IN THE COURT OF APPEALS OF TENNESSEE

AT NASHVILLE

February 19, 2019 Session

STEVEN WILLIAMS1v. GATEWAY MEDICAL CENTER, ET AL.

Appeal from the Circuit Court for Montgomery County

No. CC16CV2392 Ross H. Hicks, Judge

___________________________________

No. M2018-00939-COA-R3-CV

___________________________________

In this health care liability action, the trial court dismissed the plaintiff’s claims for 

failure to substantially comply with the requirements of Tenn. Code Ann. § 29-26-

121(a)(2)(E) upon determining that the plaintiff’s pre-suit notice failed to include a 

HIPAA-compliant medical records authorization. The trial court found that the medical 

records authorizations provided by the plaintiff failed to include a “[d]escription of 

information to be used or disclosed” and an expiration date. The trial court further 

determined that these deficiencies prejudiced the defendants from mounting a defense 

because they were unable to obtain the relevant medical records. As a result, the 

plaintiff’s claims were dismissed without prejudice. The plaintiff timely appealed. We 

consider the plaintiff’s omission of an expiration date insignificant. The HIPAA form 

provided by the plaintiff failed to substantially comply with the statute because it did not 

include a description of the information to be used or disclosed, thereby causing prejudice 

to the defendants. We, therefore, affirm the trial court’s dismissal of the plaintiff’s 

claims. 

Tenn. R. App. P. 3 Appeal as of Right; Judgment of the Circuit Court Affirmed and 

Remanded

ANDY D. BENNETT, J., delivered the opinion of the court, in which THOMAS R. FRIERSON,

II, and RICHARD H. DINKINS, JJ., filed separate opinions concurring in part and dissenting

in part.

Marvin B. Berke, Chattanooga, Tennessee, for the appellant, Steven Williams.

 

1 Although the complaint heading lists “Steven Williams, individually and as next of kin for the 

wrongful death beneficiaries of Melissa L. Johnson Williams, deceased” as the “plaintiff,” no other

beneficiaries are named within the appellate record or appear to be participating in this appeal. Therefore, 

for simplicity, we will refer to Mr. Williams throughout this opinion as the plaintiff/appellant.

04/18/2019
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Dixie W. Cooper and Kim J. Kinsler, Nashville, Tennessee, for the appellees, Clarksville 

OB/GYN Associates, P.C., and Jennifer Harris Johnston, M.D.

OPINION

I. FACTUAL AND PROCEDURAL BACKGROUND2

On September 4, 2015, Melissa Williams was admitted to Gateway Medical 

Center for the purpose of having a hysterectomy performed by Dr. Jennifer Harris 

Johnston. Following the operation, Ms. Williams developed a deep vein thrombosis; she 

died on September 8, 2015. Steven Williams, Ms. Williams’s husband, filed a health

care liability action in the Circuit Court of Montgomery County on November 4, 2016. 

Mr. Williams’s complaint alleged that Dr. Johnston and Gateway Medical Center failed 

to prescribe or administer anticoagulant medications to Ms. Williams, which was a 

violation of the standard of care due to Ms. Williams’s history of diabetes, and made her 

susceptible to post-surgical blood clots.3 Mr. Williams alleged that this violation of the 

standard of care caused his wife’s death.

Mr. Williams provided the defendants with the pre-suit notice required by Tenn. 

Code Ann. § 29-26-121 on August 24, 2016. The pre-suit notice included HIPAA 

authorizations, but these authorizations failed to include “a description of information to 

be used or disclosed” and an expiration date. 45 C.F.R. § 164.508(c)(1)(i), (v). On 

December 19, 2016, Clarksville Health System, GP (formerly Gateway Medical) (“the 

Hospital”) filed an answer, denying that Dr. Johnston was an employee. The Hospital 

further denied any departure from the applicable standard of care by its staff in the care of 

Ms. Williams.

On January 9, 2017, Dr. Johnston and Clarksville OB/GYN Associates, P.C.

(“Clarksville OB/GYN”), filed a motion to dismiss, pursuant to Tenn. R. Civ. P. 12, 

asserting that the medical authorizations accompanying the pre-suit notice were deficient. 

In their motion, Dr. Johnston and Clarksville OB/GYN outlined that the medical

authorizations provided by Mr. Williams had failed to include a “description of the 

information to be used or disclosed” or an expiration date. As a result of these missing 

components, Dr. Johnston and Clarksville OB/GYN asserted, they were unable to obtain 

Ms. Williams’s medical records from the Hospital because Dr. Johnston was not an 

 

2 The authoring judge acknowledges and appreciates Judge Frierson’s contributions to this 

opinion.

