apple, LLC v. Apple Tex. Rests., Inc., 
    442 S.W.3d 521
    , 530 n.4 (Tex. App.—Dallas 2014, pet. denied);
    accord 
    Connolly, 257 S.W.3d at 838
    .
    –9–
    Id. at 1179.
    Nevada’s “heightened pleading imperatives in shareholder derivative
    suits” require a derivative complaint to “state, with particularity, the demand for
    corrective action that the shareholder made on the board of directors (and, possibly,
    other shareholders) and why he failed to obtain such action, or his reasons for not
    making a demand.”
    Id. (citing NEV. R.
    CIV. P. 23.1); see also NEV. REV. STAT.
    § 41.520.
    In analyzing demand futility, Nevada courts generally follow the approach
    and reasoning of Delaware law. 
    Shoen, 137 P.3d at 1179
    –80, 1184. Thus, “as the
    Delaware Supreme Court has recognized in a similar shareholder demand context, a
    shareholder must ‘set forth . . . particularized factual statements that are essential to
    the claim’ that a demand has been made and refused, or that making a demand would
    be futile or otherwise inappropriate.”
    Id. at 1179–80.
    Though the shareholder “is not
    required to plead evidence,” “mere conclusory assertions will not suffice under
    NRCP 23.1’s ‘with particularity’ standard.”
    Id. at 1180;
    see also 
    Brick, 351 S.W.3d at 604
    (“The shareholder has the burden to adequately plead demand futility with
    particularized facts. The pleading standard for demand futility requires a fact-
    intensive, director-by-director analysis.” (citing Postorivo v. AG Paintball Holdings,
    Inc., Nos. 2991-VCP, 3111-VCP, 
    2008 WL 553205
    , at *6–7 (Del. Ch. Feb. 29,
    2008) (mem. op.), and other Delaware cases)); 
    Connolly, 257 S.W.3d at 840
    (same).
    Nevada courts must also examine whether particularized facts demonstrate
    (1) “in those cases in which the directors approved the challenged transactions, a
    –10–
    reasonable doubt that the directors were disinterested or that the business judgment
    rule otherwise protects the challenged decisions” (the Aronson test); or (2) “in those
    cases in which the challenged transactions did not involve board action or the board
    of directors has changed since the transactions, a reasonable doubt that the board can
    impartially consider a demand” (the Rales test). 
    Shoen, 137 P.3d at 1184
    (citing
    Aronson v. Lewis, 
    473 A.2d 805
    , 814 (Del. 1984), overruled on other grounds by
    Brehm v. Eisner, 
    746 A.2d 244
    (Del. 2000); Rales v. Blasband, 
    634 A.2d 927
    , 934
    (Del. 1993)). “[I]n practice, the Aronson and Rales ‘disinterested and independent’
    tests often amount to the same analysis—i.e., whether directorial interest in the
    challenged act or the outcome of any related litigation negates impartiality to
    consider a demand.”
    Id. at 1184
    n.62.
    Further, “to show interestedness, a shareholder must allege that a majority of
    the board members would be ‘materially affected, either to [their] benefit or
    detriment, by a decision of the board, in a manner not shared by the corporation and
    the stockholders.’”
    Id. at 1183;
    see also
    id. at 1184
    n.62 (“[W]hen considering
    whether the ‘majority’ of an even-numbered board is incapable of impartially
    considering a demand under the tests for demand futility, the ‘majority’ equals at
    least one-half of that board.”). Allegations of “mere threats of liability through
    approval of the wrongdoing or other participation” do not show sufficient
    interestedness to excuse the demand requirement.
    Id. at 1183.
    “Instead, as the
    Delaware courts have indicated, interestedness because of potential liability can be
    –11–
    shown only in those ‘rare case[s] . . . where defendants’ actions were so egregious
    that a substantial likelihood of director liability exists.’”
    Id. at 1183–84.
    “And
    directors and officers may only be found personally liable for breaching their
    fiduciary duty of loyalty if that breach involves intentional misconduct, fraud, or a
    knowing violation of the law.”
    Id. at 1184
    (citing NEV. REV. STAT. § 78.138(7)).
    Consequently, “interestedness through potential liability is a difficult threshold to
    meet.”
    Id. Appellants failed to
    adequately plead demand futility
    Here, both parties assert this case “implicates” the Rales test. 
    See 634 A.2d at 934
    . We agree.7 That test “inquires whether the complaint’s particularized facts
    show that the board is incapable of impartially considering a demand—i.e., that a
    majority of the board members are interested in the decision to act on the demand or
    dependent on someone who is interested in that decision.” 
