Should a county bear any financial responsibility when it fails to release a jail inmate on time and the inmate gets injured in an altercation when he should no longer have been in jail and therefore not in the position to be harmed.

The Tennessee Supreme Court recently decided such a case. King, an inmate of the Anderson County Detention Center, sued following an attack by another inmate in which he sustained injuries including an eye injury that required surgery and a broken nose.  He maintained he should not have been in jail at the time of the attack.

The trial court determined that both the Plaintiff Inmate and the Defendant County were responsible for Plaintiff’s injuries and assigned 45% fault to the Plaintiff for instigating the fight and 55% fault to the Defendant for failing to timely release the Plaintiff. The Court of Appeals upheld the judgment of the trial court. The Defendant County appealed to the Tennessee Supreme Court.

Tennessee Court of Appeals rules that Tennessee courts lose jurisdiction to reconsider dismissal when an aggrieved party fails to take proper action within the limited 30-day window after entry of final judgment.

In Hailey v. Wesley of the South, Inc., d/b/a Wesley at Dyersburg, No. W2012-01629-COA-R3-CV (Tenn. Ct. App. Nov. 19, 2013),the plaintiffs filed suit for wrongful death, medical negligence, negligence, intentional infliction of emotional distress, and negligent infliction of emotional distress stemming from the care and treatment of the decedent, Beatrice Jackson. Defendant filed a motion to dismiss citing the plaintiff’s failure to file a certificate of good faith within ninety days of the filing of the complaint, as then-required by Tenn. Code Ann. § 29-26-122 (note: current law requires contemporaneous filing of certificate of good faith in health care liability actions requiring expert testimony). Not finding any adequate basis for the plaintiff’s failure to comply with the certificate of good faith requirement, the circuit court granted the motion and on April 22, 2010, dismissed the entire case finding that all claims were for medical malpractice and required a certificate of good faith. A timeline of the ensuing procedural events is as follows:

  • ·       May 21, 2010 – Plaintiff files first motion to alter or amend arguing that the court erred in finding that all of her claims arose from charges of medical malpractice.
  • ·       May 21, 2010 – Plaintiff also files first notice of appeal.
  • ·       July 19, 2010 – Plaintiff’s motion to alter or amend is heard and court orders parties to file memorandums on whether the Medical Malpractice Act governs the plaintiff’s claims.
  • ·       August 3, 2010 – Defendant files a supplemental memorandum.
  • ·       August 12, 2010 – After the plaintiff fails to file a memorandum, the court enters order denying the plaintiff’s motion to alter or amend.
  • ·       August 23, 2010 – The trial judge and attorneys hold a conference call and plaintiff’s counsel claims to have authority that would convince the court to grant the plaintiff’s motion to alter or amend, resulting in the trial court instructing plaintiff’s counsel to immediately file a second motion to alter or amend along with the claimed convincing authority.
  • ·       August 30, 2010 – Plaintiff files second motion to alter or amend
  • ·       August 30, 2010 – Plaintiff also files a second amended complaint, without leave, attempting to assert new claims of negligence per se and violation of the Tennessee Adult Protection Act
  • ·       September 8, 2010 – The trial court denies plaintiff’s second motion to alter or amend, noting that the plaintiff failed to argue any new authority other than to mention the Tennessee Adult Protection Act, which was not cited in the original complaint.
  • ·       June 14, 2011 – The Court of Appeals orders the plaintiff to show cause as to why her appeal should not be dismissed for failure to timely file a notice of appeal, noting that the circuit court clerk’s only record of the notice of appeal was received by facsimile, which is not permitted under Tenn. R. Civ. P. 5A.02.
  • ·       August 11, 2011 – Court of Appeals dismisses plaintiff’s appeal for lack of jurisdiction because the plaintiff provided no proof that the notice of appeal was mailed to the trial court clerk for filing, as the plaintiff had alleged.
  • ·       August 30, 2011 – Court of Appeals denies the plaintiff’s petition for rehearing.
  • ·       December 15, 2011 – Plaintiff files third motion to alter or amend in the trial court, based on the same purported new authority that would convince the trial court that the plaintiff’s claims were not governed by the Medical Malpractice Act.
  • ·       May 9, 2012 – The trial court denies plaintiff’s third motion to alter or amend, ruling that the trial court lost all subject matter jurisdiction after the appeal without remand by the Court of Appeals.
  • ·       June 8, 2012 – Plaintiff files second notice of appeal, prompting this appeal.

