Articles Posted in Medical Negligence

Where a plaintiff in an Tennessee HCLA (medical malpractice) case “failed to obtain a competent expert witness to testify on the applicable standard of care,” summary judgment as to all of her claims was affirmed.

In Akers v. Heritage Medical Associates, P.C., No. M2017-02470-COA-R3-CV (Tenn. Ct. App. Jan. 4, 2019), plaintiff was treated by a physician assistant at defendant medical center and was given a punch biopsy on her wrist. Two days later, plaintiff went to the emergency room with complications in the same area, which were diagnosed as cellulitis and staph infection.

Plaintiff subsequently filed this complaint pro se against the treating physician assistant and the medical practice, alleging that the practitioner “was not qualified to perform the punch biopsy and did not wash her hands, wear gloves, or use sterile medical equipment when performing the procedure,” and that the complications she experienced resulted from this negligence. In response to interrogatories asking plaintiff to disclose her expert witness, she identified the emergency room doctor she had seen, but failed to give additional information including his publications, other cases in which he had testified, and the compensation to be paid. Defense counsel made several attempts to get plaintiff to supplement her responses, which eventually led to plaintiff disclosing a second doctor, but providing the same very basic information about him. For both of these doctors, plaintiff stated that they would testify that her injuries “could not likely have been the result of any factors other than negligence on the part of…Defendants,” but she did not mention standard of care testimony in the description of either named expert.

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Where plaintiff gave pre-suit notice of an HCLA suit to two defendants related by employment, but her HIPAA authorization failed to identify to whom medical records could be disclosed, the Court of Appeals analyzed whether each defendant was individually prejudiced by the lack of compliance. The Court ultimately concluded that the employer defendant who was in possession of all the records was not prejudiced and the suit could continue against it, but that the employee defendant who did not possess the records was prejudiced.

In Wenzler v. Yu, No. W2018-00369-COA-R3-CV (Tenn. Ct. App. Nov. 20, 2018), plaintiff filed a health care liability case against a dentist and the practice for which he worked. She sent pre-suit notice with a HIPAA authorization attached, but while the HIPAA authorization “mentioned that the information would be used for litigation,” it “failed to identify the person or entity that was authorized to receive the disclosure pursuant to the release.” The trial court found that the HIPAA authorizations did not substantially comply with the statutory requirements and that plaintiff was therefore not entitled to the 120-day extension of the statute of limitations, and thus dismissed the complaint as time-barred. The Court of Appeals affirmed as to the dentist but reversed as to the dental practice.

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When an HCLA plaintiff proceeds under a res ipsa loquitur theory, her expert is not required to opine on the same elements as in a traditional HCLA claim.

In Anderson v. Wang, No. M2018-00184-COA-R3-CV (Tenn. Ct. App. Oct. 5, 2018), plaintiff had laser cataract surgery performed on both eyes by defendant doctor. After the second surgery on her right eye, plaintiff experienced serious complications, including extreme loss of endothelial cells and corneal decomposition that required a corneal transplant.

Plaintiff brought this HCLA case under Tenn. Code Ann. § 29-26-115(c), which governs HCLA res ipsa loquitur claims. This section states that “there shall be a rebuttable presumption that the defendant was negligent where it is shown by the proof that the instrumentality causing injury was in the defendant’s…exclusive control and that the accident or injury was one which ordinarily doesn’t occur in the absence of negligence.” The trial court granted defendant’s motion for summary judgment, finding that plaintiff’s expert “never defined the applicable standard of care or how any instrumentality could have been improperly used contrary to the applicable standard of care.” The Court of Appeals, however, reversed.

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When a plaintiff’s lawyer terminates his representation just weeks before the statute of limitations is set to expire on a health care liability claim, this termination may constitute extraordinary cause to excuse the plaintiff’s noncompliance with certain pre-suit notice and certificate of good faith requirements.

In Reed v. West Tennessee Healthcare, Inc., No. W2018-00227-COA-R9-CV (Tenn. Ct App. Oct. 8, 2018), plaintiff was injured when he fell while in the hospital being treated for a different injury on October 18, 2015. He retained counsel over four months before the statute of limitations was set to run on his health care liability claim, but just a few weeks before it expired, the attorney terminated his representation of plaintiff. Plaintiff then sent a letter dated October 7, 2016 to a hospital executive stating that he had been injured and demanding compensation. He subsequently filed his HCLA complaint on October 14, 2016, which was within the one-year statute of limitations, but he did not attach a Certificate of Good Faith to his complaint. After he filed his complaint, he hired a new attorney.

Defendant filed two motions to dismiss, one based on plaintiff’s failure to attach a Certificate of Good Faith and one based on plaintiff’s failure to follow the pre-suit notice requirements by failing to give his notice 60 days before he filed the complaint, failing to provide a HIPAA authorization, failing to provide an affidavit from the party who mailed the notice, and failing to state that he had complied with the statute. The trial court denied both motions, finding that the termination of representation just weeks before the statute of limitations ran constituted extraordinary cause under the HCLA and thus excused compliance with these requirements. The Court of Appeals affirmed.

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Failure to comply with HCLA pre-suit notice requirements will not be excused due to local practice, and a final order dismissing defendants from a suit that is not appealed cannot later be revised by the trial court through a decision in a second suit.

