Avera Gettysburg v. Teva Pharmaceutical Industries, Ltd.

U.S. District Court, District of Minnesota

Avera Gettysburg v. Teva Pharmaceutical Industries, Ltd.

Trial Court Opinion

                UNITED STATES DISTRICT COURT                             
                    DISTRICT OF MINNESOTA                                


Avera Gettysburg, doing business as       No. 23-cv-3882 (KMM/LIB)       
Avera Gettysburg Hospital, et al.,                                       

          Plaintiffs,                                                    

v.                                          ORDER                        

Teva Pharmaceutical Industries, Ltd., et                                 
al.,                                                                     

          Defendants.                                                    


    This matter is before the Court on Plaintiffs’ Motion to Remand pursuant to 
28 U.S.C. § 1447
(c). Pls.’ Mot. (Doc. 11). Plaintiffs argue that this case should be remanded 
to state court due to lack of subject matter jurisdiction. Defendants oppose the motion. 
Defs.’ Opp’n (Doc. 17). Because the Court agrees that subject matter jurisdiction is absent, 
the Plaintiffs’ motion is granted and this matter is remanded to Hennepin County District 
Court.                                                                    
                         BACKGROUND                                      
    Plaintiffs, which include several hospitals and healthcare systems, filed this case in 
the Fourth Judicial District, Hennepin County District Court, on November 14, 2023. 
Compl. (Doc. 1-1). Plaintiffs name several companies that market and distribute opioid 
medications as Defendants, dividing them into groups of “Marketing Defendants” and 
“Distributor Defendants.” Generally, Plaintiffs allege that the Marketing Defendants have 
engaged in false, deceptive, and unfair marketing of opioids, and that all Defendants 
breached duties to protect against suspicious opioids, all of which created a public health 
epidemic.  Further,  they  allege  that  the  Distributor  Defendants  unlawfully  distributed 
opioids by failing to detect, block and report suspicious orders and misrepresented their 

compliance with legal duties.                                             
    The Complaint includes ten claims for relief. The first six claims are asserted under 
the statutes of Minnesota, Nebraska, North Dakota, and South Dakota, which impose 
protections against consumer fraud, deceptive trade practices, and false advertising.1 The 
remaining four claims are common law torts, including nuisance (Seventh Claim for 

Relief), fraud and deceit (Eighth), civil conspiracy (Ninth), and unjust enrichment (Tenth). 
    On December 22, 2023, Defendant Cardinal Health, Inc. filed a Notice of Removal 
in this Court asserting that Plaintiffs’ claims “arise under federal law.” Notice of Removal 
¶ 1 (Doc. 1). According to Cardinal Health, Plaintiffs alleged that it and “other Defendants 
violated and are liable under a federal statute, the Controlled Substances Act, 
21 U.S.C. § 801
, et seq. (the “CSA”) and its implementing regulations.” 
Id.
 Accordingly, Cardinal 
Health asserted that this action is removable because it necessarily raises a federal claim 
for purposes of determining jurisdiction under 
28 U.S.C. § 1331
. 
Id.
 ¶¶ 13–37. Plaintiffs 
filed their motion to remand on January 18, 2024, arguing that the case must be remanded 


    1 The First Claim for Relief references Minnesota’s Prevention of Consumer Fraud Act, 
Minn. Stat. § 325F.68, et seq. The Second Claim for Relief asserts violations of Minnesota’s 
Deceptive and Unfair Trade Practices Act, Minn. Stat. §§ 325D.43 through 326D.48. The Third 
Claim for Relief alleges violations of Nebraska’s Consumer Protection Act, 
Neb. Rev. Stat. §§ 59
-
1601, et seq. The Fourth Claim for Relief points to North Dakota’s Consumer Fraud Act, N.D.C.C. 
§ 51-15-01, et seq. The Fifth Claim for Relief alleges violations of South Dakota’s Deceptive 
Trade Practices and Consumer Protection Act, SDCL § 37-24-21, et seq. And the Sixth Claim for 
Relief is brought under Minn. Stat. § 325F.67, which addresses false statements in advertising. 
to Hennepin County District Court because it raises exclusively state law claims, none of 
those claims present a substantial federal question, and Defendants’ position to the contrary 
has been repeatedly rejected by other courts. Pls.’ Mem. (Doc. 14).       

                          DISCUSSION                                     
I.   Legal Standard                                                       
    A  plaintiff  may  bring  a  motion  to  remand  a  case  removed  to  federal  court 
challenging the court’s jurisdiction over the suit, and if “it appears that the district court 
lacks  subject  matter  jurisdiction,  the  case  shall  be  remanded.”  
28 U.S.C. § 1447
(c). 

