Title: Oraee v. Breeding
Citation: N/A
Docket Number: 050206
State: Virginia
Issuer: Virginia Supreme Court
Date: November 4, 2005

Present:  All the Justices 
SAMAD ORAEE, M.D., ET AL. 
v.  Record No. 050206  OPINION BY JUSTICE CYNTHIA D. KINSER 
 
 
 
 
 
             November 4, 2005 
HARLIS C. BREEDING, JR.,  
EXECUTOR OF THE ESTATE OF 
SHERRY E. BREEDING, DECEASED 
 
FROM THE CIRCUIT COURT OF FAIRFAX COUNTY 
Jonathan C. Thacher, Judge 
 
In this appeal, we revisit the scope of immunity from 
civil liability afforded a physician under Code § 8.01-
581.18(B) and our decision in Auer v. Miller, 270 Va. 172, 
613 S.E.2d 421 (2005).  We conclude that the immunity 
applies only when a physician fails to review, or take 
action in response to the receipt of, a report containing 
the results of a laboratory test or examination conducted  
“not at the request or with the written authorization of a 
physician.”  Code § 8.01-581.18(A).  Thus, we will affirm 
the judgment of the circuit court refusing to grant 
immunity pursuant to Code § 8.01-581.18(B) to a physician 
who failed to obtain the results of certain laboratory 
tests requested by another physician.  In reaching this 
result, we will also overrule our decision in Auer. 
MATERIAL PROCEEDINGS AND FACTS 
The appellee, Harlis C. Breeding Jr., executor of the 
estate of Sherry E. Breeding, deceased, filed a medical 
 
2
malpractice action against Samad Oraee, M.D., and his 
employer, Samad Oraee M.D., P.C., (collectively, Dr. 
Oraee).  The jury returned a verdict in favor of the 
plaintiff against Dr. Oraee.1  In a motion for summary 
judgment and in motions to strike the plaintiff’s evidence 
both at the close of that evidence and at the conclusion of 
all the evidence, Dr. Oraee argued that he was immune from 
civil liability pursuant to Code § 8.01-581.18(B).  The 
circuit court denied the various motions and entered 
judgment for the plaintiff. 
The events precipitating this medical malpractice 
action commenced on January 3, 2003, when the decedent 
sought treatment at an emergency room for complaints of 
facial drooping.  Dr. Oraee was called in for a neurology 
consultation.  Because a certain test was not available 
during the weekend hours at the hospital where the decedent 
first went, Dr. Oraee transferred her to a different 
hospital so that she could undergo a test known as a 
                     
1 Breeding also named as defendants Magnus K. 
Ikhinmwin, M.D., and Mert Kivanc, D.O., along with their 
respective employers, Northern Virginia Nephrology 
Associates, P.C., and Mert Kivanc, D.O., P.C.  The jury 
found in favor of the plaintiff against Dr. Kivanc and his 
employer, but it returned a verdict against the plaintiff 
in favor of Dr. Ikhinmwin and his employer.  The issue in 
this appeal does not involve these defendants. 
 
3
magnetic resonance imaging scan (MRI) of her brain.2  The 
MRI revealed that the decedent had suffered a stroke as 
well as prior strokes on both sides of her brain.  She had 
not, however, exhibited symptoms of a stroke until she 
experienced the facial drooping associated with the stroke 
that caused her to go to the emergency room. 
As a result of the MRI and other diagnostic tests, Dr. 
Oraee ruled out several possible causes for the decedent’s 
strokes.  At that point, he was left with a possible 
diagnosis of a “clotting disorder” perhaps caused by 
“antiphospholipid antibody syndrome.”3  Consequently, Dr. 
Oraee requested a rheumatology consultation by Dr. Kivanc. 
On January 7, 2003, while the decedent was still 
hospitalized, Dr. Kivanc evaluated the decedent’s condition 
and ordered multiple laboratory tests.  Some of the tests 
were specifically for the purpose of determining whether 
the decedent had antiphospholipid antibody syndrome.  Dr. 
                     
2 Dr. Ikhinmwin was listed as the decedent’s attending 
physician at the second hospital. 
 
3 According to one expert witness who testified at 
trial, the term “antiphospholipid antibody syndrome” means 
“a syndrome of probably several different causes in which 
the body inappropriately makes antibodies or has other 
derangements, abnormalities in the clotting system that 
makes it more likely for [a person] to have clots.”  
Another expert witness characterized it as “a hyper 
coagulable state, which means that patients have excessive 
clotting and form small thrombi or little clots 
characteristically in both veins and arteries.” 
 
