THI RD DI VI SI ON

ELLI NGTON, P. J.

, BETHEL, J.

, and SENI OR A PPELLA T E JUDGE PHI PPS

N O T IC E : M otions for r e c ons i de r a tion m us t be

ph y sic a l ly r e ce iv ed i n our c le r k ’s offic e w ithin te n

da y s of the da te of de c is ion to be de e m ed tim e ly file d.

http://w w w .ga a ppe a l s .us /r ule s

June 1, 2018



# I n th e Co u r t o f

A p p eals o f

G eo r g ia

A1 8 A0 27 7 . HOLM ES et al . v . LYONS et al

. PH-0 1 0

P H I P P S , Sen i o r Ap p el l at e J u d g e.

Bo n ni e Ho l m es a p p e a l s t h e d i s m i s sal o f h er co m p l ai n t fo r fai l u re t o fi l e a

s u ffi ci en t ex p ert affi d av i t i n s u p p o rt o f h er m ed i ca l m a l p r a c t i ce cl ai m pu rs u an t to

OCGA § 9 -1 1 -9

. 1

, an d fo r fai l ure t o s t at e a cl ai m an d as b ei ng b arred un d er Geo rg i a

l aw wi th res p ect t o h er sep arat e cl ai m s fo r frau d

, bat t ery

, an d n eg l i g en t

m i s rep res en t at i o n . Fo r t h e reas o n s s et fo rt h m o re fu l l y b el o w, we rev ers e.

“ A m o t i o n t o d i sm i s s b as ed u po n t h e l ack o f a s uffi ci en t ex p ert affi d av i t i s a

m o ti o n t o d i s m i ss fo r fai l u re t o s t at e a cl ai m u n d er OCGA § 9 -1 1 -1 2 (b ) (6 ).” Zi g l a r

v. St

. Jo s ep h ’s /

Ca n d l er Hea l th S

ys t em, In c.

, 3 4 1 Ga. Ap p

. 3 7 1

, 3 7 1 (8 0 0 SE2 d 3 9 5 )

(2 0 1 7) (ci t at i o n an d p u n ct uat i o n o m it t ed ). “ W e r e v i e w a t ri al co u rt ’ s ru li n g o n a

m o ti o n t o d i s m i s s d e no v o

, v i ewi n g al l wel l -p l ed al leg at i on s i n t h e co m p lai n t as t ru e.”Ho b b s v. Gr ea t Exp r es si o ns Den t a l Cen t er s of Ga

. , 3 3 7 Ga. Ap p

. 2 4 8

, 2 4 8 (7 8 6 SE2 d

8 9 7 ) (2 0 1 6 ).

So v i ewed

, t h e co m

p lai n t al l eg es t hat o n J u ne 2 3

, 2 0 1 5

, Th o m as Ly o n s

, M .D.,

p erfo rm ed g y n eco l o g i cal s u rg ery 1 on H olm e s a t R o c kda l e M e di cal Cen ter, o wn ed an d

o p erat ed b y Ro ck d al e Ho s p it al

, LLC (co l lect i v el y

, “ Ro ck d al e Ho s pi tal ”). A s a res u l t

o f t h e s u rg ery

, Ho l m es s u ffered a ri g h t d i s t al u ret eral i nju ry an d u t ero v ag i n al fi s t u l as

.

In No v em

b er 2 01 6

, Ho l m es fi l ed s u i t ag ai ns t Dr. Ly on s

, hi s em p l o y er Ro ck d al e

P h ys i ci an Pract i ces

, LLC d / b / a Ad v an ced Gy n eco l o g y As s o ci at es (“ Ro ck d al e

Ph y s i ci an Pract i ces ”), an d Ro ck d al e Ho s p it al (co ll ect i v el y, t h e “ Defen d an t s ”),

al l eg in g cl ai m s o f m ed i cal m al p ract i ce, frau d

, n eg l i g en t m i s rep res en t at i o n, b at t ery

,

p u n i t i v e d am ag es

, as wel l as a cl ai m o f l o s s of co n s o rt i u m o n b eh al f of h er h u s b an d,

J erem y Ho l m es

. Ho l m es al s o b ro u g h t a cl ai m ag ai n s t Ro ck dal e Ph y s i ci an Pract i ces

fo r neg l i g en t h iri n g, s u p erv is i o n

, an d ret en t i o n

, an d cl aim s f or ne glige nt cred en t i al i n g

an d n eg l i g en ce p er s e ag ai ns t Ro ck dal e Ho s p i t al

.

In h er co m

pl ai n t

, Ho l m es al leg ed t h at Dr. Ly o n s was n o t p h y s i cal l y cap ab l e o f

p erfo rm i n g t he J un e 23 s u rg ery

, an d h e fai l ed t o d i s cl os ed ph y s i cal i m p ai rm en t s t h at

1 Th e s u rg ery was al l eg ed t o i n cl u de a h y s t erect o m y

, ex pl o rat o ry l ap aro s co p y

, ad h es i o l y s is , u t et ero l y s i s , l ap aro s co p i c t o t al h y s t erect o m y , an d cy s t o s co p y

.

2n eg at i v el y affect ed hi s m o t o r sk i l l s an d p l aced her at in creas ed ri s k o f co m p l i cat i o n s

,

i n cl u d i n g u ret eral in

j u ry an d u tero v a g i n a l fi s t u l as

. In s u p p o rt o f her cl ai m

, Ho l m es

h i g h l i g h t ed t h at i n 2 0 1 0

, D r. Ly o n s h ad s ou g ht t o tal an d res i d ual d i s ab i li t y b en efi t s

u n d er t wo s ep arat e d i s ab i l it y i n s u ran ce po l i ci es

. A ft e r b e i n g d en i ed ben efi t s

, Dr.

