Medical Negligence

November 24, 2020

Expert affidavit created issues of fact to withstand summary judgment in HCLA case

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.

November 19, 2020

Non-compliant HIPAA Authorization Leads to Dismissal of Tennessee Malpractice Case

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

Where a Tennessee HCLA plaintiff sent a HIPAA authorization that failed to allow the defendants to obtain records from each other, the trial court’s finding that plaintiff did not comply with the statutory requirements and that the suit was thus time-barred was affirmed.

In Dial v. Klemis, No. W2019-02115-COA-R3-CV (Tenn. Ct. App. Nov. 2, 2020), plaintiff was the daughter of a patient who died after a cardiac stent procedure. The procedure was performed by defendant Dr. Klemis, who was an employee of defendant Stern Cardiovascular Foundation, and the procedure occurred at defendant Methodist Hospital, with defendant Methodist employees assisting.

Before filing this healthcare liability suit, plaintiff sent pre-suit notice as required by the HCLA, including a HIPAA authorization pursuant to Tenn. Code Ann. § 29-26-121(a)(2)(E). Plaintiff admitted, though, that the HIPAA forms she sent did “not allow each of the Defendants to obtain complete medical records from each other provider being sent notice,” which is a requirement of the HCLA. Defendants filed motions to dismiss asserting that because plaintiff’s HIPAA authorizations were non-compliant, she was not entitled to the 120-day extension of the statute of limitations granted by the HCLA, and that her suit which was filed more than one year after the allegedly negligent procedure was therefore time-barred. The trial court agreed, dismissing the case, and the Court of Appeals affirmed.

October 26, 2020

Sanctions based on HCLA Certificate of Good Faith Denied

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

Where defendant pharmacists alleged comparative fault against a doctor and filed a certificate of good faith that complied with all the necessary requirements of the statute, the trial court’s decision to deny sanctions based on the allegation that the “certificate of good faith was supported by the written statement of an incompetent expert witness” was affirmed, even though the doctor’s motion for summary judgment had been successful. The Court of Appeals explained that “nothing in the express language of section 29-26-122 requires that a party asserting fault against another guarantee that his or her expert is competent or that the claim will ultimately prevail.”

In Smith v. Outen, No. W2019-01226-COA-R3-CV (Tenn. Ct. App. Oct. 9, 2020), plaintiff filed an HCLA suit against defendant pharmacists for dispensing the wrong medicine to plaintiff. In her complaint, plaintiff stated that when her doctor realized she had been given the wrong medicine by the pharmacists, he ordered her to stop the medicine immediately. Defendant pharmacists filed an answer alleging comparative fault against the doctor, asserting that he should have had plaintiff taper off the medication rather than stop it immediately. The pharmacists’ attorney filed a certificate of good faith supporting their comparative fault allegation, as required by the HCLA, and plaintiff amended her complaint to add the doctor as a defendant.

October 23, 2020

Pharmacist not qualified to give causation testimony in medically complex HCLA case.

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

Where plaintiff’s pharmacist expert was deemed incompetent to offer necessary causation testimony against the pharmacy defendants in an HCLA suit based on his inability to rule out possible causes of death in a complex medical case, summary judgment for those defendants was affirmed.

In Kidd v. Dickerson, No. M2018-01133-COA-R3-CV (Tenn. Ct. App. Oct. 5, 2020), plaintiff was the daughter of a patient who died after a stroke. The patient had multiple health issues at the end of her life, and the proper diagnosis and medication prescribed for blood clots was in contention in this HCLA suit.

On September 30, 2014, the patient, who was 82 years old, went to Family Health Group (“FHG”) with pain and swelling. She was seen by Dr. Ball and diagnosed with a blood clot. She returned on October 7 and was seen by Dr. Farmer, who also diagnosed a blood clot and prescribed a blood-thinning medicine called Pradaxa, which the patient had filled that day by the pharmacy defendants. The patient returned to FHG on October 13 for a follow-up appointment and saw Dr. Ball again, then returned on October 20 and was seen by a nurse practitioner, who found that the patient was “ill appearing,” that she had an “irregularly irregular” cardiovascular rhythm, and that she should be referred to a cardiologist that week.

September 25, 2020

Nursing home arbitration agreement signed by patient’s daughter not enforceable.

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

Where a daughter signed admission paperwork for her mother upon the mother’s admission to a nursing home, but the mother was mentally competent and did not give the daughter authority to sign the paperwork, an arbitration agreement included in the paperwork was unenforceable.

In Manley v. Humboldt Nursing Home, Inc., No. W2019-00131-COA-R3-CV (Tenn. Ct. App. Sept. 18, 2020), plaintiff filed a wrongful death action against defendant nursing home after her mother passed away. Defendant filed a motion to compel arbitration based on an arbitration agreement included in the admission paperwork. It was undisputed that the admission paperwork was signed by the daughter, even though the mother was “competent when she was admitted” and the daughter “did not possess a power of attorney to act on behalf of her mother.”

