Medical Negligence

January 14, 2017

Article Shows Misinformation About Malpractice Litigation

An article in Becker’s Hospital Review demonstrates the need for careful review of any article that purports to give information about medical malpractice (which Tennessee now calls “health care liability”) lawsuits.

The article purports to list the number of filings per state per 100,000 residents and ranks Tennesseans as the 5th highest filers of malpractice lawsuits – at the rate of 33 per 100,000 people. That would mean that Tennesseans file about 2145 such lawsuits per year (we have a little over 6,500,000 people living here).

But that number is wrong. Information compiled by Tennessee’s Administrative Office of the Courts demonstrates that there were 374 medical malpractice suits filed in 2013-2014 and 356 suits filed in 2014-2015. (Data is kept on a July 1 – June 30 fiscal year; 2015-2016 data is not yet publicly available). My guess is that the number of suits filed in all of 2015 was down from what it was in fiscal year 2014-2015, but even assuming that it was the same (356), the rate of filed suits was less than 5.5 per 100,000. That simply didn’t happen.

January 8, 2017

Blank HIPAA Form Deemed Non-Compliant by Tennessee Court

by The Law Offices of John Day, P.C.

In J.A.C. v. Methodist Healthcare Memphis Hospitals, No. W2016-00024-COA-R3-CV (Tenn. Ct. App. Nov. 2, 2016), a plaintiff lost her chance to pursue her Tennessee medical malpractice claim due to an insufficient HIPAA release form.

Plaintiff was forty weeks pregnant when she went to the defendant hospital with lower back and abdominal pain on January 23, 2012, and she was found to have elevated blood pressure. Plaintiff was nonetheless discharged. She had her baby the next day, January 24, 2012, and a placental abruption was noted. The baby, a girl, allegedly “sustained severe brain damage that would not have occurred but for the Providers’ actions in failing to properly treat [plaintiff].”

Plaintiff filed this action on May 1, 2015, purportedly on behalf of both herself and her daughter. Plaintiff alleged that she followed the pre-suit notice requirements of the HCLA, but defendants moved to dismiss the case based on an insufficient HIPAA form. Defendants argued that, because the HIPAA form was insufficient to fulfill the statutory requirements, plaintiff was not entitled to the 120-day extension provided by the HCLA, and that her suit was thus filed outside the three-year statute of repose.

December 2, 2016

Notice and HIPAA Form Also Required for Re-Filed HCLA Claim

by The Law Offices of John Day, P.C.

Tennessee Courts continue to make it clear that each time you re-file a previously dismissed Tennessee medical malpractice (now health care liability) claim, you must abide by the statutory requirements. In Cright v. Overly, No. E2015-01215-COA-R3-CV (Tenn. Ct. App. Oct. 17, 2016), the Court of Appeals addressed the need for a plaintiff who was re-filing a previously nonsuited complaint to attach a new HIPAA-compliant release to the second pre-suit notice letter, determining that her failure to do so meant the complaint should be dismissed.

Plaintiff sued multiple defendants related to the treatment and death of her husband. In August 2009, before filing the first suit, plaintiff sent pre-suit notices with a HIPAA-compliant medical authorization to each of the defendants. This action proceeded through discovery and eventually made it to trial, but three days into trial plaintiff moved for a voluntary dismissal.

After the dismissal, plaintiff sent pre-suit notices to the defendants again, but this time she did not include a HIPAA release. Instead, the letter stated: “Medical records of the entire UT Hospital admission at issue have been previously provided to you, as well as any other records you wished to obtain pursuant to an Agreed RAS Order entered in the [original suit].” When plaintiff filed her second complaint, defendants all filed motions to dismiss based on plaintiff’s failure to include a HIPAA-compliant release with her pre-suit notice pursuant to Tenn. Code Ann. § 29-26-121. Plaintiff’s attorney asserted that a HIPAA release “was not attached, because the parties had previously entered an agreed order that the RAS service and record ordering procedure was to be the exclusive means for obtaining the deceased’s medical records, to the exclusion of any medical authorizations previously provided.” The trial court, however, granted the motions to dismiss, and the Court of Appeals affirmed.

November 22, 2016

Ex Parte Communications With Treating Physicians – TN Statute Ruled Unconstitutional

by The Law Offices of John Day, P.C.

Judge Thomas Brothers of Nashville has declared Tenn. Code Ann. Section 29-26 -121(f)(1) and (2) unconstitutional. Memorandum Order – Judge Brothers

The code section allows defense lawyers in Tennessee health care liability actions virtually unfettered ex parte communications with the plaintiff’s non-party health care providers. The code section was adopted by the Tennessee General Assembly in an attempt to override two Tennessee Supreme Court decisions.

