Surgery Center Holdings, Inc. v. Robert Guirguis, D. O.
CourtDistrict Court of Appeal of Florida
Date FiledDecember 11, 2020
Docket2D19-4889
StatusPublished
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Full Opinion
NOT FINAL UNTIL TIME EXPIRES TO FILE REHEARING
MOTION AND, IF FILED, DETERMINED
IN THE DISTRICT COURT OF APPEAL
OF FLORIDA
SECOND DISTRICT
SURGERY CENTER HOLDINGS, )
INC., TAMPA PAIN RELIEF )
CENTER, INC., and ARMENIA )
AMBULATORY SURGERY CENTER, )
LLC, )
Appellants, )
)
v. ) Case No. 2D19-4889
)
ROBERT GUIRGUIS, D.O., JOHN )
KEVYN OTERO, M.D., HECTOR )
CASES, M.D., RODOLFO GARI, JR., )
M.D., CHARLES K. FRIEDMAN, D.O., )
P.A., PHYSICIAN PARTNERS OF )
AMERICA, LLC, and MAN QUANG LE, )
M.D., )
Appellees. )
)
Opinion filed December 11, 2020.
Appeal pursuant to Fla. R. App. P. 9.130
from the Circuit Court for Hillsborough
County; Steven Scott Stephens, Judge.
Alan Rosenthal, Natalie J. Carlos, and
Charles W. Throckmorton of Carlton
Fields, P.A., Miami, for Appellants.
John A. Schifino, William J. Schifino, and
Justin P. Bennett of Gunster Law Firm,
Tampa; and Robert V. Williams and
J. Travis Godwin of Burr & Forman LLP,
Tampa, for Appellees Robert Guirguis,
D.O., John Kevyn, Otero M.D., and
Hector Cases, M.D.
Charles A. Carlson of Barnett, Bolt,
Kirkwood, Long, Koche, & Foster,
P.A., Tampa, for Appellees, Rodolfo
Gari, Jr., M.D., Charles K. Friedman,
D.O., P.A., and Physician Partners of
America, LLC.
Philip L. Schwartz and Jordan Grimaldi
of Schwartz|White, Boca Raton, for
Appellee Man Quang Le, M.D.
MORRIS, Judge.
Surgery Center Holdings, Inc. (SCHI); Tampa Pain Relief Center, Inc.
(TPRC); and Armenia Ambulatory Surgery Center, LLC (AASC) (collectively referred to
as appellants), appeal an order denying their motion for a temporary injunction filed in
their action for breach of employment agreements against Robert Guirguis, D.O.; John
Otero, M.D.; Hector Cases, M.D.; Man Le, M.D. (collectively referred to as the doctors);
Rodolfo Gari, Jr., M.D.; Charles Friedman, D.O., P.A.; and Physician Partners of
America, LLC (collectively referred to as the Gari Entities). We reverse the order in part
because the trial court erred in concluding that two of the restrictive covenants in the
agreements at issue had not been violated.
I. Background
SCHI operates TPRC, a pain relief center, and AASC, a surgery center.
Drs. Guirguis, Otero, Cases, and Le were previously employed by TPRC, and Drs.
Guirguis, Otero, and Cases had financial interests in AASC. The doctors had
agreements with appellants that contained various restrictive covenants. In late 2018
and early 2019, the doctors left their employment with appellants and began working
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with the Gari Entities, competitors of TPRC and AASC.1 Alleging that the doctors
violated various restrictive covenants of the two agreements, appellants filed a
complaint for breach of contract and a motion for temporary injunction. After a two-day
hearing, the trial court denied appellants' motion for temporary injunction.
II. Analysis
This court "employ[s] a hybrid standard of review for orders on temporary
injunctions: 'To the extent the trial court's order is based on factual findings, we will not
reverse unless the trial court abused its discretion; however, any legal conclusions are
subject to de novo review.' " REV Recreation Grp., Inc. v. LDRV Holdings Corp., 259
So. 3d 232, 235 (Fla. 2d DCA 2018) (quoting Gainesville Woman Care, LLC v. State,
210 So. 3d 1243, 1258 (Fla. 2017)).
Where the trial court's temporary injunction concerns matters
within the trial court's discretion, "[a]n appellant who
challenges the trial court's order [on a motion for temporary
injunction] has a heavy burden; the trial court's ruling is
presumed to be correct and can only be reversed where it is
clear the court abused its discretion."