“Critically, the party seeking removal has the burden to establish federal subject matter 
jurisdiction,  [and]  all  doubts  about  federal  jurisdiction  must  be  resolved  in  favor  of 
remand[.]” Central Power Co-op. v. Midwest Indep. Transmission Sys. Operator, Inc., 
561 F.3d 904, 912
 (8th Cir. 2009) (citations omitted).                        
    A defendant may remove an action from state court to federal district court where 

“at least one claim falls within the original jurisdiction of the federal court.” Minnesota v. 
Am. Petrol. Inst., 
63 F.4th 703
, 709 (8th Cir. 2023). One source of original jurisdiction is 
28 U.S.C. § 1331
, which provides that “district courts shall have original jurisdiction of all 
civil actions arising under the Constitution, laws, or treaties of the United States.” Federal 
district courts have such “federal question jurisdiction” only when the plaintiff’s complaint 

presents the federal question on its face. Am. Petrol. Inst., 63 F.4th at 709. Under the well-
pleaded complaint rule, a plaintiff “‘may avoid federal jurisdiction by exclusive reliance 
on state law.’” Id. (quoting Caterpillar Inc. v. Williams, 
483 U.S. 386
, 392 (1987)). 
    Two exceptions to the well-pleaded complaint rule can support removal even where 
the face of the complaint presents no federal question. Cagle v. NHC Healthcare-Maryland 
Heights, LLC, 
78 F.4th 1061, 1066
 (8th Cir. 2023). These exceptions apply “when the state 

law  claims  (1) are  completely  preempted  by  federal  law  or  (2) necessarily  raise  a 
substantial, disputed federal question.” 
Id.
 (quotations omitted). This case involves the 
second of these exceptions.2                                              
    The second exception to the well-pleaded complaint rule, which is sometimes 
referred to as the “Grable doctrine,”3 Am. Petrol. Inst., 63 F.4th at 711, applies in a 

“‘special and small category of cases,’” Cagle, 
78 F.4th at 1067
 (quoting Gunn v. Minton, 
568 U.S. 251, 258
 (2013). Under this doctrine “federal jurisdiction over a state law claim 
will lie if a federal issue is (1) necessarily raised, (2) actually disputed, (3) substantial, and 
(4) capable of resolution in federal court without disrupting the federal-state balance 
approved by Congress.” 
Id.
 (citing Gunn, 
568 U.S. at 258
).                

    A state law claim ‘necessarily raises’ a federal issue when the question of federal 
law is a ‘necessary element of one of the well-pleaded state claims.” 
Id.
 (quoting Franchise 
Tax Bd. v. Constr. Laborers Vacation Tr., 
463 U.S. 1, 13
 (1983)). But the issue of 
“necessity” must be assessed with “precision.” Am. Petrol. Inst., 63 F.4th at 711 (quoting 
Cent. Iowa Power Coop. v. Midwest Indep. Transmission Sys. Oper., Inc., 
561 F.3d 904, 914
 (8th Cir. 2009)). “A removing defendant should be able to point to the specific 


    2 Defendants do not argue that Plaintiffs’ claims are completely preempted by federal law. 
Defs.’ Opp’n, passim.                                                     
    3 Grable & Sons Metal Prods., Inc. v. Darue Eng’g & Mfg., 
545 U.S. 308, 312
 (2005). 
elements of the plaintiff’s state law claims that require proof under federal law.” 
Id.
 
(cleaned up).                                                             
II.  Analysis                                                             

    Defendants argue that they have met their burden because they have shown that all 
four elements of the Grable doctrine are satisfied. However, as explained below, the Court 
finds that Defendants have failed to demonstrate that Plaintiffs’ Complaint necessarily 
raises a federal issue. Am. Petrol. Inst., 63 F.4th at 712 (“Because the ‘necessarily raised’ 
element is not satisfied, the Grable exception to the well-pleaded complaint rule does not 

apply to [the plaintiff’s] claims.”); Arkansas v. TikTok Inc., No. 1:23-CV-01038, 
2023 WL 4744903
, at *5 (W.D. Ark. July 25, 2023) (explaining that Grable applies when “all four 
elements are satisfied”).                                                 
    The Defendants focus on Plaintiffs’ nuisance claim4 and argue that a federal issue 
is a necessary element of that claim because it depends entirely on a duty imposed by the 

CSA. But the Defendants don’t say much about the applicable law of nuisance or the 
elements the Plaintiffs are required to establish to prevail on a public nuisance claim.5 In 
Minnesota, a public nuisance is a misdemeanor. The statute provides, in relevant part: 



    4 Because Defendants do not contend that a federal issue is necessarily raised by any of 
Plaintiffs’ other causes of action, the Court addresses only the nuisance claim. One federal issue 
in one claim is sufficient to support removal.                            
    5  The  Complaint  refers  in  several  places  to  Defendants’  conduct  causing  “a  public 
nuisance.” Compl. ¶¶ 120, 810, 873. Under Minnesota law, private nuisance claims are “limited 
to real property interests.” Anderson v. State of Minn., Dep’t of Natural Res., 
693 N.W.2d 181, 192
 (Minn. 2005). Real property interests do not appear to be the focus at all of Plaintiffs’ nuisance 
claims.                                                                   
         Whoever  by  an  act  or  failure  to  perform  a  legal  duty  
         intentionally does any of the following is guilty of maintaining 
         a public nuisance, which is a misdemeanor:                      

         (1)  maintains  or  permits  a  condition  which  unreasonably  
         annoys,  injures  or  endangers  the  safety,  health,  morals, 
         comfort, or repose of any considerable number of members of     
         the public. . . .                                               

