Full opinion text
EXPANDED OPINION TO THIS COURT’S ENTRY OF SEPTEMBER 22, 2000 (DOC. #41), SUSTAINING IN PART AND OVERRULING IN PART THE MOTION OF DEFENDANTS DIAGNOSTIC IMAGING ASSOCIATES OF OHIO, INC., AND ROBIN E. OSBORN, D.O., TO DISMISS, PURSUANT TO FED. R. CIV. P. 12(B)(6) (DOC. # 13) AND SUSTAINING IN PART AND OVERRULING IN PART THE MOTION OF DEFENDANTS MERCY HEALTH SYSTEM-WESTERN OHIO, CATHOLIC HEALTHCARE PARTNERS, MICHAEL PETERSON, AND JERROLD MAKI TO DISMISS, PURSUANT TO FED. R. CIV. P. 12(B)(6) (DOC. #17); DEFENDANTS’ MOTIONS FOR ORAL ARGUMENT (DOC. # 13, DOC. # 17) OVERRULED; HOSPITAL DEFENDANTS’ MOTION TO STAY DISCOVERY (DOC. # 32-1) OVERRULED AS MOOT; HOSPITAL DEFENDANTS’ MOTION FOR EXPEDITED HEARING ON THE MOTION TO STAY (DOC. # 32-2) OVERRULED AS MOOT; JOINT MOTION FOR STATUS CONFERENCE SUSTAINED (DOC. #40); CONFERENCE CALL SET RICE, Chief Judge. For more than twenty years, Plaintiff Sundar V. Nilavar (“Nilavar”) was a radiologist in the Springfield and Urbana, Ohio areas. In 1976, Nilavar was hired by Springfield Radiology, Inc. (“SRI”). Between 1970 and 1995, SRI physicians provided physician diagnostic radiology services at the three hospitals and related facilities in the area centered around Springfield and Urbana, Ohio: Mercy Medical Center of Springfield, Ohio, and Mercy Memorial Hospital of Urbana, Ohio (collectively, the “Mercy Hospitals”); and Springfield Community Hospital. Mercy Health Systems-Western Ohio (“MHS-WO”) owns and operates the Mercy Hospitals, in addition to several long-term and urgent care facilities in the Springfield-Urbana area. Dr. Nilavar maintained full clinical privileges at the Mercy Hospitals from 1976, until they were terminated on December 20, 1995, effective January 1, 1996. In 1991, SRI was comprised of eleven principals. Five SRI radiologists practiced almost exclusively at Springfield Community Hospital (“Springfield group”), while the other six radiologists practiced almost exclusively at the Mercy hospitals (“Mercy group”). In 1993, SRI engaged in extensive negotiations with MHS-WO toward an exclusive contract for the provision of radiological services at the Mercy Hospitals and several other MHS-WO long-term care facilities. After several years of negotiations, no agreement had been reached. On March 22, 1995, MHS-WO decided to conclude its negotiations with SRI, and to prepare a Request for Proposal (“RFP”) for a contract of exclusive radiology services to interested radiologists and radiology groups. The physician-shareholders of SRI decided that the Mercy group would present a proposal to MHS-WO in response to the RFP. Without informing Plaintiff, Dr. Robin E. Osborn (“Osborn”), a physician-shareholder of SRI, formed his own radiology group, Diagnostic Imaging Associates of Ohio, Inc. (“DIA”), and submitted a proposal to MHS-WO on its behalf. DIA included only three physicians from SRI’s Mercy group; Dr. Nilavar was not included in the new entity. In August of 1995, MHS-WO accepted DIA’s proposal. An exclusive Radiology Services Agreement was signed on December 4, 1995, effective January 1, 1996. On December 20, 1995, MHS-WO notified Plaintiff that his clinical privileges would be terminated, effective January 1, 1996. Dr. Nilavar requested that the Mercy Hospitals grant him a hearing, in accordance with the procedures set forth in the Credentials Policy Manual. His request was refused. In 1996, Plaintiff filed suit in the Clark County Court of Common Pleas against Dr. Osborn and DIA, alleging breach of contract, estoppel, breach of fiduciary duty, and fraud arising out of Dr. Osborn’s failure to negotiate the exclusive contract on his behalf. Plaintiff states that the case was tried to a jury in June of 1999, and that he received a judgment in the amount of $100,000. On April 7, 2000, the Second District Court of Appeals issued its ruling on the cross-appeals. That court upheld the jury’s verdict in favor of Nilavar on the breach of contract claim and, due to the trial court’s error in overruling Nilavar’s motion to compel production of financial records from Osborn and DIA, it ordered a new trial on the issue of damages. Nilavar v. Osborn, 137 Ohio App.3d 469, 738 N.E.2d 1271 (2000). On November 19, 1999, Plaintiff initiated the present litigation against MHS-WO; Catholic Healthcare Partners (“CHP”), MHS-WO’s parent company; Michael J. Peterson (“Peterson”), the former Regional President and Chief Executive Officer of MHS-WO; Jerrold A. Maki (“Maki”), Mr. Peterson’s successor as Regional President and CEO of MHS-WO; Dr. Robin Osborn; and DIA. Plaintiff asserts eight causes of action, to wit: (1) contract in restraint of trade, in violation of § 1 of the Sherman Act, 15 U.S.C. § 1; (2) tying arrangement in restraint of trade, in violation of § 1 of the Sherman Act; (3) contract and tying arrangement in restraint of trade, in violation of Ohio’s Valentine Act, Chapter 1331 of the Ohio Revised Code; (4) a state law claim of tortious interference with a business relationship; (5) a state law claim of breach of implied covenant of good faith and fair dealing; (6) a state law claim of civil conspiracy; (7) a state law claim of denial of right to due process; and (8) a state law claim of breach of contract. Two motions to dismiss are presently pending before the Court: the Motion of Defendants DIA and Osborn to Dismiss, pursuant to Fed.R.Civ.P. 12(b)(6) (Doc. # 13); and the Motion of Defendants MHS-WO, CHP, Peterson, and Maid (“the Hospital Defendants”) to Dismiss, pursuant to the same provision of the Civil Rules (Doc. # 17). The two motions raise a number of identical arguments, although the Hospital Defendants’ Motion is more detailed. As a means of analysis, the Court will address the two motions together, addressing the Hospital Defendants’ arguments first. If necessary, the Court will turn to the additional arguments presented by DIA and Dr. Osborn. For the reasons assigned, Defendants’ Motions are SUSTAINED in PART and OVERRULED in PART. Defendants have requested oral argument on the issues raised in their Motions to Dismiss (Doc. # 13, # 17). The Court has concluded that oral argument is not necessary. The parties have thoroughly and competently briefed the issues. Based on the extensive memoranda submitted by counsel, the Court has been thoroughly apprized of the legal issues before it and the relevant case law. In addition, under Rule 12(b)(6), the Motions must be decided by reference to the Complaint only, including to the exhibits attached thereto. Fed. R.Civ.P. 10(c). Thus, the Court would not be permitted to consider any additional evidence or new factual assertions beyond the Complaint presented during oral argument. Furthermore, following the standard for Rule 12(b)(6) motions, the Court must construe Plaintiffs Complaint in the light most favorable to him and accept his factual allegations as true. Thus, the Court concludes that its review of the Complaint, construed in that manner, is sufficient to resolve the Defendants’ Motions. Accordingly, the Court concludes that oral argument would not aide it in resolving the Motions. Defendants’ Motions for oral argument are OVERRULED. I. Standard for Motions to Dismiss, Pursuant to Rule 12(b)(6) When considering a motion to dismiss pursuant to Rule 12(b)(6), the court must “construe the complaint in the light most favorable to the plaintiff, accept all factual allegations as true, and determine whether the plaintiff undoubtedly can prove no set of facts in support of his claims that would entitle him to relief.” Cline v. Rogers, 87 F.3d 176, 179 (6th Cir.)