Opinion
Civil No. 97-1680 (RHK/JMM).
January 22, 2001.
Gary A. Weissman, Weissman Law Offices, Minneapolis, Minnesota, and Linda R. MacLean, MacLean Law Offices, Pismo Beach, California, for Plaintiff/ Relator James B. Kinney.
Cory A. Carlson, Assistant Hennepin County Attorney, Minneapolis, Minnesota, Donald M. Lewis, David R. Schultz, and Gregory Gisvold, Halleland, Lewis, Nilan, Spikins Johnson, P.A., Minneapolis, Minnesota, for Defendant Hennepin County Medical Center.
James L. Volling, Faegre Benson, P.L.L.P., Minneapolis, Minnesota, for Defendant Hennepin Faculty Associates.
MEMORANDUM OPINION AND ORDER Introduction
Plaintiff James B. Kinney is a former Hennepin County paramedic. In 1997, Kinney began this action against Hennepin County Medical Center ("HCMC") and Hennepin Faculty Associates ("HFA"), alleging that Defendants violated § 3729 of the False Claims Act (hereinafter, "the FCA") by submitting false and fraudulent claims to the federal Medicare and Medicaid programs for reimbursement of certain ambulance services. Before the Court is the Defendants' Motion to Dismiss pursuant to Rule 12(b)(6) of the Federal Rules of Civil Procedure. HCMC moves to dismiss Kinney's Amended Complaint against it in its entirety based on the Supreme Court's recent decision in Vermont Agency of Natural Resources v. United States ex rel. Stevens, 120 S.Ct. 1858 (2000). HCMC and HFA also move to dismiss Count IV of the Amended Complaint which alleges common law fraud against both Defendants. The Plaintiff agrees that Count IV may be dismissed without prejudice on the understanding that, were the United States to later intervene in this action, the Government could assert such a claim. For the reasons set forth below, the Court will grant the motion in its entirety.
The Court will dismiss Count IV of the Amended Complaint without prejudice.
Background
HCMC is a public, full-service hospital that operates an ambulance service from which it derives income. (Answer of HCMC ¶ 7; see also Answer of HFA ¶ 8.) HFA is a physician group that provides medical services, including staffing the emergency room at HCMC, pursuant to a contract. (Answer of HCMC ¶ 8; Answer of HFA ¶ 9.) Kinney worked as a paramedic for HCMC's ambulance service over approximately 21 years. (Answer of HCMC ¶ 9.)
HCMC was established pursuant to a state statute. See Minn. Stat. § 383B.217, subd. 1 (providing that Hennepin County "may establish a medical center to provide hospital and medical services to the general public, including the indigent . . . ."). Defendants note that HCMC "is not a legal or judicable entity subject to suit" and that the proper party defendant is the County of Hennepin. (Defs.' Mem. Supp. Mot. to Dismiss at 1 n. 1.) The Defendants did not move to dismiss the Complaint on this ground, and the Court is satisfied that dismissal for the reasons set forth below would be warranted regardless of whether HCMC or the County of Hennepin is named as the defendant.
Kinney initially filed suit on July 23, 1997. (Doc. No. 1.) The United States requested and received several extensions of time within which to decide to intervene, ultimately deciding on June 3, 1999 that it would decline intervention. (Doc. No. 19.) Kinney filed an Amended Complaint on November 6, 1999, alleging that HCMC, with the assistance of the doctors of HFA, submitted false statements to the federal Medicare and Medicaid programs in connection with claims for reimbursement involving ambulance transportation services. (See generally Rule 26(f) Report (Doc. No. 50).) The Defendants each filed an Answer to the Amended Complaint. (Doc. Nos. 30, 31.)
On February 17, 2000, the Court granted the Defendants' motion to stay proceedings pending a decision by the United States Supreme Court inVermont Agency of Natural Resources v. United States ex rel. Stevens. (Order dated Feb. 17, 2000 (Doc. No. 47).) Following the Supreme Court's decision in Stevens, the Defendants brought the present Motion to Dismiss.
