INT HEU NITSETDA TDEISS TRCIOCUTR FTO RT HE EASTEDRINS TROIFCV TI RGINIA AlexaDnidvriisai on NILAU CAaSnA d. Ma.m ,i nboyar n tdh rough) hiGsu araddLi iatnNe imLa,u cas), Plaintiffs, ) ) V. ) CasNeo1 . :22-c(vP-T0GA0/)9J 8F7 ) VHCH ealeatthl ,. , ) Defendants. ) MEMORANDOUPMI NIAONNDO RDER Thmiast ctoemrbe esfo trheCe o uornDt e fendMaonttitsooD'ni smisst Fop eudresruaaln t RuolfeC i vPirlo cel2d ()u(6br ) eD. k t6s-.7P .l aiNnitLaiu ffcasan shd e mri ncohriA l.dMw,.h ,o arper oceperdsoiebn,rg i ng tuhnidsSe erac ct5ti0ioo4ofnt n hR ee habiAlci2tt9,Ua .tSi.oCn. §§7 94T,i tIlIoeIf t hAem eriwciatDnhis s abAicl(ti" tAiDeA4s"2 U) .,S .§1C 2.1 3a2n,d Sect1i5o5on7ft hPea tiPernott eacntAdiff oonr dCaabrAlece( t " ACA4"2U),., S §.1 C8.1 16, alledgiisnagdb iislcirtiyam nirdne attai.lDo ikna1t t( .i" oCpnolma. 1t"6 )- 12 D1e.fe ndmaonvtesd tod ismtihasicsst airognu,ti hnaagmt o,n ogtshtteh ri Pnlgasi,An .tMsi.c ff'l afaiimfolsrl aocfk stanadniPdnl ga iNnitLaiu ffc calsa'fai imtlsos taact lea aistm oa noyft hcei tsetda tausat es matotfle arwD .k 7ta .1t - 3P.l aisnetDnietfffe ndaaR netssp (oDnks2te1. w) h,i Dcehfe ndants subseqfiuleewndit ttlhhyC e o uarntDd,e fendfialneatRd se p(lDyk1 t5.)O .nJ un1e42 ,0 23, Plaifinltaeidnaff d ditionala sab nOr pipeofs,Di tks2itt6o.y.n l .i zed

1T hCeo uwritcl iltt ope a goefPs l ainCtoimfpflrsaa ittnhhtepa ran r agnruampbbhee rcsat uhsee paragarriaenp chosn sniusmtbeenrteldy. On June 15, 2023, a hearing was held on Defendants’ Motion to Dismiss (Dkt. 6). The Court took the matter under advisement. Having considered the parties’ written submissions and arguments, this matter is ripe for disposition. For the reasons stated below, the Court grants Defendants’ Motion to Dismiss. DKkt. 6. I. BACKGROUND The following facts, taken from Plaintiff's Complaint, are accepted as true for purposes of this Motion:? Plaintiff was a patient at Virginia Hospital Center (“VHC”) from at least August 24, 2018 to September 5, 2018, where she received medical care associated with her pregnancy. Compl. at 2, 13-14. At this time, Plaintiff was thirty-five years old and an “African American female and service connected disabled veteran (diagnosed with Traumatic Brain Injury, Post-Traumatic Stress Syndrome, Depression, Anxiety and Panic Attacks)[.]” /d. at 13. On August 24, 2018, Plaintiff's Maternal Fetal Medicine (“MFM”) provider and a VHC physician, Dr. Nisha Vayas, sent Plaintiff to VHC’s Emergency Labor and Delivery Unit “to resolve [Plaintiff's] pre-term contractions, as well and abdominal and back pain.” /d.; see also id. at 2. Around this time, Plaintiff “still had approximately three and [a] half months” left of her pregnancy. /d. at 3-4. While at VHC’s Emergency Labor and Delivery Unit on August 24, 2018, “(Plaintiff’s] pre-term contractions went untreated” and “a medical student . . . check(ed] [Plaintiff's] cervix without her permission.” Jd. at 13. VHC physicians attending to Plaintiff that day also “did not provide the recommended dosage of Indocin as prescribed by [Dr. Vayas] to stop the pre-term contraction[s.]” /d. at 2.

? In considering a motion to dismiss for failure to state a claim, as is the case here, “a court accepts all well-pled facts as true and construes these facts in the light most favorable to the plaintiff[.]” Nemet Chevrolet, Ltd. vy. Consumeraffairs.com, Inc.,

(4th Cir. 2009).