Minn. Stat. § 609.74
. Although this statute is generally enforced by public authorities, 
under certain circumstances, a private plaintiff may bring a public nuisance claim.6 
    In their nuisance claim, Plaintiffs allege that Defendants have created a public 
nuisance through the “over-saturation of opioids in the patient population of Plaintiffs and 
in the geographic area served by Plaintiffs for illegitimate purposes, as well as the adverse 
social, economic, and human health outcomes associated with widespread illegal opioid 
use.” Compl. ¶ 820. The Marketing Defendants allegedly “participated in nuisance-causing 
activities  . . .  through  their  marketing  of  opioids”  and  all  Defendants  allegedly 
“exacerbated the flood of opioids into Plaintiffs’ communities in ways that unreasonably 
interfere with the public health, welfare, and safety in Plaintiffs’ communities.” 
Id.
 ¶¶ 822–
23. Further, Plaintiffs assert that “Defendants’ nuisance-causing activities include selling 
or  facilitating  the  sale  and  distribution  of  prescription  opioids  to  patients  who  seek 

    6 If a public nuisance causes an individual “special or peculiar damage” that is “not 
common to the general public,” Minnesota law provides for a private remedy. N. Star Legal Found. 
V. Honeywell Project, 
355 N.W.2d 186, 189
 (Minn. Ct. App. 1984) (quoting Hill v. Stokely-Van 
Camp, Inc., 
109 N.W.2d 749, 753
 (Minn. 1961)). Other states implicated by the Complaint have 
similar requirements. N.D.C.C. § 42-01-08 (“A private person may maintain an action for a public 
nuisance if it is specially injurious to that person.”); Williamson v. Kelley, 
271 N.W.2d 727, 729
 
(Iowa 1978) (“In order for a private party to assert a claim [for public nuisance], he must prove he 
has been injured in a special manner different from the public generally.”). 
treatment for all purposes (not merely overdoses) at the Plaintiffs’ Hospitals, as well as to 
other  members  of  the  communities  in  Minnesota.”  Id.  ¶ 825.  Plaintiffs  allege  that 
Defendants failed “to implement effective controls and procedures in their supply chains 

to guard against theft, diversion and misuse of controlled substances,” and caused the 
public nuisance through “their failure to adequately design and operate a system to detect, 
halt  and  report  suspicious  orders  of  controlled  substances.”  Id.  ¶ 826.  These  actions 
allegedly caused significant harms and created a public health crisis, while Defendants had 
the ability to tell the truth about opioids and control the flow of opioids into Plaintiffs’ 

communities. Id. ¶¶ 828–32.                                               
    Elsewhere in the Complaint, Plaintiffs allege that under the federal Controlled 
Substances Act’s implementing regulations, distributors and manufacturers of opioids are 
required to certify compliance with state and federal law, including designing and operating 
systems to disclose suspicious orders and maintain effective controls against diversion. 

Compl. ¶ 413 (citing 
21 C.F.R. § 1301.74
; 
21 U.S.C. § 823
(a)(1)). The Complaint also 
references prior DEA enforcement actions that require Distributor Defendants to stop 
shipment  on  any  orders  that  are  flagged  as  suspicious,  only  ship  those  orders  after 
confirming that the order will not be diverted to illegal channels, and in any event to report 
all flagged orders. 
Id.
 ¶ 415 (citing Southwood Pharm., Inc., 
72 Fed. Reg. 36,487
, 36,501 

(Drug Enf’t Admin. July 3, 2017); Masters Pharm., Inc. v. Drug Enf’t Admin., 
861 F.3d 206
 (D.C. Cir. 2017)); see also id. ¶¶ 460, 462–63 (discussing DEA communications to 
Distributor Defendants). In addition, the Complaint points to the controlled substances 
statutes  of  Iowa,  Nebraska,  Minnesota,  North  Dakota,  and  South  Dakota  and  the 
requirements they impose on manufacturers, distributors, and dispensers of opioids to 
maintain controls against diversion of controlled substances and keep accurate records 
regarding their distribution. Id. ¶¶ 403–12.                              

    Defendants argue that these references to the CSA throughout the Complaint reveal 
that the only source of the duty that forms the basis for the Plaintiffs’ nuisance claim is 
federal law. The Court disagrees. The mere fact that the Complaint has referenced the CSA 
or even woven CSA-related issues into the nuisance claim does not mean that a federal 
issue has become an essential element of the nuisance claim. See Merrell Dow Pharms. 

Inc. v. Thompson, 
478 U.S. 804, 813
 (1986) (explaining that Franchise Tax Board’s 
recognition that jurisdiction may lie when a “‘question of federal law is a necessary element 
of one of the well-pleaded state claims’ . . . did not purport to disturb the long-settled 
understanding that the mere presence of a federal issue in a state cause of action does not 
automatically confer jurisdiction”) (quoting Franchise Tax Bd., 
463 U.S. at 13
); see also 