3 Although the complaint named other medical defendants, those defendants filed answers 

denying that they provided any care to Ms. Williams. The claims against those defendants were 

subsequently nonsuited by Mr. Williams. The only defendants participating in this appeal are Clarksville 

OB/GYN Associates, P.C., and Jennifer Harris Johnston, M.D.
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employee of the Hospital and had no access to its records. The Hospital also filed a 

motion to dismiss on February 8, 2017. 

After hearing oral arguments concerning the motions to dismiss, the trial court 

entered an order on February 28, 2017, determining that the motions to dismiss would be 

held in abeyance due to the pendency of a Tennessee Supreme Court case with the 

potential to be dispositive of the motions. Ultimately, the case was not dispositive, and 

Dr. Johnston and Clarksville OB/GYN filed a renewed motion to dismiss on January 29, 

2018. 

On March 23, 2018, the trial court entered an order in which it concluded that Mr. 

Williams’s pre-suit notice failed to include a HIPAA-compliant medical records 

authorization and therefore failed to substantially comply with Tenn. Code Ann. § 29-26-

121(a)(2)(E). Because the authorizations failed to include a “description of information 

to be used or disclosed” or an expiration date, the court determined that Dr. Johnston was 

prejudiced because she was unable to obtain the relevant medical records from the 

Hospital to mount a defense. As a result, the court dismissed without prejudice the 

claims against Dr. Johnston.

On April 16, 2018, Mr. Williams filed a motion pursuant to Tenn. R. Civ. P. 59. 

In this motion, Mr. Williams argued that the medical records authorizations provided to 

the defendants were sufficient and that there had been no demonstration that Dr. Johnston 

and Clarksville OB/GYN could not obtain the relevant records. Mr. Williams asserted, 

inter alia, that the records “were all stored in one place and were together at the hospital 

and were accessible to both Defendants.” Mr. Williams further asserted that Dr. Johnston 

and Clarksville OB/GYN “were instructed to fill out the balance of the HIPAA release, 

but did not do so.” Mr. Williams subsequently filed a notice of voluntary nonsuit 

regarding his claims against all defendants except Dr. Johnston and Clarksville OB/GYN.

On May 7, 2018, the trial court entered an order denying Mr. Williams’s Rule 59 

motion. Finding that the plaintiff merely sought to relitigate matters that had already 

been adjudicated, the court reaffirmed the dismissal of all claims against Dr. Johnston 

and Clarksville OB/GYN. Mr. Williams timely appealed.

II. ISSUES PRESENTED

Mr. Williams presents the following issues for review:

1. Whether the trial court erred by determining that the medical records

authorizations were not substantially compliant with HIPAA 

regulations and Tenn. Code Ann. § 29-26-121(a)(2)(E) when the 

only alleged deficiencies were the failure to include an expiration 

date and a description of relevant records.
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2. Whether a HIPAA-compliant medical authorization is necessary, 

pursuant to Tenn. Code Ann. § 29-26-121(a)(2)(E), when both 

defendants received notice and contributed to the sole medical 

record.

3. Whether the trial court erred by denying Mr. Williams’s Tenn. R. 

Civ. P. 59 motion.

III. STANDARD OF REVIEW

Our Supreme Court has provided the following guidance regarding the standard of 

review applicable to a motion to dismiss a health care liability action based upon a

plaintiff’s alleged noncompliance with Tenn. Code Ann. § 29-26-121:

The proper way for a defendant to challenge a complaint’s 

compliance with Tennessee Code Annotated section 29-26-121 and 

Tennessee Code Annotated section 29-26-122 is to file a Tennessee Rule of 

Procedure 12.02 motion to dismiss. In the motion, the defendant should 

state how the plaintiff has failed to comply with the statutory requirements 

by referencing specific omissions in the complaint and/or by submitting 

affidavits or other proof. Once the defendant makes a properly supported 

motion under this rule, the burden shifts to the plaintiff to show either that 

it complied with the statutes or that it had extraordinary cause for failing to 

do so. Based on the complaint and any other relevant evidence submitted 

by the parties, the trial court must determine whether the plaintiff has 

complied with the statutes. If the trial court determines that the plaintiff has 

not complied with the statutes, then the trial court may consider whether the 

plaintiff has demonstrated extraordinary cause for its noncompliance. If the 

defendant prevails and the complaint is dismissed, the plaintiff is entitled to 

an appeal of right under Tennessee Rule of Appellate Procedure 3 using the 

standards of review in Tennessee Rule of Appellate Procedure 13. If the 

plaintiff prevails, the defendant may pursue an interlocutory appeal under 

either Tennessee Rule of Appellate Procedure 9 or 10 using the same 

standards.

