Fall Off Examination Table Within Health Care Liability Act

Plaintiff’s allegation that the examination table provided during a doctor’s appointment was unsafe fell under the Health Care Liability Act (HCLA) and was thus subject to dismissal due to plaintiff’s failure to provide pre-suit notice.

In Johnson v. Knoxville HMA Cardiology PPM, LLC, No. E2019-00818-COA-R3-CV (Tenn. Ct. App. Mar. 24, 2020), plaintiff had suffered from dizziness and fatigue, and he had a pacemaker implanted. In a later visit “for reprogramming of his pacemaker and other issues,” plaintiff fell off the examination table and hit the wall at defendant’s office “due to a fainting spell, resulting in injuries to [his] neck.”

Plaintiff filed suit alleging negligence, and his allegations were couched in premises liability language. Plaintiff asserted that defendants were negligent by failing to provide an examination table with railing and/or by failing to have padding. Plaintiff argued that “because Defendants knew that he suffered from fatigue and dizziness, they should have been aware of the risk associated with leaving him unattended on the examination table.”

Plaintiff undisputedly did not send pre-suit notice to defendants, and defendants filed a motion to dismiss on this basis, asserting that this was a health care liability claim. The trial court agreed that the HCLA applied and dismissed the suit with prejudice, which the Court of Appeals affirmed but modified to a dismissal without prejudice.

The sole issue in this case was whether the allegations fell within the parameters of the HCLA. Plaintiff argued that this was not an HCLA case because “he did not allege in his complaint that he was receiving medical services at the time of his fall,” but the Court disagreed. The Court pointed out that the “statutory definition of ‘health care liability action’ is conclusive, and most civil claims arising in the medical setting will fall under the ‘wide net’ of the definition.” (internal citation omitted).

In dismissing this case, the trial court compared the facts presented here to those from Osunde v. Delta Medical Center, 505 S.W.3d 875 (Tenn. Ct. App. 2016), and the Court of Appeals agreed that the comparison was relevant. In Osunde, the plaintiff alleged that an x-ray tech provided a faulty stool for him to step down onto and argued that his claim sounded in ordinary negligence rather than health care liability. The Court, though, ruled that “the provision of the stool in connection with the x-ray qualifie[d] as a ‘health care service’ because such services include ‘staffing, custodial or basic care, positioning, hydration and similar patient services.’” (quoting Osunde).

After reviewing Osunde, the Court of Appeals stated that “the provision of the stool…is comparable to the provision of an examination table in the instant action.” The Court reasoned:

We conclude that [plaintiff’s] allegations are related to the provision of, or failure to provide, health care services as defined by Tennessee Code Annotated § 29-26-101(a)(1). The provision of an examination table for an appointment with a doctor is a ‘health care service’ as defined by Tennessee Code Annotated § 29-26-101(b) because it falls under ‘custodial or basic care, positioning…and similar patient services.’ Although [plaintiff] did not specifically allege that he was at Defendants’ office to receive medical services at the time of his fall, we agree with the trial court that this is the only reasonable inference to make from the complaint. Despite [plaintiff’s] attempt to base liability on a premises liability theory, if a claim meets the definition, it is a health care liability action regardless of any other claims, causes of action, or theories of liability alleged in the complaint.

(internal citations and quotations omitted). After quickly rejecting plaintiff’s theory that the medical appointment had ended by the time he fell and that the HCLA did not apply, the Court affirmed dismissal based on the failure to provide pre-suit notice, but modified it to a dismissal without prejudice in accordance with the statute.  (That does not mean the case can be re-filed.  It cannot because the statute of limitations has expired.)

The HCLA is a broad statute catching almost any case that arises in the medical context. If you have a case involving the delivery of medical care in Tennessee, it is safest to assume that the HCLA applies unless there is an appellate decision on point to the contrary and to act accordingly.

NOTE: this opinion was released about two months after oral argument.

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