JUDICIAL DISTRICT coumr
BEAVERHEAD couurv


MAR 0 5, 2018

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5..

    
     
 

MONTANA FIFTH JUDICIAL DISTRICT COURT,
BEAVERHEAD COUNTY

 

TRINA HEALTH OF MONTANA
LLC. HAROLD LARON BRIGGS,
BARRY BRIGGS, and HAROLD L.
GROGAN,

Plaintiffs, Cause No. 

VS.

HEALTH CARE SERVICE ORDER DENYING
CORPORATION d/b/a BLUE CROSS PRELIMINARY INJUNCTION
AND BLUE SHIELD OF MONTANA,

Defendant.

 

 

 

 

Plaintiffs, Trina Health of Montana, LLC, Harold Laron (Ron) Briggs,
Barry Briggs, and Harold L. Grogan (?Trina?) petitioned for declaratory
judgment and applied for a preliminary injunction and permanent injunctive relief
to prevent Defendant Healthcare Service Corporation, d/b/a Blue Cross Blue
Shield from denying coverage for Arti?cial Pancreas Treatment
(APT).

BACKGROUND

The individual Plaintiffs, Ron Briggs, Barry Briggs, and Harold Grogan,

received the APT treatments at the Trina facility owned by Ron and his Wife,

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction -
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Julie, in Dillon. Ron and Julie initially traveled frequently to Scottsdale, Arizona,
to receive the treatments, which provide microburst insulin in?tsion (MII), at the
Trina clinic in Scottsdale. To save money, in 2015 they negotiated with Trina
Corporation in Sacramento, California, and became the exclusive Montana
licensee to deliver at a clinic in Dillon. Thereafter, the Montana Trina
facility began treating 10-15 patients, including Ron. The Dillon Trina facility
treated patients between Fall of 2015 and April, 2017.

Ron, Barry Briggs, and Harold Grogan were insured for healthcare by
BCBS. Their policies, in relevant part, are the same. The BCBS policies exclude
coverage for experimental and investigational treatments. Trina billed BCBS for
the treatments by coding under multiple codes, breaking the treatments
into coding parts for of?ce visits and medical supplies rather than identifying the
speci?c procedure. BCBS paid the claims submitted for treatments of the
individual Plaintiffs ?'om September 28, 2015, to April 12, 2017. In 2017, BCBS
conducted a routine audit and discovered that the procedure was being
billed this way. On April 12, 2017, BCBS issuedta ?cease and desist? letter
directing Trina to code the procedure under code 69147, which is the
code for ?outpatient intravenous insulin treatment (OIVIT). BCBS does not

cover OIVIT because it considers it experimental and investigative.

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction 
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BCBS bases its coverage on its own Health Care Services Corporation
Medical Policy MED201.028, ?Chronic Intermittent Intravenous Insulin
Therapy,? (also known as dated May 15, 2016. This policy was not
adopted by BCBS until June 1, 2017, almost two months after its ?cease and
desist letter? was sent to Trina.

PROCEDURAL HISTORY

Trina ?led its original petition on October 23, 2017. On October 24, 2017,
Hon. Luke Berger granted a Temporary Restraining Order (TRO). On October
30, 2017, BCBS ?led a notice of removing the case to federal court. On
November 6, 2017, Hon. Sam Haddon held a hearing in federal court on the re-
?led TRO petition. On December 19, 2017, Judge Haddonheard argument on
federal jurisdiction and remanded the case to this Court. On December 20, 2017,
Trina again ?led an emergency TRO petition and requested a show cause
hearing. On December 21, 2017, BCBS moved to substitute Judge Berger. On
January 18, 2017, following brie?ng on the timeliness of the substitution motion,
the undersigned accepted the case. On January 23, 2018, Plaintiffs again asked
for a TRO, which the Court granted on January 26, 2018, and set a show cause
hearing for January 31, 2018.