Ly o n s fi l ed s u it ag ai n s t bo th i n s u rers i n 2 01 1

. A t t ach ed t o Dr. Ly o n s ’ s co m p l ai n t was

a fu n ct i o n al cap aci ty ev al uat i o n rep ort p rep ared b y M arc. A

. Y eag er, M PT, wh i ch

o p i n ed t h at Dr

. Lyo n s ’s “ fu n ct i o nal cap ab i l i t i es d o n o t m at ch t h e p h y s ical d em an d

req u i rem en t s o f hi s jo b rel at ed t o b e a Gy n eco l o g i cal Su rg eo n d u e t o d ecreas ed ri g ht

an d l eft l o wer qu art er wei g ht b e a r i n g an d d ecreas ed ri g ht

- an d left -h an d g ro s s an d

fi ne m ot o r co o rd i n at i o n .” In h i s s u i t, Dr. Ly o ns d es cri b ed t h at : (1 ) i n 2 00 2

, he b ecam e

“ res i d u al l y d i sab l ed ” d u e t o a t o t a l k n e e rep l acem en t wh i ch affect ed h i s ab i l i t y to

s t an d an d p erfo rm s u rg ery ; (2 ) h i s ri g h t t h u m b h as a j o i n t t h at n eed ed t o b e rep l aced

an d “ affect s h i m fro m a s u rg i cal s t an d po i nt ”; (3 ) i n 2 00 9

, h e lo st vi s i o n i n h i s l eft ey e,

wh i ch affect ed hi s d ep t h p ercep t i on ; an d (4 ) i n 2 0 1 1, h e s u ffered a s t r o k e

, wh i ch

res u l ted in n eu ro l o g ical p ro b l em s

, i n cl u di n g trem o rs an d o t h er i s s ues t h at i m p act ed

h i s fi n e m o t or s ki l l s . Ho l m es co n t en d ed t h at Dr. Ly o n s was i m p ai red b y t h e ab o v ereferen ced d i s ab i l i t i es wh en h e p erfo rm ed g y n eco l o g ical s u rg ery o n J u n e 2 3 , 2 0 1 5,

wh i ch res u l t ed i n a p rev en tab l e i n ju r y t o Ho l m es ’ s uret er an d o t her co m p l i cat i o n s

.

3Ho l m es fu r t h e r a l l eg ed t h at Dr. Ly o n s n ev er in fo rm ed her o f h i s d i m i n i s h ed m o t o r

s k i l l s

, v i si o n i s s ues

, or d i ffi cu l t i es i n wei g h b eari n g, an d n ev er ad v i s ed h er t h at h er

ri sk o f co m

p li cat i on s wo u l d b e red uced i f an o t h er g y n eco l o g i cal s u rg eo n

, wi t h o u t t h e

s am e p h y s i cal l i m i t at i on s , h ad p erfo rm ed t h e s u rg ery

.

Ho l m e s at t ach ed an ex p ert affi d av i t t o h er co m p l ai n t au t h o red b y Kel l y M

.

Kas per, M

. D., a b o ard cert i fi ed g y n aeco lo gi s t

, w h o s e co m p et en cy i s n o t i n d i s p u t e. 2

In p ert i n en t p art s

, Dr. Kas p er’ s affi d av i t st at ed t hat D r. L y o n s “ b reach ed t h e s t an d ard

o f care in t h e fo l l o wi n g w ay s ”: (1 ) h e p erfo rm ed t h e s u rg ical p ro ced u res o n Ho l m es

“ ev en t h o u g h h e was n o t p h y s i cal l y cap ab l e o f p erfo rm i ng th em i n a m an n er t h at was

s afe”; (2 ) h e p erfo rm ed t h e su rg i cal p ro ced u res o n Ho l m es “ ev en t h o u g h he was n ot

p h y s i c a l l y c a p a b l e o f p erfo rm in g t h em i n a m an n er t hat d i d n o t p u t

. . . Ho l m es at

i n creas ed ri sk fo r co m

p l i cat i o n s

, i n cl u d in g b ut n o t l i m i t ed t o uret eral i n ju ry an d

u t ero v ag i n al fi s t u l as ; ” (3 ) h e fai l ed t o i n fo rm Ho l m es o f h i s “ i d en t i fi ed an d ad m i t t ed

d i s ab i l i t i es an d t h e l i kel i h o o d t h at t h ey wo u l d p u t h er at ri s k fo r a n d c a u s e h e r

co m p l i c a t i o ns

, i n cl ud i n g u ret eral i n ju ry an d u t ero vag i n al fi s tu l as ; ” (4 ) he fai l ed to

i n fo rm Ho l m es o f “ p ract ical al tern at i v es ,” i n cl u d in g t h at an o th er p h y s i ci an

, wi t h o ut

2 Dr. Kas per i ni t i al l y s u b m i t t ed an affi d av i t o n A u g u s t 1 8

, 2 01 6

, wh i ch s h e

s u p p lem en t ed w it h t wo am en d ed v ers i on s o n Au g u s t 30

, 20 1 6 an d Decem b er 6

, 2 0 1 6.

4t h e “ i d en t i fi ed an d ad m it t ed d is ab i l i t i es ” co u l d per f o r m t h e s u rg ery

, “ w h i ch wo u ld

n o t carry wi t h i t t he l ik el i h o o d th at s h e w o u l d b e at ri s k fo r an d s u ffer co m p l i cat i o n s

,

i n cl u d i n g u ret eral i nju ry an d u t ero v ag i n al fi st u l as ; ” an d (5 ) h e fai led t o perfo rm t h e

s u rg ery o n Ho l m es “ in a m an n er t h at wo u l d av o id co m p l i cat i o n s

, i n cl u d i n g b u t n ot

l i m i ted t o u ret era l i n

ju r y an d u t ero v ag i n al fi s tu l as .” Dr. Kas p er co n cl ud ed t h at Dr.