4
Oraee knew that Dr. Kivanc had seen the decedent and had 
ordered those particular blood tests.  Dr. Oraee also knew 
that it would take five to ten days for the results of the 
tests to be available. 
The next day, January 8, Dr. Oraee discharged the 
decedent from the hospital and told her to follow up with 
him as an outpatient.  An appointment was scheduled for the 
decedent to come to Dr. Oraee’s office on January 22.  
Because the decedent’s daughter called Dr. Oraee’s office 
and reported that her mother was not feeling well, the 
appointment was changed to January 17.  At that 
appointment, Dr. Oraee knew that the clotting disorder was 
still being considered as the cause of the decedent’s 
strokes, but he did not take any action to obtain the 
results of the blood tests that had been outstanding at the 
time of the decedent’s discharge from the hospital.  The 
results of the tests, which were available on January 13, 
confirmed that the decedent had antiphospholipid antibody 
syndrome.  Instead, Dr. Oraee discontinued one of the two 
antiplatelet medications that had been prescribed at the 
time of her discharge from the hospital and reported to her 
primary care physician that the decedent was “much better.” 
On January 29, the decedent was again admitted to a 
hospital, having suffered “a second massive stroke.”  
 
5
During that admission, the diagnosis of antiphospholipid 
antibody syndrome was again confirmed, and the decedent, 
for the first time, was placed on anticoagulant medication.  
As a result of that stroke, the decedent died on March 12, 
2003. 
During the trial of this action, two doctors testified 
as expert witnesses for the plaintiff with regard to the 
allegations against Dr. Oraee.  Both witnesses concluded 
that the decedent had antiphospholipid antibody syndrome 
and that she should have been placed on anticoagulant 
medication, as opposed to antiplatelet medication, no later 
than January 17 when Dr. Oraee saw her in his office 
following her discharge from the hospital.  Both experts 
also opined that, if the decedent had been placed on 
anticoagulant medication on January 17, she would not have 
suffered the subsequent massive stroke on January 29 and 
would still be alive. 
With regard to the question whether Dr. Oraee breached 
the applicable standard of care, one of the witnesses, Dr. 
Bruce T. Adornato, testifying as an expert in the field of 
neurology, opined that, subsequent to the decedent’s 
discharge from the hospital and the laboratory test results 
becoming available, the standard of care required Dr. Oraee 
to inquire about and obtain the results of the tests.  This 
 
6
is so because the results were abnormal and had 
implications for the decedent’s treatment.  Dr. Adornato 
further testified that the standard of care required Dr. 
Oraee to offer the decedent the opportunity to be treated 
with anticoagulant medication, “i.e., Coumadin rather than 
just aspirin.”  During cross-examination, Dr. Adornato 
agreed that Dr. Oraee’s treatment of the decedent did not 
fall below the applicable standard of care until January 
17, when Dr. Oraee should have diagnosed antiphospholipid 
antibody syndrome and offered the decedent appropriate 
treatment.  But, as Dr. Adornato explained, Dr. Oraee could 
not have made the correct diagnosis without the results of 
the laboratory tests. 
The other witness, Dr. Lee Levitt, an expert in the 
fields of hematology and medical oncology, testified 
similarly.  Dr. Levitt opined that, at the time of the 
decedent’s follow-up visit on January 17, Dr. Oraee 
breached the standard of care by not being aware of the 
results of the laboratory tests, which would have made “a 
clear difference in her diagnosis and in management.”  As 
Dr. Levitt explained, Dr. Oraee was involved in the request 
for a consultation by a rheumatologist, the appropriate 
laboratory tests were requested to make a diagnosis of 
 
7
antiphospholipid antibody syndrome, those tests were 
performed, and the results were available. 
ANALYSIS 
The sole question in this case is whether the circuit 
court erred in refusing to grant Dr. Oraee immunity from 
civil liability pursuant to the provisions of Code § 8.01-
581.18(B).  The question is one of law, meaning that we 
review the circuit court’s resolution of it de novo.  
Davenport v. Little-Bowser, 269 Va. 546, 552, 611 S.E.2d 
366, 369 (2005).  The statute at issue states: 
Any physician shall be immune from civil 
liability for any failure to review, or to take 
any action in response to the receipt of, any 
report of the results of any laboratory test or 
other examination of the physical or mental 
condition of any person, which test or 
examination such physician neither requested nor 
authorized in writing, unless such report is 
provided directly to the physician by the person 
so examined or tested with a request for 
consultation or by the State Department of 
Health. 
 