The first of those cases was Givens v. Mullikin, 75 S.W.3d 383 (Tenn. 20o2), which held that a covenant of confidentiality between patients and their treating physicians arises because of an implied understanding between patient and doctor and from a public policy concern that private medical information should be protected.

October 24, 2016

Nonsuit OK When Motion to Dismiss is Pending in Medical Malpractice Case

by The Law Offices of John Day, P.C.

In Hurley v. Pickens, No. E2015-02089-COA-R3-CV (Tenn. Ct. App. Sept. 29, 2016), the Court of Appeals once again held that a plaintiff in a medical malpractice case can take a voluntary nonsuit without prejudice while a motion to dismiss based on an insufficient certificate of good faith is pending.

This opinion was very similar to Clark v. Werther, No. M2014-00844-COA-R3-CV (Tenn. Ct. App. Sept. 27, 2016) and discussed in this Day on Torts post, which came out just two days prior to the instant matter. In Clark, though, plaintiff was pro se and had failed to attach a certificate of good faith to his complaint. Here, plaintiff was represented by counsel and had attached a certificate of good faith, but defendants alleged the certificate was deficient and filed motions to dismiss accordingly.

While the motions to dismiss were pending, plaintiff filed a corrected certificate of good faith, a motion for extension of time to file a corrected certificate of good faith, and a motion for and notice of voluntary dismissal without prejudice. At a hearing on all of the pending motions, and before any argument on the motions to dismiss, plaintiff “announced that he wanted to take a voluntary dismissal pursuant to Tenn. R. Civ. P. 41,” which the trial court allowed. Defendants appealed the dismissal without prejudice, and the Court of Appeals affirmed.

October 18, 2016

Nonsuit OK When Motion to Dismiss is Pending – Even in Medical Malpractice Cases

by The Law Offices of John Day, P.C.

In Clark v. Werther, No. M2014-00844-COA-R3-CV (Tenn. Ct. App. Sept. 27, 2016), the Tennessee Court of Appeals held that nothing about the Health Care Liability Act (HCLA) certificate of good faith requirement prohibited a plaintiff from taking a TRCP Rule 41 voluntary nonsuit while a motion to dismiss was pending.

Here, a pro se plaintiff filed a health care liability suit against fourteen healthcare providers. When filing his complaint, however, he failed to attach a certificate of good faith as required by Tenn. Code Ann. § 29-26-122. Several of the defendants filed motions to dismiss on this basis. In response, and before any hearing on the motions to dismiss, plaintiff filed a notice of voluntary nonsuit and proposed order. Some of the defendants “opposed [plaintiff’s] notice of nonsuit on the ground that his complaint should be dismissed with prejudice because of the missing certificate of good faith,” as that is the appropriate penalty under the statute. After a hearing, the trial court dismissed without prejudice the claims against the non-objecting defendants, but dismissed with prejudice the claims against the defendants who objected to the nonsuit.

On appeal, the Court noted that Tenn. R. Civ. P. 41.01 governs voluntary nonsuits and precludes a nonsuit in certain situations, including “in a class action case, in a shareholder derivative action, in a case in which a receiver has been appointed, or while an opposing party’s motion for summary judgment is pending,” or “when it would deprive the defendant of some vested right.” (citation omitted). Otherwise, a plaintiff’s ability to take a voluntary nonsuit is “free and unrestricted…before the jury retires.” (citation omitted).

September 21, 2016

Supervision of Mental Patient Issue That Requires Expert Testimony

by The Law Offices of John Day, P.C.

In Newman v. Guardian Healthcare Providers, Inc., No. M2015-01315-COA-R3-CV (Tenn. Ct. App. July 27, 2016), the Court of Appeals affirmed the dismissal with prejudice of a medical malpractice (now known as a “health care liability” or “HCLA”) claim because the plaintiff failed to file a certificate of good faith, and expert testimony was required in the case.

Plaintiff sued various companies that provided nursing and medical staff to a psychiatric facility. According to the complaint, plaintiff’s husband, who was a patient and resident at the facility, sustained life-ending injuries when he was attacked by another resident. Plaintiff alleged that defendants were negligence because her husband, who died, was supposed to have one-to-one care and supposed to have a wheelchair, yet had neither. She also alleged that the attacker was supposed to have one-to-one care and was known to be violent, and that defendants failed to take measures to protect the patients from the attacker.

When plaintiff filed her complaint, she did not give pre-suit notice or attach a certificate of good faith to her complaint, as required by the HCLA. At the time of this appeal, it was uncontested that this claim fell under the HCLA.