Lester E. Cox Med. Centers v. Amneal Pharms., LLC, No. 6:20-03152-CV-RK, 
2020 WL 3171452
, at *2 (W.D. Mo. June 15, 2020) (“A state claim that incorporates a violation of 
federal law is insufficient to demonstrate the federal issue is ‘substantial.’”) (discussing 
Merrell Dow, 
478 U.S. 804
).                                               
    Moreover,  “‘when  a  claim  can  be  supported  by  alternative  and  independent 

theories—one of which is a state law theory and one of which is a federal law theory—
federal question jurisdiction does not attach because federal law is not a necessary element 
of the claim.’” Howell v. Grant Holding, Inc., No. 03-cv-5059 (JMR/FLN), 
2004 WL 1166955
, at *3 (D. Minn. 2004) (quoting Rains v. Criterion, 
80 F.3d 339
, 346 (9th Cir. 
1996)). That is the situation here. It is unclear why the Complaint’s references to the CSA 
highlighted  by  the  Defendants  would  make  a  federal  issue  an  essential  element  of 
Plaintiffs’ nuisance claim when Plaintiffs also refer to state law as the source of similar 

obligations. On this record it appears that whether or not Defendants’ conduct constitutes 
a public nuisance can be determined by reference to standards established by Minnesota or 
other state law independent of the CSA. See Fayetville Ark. Hosp. Co., LLC, 
2020 WL 2521515
, at *2 (“Plaintiffs have relied on state statutory and common law theories for each 
of their claims. Ultimately, a court may conclude that Plaintiffs have not pled an adequate 

basis for the duties they ascribe to Defendants, but that will be a matter of state law and 
will not require any interpretation or application of the CSA.”).         
    In this regard, the Court finds the reasoning in DCH Health Care Auth. v. Purdue 
Pharma L.P. to be instructive. 19-cv-756-WS-C, 
2019 WL 6493932
 (S.D. Ala. Dec. 3, 
2019). In that case, the plaintiff asserted a negligence per se claim, alleging that the 

defendants violated the Alabama Uniform Controlled Substances Act (AUCSA) “by failing 
to report suspicious orders and by failing to operate a system to stop orders that have been, 
or should have been, flagged as suspicious.” 
Id. at *4
. The defendant, Kroger, argued that 
only the CSA imposed those duties because they were  merely incorporated  into the 
AUCSA. 
Id.
 The court found that provisions of AUCSA and its implementing regulations 

would not support a conclusion that state law did not provide a source of the relevant duty. 
Id.
 It explained:                                                         
         [W]hile Count One rests negligence per se in part on violations 
         of the CSA, it also rests negligence per se on violations of    
         AUCSA and its regulations. Kroger has failed to show that all   
         – or any – of these asserted state-law violations either depend 
         on  non-existent  state-law  duties  supplied  by  statute  or  
         regulation  or  that  the  content  of  those  state-law  duties  is 
         measured by federal law.                                        

Id.
 Here, too, the Complaint references provisions of Minnesota, Iowa, and other states’ 
laws and regulations. Although Defendants have argued generally that those laws have 
incorporated the CSA, they have not shown that Plaintiffs’ nuisance claims depend on non-
existent state-law duties or that the obligations imposed by those state laws and regulations 
are “measured by federal law.” 
Id.
                                        
    In  similar  circumstances,  many  other  courts  have  determined  that  federal 
jurisdiction was absent where complaints raised only state law claims and references to the 
CSA did not necessarily raise a substantial federal issue. See, e.g., Pulaski Cnty. v. Walmart 
Inc., No. 4:20-CV-00983 JM, 
2020 WL 5746845
, at *2 (E.D. Ark. Sept. 25, 2020) (finding 
that although the plaintiffs acknowledged violations of the CSA would provide evidence 
of a breach of the defendants’ duties, “it is possible for the claims to be resolved without 
resolution of the CSA issues,” and remanding the case to state court); City of Philadelphia 
v. CVS RX Servs., Inc., No. 21-cv-4701, 
2022 WL 226072
, at *2 (E.D. Pa. Jan. 26, 2022) 

(“The  Complaint  discusses  the  CSA  only  as  a  potential  basis—among  others—for 
establishing Defendants’ liability under Pennsylvania state tort law.”); Lester E. Cox Med. 
Ctrs., 
2020 WL 3171452
, at *2–3. Indeed, the strong majority of courts to explore the issue 
in very similar litigation have agreed.                                   
    Finally, the Court notes that the CSA does not provide a private right of action. 

Other courts have found this reality reinforces the conclusion that complaints comparable 
to this one do not necessarily raise a federal issue. E.g., Fayetteville Ark. Hosp. Co., LLC 
v. Amneal Pharm., LLC, No. 5:20-cv-5036, 
2020 WL 2521515
, at *1 (W.D. Ark. May 18, 
2020)  (“The  conclusion  that  there  is  no  federal  subject-matter  jurisdiction  is  further 

strengthened by the fact that the CSA itself does not provide a private right of action.”) 
(citing Zink v. Lombardi, 
783 F.3d 1089, 1113
 (8th Cir. 2015)).           
    In sum, although Plaintiffs’ Complaint raises only state law claims, Defendants have 
argued that the Court has subject matter jurisdiction because a substantial federal question 
is necessarily presented by their nuisance claim. But the Defendants have failed to show 

that the “necessarily raised” element of the Grable exception is satisfied. Accordingly, the 
Court remands this case to state court.                                   

ORDER

    For the reasons set forth above, IT IS HEREBY ORDERED THAT:          
    1.   Plaintiff’s Motion to Remand (Doc. 11) is GRANTED.              

