## Facts

- Melinda Kay Broemmer, a 21-year-old Iowa resident, sought an abortion at an Arizona clinic while 16–17 weeks pregnant and experiencing significant emotional stress and conflicting family pressures.
- At the clinic intake visit, Broemmer was separated from her mother and instructed to complete three forms, including an “Agreement to Arbitrate,” without receiving expected counseling or information about the procedure or alternatives.
- The arbitration form broadly required binding arbitration of disputes arising from the clinic’s fees and/or services.
- The form specified that arbitrators appointed through the American Arbitration Association would be licensed obstetrician/gynecologist physicians.
- Broemmer completed the forms quickly; the clinic did not explain the arbitration provision and did not have a policy of doing so.
- The next day, Broemmer underwent the procedure and suffered a punctured uterus requiring medical treatment.
- Broemmer later filed a medical malpractice action against the clinic and the physician; defendants sought dismissal based on the arbitration agreement.

## Issues

1. Whether the clinic’s pre-treatment arbitration agreement was an unenforceable term in a contract of adhesion because it exceeded the patient’s reasonable expectations.
2. Whether the agreement’s requirement of physician-arbitrators and its effect on access to court and jury trial supported nonenforcement under Arizona contract doctrine.

## Decision

- The Arizona Supreme Court held the arbitration agreement was a contract of adhesion.
- The court concluded the arbitration provision was unenforceable against Broemmer because it fell outside her reasonable expectations.
- The court reversed the trial court’s judgment compelling arbitration and vacated the court of appeals’ decision in relevant part, allowing the malpractice claims to proceed in court.

## Legal Principles

- Standardized, non-negotiable agreements offered on a take-it-or-leave-it basis may be treated as contracts of adhesion.
- Adhesion contract terms are not enforced if they are beyond the adhering party’s reasonable expectations, even if the contract is otherwise valid.
- A pre-treatment arbitration clause that effectively waives court access and jury trial rights may be outside reasonable expectations when presented without explanation in a pressured medical intake setting.
- Factors bearing on reasonable expectations include the setting of assent, the party’s vulnerability and lack of bargaining power, the absence of meaningful opportunity to understand the term, and whether the term reallocates dispute resolution in a manner favoring the drafter.

## Conclusion

The Arizona Supreme Court refused to enforce a clinic’s intake arbitration clause because, given the circumstances of presentation and the patient’s situation, a patient would not reasonably expect to waive court and jury trial rights through an unexplained, non-negotiable form signed immediately before medical services.


Broemmer v. Abortion Servs. of Phx., Ltd., 173 Ariz. 148, 840 P.2d 1013 (Ariz. 1992)