On August 25, 2018, Plaintiff was discharged “without treatment of pre-term contractions and pain.” Jd. at 13. Plaintiff was told to follow up with Dr. Vayas at a regularly scheduled appointment within the next forty-eight hours and “that if [Plaintiff] was to miscarry to do so at home[.]” Jd During those forty-eight hours, Plaintiff was “sleepless, ravaged with pain, experiencing pre-term [contractions] . . . as well as[] emotionally injured[.]” /d. at 2. On August 27, 2018, Dr. Vayas “returned [Plaintiff]” to VHC’s Emergency Labor and Delivery Unit for treatment. /d. at 13. While there, “the staff made it clear that they believed that because of [Plaintiffs] diagnosed emotional conditions, ADA disabilities that limit one or more of her daily activities, that [Plaintiff] was fabricating the seriousness of the contractions and pain.” at 13-14. On August 28, 2018, Plaintiff was discharged “after making complaints about the intentional discrimination she and another patient experienced[.]” /d. at 14. Specifically, Plaintiff complained that she was not tested for or diagnosed with gestational diabetes “in accord with [Dr. Vayas’” recommendations, Plaintiff had to request a glucose tolerance test, Plaintiff was given cortisone cream, Plaintiff was diagnosed with “Cholestasis by a non-medical doctor without any information on the cause or treatment[,]” and Plaintiff's pre-term contractions and pain were untreated. /d. Plaintiff's complaint on behalf of another patient was in reference to an event “she witnessed” during which an “African American VHC phlebotomist [was] traumatizing and being derogatory to a Muslim patient[.]” /d@ at 4. Plaintiff reported her claims of intentional discrimination to Dr. Saira Mir, an OB/GYN physician at VHC, Dr. Kelly Orzechowski, an MFM physician at VHC, and Kelly White, a VHC business manager. /d. at 3, 14. The date on which Plaintiff reported her intentional discrimination claims to VHC is not alleged.

Around August or September 2018, “both Dr. Mir and Dr. Orzechowski[} falsified there [sic] medical note to include in accurate [sic] information . . . to support retaliation.” /d. at 14. On September 5, 2018, Plaintiff received a dismissal letter, which was dated August 31, 2018. /d. The letter informed Plaintiff that “there was no trust between she and... the Defendant’s [sic] and thus she was being dismissed[.]” /d On September 6, 2018, after arriving for an appointment with Dr. Mir, Plaintiff “was told to go and that her expectation could not be met.” Jd. at 15. On an unknown date, at a previous appointment, “Dr. Mir .. . informed . . . Plaintiff[] [that] she does not take care of veterans or ‘Blacks’.” Jd. On August 29, 2022, Plaintiff filed suit against VHC Health, dba Virginia Hospital Center, and VHC Physician Group, LLC, dba VHC Health Physician/Obgyn. /d. at 1. The Complaint alleged violations of the Rehabilitation Act, the ADA, and the ACA due to Defendants’ discrimination against Plaintiff Nia Lucas and her minor child, A.M., on the basis of Plaintiff's disability. /d. at 16-21. Regarding her discrimination claim, Plaintiff alleges that she “receiv[ed] disparate care from White patients, because of her race and that of her son (African American) and her service-connected disability (PTSD and depression).” /d. at 3. Although Plaintiff labels her claim as a “[d]isability [d]iscrimination” claim, see id. at 16-17, the Court will construe Plaintiff s discrimination claim as one brought under the bases of race and disability. Although the Complaint is unclear, Plaintiff also appears to allege a violation of the ACA due to Defendants’ retaliation. Id. at 19-20. Specifically, Plaintiff alleges that “VHC and its physician group retaliated against [Plaintiff] because [of] her complaint of intentional discrimination against her and another patient of color, that was Muslim.” /d. at 5—6; see also id. at 14, 19. As stated, Defendants moved to dismiss the Complaint. Dkt. 6. In her Opposition, Plaintiff withdrew all claims made on behalf of her minor child. Dkt. 26 at 1. Plaintiff also clarified the

claims she was bringing on her own behalf. Specifically, Plaintiff stated that she “perhaps errored when she wrote [CJount I and II, referencing Title VI, Rehab[ilitation] Act and ADA; when all should have been referred under [Count] III, Violation of the ADA [sic].” /d. at 3. The Court believes that Plaintiff intended to write “ACA” instead of “ADA” because in her Complaint, Plaintiff brings Count II] pursuant to the ACA. Compl. at 18-19. Plaintiff later stated that “Plaintiff clearly alleges in her Complaint .. . that VHC violated the ACA’s nondiscrimination provision, and that she seeks to recover under the ACA.” Dkt. 26 at 3. Thus, the Court will construe the Complaint as alleging discrimination and retaliation claims under the ACA alone and not under the Rehabilitation Act or the ADA. Il. LEGAL STANDARD To survive a motion to dismiss brought under Federal Rule of Civil Procedure 12(b)(6), a complaint must set forth “a claim to relief that is plausible on its face.” Bell Atl. Corp. v. Twombly,

