Sanjay Arora v. Dr. Travis Paige, et al.

[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
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No. 20-11623
Non-Argument Calendar
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D.C. Docket No. 1:18-cv-00526-TCB
SANJAY K. ARORA,
Plaintiff-Appellant,
versus
TRAVIS PAIGE,
BUCKHEAD FAMILY DENTISTRY,
CIGNA HEALTH AND LIFE INSURANCE COMPANY,
Defendants-Appellees.
________________________
Appeal from the United States District Court
for the Northern District of Georgia
________________________
(May 17, 2021)
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Before JORDAN, GRANT, and LAGOA, Circuit Judges.
PER CURIAM:
Sanjay Arora, proceeding pro se, appeals the dismissal of his medical
malpractice complaint against his dentist—Dr. Travis Paige—Dr. Paige’s dental
practice—Buckhead Family Dentistry—and his dental insurance provider—Cigna
Health and Life Insurance Company. Arora’s claims stem from an installed
permanent crown that was allegedly composed of lower quality metal than was
advertised to him and charged. For the following reasons, we affirm the district
court’s dismissal of the claims against Cigna and the medical malpractice claims
against Dr. Paige and Buckhead Family Dentistry. We also affirm the district court’s
decision related to Arora’s discovery request.
I. FACTUAL AND PROCEDURAL BACKGROUND
In 2013, Arora saw Dr. Paige, who informed him that he had a cracked tooth
that required a permanent crown. After the procedure was done, Arora experienced
severe pain and discomfort at and around the site of the crown. In March 2014,
Arora contacted Buckhead Family Dentistry on multiple occasions to report the pain
but was told that the discomfort was normal. In April 2014, because the pain had
not subsided, Arora saw a second dentist, who acknowledged the irritation and
suggested replacing the crown. Arora contacted Cigna about this option and was
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told that his insurance policy allowed for such a procedure only once every couple
of years.
On April 28, 2014, Arora saw Dr. Paige again. Dr. Paige attempted to
alleviate the pain by filing down the crown. But this provided Arora no relief, so he
sought additional opinions from various other medical professionals. In May 2014,
Arora saw a periodontist, who determined that the crown installed was composed of
a lower quality of metal that contained nickel—an irritant that causes the type of
reaction that Arora was experiencing. Arora also saw an endodontist, who
determined the same thing. Following these consultations, Arora initiated an appeal
with Cigna to refund the original cost of the crown and allow him to seek a
replacement crown. In July 2014, Cigna opened an investigation into Arora’s
claims, which ultimately found that Buckhead Family Dentistry had overcharged
Arora but found nothing related to the crown’s metal composition. In August 2014,
after receiving the findings of the investigation, Arora demanded copies of his
medical records and all billing information from Buckhead Family Dentistry. The
invoice that he received related to his crown showed that it was in fact made of lower
quality metal.
On September 9, 2016, Arora filed a complaint in federal court in the District
of Columbia alleging fraud negligent misrepresentation, breach of fiduciary duty,
negligence, and unjust enrichment against Dr. Paige and Buckhead Family
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Dentistry, breach of fiduciary duty and negligent misrepresentation against Cigna,
and fraud and unjust enrichment against the manufacturer of the crown. In his first
amended complaint, he added a conspiracy claim against Dr. Paige, Buckhead
Family Dentistry, and Cigna.
All defendants filed motions to dismiss. The district court dismissed all
claims against Cigna for failure to state a claim. It also found that it lacked personal
jurisdiction over Dr. Paige, Buckhead Family Dentistry, and the crown
manufacturer, and transferred the case to the Northern District of Georgia.
After the case was transferred, Arora moved for additional time to file a
motion for reconsideration, which the district court denied since any motion for
reconsideration would be futile. Arora then filed a second amended complaint that
repeated his prior claims and added the allegation that he received the invoice
indicating that the crown was composed of the lower quality of metal on September
17, 2014. Following some discovery and motions practice, the district court
dismissed all claims against Dr. Paige and Buckhead Family Dentistry. The district
court found that the negligence and breach of fiduciary duty claims were merely
duplications of a medical malpractice claim and as such were subject to Georgia’s
two-year statute of limitations. The district court determined that the injury occurred
within days after the crown was installed on February 25, 2014, thereby beginning
the limitations clock no later than early March 2014.
