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Landmark Cases

Case Name: Cecilia DUKES v. US HEALTHCARE

Date, Location, Cite: 1995 PA 
57 F.3rd 350
US Court of Appeals, 3rd Circuit

Darryl Dukes saw his family Dr., then a Mental Health Center Dr., then died with high blood sugar. Serena Visconti died as a stillbirth. Her parents and Mr. Dukes's wife both sued their HMO. US Healthcare, for malpractice. In both cases, the HMO said it was "related to" ERISA and pre-empted state law, so was removed to Federal. The District Courts agreed.
On appeal, the 3rd Circuit Court said: ERISA pre-empts only certain actions, and those are under §502, which covers "benefits due" or "enforces rights due" under the plan. It DOES NOT INCLUDE MEDICAL MALPRACTICE. ERISA claims under §514 have to go to State Court, and they decide if it should go to Federal. Federal District Court CAN'T decide on a §514 case. Ct. of Appeals said this was a §514, needed to go to state first,