September 8, 2016

Death of Lawyer’s Infant Son is “Extraordinary Cause” under HCLA

by The Law Offices of John Day, P.C.

The Court of Appeals recently examined whether the sickness and death of a lawyer’s child constituted extraordinary cause under the HCLA, finding that it did in fact excuse noncompliance with the statute.

In Kirby v. Sumner Regional Medical Center, No. M2015-01181-COA-R3-CV (Tenn. Ct. App. July 12, 2016), plaintiff was treated at the defendant hospital in June 2013, and plaintiff alleged that the treatment she received fell short of the required standard of care. Well before the one-year statute of limitations, on January 31, 2014, plaintiff’s counsel sent a fax to defendant regarding the claim. No other correspondence was sent, but on the day the one-year statute of limitations was to expire, plaintiff filed suit. Plaintiff attached a certificate of good faith to her complaint, but she admittedly had not served the statutorily required pre-suit notice with attached HIPAA release.

Defendant moved to dismiss the case based on the lack of pre-suit notice. In response, plaintiff’s counsel pointed out that his son was born on March 6, 2014, and subsequently died on June 20, 2014, just days before the statute of limitations was set to expire on this claim. Counsel stated that “[f]or the few months my son lived, there were frequent periodic indications that each day could be his last, including a few serious hospitalizations.” In his memorandum opposing dismissal, plaintiff’s counsel asserted:

August 16, 2016

Liability of Public Hospital Where Allegations Related to Non-Employee Doctors

by The Law Offices of John Day, P.C.

In Gilreath v. Chattanooga-Hamilton County Hosp. Authority, No. E2015-02058-COA-R3-CV (Tenn. Ct. App. June 15, 2016), the Court of Appeals affirmed summary judgment for defendant hospital in a Tennessee health care liability (formerly called “medical malpractice” case.

Plaintiff went to defendant hospital complaining of certain symptoms and allegedly told the medical providers there that her chiropractor had diagnosed her with cauda equina syndrome. Plaintiff was treated at the hospital by two doctors who “failed to recognize her symptoms as suggestive of cauda equina syndrome.” She was discharged with a diagnosis of possible impacted kidney stone, but was later correctly diagnosed at a different hospital after her condition worsened significantly. In this action, plaintiff sued defendant hospital based on the alleged inadequate treatment and diagnosis she received.

Defendant hospital moved for summary judgment on the basis that plaintiff’s expert could not support the claim against it, and that the hospital was not vicariously liable for the alleged negligence of the two physicians because the hospital was a government entity that fell under the GTLA and the physicians were not employees of the hospital pursuant to the terms of the Tennessee’s Government Tort Liability Act (“GTLA”). The trial court granted summary judgment, and the Court of Appeals affirmed.

In analyzing this case, the Court first pointed out that plaintiff had attempted to couch her claims as a contract claim and an ordinary negligence claim, but in reality the entire complaint sounded in health care liability. The Court found that “the complaint and responsive pleadings allege specific acts of negligence, namely the failure to order an MRI or other diagnostic test and a neurological or neurosurgical consult…These allegations sound in medical malpractice[.]”

August 3, 2016

Ex Parte Interviews Not Preempted by HIPAA

by The Law Offices of John Day, P.C.

In Caldwell v. Baptist Memorial Hosp., No. W2015-01076-COA-R10-CV (Tenn. Ct. App. June 3, 2016), the Court of Appeals held that the Tennessee Health Care Liability Act’s allowance for ex parte interviews between defendant and plaintiff’s health care providers was not preempted by HIPAA and was permissible under the federal law.

In this case, plaintiff filed an HCLA claim against multiple defendants, and one defendant “filed a petition for a qualified protective order (QPO) pursuant to Tenn. Code Ann. § 29-26-121(f) to allow ‘the defendant and his attorneys the right to obtain protected health information during interviews, outside the presence of claimant or claimant’s counsel, with the patient’s treating healthcare providers.’” While plaintiff acknowledged that defendant had complied with the statutory requirements under Tennessee law, she asserted that HIPAA preempted this Tennessee law and that the interviews should thus not be allowed. The trial court denied the defendant’s request for QPOs, and the defendant appealed.

On the state level, Tenn. Code Ann. § 29-26-121(f) “allows for the disclosure of protected health care information in ex parte interviews conducted during judicial proceedings,” provided certain conditions are met. The statute requires that the petition identify the healthcare provider to be interviewed; that the plaintiff can object based on the provider not possessing relevant information; that the QPO “shall expressly limit the dissemination of any protected health information to the litigation pending before the court and require the defendant or defendants who conducted the interviews to return…or destroy any protected health information obtained…at the end of the litigation;” and that the QPO must state that participation in the interview is voluntary.