Day on Torts
Where an HCLA plaintiff filed unsigned HIPAA authorizations with her complaint, but at least one defendant admitted that the HIPAA authorization it received was actually signed, dismissal was reversed.
In Buckner v. Complete Wellness Chiropractic Center, No. E2024-00698-COA-R3-CV (Tenn. Ct. App. May 15, 2025), the plaintiff suffered long-term complications after several practitioners failed to diagnose the cause of her back pain properly. She filed this healthcare liability suit against twenty defendants and asserted in her complaint that she had sent proper pre-suit notice under the HCLA. The notices attached to her complaint, however, included HIPAA authorizations that were not signed.
Based on these unsigned authorizations, the defendants moved to dismiss the complaint. The plaintiff did not provide additional proof, but she insisted that she complied with the statute. The defendants argued that the error here was substantive because the plaintiff could not prove compliance, and dismissal was therefore appropriate. During oral arguments, counsel for one of the defendants was asked by the trial court whether the HIPAA authorization his client received was signed, to which he admitted that it was. The trial court nonetheless granted the motion to dismiss, but that ruling was reversed on appeal.
Tenn. Code Ann. § 29-26-121(a)(2) requires an HCLA plaintiff to send pre-suit notice to potential defendants that includes a HIPAA-compliant medical authorization. This authorization must contain six core elements to be HIPAA compliant, including the signature of the individual. (internal citation omitted). Because the authorizations included with the plaintiff’s complaint in this case were not signed, they were not sufficient under the HCLA. The plaintiff insisted, however, that she had in fact complied with the HCLA, despite her lack of proof.
The defendants pointed to a prior case in which the plaintiff asserted that he had complied with the HCLA, but the HIPAA authorizations he filed were unsigned. (citing Travis v. Cookeville Reg’l Med. Ctr., No. M2015-01989-COA-R3-CV, 2016 WL 5266554 (Tenn. Ct. App. Sept. 21, 2016)). The plaintiff in that case had not retained signed copies of the authorizations, and dismissal was affirmed. The Court of Appeals differentiated this case, noting that counsel for one defendant admitted that his client received a signed authorization. The Court reasoned:
As in Travis, Patient here maintains that she provided signed authorizations with the pre-suit notice; different than the case in Travis, however, is the fact that counsel for Dr. Martin acknowledged the receipt of a signed copy of the medical authorization. Because Dr. Martin’s counsel admitted at the hearing that the physician received a signed medical authorization, he acknowledged that Dr. Martin was not prejudiced by Patient’s failure to attach the signed medical authorization to the complaint. We consider Dr. Martin’s counsel’s admission to the trial court’s direct question at the hearing to be a “prejudicial concession,” rather than merely a statement of counsel that would not constitute evidence[.] Given this admission by counsel for Dr. Martin, we reverse the trial court’s dismissal and remand this action to the trial court to hold an evidentiary hearing to consider whether other Practitioners received the signed medical authorizations with the pre-suit notice. If other Practitioners received proper authorizations, “[t]he purpose of the statute and the essence of the thing to be accomplished—pre-suit notice to the defendants—has been satisfied here.” When there is no prejudice and the interests of justice are promoted, “failure to conform to technical requirements is not fatal.” “[I]t is well settled that Tennessee law strongly favors the resolution of all disputes on their merits.” We should strive to resolve healthcare liability disputes as we do all other legal disputes—on their merits; acting on procedural technicalities is contrary to the purposes and intent of the statutory provisions.
(internal citations omitted).
The Court of Appeals therefore reversed dismissal and remanded the case for further proceedings.
Judge Swiney wrote a concurring opinion, specifically noting that the HCLA “statute clearly provides that trial courts may require additional evidence of compliance to determine if the provisions of Section 121 have been satisfied,” and that the statute does not limit this provision to additional evidence only from plaintiffs. Judge Swiney wrote that as long as the defendants received signed authorizations, the purpose of the statute had been served and the defendants were not prejudiced. He stated that “[t]o hold otherwise results in dismissal of a plaintiff’s complaint based on a technical omission that has no bearing on the above-mentioned purposes of the statute, namely, to ensure potential defendants can access a plaintiff’s medical records and engage in settlement negotiations prior to litigation.” He further stated that the “current framework too often produces unjust outcomes that are unrelated either to the merits of the case or the goals of the health care liability statutory scheme.”
Judge Frierson wrote a dissenting opinion, stating that the plaintiff here failed to substantially comply with the statutory requirements. He wrote that the plaintiff “bore the sole burden to demonstrate her compliance with” the HCLA, and that she failed to do so.
This is an interesting HCLA opinion, as it seems to somewhat go against the grain of former cases analyzing HIPAA authorizations. Both the majority and concurring opinion showed a desire to decide the case on the merits, rather than on a technicality, which is a common issue for HCLA litigants who fail to strictly follow the pre-suit notice requirements of the statute.
This opinion was released four months after oral arguments.