Id. (first alteration in original) (quoting Atomic Tattoos, LLC v. Morgan, 45 So. 3d 63, 64
(Fla. 2d DCA 2010)).
A temporary injunction should only issue when "the moving party has
demonstrated (1) irreparable harm to the moving party unless the injunction issues, (2)
unavailability of an adequate legal remedy, (3) a substantial likelihood of success on the
1The Gari Entities are controlled by Dr. Rodolpho Gari, Jr., who previously
held a controlling interest in both TPRC and AASC. Dr. Gari sold his interests to SCHI,
and lengthy and complex litigation resulted from that transaction. See, e.g., SP
Healthcare Holdings, LLC v. Surgery Ctr. Holdings, LLC, 208 So. 3d 775 (Fla. 2d DCA
2016); SP Healthcare Holdings, LLC v. Surgery Ctr. Holdings, LLC, 110 So. 3d 87 (Fla.
2d DCA 2013).
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merits, and (4) that the public interest is supported by the entry of the injunction."
Atomic Tattoos, LLC, 45 So. 3d at 64-65 (citing Masters Freight, Inc. v. Servco, Inc.,
915 So. 2d 666, 666 (Fla. 2d DCA 2005)).
"[E]nforcement of contracts that restrict or prohibit competition during or
after the term of restrictive covenants, so long as such contracts are reasonable in time,
area, and line of business, is not prohibited." § 542.335(1), Fla. Stat. (2019). In an
action seeking enforcement of a restrictive covenant, "[t]he person seeking enforcement
of a restrictive covenant shall plead and prove the existence of one or more legitimate
business interests justifying the restrictive covenant." § 542.335(1)(b).
The term "legitimate business interest" includes, but is not
limited to:
1. Trade secrets, as defined in s. 688.002(4).
2. Valuable confidential business or professional information
that otherwise does not qualify as trade secrets.
3. Substantial relationships with specific prospective or
existing customers, patients, or clients.
4. Customer, patient, or client goodwill associated with:
a. An ongoing business or professional practice, by way of
trade name, trademark, service mark, or "trade dress";
b. A specific geographic location; or
c. A specific marketing or trade area.
5. Extraordinary or specialized training.
Any restrictive covenant not supported by a legitimate
business interest is unlawful and is void and unenforceable.
§ 542.335(1)(b). "The violation of an enforceable restrictive covenant creates a
presumption of irreparable injury to the person seeking enforcement of a restrictive
covenant." § 542.335(1)(j). However, that presumption is rebuttable. See Variable
Annuity Life Ins. Co. v. Hausinger, 927 So. 2d 243, 245 (Fla. 2d DCA 2006).
A. Violations of the restrictive covenants
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On appeal, appellants have not met their burden of demonstrating that the
trial court erred in regard to the restrictive covenants in the noncompete provisions in
the TPRC agreement, and we do not address that issue further. However, the
appellants have shown that the trial court erred in regard to one of the restrictive
covenants in the nonsolicitation provisions of the TPRC agreement and one of the
restrictive covenants in the noncompete provision of the AASC agreement.
Three of the doctors (Drs. Guirguis, Cases, and Otero) entered into an
agreement with TPRC that contains a nonsolicitation provision preventing them from
providing services to their former TPRC patients without TPRC's written consent.2 The
provision at issue, titled "Prohibition Against Solicitation," states that during a twenty-
four-month restricted period, the doctors "shall not provide services to any person who
is a patient of the Employer or who was a patient of the Employer during the" restricted
period, unless written consent is obtained by the Employer and such services are
provided outside of the fifteen-mile radius. This language is clear and unambiguous.
At the hearing, appellants' expert testified that after the doctors left their
employment with TPRC, the doctors treated 644 of TPRC's former patients and that
those patients receive multiple treatments a year. The evidence showed that if those
patients visit twelve times a year, that amounts to 8000 patient visits that TPRC lost.