Analysis
I. Standard of Decision
In considering a motion to dismiss for failure to state a claim upon which relief may be granted, brought pursuant to Federal Rule of Civil Procedure 12(b)(6), the Court must take as true the allegations contained in the complaint. Cooper v. Pate, 378 U.S. 546, 546 (1964) (per curiam). When evaluating the Rule 12(b)(6) motion, the complaint
must be viewed in the light most favorable to the plaintiff and should not be dismissed merely because the court doubts that a plaintiff will be able to prove all of the necessary factual allegations. "Thus, as a practical matter, a dismissal under Rule 12(b)(6) is likely to be granted only in the unusual case in which a plaintiff includes allegations that show on the face of the complaint that there is some insuperable bar to relief."Fusco v. Xerox Corp., 676 F.2d 332, 334 (8th Cir. 1982) (quoting Jackson Sawmill Co. v. United States, 580 F.2d 302, 306 (8th Cir. 1978)). Viewing the complaint in this manner, the court may dismiss a complaint under Rule 12(b)(6) only if it is clear that no relief could be granted under any set of facts that could be proved consistent with the allegations made in the complaint. Hishon v. King Spalding, 467 U.S. 67, 73 (1984) (citing Conley v. Gibson, 355 U.S. 41, 45-46 (1957)).
II. The False Claims Act and the Stevens Decision
The FCA imposes civil liability on "any person" who, inter alia,:
(1) knowingly presents, or causes to be presented, to an officer or employee of the United States Government . . . a false or fraudulent claim for payment approval; [or]
(2) knowingly makes, uses, or causes to be made or used, a false record or statement to get a false or fraudulent claim paid or approved by the Government. . . . .31 U.S.C. § 3729(a)(1)-(2). A person who has committed an act prohibited by § 3729 "is liable to the United States Government for a civil penalty of not less than $5,000 and not more than $10,000, plus three times the amount of damages which the Government sustains because of the act of that person." 31 U.S.C. § 3729(a). A private person, referred to as a "relator," may bring a civil action both for the relator and for the United States Government alleging violations of § 3729. 31 U.S.C. § 3730(b)(1); Vermont Agency of Natural Resources v. United States ex. rel. Stevens, 120 S.Ct. 1858, 1865 (2000) (holding that a qui tam relator under the FCA has Article III standing).
If the Government decides to intervene in an action initiated by a relator, it assumes primary responsibility for prosecuting the action, and the relator may continue to participate in the litigation. See 31 U.S.C. § 3730(c)(1)-(2). If the Government declines to intervene — as happened here — the relator has the exclusive right to prosecute the claim, and the Government may only intervene subsequently upon a showing of "good cause." Id. § 3730(c)(3).
Although § 3729 defines such terms as "knowing," "knowingly," and "claim," it does not define the term "person." See 31 U.S.C. § 3729. In Vermont Agency of Natural Resources v. United States ex. rel. Stevens, the Supreme Court considered whether the term "person" in § 3729 includes States and state agencies. Stevens brought a FCA action against his former employer, the Vermont Agency of Natural Resources ("VANR"), alleging that the VANR "had submitted false claims to the Environmental Protection Agency ("EPA") in connection with various federal grant programs administered by the EPA." Stevens, 120 S.Ct. at 1861. The VANR brought a motion to dismiss "arguing that a State (or state agency) is not a "person" subject to liability under the FCA and that a qui tam action in federal court against a State is barred by the Eleventh Amendment." Id. The trial court denied the motion and, on appeal, the Second Circuit affirmed. Id. The Supreme Court first addressed (and found it unnecessary to proceed farther than) whether a State or state agency is a "person" pursuant to § 3729 in an action brought by a qui tam relator. Id. at 1866.
The Supreme Court began its analysis with the "longstanding interpretive presumption that `person' does not include the sovereign" to the language of § 3729(a). Stevens, 120 S.Ct. at 1866; see also Will v. Michigan Dep't of State Police, 491 U.S. 51, 64 (1989) (stating that "[i]n common usage, the term `person' does not include the sovereign," and holding that the term "person" in 42 U.S.C. § 1983 does not include states). The Stevens Court then looked for "some affirmative showing of statutory intent to the contrary" that would indicate that the presumption could be disregarded. Id. at 1867. In searching for evidence of this statutory intent, the Supreme Court first looked to when the FCA was enacted — 1863.