Ly o n s ’ s cu m

u l at i ve f a i l u r es “ cau sed Bo n n ie Ho l m es ’ co m p l i cat i o n s o f ri g h t d i st al

u ret eral i n

ju ry an d u t ero v ag i n al fi s t u l a.” In a s eco n d am en d ed affi d av i t

, Dr. Kas p er

ad d ed

, “ th e co m

p li cat i o n s t h at Bo n n i e Ho l m es ex p eri en ced s eco n d ary t o t h e J u n e 2 3,

2 0 1 5 [p ] ro ced u res

, in cl u d i n g, b u t n o t l i m i t ed to

, u ret eral in ju ry an d u t ero v ag i n al

fi st u l as

, were a d irect re s ul t o f [Dr. Ly o n s ] p h y s i cal i m p ai rm en t s ” an d t h e

“ co m p l i cat i o n s were s eco n dary t o d efi ci en t s u rg i cal t ech n iq u e rel at ed t o at l eas t Dr.

Ly o n s ’ ‘ d ecreas ed ri g h t an d l eft l o w e r q u art er wei g h t b eari n g an d d ecreas ed ri g h t

an d l eft -h an d g ro s s an d fi n e m o t o r co o rd in at i o n .’ ”

Th e Defen d an t s fi l ed s ep arat e m o t i o n s t o d i sm i s s . Th e t ri al co u rt g ran t ed t h e

m o ti o n s to d is m i ss

, fi n di ng

, as rel ev an t to t h i s ap p e a l

, t h at : (1 ) Ho l m es ’ s m ed i cal

m al p ract i ce cl ai m was s u bject t o d i s m i ss a l b e c a u s e Dr. Kas p er’ s ex p ert affi d av i t

fai l ed t o sp eci fy at l eas t o ne n eg l i g en t act o r o m i s s i o n co m m i tt ed b y Dr. Ly o n s ; an d

(2 ) u n der Geo rg i a law, a p h y s i ci an ’ s fai l u re t o d i sc l o s e t o a p at ien t “ n eg at i v e l i fe

5fact ors

, ” wh i ch m i g h t ad vers el y affect t h ei r p ro fes s io n al p erfo rm an ce co u l d n o t s erv e

a s a b as i s fo r Ho l m es ’ s s ep arat e cl ai m s o f frau d

, neg l i g en t m i s rep res en t at i o n

, a n d

b at t ery

. T h e co urt al s o d i s m is s e d H o l m es ’ s cl ai m s ag ai n s t Ro ck d al e Ph y s i ci an

Pr a c t i ces an d Ro ck d al e Ho s p i t al as “ d eri v at i v e” o f Ho l m es ’ s m eri t l es s s u b s t an t i v e

cl ai m s . Ho l m es t h en fi l ed t h e i n s tan t ap p eal

.

1

. In h er fi rs t en u m erat i o n o f erro r, Ho l m es co n ten d s t h at t h e t ri al co u rt erred

i n d i s m i s s i n g h er m e d i cal m al p ract i ce cl ai m fo r fai l ure t o fi l e a s uffi ci en t ex p ert

affi d av i t. Pu rs u an t t o OCGA § 9 -1 1 -9 .1 (a), a p l ai n t i ff wh o fi les p ro fes s i o n al

n eg li g en ce cl ai m s ag ai n s t “ (1 ) [a] pro fes s i o n al l i cen s ed b y t h e St at e o f Geo rg i a an d

l i st ed i n s u b s ect io n (g ) o f th is Co d e s ect i o n ; [o r] (3 ) [a] n y l i cen s ed h eal th care faci l i t y

al l eg ed to b e l i ab le b as ed u p o n t h e act i o n o r i n act i o n o f a h eal t h c a r e p r o fes s i o n al

l i ce n s e d b y t h e St at e o f Geo rg i a an d l i s t ed i n s u b s ect i o n (g ) o f th i s Co d e s ect i o n,”

m u st fi l e an ex p ert affi d av i t wi t h t h ei r co m p l ai n t

. F u rt h er, t h e st at ut e al s o p l ai n l y

p ro v id es t h at t h e ex p ert ’ s “ affi d av it s hal l s et fo rt h s p eci fi cal l y at l eas t o n e n eg l i g en t

act o r o m i s s io n cl ai m ed t o ex i s t an d t h e fact ual b as is fo r each s u ch cl ai m .” OCGA §

9 -1 1 -9 .1 (a). Un l i k e OCGA § 9 -1 1 -5 6

, wh ich i m p o ses an ev i d en t i ary req u irem en t in

t h e co n t ex t o f s u m

m ary ju d g m en t o n t h e m eri t s

, OCGA § 9 -1 1-9 .1 m erel y i m p o s es

an in i t i al p l ead i n g req u i rem en t o n t h e p l ai n t i ff i n a m al pract i c e a c t i o n

. Ro b i n s o n v.

6S t a r r

, 1 9 7 Ga. Ap p

. 4 4 0

, 4 4 1 (2 ) (3 9 8 SE2 d 7 1 4 ) (1 9 9 0 )

. Acco rd i n g ly

, an ex p ert

affi d av i t wh i ch wo u l d b e i n s u ffi ci en t t o s at is fy t h e ev i d en t i ary s t an d ard s of OCGA

§ 9 -1 1 -5 6 m ay n ev ert h el es s b e s u ffi ci en t t o s at i s fy t h e p lead i n g s t an d ard s o f OCGA

§ 9 -1 1 -9

. 1

. 0 -1 Do ct o r

s Mem. Ho l d i n g Co

. v. Mo o r e

, 1 90 Ga. Ap p. 2 8 6

, 2 8 7 (1 ) (3 7 8

SE2 d 70 8 ) (1 9 8 9 ). Th e s uffi ci en cy o f t h e ex p ert affi d av i t d et erm i n e s wh et h er t h e

co m p l ai n t fo r m al p ract i ce i s “ s u b ject t o d i s m i s s al fo r fai l u re t o s t at e a c l a i m [

. ]”

OCGA § 9 -1 1 -9 .1 (e). “ A Sect i o n 9 -1 1 -9 .1 affi d av i t s h o u l d b e co n s tru ed m o s t

fav o rab l y t o t h e p l ai n t i ff an d al l d o u bt s s ho u l d b e res o l v ed i n p l ai n t iff’ s fav o r, ev en

i f an u n fav orab l e co n s tru ct i o n o f t h e affi d av i t m ay b e p o s s i b l e.” Cr o o k v. Fu n k

, 2 1 4

Ga. Ap p . 2 1 3 , 2 1 4 (1 ) (4 4 7 SE2 d 6 0 ) (1 9 9 4 ) (ci tat i o n an d p u n ct u at i o n o m i t t ed ).