* * *

The leading rule governing our construction of any statute is to ascertain 

and give effect to the legislature’s intent. Walker v. Sunrise Pontiac-GMC 

Truck, Inc., 249 S.W.3d 301, 309 (Tenn. 2008). To that end, we start with 

an examination of the statute’s language, Curtis v. G.E. Capital Modular 

Space, 155 S.W.3d 877, 881 (Tenn. 2005), presuming that the legislature 

intended that each word be given full effect. Lanier v. Rains, 229 S.W.3d 
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656, 661 (Tenn. 2007). When the import of a statute is unambiguous, we 

discern legislative intent “from the natural and ordinary meaning of the 

statutory language within the context of the entire statute without any 

forced or subtle construction that would extend or limit the statute’s 

meaning.” State v. Flemming, 19 S.W.3d 195, 197 (Tenn. 2000); see also 

In re Adoption of A.M.H., 215 S.W.3d 793, 808 (Tenn. 2007) (“Where the 

statutory language is not ambiguous . . . the plain and ordinary meaning of 

the statute must be given effect.”) (citing Calaway ex rel. Calaway v. 

Schucker, 193 S.W.3d 509, 516 (Tenn. 2005)). The construction of a 

statute is also a question of law which we review de novo without any 

presumption of correctness. Lind [v. Beaman Dodge, Inc.], 356 S.W.3d 

[889,] 895 [(Tenn. 2011)].

Myers v. AMISUB (SFH), Inc., 382 S.W.3d 300, 307-08 (Tenn. 2012). 

In Arden v. Kozawa, 466 S.W.3d 758, 763 (Tenn. 2015), our Supreme Court 

clarified:

The content and affidavit requirements of Tennessee Code 

Annotated sections 29-26-121(a)(2), (a)(3), and (a)(4) are not mandatory, 

but directory, and can be achieved through substantial compliance. See

Thurmond v. Mid-Cumberland Infectious Disease Consultants, PLC, 433 

S.W.3d 512, 520 (Tenn. 2014) (allowing substantial compliance with the 

affidavit requirement under Tennessee Code Annotated sections 29-26-

121(a)(3)(B) and (a)(4)); Stevens ex rel. Stevens v. Hickman Comm. Health 

Care Servs., Inc., 418 S.W.3d 547, 555 (Tenn. 2013) (allowing substantial 

compliance with the HIPAA form requirement under Tennessee Code 

Annotated section 29-26-121(a)(2)(E)). “[U]nless strict compliance with a 

notice content requirement ‘is essential to avoid prejudicing an opposing 

litigant,’ substantial compliance with a content requirement will suffice.” 

Thurmond, 433 S.W.3d at 520 (quoting Stevens, 418 S.W.3d at 555).

The Court has also explained that to determine 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 plaintiff’s noncompliance.” Stevens ex rel. Stevens v. Hickman Cmty. 

Health Care Servs., Inc., 418 S.W.3d 547, 556 (Tenn. 2013). 
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ANALYSIS

IV. STATUTORY REQUIREMENTS CONCERNING HIPAA-COMPLIANT MEDICAL 

AUTHORIZATION

Mr. Williams contends that the trial court erred in dismissing his claims based on 

his failure to substantially comply with Tenn. Code Ann. § 29-26-121(a)(2)(E). The 

medical records authorizations provided by Mr. Williams did not include a “description 

of information to be used or disclosed” or an expiration date. See 45 C.F.R. § 

164.508(c)(1)(i), (v). Dr. Johnston and Clarksville OB/GYN (collectively, “Defendants”)

argue that the trial court properly dismissed the action because the medical authorizations

provided by Mr. Williams were insufficient to allow Defendants to access relevant 

medical records to prepare a defense. 

Tennessee Code Annotated section 29-26-121 (Supp. 2016) provides, in pertinent 

part:

(a)(1) Any person, or that person’s authorized agent, asserting a potential 

claim for health care liability shall give written notice of the 

potential claim to each health care provider that will be a named 

defendant at least sixty (60) days before the filing of a complaint 

based upon health care liability in any court of this state.