Code § 8.01-581.18(B). 
 
 
As both parties recognize, answering the question 
raised in this appeal implicates our recent decision in 
Auer.  There, the trial court granted immunity under Code 
§ 8.01-581.18(B) to a defendant doctor, Nicolas Auer’s 
cardiologist, for his alleged failure to review or to take 
any action in response to the results of a laboratory test 
 
8
ordered by a cardiovascular surgeon during Auer’s 
hospitalization.  Auer, 270 Va. at 175, 613 S.E.2d at 422.  
Auer had undergone surgery to remove his native aortic 
valve and to replace it with a prosthetic valve.  Id. at 
175-76, 613 S.E.2d at 423.  The surgeon had ordered a 
culture and sensitivity test on the native valve, and the 
results of the test were positive for staphylococcus.  Id. 
at 176, 613 S.E.2d at 423.  The cardiologist saw Auer 
several times during the hospitalization and prepared a 
discharge summary, but he never reviewed the report of the 
test results even though the report had been posted to 
Auer’s chart.  Id.  The surgeon likewise failed to review 
the report.  Id.  Consequently, the infection remained 
untreated, and Auer subsequently died from endocarditis.  
Id. 
 
On appeal, we affirmed the trial court’s judgment.  
Id. at 179, 613 S.E.2d at 423.  We found “the language of 
subsection B of Code § 8.01-581.18 to be clear and 
unambiguous” and stated that this subsection 
clearly provides that a physician shall be immune 
from civil liability for any failure to take any 
action in response to a laboratory test or other 
examination that the physician did not request or 
authorize unless the person tested or examined 
provides a copy of the report of the results and 
requests a consultation. 
 
 
9
Id. at 177, 613 S.E.2d at 423.  We concluded that Code 
§ 8.01-581.18(B) applied to the cardiologist because he 
“neither requested nor authorized” the culture and 
sensitivity test and Auer did not provide him with the 
report of the test results and request a consultation.  Id. 
at 177, 613 S.E.2d at 424. 
 
Dr. Oraee argues that, since the allegations 
concerning his breach of the standard of care were confined 
to his failure to obtain the results of the blood tests 
ordered by Dr. Kivanc and to respond with appropriate 
treatment, our holding in Auer is dispositive of the 
question presented in this case.  Dr. Oraee further points 
out that there is no evidence that the decedent provided 
the results of those blood tests to him with a request for 
consultation.  Thus, in Dr. Oraee’s view, “all the elements 
for granting immunity were in place and [the plaintiff] 
offered no other theory of liability against [him] 
independent of the test results.” 
 
Responding, the plaintiff asserts that Auer is 
factually distinguishable from the present case and thus 
not controlling.  The plaintiff points out that the 
cardiologist in Auer did not know about the culture and 
sensitivity test ordered by the cardiovascular surgeon and 
was not involved in the decision to order that test.  Id. 
 
10
at 176, 613 S.E.2d at 423.  Continuing, the plaintiff 
emphasizes that Dr. Oraee, unlike Auer’s cardiologist, made 
a possible diagnosis of antiphospholipid antibody syndrome 
and consequently requested the rheumatology consultation; 
he knew that Dr. Kivanc had ordered specific blood tests to 
determine whether the decedent had this clotting disorder; 
he knew at the time of the plaintiff’s discharge from the 
hospital that the results of the test would not be 
available for five to ten days; and he scheduled a follow-
up appointment for the decedent.  In the plaintiff’s words, 
“[s]imply because [Dr. Oraee] failed to sign the slip for 
the lab work does not mean that he did not authorize or 
intend for the lab work to be completed, thus making [Code 
§ 8.01-581.18(B)], and Auer, inapposite.”  The plaintiff 
also claims that Dr. Oraee’s overall breach of the standard 
of care was his failure to properly diagnose and treat the 
decedent’s condition and that it was not merely Dr. Oraee’s 
failure to review and respond to the results of the 
laboratory tests. 
 