Here, t h e Defen d an t s co n t en d t hat Dr. Kas p e r ’s a f f i d av i t

, as am en d ed

, was

fat al l y d efec t i v e b e c au s e i t fai l ed t o s et fo rt h at l eas t o n e n eg li g en t act o r o m i s s i o n

c lai m ed t o ex i s t

. Th ey h i g h l i g h t t h at t h e affi d av i t s um m ari ly co n cl u d ed t h at Dr. L y ons

u t i l i zed a d efi ci t s u rg i cal tech n i q u e b ecau s e Ho l m es ex p eri en ced co m p l i cat i o n s

,

wi t h o u t p ro v i d i ng an y d et ai l s o n h o w D r. Ly o n s was n eg li g en t i n p erfo rm i n g t h e

s u rg ery

. See Ha wki n s v. OB-GY N As s o cs

. , P .A.

, 29 0 Ga. Ap p

. 8 92

, 8 94 (1 ) (6 6 0 SE2 d

8 3 5 ) (2 0 0 8 ) (“ [T] h e d o ct ri n e o f res i p s a l o q u it u r d o es no t ap p ly i n a m al p ract i ce cas e.

An i n ten d ed res ul t d oes n o t rai s e an i n feren ce o f n eg li g en ce.”).

7It i s t ru e t h at an ex p ert affi d av i t m u s t i n cl u d e at l eas t o n e s p eci fi c n eg l i g en t act

o r om i s s i o n g i v i n g ri s e t o a m al p ract ice cl ai m

. See, e.g

., Po r q u ez v. W a s h i n g t o n

, 2 6 8

Ga. 64 9

, 6 50 -6 5 1 & n

. 1 (1 ) (4 9 2 SE2 d 6 6 5 ) (1 9 97 ) (fi n d i n g an ex p ert affi d av i t s et

fo rt h at l eas t o n e s p eci fi c “ fact u al l y -b as ed act o f n eg l ig en ce” b y s t at i n g t h e

d efen d an t s fai led t o m o n i t o r th e u s e o f an em erg en cy m ed i cal d ev i ce); Vi t n er v.

Mi l l er

, 2 2 3 Ga. Ap p

. 6 9 2

, 6 9 4 (2 ) (4 7 9 SE2 d 1 ) (1 9 9 6 ) (fi n d i n g a n a f f i d a v i t t o b e

l eg al ly s u ffi ci en t w h ere t h e ex p ert av erred t h at a ph y s i ci an ’ s “ fai l ure to co m p l et e t h e

t wo s u ct i o n ab o rt i o n s co n s t i t u t ed n eg l i g en ce”); Cr o ok

, 2 1 4 Ga. Ap p. at 2 1 4 (1 )

(co n cl u d i n g t h at an ex pert affi d av it m et t h e m i n i m u m req u i rem en t s by referen ci n g

m u lt i p l e act s b y t h e d efen d an t s, i n cl u d i n g t h ei r fai l u re t o d i ag n os e an an eu ry s m an d

o rd eri n g a t read m i l l s t res s t es t, d es p i t e t h e p at i en t ’ s p o o r p h y s i cal co n d i t i o n an d h i g h

b l o o d p res s u re).

In t h i s cas e, h o wev er, D r. Kas p er’ s affi d av i t d es cri b ed th at Dr. Ly o n s ’ s act o f

p erfo rm i n g t he set o f s i x s u rg i cal p r o c e d u r e s o n Ho l m es o n t he d at e in q u es t i o n

d es p it e h i s k n o wn p h ys i cal l i m i t at i o n s “ breach ed t he s t an d ard o f care.” See Bo wen

v. Ad a ms

, 2 0 3 Ga. Ap p. 1 2 3, 1 2 4 (4 1 6 SE2 d 1 0 2 ) (1 9 9 2 ) (“ Th e neg l i g en t act ‘ cl ai m ed

t o ex i s t ’ i n t h e i n st an t cas e i s a p p el l ee’ s p erfo rm an ce o f ‘ an u n n eces s ary o p erat i v e

p ro ced ure’ u p o n ap p el l an t .”). Sp eci fi cal l y

, Dr. Kas per o p i n ed th at Dr. Ly o n s : (1 )

8p erfo rm ed t h e s urg ery d es p i t e hi s p h y s i cal l im i t at io n s

, (2 ) fai l ed t o i n fo rm Ho l m es

o f h i s d i s ab i l i t i es

, an d (3 ) em p l o y ed a “ defi ci en t s u rg i ca l t e c h n i q u e,” w hi ch aro s e

f r o m h i s p h y s i cal i m

p ai rm en t s. Dr. Kas p er fu rt h er av erred t h at t h e co m p l i cat i o n s

s u ffered b y Ho l m es

, “ i n cl u di n g

, b u t n o t l i m it ed t o

, u ret eral i n ju ry an d u t ero v ag i n al

fi st u l as

, w ere a d i r ect r es u l t o f [Dr. Ly o n s ’ s ] p h y s i cal im pai rm en t s[,]” a n d t h at t h e

“ co m p l i cat i o n s w ere s eco n dary t o d ef i ci en t s ur g i ca l t ech n i q u e ” d u e t o Dr. Ly o n s ’ s

“ d ecreas ed ri g h t an d l eft l o wer q u art er wei g h t b eari n g an d d ecreas ed ri gh t

- an d l eft

h an d g ro s s an d fi n e m o to r co o rd i n at i o n.” Al t h o u g h an u nfav o rab l e co n s tru ct i o n o f

t h i s affi d av i t m ay b e p o s s i b l e, co n s t ru i n g i t m o s t fav o rab l y fo r Ho lm es an d res o l v i n g

a l l d o u b t s in h er fav o r, as we m u s t o n a m o t i on t o d i s m is s

, t h e t ri al co urt co u l d n o t

co n cl u d e t h at Dr. Kas p er’ s affi d av i t “ d i s cl o s es with c e r ta i nty th at [Ho l m es ] w o u l d n ot

b e en t i t l ed t o rel i ef un d er an y s tat e o f p ro v ab l e fact s .” Gr a h a m v. Reyn o ld s

, 3 4 3 Ga.

