Tennessee Medical Malpractice Decision on Reversed – Notice Issue

In Hughes v. Henry Co. Med. Center, No. W2014-01973-COA-R3-CV (Tenn. Ct. App. June 9, 2015), plaintiffs filed a health care liability action against defendants Henry County Medical Center (“HCMC”) and Dr. Gold. The defendants filed motions to dismiss alleging that plaintiffs failed to comply with the pre-suit notice requirements in Tenn. Code Ann. § 29-26-121. Specifically, defendants asserted that plaintiffs did not include a HIPAA-compliant medical authorization as required by the statute because the authorization did not permit the providers receiving the notice to obtain medical records from each other. The form provided to defendants only allowed HCMC to use its own records in the suit.

Plaintiffs admitted that the form was technically deficient but argued that defendants were not prejudiced because “Dr. Gold only saw [plaintiff] at HCMC and had no records independent of HCMC’s records.” In fact, during the hearing on the motions to dismiss, “counsel for HCMC conceded that Dr. Gold had no records, and there was no actual prejudice in view of this fact.” Nevertheless, the trial court dismissed the action due to plaintiffs’ failure to substantially comply with the statutory requirements. Plaintiffs appealed this decision as to HCMC, and the Court of Appeals overturned the dismissal in favor of that defendant.

The Court rejected HCMC’s argument that prejudice need not be analyzed since the plaintiffs “plainly and entirely failed to substantially comply” with the statutory requirements. Instead, the Court noted that in Stevens v. Hickman Cmty. Health Care Servs., Inc., 418 S.W.3d 547 (Tenn. 2013), the Tennessee Supreme Court stated that “in determining whether a plaintiff has substantially complied with a statutory requirement, a reviewing court should consider the extent and significance of the plaintiff’s errors and omissions and whether the defendant was prejudiced by the noncompliance. Not every non-compliant HIPAA medical authorization will result in prejudice.”

Analyzing the instant case in light of both the error on the form and the lack of prejudice, the Court of Appeals found that this case should not have been dismissed. The Court pointed out that since Dr. Gold had no medical records, a release for his records would have had no affect on the case or on HCMC’s ability to obtain “complete medical records.” The Court found that “HCMC was able to obtain all of the Appellants’ relevant medical records, and evaluate the merits of the claim despite Appellants’ technical failure to include Dr. Gold’s records in its release.” The Court differentiated this case from previous cases where dismissals were upheld when the medical authorization provided did not allow for the use of medical records, as here the only relevant medical records in existence were released for use in the litigation.

In its opinion, the Court referenced Tennessee’s “general policy in favor of the resolution of disputes on the merits.” Here, the Court found that “HCMC’s argument that Appellant’s case should be dismissed elevates form over substance” and that the purposes of the pre-suit notice statute (timely notice and authorized use of medical records) had been fulfilled. Accordingly, the dismissal was reversed since defendant suffered no prejudice as a result of the technical error on the medical authorization.

This was definitely the correct result in this case. Here, the Court took a reasoned approach to substantial compliance with the pre-suit notice requirements, coming to the sensible conclusion that where there was no prejudice there should be no dismissal. Cases addressing dismissal due to technical or clerical mistakes on HIPAA forms seem to be a bit all over the board, with many unfortunate dismissals. This case, though, represents a more promising approach.

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