(2) The notice shall include:

. . . .

(E) A HIPAA compliant medical authorization permitting the 

provider receiving the notice to obtain complete medical 

records from each other provider being sent a notice.

The trial court determined that Mr. Williams had failed to substantially comply 

with Tenn. Code Ann. § 29-26-121(a)(2)(E) because the medical records authorizations 

provided did not include a “description of information to be used or disclosed” or an 

expiration date. The court also determined that these deficiencies prejudiced Defendants

from obtaining the relevant medical records from the Hospital so that they could mount a 

defense. On appeal, Mr. Williams asserts that the authorizations were substantially 

compliant because the only alleged deficiencies were the lack of an expiration date and 

description of the records to be disclosed. Mr. Williams argues that Defendants were 

able to “fill in the blanks” on the authorization forms in order to obtain the records they 

deemed necessary.4

 

4 Despite Mr. Williams’s assertion, the letter accompanying the medical release provided no 

further instruction concerning the release.
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As our Supreme Court has explained:

Tenn. Code Ann. § 29-26-121(a)(2)(E) serves to equip defendants with the 

actual means to evaluate the substantive merits of a plaintiff’s claim by 

enabling early access to a plaintiff’s medical records. Because HIPAA 

itself prohibits medical providers from using or disclosing a plaintiff’s 

medical records without a fully compliant authorization form, it is a 

threshold requirement of the statute that the plaintiff’s medical 

authorization must be sufficient to enable defendants to obtain and review a 

plaintiff’s relevant medical records. See 45 C.F.R. § 164.508(a)(1) (“a 

covered entity may not use or disclose protected health information without 

an authorization that is valid under this section”). Tenn. Code Ann. § 29-

26-121(d)(1) creates a statutory entitlement to the records governed by § 

29-26-121(a)(2)(E). See Tenn. Code Ann. § 29-26-121(d)(1) (“All parties 

in an action covered by this section shall be entitled to obtain complete 

copies of the claimant’s medical records from any other provider receiving 

notice . . . .”) (emphasis added).

Stevens, 418 S.W.3d at 555. The Court referenced the following federal regulations 

establishing the six elements of a HIPAA-compliant authorization:

Core elements. A valid authorization under this section must contain at 

least the following elements: 

(i) A description of the information to be used or disclosed that identifies 

the information in a specific and meaningful fashion. 

(ii) The name or other specific identification of the person(s), or class of 

persons, authorized to make the requested use or disclosure.

(iii) The name or other specific identification of the person(s), or class of 

persons, to whom the covered entity may make the requested use or 

disclosure.

(iv) A description of each purpose of the requested use or disclosure . . . .

(v) An expiration date or an expiration event that relates to the individual or 

the purpose of the use or disclosure . . . .

(vi) Signature of the individual and date. If the authorization is signed by a 

personal representative of the individual, a description of such 

representative’s authority to act for the individual must also be provided.
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45 C.F.R. § 164.508(c)(1) (quoted in Stevens, 418 S.W.3d at 555-56). We emphasize 

that, “[i]n 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 

plaintiff’s noncompliance.” Stevens, 418 S.W.3d at 556. In Stevens, our Supreme Court 

determined that the “errors and omissions [in the medical authorization] were numerous 

and significant,” such that the plaintiff had not substantially complied with the 

requirements of the statute. Id. Mr. Williams asserts that the omissions in this matter are 

not as significant.

A. Expiration date.

We begin by considering the significance of the omission of the HIPAA form’s 

expiration date. There are a few relevant cases. In Hamilton v. Abercrombie 

Radiological Consultants, Inc., 487 S.W.3d 114, 120 (Tenn. Ct. App. 2014), the only 

alleged error on the plaintiff’s HIPAA form was the missing date required under C.F.R. § 

164.508(c)(1)(vi), which requires a “[s]ignature of the individual and date.” The plaintiff 

explained that this date line was left blank “as a courtesy” to the defendants so that the 

form would not “become stale.” Hamilton, 487 S.W.3d at 120. The trial court granted 

the defendants’ motion to dismiss based upon this omission on the HIPAA form. Id. at 

116. On appeal, this court found no evidence that the defendants “were prejudiced or 

otherwise denied access to medical records as a result of the missing date.” Id. at 122. 