(2007). A claim is facially plausible “when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal,

(2009) (citing Twombly,

). When reviewing a Rule 12(b)(6) motion, the Court “must accept as true all of the factual allegations contained in the complaint,” drawing “all reasonable inferences” in the plaintiff's favor. du Pont de Nemours & Co. v. Kolon Indus., Inc.,

(4th Cir. 2011) (quoting Erickson v. Pardus,

(2007) and Nemet Chevrolet, Ltd. v. Consumeraffairs.com, Inc.,

(4th Cir. 2009)). “[T]he court ‘need not accept the [plaintiffs] legal conclusions drawn from the facts,’ nor need it ‘accept as true unwarranted inferences, unreasonable conclusions, or arguments.’” Wahi v. Charleston Area Med. Ctr., Inc.,

, 616 n.26

(4Ctih2r 0.0 (9a)l teirnoa rtiig(oiqnnu aolKt)li ovntM.ghi crCoosro4pft4. F4,. 331d32 1,(9 4 th Ci2r0.0 6)). IIIA.NALYSIS Fotrhs ea okfce o mplettheCeno eucsrostn, s PtlrauienCsto imfpflasan Oidpn pto saistion assedritsicnrgi amnirdne attailcolinaa iutmdniseot rnhA eCA .D efednatnasr gtuhea t

Plaintibfrfosu ugcnhldttaeeh Air Cm Asfa li tsot aact leaDikm7t.a . 7t . a.PlaiFnatiitlffoAs l laeD gies crimCilnaaitmi otUnhn AedC eAr Sect1i5o5on7ft hAeC As taatsfoe lsl ows: [Ai]nnd ivsihdanulooaltnlt , h ger opurnodh iubnidtteierVtd Iol tfeh Cei vRiilg hts Acotf1 96.4 .t iI.tX lo ,eft hEed ucaAtmieonnd moef1n 9t7.s2 .t hA.eg e, DiscrimAicontf1a 9t7.i5o., on .rs ec7t9io4oft n i 2t9[l teRh eeh abiAlcitt]a,tion bee xclfruodmep da rticiinbp,eda etnitiohenbed e neofifot,rsb es ubjteocted discriminaanthyie oapnlr touhgn ordraae cmrt ,ia vnpiyat oryfwt, h iicrshe ceiving Fedefirnaaln acsisails tTahneecn efo[r.c]em meecnhta npirsomvsfoi rda endd avaiulnadbseluretc ihVt Ilt,ei I tXls,ee c7t9io4ors,n u AchgD ei scrimAicntation shaalplpfo lrpy u rpoofvs ieosl aotfti hsoiunsbs s ection. 3 42U .S§.1 C8.1 16(a). Tos taact lea foiram S ect1i5o5vn7i oluantditeohArneC AP,l aimnutsaitlff l faecgtes adeqtusoa ttaaec t lea uinmdo enroe ft h foeu ferd enroanld iscrsitmaitinunatcteoisro pinon rtaot ed Sect1i5o5Bn7a .sv tN.ao vHaenatIl nt5ch6F. .,4 3t0h37 1,4 -(14C5ti h2r 0.2 B2e)c.a Pulsaei ntiff speoafbko srt ahac ned disabiliithnye C rod mipslctarhCiieonm utiwr,nit aal ntlai lwoyhnze et her Plaihnatasil ffl efagcetds atdose tqaauct aleta eoi frm a dcies criumnidnTeairttV ilIooe ftn h e CivRiilgA hct(ts" TViIt"al)ned d i sadbiislcirtiyum nidnteahRrtee i hoanb ilitation Ac 3 Plaiinntcioffr srteacttthel"asy[t t A]ChAea do.p t[.sA m.e riwciatDnhi ss abAiclti]t ies prohifobrid tiisocnrsi miDnka2tt6.ai 2tos; n ea[el. is]dao" 4t . A ss een Saebcot1vi5eo5,on7 f thAeC Ao nliyn corpToirtValIote fte hsCe i vRiilg Ahctotsf1 96T4i,tI lXoe ft hEed ucation Amendmoef1n 9t7ts2h A,eg Dei scrimAicontf1a 9t7ia5on,Snd e ct5i0oo4ftn h Ree habilitati Act4.2U .S§.1 C8.1 16(a). To state a claim of race discrimination under Title VI, the plaintiff must plausibly allege that the defendant received federal financial assistance and engaged in intentional racial discrimination. Alexander v. Sandoval,

