Segura-Snchez et al v. Hospital General Menonita, Inc. et al

Filing 80

MEMORANDUM AND ORDER. The Court must DISMISS WITHOUT PREJUDICE plaintiffs' survivorship claim. Each individual plaintiff's claim for his or her own pain and suffering due to Ms. Arvelo's death, however, survives. Signed by Judge Francisco A. Besosa on 07/12/2013. (brc)

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF PUERTO RICO
MARIA SEGURA-SANCHEZ, et al.,
Plaintiffs,
Civil No. 12-1760 (FAB)

v.
HOSPITAL GENERAL MENONITA, INC.,
et al.,
Defendants.

MEMORANDUM AND ORDER
BESOSA, District Judge.
On May 24, 2013, the Court ordered the parties to submit
simultaneous briefs discussing whether subject matter jurisdiction
exists.

(Docket No. 69.)

Two jurisdictional issues have been

raised. First, whether the forum selection clause signed by Victor
Martinez-Valdez (“Mr. Martinez”) upon decedent Arquidiana ArveloSegura (“Ms. Arvelo”)’s admission to the hospital on February 24,
2011,

is

enforceable.

Second,

whether

Mr.

Martinez,

as

Ms. Arvelo’s widower, is an indispensable party who would destroy
diversity jurisdiction because he is a forced heir, even though he
has remarried.

The Court addresses each issue in turn.
DISCUSSION

I.

Forum Selection Clause Enforceability
Defendant

Mennonite General Hospital

(“MGH”)

argues

that

pursuant to a forum selection clause Mr. Martinez executed on
February 24, 2011, the Commonwealth of Puerto Rico is the only

Civil No. 12-1760 (FAB)

2

appropriate forum in which to file the claims set forth in the
amended complaint.

(Docket No. 73 at 2.)

The Court disagrees,

however, and finds the forum selection clause at issue to be
illegal and unenforceable.1
As a matter of federal law, forum selection clauses “are prima
facie valid.”
(1972).

M/S Bremen v. Zapata Off-Shore Co., 407 U.S. 1, 10

Consequently, they “should be enforced unless . . .

‘enforcement would be unreasonable and unjust, or . . . the clause
was invalid for such reasons as fraud or overreaching . . . [or]
enforcement would contravene a strong public policy of the forum in
which suit is brought.’”

Rivera v. Centro Medico de Turabo, Inc.,

575 F.3d 10, 18 (1st Cir. 2009) (quoting M/S Bremen, 407 U.S. at
15).

The First Circuit Court of Appeals has noted that Regulation

No. 7617 reflects a strong public policy in Puerto Rico today that
forum

1

selection

clauses

in

informed

consent

forms

are

To obtain treatment for Ms. Arvelo, Mr. Martinez signed a
document which purported to limit the patient’s options for
litigation and to obligate the patient to file any legal claim
“only and exclusively before the Courts of First Instance of the
Commonwealth of Puerto Rico.” (Docket No. 71-2 at 1.)

Civil No. 12-1760 (FAB)
unenforceable.2

3

Rivera, 575 F.3d at 23.

Indeed, the Puerto Rico

Supreme Court has held that the inclusion of “forum selection
clauses in the informed consent documents presented to patients
. . . has been validly banned in our legal system.”

Garcia-Mones

v. Groupo HIMA San Pablo, Inc., 875 F. Supp. 2d 98, 105-06 (D.P.R.
2012) (Besosa, J.) (citing Centro Medico del Turabo, Inc. v.
Departamento de Salud, 2011 TSPR 35, 181 D.P.R. 72, 77 n.1 (2011).
Defendant MGH seeks to distinguish the forum selection clause
in this case from the forum selection clause in Garcia-Mones that
this Court held to be unenforceable.

It does so by merely stating

that in this case, the forum selection clause was not contained in
an informed consent or an analogous form.

(Docket No. 73 at 3.)