Although we acknowledged that “it is not good practice to omit any of the C.F.R. criteria 

from a HIPAA form,” we determined that “the relatively minor shortcoming in the 

HIPAA form here [was] not fatal” to the plaintiff’s case. Id. 

The result in Hamilton differs from that in Buckman v. Mountain States Health 

Alliance, No. E2017-01766-COA-R3-CV, 2018 WL 3608416, at *1 (Tenn. Ct. App. July 

26, 2018), a case in which the HIPAA authorization form provided by the plaintiff 

included an expiration date that had already passed. This court affirmed the decision of 

the trial court dismissing the plaintiff’s complaint for failure to substantially comply with 

the statute. Buckman, 2018 WL 3608416, at *8. The defendants were prejudiced 

because they could not legally obtain medical records with an invalid (expired) HIPAA 

release form. Id. at *6-7.

The facts in the present case are similar to those in Hamilton. There has been no 

showing that Defendants were prejudiced by Mr. Williams’s omission of an expiration 

date. Counsel for Dr. Johnston acknowledged that this omission was “not an extremely 

significant oversight.” Her further statement that, if this were the only issue, the case 

probably would not be in court, indicates a lack of prejudice. We conclude that Mr. 

Williams’s omission of an expiration date was insignificant and did not prevent the 

HIPAA form from being substantially compliant with Tenn. Code Ann. § 29-26-

121(a)(2)(E). 
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B. Description of records. 

The pertinent portion of the medical records authorization form sent by Mr. 

Williams is entitled, “Description of information to be used or disclosed.” Underneath 

this heading, the form asks: “Is this a request for psychotherapy notes?” If the answer to 

this question is “Yes,” the instructions state that “[y]ou must submit another authorization 

for other items below.” If the answer is “No, then you may check as many items below 

as you need.” Following these preliminary questions is a listing of types of medical 

records with boxes to check and dates of the records for each type of medical record 

requested. The first item in the list is “All PHI [Protected Health Information] in medical 

record.” The remainder of the list describes more specific records. On the HIPAA 

authorization forms sent by Mr. Williams to Defendants, no check marks appeared in this 

section.

Mr. Williams argues that the authorizations were sufficient because Defendants

could “check however many records or what type of records the Defendant wants to 

obtain” and that “Defendant was entitled to check any box the Defendant wanted.” This 

court has previously held, however, that it is not the burden of medical defendants to 

“assist” a plaintiff in achieving compliance with Tenn. Code Ann. § 29-26-121(a)(2)(E)

or to “test” a deficient authorization to ascertain whether records can be obtained. See

J.A.C. by and through Carter v. Methodist Healthcare Memphis Hosps., 542 S.W.3d 502, 

514 (Tenn. Ct. App. 2016). As the J.A.C. court explained:

Several Tennessee decisions have rejected the proposition that a health care 

liability defendant has a duty to assist a plaintiff [to] achieve compliance or 

to test whether an obviously deficient HIPAA form would allow the release 

of records. See, e.g., Stevens, 418 S.W.3d at 559 (“Plaintiff—not 

Defendants—was responsible for complying with the requirements of 

Tenn. Code Ann. § 29-26-121(a)(2)(E).”); Dolman v. Donovan, No. 

W2015-00392-COA-R3-CV, 2015 WL 9315565, at *5 (Tenn. Ct. App. 

Dec. 23, 2015) (rejecting the plaintiffs’ argument that the medical providers 

could not have been prejudiced because they never attempted to obtain 

medical records with the deficient medical authorization provided), perm. 

app. denied (Tenn. May 6, 2016). Similarly, our courts have rejected the 

notion that a health care liability defendant needs to inform a plaintiff that 

the provided authorization form is deficient before filing a motion to 

dismiss. Stevens, 418 S.W.3d at 559; Vaughn v. Mountain States Health 

Alliance, No. E2012-01042-COA-R3-CV, 2013 WL 817032, at *4 (Tenn. 

Ct. App. Mar. 5, 2013) (rejecting the argument that the defendants should 

have contacted plaintiff’s counsel prior to an action being filed against 

them in order to inform plaintiff’s counsel that the requirements of 

Tennessee Code Annotated section 29-26-121 had not been met), overruled 

on other grounds by Davis v. Ibach, 465 S.W.3d 570 (Tenn. 2015).
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The argument that a health care liability defendant should complete 

or “customize” a medical authorization that contains blanks has been 

specifically rejected by two recent decisions of this Court. In Roberts v. 