(citing In re DeLo- rean Motor Co., 991 F.2d 1236, 1240 (6th Cir.1993)), cert. denied, 519 U.S. 1008, 117 S.Ct. 510, 136 L.Ed.2d 400 (1996); see also Conley v. Gibson, 355 U.S. 41, 45-46, 78 S.Ct. 99, 2 L.Ed.2d 80 (1957); Barrett v. Harrington, 130 F.3d 246 (6th Cir.1997), cert. denied, 523 U.S. 1075, 118 S.Ct. 1517, 140 L.Ed.2d 670 (1998)(“In considering a motion to dismiss for failure to state a claim, the Court is required to take as true all factual allegations in the complaint.”); Lamb v. Phillip Morris, Inc., 915 F.2d 1024, 1025 (6th Cir.1990), cert. denied, 498 U.S. 1086, 111 S.Ct. 961, 112 L.Ed.2d 1048 (1991). However, the Court need not accept as true a legal conclusion couched as a factual allegation. Papasan v. Allain, 478 U.S. 265, 286, 106 S.Ct. 2932, 92 L.Ed.2d 209 (1986). A well-pleaded allegation is one that alleges specific facts and does not merely rely upon conclusory statements. The Court is to dismiss the complaint “only if it is clear that no relief could be granted under any set of facts that could be proved consistent with the allegations.” Hishon v. King & Spalding, 467 U.S. 69, 73, 104 S.Ct. 2229, 81 L.Ed.2d 59 (1984). II. Antitrust Claims (Counts One, Two, and Three) All of the Defendants seek dismissal of Plaintiffs antitrust claims. First, they argue that the first, second, and third causes of action are barred by the statute of limitations. Second, they argue that Plaintiffs first and third causes of action must be dismissed, because he has not suffered an antitrust injury. Third, the Hospital Defendants assert that Counts One, Two and Three must be dismissed, because Plaintiff is not an efficient enforcer of the antitrust laws. Fourth, all contend that Plaintiffs tying claims must be dismissed, because he has failed to allege that MHS-WO receives a “direct economic benefit” from the arrangement. Finally, Osborn and DIA assert that Plaintiffs third cause of action is barred by the doctrine of res judicata. As a means of analysis, the Court will first address whether Plaintiffs action is timely, and then turn to the arguments dealing with antitrust standing. If necessary, the Court will next address Defendants’ additional arguments. A. Statute of Limitations The statute of limitations for federal antitrust actions is four years from the date of accrual of the action. 15 U.S.C. § 15b; Zenith Radio Corp. v. Hazeltine Research, Inc., 401 U.S. 321, 338, 91 S.Ct. 795, 28 L.Ed.2d 77 (1971). Generally, a cause of action accrues and the statute begins to run when a defendant commits an act that injures a plaintiffs business. Id.; see Grand Rapids Plastics, Inc., v. Lakian, 188 F.3d 401, 405 (6th Cir.1999). “For statute of limitations purposes, ... the focus is on the timing of the causes of injury, i.e., the defendant’s overt acts, as opposed to the effects of the overt acts.” Peck v. General Motors Corp., 894 F.2d 844, 849 (6th Cir.1990) (per curiam). A continuing violation is one in which the plaintiffs interests are repeatedly invaded. Id. “When a continuing antitrust violation is alleged, a cause of action accrues each time a plaintiff is injured by an act of the defendants.” DXS, Inc., v. Siemens Medical Sys., Inc., 100 F.3d 462, 467 (6th Cir.1996); Barnosky Oils, Inc. v. Union Oil Co. of Cal, 665 F.2d 74, 81 (6th Cir.1981). “[E]ven when a plaintiff alleges a continuing violation, an overt act by the defendant is required to restart the statute of limitations and the statute runs from the last overt act.” Peck, 894 F.2d at 849 (quoting Pace Indus., Inc., v. Three Phoenix Co., 813 F.2d 234, 237 (9th Cir.1987)). An overt act that restarts the statute of limitations is characterized by two elements: (1) it must “be a new and independent act that is not merely a reaffirmation of a previous act,” and (2) it must “inflict new and accumulating injury on the plaintiff.” Pace, 813 F.2d at 238. “Acts that simply reflect or implement a prior refusal to deal, or acts that are merely ‘unabated inertial consequences’ (of a single act) do not restart the statute of limitations.” DXS, Inc., 100 F.3d at 467 (citations omitted). Defendants argue that the relevant overt acts occurred in August of 1995 and on September 1, 1995. Specifically, they stated that by August of 1995, MHS-WO had accepted DIA’s proposal for the exclusive providing of radiologic services (Compl.1142). Dr. Nilavar became aware that MHS-WO had awarded DIA the contract on September 1, 1995 (id. ¶ 46). Defendants argue that MHS-WO’s selection of DIA constituted an overt act, triggering the statute of limitations, and because Plaintiff did not file his antitrust action until November of 1999, his antitrust claims must be dismissed as untimely. Plaintiff has responded that MHS-WO did not actually execute their exclusive Radiology Services Agreement until December 4, 1995. He further asserts that MHS-WO did not notify him of its intention to terminate his clinical privileges at the Mercy Hospitals until December 20, 1995, and the termination of his privileges did not become effective until January 1, 1996. Dr. Nilavar argues that Defendants’ expression of their intent to enter into an exclusive agreement did not result in any damages. Rather, his damages and his ability to calculate those damages accrued, at the earliest, when the agreement was formalized on December 4, 1995. This Court agrees with Plaintiff. Although MHS-WO selected DIA to be its exclusive provider of radiologic services in August of 1995, and Dr. Nilavar became aware of that fact on September 1st of that year, Defendants did not actually enter into an exclusive provider relationship, thereby committing an overt act, until December 4, 1995. In other words, Defendants allegedly agreed to commit acts, which Plaintiff alleges constitute antitrust violations, in August of 1995, when MHS-WO selected DIA. Dr. Nilavar became aware of their intention to commit those alleged antitrust violations on September 1, 1995. However, at the earliest, Defendants performed an overt act in furtherance of that agreement on December 4, 1995, when they formally entered into their exclusive relationship. Until that date, there had been no acts which would result in an antitrust injury to Plaintiffs business. Plaintiff received notification that MHS-WO would be terminating his clinical privileges at the Mercy hospitals on December 20, 1995, effective January 1, 1996. The Court agrees with Defendants that the notification merely constituted reaffirmation of MHS-WO’s contract with DIA. However, Plaintiff filed this action in November, 1999, forty-seven months after DIA and MHS-WO had entered into their agreement on December 4, 1995. Plaintiffs action is, therefore, within the four-year statute of limitations for federal antitrust actions. Accordingly, Plaintiffs action is timely. B. Antitrust Standing to Bring Claims for Contract in Restraint of Trade (Counts One and Three) The Sixth Circuit has repeatedly emphasized the importance of antitrust standing. In HyPoint Tech, Inc., v. Hew lett Packard Co., it described antitrust standing as follows: Antitrust standing to sue is at the center of all antitrust law and policy. It is not a mere technicality. It is the glue that cements each suit with the purposes of the antitrust laws, and prevents abuses of those laws. The requirement of antitrust standing ensures that antitrust litigants use the laws to prevent anticom-petitive action and makes certain that they will not be able to recover under the antitrust laws when the action challenged would tend to promote competition in the economic sense. Antitrust laws reflect considered policies regulating economic matters. The antitrust standing requirement makes certain that the laws are used only to deal with the economic problems whose solutions these policies were intended to effect. 