The Supreme Court observed that the principal goal of Congress in enacting the FCA was to stop "the massive frauds perpetrated by large [private] contractors during the Civil War." Stevens, 120 S.Ct. at 1867 (brackets and bracketed text in original). The Court further noted that the liability provision in the original FCA applied only to "any person not in the military or naval forces of the United States, nor in the militia called into or actually employed in the service of the United States." Id. (citing Act of Mar. 2, 1863, ch. 67, § 3, 12 Stat. 698). From this, the Stevens Court concluded that the original liability provision in the FCA "bore no indication that States were subject to its penalties." Indeed, the Court concluded that "the text of the original statute does less than nothing to overcome the presumption that States are not covered." Id. at 1868.
The Supreme Court was quick to clarify that it was not suggesting that these characteristics of the original FCA (which were directed only at natural persons) "cast doubt upon the courts' assumption that § 3729(a) applies to corporations." Stevens, 120 S.Ct. at 1867. The Supreme Court reasoned that "the courts' assumptions" regarding corporate liability under the FCA would remain valid because "the presumption with regard to corporations is just the opposite of the one governing here: they are presumptively covered by the term `person.'" Id. at 1868 (citing 1 U.S.C. § 1).
The Supreme Court next considered whether the liability provision of the original FCA had undergone any changes over the intervening years that would indicate that Congress intended to subject States to § 3729 liability. It concluded that none of the changes "suggests a broadening of the term `person' to include States." Id. The Court then reviewed the current version of the FCA as a whole and determined that "[s]everal features of the current statutory scheme further support the conclusion that States are not subject to qui tam liability." Id. Among these features, the Court noted that the treble damages provision in § 3729 is "essentially punitive in nature, which would be inconsistent with state qui tam liability in light of the presumption against imposition of punitive damages on governmental entities." Id. at 1869.
The Supreme Court also considered the Program Fraud Civil Remedies Act of 1986, which it described as a "sister scheme creating administrative remedies for false claims." Id. at 1870. The Court observed that Congress defined the "persons" subject to liability under the PFCRA and yet did not include States. Id. (citing 31 U.S.C. § 3801(a)(6)). The Court then reasoned that it "would be most peculiar to subject states to treble damages and civil penalties in qui tam actions under the [FCA], but exempt them from the relatively smaller damages provided under the PFCRA." Id.
The Supreme Court also considered that § 3733 of the FCA, which enables the United States Attorney General to issue civil investigative demands to "any person . . . possessing information relevant to a false claims law investigation," 31 U.S.C. § 3733(a)(1), expressly defines the term "person" as follows:
. . . any natural person, partnership, corporation, association, or other legal entity, including any State or political subdivision of a State.31 U.S.C. § 3733(l)(4) (emphasis added). The Supreme Court noted that (1) Congress has defined "person" in one part of the FCA (and expressly included States when it did so), and (2) Congress has not defined "person" in connection with § 3729 (let alone done so to expressly include States), which further "suggests that States are not `persons' for purposes of qui tam liability under § 3729." Id. at 1868-69.
The Supreme Court concluded its reasoning with two final considerations. First, the Court noted "the ordinary rule of statutory construction that if Congress intends to alter the usual constitutional balance between States and the Federal Government, it must make its intention to do so unmistakably clear in the language of the statute."Id. at 1870 (quoting Will, 491 U.S. at 65) (internal quotation marks omitted). Second, the Court observed that statutes should be construed so as to avoid difficult constitutional questions. Id. In light of the foregoing, the Supreme Court held that "a private individual has standing to bring suit in federal court on behalf of the United States under the False Claims Act, 31 U.S.C. § 3729-3733, but that the False Claims Act does not subject a State (or state agency) to liability in such actions." Id. at 1871.
III. The Applicability of the Stevens Decision to This Action
A. "Governmental entity" versus "State"
HCMC's motion to dismiss the FCA claims raises the novel question in this circuit of whether counties are included within the scope of the "persons" subject to liability in actions brought by a qui tam relator. HCMC acknowledges that the Stevens decision did not directly address this question. (Defs.' Mem. Supp. Mot. to Dismiss at 3.) It contends, however, that the Stevens opinion "provides a clear answer" to the issue presented in this case because the Supreme Court's decision "was based not on the fact that the [VANR] was a state entity, but rather that it was a governmental entity." (Id. (emphasis in original).) HCMC reads the Stevens opinion too expansively.
