## Facts

- Dr. Theodore R. Bledsoe, a physician, underwent long-term psychiatric treatment beginning in 1969 for impulse-control problems.
- Dr. Brian Crowley provided psychoanalysis for about eleven years, then referred Bledsoe in 1979 to Dr. Sylvia Friedman for group therapy lasting about two and one-half years.
- Crowley and Friedman practiced in Maryland, and the treatment occurred in Maryland.
- In 1984, after ending therapy, Bledsoe was admitted to St. Elizabeths Hospital in Washington, D.C., where a CAT scan revealed a brain tumor.
- Bledsoe alleged the psychiatrists negligently failed to diagnose the tumor over roughly twelve years, causing permanent harm and preventing him from continuing to practice medicine.
- Bledsoe filed a diversity medical-malpractice action in the U.S. District Court for the District of Columbia while residing in D.C.
- Maryland law required presuit submission of medical-malpractice claims to an arbitration panel; Bledsoe did not comply before filing suit.

## Issues

1. Under District of Columbia choice-of-law principles, whether Maryland law—including its presuit medical-malpractice arbitration requirement—governed a diversity malpractice suit filed in federal court in the District of Columbia when treatment occurred in Maryland.
2. Whether Maryland’s arbitration statute applied only to actions brought in Maryland courts, or also to actions in other courts applying Maryland law.
3. Whether defendants waived the arbitration requirement, and if not, whether the proper disposition for noncompliance was dismissal or a stay pending arbitration.

## Decision

- The court held that District of Columbia choice-of-law principles required application of Maryland law to the malpractice claims.
- The court held Maryland’s presuit arbitration requirement applied as part of the governing law, notwithstanding that the action was filed in federal court in the District of Columbia.
- The court rejected the argument that the statutory phrase limiting suits “in any court of this State” confined the requirement to Maryland courts only.
- The court found no waiver of the arbitration requirement by defendants.
- The court affirmed the application of Maryland law, vacated the district court’s dismissal, and remanded with instructions to stay the action pending completion of the arbitration process.

## Legal Principles

- A federal court sitting in diversity applies the forum’s choice-of-law rules to determine the governing substantive law.
- When the forum’s choice-of-law rules select another state’s law for a claim, statutory presuit conditions attached to that state’s medical-malpractice cause of action must be enforced by the forum court.
- Statutory language referring to actions in the enacting state’s courts does not necessarily prevent enforcement of the statute’s presuit precondition in another jurisdiction applying that state’s law.
- When a mandatory presuit arbitration process has not been completed, the appropriate remedy is generally a stay pending arbitration rather than dismissal, preserving the filed action while the required process proceeds.

## Conclusion

The D.C. Circuit required application of Maryland medical-malpractice law, including presuit arbitration, to a D.C. diversity action arising from Maryland treatment, and held the case should be stayed for arbitration rather than dismissed.


Bledsoe v. Crowley, 849 F.2d 639 (D.C. Cir. 1988)