949 F.2d 874, 877 (6th Cir.1991). In determining whether Plaintiff has antitrust standing, the Court must consider whether he has suffered an antitrust injury and whether he is an efficient enforcer of the antitrust laws. Associated General Contractors of Cal. v. California State Council of Carpenters, 459 U.S. 519, 103 S.Ct. 897, 74 L.Ed.2d 723 (1983); Balaklaw v. Lovell, 14 F.3d 793 (2d Cir.1994); Leak v. Grant Med. Ctr., 893 F.Supp. 757, 762 (S.D.Ohio 1995); Southaven Land Co. v. Malone & Hyde, Inc., 715 F.2d 1079 (6th Cir.1983); Park Avenue Radiology Assocs. v. Methodist Health Sys., Inc., 1999 WL 1045098 (6th Cir. Nov. 10, 1999). The Court will address these two factors in turn. 1. Antitrust Injury Defendants initially argue that the Court must dismiss Plaintiffs antitrust claims, because the Plaintiff has failed to allege that he has suffered an antitrust injury. In Brunswick Corp. v. Pueblo Bowl-O-Mat, 429 U.S. 477, 97 S.Ct. 690, 50 L.Ed.2d 701 (1977), the Supreme Court first recognized the requirement that a private party bringing an action for treble damages for violations of federal antitrust laws must have suffered an antitrust injury. The Brunswick court reiterated that antitrust laws protect competition and not competitors and wrote that antitrust plaintiffs: must prove more than injury causally linked to an illegal presence in the market. Plaintiffs must prove antitrust injury, which is to say injury of the type the antitrust laws were intended to prevent and that flows from that which makes defendants’ acts unlawful. The injury should reflect the anticompetitive effect either of the violation or of anti-competitive acts made possible by the violation. Id. at 489. In Atlantic Richfield Co. v. USA Petroleum Co., 495 U.S. 328, 110 S.Ct. 1884, 109 L.Ed.2d 333 (1990), the Supreme Court explained that “injury, although casually related to an antitrust violation, nevertheless will not qualify as “antitrust injury,” unless it is attributable to an anticompetitive aspect of the practice under scrutiny, since it is inimical to the [antitrust] laws to award damages for losses stemming from continued competition.” Id. at 334, 110 S.Ct. 1884 (citations and internal quotation marks omitted). In addition, Ohio courts have held that a plaintiff must allege an antitrust injury in order to maintain an action under the Valentine Act, and have applied the jurisprudence developed by the Supreme Court in Brunswick and Atlantic Richfield to ascertain whether the plaintiff has suffered such an injury. See Lee v. United Church Homes, Inc., 115 Ohio App.3d 705, 686 N.E.2d 288 (1996); Schweizer v. Riverside Methodist Hospitals, 108 Ohio App.3d 539, 671 N.E.2d 312 (1996). In Valley Products v. Landmark, 128 F.3d 398, 403 (6th Cir.1997), the Sixth Circuit recently reviewed its jurisprudence relating to the antitrust injury doctrine: ... The Sixth Circuit, it is fair to say, has been reasonably aggressive in using the antitrust injury doctrine to bar recovery where the asserted injury, although linked to an alleged violation of the antitrust laws, flows directly from conduct that is not itself an antitrust violation. In Axis, S.p.A. v. Micafil, Inc., 870 F.2d 1105 (6th Cir.), cert. denied, 493 U.S. 823, 110 S.Ct. 83, 107 L.Ed.2d 49 (1989), this court dealt with a situation where the plaintiff, a European manufacturer of armature winding machines, hoped to get into the business of manufacturing such machines in the United States. The plaintiff found itself foreclosed from entering the U.S. market after the defendant, an American subsidiary of a European competitor, obtained key patents from one American manufacturer and took over a second American manufacturer, a company holding a license to use the patents. Although the defendant’s takeover of the latter company was assumed to violate § 1 of the Sherman Act and § 7 of the Clayton Act, our court did not view the antitrust violation as having inflicted the requisite antitrust injury. The harm of which the plaintiff complained, as the Axis panel saw it, was a direct result of the plaintiffs inability to obtain the patents, or a license to use the patents — and this harm did not “flow from” the element of the takeover that created the antitrust problem. Id. at 1112, quoting Brunswick, 429 U.S. at 489, 97 S.Ct. 690. The plaintiff in Axis never became a competitor in the American market, and the panel observed by way of dictum that perhaps a competitor could have stated a claim for damages. Axis, 870 F.2d at 1111-12. But the plaintiffs in Hodges v. WSM, Inc., 26 F.3d 36 (6th Cir.1994), appear to have been in competition with two of the defendants in that case (Grand Ole Opry Tours and Opry-land USA) for a short time prior to the advent of an allegedly illegal market-sharing agreement in the Nashville sightseeing tour and airport shuttle market. We nonetheless held in Hodges that the plaintiff shuttle operators could not claim antitrust injury when denied permission to drive their vans past the gates of the defendants’ Opryland eom-plex[:] “It was Opryland’s refusal to allow Plaintiffs vans on its property which caused Plaintiffs injury. If Plaintiff would have suffered the same injury without regard to the allegedly anti-competitive acts of Defendants, Plaintiff has not suffered an antitrust injury.” Id. at 38 (quoting district court opinion). In other words, as the Hodges panel put it, a violation of the antitrust laws was not a “necessary predicate” to the plaintiffs’ loss of business: “Because plaintiffs did not allege, nor could they, that the illegal antitrust conduct was a necessary predicate to their injury or that defendants could exclude plaintiffs only by engaging in the antitrust violation, it was appropriate to dismiss the case pursuant to Federal Rule of Civil Procedure 12(b)(6).” Id at 39. Id. at 403-04. In Valley Products, the plaintiff was engaged in the business of manufacturing and selling guest amenities, such as soap, to hotels. The soap and other amenities were packaged in wrappers that bore the trademark of the hotel chain, of which the purchaser was a part. After the defendant, which owned the trademarks to a number of hotel chains, terminated the license under which the plaintiff had been permitted to use those trademarks on the products that it manufactured and sold, the plaintiff brought suit, alleging that the defendant had violated the Sherman Act. The Sixth Circuit affirmed the decision of the District Court to dismiss the plaintiffs claim under the Sherman Act, since the harm it had suffered flowed from the defendant’s decision to terminate the license, rather than from any violation of the Sherman Act (illegal tying arrangement) and, therefore, the alleged antitrust violation was not a necessary predicate of the plaintiffs loss. Defendants argue that this case is analogous to this Court’s recent decision in Baseball at Trotwood v. Dayton Professional Baseball Club, LLC, 113 F.Supp.2d 1164 (1999) (Rice, J.). In that case, two groups competed to bring minor league