Ap p . 2 7 4 , 2 8 2 (3 ) (8 0 7 SE2 d 3 9 ) (2 01 7 ).

No wh ere i n t he i n st an t affi d av i t d i d Ho l m es ’ s ex p ert s p eci fi cal l y as s ert t h at Dr.

Ly o n s ’ s p erfo rm an ce o f th e s urg i cal p ro ced u re res u l t ed i n t h e cu t to Ho l m es ’ s u ret er,

as Ho l m es al l eg es i n h e r b ri ef. Ho wev er, “ O CGA § 9 -1 1-9 .1 d o es no t req u i re an

affi an t t o s p eci fi c a l l y o p i ne t h at t h e act co n s t i t u t ed n eg l i g en ce.” Gr a h a m

, 3 4 3 Ga.

Ap p

. at 2 8 1 (3 ). Ho l m es can n o t b e req u i red t o s ub m i t an ex p ert affi d av i t wh i ch

9u n eq ui v o cal l y d em o n s t rat es t h e ev i d en ti ary m eri t s o f h er cl ai m u n les s an d u n t i l t h e

Defen d an t s m o v e fo r s u m m ary ju d gm en t an d s u b m i t ev i d en ce d em o n s t rat i n g t h at

Ho l m es ’ s cl ai m l ack s m eri t

. See Bo wen

, 2 0 3 Ga. Ap p

. at 12 4 ( “ Th e p u r p o s e o f

OCGA § 9 -1 1 -9

. 1 i s t o red u ce t h e n u m b er o f fri v o l o u s m al p ract i ce s u i t s bei n g fi l ed

,

n o t t o req u i re a p l ai n t iff to pro v e a p ri m a faci e c a s e en t i t l i n g hi m t o reco v er an d

cap ab l e o f wi t h s t an d in g a m o t i o n fo r s u m m ary j u d gm en t b efo re t h e d efen d an t n eed

fi le h i s an s wer.”) (ci t at i o n o m i t t ed ). It fo l l o ws t h at t h e t ri al co urt erred in g ran t i n g t h e

Defen d an t s ’ res p ect i v e m o t i o n s t o di s m i s s wi t h reg a r d s t o Ho l m es ’ s m ed i cal

m al p ract i ce cl ai m

.

Gi v en o u r co n cl u s i o n t h a t th e t ri al co u rt erred i n d i s m i s s i n g Ho l m es ’ s

s u b s t an t i ve cl ai m s fo r pro fes s i on al m al p ract i ce ag ai n s t t h e Defen d an t s

, we al s o fi n d

t h at t h e co u rt erred in d i s m i s s i n g t h e cl ai m fo r l o s s of co n s o r t i u m fi l ed b y J erem y

Ho l m es

. See Eva n s v. Ro ckd a le Ho s p

., LLC

, No

. A1 8 A0 2 33

, 2 0 1 8 W L 1 75 3 8 2 0

, at

* 8 (2 ) (Ga. Ct . Ap p ., Ap r. 1 2 , 2 0 1 8 ) (a s po u se’ s cl ai m fo r l os s o f co n s ort i um s t em s

fro m t h e ri g h t o f t h e o t h er s p o u se t o reco ver fo r hi s o r h er i n ju ri es ). L ik ewi s e, t h e t ri al

co u rt erred in d i s m i ss i n g Ho lm es ’s c l a i m s o f neg l i g en t h i ri n g

, s up erv i s i o n

, an d

ret en t i o n ag ai n s t Ro ck dal e Ph y s i ci an Pract i ces

. See Ci t y o f Ki n g s l a n d v. Gr a n t h a m

,

3 4 2 Ga. Ap p

. 69 6, 6 9 9 (8 0 5 SE2 d 1 16 ) (2 0 17 ) (“ cl ai m s b as ed u po n n eg l ig en t h i ri n g,

10s u p erv i s i o n

, an d ret en t i o n o f an e m p l o ye e are d eri v at i v e o f t h e u n d erl y i n g t o rt i ou s

c o n d u c t o f t h e em

p l o y ee”) (ci t at i o n an d p u n ct u at i o n o m i tt ed ). Th e co u rt al s o err e d

i n di s m i ss i n g Ho l m es ’ s cl ai m s a g a i n s t Ro ck d al e Ho s p i t al

, as t h es e cl ai m s are

d ep en d en t o n a l eg al ly s u f f ici en t cl ai m o f m ed i cal m al p ract ice ag ai n s t a p hy s i ci an

.

La d n er v. No r t hs i de Ho s

p

. , In c., 3 1 4 Ga. Ap p

. 1 3 6

, 1 4 2-1 4 3 (7 2 3 SE2 d 4 50 ) (2 0 1 2 ).

2

. In h er n ex t en u m erat i o n o f erro r, Ho l m es arg ues t h at g i v e n Dr. Ly o n s ’ s

fai l u re t o d i s cl o s e h i s ad m i t t ed on g o i n g p h y s i cal d i s a b i l i t i e s t h at i m p act ed h i s

s u r g i cal ab i l i t i es

, t h e t ri al co u rt erred i n d i s m is s i n g h er s ep arat e cl ai m s fo r frau d,

n eg li g en t m i srep res en t at io n, a n d b at t ery fo r fai l u re t o s t at e a cl ai m an d as b ei n g

b arred u n d er Geo rg i a l aw. W e ag ree.