    2.   This matter is REMANDED to the State of Minnesota District Court, Fourth 
Judicial District, County of Hennepin.                                    

Date: May 7, 2024               s/Katherine Menendez                     
                                Katherine Menendez                       
                                United States District Judge             

Trial Court Opinion

                UNITED STATES DISTRICT COURT                             
                    DISTRICT OF MINNESOTA                                


Avera Gettysburg, doing business as       No. 23-cv-3882 (KMM/LIB)       
Avera Gettysburg Hospital, et al.,                                       

          Plaintiffs,                                                    

v.                                          ORDER                        

Teva Pharmaceutical Industries, Ltd., et                                 
al.,                                                                     

          Defendants.                                                    


    This matter is before the Court on Plaintiffs’ Motion to Remand pursuant to 
28 U.S.C. § 1447
(c). Pls.’ Mot. (Doc. 11). Plaintiffs argue that this case should be remanded 
to state court due to lack of subject matter jurisdiction. Defendants oppose the motion. 
Defs.’ Opp’n (Doc. 17). Because the Court agrees that subject matter jurisdiction is absent, 
the Plaintiffs’ motion is granted and this matter is remanded to Hennepin County District 
Court.                                                                    
                         BACKGROUND                                      
    Plaintiffs, which include several hospitals and healthcare systems, filed this case in 
the Fourth Judicial District, Hennepin County District Court, on November 14, 2023. 
Compl. (Doc. 1-1). Plaintiffs name several companies that market and distribute opioid 
medications as Defendants, dividing them into groups of “Marketing Defendants” and 
“Distributor Defendants.” Generally, Plaintiffs allege that the Marketing Defendants have 
engaged in false, deceptive, and unfair marketing of opioids, and that all Defendants 
breached duties to protect against suspicious opioids, all of which created a public health 
epidemic.  Further,  they  allege  that  the  Distributor  Defendants  unlawfully  distributed 
opioids by failing to detect, block and report suspicious orders and misrepresented their 

compliance with legal duties.                                             
    The Complaint includes ten claims for relief. The first six claims are asserted under 
the statutes of Minnesota, Nebraska, North Dakota, and South Dakota, which impose 
protections against consumer fraud, deceptive trade practices, and false advertising.1 The 
remaining four claims are common law torts, including nuisance (Seventh Claim for 

Relief), fraud and deceit (Eighth), civil conspiracy (Ninth), and unjust enrichment (Tenth). 
    On December 22, 2023, Defendant Cardinal Health, Inc. filed a Notice of Removal 
in this Court asserting that Plaintiffs’ claims “arise under federal law.” Notice of Removal 
¶ 1 (Doc. 1). According to Cardinal Health, Plaintiffs alleged that it and “other Defendants 
violated and are liable under a federal statute, the Controlled Substances Act, 
21 U.S.C. § 801
, et seq. (the “CSA”) and its implementing regulations.” 
Id.
 Accordingly, Cardinal 
Health asserted that this action is removable because it necessarily raises a federal claim 
for purposes of determining jurisdiction under 
28 U.S.C. § 1331
. 
Id.
 ¶¶ 13–37. Plaintiffs 
filed their motion to remand on January 18, 2024, arguing that the case must be remanded 


    1 The First Claim for Relief references Minnesota’s Prevention of Consumer Fraud Act, 
Minn. Stat. § 325F.68, et seq. The Second Claim for Relief asserts violations of Minnesota’s 
Deceptive and Unfair Trade Practices Act, Minn. Stat. §§ 325D.43 through 326D.48. The Third 
Claim for Relief alleges violations of Nebraska’s Consumer Protection Act, 
Neb. Rev. Stat. §§ 59
-
1601, et seq. The Fourth Claim for Relief points to North Dakota’s Consumer Fraud Act, N.D.C.C. 
§ 51-15-01, et seq. The Fifth Claim for Relief alleges violations of South Dakota’s Deceptive 
Trade Practices and Consumer Protection Act, SDCL § 37-24-21, et seq. And the Sixth Claim for 
Relief is brought under Minn. Stat. § 325F.67, which addresses false statements in advertising. 
to Hennepin County District Court because it raises exclusively state law claims, none of 
those claims present a substantial federal question, and Defendants’ position to the contrary 
has been repeatedly rejected by other courts. Pls.’ Mem. (Doc. 14).       

                          DISCUSSION                                     
I.   Legal Standard                                                       
    A  plaintiff  may  bring  a  motion  to  remand  a  case  removed  to  federal  court 
challenging the court’s jurisdiction over the suit, and if “it appears that the district court 
lacks  subject  matter  jurisdiction,  the  case  shall  be  remanded.”  
28 U.S.C. § 1447
(c). 