baseball to Greater Dayton, Ohio, area. The plaintiffs (“the Trotwood group”) had obtained an oral agreement from the Cincinnati Reds’ Managing Executive that if the Reds were to waive its territorial, rights, it would be the exclusive group to locate in the Dayton area. In reliance upon that assurance, in March of 1997, the Trotwood group took steps to arrange for the construction of a stadium, and executed a contract to purchase the Michigan Battle Cats. In March of 1997, a second group (“the Dayton group”) began steps to bring a minor league team to Dayton. On May 30, 1997, the Reds issued a conditional territorial exclusivity waiver in favor of the Dayton group, despite its prior assurances to the Trotwood group. Thereafter, the Dayton group contracted to purchase an existing team, and sought the necessary approvals from the Midwest League, NAPBL and Major League Baseball. The Dayton group received approval from the Midwest League and the NAPBL, but not from Major League Baseball. On September 26, 1997, the Reds terminated the conditional waiver of territorial exclusivity that it had granted to the Dayton group. In November of 1997, the Reds again granted a waiver of its territorial exclusivity to the Trotwood group. That waiver would, in accordance with its terms, expire on January 26, 1998. While the waiver was in effect, a new group (the “Mandalay Defendants”) began investigating the possibility of locating a minor league baseball team in Downtown Dayton. The Mandalay Defendants negotiated with a former member of the Dayton group about purchasing her interest in their team. On January 14, 1998, the Trotwood group filed its applications with the Midwest League and the NAPBL, seeking permission to purchase the Michigan Battle Cats and to move that franchise to the Dayton area. Both the Midwest League and the NAPBL refused even to review those applications, because the application filed by the Dayton group had not been withdrawn. As a result, the Trotwood group’s period of exclusivity expired, before they were able to secure permission to purchase the Michigan Battle Cats and to move that franchise to the Dayton area. As a consequence, the Mandalay Defendants brought minor league baseball to the Dayton area. The Trotwood group brought suit against (among others) the Dayton group, the Mandalay group, and the Reds, alleging, inter alia, that the Defendants conspired and acted in concert to restrain trade and to create a monopoly, in violation of §§ 1 and 2 of the Sherman Act (Count I). In addition, the plaintiffs alleged that those same Defendants violated the Valentine Act, Ohio’s antitrust statutes, Chapter 1331 of the Ohio Revised Code (Count II). In addressing the Defendants’ motion to dismiss, pursuant to Rule 12(b)(6), this Court concluded that the plaintiffs had not alleged that they had suffered an antitrust injury, because a reduction of competition, in the economic sense in the relevant market, would not flow from the decision to permit the Mandalay defendants rather than themselves to be the group permitted to purchase a minor league baseball franchise and to move it to this area. This Court further stated: Herein, the Plaintiffs’ injury flows from the fact that only one group would be selected as the anointed monopolist in the minor league baseball market in the Dayton area, rather than from a decrease in competition among groups in that market. Moreover, since only one group would be selected to provide minor league baseball in this area, the Plaintiffs could have suffered the same injury had a group other than the Plaintiffs been selected, in the normal course of events, regardless of whether the Defendants had engaged in an alleged antitrust conspiracy. Accordingly, given that the Plaintiffs’ injuries could have occurred absent conduct prohibited by antitrust laws, the alleged violations of those laws by the Defendants are not the necessary predicate of the injuries which the Plaintiffs claim to have suffered. ‡ ‡ ‡ Í Í! [Gjiven that the Plaintiffs have not alleged that the Defendants’ actions limited the number of franchises that would be allowed to be located in the Dayton area, there is no allegation that the actions of the Defendants altered the market structure for minor league baseball in the Dayton area, increased prices or reduced the quantity of minor league baseball supplied in that area. In short, there are no allegations that the Defendants’ actions curtailed competition in the minor league baseball market in the Dayton area, only that those actions curtailed the Plaintiffs’ ability to be the entity servicing that market. Only one minor league team would be located in the Dayton area, regardless of whether the Plaintiffs, the Mandalay Defendants or some other group were the successful competitor for the right to become the owner of that team. In other words, there was bound to be one winner and one loser of that competition, and one and only one monopolist would emerge to provide minor league baseball in this area. While there is an allegation, but no facts alleged to support the conclusion that the Defendants’ alleged violations of the Sherman and Valentine Acts caused an injury to consumers by restricting competition, the Court concludes that the Plaintiffs have not sufficiently alleged that they have suffered an antitrust injury. Regardless of whether the actions of the Defendants may have affected competition in the market to acquire minor league baseball teams, generally, or the team that would be permitted to be located in the Dayton area, specifically, the Plaintiffs have not alleged that they have suffered an antitrust injury, in the absence of the contention'that those actions have harmed consumers. In other words, although the actions of the Defendants may have harmed one of the groups competing to bring minor league baseball to this area and, further, while those actions may constitute business torts, those actions did not cause the Plaintiffs to suffer an antitrust injury, since they did not prevent the Plaintiffs from being one of two or more groups presenting minor league baseball in this area. It was always understood that Dayton would be a one-team market. There is no allegation, in short, that the Defendants’ actions curtailed competition in the minor league baseball market in this area, by hurting one group’s ability to compete in a mul-ti-team market. (Doc. #4 at 17-18, 20 -2)(footnotes omitted). Upon reviewing Plaintiffs Complaint, Dr. Nilavar has alleged that the harm he suffered was the result of an antitrust violation. The conduct of which Plaintiff complains, the execution of an exclusive agreement between a hospital and group of physicians, is not per se lawful. See Jefferson Parish Hosp. Dist. No. 2 v. Hyde, 466 U.S. 2, 30 n. 61, 104 S.Ct. 1551, 80 L.Ed.2d 2 (1984) (“Like any exclusive requirements contract, this contract could be unlawful if it foreclosed so much of the market from penetration by Roux’s competitors as to unreasonably restrain competition in the affected market, the market for anesthesiological services.”); Morgan, Strand, Wheeler & Biggs v. Radiology, Ltd., 924 F.2d 1484, 1488 (9th Cir.1991). The Supreme Court has recognized that exclusive contracts may violate federal antitrust laws when they unreasonably restrain trade, Jefferson, supra; Smith v. Northern Mich. Hosp., Inc., 703 F.2d 942 (6th Cir.1983), and that the health care profession is not immune from scrutiny under federal antitrust laws. See FTC v. Indiana Fed’n of Dentists, 476 U.S. 447, 465-66, 106 S.Ct. 2009, 90 L.Ed.2d 445 (1986) (upholding FTC’s ruling that dentists violated antitrust laws by agreeing to withhold x-rays from insurers); Jefferson, supra; Leak, 893 F.Supp. at 763 (“The Court does not find ... that the above authorities establish a per se rule that a health care professional could never have standing to assert antitrust claims arising from the denial of hospital staff privileges.”) In his Complaint, Plaintiff has alleged the relevant markets and the injuries to competition in those markets. Continental Orthopedic Appliances, Inc., v. Health Ins. Plan of Greater N.Y., Inc., 40 F.Supp.2d 109, 117 (E.D.N.Y.1999)(“On a motion to dismiss, under the rule of reason, the plaintiff must ‘identify the relevant product market and allege how the net effect of the alleged violation is to restrain trade in the relevant market.’ ”) (citations omitted). In particular, he alleges that the relevant geographic market is the Springfield-Urbana area, and that the relevant product markets are physician diagnostic radiology services and hospital services. He further alleges that MHS-WO is one of only two hospital organizations in the Springfield-Urbana area. Whether Plaintiff has alleged relevant markets for antitrust purposes is a question of fact for the jury. Fishman v. Estate of Wirtz, 807 F.2d 520, 531 (7th Cir.1986) (trier of fact determines relevant market); Raiders I, 726 F.2d at 1394 (jury need not accept either parties’ definitions, of the relevant market). For purposes of a motion to dismiss, the Court must accept the market designations alleged as true. Murray v. National Football League, 1996 WL 363911, *24 (E.D.Pa. June 28, 1996); see In re Cardizem CD Antitrust Litigation, 105 F.Supp.2d 618 (E.D.Mich.2000). As to specific allegations of an antitrust injury, Plaintiff has alleged that he practiced radiology in the alleged relevant geographic market, and that he competed in the physician diagnostic radiology services market. He further alleges the following injuries as a result of Defendants’ conduct: 1) that his and other physicians’ ability to compete in the market for physician diagnostic radiologic services has been restrained or eliminated; 2) that purchasers of physician diagnostic radiologic services in the area centered around Springfield and Urbana have been deprived of free and open competition in the sale of such services; 3) that competition regarding the price and quality of physician diagnostic radiologic services in the relevant market have been suppressed; 4) that patient care in the relevant geographic market has been harmed by the lack of competition; 5) that quality assurance and pooling of knowledge have been drastically reduced; 6) that patients and referring physicians in the relevant geographic market have been deprived of the choice of physician diagnostic radiology service providers; 7) that a significant number of consumers of physician diagnostic radiology services are now forced to purchase such services from DIA when they would prefer other physicians; and 8) that patients and referring physicians have been deprived of information regarding the quality of physician diagnostic radiology services. In short, Dr. Nilavar alleges that, as a result of Defendants’ conduct, his ability to compete has been restrained, resulting in higher prices, lower quality services, and less choice for consumers and their physicians. These allegations constitute the kind of injuries that the antitrust laws were enacted to prevent. Compare Korshin v. Benedictine Hosp., 34 F.Supp.2d 133, 138 (N.D.N.Y.1999) (dismissing, pursuant to Rule 12(b)(6), for lack of antitrust injury, when plaintiff failed to allege, e.g., any change in the price of anesthesiology services, a decrease in quality or efficiency of care, or that the consumers of anesthesiology services, be they patients, referring physicians, or third-party payers, have less of a market choice, other than their inability to select plaintiff, as a result of defendants’ actions). Plaintiffs allegations survive the Sixth Circuit’s necessary predicate test. Valley Products, supra. Unlike Valley Products, in which the plaintiffs exclusion from the market flowed from the decision to terminate the license, rather from the alleged illegal tying arrangement, Plaintiffs exclusion from the Springfield-Urbana market allegedly stems from the exclusive contract. Although Defendants argue that Plaintiffs exclusion stems from his failure to apply for and to be awarded the exclusive contract and from his lack of association with DIA, the Complaint alleges, when construed in the light most favorable to Plaintiff, that his failure to apply and DIA’s award of the exclusive contract stem from a conspiracy among Defendants. The Complaint further alleges that his injuries flowed directly from this conduct and the effect of the exclusive contract. In addition, as Plaintiff notes, he has requested, in his prayer for relief, that the exclusive contract be enjoined, not that it be awarded to him. Furthermore, unlike the plaintiffs in Baseball at Trotwood, Dr. Nilavar has alleged that a reduction in competition flows directly from the exclusive contract between DIA and MHS-WO. He alleges that, as a result of Defendants’ activities, the number of providers of radiologic services was curtailed, and that he and other physicians, who are direct competitors of DIA, were excluded from the existing Springfield-Urbana market. Unlike the competitors for a Dayton minor league team, Dr. Nilavar and DIA did not compete to provide a new product (radiologic services) in the Springfield-Urbana area, under circumstances in which it was understood that only one provider would be selected. Nilavar and DIA did not compete to be a monopolist in a new market, nor did they compete to join the existing market of radiologic providers. Rather, Plaintiff alleges that prior to the exclusive contract, there were a number of providers of radiologic services and that, as a result of the contract between Defendants, the competition among radiologists to provide such services in that area was reduced. To be clear, Plaintiff has alleged that “but for” the exclusive Contract, he would still be practicing in the Springfield-Urbana area. Thus, he has alleged that the contract, allegedly in violation of the antitrust laws, was a necessary predicate to his injury. In re Cardizem CD Antitrust Litigation, 105 F.Supp.2d 618 (2000)(using 12(b)(6) standard to determine whether antitrust injury has been alleged). Defendants’ argument that this Court’s decision in Baseball at Trotwood requires the conclusion that Plaintiff has failed to allege an antitrust injury is without merit. Defendants have further argued that Plaintiff has failed to allege an antitrust injury, because MHS-WO merely substituted one exclusive provider of radiologic services (SRI) with another (DIA). They assert that there has been no alteration in the amount of competition in the market, and from the standpoint of consumers, the market remains unchanged. Decisions within the Sixth Circuit support Defendants’ argument that a plaintiff cannot establish an antitrust injury 'if a hospital merely substitutes one exclusive provider with another. E.g., Mid-Michigan Ra diology Assocs. v. Central Mich. Community Hosp., 1995 WL 239360 (E.D.Mich. Feb. 14, 1995), citing Balaklaw v. Lovell, 14 F.3d 793 (2d Cir.1994). However, Plaintiff