In th i s cas e, t h e D efen d an t s co n t en d t h at

, ab s en t an i nq u i ry b y Ho l m es p ri o r to

s u rg ery

, Dr. Ly o n s h ad n o d u t y t o vo l u n t ari l y di s cl o s e h i s p o s s i b l e p h y s i cal

l i m i tat i on s b ecau s e t h i s i s no t l i s t ed as a s peci fi c cat eg ory o f i n fo rm at i o n i n G eo rg i a’ s

i n fo rm ed co n s en t s t at u t e, OCGA § 3 1 -9 -6 .1 (a). 3 See Al b a n y Ur o l o g y Cl i n i c, P.C. v.

3 Th e i m p l i ed co n sen t s t at u t e’ s m an d at ory d i s cl o s u res i n cl u d e: (1 ) t h e p at i en t ’ s

d i ag n o s is req u i ri n g t h e p ro p o s ed p ro ced u re; (2 ) t h e n at ure an d pu rp o s e o f t h e

p ro ced ure; (3 ) t h e g en eral ly reco g n i zed an d m at e r i a l r i s k s o f “ i n fect i o n

, al l erg i c

react i o n, s ev ere l o s s of b l o o d

, l o s s o r l o ss o f fu n ct i o n o f an y l i m b or o rg an

, p aral y s i s

o r p art ial pa

r a ly sis, pa r a ple gia or qua dr ipl eg i a, d i s fi g uri n g s car, brai n dam ag e, card i ac

arres t

, o r d eat h ” as s o ci at ed w i t h t h e p ro ced u re; (4 ) th e l ik el i h o o d o f t h e p ro ced u re’ s

s u cces s ; (5 ) t h e pract ical

, reco g n i zed an d accep t ed al t ern at i ves t o t h e p ro ced u re; an d

11Cl evel a n d

, 2 7 2 Ga. 2 9 6, 2 9 8-2 99 (1 ) (5 2 8 SE2 d 7 7 7 ) (2 0 0 0 ). Th e G eo rg i a Su p rem e

Co u rt h as ex p l ai n ed t h at “ [b ] ecau s e OCGA § 31 -9 -6 .1 i s i n d ero g at i on of t h e co m m o n

l aw ru le ag ai n s t req u i ri n g p h y s i c i a n s t o d i scl o s e m ed ical ri s k s t o t h ei r p at i en t s

, i t

m u st b e s t ri ct ly co n st ru ed an d can n o t b e ex ten d ed b ey o nd i t s p l ai n an d ex p l i ci t

t erm s .” Id . at 2 9 9 (1 ).

[N] ei t h er th e co m

m o n l aw n o r th e Co d e i m p o s e a d u ty u po n ph y s i ci an s

o r an y o t h er p ro fes s i on al t o d i scl o s e p ers o n al l i f e f a c t o rs wh i ch m i g h t

a d v ers el y affect t h ei r pro fes s i o n al p erfo rm an ce. Hen ce, t h e fai l u r e t o

m ak e s u c h d i s c lo s ure can n o t b e a b as i s fo r ei t h er a frau d o r b at t ery

cl ai m

.

Id

. at 3 0 3 (5 ). B u t A l b a n

y d o es n o t s t an d fo r t h e p ro p os i t i o n t h at a p hy s i ci an n ev er

h as a du t y t o d is cl o s e n eg at i v e i n fo rm at io n ab o u t h is pers o n al l i fe t o p at i en t s

. Rat h er,

i t s t a t e d t h at “ fai lu re t o m ak e d i s cl o s u res t h at are n ot req u i red [u n d er t h e In fo rm ed

Co n s en t D o c t r i n e] can n o t g i v e ri s e t o an in d ep en d en t cau s e o f act i o n ” fro m a

m al p ract i ce c l ai m

. Id

. at 3 0 0 (2 ). No t ab l y

, t h e Co u rt ex p lai n ed t hat “ ob t ai n i ng co n s en t

fo r m ed i cal t reat m en t b y an art i fi ce th at i s d i r ect ly r el a t ed t o t he s u b ject m at t er o f t h e

p ro fes s i on al rel at io ns h ip

— i .e.: d i ag n o s es

, t reat m en t s

, p ro ced u res

— m a y res u l t i n an

(6 ) t h e p at i en t ’ s p ro g n os i s i f t h e p ro p o s ed pro ced u re i s reject ed

. See OCGA § 3 1 -9

-

6 .1 (a) (1 )-(6 ).

12u n l awfu l t o u ch i n g t h at s u p p o rt s a b at t ery cl ai m .” Id

. at 3 0 1 (3 ) (em p h as i s ad d ed ). In

Al b a ny

, t h e Su p rem e Co u rt decl i n ed t o ap p l y t h e i n fo rm ed co ns en t s t at u t e t o t h e fact s

o f t h at cas e, i n wh i ch a p h y s i ci an ’ s dru g u s e was at i s s u e i n a p at i en t ’ s s ui t al l eg i n g

p ro fes s i on al n eg l ig en ce, b a t t e ry an d frau d u l en t co n ceal m en t o f i l l eg al co cai n e u s e.

I d

. a t 3 0 1 (3 ). Sp eci fi cal ly

, t h e Co u rt h i g h l i g h t ed t h ere was n o ev i d en ce t h at t h e

“ p h y s i ci an was i m

p ai red o r affect ed b y t h e n e g a t i v e p ers o nal li fe fact o r at t h e t i m e

co n sen t was o bt ai n ed an d t reat m en t was ren d ered

. ” Id

.