In its order, the trial court did not explicitly address whether the doctors'
treatment of their former TPRC patients violated the agreements. On page seven of its
2Dr. Le also entered into an agreement with TPRC, but appellants do not
claim that Dr. Le violated his agreement with TPRC in this regard.
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order, the trial court seems to have acknowledged that the doctors are treating their old
TPRC patients, by finding that
[s]ome of the patients may have chosen to follow a doctor
over a greater distance, but to some extent that is built into
the radius. In some cases the doctor's new location may be
closer to the patient. And in any event the doctor is allowed
under the agreement to compete as long as the services are
provided fifteen miles from plaintiff's installations.
But the trial court did not acknowledge the language of the provision prohibiting the
doctors from providing services to former TPRC patients during the twenty-four-month
restricted period without the written consent of TPRC. In light of the clear language of
the agreement and the evidence presented by appellants that the doctors are treating
former TPRC patients, the trial court erred in failing to conclude that Drs. Guirguis,
Cases, and Otero violated this particular provision.
Appellants further argue that the trial court misapprehended the AASC
noncompete agreement signed by Drs. Guirguis, Cases, and Otero, which states that
the doctors may not
directly, or indirectly, . . . (a) act as a director, officer,
manager, employee, member or partner of, or have any
equity or other financial interest in, any Person that owns
and/or operates an ambulatory surgery center, hospital,
licensed surgical facility or other outpatient surgical facility
that is located within a twenty-five (25) mile radius of the
Center . . . .
This prohibition remains effective for two years. The AASC agreement defines
"[p]erson" as "any individual, sole proprietorship, corporation, partnership, limited liability
company, association, trust, any unincorporated organization or other entity."
Regarding this agreement, the trial court found as follows:
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There is a separate agreement pertaining to
ambulatory or outpatient surgery centers which merits only
brief mention. The agreement pertaining to that facility
provides that its signatories will not go into operation of a
competing business within a 25[-]mile radius. There is no
credible evidence that the doctors have taken on an owner
or operator role in a competing business facility within the
radius, although there is evidence that some sporadic
medical treatments or procedures may have been performed
there.
Appellants claim that the language of the provision prevents the doctors
from working for or managing two ambulatory centers within the twenty-five-mile radius.
Appellants point to a list of procedures that Drs. Guirguis and Otero performed at the
West Park ASC, which is within the twenty-five-mile radius. This list was presented to
the trial court. Also, at the hearing, appellants introduced parts of the depositions of
Drs. Guirguis and Otero in which both doctors testified that they "worked" at West Park
ASC once a week and that they see at least fifteen patients per day that they work.
Appellants also presented evidence that Dr. Guirguis is on West Park ASC's Medical
Executive Committee.
Thus, appellants presented evidence that Drs. Guirguis and Otero were
"employed" by an entity that operates an ambulatory center within the twenty-five-mile
radius and that Dr. Guirguis was an "officer" of an entity that operates an ambulatory
center within the twenty-five-mile radius. The trial court erred in interpreting the
language of the covenant to only prevent the doctors from having an "owner or operator
role in a competing business facility." In doing so, the trial court failed to consider the
clear and unambiguous language preventing the doctors from acting as a "director,
officer, manager, employee, member or partner of" an entity that owns or operates an
ambulatory center within twenty-five miles. When the terms of a noncompete
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agreement are clear and unambiguous, the contracting parties are bound by its terms.
Morgan v. Herff Jones, Inc., 883 So. 2d 309, 313 (Fla. 2d DCA 2004) (citing Emergency
Assocs. of Tampa, P.A. v. Sassano, 664 So. 2d 1000 (Fla. 2d DCA 1995)). The
evidence showed that Drs. Guirguis and Otero violated the terms of the AASC
agreement.
B. Irreparable injury
As noted above, a showing of irreparable injury is required for a temporary
injunction to issue. Atomic Tattoos, LLC, 45 So. 3d at 64. And "[t]he violation of an
enforceable restrictive covenant creates a presumption of irreparable injury to the
person seeking enforcement of a restrictive covenant." § 542.335(1)(j). Thus, "a party
seeking to enforce a restrictive covenant by injunction need not directly prove that the
defendant's specific activities will cause irreparable injury if not enjoined." Am. II Elecs.,
Inc. v. Smith, 830 So. 2d 906, 908 (Fla. 2d DCA 2002). A party only needs to prove a
violation of an enforceable restrictive covenant to be entitled to the presumption. Id.
