ER doctor not qualified on standard of care in correctional facility.

Where plaintiff’s HCLA claims were based upon medical care he received while incarcerated, and his only medical expert had never practiced or studied medical care for incarcerated persons, summary judgment for defendant was affirmed.

In Higgins v. CoreCivic, Inc., No. E2022-01101-COA-R3-CV (Tenn. Ct. App. Oct. 23, 2023), plaintiff fell from the top bunk while he was incarcerated and suffered severe injuries. Plaintiff alleged that he should have been given seizure medication and a bottom bunk based on his history of seizures. Plaintiff also asserted that he was injured while being transported from the hospital back to the correctional facility. Plaintiff’s injuries all occurred in April 2017.

Plaintiff brought claims against three defendants in May 2018, including CoreCivic who operated the facility under a contract with Hamilton County, CCS who provided medical treatment to inmates through a contract with CoreCivic, and Hamilton County who ultimately owned the facility. Defendants filed for summary judgment, which the trial court granted on various grounds, all of which were affirmed on appeal.

The first issue on appeal was whether the trial court had exercised independent judgment in issuing its ruling. The Court noted that the trial court attached a transcript of its oral ruling to its final judgment, and that both showed that it carefully considered all the issues at play in this case, finding that “[n]othing in the record suggests that the Trial Court’s decision was not of its own making.”

Next, the Court of Appeals considered whether the trial court erred in granting summary judgment on Plaintiff’s HCLA claim against CCS based on a lack of expert proof. Plaintiff alleged that his injury was caused by the failure to provide him with seizure medication and a bottom bunk based on his history of seizures. To support his claim, plaintiff offered the testimony of an emergency room doctor who had never practiced or studied medicine in a correctional facility. While the expert testified that the standard would be the same, the Court of Appeals disagreed, explaining:

In the case at bar, Plaintiff’s expert proof suffers from a major flaw—it fails to specifically contend with medical care in a correctional setting. This is significant because Plaintiff was injured in prison and the alleged negligent medical care was delivered in a correctional setting. Dr. Perlaky, the emergency room physician testifying as an expert for Plaintiff, essentially said when asked about the standard of care for nurses in a correctional setting that medical care is medical care regardless of the setting. However, that is too generalized and ignores the particular challenges of the prison environment. The conditions under which medical care is delivered in prison are quite different from those in a hospital. In prison, there are ever-present and justifiable concerns about security. There are barriers to free movement. There may well be a relative lack of equipment or drugs, or at least equipment or drugs are not as readily accessible as they would be at a hospital. While Dr. Perlaky reviewed certain regulations, he has not completed training on health care in a correctional setting; he has never written or taught on medicine in a correctional setting; and he has not served on staff at a prison. An expert witness in a health care liability case need not have direct or firsthand experience in the defendant’s community. Nevertheless, it is clear from the record that Dr. Perlaky’s expertise is not in correctional medicine, and the specific issues of this case implicate the unique considerations of health care in a correctional setting. Plaintiff’s allegations implicate screening; the assignment of a bed; the provision of drugs; and reaction time to an incident. Dr. Perlaky could not address these special correctional considerations because he lacks experience or background with medicine in a correctional setting, “the community in which the defendant practices. . . .”

(internal citations omitted).

Plaintiff argued that expert proof was not actually needed here, as his allegations fell within the common knowledge exception. The Court ruled, however, that this case presented issues requiring various expertise, and that it was “not at all obvious that CCS was negligent in its care of Plaintiff, especially in view of the unique conditions attendant to correctional care.”

Because expert proof was required and plaintiff’s expert was not qualified to testify as to the appropriate standard of care, summary judgment on the HCLA claims against CCS was affirmed.

Finally, the Court considered whether the trial court erred by dismissing the non-HCLA claims against the other two defendants in this case. Plaintiff asserted that all the claims he filed should benefit from the 120-day statute of limitations extension found in the HCLA. The Court ruled, though, that the HCLA could not apply to the other two defendants because they were not health care providers, as “one handles prison administration and security while the other is a county.” The Court explained that “under the [HCLA], only health care providers are subject to a health care liability action.” Because the other two defendants were not health care providers and the suit was filed more than a year after the cause of action accrued, summary judgment based on the statute of limitations was affirmed.

The judgment of the trial court in favor of defendants was therefore affirmed. This case is a reminder to carefully consider any experts needed to support your HCLA claims, as a general medical expert may not be sufficient depending on the facts of your case.

This opinion was released four months after oral arguments in this case.

Note:  Chapter 56, Section 10 of Day on Torts: Leading Cases in Tennessee Tort Law has been updated to include this decision.

Day on Torts: Leading Cases in Tennessee Tort Law contains summaries of leading cases on over 500 topics and citations to more than 2500 additional cases.  The 550,000+ word book  (and three others, Tennessee Law of Civil TrialTennessee Wrongful Death Law,  Compendium of Tennessee Tort Reform Cases) is available by subscription at and is continually updated as new decisions and statutes impact Tennessee law.  Click on the link to see the book’s Table of Contents.

BirdDog Law also provides Tennessee lawyers with free access to user-friendly versions of the Tennessee rules of evidence and procedure and lots of other free resources, including a database for each of Tennessee’s 95 counties that will help find out information about court clerks, judges, filing fees, local rules, local forms, the presence (or absence) of electronic filing, case filings, and tort trial statistics.

Contact Information