No certificate of good faith required for HCLA case that falls under common knowledge exception.

Where plaintiff alleged that the nursing facility she lived in gave her a defective shower chair, and the broken wheel lock and torn netting on the chair caused her to fall and be injured, no certificate of good faith was required due to the common knowledge exception to Tennessee’s health care liability (historically referred to as “medical malpractice”) law.

In Mears v. Nashville Center for Rehabilitation and Healing, LLC, No. M2022-00490-COA-R3-CV (Tenn. Ct. App. Mar. 29, 2023), plaintiff was a resident at defendant skilled nursing facility. Defendant’s policy required residents to use a shower chair when showering, and plaintiff was provided such a shower chair. According to plaintiff, the shower chair she was given was defective because the wheel lock did not work and the netting was torn. While showering, plaintiff fell out of the chair and was injured.

Plaintiff filed this suit against defendant asserting various acts of negligence. Plaintiff did not, however, provide pre-suit notice or a certificate of good faith under the HCLA, and defendant filed a motion to dismiss on that basis. The trial court agreed that the case fell within the HCLA and dismissed the suit without prejudice due to plaintiff’s failure to provide pre-suit notice. The court ruled, however, that the claims did “not require expert medical testimony and came within the common knowledge of laymen and, therefore, that a certificate of good faith [was] not required.” The trial court thus refused defendant’s request to dismiss the case with prejudice, which was affirmed on appeal.

The only issue on appeal was whether defendant was entitled to a dismissal with prejudice based on plaintiff’s failure to file a certificate of good faith with her complaint. Defendant first argued that expert testimony was required in this case “to establish the standard of care,” while plaintiff asserted that the trial court was correct in holding that the common knowledge exception applied.

While most HCLA cases require a certificate of good faith pursuant to Tenn. Code Ann. § 29-26-122, the statute itself limits its applicability to those cases “in which expert testimony is required…” The common knowledge exception to certificate of good faith requirement has been recognized by the Tennessee Supreme Court, with the Court explaining that “[t]he practical effect of applying the common knowledge exception is that the plaintiff need not produce expert testimony to prove…the standard of care applicable to the defendant, a deviation from that standard of care, and a resulting injury that would not have otherwise occurred.” (internal citation omitted). When a plaintiff does not need expert testimony to prove her case pursuant to the common knowledge exception, she likewise does not need to file a certificate of good faith. (internal citation omitted).

The common knowledge exception applies “where the act of alleged wrongful conduct lies within the common knowledge of a layperson.” (internal citation omitted). While the exception applies often in res ipsa loquitur type cases where the negligence is “patently obvious,” the Court of Appeals pointed out that the exception also applies to some cases where the “claim may sound in ordinary negligence and not require expert medical testimony.” (internal citation omitted). The Court noted that it has applied the common knowledge exception “to claims of ordinary negligence which are brought under the THCLA,” and that whether the exception applies must be determined on a case-by-case basis. (internal citation omitted).

After comparing this case to one in which a plaintiff was given a defective stool to stand on, the Court affirmed the ruling that no expert testimony was needed here to establish the standard of care. The Court explained:

[Plaintiff’s] complaint does not allege negligence arising from any conduct involving the exercise of medical judgment or skill. Instead, the complaint alleges that the shower chair was defective in that the wheel lock was broken and the netting was torn. [Plaintiff’s] complaint does not dispute the medical judgment of the nursing facility that residents must sit in a shower chair while showering; rather, she contends the chair she was given was broken. There is no specialized knowledge that health care experts possess regarding chair locking mechanisms and torn chair netting that the average layperson likely would not have. …[T]he determination of whether providing an allegedly defective shower chair is negligent presents a question not of medical expertise but instead is within the knowledge and experience of an ordinary layperson.

Defendant next argued that a certificate of good faith was required because expert medical testimony was needed to prove the proximate cause of plaintiff’s injuries. The Court, however, ruled that plaintiff’s “allegations assert a claim of an injury the existence and proximate causation of which can be established without expert testimony[.]” The Court pointed out that plaintiff was claiming that she fell due to the chair being broken, and that when she fell she injured her back and buttocks. Looking to other caselaw as a guide, the Court stated that “this is not a case in which expert testimony would be required to establish proximate causation,” and that “the imposition of the good faith requirement in the present case would be contrary to the framework of the THCLA and existing case law on the common knowledge exception.”

While the Court agreed that plaintiff “might struggle to establish the full extent of her claimed damages in connection with injury to her back and buttocks without expert testimony,” it nonetheless ruled that she could establish all the elements of her claim without an expert. The fact that her use of an expert might allow her to prove more damages did not remove this case from the common knowledge exception.

Because the facts of the case fell within the common knowledge exception, no certificate of good faith was required and denial of dismissal with prejudice was affirmed.

This opinion is an important read for anyone arguing for or against the application of the common knowledge exception to the certificate of good faith requirement. While it is always safest to file a certificate of good faith with any complaint under the HCLA, this case is a good example of a fact pattern that falls within the common knowledge exception.

Note:  Chapter 53, Section 4 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 1500 additional cases.  The 500,000+ word book  (and two others, Tennessee Law of Civil Trial and 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.

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