It appears that the Stevens decision references the phrase "governmental entity" only once. In discussing the "essentially punitive nature" of the FCA's treble damages provision, the Supreme Court indicated that "state qui tam liability" would be inconsistent with "the presumption against imposition of punitive damages on governmental entities." Stevens, 120 S.Ct. at 1869 (emphasis added). At several other instances in the Stevens opinion, the Supreme Court clearly indicated that the important fact for its analysis was the defendant's status as an agency of the State of Vermont. The Supreme constitutional balance between States and the Federal Government, it must make its intention to do so unmistakably clear in the language of the statute.").
See e.g., Stevens, 120 S.Ct. at 1866-67 (reasoning that the presumption that "person" does not include the sovereign is "particularly applicable where it is claimed that Congress has subjected the States to liability to which they had not been subject before."); id. at 1867 n. 9 (noting that "[w]hile the States do not have the immunity against federally authorized suits that international law has traditionally accorded foreign sovereigns . . . they are sovereigns nonetheless, and both comity and respect for our federal system demand that something more than the mere use of the word `person' demonstrate the federal intent to authorize unconsented private suit against them."); id. at 1868 n. 12 (noting that a particular section of the Senate Committee's 1986 report on the FCA "details a single incident of fraud by a state official against a State, not an incident of fraud by a State against the Federal Government."); id. at 1868 n. 13 (noting that it is "entirely appropriate" that States be subject to civil investigative demands "since States will often be able to provide useful evidence in investigations of private contractors."); id. at 1870 (stating the well-established rule that "if Congress intends to alter the usual.
Court's holding in Stevens thus was not based upon the defendant being simply a "governmental entity." This Court returns to the issue presented by HCMC's motion: whether counties are among the "persons" subject to liability in a qui tam action brought by a private person under § 3729. In support of its motion, HCMC invoked two presumptions of statutory interpretation that were discussed in Stevens as militating against holding that a State is a "person" for purposes of § 3729. The Court considers each in turn.
B. The "Longstanding" Presumption that "Person" Does Not Include the "Sovereign"
If this Court begins its analysis where the Supreme Court began in Stevens, it first encounters the "longstanding interpretive presumption" in construing federal statutes "that `person' does not include the sovereign." Stevens, 120 S.Ct. at 1866. That longstanding interpretive presumption" only applies, however, if Hennepin County can be considered a "sovereign." HCMC contends that, in 1863, "municipalities were considered integral to sovereign states" and, therefore, "shared in the presumption" that `person' did not include the sovereign. (Defs.' Reply at 7.) HCMC cites no federal or state case decided at about the time the FCA was enacted holding that either counties or municipalities were regarded as sovereigns or "shared in the presumption" to which the sovereign state was entitled. Cases from both the United States Supreme Court and the Minnesota Supreme Court suggest the contrary.
Elsewhere, HCMC argues that Hennepin County is "either a sovereign in its own right, or an agency of the sovereign State of Minnesota." (Defs.' Mem. Supp. Mot. to Dismiss at 6-7.) HCMC provides the Court with no authority, however, for the proposition that Hennepin County is an "agency" of the State of Minnesota. Indeed, the Minnesota Legislature has stated that counties are bodies politic and corporate that can sue and be sued. See Minn. Stat. § 373.01, subd. 1(1).
Prior to the enactment of the FCA, the Supreme Court had considered the legal status of counties in Maryland ex rel. Washington County v. Baltimore Ohio Railroad Co., 44 U.S. 534 (1845). In Baltimore Ohio Railroad, the Court construed an 1836 Maryland statute intended to promote the development of a railroad across parts of the state, including Washington County. The 1836 statute required that the railroad run through Washington County and, if it did not, imposed a penalty of $1,000,000 that was designated for the use of Washington County. When the railroad ultimately did not pass through Washington County, the county commissioners insisted that the State bring a lawsuit to collect the penalty from the railroad. In 1840, however, the Maryland Legislature had repealed those provisions of the 1836 statute requiring that the railroad pass through Washington County and imposing the penalty if it did not. The Supreme Court held that neither the commissioners, nor the county, nor any of the citizens of the county had acquired any separate or private interest in Maryland's contract with the railroad or the penalty called for by the 1836 statute. The Court observed that " [t]he several counties are nothing more than certain portions of territory into which the state is divided for the more convenient exercise of the powers of government. They form together one political body in which the sovereignty resides." 44 U.S. at 550 (emphasis added). As the Supreme Court confirmed forty years later:
The soil and the people within these [geographical] limits [of the United States] are under the political control of the government of the United States, or of the states of the Union. There exists within the broad domain of sovereignty but these two. There may be cities, counties, and other organized bodies, with limited legislative functions, but they are all derived from, or exist in, subordination to one or the other of these.United States v. Kagama, 118 U.S. 375, 379 (1886) (emphasis added).
