## Facts

- Frank Paterno, a New York resident with severe back pain, saw an internet advertisement for Laser Spine Institute (LSI), a Florida-based surgical facility.
- From New York, Paterno contacted LSI by phone and email and sent MRI films to Florida for review.
- LSI emailed preliminary treatment recommendations, expressly subject to change after in-person evaluation in Florida.
- LSI offered a discounted, short-notice surgery date in Florida; Paterno exchanged multiple emails with LSI about registration, insurance, and payment arrangements to prepare for travel.
- Paterno traveled to Florida and underwent the first two spine surgeries at LSI’s Tampa facility.
- He alleged those surgeries were negligently performed, causing extreme pain and ongoing injury experienced after he returned to New York.
- Paterno sued LSI and its medical professionals in New York for malpractice based on the alleged negligence during the first two Florida surgeries.

## Issues

1. Whether New York had specific jurisdiction under CPLR 302(a)(1) because LSI’s internet advertising and pre-/post-treatment communications with Paterno in New York constituted “transacting business” in New York, and whether the malpractice claim “arose from” those contacts.
2. Whether New York had jurisdiction under CPLR 302(a)(3) for an out-of-state tort causing injury “within” New York where the alleged malpractice occurred in Florida but continuing effects were felt in New York.

## Decision

- The New York Court of Appeals affirmed dismissal for lack of personal jurisdiction.
- CPLR 302(a)(1) did not apply because defendants did not purposefully transact business in New York, and the malpractice claim did not arise from any in-state transaction.
- CPLR 302(a)(3) did not apply because the situs of the injury was Florida, where the surgeries occurred, not New York where consequences were later experienced.

## Legal Principles

- CPLR 302(a)(1) requires (1) purposeful in-state transaction of business (or contracting to supply goods/services in the state) and (2) an articulable nexus or substantial relationship between that transaction and the claim.
- A non-targeted, non-interactive (passive) internet presence accessible in New York, without more, does not constitute transacting business in New York.
- Pre- and post-treatment phone/email communications that are incidental and directed to arranging or following up on out-of-state medical care generally do not amount to purposeful New York transactions.
- For CPLR 302(a)(3) in medical malpractice, the situs of injury is where the negligent treatment and original injury occurred, not where the patient later experiences continuing effects.

## Conclusion

Because LSI’s New York-related contacts were limited to passive advertising and communications incidental to treatment performed entirely in Florida, and because the alleged injury occurred in Florida, New York courts lacked long-arm jurisdiction under CPLR 302(a)(1) and CPLR 302(a)(3).


Paterno v. Laser Spine Inst., 24 N.Y.3d 370 (N.Y. 2014)