The main issues on appeal concerned: (1) whether the trial court correctly dismissed the plaintiff’s third motion to alter or amend for lack of subject matter jurisdiction; and (2) whether the Court of Appeals had subject matter jurisdiction to entertain the appeal.

There is a new case on how one establishes the deadline for filing medical malpractice claims against the military hospitals and other health care providers associated with the federal government under the Federal Tort Claims Act (FTCA).  The case applies to FTCA claims arising in Tennessee, Kentucky, Ohio, and Michigan.

Federal law is different that state law.  The general rule in Tennessee is that a person or entity that is going to be sued for medical malpractice (now called health care liability)  must be given written notice in the manner prescribed by law within one year of the date of the negligent act or omission causing an injury.  This is, I repeat, the general rule:  at actual rule is more complicated.

The Tennessee rule does not apply in actions against the hospitals and other health care providers of the federal government under the FTCA.   In such cases, notice must be given within two years after the claim accrues. Once again, the actual rule gets more complicated, but "two years" is the basis rule.

More of our coverage of the 2013 Tennessee Health Care Liability Report issue by the Tennessee Department of Commerce and Insurance reflecting medical malpractice claims information for the year ending December 31, 2012.

As mentioned in Part 1 of this series, the total damages paid to claimants in 2012 was $90,520,000, for an average of $208,000 per claimant.  Here are the numbers for the previous four years.

Total Payments to Claimants
2008 2009 2010 2011 2012
119,300,00 111,000,000 109,000,000 114,000,000 90,520,00

Thus, we see an almost 25% decline in the total dollars paid to claimants in the last five years.

This chart gives us an understanding of the severity of injuries in the claims paid in 2012:

Severity of Injury
Injury  Number Paid   Amount Paid
Death  124 $51,403,476
Major Temporary 72 $11,855,186
Minor Temporary 72 $5,436,395
Significant Permanent 23 $7,732,010
Insignificant 21 $338,185
Emotional Only 3 $103,804
Major Permanent 11 $4,116,000
Grave Permanent  13 $7,003,500
Minor Permanent  16 $1,222,309
     

 Now let’s add a few more columns of data to get a clear understanding of what is going on in the medical malpractice claims world in Tennessee:

Severity of Injury – Paid and Unpaid Claims Data – 2012
Injury Total Number of  Claims Paid Claims %  Paid    of Total Claims Unpaid Claims  % Unpaid of Total Claims Total Claim Payments Average Amount Per Paid Claim
Death  549  124  23%  335  77%  $51,403,476  $414,544
Major Temporary  277  72  26%  205  74% $11,855,186   $164,655
Minor Temporary  263  72  27%  191  73% $5,436,395   $75,505
Significant Permanent  128  23 18%  105   82%  $7,732,010  $336,174
Insignificant  90  21 23%   69  77%  $338,185  $16,104
Emotional Only  88  3  3%  85  97%  $103,804  $34,601
Major Permanent 67   11  16%  56  84%  $4,116,000 $374,182 
Grave Permanent  63  13  21%  50  79%  $7,003.500  $538,731
Minor Permanent  52  16  31%  36  69%  $1,222,309  $76,394

Let this data be a warning to inexperienced medical malpractice lawyers:  severe injury and death do not result in settlements or judgments.   More than 70% of the time allegations involving that type of injury result in no payment whatsoever to the claimant.  