Early in Minnesota's history, the Minnesota Supreme Court considered the relationship between the State and the counties therein. The court held that, aside from certain limits set out in the state's constitution over the legislature's ability to modify the boundaries or the area of a county or to remove county seats,
the whole field of legislative power over counties and county governments is left open and the authority of the legislature therein is supreme. It may at pleasure create, alter, modify, and abolish, without the consent of the people or corporation to be thereby affected. This results from the very character and object of a county organization, and the political nature of the powers and functions with which it is invested. The creation of such an involuntary and quasi corporation belongs to, and is a part of , the general governmental policy of the state, and the powers conferred upon it are given mainly, if not exclusively, for public purposes connected with matters of local administration and concern, and can never become vested as against the sovereign, whose right of control over all its civil, political, and governmental powers is necessarily supreme in the absence of any constitutional limitations.State ex. rel. Slipp v. McFadden, 23 Minn. 40, 43 (1876) (italics in original, emphasis added). Nothing from these opinions suggests that counties have been understood by either the United States Supreme Court or the Minnesota Supreme Court to be "sovereign." Indeed, the Minnesota Supreme Court analogized counties to corporations, which in the 1860s were presumed to be "persons." Id.; see Monell v. Department of Soc. Servs. of City of New York, 436 U.S. 658, 687-90 (1976). This understanding is reflected in the Minnesota statute providing that "[e]ach county is a body politic and corporate and may . . . sue and be sued." Minn. Stat. § 373.01, subd. 1.
In Monell v. Department of Soc. Servs. of City of New York, 436 U.S. 658, 690 (1976), the Supreme Court had held that local governmental bodies can be sued directly under 42 U.S.C. § 1983 for monetary, equitable, and injunctive relief. In reaching its holding, the Monell Court considered "whether the general language describing those to be liable under § 1 — `any person' — covers more than natural persons." 436 U.S. at 683. The Supreme Court considered whether members of Congress in 1871 understood the term "person" to include municipal corporations. It observed that, by 1844, the Supreme Court had abandoned the principle (referred to as the Deveaux principle) that corporations were not "persons" for purposes of Article III and the Judiciary Act of 1789. Id. at 687-88 (citing Louisville Railway Co. v. Letson, 2 How. 497, 558, 11 L.Ed. 353 (1844)). The Monell Court further noted that, in 1869, the Supreme Court had extended the holding in Letson "automatically and without discussion" to a municipal corporation. Id. at 688 (citing Cowles v. Mercer County, 7 Wall. 118, 121, 19 L.Ed. 86 (1869)).
From the analysis in Monell, HCMC would have the Court infer that when the FCA was enacted in 1863, it was not "well-settled" that municipalities and counties were included in the term "person." The Court is not persuaded. As noted in Monell, prior to 1863, the Supreme Court had enforced the Contract Clause against a municipality. Monell, 436 U.S. at 672-73 (citing Board of Comm'rs v. Aspinwall, 24 How. 376, 16 L.Ed. 735 (1861)); see also id. n. 28 (collecting cases dating back to 1864). HCMC cites no authority after Letson holding that municipalities or counties, unlike "corporations," were not "persons" for purposes of federal statutes imposing liability, and the Court is aware of none.
This Court concludes that, as of 1863, counties did not clearly share in the presumption that the "sovereign" was not included in the term "person" in federal statutes. Accordingly, HCMC does not benefit from the "longstanding interpretative presumption" that the "sovereign" is not included in the term "person," on which much of the Stevens opinion is built. The Court therefore turns to the second interpretive presumption invoked by HCMC.
C. The Common-Law Presumption Against Municipal Liability for Treble Damages
The Stevens opinion addressed a second presumption supporting its holding: the common-law presumption that punitive damages may not be imposed on a governmental entity unless expressly authorized by statute.See Stevens, 120 S.Ct. at 1869. Both the Stevens opinion and HCMC cite to the Supreme Court's decision in City of Newport v. Fact Concerts, Inc., 453 U.S. 257 (1981), which explored municipal corporations' common-law immunity from punitive damages.