HEARING

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The Court heard evidence on Trina?s request for a preliminary injunction
on January 31 and February 2, 2018. On January 31, 2018, Julie Briggs (Julie),
Ron?s widow, appearing from Dillon with her lawyers via VisionNet, with the
Court sitting in Cascade County because of prior scheduled matters earlier in the
day, testi?ed at the preliminary injunction hearing. Although she said she was
the ?administrator? of the Trina facility in Dillon, she seemed unfamiliar with its
practices, billing decisions, or coding.

Julie testi?ed that BCBS forced Trina in Dillon to shut its doors and close
down through its ?cease and desist letter.? Julie testi?ed that, including her
husband Ron, three of the 10-15 Dillon Trina patients were insured by BCBS.
Those three patients are the named Plaintiffs. The other patients were insured by
Medicare or other insurers. Julie admitted that Medicare was conducting an audit
during the same period when the BCBS letter was issued, and that Medicare
refused to pay for the procedures during the audit. She did not answer in a
comprehensible way whether other insurers also refused to cover the 
treatments. She testi?ed in varying ways, sometimes contradictory, but seemed
to insist it was letter that drove Trina out of business. The Court did not
?nd Julie?s testimony to be credible on the above points.

Julie testi?ed that Trina has posted an injunction bond in the amount of

$53,327.50 [Hearing Ex. 1) so that BCBS is not harmed by paying costs of

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction 
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 for the Plaintiffs until the Court decides the substantive issues in the
event a preliminary injunction is granted.

Barry Briggs1 and Harold Grogan also testi?ed via Vision Net. Both men
are very sick with diabetes. They were treated at Trina for about a year and a
half, after Julie and Ron Opened the Dillon clinic. Both received twice weekly
(or more) treatments at the clinic until the BCBS letter was received. Both
testi?ed that they were covered for these treatments under their BCBS policies
until then. Both men sincerely testi?ed that they believed that the treatments
made them feel better, and that since the treatments stopped, they felt worse.
Both testi?ed that they believed that their usual doctors did not ?understand?
diabetes, but that Trina did.

Dr. John Elliott, an obstetrician and the Trina corporate Medical Director,
testi?ed via the ?Remote Presence? app from Dallas, TX. He testi?ed that
APTMI is different than the excluded treatments under the BCBS
policies. He also pointed to an article that he wrote, in his capacity as the Trina
Medical Director, about an ?observational study? of patientsusing the Trina
treatment, showing improved He describes the study as a peer
reviewed paper showing that the Trina treatments are not experimental or

investigative, and that they should therefore be covered. Dr. Elliott testi?ed that

 

Barry Briggs testi?ed that he is not related to Julie or Ron.
Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction -
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the Trina treatments are different than the excluded OIVIT treatments
because they are delivered through a different pump and ?burst? insulin at
different intervals.

On February 2, 2018, the hearing continued. Medical Director,
Dr. Jean-Pierre Pujol, testi?ed that BCBS Medical Policy MEDZOLOZS is
authored by the BCBS Medical Policy Committee following review of scienti?c
information, literature, expert information and claims data. The Committee
reviews literature and guidelines published by relevant Specialty societies and
associations in order to establish policies. In this case, it reviewed published
scienti?c literature of the American Diabetes Association. The Committee
speci?cally seeks out evidence-based and peer-reviewed studies, as- well as
industry standards of care, and reviews policies at least annually. As with any
scienti?c evaluation, the Committee weighs less heavily anecdotal and
observational studies, and considers them less reliable than randomized control
and meta-analytical studies. The Committee also considers standards in the
?industry,? which in, this case means other providers of health bene?t plans.

Dr. Pujol testi?ed that in the case of Trina?s APT, because the only study
attesting to its effectiveness is an observational study, the results of which are
authored by Dr. Elliott, a part owner of Trina, and there are no randomized

control, meta-analysis type studies, the APT treatment is considered

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction -
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experimental, investigational, and unproven. Moreover, other health care plan
carriers likewise exclude coverage of OIVIT, and APT because they are
still considered investigational.

Dr. Pujol testi?ed that APT does not meet Medical Policy
standards for scienti?c basis or industry standard acceptance. Accordingly, it is
excluded. Dr. Pujol ?irther testi?ed that APT most closely meets the coding -
de?nition of 69147, intravenous insulin therapy, which code is expressly
excluded under MED201.028.