    Shoen, 137 P.3d at 1185
    .
    Appellants contend (1) “despite the rigorous oversight imposed by the CIA
    and overseen by Defendants, Tenet’s bribes-for-referrals-of-pregnant-women
    scheme continued unabated throughout the five-year term of the CIA and persisted
    until at least 2013, giving rise to a ‘reasonabl[e] infer[ence] that the Board had
    consciously disregarded [Tenet]’s commitments under the [CIA] and its own
    oversight responsibilities’” (quoting Horman v. Abney, No. 12290-VCS, 
    2017 WL 7
         See 
    Shoen, 137 P.3d at 1184
    –85 (“Since, for the most part, appellants have alleged a failure to properly
    supervise or a willful disregard of duties, they do not challenge any board-considered business decision.
    Therefore, the Rales test applies.”).
    –12–
    242571, at *11 (Del. Ch. Jan. 19, 2017) (mem. op.)); (2) “[i]t is that inference that
    raises a ‘substantial likelihood’ of liability as to a majority of the current board and
    excuses demand”; and (3) “[t]hat inference is also supported by the magnitude and
    duration of the alleged wrong.” Appellants further assert the trial court’s ruling
    implies it “adopted an extreme reading of Brick” that required “direct—rather than
    inferential—allegations of knowledge and a unique showing as to each individual
    director,” neither of which, according to appellants, is required by Delaware or
    Nevada law.
    In Horman, United Parcel Service (UPS) entered into a 2005 “Assurance of
    Discontinuance Agreement” (AOD) with the government in which UPS agreed to
    comply with laws regarding the prohibited shipment of untaxed cigarettes from
    retailers on Native American reservations and establish effective monitoring systems
    going forward. Horman, 
    2017 WL 242571
    , at *3. The shareholder plaintiffs alleged
    that after about five years of compliance, the director defendants “began to ignore
    their oversight responsibilities and UPS began to operate in violation of the AOD
    and applicable state and federal laws governing the shipment of cigarettes.”
    Id. at *4.
    The shareholders contended the directors “breached their duty of loyalty owed
    to UPS and its stockholders” by “willfully, consciously recklessly, and intentionally
    failing to perform their duties of oversight to ensure the Company’s compliance with
    positive law.”
    Id. at *7.
    The directors moved to dismiss the complaint for failure to
    adequately plead demand futility.
    Id. at *1.
                                             –13–
    The court in Horman stated that on a motion to dismiss pursuant to Rule 23.1,
    the court “accepts well-pled allegations as true, and makes reasonable inferences in
    favor of the plaintiff,” but “[g]iven the heightened requirements of Rule
    23.1, . . . conclusory allegations of fact or law not supported by allegations of
    specific fact may not be taken as true.”
    Id. at *6.
    The court observed that “Delaware
    courts routinely reject the conclusory allegation that because illegal behavior
    occurred, internal controls must have been deficient, and the board must have known
    so.”
    Id. at *7.
    “Rather, a plaintiff must plead with particularity a sufficient
    connection between the corporate trauma and the board.”
    Id. One way to
    do so is to
    “plead that the board knew of evidence of corporate misconduct—the proverbial ‘red
    flag’—yet acted in bad faith by consciously disregarding its duty to address that
    misconduct.”
    Id. Though the Horman
    shareholders argued the AOD itself served as a red flag,
    the court disagreed, noting that typically “the red flag analogy depicts events or
    reports that serve as warning signs to the Board of corporate wrongdoing after a
    system of reporting and compliance is in place.”
    Id. at 11.
    The court stated:
    There might well be a reasonably conceivable scenario where the AOD
    itself could have taken the form of a red flag. For instance, if UPS had
    entered the AOD in 2005 and then continued a pattern of non-compliant
    shipments immediately thereafter and through 2014, one might
    reasonably infer that the Board had consciously disregarded UPS’s
    commitments under the AOD and its own oversight responsibilities.
    But that is not what Plaintiffs have alleged.
    Id. –14– The court
    then addressed the shareholders’ argument that a 2010 report to
    UPS’s Audit Committee by UPS’s vice president of its legal department constituted
    a red flag sufficient to establish demand futility.
    Id. Specifically, the shareholders
    contended the VP’s presentation “reviewed significant matters and trends” and it
    was reasonable to infer that the VP, “given his authority and knowledge under the
    [AOD], his direct reporting relationship with the Audit Committee, and his status of
    Vice Secretary of the Audit Committee . . . , knew of UPS’s abandonment of its
    obligations under the [AOD] and reported the same to the Audit Committee in
    November 2010.”