(2001). Regarding the receipt of federal financial assistance, Plaintiff pleads that Defendants “receiv[e] federal financial assistance.” Compl. at 6; see also id. at 16, 19-20. Regarding intentional racial discrimination, Plaintiff's Complaint speaks to racial discrimination in maternal and infant health care in the American medical system at great length. id. at 8-12. Although racial disparities in the health care system may exist, the Court is bound to examine only the “factual content” in Plaintiff's Complaint “that allows [it] to draw the reasonable inference” that Defendants are liable for discriminating against Plaintiff on the basis of race. Ashcroft,

(citing Twombly,

). The Complaint’s factual content concerning racial discrimination is limited to the following: “Defendant’s refusal to provide... mitigation for pre-term [contractions] and discharge without pain management was based on intentional racism and discrimination.” Compl. at 3. Defendants “assumed that, because [Plaintiff] was African American that [Plaintiff] could withstand the contractions and pain[.]” /d. at 4. Finally, at an undated medical appointment, one of Defendants’ medical providers, Dr. Mir, “informed [] Plaintiff[] [that] she does not take care of veterans or ‘Blacks’.” /d. at 15. Taking the Complaint as a whole, the Court finds that the Complaint fails to plausibly allege that Defendants engaged in intentional racial discrimination. As an initial matter, Plaintiff's statement that Defendants refused to provide pre-term mitigation due to “intentional racism and discrimination” and assumed that Plaintiff could sustain contractions and pain due to her race are conclusory and speculative. Accordingly, the Court disregards these allegations because such

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beidincsgr iminatSeedCea mapag i4ta(. i"An][sftther.e rco mplatihDneet f,e ndetaanlti'ast iron dismihse.sr.i ".n)i.g;d ( .a llae" grientga dliisamtaioftsre[syrPa lla icnotmipflofaftsi h]ne t intendtiisoandbaiilsl cirtiym iid.an 5ta( t"iVoaHnnC"id )tp ;sh ysgircoiruaepnt aalgiaaitnesdt [Plabienctai[ouf f]hsf] ee cr o mpolifan itnetn dtiisocnraialmg ianhiaenatrsnia tdon no ptahteire nt ofc oltohrwa,atM s u sl"i)im;da. .1t 9 ( "TPhlea ianltlitefhgf[tae]hts De e fendianntte'nst iona discrim[iwnabasat]so[ en[id Po lna]i cnotmipfolfifasn i]tn etnd tiisocnrairlme itnaa[ltsiiiaoctn]e d ind ismihse]sr"i[D)n.k;gt2 .a6 t ( "4T Phlea iinnht eCiroff m plsatiatnthtesa sht e btehlaite ved shwea asv icotf[iD]me fenrdeatnatl.si..'aa s[t ari]eo snou f[lP]tl aimnatkiiaffpn rgo tected complaint[.]”). By Plaintiff's own admissions, then, Defendants’ alleged act of dismissing Plaintiff from receiving further medical services was motivated by complaints she voiced with Defendants, and not because of her race. Accordingly, for all of these reasons, any claim of race discrimination under Section 1557 of the ACA must be dismissed. Next, the Court turns to Plaintiff’s claim of disability discrimination. To state a claim of disability discrimination under the Rehabilitation Act against a private entity which receives federal funds, a plaintiff must show: (1) that she is a “disabled individual” as defined in the Rehabilitation Act; (2) that she is “otherwise qualified” to participate in the offered activity or to enjoy its benefits; (3) that she is “excluded from such participation or enjoyment solely by reason of... her handicap”; and (4) “that the program administering the activity receives federal financial assistance.” Basta, 56 F.4th at 315 (emphasis added). Similar to the race discrimination claim, Plaintiff's disability discrimination claim fails because the Complaint does not plausibly allege that Plaintiff was excluded from Defendants’ services and treatment solely by reason of her handicap. On August 27, 2018, Plaintiff alleges that “the staff made it clear that they believed that because of [Plaintiff's] diagnosed emotional conditions... that [Plaintiff] was fabricating the seriousness of the contractions and pain.” Compl. at 13-14. The Complaint alleges that Plaintiff was discharged on August 28, 2018, “after making complaints about the intentional discrimination she and another patient experienced... because of their potential race, ethnicity, disability and religion[.]” /d at 14. On September 5, 2018, Plaintiff received a dismissal letter from Defendants, stating that “there was no trust between” Plaintiff and at least one of Defendants’ medical providers and that Plaintiff “was being dismissed[.]” /d. Thus, it is clear based on the facts that Plaintiff alleges that her disability was

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