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The district court then assumed, without deciding, that Dr. Paige’s knowing
installation of a lower quality crown amounted to fraud, but because Arora sought
the opinions of outside medical specialists, the limitations period would be tolled to
no later than May 13, 2014—the date that he saw a periodontist who put him on
notice of the lower quality of metal of the crown. Because Arora filed his complaint
almost four months after the statute of limitations period expired, even accounting
for potential tolling related to Dr. Paige and Buckhead Family Dentistry’s alleged
fraud, his medical malpractice claims were time barred. And because the other
claims against Dr. Paige and Buckhead Family Dentistry—fraud, negligent
misrepresentation, and unjust enrichment—arose from that medical malpractice
claim, they are likewise barred by the same statute of limitations.
When the district court dismissed the claims against Dr. Paige and Buckhead
Family Dentistry, it found moot Arora’s earlier filed discovery motion seeking to
extend the discovery period. Arora moved for reconsideration, which the court
denied. The district court then granted summary judgment in favor of the crown
manufacturer. Arora timely appealed the order granting summary judgment in favor
of the crown manufacturer, the order dismissing the claims against Dr. Paige and
Buckhead Family Dentistry, the order denying Arora’s motion for reconsideration
of that dismissal, the order related to Arora’s request for an extension of discovery,
and the order from the district court dismissing all claims against Cigna for failure
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to state a viable claim. Following a settlement agreement with the crown
manufacturer, Arora dismissed his appeal as to it. The present appeal therefore only
involves Dr. Paige, Buckhead Family Dentistry, and Cigna.
II. STANDARD OF REVIEW
We review a district court’s grant of a motion to dismiss under Rule 12(b)(6)
de novo, accepting the allegations in the complaint as true while construing them in
the light most favorable to the non-movant. Bourff v. Rubin Lublin, LLC, 674 F.3d
1238, 1240 (11th Cir. 2012). A Rule 12(b)(6) dismissal on statute of limitations
grounds is appropriate if it is apparent from the face of the complaint that the claim
is time barred. Gonsalvez v. Celebrity Cruises Inc., 750 F.3d 1195, 1197 (11th Cir.
2013).
We review for abuse of discretion a district court’s discovery decisions.
Bradley v. King, 556 F.3d 1225, 1229 (11th Cir. 2009). “A court abuses its discretion
if it makes a ‘clear error of judgment’ or applies an incorrect legal standard.” Id.
(quoting Carpenter v. Mohawk Indus., Inc., 541 F.3d 1048, 1055 (11th Cir. 2008)).
III. ANALYSIS
On appeal, Arora argues that his claims were not time barred because Dr.
Paige and Buckhead Family Dentistry concealed their misconduct, so the limitations
period should have been tolled. He further argues that the district court erred by not
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ruling on his motion to extend all discovery. Finally, he argues that the dismissal of
Cigna from the action was premature. We address each argument in turn.
A. Statute of Limitations and Tolling
Arora first argues that the district court erred in finding his claims against Dr.
Paige and Buckhead Family Dentistry time barred. Under Georgia law, an action
for medical malpractice generally must be brought within two years after the date on
which an injury arising from a negligent or wrongful act occurred. O.C.G.A. § 9-3-
71(a); see Deen v. Egleston, 597 F.3d 1223, 1228 (11th Cir. 2010). The limitation
period is tolled where the defendant is guilty of a fraud “by which the plaintiff has
been debarred or deterred from bringing an action,” and it runs “only from the time
of the plaintiff’s discovery of the fraud.” Gallant v. MacDowell, 759 S.E.2d 818,
820 (Ga. 2014) (citing O.C.G.A. § 9-3-96). Once a plaintiff seeks the care of another
doctor, though, he is “no longer deterred from learning the true facts by any conduct
of a defendant ‘even if the other doctor consulted does not diagnose the medical
problem as arising from the defendant's improper treatment.’” See id. at 820
(quoting Witherspoon v. Aranas, 562 S.E.2d 853, 858 (Ga. Ct. App. 2002), overruled
on other grounds by Chandler v. Opensided MRI of Atlanta, LLC, 682 S.E.2d 165
(Ga. Ct. App. 2009)).
The “medical malpractice statute of limitation applies to both tort and contract
theories of liability when the claim ‘calls into question the conduct of a professional
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in his area of expertise.’” Robinson v. Williamson, 537 S.E.2d 159, 161 (Ga. 2000)
(quoting Knight v. Sturm, 442 S.E.2d 255, 256–57 (Ga. Ct. App. 1994)). And it
applies to all claims arising out of a medical malpractice action. Knight, 442 S.E.2d
at 256.