has not alleged that SRI provided radiology services at the Mercy Hospitals, pursuant to an exclusive arrangement (either contractual or de facto) between those entities. In fact, there are no allegations that SRI was an exclusive provider of radi-ologic services at the hospitals. The sole allegations with regard to the relationship between SRI and MHS-WO state that, beginning in 1993, SRI and the MHS-WO began negotiations towards an exclusive contract for the provision of radiologic services at the Mercy Hospitals and several other MHS-WO long-term care facilities. These negotiations concluded, without successfully reaching an agreement, on March 22, 1995. These allegations do not support the inference that SRI had previously provided radiologic services to MHS-WO under an exclusive arrangement. Likewise, the allegations do not support an inference that the contract between the Mercy Hospitals and DIA constitutes merely a reshuffling of radiologic service providers. In summary, although undisputed evidence in support of Defendants’ assertion that SRI operated under an exclusive arrangement at the Mercy Hospitals might justify a grant of summary judgment in favor of Defendants on this issue, the Complaint does not contain allegations of such an arrangement. Accordingly, the Court cannot dismiss Plaintiffs antitrust claims, pursuant to Rule 12(b)(6), on that basis. Defendants also contend that Plaintiff has not suffered an antitrust injury, because the exclusive contract has a pro-competitive effect. Although the contract between DIA and MHS-WO may, in fact, have a pro-competitive effect on the market for radiologists and radiological services, the Court cannot make a conclusion to that effect, as a matter of law. The extent of the pro-competitive and anti-competitive effects of a given contract requires a factual inquiry, considering the circumstances of the exclusive dealing arrangement and their effect on competition in the relevant market. Therefore, although a number of courts have concluded that exclusive contracts in the health care industry are beneficial and pro-competitive, the Court cannot reach such a conclusion without evidence of this contract’s effect on the relevant market. See Balaklaw, 14 F.3d at 799, n. 13. The Court will not dismiss Plaintiffs antitrust claims, pursuant to Fed.R.Civ.P. 12(b)(6), on the ground that the contract is pro-competitive. Defendants have asserted that Plaintiffs antitrust claims must be dismissed, because the award of the exclusive contract to DIA is the result of healthy competition between competing radiologists. Numerous courts have stated that where an exclusive contract for the provision of medical services has resulted from competition between providers for the contract, the contract is not a restriction on competition but, rather, is the result of competition. E.g., Balaklaw, 14 F.3d at 801-2 (“It is the nature of competition that at some point there are winners and losers, and the losers are excluded ... By closing its doors to Dr. Balaklaw in favor of one of his competitors, CMH did nothing to inflict an injury of the type the antitrust laws were intended to prevent.”); Dos Santos v. Columbus-Cuneo-Cabrini Medical Ctr., 1983 U.S. Dist. LEXIS 12377 (N.D.Ill. Oct. 25, 1983)(“The exclusive anesthesiology contract between the Medical Center and Anesthesia Associates is the result of competition, not a restriction on competition. It is the result of a process of rivalry to be the hospital’s supplier of anesthesia services over a period of time.”); see also Baseball at Trotwood, supra. In his Complaint, Dr. Nilavar alleges that after SRI failed to reach an agreement with MHS-WO, MHS-WO decided to prepare a Request for Proposal (“RFP”) for a contract for the provision of exclusive radiology services to interested radiologists and radiology groups (ComplJ 37). The RFP was published on April 27, 1995. Plaintiff alleges that the Mercy group of SRI voted to submit a bid but, unbeknownst to SRI members, Dr. Osborn formed his own corporation, DIA, and submitted a proposal for the MHS-WO contract. There is no indication as to how many other entities, if any, bid on the radiology services contract. DIA was awarded the contract in August, 1995. Plaintiff has further alleged that MHS-WO and DIA have conspired to prevent him and other radiologists from providing radiology services to the Mercy hospitals and other MHS-WO facilities. Accepting these facts as true and construing them in the light most favorable to Plaintiff, Plaintiffs Complaint could reasonably be interpreted to allege that the RFP was a sham and Defendants conspired to award the contract to DIA. The Court will not dismiss Plaintiffs claim on this basis, on a Rule 12(b)(6) motion. In addition, Defendants contend that the exclusive radiology services contract has no adverse effect on competition, because of its limited, one-year duration. Many courts have considered the duration of a contract to be one of many factors considered in determining whether a given exclusive contract is anti-competitive. See Ho-venkamp, Antitrust Law ¶ 1802g (1998). “Others have noted that where exclusive distribution contracts were either of short duration or terminable on relatively short notice,'any alternative manufacturer could come along and offer a distributor a better deal.” Id. The Balaklaw court, for example, found that the plaintiff lacked antitrust standing, due to the short duration of the exclusive contract involved: Even at CMH, opportunities for competition remain, since the contract with Dr. King has a term of only three years and may be cancelled [sic] without cause upon six-months’ notice. In Konik v. Champlain Valley Physicians Hospital Medical Center, 733 F.2d 1007, 1014-15 (2d Cir.), cert. denied, 469 U.S. 884, 105 S.Ct. 253, 83 L.Ed.2d 190 (1984), we rejected an antitrust challenge to an anesthesiology contract in part because the parties were free at the end of any six-month period to terminate the agreement. Here, as there, “the Hospital [is] free at the end of six months to enter into a new arrangement either with [the current group] or with any other anesthesiologist.” Id. at 1015. Such a situation may actually encourage, rather than discourage, competition, because the incumbent and other competing anesthesiology groups have a strong incentive continually to improve the care and prices they offer in order to secure the exclusive positions. We thus see no “foreclosure of competition” in either of the two relevant markets, and consequently, we find no antitrust injury. Balaklaw, 14 F.3d at 799. However, other terms of the exclusive contract, such as the presence of a significant penalty attached to terminating the agreement, may result in contracts of short duration or contracts terminable on relatively short notice having an anti-competitive effect. Id.; U.S. Healthcare, 986 F.2d at 596. In the present case, Plaintiff has attached the exclusive contract between MHS-WO and DIA to his Complaint (Compl.Ex.3). According to that document, the exclusive contract between those parties has an initial term of two years, and the contract would automatically renew for successive one-year terms {id. ¶ 11). At the end of the first year, the contract is terminable by either party, without cause, with ninety-days notice (id. ¶ 12). On their face, these terms do not appear to unreasonably restrain competition, because, as stated by the Balaklaw court, MHS-WO is free