Five years earlier, the Supreme Court held that local governmental bodies can be sued directly under 42 U.S.C. § 1983 for monetary, equitable, and injunctive relief. Monell v. Department of Soc. Servs. of City of New York, 436 U.S. 658, 690 (1976).
The Fact Concerts case involved municipal liability under 42 U.S.C. § 1983, specifically under the statute's treble damages provision. As the Stevens Court did with the FCA, the Fact Concerts Court began its analysis with Congress's understanding of the law at the time the predecessor of § 1983 — section 1 of the Civil Rights Act of 1871 — was enacted. The Fact Concerts Court determined that state courts at that time were "virtually unanimous" in denying awards of punitive or exemplary damages against municipal corporations. Fact Concerts, 453 U.S. at 259-60 (citing several cases dating back to the 1840s). The rationale for this common-law rule was that punitive damages were "contrary to sound public policy, because such awards would burden the very taxpayers and citizens for whose benefit the wrongdoer was being chastised." Id. at 263. Upon concluding that the doctrine of "municipal immunity from punitive damages was well-established by 1871," the Supreme Court "proceed[ed] on the familiar assumption that `Congress would have specifically so provided had it wished to abolish the doctrine.'" Id. (quoting Pierson v. Ray, 386 U.S. 547, 555 (1967)). The Court reviewed the legislative history surrounding the enactment of § 1 of the Civil Rights Act of 1871 and found "no evidence that Congress intended to disturb the settled common-law immunity" for municipalities. Id. at 266. The Fact Concerts Court then considered whether public policy dictated that the common-law immunity be disturbed. Id. The Court reasoned that "an award of punitive damages against a municipality `punishes' only the taxpayers, who took no part in the commission of the tort," id. at 267, and that none of the policies underlying § 1 of the Civil Rights Act — such as deterring civil rights violations — would be served by imposing punitive damages on a municipality (as opposed to the individual officials who violated the plaintiff's civil rights). Id. at 268.
Defendants argue that the same reasoning applies here. The Court concurs. The current version of § 3729 of the FCA imposes "a civil penalty of not less than $5,000 and not more than $10,000, plus three times the amount of damages which the Government sustains because of the act of that person." 31 U.S.C. § 3729(a). The Stevens Court has unequivocally stated that the FCA, in its present form, "imposes damages that are essentially punitive in nature." Stevens, 120 S.Ct. at 1869; see also Texas Indus., Inc. v. Radcliff Materials, Inc., 451 U.S. 630, 639 (1981) (stating that the "very idea of treble damages reveals an intent to punish past, and to deter future, unlawful conduct."); United States ex rel. Graber v. City of New York, 8 F. Supp.2d 343, 349 (S.D.N.Y. 1998) (observing that the damages mandated by the FCA substantially exceed the actual damages suffered by the United States). When Congress amended the FCA to increase the liability from double damages to treble damages, thus making the FCA "essentially punitive," it did not clearly authorize the imposition of such damages against municipalities. Numerous other statutes demonstrate that, when Congress wishes to include municipalities and political subdivisions of the states, it knows how to explicitly define the phrase "person" to do so. See Graber, 8 F. Supp.2d at 351 n. 8 (collecting statutes). Congress has been aware of the common-law immunity of municipalities to punitive damages and took no action to disturb that immunity. See Fact Concerts, 453 U.S. at 266. If Congress wishes to impose treble damages liability under the FCA, it can expressly do so.
Conclusion
Based on the foregoing, and all of the files, records and proceedings herein, IT IS ORDERED THAT Defendants' Motion to Dismiss (Doc. Nos. 53 55) is GRANTED as follows:
1. Plaintiff's Amended Complaint against Defendant Hennepin County Medical Center is hereby DISMISSED WITH PREJUDICE;
2. Count IV of Plaintiff's Amended Complaint is hereby DISMISSED WITHOUT PREJUDICE as to Defendant Hennepin Faculty Associates.
The Court further expressly determines that there is no just reason for delay in the entry of judgment as to Defendant Hennepin County Medical Center. Accordingly, the Clerk of Court is expressly directed to enter judgment in favor of Hennepin County Medical Center and against the Plaintiff.
LET JUDGMENT BE ENTERED ACCORDINGLY.