Alternatively, the plaintiff argues that subsection A 
and subsection B of Code § 8.01-581.18 must be read 
together and that subsection B cannot be viewed in 
isolation.  According to the plaintiff, the intent of the 
statute is to direct the appropriate course of action when 
 
11
an individual, as opposed to a physician, requests a 
laboratory test or examination.  The plaintiff contends the 
provisions of subsection A require the report of the 
results of such test or examination to be delivered to the 
individual who was tested or examined and to state in bold 
type that the individual has the responsibility to arrange 
for a consultation with a physician to review the report 
and interpret the results. 
In light of the context in which subsection A applies, 
the plaintiff further argues that subsection B grants 
immunity only when a physician fails to review, or take 
action in response to the receipt of, a report containing 
the results of a test or examination obtained by an 
individual on his/her own initiative.  In other words, the 
plaintiff’s position is that subsection B does not come 
into play if the report at issue contains the result of a 
test or examination requested or authorized by a physician.  
This interpretation, in the plaintiff’s view, is consistent 
with the language of the statute when read as a whole, 
including its title “Delivery of results of laboratory 
tests and other examinations not authorized by physician; 
immunity of physician.”  Code § 8.01-581.18. 
 
We do not agree with the plaintiff’s position that the 
present case is factually distinguishable from our decision 
 
12
in Auer.  Like the cardiologist in Auer, Dr. Oraee failed 
to review an available and critical report reflecting the 
results of a laboratory test that another physician had 
authorized.  In both instances, the report contained 
information that directly affected the appropriate medical 
treatment for the patient.  For purposes of deciding the 
question before us, it does not matter that Dr. Oraee knew 
about the laboratory tests ordered by Dr. Kivanc. 
Nor are we persuaded by the plaintiff’s argument that 
Dr. Oraee implicitly authorized the laboratory tests at 
issue.  Dr. Oraee’s request for the rheumatology 
consultation after he suspected that the decedent had 
antiphospholipid antibody syndrome is not the same as 
requesting laboratory tests.  Likewise, we do not agree 
with the plaintiff’s assertion that the breach of the 
standard of care at issue was something more than Dr. 
Oraee’s failure to review and take appropriate action in 
response to the report of the laboratory test results. 
 
Thus, we turn to the plaintiff’s argument regarding 
the proper interpretation of Code § 8.01-581.18.  To adopt 
the plaintiff’s position would require that we overrule our 
decision in Auer, and he asks us to do so.  Thus, the 
doctrine of stare decisis is necessarily implicated. 
 
13
 
That doctrine plays a significant role in the 
orderly administration of justice by assuring 
consistent, predictable, and balanced application 
of legal principles.  And when a court of last 
resort has established a precedent, after full 
deliberation upon the issue by the court, the 
precedent will not be treated lightly or ignored, 
in the absence of flagrant error or mistake. 
 
Selected Risks Ins. Co. v. Dean, 233 Va. 260, 265, 355 
S.E.2d 579, 581 (1987) (citing Kelly v. Trehy, 133 Va. 160, 
169, 112 S.E. 757, 760 (1922)); accord Pulliam v. Coastal 
Emergency Servs. of Richmond, Inc., 257 Va. 1, 10, 509 
S.E.2d 307, 312 (1999); Nunnally v. Artis, 254 Va. 247, 
252-53, 492 S.E.2d 126, 128-29 (1997).  The question, then, 
is whether our decision in Auer was a “flagrant error or 
mistake.”  Selected Risks, 233 Va. at 265, 355 S.E.2d at 
581. 
In Auer, we did not expressly address the argument 
that, when subsection B is read in light of subsection A, 
the immunity granted in subsection B is available only when 
the report at issue is one generated as a result of an 
individual’s request, as opposed to a physician’s request 
or written authorization, for a laboratory test or 
examination.  Instead, we focused solely on the provisions 
of subsection B in reaching our decision. 
However, we have a duty, whenever possible, “to 
interpret the several parts of a statute as a consistent 
 
14
and harmonious whole so as to effectuate the legislative 
goal.”  Virginia Elec. & Power Co. v. Board of County 
Supervisors of Prince William County, 226 Va. 382, 387-88 
309 S.E.2d 308, 311 (1983).  Generally, the Court “will 
look to the whole body of [a statute] to determine the true 
intention of each part.”  McDaniel v. Commonwealth, 199 Va. 
287, 292, 99 S.E.2d 623, 627 (1957); accord Rockingham 
Coop. Farm Bureau, Inc. v. City of Harrisonburg, 171 Va. 
339, 344, 198 S.E. 908, 910 (1938).  “[A] statute should be 
read and considered as a whole, and the language of a 
statute should be examined in its entirety to determine the 
intent of the General Assembly from the words contained in 
the statute.”  Department of Medical Assistance Servs. v. 
Beverly Healthcare of Fredericksburg, 268 Va. 278, 285, 601 
S.E.2d 604, 607-08 (2004).  “In doing so, the various parts 
of the statute should be harmonized so that, if 
practicable, each is given a sensible and intelligent 
effect.”  Colchester Towne Condominium Council of Co-Owners 
v. Wachovia Bank, N.A., 266 Va. 46, 51, 581 S.E.2d 201, 203 
(2003) (citing VEPCO v. Prince William Co., 226 Va. 382, 
387-88, 309 S.E.2d 308, 311 (1983)). 
Applying these principles requires subsection B of 
Code § 8.01-581.18 to be construed together with subsection 
A.  As the plaintiff argues, subsection A pertains only to 
 