Th e i n s t an t cas e ap p ears d i st i ng u i sh ab l e. Vi ewed i n H o l m es ’ s fav o r, as we

m u st o n a m o t i o n to d i s m i ss

, 4 t h e co m pl ai n t co u l d be read t o ad eq u at el y p lead cl ai m s

4 No t ab l y

, in Al b a n

y

— a cas e h eav i l y ci ted b y th e Defen d a n t s i n fav o r o f

d i s m i s s al o f Ho l m es ’ s cl ai m s o f ba tte r y

, frau d

, an d n eg l i g en t m i s rep res en t at i o n

— t h e

p l ai n t i ff’ s cl ai m s were t ri ed b efo re a ju ry

. Al b a ny

, 2 72 Ga. at 2 9 7

. In t h at cas e, aft er

t h e ju ry ru l ed i n fav o r o f t h e d efen d an t o n t h e m al p r a c t i ce cl ai m

, b ut ret u rn ed

p l ai n t i ff’ s v erd i c t s o n t h e cl ai m s o f frau d u l en t co n ceal m en t an d m i s rep res en t at i o n

b as ed o n t h e p h y s i ci an ’ s al l eg ed d ru g u s e, t h e t ri al co u rt g ran t ed t h e d e f e n d an t ’ s

m o ti o n fo r ju d g m en t n ot wi t h s t an d i n g t h e v erd i ct b ecau se t h e p l ai n t i ff’ s frau d cl ai m

fai l ed as a m at t er o f l a w

. S e e al s o W il l i a ms v. B o o ker

, 3 1 0 Ga. Ap p

. 20 9

, 2 0 9 (7 1 2

SE2 d 6 1 7 ) (2 0 1 1 ) (p h y s i ci an an d h i s m ed i cal p ract i ce s o u g h t in terl o cu t o ry rev i ew to

ap p ea l t h e d en i al o f t h ei r m o ti o n s fo r p art ial s u m m ary ju dg m en t o n t h e i s s u e o f

wh et h er th e p h y s i ci a n h ad a d u t y t o i n fo rm a pat i en t ab o u t h is al co ho l ad d i ct i o n );

Ho o ks v. Hu m

p h r ies

, 3 0 3 Ga. A p p

. 26 4

, 2 6 4 -2 6 6 (6 9 2 SE2 d 8 4 5 ) (2 0 1 0 ) (ap p eal o f

g ran t o f p art i al m o t i o n fo r s u m m ary ju d g m en t ag ai n s t p l ai n t i ff’ s cl ai m s as t o b reach

o f fi d uci ary d u t y an d o r d i n a r y n eg l i g en ce b as ed o n p h y s i ci an ’ s fai l u re t o d i s cl o s e

reas on s h e n o l o n g er d el iv ered b ab i es ); Bl o t n er v. Do r ei ka

, 2 8 5 Ga. 4 81

, 4 8 1-4 8 2 (1 )

(6 7 8 SE2 d 8 0 ) (2 0 0 9 ) (p lai n t i ff ap p eal ed fo l l o w i n g a ju ry v erd ict i n fav o r o f

ch i ro p ract o r, as sert i n g th at t h e ch i ro p ract or fai l ed to i nfo rm h i m ab ou t ri s k s o r

13fo r frau d

, 5 b at t ery

, 6 an d n eg l i g en t m is rep res en t at i o n

. Th e cru x o f Ho l m es ’ s cl ai m i s

t h at (1 ) D r. Ly o n s fai l ed t o i n fo rm h er o f h i s k n o w n d i s ab i l i t i es p ri or t o t h e s u rg ery ;

(2 ) Dr. Ly o n s ’ s kn o wn ph y s i cal l i m i t at i o n s cau sed hi m t o p e r f o rm t h e su rg ery i n a

d efi ci en t m an n er; an d (3 ) Ho l m es ex p eri en ced co m pl i cat i o n s, i n cl ud i n g a ri g h t d i st al

u ret eral i n

ju ry an d u tero v ag i n al fi s t u l as

, as a d i rect res u l t of t h e s urg ery

. Ho l m es p ut

fo rt h s p eci fi c al l eg at i o n s

, i n c l u d i n g t h at Dr. L y o ns : (1 ) was i m p ai red b y m

u l t i p l e

d i s ab i l i t i es wh en h e p erfo rm ed g y n eco l o g i cal s u rg ery on J u n e 2 3

, 2 0 1 5

, wh i ch

res u l ted i n a prev en t ab l e i n ju ry t o Ho l m es ’ s u ret er an d o t h er co m p li cat i o n s ; (2 ) n ev er

i n fo rm ed h er o f h i s d i m i n i s h e d m o t o r sk i l l s

, v i s io n i s s u es

, o r d i ffi cu l t i es i n wei g h

b eari n g ; an d (3 ) n ev er ad v i s ed h er t h at h er ri s k of co m pl i c a t i o n s w o u l d b e red u ced

i f an o t her g y neco l o g ical su rg eo n, wi t h o u t t h e s am e p h y s i cal l i m i t at i o n s

, h ad

p erfo rm ed t h e s u rg ery

. Bas ed o n t h e f o r e g o i n g

, t h e t ri al co u rt co u l d n o t h av e s ai d

t reat m en t al t ern at i v es p ri o r t o p erfo rm i n g a n eck ad ju s t m en t).

5 See Al b a n

y

, 2 7 2 Ga. at 3 0 0 (2 ) n

. 1 4 (“ t h e s u cces s fu l p u rs u i t o f a frau d cl ai m

,

ev en o n e w i th i n t h e p r o f e s s i on al co n t ex t

, req u i res a s h o wi n g o f an i n t en t i o n to

d ecei v e”).

6 A cl ai m fo r m ed i cal b at t ery ari s es w h en a p at i en t ’ s co n sen t t o a p ro ced u re i s

o b t ai n ed b y “ frau d u l en t m i s rep res en t at i o n s of m at eri al fac t s ” i n o b t ai n i n g t h at

co n sen t

. OCGA § 3 1 -9 -6 (d ); Ll o yd v. Kr amer

, 2 33 Ga. Ap p

. 3 7 2

, 3 7 5 (1 ) (5 0 3 SE2 d

6 3 2 ) (1 9 9 8 ).