    Id. The court rejected
    that argument, stating:
    Plaintiffs would have the Court make two inferential leaps here: (1) [the
    VP] knew of compliance issues related to the AOD; and (2) he reported
    those issues to the Audit Committee.
    Plaintiffs’ invitation to play inferential hopscotch does not
    comport with Rule 23.1’s “stringent requirements of factual
    particularity.” While the Court must “draw all reasonable inferences in
    the plaintiff’s favor,” our Supreme Court has made clear that
    “conclusory allegations are not considered as expressly pleaded facts
    or factual inferences.” Even reasonable inferences “must logically flow
    from particularized facts alleged by the plaintiff.” Plaintiffs’ allegations
    that [the VP] had knowledge of the AOD because he was charged with
    the ultimate responsibility to implement it, and that he must have
    advised the Audit Committee that UPS had abandoned its obligations
    when he reported on “significant matters and trends,” are both wholly
    conclusory. Plaintiffs have not tied these allegations to any
    particularized facts about what [the VP] knew, when he knew it or what
    he actually told the Audit Committee.
    Id. at *12
    (quoting Wood v. Baum, 
    953 A.2d 136
    , 140 (Del. 2008); 
    Brehm, 746 A.2d at 254
    ).
    –15–
    Here, appellants contend Horman “supports a ‘reasonabl[e] infer[ence]’ of
    conscious disregard by the Board.” They assert (1) “[w]hile the CIA did not identify
    Clinica by name, in Horman, . . . UPS did not enter an agreement not to ship from
    specific tribes to specific customers—it committed to not do it all”; (2) “[t]hus,
    Horman recognized that a failure to stop that general category of misconduct
    supported an inference of conscious disregard”; and (3) “[s]o, too, here, where the
    CIA was not specific to particular referral agreements; it broadly required careful
    analysis of all such agreements, and Defendants consciously disregarded their duty
    to halt them.”
    Though Horman described a hypothetical circumstance in which the facts
    before that court, if altered slightly, “might” give rise to a reasonable inference
    supporting demand futility, we do not find it persuasive under our facts. Here, the
    NPA’s Statement of Facts stated that employees of four Tenet hospitals in Georgia
    and South Carolina created contractual agreements with Clinica as a “pretextual
    mechanism” to make illegal payments in exchange for patient referrals, “concealed
    material facts from Tenet lawyers and outside counsel because they knew that the
    agreements would not be approved if the true nature of the Clinica arrangements
    were disclosed to the lawyers,” and facilitated payments to Clinica “in violation of
    then-existing company policies and controls governing the disbursement of monies
    to referral sources.” Appellants argue “[t]here is no reason to believe that [the CIA’s]
    level of scrutiny would be frustrated because some executives concealed facts
    –16–
    sometimes, or made substantial payments to Clinica without proper documentation,”
    and, moreover, “the Statement of Facts gives every indication that Tenet’s lawyers
    independently acquired information, strongly supporting an inference that the Board
    was made aware of the Clinica issues—yet the Board members either consciously
    disregarded their duty to review those contracts or chose inaction regarding [Tenet’s
    violations].” But appellants point to no particularized facts supporting those
    suggested inferences.8 See
    id. at *12
    (“Even reasonable inferences ‘must logically
    flow from particularized facts alleged by the plaintiff.’”).
    Appellants also contend that the inference that the CIA’s requirements would
    have brought the continuing misconduct regarding Clinica to the Board’s attention
    is compelling because “[w]here there is a corporate governance structure in place,
    we must then assume the corporate procedures were followed and that the board
    knew of the problems and decided no action was required.” (quoting In re Abbott
    Labs. Derivative S’holders Litig., 
    325 F.3d 795
    (7th Cir. 2003)). Although Abbott
    Labs purported to apply Delaware law, the statement appellants quote has not been
    8
    Appellants also cite In re McKesson Corp. Derivative Litigation, No. 17-cv-01850-CW, 
    2018 WL 2197548
    (N.D. Cal. May 14, 2018), a case based on Horman’s reasoning. In McKesson, the corporation
    entered into a 2008 DOJ settlement that required it to implement a controlled-substance monitoring
    program. The court found the shareholders’ allegations sufficient to establish demand futility where certain
    directors “continued a pattern of noncompliance” after the corporation settled.
    Id. at *10.
    Specifically, the
    audit committee failed to take action even after receiving “regular signals” during at least five meetings that
    the monitoring program it had established in connection with the settlement “was failing and required more
    attention.”
    Id. at *7–10.