15
a laboratory test or examination conducted “not at the 
request or with the written authorization of a physician.”  
Code § 8.01-581.18(A).  For example, subsection A is 
applicable when a person elects, on his/her own initiative, 
to be tested for a sexually transmitted disease.  In other 
words, the testing would not be done at the request of or 
with written authorization from a physician.  In that 
situation, the report stating the results of the test would 
be provided directly to the person who was the subject of 
the test.  Id.  The individual tested would then have the 
responsibility to arrange for a consultation with a 
physician about the test results.  Id.  The report itself 
would have to state this responsibility in bold type.  Id. 
With that understanding of subsection A, it then 
follows that the immunity from civil liability granted in 
subsection B applies only when a physician is charged with 
failing to review, or take action in response to receiving, 
a report of the results of a laboratory test or examination 
conducted “not at the request or with the written 
authorization of a physician.”  Code § 8.01-581.18(A).  The 
immunity granted in subsection B in essence follows the 
report described in subsection A.  Subsection B insulates 
from civil liability any physician who fails to review that 
report or to take any action in response to receiving it.  
 
16
That immunity, however, is not available if “such report is 
provided directly to the physician by the person so 
examined or tested with a request for consultation.”  Code 
§ 8.01-581.18(B).  The circumstance eliminating a 
physician’s immunity in subsection B corresponds to the 
provision in subsection A requiring a report of a 
laboratory test or examination “conducted . . . not at the 
request or with the written authorization of a physician” 
to be provided directly to the person tested or examined.  
Code § 8.01-581.18(A).  That common requirement reflects 
the General Assembly’s intent that these two subsections be 
“considered as a whole.”  Department of Medical Assistance 
Servs., 268 Va. at 285, 601 S.E.2d at 607.  Overall, the 
provisions of Code § 8.01-581.18, create a mechanism for 
handling reports of the results of laboratory tests or 
examinations requested by an individual rather than by a 
physician.  The statute does not pertain to reports of 
laboratory tests or examinations requested or authorized by 
a physician. 
To grant Dr. Oraee immunity under Code § 8.01-
581.18(B) would lead to consequences the General Assembly 
could not have intended.  Assume that a physician orders a 
blood test that preliminarily suggests the need for 
surgery, and the physician then refers the patient to a 
 
17
surgeon.  Assume further that the final report of the blood 
test results demonstrates that surgery is not necessary, 
but the surgeon never reviews the final report and proceeds 
with surgery.  Under Dr. Oraee’s interpretation of 
subsection B and our decision in Auer, the surgeon would be 
immune from civil liability for breaching the standard of 
care merely because he did not personally request or 
authorize the blood test.  Furthermore, since the patient 
in this hypothetical did not request the blood test, the 
patient would not receive the report with the warning in 
bold type that is it the patient’s responsibility to 
arrange for consultation with a physician about the report. 
Thus, we conclude that our decision in Auer was a 
mistake.  While we adhere strongly to the doctrine of stare 
decisis in this Commonwealth, this is one of those rare 
situations in which we cannot perpetuate a clearly 
incorrect application of the law.  See Nunnally, 254 Va. at 
253, 492 S.E.2d at 129.  It is “this Court’s obligation to 
reexamine critically its precedent” and, by doing so, 
“confidence in the judiciary” and “the importance of stare 
decisis in our jurisprudence” will be enhanced.  Id. 
CONCLUSION 
 
The doctrine [of stare decisis] grows out of 
the necessity for a uniform and settled rule of 
property, and definite basis for contracts and 
 
18
business transactions. If a decision is wrong, it 
is only when it has been so long the rule of 
action as that time and its continued 
application, as the rule of right between 
parties, demand the sanction of its error; 
because when a decision has been recognized as 
the law of property, and conflicting demands have 
been adjusted, and contracts have been made with 
reference to and on the faith of it, greater 
injustice would be done to individuals, and more 
injury result to society by a reversal of such 
decision, though erroneous, than to follow and 
observe it.  But when a decision is not of this 
character, upon no sound principle do we feel at 
liberty to perpetuate an error into which either 
our predecessors or ourselves may have 
inadvertently fallen, merely upon the ground of 
such erroneous decision having been previously 
rendered. 
 
