Articles Posted in Medical Negligence

Where a trial judge bifurcated an HCLA trial, addressing only the standard of care and whether defendants deviated from said standard in the first phase, and analyzing causation in the second phase if needed, the Court of Appeals affirmed the decision to bifurcate.

In Jernigan v. Paasche, No. M2020-00673-COA-R3-CV (Tenn. Ct. App. June 21, 2021), plaintiff filed a health care liability and wrongful death suit after the death of his wife. The wife had presented at an emergency room with severe abdominal pain and nausea and been examined by defendant Dr. Paasche. Dr. Paashe ordered a CT scan, which “revealed that Decedent suffered from a large paraesophageal hernia.” Dr. Paashe discharged the wife with a prescription and advice to follow up with her doctor within a few days.

The following day, the wife went to a different emergency room with severe abdominal pains and vomiting. She was seen by defendant Dr. Wojcik, who gave her fluids and medication and discharged her with instructions to follow up with her doctor within the week.  When the wife went to the emergency room again, another CT scan was performed and showed that she “had suffered a perforation with portions of her stomach having herniated into her chest.” The wife was taken into surgery, but she died in the recovery room after the procedure. Plaintiff subsequently filed this suit, alleging that “both Dr. Paasche and Dr. Wojcik were negligent for failing to properly diagnose Decedent’s condition, failing to obtain a surgical consult following their respective initial examinations of Decedent, and discharging her in an unstable condition.”

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Where plaintiff nonsuits a complaint that contains medical malpractice (now known as  health care liability action or “HCLA”)  claims then later re-files a different complaint containing HCLA claims against the same defendant, she must give a new, separate pre-suit notice for the re-filed complaint.

In Byington v. Reaves, No. E2020-01211-COA-R3-CV (Tenn. Ct. App. April 20, 2021), plaintiff was treated by defendant for cancer on her nose. The treatment recommended by defendant eventually led to “removal of [plaintiff’s] right nostril, leaving her noticeably disfigured.” Plaintiff sent pre-suit notice of her HCLA claims on April 23, 2019 to defendant doctor and clinic, then filed a complaint the next day on April 24, 2019. This first complaint alleged that defendants fraudulently induced plaintiff into going through with the surgery, that there was a lack of informed consent due to the fraudulent inducement, that defendant doctor “failed to adhere to the standard of care,” and that defendant doctor did not tell plaintiff about alternative treatment options.

Defendants filed a motion to dismiss, asserting that plaintiff failed to comply with the HCLA by providing them pre-suit notice less than 60 days prior to filing her complaint, and that plaintiff failed to file a certificate of good faith. Plaintiff then voluntarily dismissed this first complaint.

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Where an HCLA plaintiff decides to pursue claims only against the principal under a vicarious liability theory and the plaintiff follows the statutory timing outlined in the HCLA, the claim will not be barred due to the previous common law holding that a vicarious liability claim against a principal is barred “when the plaintiff’s claim against the agent is procedurally barred by operation of law before the plaintiff asserts a vicarious liability claim against the principal.” In Gardner v. Saint Thomas Midtown Hospital, No. M2019-02237-COA-R3-CV (Tenn. Ct. App. April 1, 2021), plaintiff filed an HCLA claim against defendant hospital based on allegedly negligent care by an anesthesiologist while she was having surgery at defendant hospital. In her complaint, plaintiff stated that defendant was “careless and negligent” while “acting through its employees and/or agents,” and that defendant was “liable for any negligent acts and/or omissions of any actual or apparent agents and/or employees[.]” In defendant’s answer, it “specifically denie[d] that the physicians whose care is alleged in the Complaint were agents or employees of defendant.”

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Where plaintiff’s medical authorizations lacked required elements and plaintiff failed to show that defendants already had all relevant records, dismissal of plaintiff’s HCLA case was affirmed.

In Woods v. Arthur, No. W2019-01936-COA-R3-CV (Tenn. Ct. App. Mar. 23, 2021), plaintiff filed an HCLA claim related to two spinal surgeries, the first performed by Dr. Arthur and Dr. Lingo, who were employees of the same clinic, and the second performed by Dr. Sorenson. According to plaintiff, the wrong size screw was used in the first surgery, which caused injuries, and he was further injured by the second corrective surgery.

Before filing suit, plaintiff sent pre-suit notice to Dr. Arthur, Dr. Sorenson, and Methodist Hospital, which is where the first surgery was performed. Notice was also sent to Dr. Lingo, but he did not make an appearance in the case and was not a party to this appeal. After receiving the notices, defendant doctors “replied…and informed Plaintiff they were investigating the matter.” During a phone call, counsel for the doctors “stated that he had the Operative Reports for both” surgeries. Despite communication between the parties, no settlement was reached, and plaintiff filed his complaint. Defendant doctors and defendant hospital filed motions to dismiss, alleging that the medical authorizations sent with plaintiff’s pre-suit notice were not HIPAA compliant, and that plaintiff was therefore not entitled to the 120-day extension of the statute of limitations under Tenn. Code Ann. § 29-26-121(c), making his suit untimely. The trial court agreed, granting the motions to dismiss, and the Court of Appeals affirmed.