The trial court recognized the presumption of irreparable injury but found
that "there is no indication that any such injury that may have occurred is ongoing or
threatened in the future." However, this finding was based on the trial court's earlier
erroneous finding that the "doctors in this case . . . are practicing only in the area where
the contract specifically authorized them to practice." As explained above, the evidence
showed that three doctors are treating former patients in violation of the prohibition
against solicitation in the TPRC agreements and that two doctors are acting in violation
of the AASC agreements. Thus, appellants are entitled to a rebuttable presumption of
irreparable injury, and the burden is shifted to the doctors to establish its absence. See
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Medco Data, LLC v. Bailey, 152 So. 3d 105, 107 (Fla. 2d DCA 2014) ("[B]ecause Medco
Data was entitled to a presumption of irreparable injury based on the findings the court
had already made, the court was required to apply the presumption pursuant to
subsection (1)(j), shifting the burden to the defendants to establish its absence.").
C. Legitimate Business Interest
In an action seeking enforcement of a restrictive covenant, "[t]he person
seeking enforcement of a restrictive covenant shall plead and prove the existence of
one or more legitimate business interests justifying the restrictive covenant." §
542.335(1)(b). "A person seeking enforcement of a restrictive covenant also shall plead
and prove that the contractually specified restraint is reasonably necessary to protect
the legitimate business interest or interests justifying the restriction." § 542.335(1)(c).
In its order, the trial court found that appellants had not proven a legitimate business
interest as required by section 542.335. But the trial court's conclusion appears to be
based on its findings that the doctors did not violate the restrictive covenants because
the doctors did not compete within the radius of the TPRC agreement and the doctors
did not violate the language of the AASC agreement. As discussed above, the trial
court failed to consider whether the doctors violated the nonsolicitation provision of the
TPRC agreement by treating former patients and the trial court erred in concluding that
the doctors did not violate the AASC agreement. Thus, the trial court failed to
specifically consider whether those two restrictive covenants were "reasonably
necessary to protect the legitimate business interest or interests justifying the
restriction." § 542.335(1)(c). Even where a trial court finds that "a contractually
specified restraint is overbroad, overlong, or otherwise not reasonably necessary to
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protect the legitimate business interest or interests, [the] court shall modify the restraint
and grant only the relief reasonably necessary to protect such interest or interests." Id.
In light of our determination that appellants proved two specific violations
of the agreements and in light of the requirements of section 542.335(1)(c), on remand,
the trial court shall reconsider this issue.3 The legitimate business interests invoked in
this case include "[s]ubstantial relationships with specific prospective or existing
customers, patients, or clients" and "[c]ustomer, patient, or client goodwill associated
with . . . [a] specific geographic location." § 542.335(1)(b)(3), (1)(b)(4)(b). A corporate
representative for both TPRC and AASC testified that they both operate a patient-
centric business that focuses on a strong patient experience. They invest in physicians,
geographies, and markets to best serve their patient population. They implement
measures to promote patient goodwill and satisfaction. They strive for continuity of
care, where "a patient see[s] the same provider for months or years at a time." Pain
management involves "longitudinal patients," those who see their doctors regularly,
3Section 542.335(1)(c) provides in full:
A person seeking enforcement of a restrictive
covenant also shall plead and prove that the contractually
specified restraint is reasonably necessary to protect the
legitimate business interest or interests justifying the
restriction. If a person seeking enforcement of the restrictive
covenant establishes prima facie that the restraint is
reasonably necessary, the person opposing enforcement
has the burden of establishing that the contractually
specified restraint is overbroad, overlong, or otherwise not
reasonably necessary to protect the established legitimate
business interest or interests. If a contractually specified
restraint is overbroad, overlong, or otherwise not reasonably
necessary to protect the legitimate business interest or
interests, a court shall modify the restraint and grant only the
relief reasonably necessary to protect such interest or
interests.