“Critically, the party seeking removal has the burden to establish federal subject matter 
jurisdiction,  [and]  all  doubts  about  federal  jurisdiction  must  be  resolved  in  favor  of 
remand[.]” Central Power Co-op. v. Midwest Indep. Transmission Sys. Operator, Inc., 
561 F.3d 904, 912
 (8th Cir. 2009) (citations omitted).                        
    A defendant may remove an action from state court to federal district court where 

“at least one claim falls within the original jurisdiction of the federal court.” Minnesota v. 
Am. Petrol. Inst., 
63 F.4th 703
, 709 (8th Cir. 2023). One source of original jurisdiction is 
28 U.S.C. § 1331
, which provides that “district courts shall have original jurisdiction of all 
civil actions arising under the Constitution, laws, or treaties of the United States.” Federal 
district courts have such “federal question jurisdiction” only when the plaintiff’s complaint 

presents the federal question on its face. Am. Petrol. Inst., 63 F.4th at 709. Under the well-
pleaded complaint rule, a plaintiff “‘may avoid federal jurisdiction by exclusive reliance 
on state law.’” Id. (quoting Caterpillar Inc. v. Williams, 
483 U.S. 386
, 392 (1987)). 
    Two exceptions to the well-pleaded complaint rule can support removal even where 
the face of the complaint presents no federal question. Cagle v. NHC Healthcare-Maryland 
Heights, LLC, 
78 F.4th 1061, 1066
 (8th Cir. 2023). These exceptions apply “when the state 

law  claims  (1) are  completely  preempted  by  federal  law  or  (2) necessarily  raise  a 
substantial, disputed federal question.” 
Id.
 (quotations omitted). This case involves the 
second of these exceptions.2                                              
    The second exception to the well-pleaded complaint rule, which is sometimes 
referred to as the “Grable doctrine,”3 Am. Petrol. Inst., 63 F.4th at 711, applies in a 

“‘special and small category of cases,’” Cagle, 
78 F.4th at 1067
 (quoting Gunn v. Minton, 
568 U.S. 251, 258
 (2013). Under this doctrine “federal jurisdiction over a state law claim 
will lie if a federal issue is (1) necessarily raised, (2) actually disputed, (3) substantial, and 
(4) capable of resolution in federal court without disrupting the federal-state balance 
approved by Congress.” 
Id.
 (citing Gunn, 
568 U.S. at 258
).                

    A state law claim ‘necessarily raises’ a federal issue when the question of federal 
law is a ‘necessary element of one of the well-pleaded state claims.” 
Id.
 (quoting Franchise 
Tax Bd. v. Constr. Laborers Vacation Tr., 
463 U.S. 1, 13
 (1983)). But the issue of 
“necessity” must be assessed with “precision.” Am. Petrol. Inst., 63 F.4th at 711 (quoting 
Cent. Iowa Power Coop. v. Midwest Indep. Transmission Sys. Oper., Inc., 
561 F.3d 904, 914
 (8th Cir. 2009)). “A removing defendant should be able to point to the specific 


    2 Defendants do not argue that Plaintiffs’ claims are completely preempted by federal law. 
Defs.’ Opp’n, passim.                                                     
    3 Grable & Sons Metal Prods., Inc. v. Darue Eng’g & Mfg., 
545 U.S. 308, 312
 (2005). 
elements of the plaintiff’s state law claims that require proof under federal law.” 
Id.
 
(cleaned up).                                                             
II.  Analysis                                                             

    Defendants argue that they have met their burden because they have shown that all 
four elements of the Grable doctrine are satisfied. However, as explained below, the Court 
finds that Defendants have failed to demonstrate that Plaintiffs’ Complaint necessarily 
raises a federal issue. Am. Petrol. Inst., 63 F.4th at 712 (“Because the ‘necessarily raised’ 
element is not satisfied, the Grable exception to the well-pleaded complaint rule does not 

apply to [the plaintiff’s] claims.”); Arkansas v. TikTok Inc., No. 1:23-CV-01038, 
2023 WL 4744903
, at *5 (W.D. Ark. July 25, 2023) (explaining that Grable applies when “all four 
elements are satisfied”).                                                 
    The Defendants focus on Plaintiffs’ nuisance claim4 and argue that a federal issue 
is a necessary element of that claim because it depends entirely on a duty imposed by the 

CSA. But the Defendants don’t say much about the applicable law of nuisance or the 
elements the Plaintiffs are required to establish to prevail on a public nuisance claim.5 In 
Minnesota, a public nuisance is a misdemeanor. The statute provides, in relevant part: 



    4 Because Defendants do not contend that a federal issue is necessarily raised by any of 
Plaintiffs’ other causes of action, the Court addresses only the nuisance claim. One federal issue 
in one claim is sufficient to support removal.                            
    5  The  Complaint  refers  in  several  places  to  Defendants’  conduct  causing  “a  public 
nuisance.” Compl. ¶¶ 120, 810, 873. Under Minnesota law, private nuisance claims are “limited 
to real property interests.” Anderson v. State of Minn., Dep’t of Natural Res., 
693 N.W.2d 181, 192
 (Minn. 2005). Real property interests do not appear to be the focus at all of Plaintiffs’ nuisance 
claims.                                                                   
         Whoever  by  an  act  or  failure  to  perform  a  legal  duty  
         intentionally does any of the following is guilty of maintaining 
         a public nuisance, which is a misdemeanor:                      

         (1)  maintains  or  permits  a  condition  which  unreasonably  
         annoys,  injures  or  endangers  the  safety,  health,  morals, 
         comfort, or repose of any considerable number of members of     
         the public. . . .                                               