Burks v. Hinton, 77 Va. 1, 24-25 (1883) (quoting Willis v. 
Owen, 43 Tex. 41, 48-49 (1875)). 
 
To reaffirm our decision in Auer would perpetuate a 
mistake.  Thus, the holding in Auer pertaining to Code 
§ 8.01-581.18(B) is expressly overruled.  Accordingly, we 
conclude that the circuit court did not err in refusing to 
grant immunity to Dr. Oraee under the provisions of Code 
§ 8.01-581.18(B), nor did it err in denying Dr. Oraee’s 
various motions and jury instruction dealing with this 
statutory provision.  For these reasons, we will affirm the 
judgment of the circuit court. 
Affirmed. 
JUSTICE AGEE, with whom JUSTICE KEENAN and JUSTICE KOONTZ 
join, dissenting. 
 
 
19
The majority overrules our recent decision in Auer v. 
Miller, 270 Va. 172, 613 S.E.2d 421 (2005), interpreting 
Code § 8.01-581.18(B), by finding that decision to be a 
"mistake."  In doing so, the majority holds that subsection 
A of Code § 8.01-581.18 restricts the application of the 
immunity provision of subsection B to only those laboratory 
tests described in subsection A.  I believe subsection B 
clearly provides otherwise and therefore our analysis of 
Code § 8.01-581.18 in Auer correctly applied the statute 
and was not in error.  Further, I also believe the majority 
fails to properly observe the long-standing role of the 
doctrine of stare decisis by overruling Auer. 
I.  STARE DECISIS 
It is a bedrock foundation of our jurisprudence 
that prior decisions of this Court are entitled to 
respect and deference under the doctrine of stare 
decisis.  The doctrine is foundational because 
in a well ordered society it is important for 
people to know what their legal rights are, not 
only under constitutions and legislative 
enactments but also as defined by judicial 
precedent, and when they have conducted their 
affairs in reliance thereon they ought not to 
have their rights swept away by judicial decree 
. . . . 
 
Myers v. Moore, 204 Va. 409, 413, 131 S.E.2d 414, 417 
(1963). 
 
20
Heralded as “one of the most important principles in 
the structure of our law,” stare decisis entails more than 
a passing reference or fleeting mention.  Id.; see also 
Selected Risks Ins. Co. v. Dean, 233 Va. 260, 265, 355 
S.E.2d 579, 581 (1987).  As this Court has stated, 
[stare decisis] plays a significant role in the 
orderly administration of justice by assuring 
consistent, predictable, and balanced application 
of legal principles.  And when a court of last 
resort has established a precedent, after full 
deliberation upon the issue by the court, the 
precedent will not be treated lightly or ignored, 
in the absence of flagrant error or mistake. 
 
Selected Risks, 233 Va. at 265, 355 S.E.2d at 581. 
 
 
In my view, the majority has failed to articulate a 
compelling argument that the unanimous opinion of this 
Court in Auer was of such a degree of error that stare 
decisis can be cast aside.  Reversing a prior opinion of 
this court, particularly where the grounds to do so are so 
open to question, lessens the value of stare decisis for 
our jurisprudence as a whole.  See Newman v. Erie Ins. 
Exch., 256 Va. 501, 510-11, 507 S.E.2d 348, 353 (1998) 
(Compton, J., dissenting) (“Frequent overruling of an 
appellate court’s decisions tends to bring adjudications of 
the tribunal ‘into the same class as a restricted railroad 
ticket, good for this day and train only.’ ”). 
II.  CODE § 8.01-581.18 
 
21
Code § 8.01-581.18 provides as follows: 
A. Whenever a laboratory test or other 
examination of the physical or mental condition 
of any person is conducted by or under the 
supervision of a person other than a physician 
and not at the request or with the written 
authorization of a physician, any report of the 
results of such test or examination shall be 
provided by the person conducting such test or 
examination to the person who was the subject of 
such test or examination. Such report shall state 
in bold type that it is the responsibility of the 
recipient to arrange with his physician for 
consultation and interpretation of the results of 
such test or examination. The provisions of this 
subsection shall not apply to any test or 
examination conducted under the auspices of the 
State Department of Health. 
 