Rather, ‘[t]he informed consent form was separate and the “Personal

2

In Puerto Rico, Regulation No. 7617 bans the inclusion of
forum selection clauses in documents used to secure medical
patients’ informed consent. Office of the Patient’s Advocate of
P.R. (OPA), Regulations to Implement the Provisions of Public Law
194 of August 25, 2000, Regulation No. 7617, art. 13, § 8(C)(2)
(Nov. 21, 2008). Regulation No. 7617 replaced Regulation No. 7504,
which the OPA passed on May 12, 2008. The court of appeals
addressed Regulation No. 7504 (because No. 7617 had not yet been
passed) in Rivera, but the relevant language on forum selection
clauses at issue in this case is identical in both regulations.
The Regulation states, in pertinent part:
It is strictly prohibited that a provider requests a
patient or make[s] part of the informed consent to be
signed by the patient, the following: . . . (2) Legal
clauses foreign to the field of medicine or health or
related to the condition of the patient or treatment to
be provided to the patient. Such as, but not limited to:
[f]orum selection clauses.
(Docket No. 71-1 at 3.)

Civil No. 12-1760 (FAB)

4

Responsibility for Invoice Payment” form including a section on
“Legal Claims” with a forum selection clause or agreement contains
specific language as to the course of action that a patient can
follow if he or she disagrees with the forum selection.”

Id. at 6.

Without any further analysis, defendant MGH simply concludes “that
in

such

circumstances

the

Garcia-Mones

inapplicable in the case at hand.”

holding

would

be

Id. at 6–7.

Even assuming — favorably to defendants — that the forum
selection clause in this case was not included in the informed
consent

document

presented

to

Mr.

Martinez,

the

Court

is

unpersuaded by defendant MGH’s contention. Forum selection clauses
contained in medical admissions forms also violate Puerto Rico’s
public policy and are unenforceable.

See, e.g., Vazquez v. Hosp.

Episcopal Cristo, 2011 U.S. Dist. LEXIS 147274 (D.P.R. 2011)
(Fuste, J.) (relying on Regulation No. 7617 to conclude that a
forum selection agreement a mother signed as part of her minor
son’s admission to the hospital was against Puerto Rico’s public
policy and unenforceable); Prince v. Hosp. HIMA San Pablo-Caguas,
2013 U.S. Dist. LEXIS 62528, 2013 WL 1840578 (D.P.R. 2013) (PerezGimenez, J.) (“Certainly, the enactment of Regulation No. 7617 is
a testament to the public policy of prohibiting the enforcement of
forum

selection

clauses

medical treatment.”).

included

in

admissions

documents

for

Like in Vazquez and Prince, the forum

selection clause in this case was signed to gain admission to the

Civil No. 12-1760 (FAB)

5

hospital under emergency circumstances.
71-5 & 77-1.)

(See Docket Nos. 71-2 to

Accordingly, the strong public policy against forum

selection clauses in hospital admissions documents applies here.
Because the forum selection clause violates that public policy, it
is unenforceable.
I.

Subject Matter Jurisdiction
The second issue before the Court is whether subject matter

jurisdiction exists over plaintiffs’ survivorship claim despite Mr.
Martinez’s absence as a party.

Defendant Dr. Ramon Perez-Ramirez

and his conjugal partnership (collectively, “Dr. Perez”) submit
that all legal heirs to Ms. Arvelo’s “sucesion,” including her
widower, must be joined for the survivorship claim to proceed.
(Docket No. 70 at 2.)

Because several defendants and Mr. Martinez

have citizenship in Puerto Rico, joining Mr. Martinez as a party
would destroy diversity jurisdiction.

Id.

seeks dismissal of the survivorship claim.

Dr. Perez therefore
In contrast, the

plaintiffs admit that as a widower, Mr. Martinez is a forced heir,
but contend that he is an heir only as the holder to the right of
usufruct, which they claim is not an ownership or property right
but rather a lien or encumbrance over the deceased’s estate.
(Docket No. 71 at 6–8.)

They claim that Mr. Martinez’s right over

the survivorship claim is also in usufruct and not in ownership;
and

that

only

the

owners

(“the

heirs”)

may

exercise

the

survivorship cause of action, and that “[o]nce such cause of action

Civil No. 12-1760 (FAB)

6

bears fruit (if any), the heirs must respect the usufruct . . . .”
Id. at 7–8.

Accordingly, they would have the Court believe that

Mr. Martinez is “different, in terms of the indispensable-party
analysis,” than the other heirs and is not an indispensable party
to the federal litigation.

Id.

at 7.