Here, Arora’s claims—all of which arose out of the same alleged medical
malpractice—were time barred. Arora stated in his complaint that he felt pain from
his injury beginning in March 2014 and sought care from other dental professionals
in April and May of 2014. Even though those other dentists and specialists did not
specifically provide a diagnosis to account for the pain, two of them did indicate that
the crown was composed of lower quality metal that was the cause of Arora’s
irritation. Arora was therefore no longer deterred from learning the truth of his
condition after he met with the outside specialists. As such, his malpractice claims
accrued at that time—no later than May 2014—and expired two years later in May
2016, almost four months before he filed his complaint. See O.C.G.A. § 9-3-71(a);
Gallant, 759 S.E.2d at 820. Accordingly, we affirm the dismissal of all claims
against Dr. Paige and Buckhead Family Dentistry on statute of limitation grounds.
B. Motion to Extend Discovery
Arora next argues that the district court abused its discretion by not ruling on
his motion to extend all discovery because the Dr. Paige and Buckhead Family
Dentistry provided incomplete discovery and waited to produce useful information,
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including disclosing witnesses, only five days before written discovery ended. To
constitute an abuse of discretion, “a district court’s denial of additional discovery
must result in substantial harm to a party’s case in order to establish an abuse of
discretion.” Bradley, 556 F.3d at 1229.
Here, denying Arora’s request for an extension of time to conduct discovery
did not result in substantial harm to Arora’s case because, as discussed above, his
case was properly dismissed on statute of limitation grounds. Arora does not
contend that discovery was needed on the limitations issue. And there is nothing
that would be produced during extended discovery that would have altered the
statute of limitations determination. See id. We therefore affirm.
C. Dismissal of Cigna
Finally, Arora argues that the district court erred in dismissing all claims
against Cigna for failure to state a claim. Specifically, he argues that the dismissal
was premature because later-produced documents showed that Dr. Paige installed a
lower quality metal crown than was paid for by Cigna.
Arora misunderstands the procedural significance of a dismissal based on a
failure to state a viable claim. “Facial challenges to the legal sufficiency of a claim
or defense, such as a motion to dismiss based on failure to state a claim for relief,
should . . . be resolved before discovery begins. Such a dispute always presents a
purely legal question; there are no issues of fact because the allegations contained in
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the pleading are presumed to be true.” Chudasama v. Mazda Motor Corp., 123 F.3d
1353, 1367 (11th Cir. 1997). The complaint when filed must allege sufficient facts
to raise a right to relief above the speculative level or merely creates a suspicion of
a legally cognizable right of action. See Bell Atl. Corp. v. Twombly, 550 U.S. 544,
555 (2007). As such, discovery “follow[s] the filing of a well-pleaded complaint. It
is not a device to enable a plaintiff to make a case when his complaint has failed to
state a claim.” Chudasama, 123 F.3d at 1367 (quoting Kaylor v. Fields, 661 F.2d
1177, 1184 (8th Cir.1981)). Arora’s argument that discovery would bolster his
claims against Cigna is therefore without merit. He failed to plausibly allege facts
sufficient to raise viable claims against Cigna in both his initial complaint and his
first amended complaint—a purely legal question that does not require discovery.
Because Arora makes no argument on appeal that his complaint actually
contained sufficient factual content to survive a motion to dismiss, he has abandoned
any argument that would save his claims against Cigna. See Timson v. Sampson,
518 F.3d 870, 874 (11th Cir. 2008) (although we read briefs filed by pro se litigants
liberally, issues not briefed in the initial brief are considered abandoned); see also
Sapuppo v. Allstate Floridian Ins. Co., 739 F.3d 678, 681 (11th Cir. 2014) (a party
fails to adequately brief an issue when he raises it in a perfunctory manner, without
supporting arguments and authority). We therefore affirm the district court’s
dismissal of Arora’s claims against Cigna.
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IV. CONCLUSION
For the foregoing reasons, the district court did not err in dismissing Arora’s
complaint against Dr. Paige, Buckhead Family Dentistry, or Cigna, nor did it abuse
its discretion in denying Arora’s discovery motion. We therefore affirm.
AFFIRMED.
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