Prill, No. E2013-02202-COA-R3-CV, 2014 WL 2921930 (Tenn. Ct. App. 

June 26, 2014), the plaintiff admitted that she intentionally left portions of 

the HIPAA form blank and anticipated that the defendant medical providers 

would fill it in. Id. at *6. In summarizing the crux of the plaintiff’s

argument as to why her complaint should not be dismissed despite the 

presence of an incomplete form, we noted as follows: “She essentially 

argues that the onus should be placed on Defendants to test the sufficiency 

of the form or even to complete an inadequate form.” Id. We rejected the 

plaintiff’s argument and noted as we had in Stevens that it is the health care 

liability plaintiff, not defendant, that is responsible for complying with the 

requirements of Tennessee Code Annotated section 29-26-121(a)(2)(E). Id.

(citation omitted).

Id. at 514-15.

Similarly, in Roberts v. Wellmont Health Sys., No. E2017-00845-COA-R9-CV, 

2018 WL 3302178, at *1 (Tenn. Ct. App. July 5, 2018), the plaintiff provided a medical 

authorization that contained blanks to be filled out by the defendants in accordance with a 

purported local custom in the second judicial district. The trial court relied upon and took 

judicial notice of this custom in denying the defendants’ motion to dismiss for lack of 

substantial compliance with the statute. Roberts, 2018 WL 3302178, at *1. On 

interlocutory appeal, this court reversed the trial court’s decision and dismissed the 

plaintiff’s complaint with prejudice. Id. at *6. In so doing, this court stated:

We next consider whether a third party is permitted to alter or 

modify a medical authorization after it has been executed by a patient or 

patient’s authorized representative. The trial court, in its order denying 

defendants’ motions to dismiss, rejected defendants’ position that it would 

be improper for a medical provider or medical provider’s counsel to alter a 

medical authorization after it is received from a patient, and litigation is not 

yet pending. The trial court stated that:

the Court finds there is no prejudice demonstrated by failing 

to fill out the forms with the names, and it is ridiculous to use 

technicalities of this nature to terminate a potentially 

meritorious case, which is contrary to the constitution of the 

State of Tennessee.

“Defective authorizations” are defined in 45 C.F.R. § 164.508(b)(2). An 

authorization is not valid if, among other things, it “has not been filled out 
- 11 -

completely, with respect to an element described by paragraph (c) of this 

section.” See 45 C.F.R. § 164.508(b)(2). Defendants argue that the 

implication of defining an incomplete authorization as defective is that an 

individual is not permitted to fill-in blanks on a medical authorization after 

it has been presented partially completed by a patient or a patient’s 

representative. We agree with the defendants.

Id. at *5.

We concur with the precedent from the eastern and western sections of this court

and conclude that Mr. Williams’s failure to check the requested medical records makes 

the HIPAA authorization fall short of the standard of substantial compliance with Tenn. 

Code Ann. § 29-26-121(a)(2)(E).5 

V. NECESSITY OF HIPAA-COMPLIANT MEDICAL AUTHORIZATION

Mr. Williams asserts that a HIPAA-compliant medical authorization was 

unnecessary in this matter because there was only one medical record to which both Dr. 

Johnston and the Hospital contributed. Mr. Williams posits that the case at bar is thus 

factually similar to Hughes v. Henry County Medical Center, No. W2014-01973-COAR3-CV, 2015 WL 3562733, at *5 (Tenn. Ct. App. June 9, 2015). 

In Hughes, the plaintiffs provided a medical authorization that did not permit one

health care provider, Henry County Medical Center (“HCMC”), to obtain the records of 

another health care provider, who was an individual physician. Hughes, 2015 WL

3562733, at *1. The hospital filed a motion to dismiss, arguing that the medical 

authorization was insufficient. Id. The hospital admitted, however, that it had not been 

prejudiced thereby because the other defendant, Dr. Gold, only saw the patient at HCMC 

and had no medical records of his own. Id. at *2. The Hughes court stated:

HCMC admittedly suffered no prejudice as a result of the medical 

authorization provided by Appellants. Furthermore, HCMC does not deny 

that they received timely pre-suit notice containing all of the items required 

 