Having reviewed the

arguments contained in both parties’ briefs, the Court rejects
plaintiffs’ contentions.
This Court has previously held that a widower is a forced
heir:3
[p]ursuant to Puerto Rico law, a widow[er] is an heir,
because a surviving spouse is entitled to a hereditary
portion of the deceased spouse’s estate called the
“usufructo viudal.” Delgado v. Bowen, 651 F. Supp. 1320,
1322 (D.P.R. 1987) (Fuste, J.); P.R. Laws Ann. tit. 31,
§§ 2411-2416; see also Luce & Co. v. Cianchini, 76 P.R.R.
155, 162, 76 D.P.R. 165 (1954) (“[T]he widow[er]’s
usufructuary quota is the legal portion . . . which the
law reserves for the surviving spouse, who is a forced
heir.”); Moreda v. Rosselli, 141 D.P.R. 674, 682, 1996
Juris P.R. 131 (1998) (“We have repeatedly held that the
widow[er] spouse is a forced heir.”).
Pino-Betancourt v. Hosp. Pavia Santurce, 2013 U.S. Dist. LEXIS
31755, 7-8 n.3 (D.P.R. 2013) (Besosa, J.).

That the widower’s

quota is held in usufruct does not lead to the conclusion that his
status as an heir is somehow secondary to other heirs.

To the

contrary, the Puerto Rico Supreme Court has ruled that a widower’s

3

The Supreme Court of Puerto Rico defines “forced heirship”
as “that portion of the estate that the testator cannot dispose of,
because the law has reserved it for particular heirs.” ClaveloPerez v. Hernandez-Garcia, 177 D.P.R. 822, 837 n.53 (2010)
(Translation provided as the attachment to this Memorandum and
Order.).

Civil No. 12-1760 (FAB)

7

usufruct is a “legitimate share” in the intestate inheritance.
Clavelo-Perez v. Hernandez-Garcia, 177 D.P.R. 822, 824 (2010); id.
at 840 (finding that a remarried widower “is entitled to the
usufructuary widower’s share.”).
established

that

the

surviving

“[T]he Civil Code itself has
spouse

is

a

legitimate

heir,

granting him or her a right in the estate of the deceased.”

Id.

at 840. Moreover, the widower’s presence is required alongside all
other heirs until all matters regarding the estate are resolved:
“A surviving spouse . . . must appear at the estate
division process until such time as all other heirs have
paid or commuted the surviving spouse’s share, which can
be done by assigning an annuity for life from the
proceeds of certain assets or liquid capital. In other
words, the properties within the estate shall be
encumbered by the widow/widower’s usufruct until such
time as the conversion takes place.”
Id. at 837. In light of such precedent, the Court cannot subscribe
to plaintiffs’ argument that a widower is “different” from other
heirs such that his absence from a survivorship claim may be
excused.
As the Court has iterated before, “[a]ll heirs to an estate
must be joined as parties to a survivorship lawsuit because a
‘sucesion’ is not an entity distinct and separate from the persons
composing it and does not have existence by itself as a juridical
person or entity.”

Pino-Betancourt, 2013 U.S. Dist. LEXIS 31755

at 7 (internal quotations and citations omitted).

Pursuant to

Fed.R.Civ.P. 19, the Court finds that Mr. Martinez is a necessary
and indispensable party to the survivorship claim because he is a

Civil No. 12-1760 (FAB)

8

member of Ms. Arvelo’s “sucesion.”

See Cruz-Gascot, 728 F.Supp.2d

at 26-31; Pino-Betancourt, 2013 U.S. Dist. LEXIS 31755 at 7.

In a

case grounded in diversity of citizenship, however, “the absence of
a non-diverse, indispensable party to the survivorship claim is not
a mere procedural defect. Rather, it destroys the district court’s
original subject matter jurisdiction.”
at 31.

Thus, including Mr. Martinez as a plaintiff will destroy

diversity jurisdiction.
in

Cruz-Gascot, 728 F.Supp.2d

order

to

gain

Plaintiffs may not manufacture diversity

access

to

federal

court,

and

“[w]hen

a

survivorship claim arising under article 1802 does not include all
heirs of the estates, dismissal is warranted.”
2013 U.S. Dist. LEXIS 31755 at 5.

Pino-Betancourt,

Accordingly, the Court must

DISMISS WITHOUT PREJUDICE plaintiffs’ survivorship claim.

Each

individual plaintiff’s claim for his or her own pain and suffering
due to Ms. Arvelo’s death, however, survives.
IT IS SO ORDERED.
San Juan, Puerto Rico, July 12, 2013.
s/ Francisco A. Besosa
FRANCISCO A. BESOSA
UNITED STATES DISTRICT JUDGE