Minn. Stat. § 609.74
. Although this statute is generally enforced by public authorities, 
under certain circumstances, a private plaintiff may bring a public nuisance claim.6 
    In their nuisance claim, Plaintiffs allege that Defendants have created a public 
nuisance through the “over-saturation of opioids in the patient population of Plaintiffs and 
in the geographic area served by Plaintiffs for illegitimate purposes, as well as the adverse 
social, economic, and human health outcomes associated with widespread illegal opioid 
use.” Compl. ¶ 820. The Marketing Defendants allegedly “participated in nuisance-causing 
activities  . . .  through  their  marketing  of  opioids”  and  all  Defendants  allegedly 
“exacerbated the flood of opioids into Plaintiffs’ communities in ways that unreasonably 
interfere with the public health, welfare, and safety in Plaintiffs’ communities.” 
Id.
 ¶¶ 822–
23. Further, Plaintiffs assert that “Defendants’ nuisance-causing activities include selling 
or  facilitating  the  sale  and  distribution  of  prescription  opioids  to  patients  who  seek 

    6 If a public nuisance causes an individual “special or peculiar damage” that is “not 
common to the general public,” Minnesota law provides for a private remedy. N. Star Legal Found. 
V. Honeywell Project, 
355 N.W.2d 186, 189
 (Minn. Ct. App. 1984) (quoting Hill v. Stokely-Van 
Camp, Inc., 
109 N.W.2d 749, 753
 (Minn. 1961)). Other states implicated by the Complaint have 
similar requirements. N.D.C.C. § 42-01-08 (“A private person may maintain an action for a public 
nuisance if it is specially injurious to that person.”); Williamson v. Kelley, 
271 N.W.2d 727, 729
 
(Iowa 1978) (“In order for a private party to assert a claim [for public nuisance], he must prove he 
has been injured in a special manner different from the public generally.”). 
treatment for all purposes (not merely overdoses) at the Plaintiffs’ Hospitals, as well as to 
other  members  of  the  communities  in  Minnesota.”  Id.  ¶ 825.  Plaintiffs  allege  that 
Defendants failed “to implement effective controls and procedures in their supply chains 

to guard against theft, diversion and misuse of controlled substances,” and caused the 
public nuisance through “their failure to adequately design and operate a system to detect, 
halt  and  report  suspicious  orders  of  controlled  substances.”  Id.  ¶ 826.  These  actions 
allegedly caused significant harms and created a public health crisis, while Defendants had 
the ability to tell the truth about opioids and control the flow of opioids into Plaintiffs’ 

communities. Id. ¶¶ 828–32.                                               
    Elsewhere in the Complaint, Plaintiffs allege that under the federal Controlled 
Substances Act’s implementing regulations, distributors and manufacturers of opioids are 
required to certify compliance with state and federal law, including designing and operating 
systems to disclose suspicious orders and maintain effective controls against diversion. 

Compl. ¶ 413 (citing 
21 C.F.R. § 1301.74
; 
21 U.S.C. § 823
(a)(1)). The Complaint also 
references prior DEA enforcement actions that require Distributor Defendants to stop 
shipment  on  any  orders  that  are  flagged  as  suspicious,  only  ship  those  orders  after 
confirming that the order will not be diverted to illegal channels, and in any event to report 
all flagged orders. 
Id.
 ¶ 415 (citing Southwood Pharm., Inc., 
72 Fed. Reg. 36,487
, 36,501 

(Drug Enf’t Admin. July 3, 2017); Masters Pharm., Inc. v. Drug Enf’t Admin., 
861 F.3d 206
 (D.C. Cir. 2017)); see also id. ¶¶ 460, 462–63 (discussing DEA communications to 
Distributor Defendants). In addition, the Complaint points to the controlled substances 
statutes  of  Iowa,  Nebraska,  Minnesota,  North  Dakota,  and  South  Dakota  and  the 
requirements they impose on manufacturers, distributors, and dispensers of opioids to 
maintain controls against diversion of controlled substances and keep accurate records 
regarding their distribution. Id. ¶¶ 403–12.                              

    Defendants argue that these references to the CSA throughout the Complaint reveal 
that the only source of the duty that forms the basis for the Plaintiffs’ nuisance claim is 
federal law. The Court disagrees. The mere fact that the Complaint has referenced the CSA 
or even woven CSA-related issues into the nuisance claim does not mean that a federal 
issue has become an essential element of the nuisance claim. See Merrell Dow Pharms. 

Inc. v. Thompson, 
478 U.S. 804, 813
 (1986) (explaining that Franchise Tax Board’s 
recognition that jurisdiction may lie when a “‘question of federal law is a necessary element 
of one of the well-pleaded state claims’ . . . did not purport to disturb the long-settled 
understanding that the mere presence of a federal issue in a state cause of action does not 
automatically confer jurisdiction”) (quoting Franchise Tax Bd., 
463 U.S. at 13
); see also 