B. Any physician shall be immune from civil 
liability for any failure to review, or to take 
any action in response to the receipt of, any 
report of the results of any laboratory test or 
other examination of the physical or mental 
condition of any person, which test or 
examination such physician neither requested nor 
authorized in writing, unless such report is 
provided directly to the physician by the person 
so examined or tested with a request for 
consultation or by the State Department of 
Health.4 
 
The majority maintains that Auer was in error because 
it failed to read subsection B "in light of subsection A."  
The majority opines that because subsection B follows 
subsection A, "[t]he immunity granted in subsection B in 
essence follows the report [prepared by a non-physician] 
described in subsection A."  The majority partly bases its 
                     
4 Code § 8.01-581.18(C) is omitted as it has no bearing 
on any issues before the Court. 
 
22
holding on the view that since subsection B follows 
subsection A in the statute, the later subsection should be 
read only as referencing the first subsection.  I am aware 
of no rule of statutory construction which directs such a 
reading, and the majority cites none.  We have not held 
that a statutory subsection must be read solely in 
reference to the subsection it follows; rather, we are 
always guided by the plain language of the statute as the 
General Assembly has written it. 
As noted below, neither subsection A nor B of Code 
§ 8.01-581.18 are ambiguous.  The plain language of each 
subsection establishes a legal duty or action wholly 
independent of the other.  Further, the plain language of 
subsection B establishes physician immunity for certain 
laboratory tests which is not dependent upon or 
circumscribed in any way by the provisions of subsection A.  
The General Assembly knows how to write subsection B as the 
majority construes that subsection, but it did not do so. 
Our duty is "to construe the law as it is written." 
Hampton Roads Sanitation Dist. Comm'n v. City of 
Chesapeake, 218 Va. 696, 702, 240 S.E.2d 819, 823 (1978).  
"To depart from the meaning expressed by the words is to 
alter the statute, to legislate and not to interpret." 
 
23
Faulkner v. Town of South Boston, 141 Va. 517, 524, 127 
S.E. 380, 382 (1925).  Thus, 
[w]e presume that the legislature chose, 
with care, the words it used when it enacted the 
statute. Courts cannot add language to the 
statute the General Assembly has not seen fit to 
include. Nor are they permitted to accomplish the 
same result by judicial interpretation. Where the 
General Assembly has expressed its intent in 
clear and unequivocal terms, it is not the 
province of the judiciary to add words to the 
statute or alter its plain meaning. 
 
Jackson v. Fidelity & Deposit Co., 269 Va. 303, 313, 608 
S.E.2d 901, 906 (2005) (citations and internal quotation 
marks omitted). 
As the majority opinion accurately recites, Code 
§ 8.01-581.18(A) provides that the results of a laboratory 
test made "not at the request or with the written 
authorization of a physician" shall be provided "to the 
person who was the subject of that test."  Further, 
subsection A mandates that it is solely the recipient's 
responsibility to arrange for any "such test" to be 
reviewed by a physician.  The plain language of subsection 
A does not address any other subject.  There is no 
ambiguity in subsection A and the majority cites none.  
Thus, subsection A fulfills a distinct and independent 
purpose to direct the result of non-physician ordered 
laboratory tests to the subject of the test and to place 
 
24
responsibility solely on that person for any further 
review.  Subsection A thus sets forth a substantive 
provision of law in and of itself. 
Subsection A of Code § 8.01-581.18 makes no reference 
to subsection B or to immunity of physicians in any way.  
Importantly, neither does subsection B make reference to 
subsection A. 
Subsection B plainly provides, as we noted in Auer, 
that "[a]ny physician shall be immune from civil liability 
for any failure to review . . . any report of the results 
of any laboratory test . . . which test . . . such 
physician neither requested nor authorized in writing."  
Code § 8.01-581.18(B)(emphasis added).  Nothing in the 
straightforward language of subsection B limits the scope 
of its granted immunity only to tests described in 
subsection A.  There is no ambiguity in subsection B, and 
the majority cites none.  Instead, subsection B provides 
exactly for what the General Assembly wrote: immunity for 
physicians from liability for failure to review any 
laboratory test the physician did not order or authorize.  
As in the case at bar and Auer, that immunity encompasses 
laboratory tests ordered by physicians other than the 
defendant physician. 
 