The average settlement of per claim data on some of these categories is quite a surprise.  To be sure, some number of cases involve two or more claims, and thus the settlement or judgment would tend to be higher.  But, still, the numbers here are lower than I would expect.

There will be more data in the our next post, Tennessee Medical Malpractice (Health Care Liability) Statistics – Part 3.

Tennessee law has an unusual rule concerning expert witnesses in health care liability cases – the "contiguous state rule."  Usually, the rule hurts patients because it limits the pool of expert witnesses available to testify on their behalf.  Sometimes, however, it comes back to bit health care providers.

An ophthalmologist in a medical negligence case requested that the trial court waive the expert competency requirement known as the contiguous state rule  under Tenn. Code Ann. § 29-26-115(b).  Under this rule, in order for an expert to testify in a Tennessee medical malpractice case, the expert must have been licensed to practice and did practice in a relevant specialty in Tennessee or a contiguous bordering state within the year preceding the date of the alleged malpractice. This requirement can be waived by a court when the court “determines that the appropriate witness otherwise would not be available.” Tenn. Code Ann. § 29-26-115(b).

In Gilbert v. Wessels, E2013- 00255-COA-R10-CV (Tenn. Ct. App. Nov. 18, 2013), the defendant ophthalmologist’s attorney spent approximately 35 hours searching for an expert and contacted 13 doctors in Tennessee and contiguous states before finding an expert in Florida. The defendant argued that this was sufficient to warrant a waiver of the contiguous state rule and also argued that the Florida expert had actual experience performing the procedure at issue and therefore was more qualified to testify than an expert who might meet the contiguous state requirements but had no experience with the procedure. 

The Tennessee Department of Commerce and Insurance has released the 2013 Health Care Liability Report.  Unfortunately, the report bears the date on which it is issued rather than the year the data used to generate the report is based.  

In any event, the data confirms what most of us know about the state of health care liability litigation in Tennessee.  Medical malpractice claims have dropped substantially since 2008 when the notice and certificate of good faith statutes went into effect.

Claims Pending At End of Calendar Year
2008 2009 2010 2011 2012
5780 5030 4082 3950 3927

Here is data on the number of paid claims for the period from 2010 through 2012:

Paid Claims
2010 2011 2012
451 437 436

The number of claims closed without payment is about 80% of closed claims.  Stated differently, for every five claims that are opened four are later closed with no payment to the patient.

Claims Closed Without Payment
2010 2011 2012
2707 1895 1775

So, if there are 3927 pending claims at the end of 2012 and historically payments have been made to patients in 20% of claims, that means that a payment to a patient will be made in about 800 of the pending claims.

Notice that in the last three years the number of closed claims and end-of-year totals has dropped substantially.  This is consistent with complaints we are hearing from the defense bar – they have seen that their case inventory is dropping because the number of new case filings has dropped.

Remember that "claims" are different than lawsuits.  Not every claim results in a lawsuit, and multiple claims can result in one lawsuit.  Here is the data on filings of health care liability cases for the last few fiscal years ending on June 30.

Health Care Liability Filings (Year Ended June 30)

2008 2009 2010 2011 2012 2013 
537 426 324 343 369 385

 

So we are seeing some increase in filings, although they are still down about 30% from where they were six years ago.  What is going on?

I am not sure.  There has been an increase in population and that would impact the number of patients and thus the number of possibilities for malpractice to occur.  Financial pressure on the health care industry may be impacting quality of care.  Several defense lawyers have told me that they are seeing an increase claims brought by inexperienced lawyers.  Of course, the defense bar secretly loves these cases – these lawyers are unlikely to have the savvy or money to bring even a good case across the finish line, much less actually win the case.  If inexperienced lawyers are bringing more cases we should see the results of that in an increase in unpaid claims.

The total damages paid on health care liability cases in 2012 was $90,520,000.  Since we know that there were 436 claims paid in 2012, the average payment per claim was $208,000. 