    McKesson’s “strong factual allegations of board knowledge of ongoing legal
    violations in the wake of federal government enforcement proceedings” distinguish that case from the one
    before us. See Rojas on behalf of J.C. Penney Co., Inc. v. Ellison, No. 2018-0755-AGB, 
    2019 WL 3408812
    ,
    at *13 (Del. Ch. July 29, 2019) (mem. op.) (distinguishing McKesson because “[f]actual allegations of this
    nature are precisely what is missing here”).
    –17–
    adopted or recognized as correct by any Delaware (or Nevada) court and, in fact, has
    been specifically rejected or distinguished by several other jurisdictions applying
    Delaware law.9 We do not find Abbott Labs instructive. See Horman, 
    2017 WL 242571
    , at *9 (rejecting “bald allegation that directors bear liability where a
    concededly well-constituted mechanism, having received no specific indications of
    misconduct, failed to discover fraud”); see also 
    Connolly, 257 S.W.3d at 851
    (rejecting Abbott Labs-based argument that Delaware law allows knowledge of
    alleged defects in company’s internal controls and alleged violations to be “imputed
    generally” to company’s directors).
    Appellants further argue that “the size and duration of the Clinica kickback
    scheme also supports the reasonable inference that Defendants . . . had knowledge
    of the scheme.” Specifically, appellants contend (1) “[t]he scheme spanned over a
    9
    See Cottrell on behalf of Wal-Mart Stores, Inc. v. Duke, 
    829 F.3d 983
    , 993 (8th Cir. 2016) (rejecting
    shareholders’ Abbott Labs argument because “[t]he shareholders take that line out of context” and “the
    court [in Abbott Labs] did not simply infer that knowledge based on the ‘assum[ption]’ that ‘corporate
    governance procedures were followed,’ as the shareholders’ quotation might suggest in isolation,” but “[t]o
    the contrary, the court repeatedly listed other specific factual allegations establishing the directors’
    awareness”); In re First Solar Derivative Litig., No. CV-12-00769-PHX-DGC, 
    2016 WL 3548758
    , at *9
    (D. Ariz. June 30, 2016) (refusing to “conclude that the existence of internal risk management procedures
    allows the Court to infer that the continuing outside directors each knowingly chose not to disclose the
    [complained-of] defect” because, regardless of the language used in Abbott Labs, that case “included many
    factual allegations in addition to the corporate governance structure” and “[w]ith such detailed allegations,
    little inference was required to conclude that the board members knew of the non-compliance problems”);
    cf. In re Pfizer Inc. S’holder Derivative Litig., 
    722 F. Supp. 2d 453
    , 461–62 (S.D.N.Y. 2010) (noting “the
    Complaint detail[ed] at great length a large number of reports made to members of the board,” including
    “reports to the board of the Neurontin and Genotropin settlements, a large number of FDA violation notices
    and warning letters, [and] several reports to Pfizer’s compliance personnel and senior executives of
    continuing kickbacks and off-label marketing,” and concluding “[t]here is no reason to believe [the CIA’s]
    reporting requirement was not fully complied with, thus guaranteeing that each member of the board was
    bombarded with allegations of continuing misconduct of the very kind that the prior settlements looked to
    the board to prevent,” and “[i]n such circumstances, nothing in either federal or Delaware law holds it
    insufficient for individual directors’ knowledge and liability to be pleaded inferentially” (citing Abbott
    
    Labs, 325 F.3d at 806
    )).
    –18–
    decade—from 2000 through 2013—and subsumed the entire five-year term of the
    2006 CIA”; (2) “[d]uring that time, Tenet paid Clinica bribes and kickbacks totaling
    over $12 million,” which “allowed Tenet to collect more than $145 million in
    unlawful Medicare and Medicaid funds”; and (3) “the Audit Committee would have
    been watching this issue closely given the $900 million price tag of the previous
    compliance failures.” According to appellants, “in assessing the magnitude and
    duration of the alleged wrongdoing, this Court should bear in mind not only Tenet’s
    millions of dollars in bribes and kickbacks, and its $145 million in tainted revenues,
    but also the far-greater risks of enormous liability to which these wayward
    fiduciaries exposed Tenet—risks that resulted in a second fine of $513 million to
    resolve its . . . liability for defrauding the United States and paying bribes to Clinica
    in exchange for patient referrals.”