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Where plaintiff alleged that defendant doctor committed intentional misrepresentation and medical battery by stating that he was board-certified in plastic surgery when he was not, the Tennessee Court of Appeals affirmed the ruling that these claims were not governed by Tennessee’s HCLA. In Cooper v. Mandy, No. M2019-01748-COA-R9-CV (Tenn. Ct. App. Nov. 17, 2020), plaintiff saw advertisements for NuBody and went to their office in Brentwood for a consultation regarding surgical breast reduction. Plaintiff met with Ms. Norris, a NuBody representative, and defendant Dr. Mandy, at which time they told plaintiff that Dr. Mandy was board-certified in plastic surgery. Plaintiff alleged that she entered into an agreement to have the surgery in reliance on these statements, but that the subsequent surgery was not properly performed, leaving her “disfigured and with grotesque and painful bacterial infections.” Plaintiff later learned that Dr. Mandy was not board-certified in plastic surgery, and was actually not board-certified in any field at the time of her treatment.

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Those seeking to learn the current state of the law on whether and when one can avoid the use of an expert witness on the negligence issue in Tennessee medical malpractice litigation may wish to read my recent article, “Flies, Buttermilk and Malpractice.”  The article appeared in the Jan./Feb. issue of Tennessee Bar Journal.

HCLA statute of limitations for claim against doctor and hospital began to run on same date.

Where plaintiff knew on October 31, 2017 that her surgeon had wrongly positioned screws during a previous spine surgery, the statute of limitations for her Tennessee HCLA claims against the hospital defendants who allegedly employed the surgeon began to run on that day.

In Karr v. Saint Thomas Midtown Hospital, No. M2020-00029-COA-R3-CV (Tenn. Ct. App. Feb. 9, 2021), plaintiff had spine surgery in July 2016 performed by Dr. McCord at defendant hospital. Plaintiff continued seeing Dr. McCord until October 31, 2017, when she discovered that he had “malpositioned screws during the surgery.” Plaintiff did not return to Dr. McCord after this date, and instead began treating with Dr. Cheng. Dr. Cheng performed surgery on plaintiff on May 14, 2018, at which time he “discovered…that both the number and the extent of the malpositioned screws was greater than previously known,” and he told plaintiff that the surgery performed by Dr. McCord did not properly address the diagnosis she had been given.

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Where an HCLA plaintiff attempted to sue defendant medical center but sent pre-suit notice to the center’s administrator addressed only to the administrator and not referencing the center, dismissal based on a lack of pre-suit notice was affirmed.

In Webb v. Trevecca Center for Rehabilitation and Healing, LLC,  No. M2019-01300-COA-R3-CV (Tenn. Ct. App. Nov. 10, 2020), plaintiff filed this health care liability suit against defendant medical center and four individual employees of the center. Prior to filing suit, she sent five pre-suit notices to the center’s business address. Four of the notices were addressed to the four individual defendants and the fifth was addressed to Pamela Bishop, who was the medical center’s administrator. In neither the address, the address block on the letter, nor the greeting was Ms. Bishop’s role as administrator addressed. Instead, the letter was simply written to Pamela Bishop.

Plaintiff voluntarily dismissed the four individual defendants, and then defendant medical center moved to dismiss based on plaintiff’s failure to give proper pre-suit notice. Defendant asserted that the notice addressed to Ms. Bishop did not fulfill the statutory requirements, and the trial court agreed. On appeal, dismissal was affirmed.

Where an HCLA plaintiff presented expert testimony that defendant doctor deviated from the standard of care for a patient in respiratory distress by “failing to provide necessary treatment before ending his shift,” summary judgment for defendant was reversed because genuine issues of material fact existed.

In Davis v. Ellis, No. W2019-01367-COA-R3-CV (Tenn. Ct. App. Nov. 5, 2020), plaintiff’s wife was admitted to the emergency room and diagnosed with pneumonia. The following day at 4:00 pm, she was examined by defendant doctor, who was the on-call intensivist. Defendant noted that the patient was awake and alert but that her oxygen saturation level was 93% and that her “respiratory condition had progressively worsened over the past 24 hours.” Defendant “did not order intubation at that time but referred [the patient] to the ICU for observation.” Defendant’s shift ended two hours later.

By 7:30 pm, the patient’s oxygen saturation level had dropped to 82%, and the intensivist who was on call ordered that she be put on non-invasive, positive-pressure face mask ventilation. Around 10:00 pm, her oxygen levels began falling again and were down to 74% by 11:00 pm. The emergency room doctor then tried to intubate her but eventually called anesthesiology for assistance. The patient was finally intubated, but she died approximately six hours later.

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