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"potentially every single month." Appellants' expert also testified that eighty-four to
eighty-seven percent of TPRC's patients live within the fifteen-mile radius. Appellants
also presented evidence that TPRC lost 644 of its patients after the doctors left their
employment and that the patients typically visit the doctors twelve times per year. Thus,
appellants established patient goodwill within a specific geographic location and
substantial relationships with existing patients, proving legitimate business interests that
are reasonably related to the restrictive covenants.
D. Other requirements for an injunction
Because the trial court concluded that the doctors had not violated the
agreements and that there was no irreparable injury, the trial court did not address the
other requirements for granting an injunction. On remand, the trial court shall consider
the likelihood of appellants succeeding on the merits in light of our conclusion that the
doctors violated the agreements by treating TPRC's former patients and by working at
surgical centers within a twenty-five-mile radius.
And because appellants are entitled to a rebuttable presumption of
irreparable injury, appellants should be entitled to a rebuttable presumption that there is
no adequate legal remedy available.
The question of whether the injury is "irreparable" turns on
whether there is an adequate legal remedy available.
Irreparable injury means, in essence, that injunction is the
only practical mode of enforcement. A negative covenant,
where one party promises that he will not do certain things,
is an apt example. The supreme court observed in Miller
Mechanical[, Inc. v. Ruth, 300 So. 2d 11 (Fla. 1974),] that
certain types of contractual covenants, like covenants not to
compete, by their nature lend themselves principally to
enforcement by injunction because of the difficulty of arriving
at a dollar figure for the actual damage done as the result of
the breach.
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Corp. Mgmt. Advisors, Inc. v. Boghos, 756 So. 2d 246, 247-48 (Fla. 5th DCA 2000)
(citations omitted) (quoting Jewett Orthopaedic Clinic, P.A. v. White, 629 So. 2d 922,
927 (Fla. 5th DCA 1993)); see also Weinstein v. Aisenberg, 758 So. 2d 705, 708 (Fla.
4th DCA 2000) (Gross, J., concurring specially) ("Florida cases often discuss irreparable
harm and the inadequacy of a remedy at law as if they were distinct concepts.
However, Florida's application of the irreparable injury rule is consistent with Professor
Laycock's observation that '[t]he irreparable injury rule has two formulations. Equity will
act only to prevent irreparable injury, and equity will act only if there is no adequate
legal remedy. The two formulations are equivalent; what makes an injury irreparable is
that no other remedy can repair it. Attempts to distinguish the two formulations have
produced no common usage.' " (quoting Douglas Laycock, The Death of the Irreparable
Injury Rule, 103 Harv. L. Rev. 687, 694 (1990))).
And as for the public's interest, section 542.335(1)(i) provides as follows:
No court may refuse enforcement of an otherwise
enforceable restrictive covenant on the ground that the
contract violates public policy unless such public policy is
articulated specifically by the court and the court finds that
the specified public policy requirements substantially
outweigh the need to protect the legitimate business interest
or interests established by the person seeking enforcement
of the restraint.
Thus, an injunction cannot be denied on this basis unless the trial court specifically
articulates the public policy and how the public policy outweighs the need for the
injunction. See TransUnion Risk & Alt. Data Sols., Inc. v. Reilly, 181 So. 3d 548, 551
(Fla. 4th DCA 2015) (holding that trial court's finding that movant "failed to establish that
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a temporary injunction will serve the public interest" was inadequate where statute
requires trial court to "specifically articulate an overriding public policy reason").
On remand, the trial court shall consider these requirements for an
injunction that it did not reach before.
III. Conclusion
In sum, we reverse the order denying appellants' motion for a temporary
injunction as it relates to the two violations of restrictive covenants discussed above and
remand for further proceedings in compliance with section 542.335 and this opinion.
See Medco Data, LLC, 152 So. 3d at 107 (reversing and remanding for reconsideration
where there were violations of covenant but trial court failed to apply presumption of
irreparable injury under section 542.335(1)(j)); Anarkali Boutique, Inc. v. Ortiz, 104 So.
3d 1202, 1206 (Fla. 4th DCA 2012) (holding that trial court misconstrued agreement and
reversing and remanding for trial court to consider whether appellant met burden for
temporary injunction, leaving it to the court's discretion to decide whether a further
hearing is required).
Affirmed in part; reversed in part; remanded.
LaROSE and ATKINSON, JJ., Concur.
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