at the end of that period of time to enter into a new arrangement, either with DIA or with any other radiologist. Accepting Plaintiffs allegations as true and construing them in the light most favorable to him, however, Plaintiffs Complaint could reasonably be interpreted to allege that the term of the exclusive contract does not render the contract reasonable, when considered in light of the extent that the relevant market is foreclosed. Dr. Nilavar has alleged that the he was unable to secure privileges at Springfield Community Hospital and that, as a result, he has been entirely foreclosed from the Springfield-Urbana physician diagnostic radiology services market due to the contract between DIA and MHS-WO (ComplJ 50). Accepting that statement as true, it is unlikely that Dr. Nilavar and other similarly-situated radiologists would remain in the Springfield-Urbana area for two years, pending the opportunity to seek a contract with MHS-WO, and, thus, to practice their profession. Likewise, it is similarly unlikely that Plaintiff and others similarly situated will remain in the area, hoping that either party to the agreement will decide to terminate same. With this scenario, the supposed opportunity to compete two years hence would be illusory. Accordingly, the Court will not conclude that Plaintiff has failed to state a claim upon which relief may be granted, even though he has alleged that the exclusive contract has an initial two year term and is terminable thereafter on short notice. The duration of the exclusive contract is merely a factor which the Court will consider, when presented with relevant evidence, in determining whether the contract unreasonably restrains trade. Accordingly, Plaintiff has adequately alleged that he has suffered an antitrust injury. 2. Efficient Enforcer Defendants assert that Plaintiff lacks standing to bring his antitrust claims, because he is not an efficient enforcer of the antitrust laws. “[I]t is not enough ... that plaintiffs can show that defendants’ conduct caused them injury. Associated Gen. Contractors, 459 U.S. at 535 n. 31, 103 S.Ct. 897. Plaintiffs also must show that their injuries were sufficiently direct and that they would be efficient enforcers of the antitrust laws. See id.” Leak, 893 F.Supp. at 762. A number of courts have held that physicians lack antitrust standing on the ground that they are not efficient enforcers of antitrust violations which arise out of exclusive contracts with physicians. As stated by the court in Korshin v. Benedictine Hosp., 34 F.Supp.2d 133 (N.D.N.Y.1999): Numerous courts have held that a physician is not the most appropriate person to enforce potential antitrust violations in circumstances similar to those presented here. Rather, patients, referring physicians, and third-party payers, and the government would be more “efficient enforcers” of the antitrust laws because they have stronger interests in ensuring that prices, services, quantity and quality remain at competitive levels. Id. at 140. Other courts, however, have concluded otherwise. For example, the Third Circuit recently stated in Angelico v. Lehigh Valley Hosp., Inc., 184 F.3d 268 (3d Cir.1999): First, because no discovery was allowed on the issue, we must assume Angelico’s allegation that the defendants acted in concert and with an anticompet-itive motive, i.e., conspired, is true. Following this assumption, Angelico’s harm clearly resulted from the conspiracy that prevented him from competing in the market and thereby earning a living. At this stage, therefore, the causal connection/defendant intent element of the standing analysis is satisfied. Turning to the second element, whether Angelico’s alleged injury is of the type the antitrust laws were meant to redress, we conclude that the injury he suffered, when shut out of competition for anticompetitive reasons, is indeed among those the antitrust laws were designed to prevent. * * * Angelico also satisfies the third, fourth and fifth elements of the AGC standing analysis. The injury to Angelico from the assumed conspiracy is clearly direct (and substantial). Angelico’s injury is the direct result of the alleged conspiracy. In contrast, the harm to consumers is less direct because it will only arise from higher costs or poorer treatment that result from the removal of a strong competitor from the market. A consumer would be highly unlikely to sue for a loss of this type. Finally, there is no potential for duplicative recovery or complex apportionment of damages, because Angelico’s injury has not been passed along to others. Angelico, 184 F.3d at 274-75; Allen v. The Washington Hosp., 34 F.Supp.2d 958, 962 (W.D.Pa.1999)(“Here, the Defendants ... would have this Court essentially adopt a per se rule denying standing to any physician who challenges alleged exclusionary practices. No court has adopted such a rule, and I decline the Defendants’ invitation to do so.”). In analyzing whether Plaintiff is an efficient enforcer, the Court must consider the four factors set forth in Southaven, to wit: (1) the causal connection between the antitrust violation and harm to the plaintiff and whether that harm was intended to be caused; (2) the directness or indirectness of the injury, and the related inquiry of whether the damages are speculative; (3) the potential for duplicative recovery or complex apportionment of damages; and (4) the existence of more direct victims of the alleged antitrust violation. First, Plaintiff has alleged that the antitrust violation has caused him harm. Turning to the Complaint, Count One states that Defendants have conspired to exclude Plaintiff and other radiologists from supplying physician diagnostic radiology services at the Mercy hospitals and other facilities, and to eliminate competition between Plaintiff and other radiologists in the provision of such services in the Springfield-Urbana area. Plaintiff further alleges that he has been foreclosed from that market due to Defendants’ conduct. Thus, Plaintiff has alleged that Defendants intended to eliminate competition in the physician diagnostic radiology services market, and their conduct has caused him (and other radiologists) injury. Second, that injury is direct, because Plaintiff has been foreclosed from the SpringfieldUrbana market, as was the alleged intent of Defendants. Simon v. Value Behavioral Health, Inc., 208 F.3d 1073, 1082 (9th Cir.2000)(“To the extent that Appellees’ practices drove certain health care providers out of business, it was the providers who suffered the injury.”). Moreover, it is likely that Plaintiff could calculate his lost income due to his unlawful foreclosure from the physician diagnostic radiology services market in the Springfield and Urbana, Ohio, area. Thus, there is no indication that his damages would be speculative. As for the third and fourth factors, it is apparent that there are other possible efficient enforcers of the alleged antitrust injuries. Plaintiff has asserted numerous injuries to patients {e.g., higher prices, lower quality care, less choice of physicians) and to referring physicians {e.g., less choice, less information about quality of care). In addition, if Defendants’ conduct is anti-competitive, the government would also have an interested in halting the illegal activity. However, Plaintiff has also alleged that Defendants acted to eliminate him and other competitors from the market and that they have done so. Although Plaintiff is a rival