September 21, 2020

Unconscionable fee-splitting provision in arbitration agreement could be severed from agreement as a whole.

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

Although a fee-splitting provision in an arbitration agreement was unconscionable based on the plaintiff’s financial situation, the Court of Appeals ruled that the fee-splitting provision was severable and that defendant’s motion to compel arbitration should have been granted.

In Stokes v. Allenbrooke Nursing and Rehabilitation Center LLC, No. W2019-01983-COA-R3-CV (Tenn. Ct. App. Sept. 15, 2020), plaintiff filed an HCLA complaint against defendant nursing home alleging that he had contracted sepsis due to the negligence of one of defendant’s nurses, and that he had suffered severe permanent injuries. Defendant filed a motion to compel arbitration, attaching a three-page arbitration agreement that plaintiff had signed on two occasions. The agreement contained a provision stating that the parties would split the arbitration expenses equally. Plaintiff opposed the motion on a “cost-based unconscionability defense,” arguing that plaintiff would never be able to afford paying half of the arbitration costs. Defendant responded that this argument was moot, as it had offered to cover the entire cost of the arbitration. After a hearing, the trial court refused to compel arbitration, finding that the agreement was unconscionable. This appeal followed.

July 2, 2020

Damage Award Affirmed in Brachial Plexus Injury Case

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

The Seventh Circuit Court of Appeals has affirmed a $8.3 million damage award in the brachial plexus injury case brought under the Federal Tort Claims Act.

The damage award was broken down as follows:

$64,967.77 for past medical expenses
$80,000 for future medical expenses
$2,653,000 in lost earnings
$1,500,000 for the permanent disfigurement of his right arm
$2,000,000 for the deprivation of a normal life and
$2,000,000 for pain, suﬀering, and emotional distress.

June 30, 2020

Second HIPAA authorization sent after statute of limitations had run could not cure previous defects.

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

Where plaintiff’s initial HCLA pre-suit notice included HIPAA authorizations that were left blank, and plaintiff’s supplemental authorization that attempted to correct the problem was sent after the one-year statute of limitations on his claim had run, dismissal was affirmed.

In Carrasco v. North Surgery Center, LP, No. W2019-00558-COA-R3-CV (Tenn. Ct. App. May 28, 2020), plaintiff filed a health care liability suit against defendants based on “injuries sustained by a guidewire left in the plaintiff’s neck following a procedure.” Prior to filing his suit, plaintiff sent defendants a pre-suit notice letter on August 31 and September 1, 2016, that was accompanied by the HIPAA authorizations required by Tenn. Code Ann. § 29-26-121(a)(2)(E). The authorizations, however, contained blanks that were not filled in, and “plaintiff concede[d] that the authorizations did not substantially comply with the requirements of the [HCLA].” Later, on November 2, 2016, plaintiff sent new authorizations which purportedly corrected the issues with the first set of authorizations. In paragraph three of the new authorizations, however, the information to be used or disclosed named “Narinder Sanwal, Deceased,” instead of plaintiff.

Defendants filed a motion to dismiss based on the noncompliant HIPAA authorizations, which the trial court granted, and the Court of Appeals affirmed.

June 16, 2020

Notice letter could not cure deficiencies in HIPAA authorization.

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

Where plaintiff failed to include one of the core elements in the HIPAA authorizations sent with her HCLA pre-suit notice, she could not rely on her notice letter to “cure any deficiency on the authorization document.”

In Hancock v. BJR Enterprises, LLC, No. E2019-01158-COA-R3-CV (Tenn. Ct. App. May 14, 2020), plaintiff sued defendants as power of attorney for patient, who allegedly suffered skin problems, pressure sores, and severe sepsis after his treatment by defendants. Plaintiff sent a timely pre-suit notice “packet” to defendants, which included a cover letter directed to each provider, an attached list of the names and addresses of all providers being sent notice, and a HIPAA authorization.

June 12, 2020

No magic words required to make HIPAA authorization compliant

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

Where a HIPAA authorization included with HCLA pre-suit notice “permits a defendant to obtain medical records in actual fact but simply does not include the word ‘obtain,’ it is still compliant.”

In Combs v. Milligan, No. E2019-00485-COA-R3-CV (Tenn. Ct. App. May 1, 2020), plaintiffs filed a health care liability suit against several defendants based on a surgically inserted port that became infected and caused permanent injuries. Before filing their complaint, plaintiffs sent the defendants pre-suit notice and included a HIPAA authorization as required by the HCLA. The authorization was accompanied by a letter that stated: “Attached please find a list of providers to whom a substantially similar notice is being sent…[Plaintiff] has executed a HIPAA-compliant medical authorization authorizing you to obtain complete medical records from [same list of providers].”