    Though “magnitude and duration may be probative of whether the Board
    knew or should have known about a violation of the law,” these factors “will rarely
    suffice in their own right to satisfy Rule 23.1’s requirement in this context that
    plaintiffs allege with particularity actual or constructive board knowledge.” In re
    SAIC Inc. Derivative Litig., 
    948 F. Supp. 2d 366
    , 387 (S.D.N.Y. 2013) (applying
    Delaware law); accord 
    Cottrell, 829 F.3d at 996
    . Here, the alleged wrongdoing
    involved four Tenet hospitals out of about seventy-seven. And while the $513-
    million fine imposed after the improper conduct came to light is not insubstantial,
    appellants do not dispute appellees’ assertion that $145 million—the “tainted”
    –19–
    revenue—“is the equivalent of approximately 1.3% of Tenet’s operating revenues
    for 2013 alone.” Without minimizing the alleged wrongdoing here, we conclude the
    “magnitude and duration” of the alleged “scheme” do not, “in their own right” or in
    concert with appellants’ other allegations, support a reasonable inference of board
    knowledge. See 
    SAIC, 948 F. Supp. 2d at 387
    ; 
    Cottrell, 829 F.3d at 996
    ; see also
    Horman, 
    2017 WL 242571
    , at *14–15 & n.91 (considering ratio of UPS’s illegal
    shipments to its overall operations in rejecting shareholders’ “magnitude and
    duration” argument); In re Chemed Corp., S’holder Derivative Litig., No. 13-1854-
    LPS-CJB, 
    2015 WL 9460118
    , at *14 (D. Del. Dec. 23, 2015) (“The allegations in
    the Complaint do span a lengthy period of years. Yet while that is so, and while the
    allegations are otherwise long on describing misconduct of Vitas and/or Chemed
    executives, they are short on particularized facts indicating that Board members were
    aware of any such misconduct and failed to take action.”).
    On this record, we conclude appellants did not meet their burden to
    “adequately plead demand futility with particularized facts.” See 
    Brick, 351 S.W.3d at 604
    ; 
    Connolly, 257 S.W.3d at 840
    ; see also Horman, 
    2017 WL 242571
    , at *12
    (“[O]ur Supreme Court has made clear that ‘conclusory allegations are not
    considered as expressly pleaded facts or factual inferences.’ Even reasonable
    inferences ‘must logically flow from particularized facts alleged by the plaintiff.’”).
    Consequently, the trial court did not abuse its discretion by granting appellees’
    –20–
    special exceptions and dismissing appellants’ petition with prejudice. See 
    Connolly, 257 S.W.3d at 838
    .
    We decide appellants’ two issues against them and affirm the trial court’s
    judgment.
    /Cory L. Carlyle/
    CORY L. CARLYLE
    JUSTICE
    Molberg, J., dissenting without opinion
    190260F.P05
    –21–
    Court of Appeals
    Fifth District of Texas at Dallas
    JUDGMENT
    CITY OF WARREN POLICE AND                     On Appeal from the 14th Judicial
    FIRE RETIREMENT SYSTEM                        District Court, Dallas County, Texas
    AND JANICE STEWART,                           Trial Court Cause No. DC-16-15118.
    Appellants                                    Opinion delivered by Justice Carlyle.
    Justices Molberg and Browning
    No. 05-19-00260-CV           V.               participating.
    TENET HEALTHCARE
    CORPORATION, JAMES A.
    UNRUH, RONALD A.
    RITTENMEYER, BRENDA J.
    GAINES, KAREN M. GARRISON,
    RICHARD R. PETTINGILL, J.
    ROBERT KERREY, EDWARD A.
    KANGAS, FREDA C. LEWIS-
    HALL, TAMMY ROMO,
    MATTHEW J. RIPPERGER,
    RANDOLPH C. SIMPSON,
    TREVOR FETTER, DANIEL
    CANCELMI, R. SCOTT RAMSEY,
    J. MCDONALD WILLIAMS, JOHN
    ELLIS BUSH, AND BIGGS C.
    PORTER, Appellees
    In accordance with this Court’s opinion of this date, the judgment of the trial
    court is AFFIRMED.
    It is ORDERED that appellees Tenet Healthcare Corporation, James A.
    Unruh, Ronald A. Rittenmeyer, Brenda J. Gaines, Karen M. Garrison, Richard R.
    Pettingill, J. Robert Kerrey, Edward A. Kangas, Freda C. Lewis-Hall, Tammy
    Romo, Matthew J. Ripperger, Randolph C. Simpson, Trevor Fetter, Daniel
    Cancelmi, R. Scott Ramsey, J. McDonald Williams, John Ellis Bush, and Biggs C.
    Porter recover their costs of this appeal from appellants City of Warren Police and
    Fire Retirement System and Janice Stewart.
    Judgment entered this 28th day of September, 2020.
    –2–