of DIA, not a consumer of physician diagnostic radiology services, he has a strong interest in ensuring that his ability to compete is not unlawfully extinguished. In addition, although there are others who would be efficient enforcers of the antitrust laws in the circumstances presented herein, thus creating a risk of duplicative actions, it is unclear whether patients and third-party providers would pursue this litigation. Accordingly, the Court will not dismiss Plaintiffs antitrust claims (Counts One, Two, and Three) on the ground that he is not an efficient enforcer of the antitrust laws herein. C. Tying Arrangment Claims (Count Two and a Portion of Count Three) Defendants challenge Plaintiffs claim that the exclusive contract constitutes a tying arrangement on two grounds. First, they argue that they do not condition all Mercy Hospital patients’ purchases of hospital services on their purchase of radiological services. Second, they assert that the claim must be dismissed, because the hospital does not receive a direct economic benefit. A tying arrangement is an agreement by a party to sell one product but only on the condition that the buyer also purchases a different (or tied) product, or at least agrees that he will not purchase that product from any other supplier. Such an arrangement violates § 1 of the Sherman Act if the seller has “appreciable economic power” in the tying product market and if the arrangement affects a substantial volume of commerce in the tied market. Eastman Kodak Co. v. Image Technical Sens., Inc., 504 U.S. 451, 461-62, 112 S.Ct. 2072, 119 L.Ed.2d 265 (1992) (citations omitted). To establish an illegal tying arrangement, Plaintiff must demonstrate (1) that the Hospitals’ requirement that patients obtain necessary radiologic services from DIA combined the purchase of two distinguishable services in a single transaction, and (2) that patients are forced to purchase DIA’s services as a result of the hospitals’ market power. Jefferson, 466 U.S. at 24, 104 S.Ct. 1551. In addition, an illegal tying arrangement cannot exist unless the plaintiff can establish that the MHS-WO had a direct economic interest in the tied product. Beard v. Parkview Hosp., 912 F.2d 138 (6th Cir.1990). In his Complaint, Dr. Nilavar alleges that the tying product is hospital services, and the tied product is physician diagnostic radiology services. (Compl.1ffl 72-73) He describes the alleged illegal arrangement as follows: patients and referring physicians agreed, as a condition of receiving hospital services, that they will purchase any needed physician diagnostic radiology services from DIA, when the patients or referring physicians would prefer to purchase radiologic services from someone else under different terms. In addition, Plaintiff has alleged that MHS-WO and/or CHP holds a dominant market position in the relevant geographic market (the Springfield-Urbana area), and that the tying arrangement affects a substantial volume of commerce. Id. First, Defendants argue that Plaintiff has not alleged a tying arrangement, because he has not alleged that Defendants condition all Mercy hospital patients’ purchases of hospital services on their purchase of radiological services. Antitrust claims identical to those presented herein have been recognized in the Sixth Circuit. See Beard v. Parkview Hosp., 912 F.2d 138, 140-41 (6th Cir.1990) (“[T]he alleged tying arrangement challenged in this case arises from the exclusive contract Park-view entered into with Bucholz for the provision of radiological services. Consequently, under the Jefferson Parish analysis, [which set forth the two prongs of an illegal tying claim,] we must decide whether Parkview’s contract with Bucholz is illegal as forcing surgical patients at Park-view to obtain radiological services from Bucholz which they might wish to obtain from another provider or as unreasonably restraining competition among radiologists in the Parkview area.”). Because the Sixth Circuit has recognized tying arrangement claims based on a contract which requires hospital patients to obtain services from a particular provider, the Court will not dismiss Plaintiffs tying claims on this ground. Second, Defendants contend that Plaintiffs allegations are insufficient, because he has not alleged a direct economic benefit to Defendants MHS-WO and CHP as a result of the contract. The Sixth Circuit has held that defendants must receive a direct economic benefit, such as professional fees for the tied product, for a contract to constitute an illegal tying arrangement. Beard, 912 F.2d at 141. (“The district court’s reliance on the “direct economic benefit” rule was well-grounded in antitrust law ... An absence of direct economic benefit was taken as a determinative indicator that the provider of the tying product or service had no anti-competitive impact upon the market for the tied product or service.”). In Beard, a radiologist alleged that a hospital had engaged in an illegal tying arrangement when it entered into an exclusive contract with another radiology service. The Sixth Circuit affirmed the district court’s grant of summary judgment to the hospital on the tying claim, stating: In its decision granting Parkview’s motion for summary judgment, the district court said: In order for a tying arrangement to violate § 1 of the Sherman Act, the seller must exploit its market power over the tying product to force the buyer into purchasing a tied product that the buyer either did not want at all, or might have preferred to purchase from someone else. An implicit requirement to a finding that a tying arrangement violates § 1 is that the seller of the tying product must also profit from the sale of the tied product. The district court went on to say that, “[i]n all of the cases addressing this question which the Court is aware of, the courts require that the seller of the tying product must have benefited directly from the sale of the tied product.” And, “[i]n this case, it is clear from the evidence before the Court that none of the monies paid to Bucholz, Inc. reached Parkview’s hands. Therefore, the Court finds defendants’ motions for summary judgment as to plaintiffs § 1 claim well taken.” Id. In Scara v. Bradley Mem’l Hosp., 1993 WL 404160 (E.D.Tenn. Feb. 4, 1993), the district court likewise dismissed a physician’s tying claim against a hospital, stating that the hospital did not share in the professional fees for the anesthesiological services. It rejected the plaintiffs argument that the hospital had enhanced its revenues as a result of the exclusive contract for anesthesiological services, because surgical services, recovery rooms, and anesthesiology equipment and supplies were more fully utilized by consumers. The court reasoned that such indirect economic benefits do not rise to the level of economic benefits as required for an illegal tying arrangement. Id. at *5; see also Leyba v. Renger, 874 F.Supp. 1229, 1233 (D.N.M.1994)(the fact that exclusive contract between hospital and anesthesiologists may prevent hospital from losing patients was an indirect benefit, not a direct economic benefit as required for an illegal tying arrangement). Herein, Dr. Nilavar alleges that, as a result of the “forced sale of Defendant DIA’s physician diagnostic radiology services,” MHS-WO and CHP have derived increased revenues and have benefitted financially. Specifically, he' alleges that they have derived a direct economic benefit from: 1) con