In Smith v. Wellmont Health System, No. E2017-00850-COA-R9-CV (Tenn. Ct. App. July 9, 2018), plaintiff filed an HCLA claim against several defendants, all of whom filed motions to dismiss based on an inadequate HIPAA authorization in the pre-suit notice. The trial court granted three defendants’ joint motion to dismiss and entered a dismissal order, from which plaintiff did not appeal. Before the motions from the other defendants were decided, plaintiff voluntarily nonsuited those claims.

Plaintiff subsequently sent a second pre-suit notice to all original defendants and filed a second suit naming all of them, including the three dismissed from the original suit. All defendants filed motions to dismiss in this case as well, and the trial court denied them all. It ruled that its first dismissal order was incorrect because “plaintiff’s first complaint was not time-barred because…plaintiff provided proper pre-suit notice.” This interlocutory appeal followed.

The issues in this case were identical to those in Roberts v. Wellmont Health System, No. 2017-00845-COA-R9-CV (Tenn. Ct. App. July 5, 2018), a decision that came out just four days before this one. In both cases, plaintiff provided a HIPAA authorization that left blanks for which parties could disclose protected health information, to whom disclosures could be made, and the expiration date. Here, the Court noted that plaintiff expressly stated in a letter accompanying the HIPAA form that defendants “could use the authorizations to get the records of the other Defendants and he invited them to contact him if they had any questions.” In this case, like in Roberts, the plaintiff and trial court relied on the fact that providing blank forms was the local practice to deem the forms sufficient.

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A HIPAA authorization form that leaves blanks for which parties may make disclosures and to whom disclosures can be made is most likely insufficient to meet the statutory requirements of the HCLA, even if it complies with the local practice.

In Roberts v. Wellmont Health System, No. 2017-00845-COA-R9-CV (Tenn. Ct. App. July 5, 2018), plaintiff sent defendants a pre-suit notice and then filed an HCLA complaint. When defendants filed motions to dismiss in the first matter, plaintiff voluntarily dismissed the case, then subsequently sent new pre-suit notices and filed a second complaint. Defendants filed motions to dismiss, arguing that the first pre-suit notice was deficient due to an incomplete HIPAA authorization, that plaintiff was thus not entitled to the 120-day extension of the statute of limitations which would mean that the first suit was filed outside the statute of limitations, and that the second suit was therefore time-barred.

When sending the first pre-suit notice, plaintiff included a HIPAA authorization that left blank the spaces for (1) the persons authorized to disclose protected health information and (2) the persons to whom disclosure could be made. The form also failed to state an expiration date.

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Where a plaintiff sent notice to and filed suit against an incorrect HCLA defendant, then moved to amend to name the correct defendant, the motion to amend may be futile if the complaint was originally filed outside the one-year statute of limitations, as the 120-day extension would not apply to the new defendant to whom notice was not given.

In Runions v. Jackson-Madison County General Hospital District, No. W2016-00901-SC-R11-CV (Tenn. June 6, 2018), the plaintiff and her infant daughter had been treated at the defendant hospital, and the infant daughter died, allegedly due to defendant’s negligence. Plaintiff sent pre-suit notice to several entities, all of whom had Ms. Higgs listed as their registered agent. Ms. Higgs was also the registered agent for the Jackson-Madison County General Hospital District (the District), who was not sent notice but ultimately was identified as the proper defendant.

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Where an HCLA plaintiff sent defendants a HIPAA authorization that “failed to include the mother’s authority to sign the document, the expiration date of the document, and the names of all healthcare providers authorized to use or disclose the requested information,” plaintiff was still deemed to have substantially complied with the statutory requirements, and dismissal of the complaint was reversed.

In Martin v. Rolling Hills Hospital, LLC, No. M2016-02241-COA-R3-CV (Tenn. Ct. App. June 22, 2018), plaintiffs were the parents and children of a patient who was admitted to defendant hospital for suicidal ideation and detoxification, and was found unresponsive two days after her admission, dying later that day.

The death occurred on June 28, 2013, and the first complaint was filed on October 17, 2014, which was outside the one-year limitations period but within the 120-day extension period. That complaint was nonsuited, and a second complaint was filed naming the same defendants within a year of the nonsuit. Defendants filed a motion to dismiss, arguing that plaintiffs did not comply with the pre-suit notice requirements, which meant they were not entitled to the 120-day extension of the statute of limitations. Accordingly, defendants argued that the first suit was time-barred, making the second suit also time-barred. The trial court granted to motion to dismiss based on plaintiffs’ incomplete HIPAA authorization, but the Court of Appeals reversed.

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The Wisconsin Supreme Court has reversed a 2005 opinion and held that a cap of $750,000 on non-economic damages in medical malpractice cases is constitutional.

The female plaintiff in the case lost her arms and legs as a result of a medical error.  A jury determined that her pain, suffering, and disfigurement had a value of $16.5 million.  However, Wisconsin’s highest court deferred to legislation limiting such awards to a maximum of $750,000 in all cases, regardless of the severity of the injuries.

A dissent was filed by Justice Bradley, joined by Justice Abrahamson. “Only those with the most catastrophic injuries will be denied a full and fair damages award,” Bradley wrote. “It makes no sense that those who are injured most get the least.”