Lester E. Cox Med. Centers v. Amneal Pharms., LLC, No. 6:20-03152-CV-RK, 
2020 WL 3171452
, at *2 (W.D. Mo. June 15, 2020) (“A state claim that incorporates a violation of 
federal law is insufficient to demonstrate the federal issue is ‘substantial.’”) (discussing 
Merrell Dow, 
478 U.S. 804
).                                               
    Moreover,  “‘when  a  claim  can  be  supported  by  alternative  and  independent 

theories—one of which is a state law theory and one of which is a federal law theory—
federal question jurisdiction does not attach because federal law is not a necessary element 
of the claim.’” Howell v. Grant Holding, Inc., No. 03-cv-5059 (JMR/FLN), 
2004 WL 1166955
, at *3 (D. Minn. 2004) (quoting Rains v. Criterion, 
80 F.3d 339
, 346 (9th Cir. 
1996)). That is the situation here. It is unclear why the Complaint’s references to the CSA 
highlighted  by  the  Defendants  would  make  a  federal  issue  an  essential  element  of 
Plaintiffs’ nuisance claim when Plaintiffs also refer to state law as the source of similar 

obligations. On this record it appears that whether or not Defendants’ conduct constitutes 
a public nuisance can be determined by reference to standards established by Minnesota or 
other state law independent of the CSA. See Fayetville Ark. Hosp. Co., LLC, 
2020 WL 2521515
, at *2 (“Plaintiffs have relied on state statutory and common law theories for each 
of their claims. Ultimately, a court may conclude that Plaintiffs have not pled an adequate 

basis for the duties they ascribe to Defendants, but that will be a matter of state law and 
will not require any interpretation or application of the CSA.”).         
    In this regard, the Court finds the reasoning in DCH Health Care Auth. v. Purdue 
Pharma L.P. to be instructive. 19-cv-756-WS-C, 
2019 WL 6493932
 (S.D. Ala. Dec. 3, 
2019). In that case, the plaintiff asserted a negligence per se claim, alleging that the 

defendants violated the Alabama Uniform Controlled Substances Act (AUCSA) “by failing 
to report suspicious orders and by failing to operate a system to stop orders that have been, 
or should have been, flagged as suspicious.” 
Id. at *4
. The defendant, Kroger, argued that 
only the CSA imposed those duties because they were  merely incorporated  into the 
AUCSA. 
Id.
 The court found that provisions of AUCSA and its implementing regulations 

would not support a conclusion that state law did not provide a source of the relevant duty. 
Id.
 It explained:                                                         
         [W]hile Count One rests negligence per se in part on violations 
         of the CSA, it also rests negligence per se on violations of    
         AUCSA and its regulations. Kroger has failed to show that all   
         – or any – of these asserted state-law violations either depend 
         on  non-existent  state-law  duties  supplied  by  statute  or  
         regulation  or  that  the  content  of  those  state-law  duties  is 
         measured by federal law.                                        

Id.
 Here, too, the Complaint references provisions of Minnesota, Iowa, and other states’ 
laws and regulations. Although Defendants have argued generally that those laws have 
incorporated the CSA, they have not shown that Plaintiffs’ nuisance claims depend on non-
existent state-law duties or that the obligations imposed by those state laws and regulations 
are “measured by federal law.” 
Id.
                                        
    In  similar  circumstances,  many  other  courts  have  determined  that  federal 
jurisdiction was absent where complaints raised only state law claims and references to the 
CSA did not necessarily raise a substantial federal issue. See, e.g., Pulaski Cnty. v. Walmart 
Inc., No. 4:20-CV-00983 JM, 
2020 WL 5746845
, at *2 (E.D. Ark. Sept. 25, 2020) (finding 
that although the plaintiffs acknowledged violations of the CSA would provide evidence 
of a breach of the defendants’ duties, “it is possible for the claims to be resolved without 
resolution of the CSA issues,” and remanding the case to state court); City of Philadelphia 
v. CVS RX Servs., Inc., No. 21-cv-4701, 
2022 WL 226072
, at *2 (E.D. Pa. Jan. 26, 2022) 

(“The  Complaint  discusses  the  CSA  only  as  a  potential  basis—among  others—for 
establishing Defendants’ liability under Pennsylvania state tort law.”); Lester E. Cox Med. 
Ctrs., 
2020 WL 3171452
, at *2–3. Indeed, the strong majority of courts to explore the issue 
in very similar litigation have agreed.                                   
    Finally, the Court notes that the CSA does not provide a private right of action. 

Other courts have found this reality reinforces the conclusion that complaints comparable 
to this one do not necessarily raise a federal issue. E.g., Fayetteville Ark. Hosp. Co., LLC 
v. Amneal Pharm., LLC, No. 5:20-cv-5036, 
2020 WL 2521515
, at *1 (W.D. Ark. May 18, 
2020)  (“The  conclusion  that  there  is  no  federal  subject-matter  jurisdiction  is  further 

strengthened by the fact that the CSA itself does not provide a private right of action.”) 
(citing Zink v. Lombardi, 
783 F.3d 1089, 1113
 (8th Cir. 2015)).           
    In sum, although Plaintiffs’ Complaint raises only state law claims, Defendants have 
argued that the Court has subject matter jurisdiction because a substantial federal question 
is necessarily presented by their nuisance claim. But the Defendants have failed to show 

that the “necessarily raised” element of the Grable exception is satisfied. Accordingly, the 
Court remands this case to state court.                                   

ORDER

    For the reasons set forth above, IT IS HEREBY ORDERED THAT:          
    1.   Plaintiff’s Motion to Remand (Doc. 11) is GRANTED.              

    2.   This matter is REMANDED to the State of Minnesota District Court, Fourth 
Judicial District, County of Hennepin.                                    

Date: May 7, 2024               s/Katherine Menendez                     
                                Katherine Menendez                       
                                United States District Judge             

Reference

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