In rebuttal deposition testimony, Dr. Elliott testi?ed that Dr. Pujol does not
understand APT, and that APT is clearly distinguishable from PIVIT, OIVIT, and
However, Dr. Elliottexpressly admitted in his rebuttal that APT ?is a We
of PI VI (Rebuttal depo., p. 87). According to Dr. Elliott, APT is the current
state of ?evolution? of Id. Marketing on the Trina website claims that
and PIVIT are evidence that APT is effective. Despite these admissions,
Plaintiffs assert that APT ?is not OIVIT or by de?nition.? Piaz'ntr'ffs Post-
Hearz'ng Brief p. 14.

For a year and a half, Trina submitted bills to BCBS coded in a way that
APT was not identi?ed as the actual service, and instead multiple individual
fragments of the treatment were coded separately. When a BCBS coder, Jamie

Smith, noted the odd billing pattern, known as ?unbundling,? and an audit was

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction -
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conducted, BCBS directed the correct coding for the billing. In her rebuttal

testimony, Trina billing witness Taylor Romine admitted that it is not permissible

to ?just take a code, rip it apart, and put any codes you (Post-hearing

depo., 37). Testimony at the hearing disclosed that federal regulators are now

investigating Trina?s billing practices, and that Kansas BCBS has issued a fraud

alert related to the same practices.

ANALYSIS

Section 27?19?201, MCA governs preliminary injunctions in Montana. It

provides several disjunctive circumstances under which an injunction may be

ordered:

1)

2)

3)

4)

5)

When it appears the applicant is entitled to relief;

When it appears the applicant would suffer great or irreparable
injury if the relief is not granted;

When the adverse party is doing or threatening to do something to
the applicant if the relief is not granted;

When the adverse party is threatening to remove or dispose of the
adverse party?s property with intent to defraud the applicant;

When it appears that the applicant has applied for an order under
?40-4-121, MCA or an order of protection under Title 40, Chapter

15.

Trina Health of Montana v. Healthcare Service Corp- Order Denying Preliminary Injunction -

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Trina is only required to prove one of the above criteria to be entitled to
preliminary injunctive relief. Sweet Grass Farms, Ltd. 12. Bd. of Co. Comm ?rs of
Sweet Grass C0., 2000, MT 147, 1i27, 300 Mont.66, 2 P.3d 825. Trina asserts
that paragraphs 1) and (2) apply here. To show the likelihood of success on the
merits and irreparable harm, the Court looks to recent Montana cases for
guidance. See, for example, Doe v. Community Med. Ctr., 2009 MT 395, 1118,
353 Mont. 378, 221 P.3d 651, Cole v. St. James Healthcare, 2008 MT 453, 1115,
348 Mont.68, 199 P.3d 810.

A preliminary injunction may be granted where the Plaintiffs show that
they have ?a legitimate cause of action? and are ?likely to succeed on the merits.?
Cole, 1[15. To show a ?likelihood. of irreparable harm? the Plaintiffs generally -
must show that money damages are inadequate. Caldwell v. Saba, 2013 MT 240,
1129, 371 Mont. 328, 308 P.3d 81.

A. Likelihood of Success on the Merits.

The Plaintiffs assert that BCBS improperly applied its own exclusionary
language to the bene?t plans at issue. The plain language of the individual
Plaintiffs? health bene?t plans gives BCBS discretion to interpret and apply its
?Medical Policies? in order to make coverage determinations. Ex. 3, p. 282.
BCBS de?nes its ?Medical Policy? to determine coverage as relying on criteria
including ?nal approval from governmental regulatory agencies, scienti?c

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction -
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studies showing conclusive evidence of improved net health outcome, and
established standards of good medical practice. Ex. 3, p. 321.

The plans at issue in this case explicitly exclude from coverage ?Any
services, supplies, drugs and devices which are: 
Ex. 2., pp. 182, 183. BCBS Medical
Policy provides that ?Chronic intermittent intravenous insulin
therapy is considered experimental, investigational, and/or unproven.?
Ex. 5, p. 392. By the express language of the policy, under own
interpretation of its policy, then, is excluded from coverage. The question
then presented is whether the APT treatments offered by Plaintiff Trina are
GMT, and excluded frorncoverage. .. .

