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No long-arm jurisdiction in medical malpractice case

Where appellant, a Virginia resident, sought to exert long-arm personal jurisdiction over a North Carolina medical center, the trial court properly granted the center’s motion to dismiss. The medical center did not purposefully avail itself of the privilege of doing business in Virginia.

“Rather than a case about Wake Forest reaching into Virginia, this is a case of a plaintiff reaching back into North Carolina.”


After being unsuccessfully treated by Dr. Szulecki, a Virginia dermatologist, for a rash and infection in his groin area, Mr. Worth Carter’s primary doctor referred him “to Wake Forest University Baptist Medical Center … in Winston-Salem, North Carolina.” Dr. High, a Wake Forest physician, examined Mr. Carter. Later, Mr. Carter’s daughter, Ms. Carter, contacted Dr. High to follow up on Mr. Carter’s “worsening condition.”

Dr. High opined that Mr. Carter could be having congestive heart failure. He was treated at Johns Hopkins Hospital. When Mr. Carter was discharged, he was referred back to Wake Forest for his groin condition.

Between July 2016 and February 2017, Mr. Carter consulted with various Wake Forest physicians. He was hospitalized in Virginia in January 2017 and later underwent a biopsy at Wake Forest. After further testing, he was diagnosed with cancer and died a few weeks later.

Ms. Carter, as Mr. Carter’s executor, filed suit in the Martinsville Circuit Court. Wake Forest and four of its physicians were named as defendant, along with Dr. Szulecki. Later, Ms. Carter nonsuited the four doctors, leaving Wake Forest and Dr. Szulecki as defendants.

Wake Forest filed a special appearance to contest long-arm jurisdiction. The circuit court granted Wake Forest’s motion to dismiss.

Long-arm jurisdiction

“‘[D]ue process requires only that in order to subject a defendant to a judgment in personam, if he be not present within the territory of the forum, he have certain minimum contacts with it such that the maintenance of the suit does not offend ‘traditional notions of fair play and substantial justice.’ …

“General jurisdiction exists when a defendant is ‘essentially at home’ in the forum state. … This broader jurisdiction, in the context of corporate defendants, exists where the defendant is incorporated or has its principal place of business. … Here, general jurisdiction is inapplicable.

“Specific jurisdiction, however, is entirely different. … Specific jurisdiction requires that the defendant act ‘by which [it] purposefully avails itself of the privilege of conducting activities within the forum State.’ …

“These acts, or contacts, cannot be ‘random, isolated, or fortuitous.’ … Rather, ‘[t]hey must show that the defendant deliberately “reached out beyond” its home.’… Put differently, ‘there must be “an affiliation between the forum and the underlying controversy, principally, [an] activity or an occurrence that takes place in the forum State and is therefore subject to the State’s regulation.”’ …

“Although not binding on this Court, the United States Court of Appeals for the Fourth Circuit has helpfully organized the due process requirements of specific personal jurisdiction into a three-prong test: ‘(1) the extent to which the defendant purposefully availed itself of the privilege of conducting activities in the State; (2) whether the plaintiffs’ claims arise out of those activities directed at the State; and (3) whether the exercise of personal jurisdiction would be constitutionally reasonable.’”


As to the first factor, “Wake Forest maintained no offices or agents or property in Virginia prior to litigation; did not solicit or initiate business with Mr. Carter in Virginia; did not deliberately engage in long-term business activities in Virginia; had no choice of law provision; had no in-person contact in Virginia; and had no relevant, contractual duties that require performance in the state.

“As for the nature, quality, and extent of the parties’ communications about the business being transacted, there is scant evidence of a deliberate attempt, by Wake Forest, to purposefully avail themselves of Virginia.

“Ms. Carter alleges that Mr. Carter received additional, virtual treatment from Wake Forest, but the evidence bears out that this ‘treatment’ consisted of follow-up conversations – in an online portal that acted as an in-house email server – regarding Mr. Carter’s condition after the treatment he had received in person from Wake Forest in North Carolina.

“Moreover, the only other alleged contacts consist of phone calls and text messages regarding scheduling appointments, following up on Mr. Carter’s condition, or filling prescriptions at local Virginia pharmacies. These contacts were initiated by Ms. Carter – not Wake Forest.

“At the onset of the evaluation and treatment of Mr. Carter’s condition, he availed himself of the North Carolina jurisdiction, not the other way around. The North Carolina physicians, as is expected and as is required, engaged in communication that constituted advice and care that amounted to follow up to the evaluation and treatment that took place in North Carolina.

“Rather than a case about Wake Forest reaching into Virginia, this is a case of a plaintiff reaching back into North Carolina. …

“Given that the facts fail to show Wake Forest purposefully availed themselves of the privilege of conducting business in Virginia, we end our inquiry.”

Carter v. Wake Forest Univ. Baptist Medical Center, et al., Record No. 0309-22-3, March 7, 2023. CAV (published opinion) (White). From the Circuit Court of the City of Martinsville (Greer). Monica T. Monday for appellant. S. Virginia Bondurant Price for appellees. VLW 023-7-098, 11 pp.