In 2011, the total amount paid was $114,000,000, so the total payments dropped over 20%.  

I will share more data in my next post "2012 Tennessee Medical Malpractice (Health Care Liability Statistics – Part 2."

 

What constitutes "excusable neglect" under Rule 59 of the Tennessee Rules of Civil Procedure?

Ms. Hayes, who goes by the stage name Shania Twang, entered into a written contract with Mr. Cunningham to perform in a musical show in Branson, Missouri. The show was to run a little over 5 months, and Shania Twang’s compensation was set at $1600.00 per week. However, after only one month, Mr. Cunningham canceled the show. Because she only received $3,066.00 in compensation, Ms. Twang sued Mr. Cunningham for breach of contract. Mr. Cunningham’s primary defense was he was not individually implicated in the contract as he was only an agent and the culpable party was SuperStars Live Concert, LLC. Following discovery and a pretrial conference, the case was set for trial.

Although there was no dispute that Mr. Cunningham was aware of the trial date, he chose not to attend. According to Mr. Cunningham, he did not appear because his counsel told him the case would turn on Missouri law and so his personal appearance was not absolutely necessary. However, Mr. Cunningham’s lawyer indicated his client did not appear at the trial because it conflicted with another show date and Mr. Cunningham had expressed he would be "ruined" if he missed the show. Given Mr. Cunningham’s position, the lawyer asked Mr. Cunningham to provide him evidence to support the defense. The evidence was never received and Mr. Cunningham quit returning his lawyer’s calls or emails. It should be noted that during the course of the case Mr. Cunningham and his lawyer had a tumultuous relationship resulting in multiple motions to withdraw. 

These days, almost all Tennessee nursing homes and rehabilitation centers include arbitration agreements in their admission documents. In this case, enforceability became an issue because the arbitration agreement was signed by the patient’s sister who did not have a power of attorney. Moreover, it was undisputed the patient did not have any mental competency issues. However, the nursing home argued sister had implied and apparent authority to bind the patient. 

Marie Farmer was a 36 year old woman with multiple health issues including diabetes and end-stage renal disease. Over the course of several years, she had been in and out of various hospitals and medical facilities and her sister, Angelica Massey, had typically accompanied her and completed the necessary paperwork and Farmer’s admission to defendant’s nursing home was no different. While a patient at the nursing home, Farmer died allegedly from complications of hypoglycemia and her husband and minor children brought a wrongful death action. The nursing home then sought to enforce the arbitration agreement.

Since implied authority has been defined as "actual authority circumstantially proved, or evidenced by conduct, or inferred from a course of dealing between the alleged principal and the agent", defendant argued Massey had implied authority to sign the arbitration agreement since she routinely performed that function for her sister. The Court of Appeals disagreed. While Farmer knew Massey was signing admission documents for her, there was no evidence to establish Farmer knew an arbitration agreement was contained within those documents as even the nursing home’s representative testified it was not discussed in Farmer’s presence. Moreover, the undisputed testimony was the arbitration agreement was not mandatory. In other words, admission was not conditioned upon signing it. Given its optional nature, knowledge of its existence and an acquiescence to its terms was necessary, and evidence of that was absent in the record.

Nashville is the home of country music, and country music is filled with wonderful stories. I envy the ability of country music songwriters to tell a complete story in three minutes, purposefully injecting  a handful of magical words called "the hook"  to make that story stick in your mind and heart forever.   "He Stopped Loving Her Today" is a famous example.

Stories about life and love, adversity and hope, tractors and trucks. About death and broken hearts, revenge and forgiveness,  patriotism and God. Sometimes downright silly, sometimes frighteningly real, country songs, written and performed by those with a true gift,  result in unforgettable stories.

But there are no songs about tort reform. You would think the subject is ripe for such a song – there is more than enough human tragedy in tort reform to give rise to one heck of a country song.

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