To show that they are likely to succeed on the merits, Plaintiffs must Show
that BCBS likely violated a contractual or other duty. Doe v. Community
Medical Center, Inc., 2009 MT 395, 1H9, 353 Mont. 378, 221 P.3d 361. The
Preferred Provider Agreement (PPA) expressly excludes APT and its related
treatments, and defers to its medical policies such as MED201.028. Trina is .
bound by the PPA to follow BCBS policies. Ex. C, Art. II, ?lO. In the PPA,
Trina agrees that BCBS is not required to pay for services it does not cover. Id.,
Art. IV, The agreement between the two corporations also requires resolution

of disputes through, inter alia, arbitration.

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction -
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The testimony before the Court is that one of the Plaintiffs has died, and
the remaining individual Plaintiffs are very sick with diabetes. No treating
physicians have testi?ed about the actual state of the Plaintiffs? health, the cause
of Ron Briggs?s death, the ef?cacy of the treatment at issue, or the relationship
between the living Plaintiffs? current health and the fact that they have not been
treated by since April, 2017.

While the Plaintiffs, including the widow of Ron Briggs, have testi?ed that
they believe that without the availability of care from the Dillon Trina Clinic,
they will suffer irreparable harm, a showing to meet necessary legal standards has
not been met. Several witnesses have testified to the availability of 
treatment in Scottsdale and other locations in the country. Moreover, the
Plaintiffs? testimony re?ects that they are not being followed by endocrinologists,
who are the specialists in diabetes. There is coverage for this type of care under
the BCBS plan. It appears other alternatives are available, and some are not
costly.

The Court aclmowledges that Trina?s corporate Medical Director has
offered very general, broad brush Opinions that the Plaintiffs would suffer
irreparable harm. The Court is not satis?ed that Dr. Elliott?s testimony on this
point is based on adequate foundation or satis?es any standard of proof. Dr.

Elliott is an obstetrician, not an endocrinologist. He did not testify that he has

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction -
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any relevant expertise in diabetes, other than his experience with prenatal diabetic
patients and a father who had diabetes. The Court does not suggest that Dr.
Elliott is not learned or thoughtful. However, to meet the relevant legal
standards, he must have the expertise in the appropriate specialized scienti?c
discipline.

As to one of the primary issues, whether BCBS caused Trina in Dillon to
close its doors, the Plaintiffs have not met their burden of proving a likelihood of
success. Julie Briggs, who, for an administrator of a health care facility, has an
astonishing dearth of knowledge about how her facility runs, the sources of
revenue, and the coding required to bring in revenue, testi?ed that 10-15 patients,
. total, were treated by Trina in Dillon when its doors were open. Two to three of
those patients were insured by BCBS.

Even assuming an improper application of policy exclusions, it is dif?cult
to conceive that loss of income from those few BCBS covered patients is the
cause of Trina?s decision to shut down. Ms. Briggs testi?ed that Medicare
insured perhaps more patients, and stOpped coverage pending an audit. Other
patients had private coverage according to Ms. Briggs, but inexplicably she did
not remember whether those carriers covered the procedure.

Moreover, assuming for the sake of argument that the loss of only the

BCBS coverage shut down the Clinic, the Court is not persuaded that BCBS was

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction 
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required to cover the procedure. The express terms of the policies
exclude ?outpatient intravenous insulin treatmen which is known by the
abbreviation, The plain language of this exclusion encompasses the
treatment. It is outpatient. It is intravenous. It is insulin treatment.
Whether experimental or not, APTIMII is excluded by the contract language.
Accordingly, the Plaintiffs cannot meet the ?likelihood of success on the merits?
prong necessary to obtain a preliminary or permanent injunction.
Notwithstanding the above, the Court is not convinced that 
treatment is accepted within the medical community as a standard of care for
diabetes. It is certainly showing hope?il signs. However, Dr. Elliott?s article,
while well written, is not a peer reviewed article, and it suffers from the defect
that it is simply not objective, in that it was written- and published by the
company hoping to pro?t by its use. As such, it is viewed by the Court as more

advanced marketing literature than a scienti?cally sound study.
B. Irreparable Harm.