5 The author of this majority opinion has concerns about this ruling, but acknowledges the 

precedent. The provision by a plaintiff to a defendant of a checklist form for medical records has much to 

commend it. The practice allows a defendant to choose the records it wants rather than having to sift 

through potentially years of irrelevant health records. If the defendant so chooses, it may check “All PHI 

in the medical record.” That is hardly an imposition. Furthermore, encouraging some cooperation 

between or among parties is not a bad thing. Finally, the deficiencies in this case are easily curable. Yet, if 

mistakes are made, we allow a defendant to file a “gotcha” motion to dismiss without even trying to 

acquire the records, rather than having the parties work it out and try to resolve the case on its merits. The 

countless cases that have arisen under these statutes, with the many different factual permutations, reveal 

the confusing and mostly unforgiving nature of these laws. 
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by the statute. The purpose of the statute and the essence of the thing to be 

accomplished, i.e., pre-suit notice to the defendant, have both been satisfied 

in this case. Moreover, the goal of section 29-26-121(a)(2)(E) is to provide 

the means necessary to “evaluate the substantive merits of a plaintiff’s 

claim by enabling early access to a plaintiff’s medical records.” Here, that 

goal was clearly satisfied because HCMC was authorized to use all of the 

patient’s relevant medical records.

Id. at *5 (internal citations omitted).

In the instant action, the facts are distinguishable from those in Hughes. Dr. 

Johnston asserted in her motion that she was unable to obtain Ms. Williams’s medical 

records that were in the possession of the Hospital. Both the Hospital and Dr. Johnston 

have denied that Dr. Johnston is an employee of the hospital. Taking as true Mr. 

Williams’s allegation that the Hospital maintains sole possession of Ms. Williams’s 

medical record, we have a factual situation much different than that in Hughes. It 

appears that, without a valid HIPAA authorization, neither defendant can access the 

necessary medical records. We, therefore, find Mr. Williams’s argument that Hughes is 

controlling authority in this situation to be unavailing.

 

VI. RULE 59 MOTION

Finally, Mr. Williams asserts that the trial court erred by denying his motion made 

pursuant to Tenn. R. Civ. P. 59 upon the court’s finding that Mr. Williams was

attempting to “relitigate matters that have already been adjudicated.” 

This court’s scope of review with regard to the denial of a Rule 59 motion is to 

determine whether the trial court abused its discretion in denying the motion. See Smith 

v. Haley, No. E2000-001203-COA-R3-CV, 2001 WL 208515, at *5 (Tenn. Ct. App. Mar. 

2, 2001). “A court abuses its discretion when it causes an injustice to the party 

challenging the decision by (1) applying an incorrect legal standard, (2) reaching an 

illogical or unreasonable decision, or (3) basing its decision on a clearly erroneous 

assessment of the evidence.” Lee Med., Inc. v. Beecher, 312 S.W.3d 515, 524 (Tenn. 

2010). 

As the trial court’s May 17, 2018 order explained in significant detail, the trial 

court had already considered and rejected each of the arguments raised by Mr. Williams’s 

Rule 59 motion. With regard to the function of a Rule 59 motion, this court has 

previously explained:

The purpose of Tenn. R. Civ. P. 59 motions is to prevent 

unnecessary appeals by providing trial courts with an opportunity to correct 

errors before a judgment becomes final. Tenn. R. Civ. P. 59.04 motions 
- 13 -

may be granted (1) when the controlling law changes before a judgment 

becomes final, (2) when previously unavailable evidence becomes 

available, or (3) when, for sui generis reasons, a judgment should be 

amended to correct a clear error of law or to prevent injustice. They should 

not, however, be granted if they are simply seeking to relitigate matters that 

have already been adjudicated.

Bradley v. McLeod, 984 S.W.2d 929, 933 (Tenn. Ct. App. 1998), overruled in part on 

other grounds by Harris v. Chern, 33 S.W.3d 741 (Tenn. 2000) (internal citations 

omitted).

As discussed previously in this opinion, we conclude that the trial court erred 

because Mr. Williams's omission of an expiration date did not prevent the HIPPA form 

from being substantially compliant with Tenn. Code Ann. Section 29-26-121(a)(2)(E). 

The trial court did not err in determining that the lack of description of the records failed 

to comply with the law.

VII. CONCLUSION

For the foregoing reasons, we affirm the trial court’s dismissal of Mr. Williams’s 

claims against Dr. Johnston and Clarksville OB/GYN. We remand this matter to the trial 

court for collection of costs assessed below. Costs on appeal are taxed to the appellant, 

Steven Williams.

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ANDY D. BENNETT, JUDGE