Shah sued about the alleged monopolization of pediatric anesthesiology services in Bexar County. The Fifth Circuit looked to its discussion of market definition in Surgical Care Center of Hammond, L.C. v. Hosp. Serv. Dist. No. 1, 309 F.3d 836, 840 (5th Cir. 2002), which looked for “a showing of where people could practicably go” to obtain the services at issue. Here, Shah failed to satisfy that standard: “He did not even specify individual pediatric anesthesiologists from whom patients could practicably obtain health care services. Rather, he provided tallies, by county, of pediatric anesthesiologists in Texas that fit the anesthesiology requirements of the BHS-STAR Agreement. Moreover, as the BHS parties argue, Shah’s proposed relevant market does not encompass all interchangeable substitute products because it does not include the two non-BHS facilities that the BHS parties contend serve as viable alternatives to BHS facilities. Shah has not provided evidence or any persuasive argument to raise a genuine dispute as to either of those facilities.” Shah v. VHS San Antonio Partners LLC, No. 20-50394 (Jan. 13, 2021).

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