To prevail on a preliminary injunction, the Plaintiffs ?must establish a
prima facie case, or show that it is at least doubtful whether or not [they] will
su?'er irreparable injury before [their] rights can be ?illy litigated.? Bene?s
Healthcare v. Great Falls Clinic, LLP, 2006 MT 254, 1114, 334 Mont. 86, 146
P.3d 714. The individual Plaintiffs assert that they will suffer irreparable harm if

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction -
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the Court does not grant the preliminary injunction. They base this assertion on
Plaintiff Trina?s claim that it cannot remain open if the injunction is not granted
and it is allowed to continue billing ?unbundled? for the APT treatments.

Undisputed testimony at the hearing is that, while more costly for the
Plaintiffs if Trina's Dillon facility closes and they will have to travel, or because
they may need to pay for the APT out-of-pooket if the Dillon facility does not
close, they still can get APT treatment. So, assuming for argument?s sake that
the APT treatment is effective, the individual Plaintiffs can avoid harm by paying
out-of-pocket or by traveling to obtain services. Because this element of
damages, if proven, can be compensated with money damages, Plaintiffs have not
shown irreparable harm. Money damages are not irreparable harm. Caldwell v.
Saba, 2013 MT 240, 1129, 371 Mont. 328, 308 P.3d 81.

Plaintiff Trina argues that it will suffer irreparable harm without an
injunction because if BCBS does not pay for APT it will have to ?close its
doors.? The Court is not persuaded. At most, Trina had a total of 10 - 15 APT
patients. Testimony at the hearing was that either 3 or 4 of those patients were
insured by BCBS. Accordingly, it still has 7 - 11 patients who are paying for
APT in other ways, either individually or through other carriers. The Court is not
persuaded that enforcement of its exclusion forced Trina to close its

doors. Assuming, arguendo, that BCBS forced Trina to close its doors, this harm

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction -
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can be remedied with money damages, and the ?irreparable harm? element has
not been met.

The cease?and-desist letters sent by BCBS to Trina did not require or force
the door?closing. Not only did BCBS learn of the unbundling coding practice
and direct it to stop, testimony at the hearing was that the U.S. Department of
Health and Human Services, Center for Medicare and Medicaid Services (CMS),
was investigating its practices and that the CMS investigation caused a halt in
billing to CMS for APT for at least 180 days. BCBS showed that its audit and
cease-and-desist letters were consistent with its own policies, the medical
standard of care, and industry health insurance practices.

Regardless of the reason that Trina Montana closed its doors, the evidence
at the hearing was that the individual Plaintiffs can obtain APT treatment at other
Trina clinics, and have done so. The treatment is not, however, covered under
plans.

C. Propriety of Iniunctive Relief
The purpose of a preliminary injunction is to prevent ?irther injury or
irreparable harm pending an adjudication on the merits. Flora v. Clearman, 2016
MT 290, 1111 13-23, 385 Mont. 341, 13-23, 384 P.3d 448, 1111 13-23; Yockey v.
Kearns' Props, L.L.C., 2005 MT 27, 1] 18, 326 Mont. 28, 106 P.3d 1185. This

Court is required to decide whether a suf?cient case was made to warrant the

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction -


preservation of the status quo until trial. Yockey, 1] 18. "Upon the requisite
showing, a preliminary injunction is issued to maintain the status quo pending
trial, which has been defined as ?the last actual, peaceable, noncontested
condition which preceded the pending controversy!" Sandrock v. DeTz'enne, 2010
MT 237, 11 16, 358 Mont. 175, 243 P.3d 1123. (citations omitted).

In Van Loan v. Van Loan, the Montana Supreme Court adopted the
following test for determining whether an injunction is proper in a money
damages context. The moving party has the burden of proving all elements:

(1) the likelihood that the movant will succeed on the merits of the

action;

(2) the likelihood that the movant will suffer irreparable injury absent

the issuance of a preliminary injunction;

(3) the threatened injury to the movant outweighs whatever damage the

proposed injunction may cause the opposing party (a balancing of

the equities); and

(4) the injunction, if issued, would not be adverse to the public interest.