14wi t h cert ai nt y at t h i s s t ag e i n th e p ro ceed in g t h at Ho l m es “ w i ll b e u n ab le t o p ro v e an y

s et o f fact s i n s u p p o rt o f [h er] cl ai m t h at w o u l d en ti t l e [h er] t o rel ief.” Es t a t e of

S h a n n o n v. Ah med

, 30 4 Ga. Ap p

. 3 8 0

, 3 8 4 (1 ) (6 9 6 SE2 d 4 0 8 ) (2 0 1 0) (rev ers i n g

g ran t o f m o t io n t o di s m i s s wi t h res p ect t o p l ai n t i ff’ s ad eq u at el y p l ed cl ai m s fo r frau d,

b at t ery

, an d co n s p iracy ). Acco rd i n g l y

, we rev ers e t h e t ri al co urt ’s d i s m i s s al o f

Ho l m es ’ s cl ai m s fo r frau d, b at tery , an d n eg l i g en t m i s rep res en t at io n

.

3

. Fi n al l y

, Ho l m es as s ert s t h at t h e t ri al ju d g e erred b y n o t recu s i ng h ers el f s u a

s p o n te b as ed on an ap paren t fi n an ci al co n f l i c t o f i n teres t wi t h res pect t o Ro ck d al e

Ho s pi t al

. W e n eed n o t ad d res s t hi s i s s u e b e c a u s e t h e reco rd refl ect s t h at Ho l m es

fai l ed to rai s e it i n t h e t ri al co u rt or t o req u es t recu s al b el o w

. See W il ch er v. W

a y

Accep t a n ce Co

. , 3 0 5 Ga. Ap p

. 8 6 8

, 8 7 1 (5 ) (7 0 0 SE2 d 8 76 ) (2 0 1 0 ) ( w h e r e recu s al

i s su e was n o t rai sed i n t h e t ri al co u rt

, cl ai m was n ot p ro p erl y b efo re ap p el l at e co u rt ).

J u d g m e n t r ever

s ed

. El l i n g to n

, P.J., co n cu r s. a n d Bet h el

, J., co n cu r

s i n

Di vi s i o n s 1 a n d 3 , a n d

d i s s en t s i n Di vi s io n 2

.

* DI VI SI ON 2 OF T H I S OPI NI ON IS P HYSI C AL PRECEDENT ONLY,

COURT OF APPEALS RULE 3 3 .2 (a ).

15A1 8 A0 27 7 . HOLM ES et al . v . LYONS et al

.

B E T H E L , J u d g e, co n cu rri n g i n p art an d d i s s en ti n g i n p art

.

W h i l e I co n cu r i n D i v i s i o ns 1 an d 3 o f t h e m ajo ri t y ’ s o pi n i o n

, I m u s t

res p ect fu l l y d i s s en t as t o Di v i s i on 2

. In Di v i s i o n 2

, t he m ajo ri t y d is t in g u i s h es Al b a n y 1

an d fi n d s t h a t t h e t ri al co u rt wro n g l y d i s m i ss ed Ho l m es ’ s cl ai m s fo r frau d, b at t ery

,

a nd ne g l i g en t m is rep res en t at i o n b ecau s e Ho l m es ’ s al l eg at i o n s cl ear t h e r e la tive ly low

h u rd le s et fo r co m

p l ai n t s o n a m o t i o n t o di s m i s s

. I d o n o t ag ree wi t h t h e m ajo ri t y ’ s

i n t erp ret at io n o f Al ba n

y an d wo u l d affi rm t h e t ri al co u rt ’ s d i s m i s s al o f t h es e cl ai m s

.

As t h e m ajo ri t y co rrec t l y n o t es

, t h e G eo rg i a Su p rem e Co u rt s t at ed i n Al b a n y

t h at

n ei t h er t h e co m

m o n law n o r t h e Co d e i m p o s e a d u t y u p o n ph y s i ci an s

o r an y o t h er p ro fes s i on al t o d i scl o s e p e r s o n al l i fe fact o rs wh i ch m i g h t

ad v ers el y affect t h e i r p ro fes s i o n al p erfo rm an ce. Hen ce, t he fai lu re t o

m ak e s uch d i s cl o s u re can n o t b e a b a s i s fo r ei t h er a frau d o r b at t ery

cl ai m

.

1 2 7 2 Ga. 2 9 6 (5 2 8 SE2 d 7 7 7 ) (2 0 0 0 ).2 7 2 Ga. at 3 0 3 (5 ).

Des p i t e t h i s b r o a d p ro n o u n cem en t

, t h e m ajo ri t y rel i es u p o n d i ct a i n t h e

o p i n i o n s t at i n g th at “ o b tai n i n g co n s en t fo r m ed ical t reat m e n t b y an art i fi ce t h at i s

d i rect l y rel at ed t o th e s ub

ject m at t er o f t h e p ro fes s i on al rel at i o ns h ip

– i .e.: d i ag n o s es

,

t reat m en t s

, p ro ced u res

– m ay res u lt i n an u n l awfu l t o uch i n g th at su p po rt s a b at t ery

cl ai m .” Id

. at 3 0 1 (3 ). I d o no t fi n d Dr. Ly o n s ’ s p h y s i c a l l i m i t at i o ns to b e “ d i rect l y

rel at ed t o t h e s u b

j ect m at t er o f t h e p ro fes s i on al rel at i o n s hi p

– i .e.: d i ag n o s es

,

t reat m en t s

, [o r] p ro ced u res [.] ” Th u s

, I b el i ev e Ho l m e s i s barred fro m as s ert i n g

i n d ep en den t cau s es o f act i o n b as ed o n D r. Ly o n s’ s fai l u re t o d i s cl o s e t ho s e p h y s i cal

l i m i tat i on s

.

2