Van Loan v. Van Loan, 271 Mont. 176, 895 P.2d 614, 617-18 (1995).

As discussed above, the question here is a monetary dispute. Plaintiffs ask
the Court to declare that BCBS is required to cover APT and pay for it. BCBS
disputes that it should be required to pay. The Court has discussed the evidence

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction -
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adduced at the hearings and the post-hearing rebuttal depositions above. As to
element (1), the Court concludes that the Plaintiffs are not likely to succeed on
the merits. As discussed above, with respect to element (2), it is unlikely that
Plaintiffs will suffer irreparable injury without an injunction. With respect to
element (3), the threatened injuries to the Plaintiffs equal the damage an
injunction may cause to BCBS. In other words, the cost of the APS treatment is 
the same. If the Plaintiffs pay it, they bear the burden. If BCBS pays, it bears the
same burden. The Court acknowledges that the individual Plaintiffs will have to
pay the costs of travel to obtain APS treatment elsewhere, however, and this tips
the scale in their favor.

As to element (4), the Plaintiffs have not shown that an injunction would
not be adverse to the public interest. The Court recognizes that individual
citizens are over a barrel in the health care climate currently. The Court further
recognizes that the individual Plaintiffs are extremely sick, and need some form
of effective treatment for relief ?'om their However, it has not been
shown that requiring BCBS to cover a treatment which is clearly excluded is in
the interests of the public.

Section 27-19-201, MCA, provides, in part, that, ?[fjinal injunctive relief
may only be granted if pecuniary compensation would not afford adequate

Here, while ooncededly expensive, the Plaintiffs can (and some have)

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction -
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obtain APT in other Trina locations, even if Trina Montana remains closed. The
only question presented is who will pay for the treatment. Pecuniary
compensation would afford adequate relief. A preliminary injunction is not the
appropriate remedy. Plaintiffs have an adequate remedy at law, if the facts and

law support their claim.

D. Propriegg of Declaratogy Judgment.

The Court has not yet required either party to brief this issue. Although
BCBS did brief it, to give the Plaintiffs a full opportunity, the Court below sets a
brie?ng schedule. Both parties should brief the following:

1) Whether a breach of contract issue is proper to decide rights, status, and

duties under a contract;

2) Whether, in light of the disputed fact issues in this case, declaratory

judgment is proper.

E. Arbitration.

The Court has not yet called for brie?ng on pending Motion to
Compel Arbitration and to Stay Remaining Claims. (Doc. 33). This Motion, as
the Court understands it, focuses on Plaintiff Trina?s claims, and not those of the
individual Plaintiffs. Below, the Court sets out the brie?ng schedule for this

Motion, if necessary.

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction 
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F. Other Issues.

Although BCBS briefed the scope of the injunction and adequacy of bond,
because the Court has declined to issue an injunction, these issues are meet and
are not addressed.

cause

For the foregoing reasons, IT IS HEREBY ORDERED:

l) Plaintiffs? request for a Preliminary Injunction is 

2) The parties shall, within twenty-one (21) days of the date of this Order,

?le simultaneous briefs addressing:
a. Propriety of Declaratory Judgment (and addressing the two issues
identi?ed above);

b. Arbitration.

DATED THIS 1 day of March, 2018.



Elizabeth A. Best
District Court Judge

cc: Erin F. MacLean/Laurie Zmrzel dej
Kimberly A. Beatty/Daniel J. Auerbach 

0 Kiwi?? 

Trina Health of Montana v. Healthcare Service Corp. Order Denying Preliminary Injunction -
l9

 

 
  

atlpa?es listed beiow. by US. Mall. persmal delivery. e-mail or
attorney?s mailbox within the Clerk of Courts 0mm
this 51h day of March .13_
. . - . . . 

Is to certify manna wit-lie dominant was duly served on

. ni
H011 Elizabeth Best