25
Subsection B thus sets forth a substantive provision 
of law in and of itself.  It fulfills a distinct and 
independent purpose, wholly different from that of 
subsection A, by granting immunity to any physician 
regarding any laboratory test the physician "neither 
requested nor authorized in writing."  Code § 8.01-
581.18(B).  While, a fortiori, this would include a 
laboratory test ordered by a non-physician under subsection 
A, absolutely nothing in Code § 8.01-581.18 limits the 
application of subsection B physician immunity to only 
subsection A non-physician ordered tests.  The plain 
language of the statute means what it says, and we have no 
authority to rewrite the statute by judicial decision.  
Burlile v. Commonwealth, 261 Va. 501, 511, 544 S.E.2d 360, 
365 (2001). 
Although the language of Code § 8.01-581.18 is plain, 
the majority nevertheless maintains that subsection A's 
limitation to tests administered by non-physicians should 
be read into subsection B in order to construe those 
provisions together as a "consistent and harmonious whole."  
But nothing in Auer's construction of Code § 8.01-581.18(B) 
creates an inconsistency within the statute.  There is no 
requirement that two sections of the same statute be 
interdependent unless the statute so provides by its terms, 
 
26
and Code § 8.01-581.18 does not.  Acknowledging subsection 
B to have a meaning separate, distinct and independent from 
subsection A does not create an inconsistent statute.  As 
noted above, each subsection has a particular purpose 
independent and free standing of the other under the plain 
language of the statute. 
Subsection A simply directs a laboratory to send the 
test results of a non-physician ordered test to the subject 
of that test and imposes responsibility upon that person to 
arrange for any physician review.  Separate and distinct 
from this function, subsection B provides physician 
immunity from "any failure to review . . . any report . . . 
of any laboratory test . . . which test . . . such 
physician neither requested nor authorized in writing."  
(Emphasis added).  While related, each subsection has a 
distinct and independent focus and stands alone without 
need of the other in establishing a substantive legal 
requirement. 
The majority's contention that the language in 
subsection B which limits physician immunity where a 
laboratory "report is provided directly to the physician by 
the person so examined" somehow limits subsection B 
immunity only to subsection A tests is erroneous.  As fully 
discussed above, the plain language of subsection B 
 
27
immunity encompasses any test not ordered by the physician.  
The fact that subsection B immunity is restricted where the 
patient delivers a copy of his laboratory test to the 
physician cannot be read as circumscribing immunity only to 
those subsection A tests.  This is so because "any" report 
includes not only those subsection A tests of the patient 
which that patient or other non-physician ordered and 
delivers to the physician, but also tests ordered by 
another physician which the patient delivers.  Thus, the 
language in subsection B cannot be read as the majority 
concludes to limit subsection B immunity to only subsection 
A laboratory tests. 
It is not uncommon for the General Assembly to 
draft a statute which contains independent, though 
related provisions, and this Court has repeatedly 
recognized that successive provisions of a statute may 
function separately.  In Greenberg v. Commonwealth, 
255 Va. 594, 597, 499 S.E.2d 266, 267-68 (1998), we 
reversed the trial court's judgment imposing personal 
liability on a check cashing company's majority 
shareholder for making loans in amounts and at 
interest rates prohibited by Code § 6.1-249.  Another 
code provision, Code § 6.1-308, set forth the 
penalties for violations of Code § 6.1-249 as follows: 
 
28
A. Any person and the several members, officers, 
directors, agents, and employees thereof, who 
violate or participate in the violation of any 
provision of § 6.1-249 shall be guilty of a Class 
2 misdemeanor. 
 
B. Any contract of loan in the making or 
collection of which any act has been done which 
violates § 6.1-249 shall be void and the lender 
shall not collect, receive, or retain any 
principal, interest, or charges whatsoever, and 
any amount paid on account of principal or 
interest on any such loan shall be recoverable by 
the person by or for whom payment was made. 
 
Greenberg, 255 Va. at 599, 499 S.E.2d at 269 (emphasis 
added). 
The shareholder in Greenberg argued that he could not 
be individually liable under Code § 6.1-308(B) because that 
subsection provided for recovery against only the lender.  
Id. at 600, 499 S.E.2d at 269.  We agreed, noting that 
though subsection A of that statute provided for individual 
liability, subsection B did not. 
In contrast to subsection (A), Code § 6.1-308(B), 
provides that only the "lender shall not collect, 
receive, or retain any principal, interest, or 
charges whatsoever, and any amount paid on 
account of principal or interest on any such loan 
shall be recoverable by the person by or for whom 
payment was made." (Emphasis added). Absent from 
subsection (B) is the broad category of entities 
found in subsection (A). In other words, 
subsection (B) does not include any individual, 
officer, director, or entity other than the 
lender. 
 
Id. 255 Va. at 601, 499 S.E.2d at 270.  We noted that 
reading the sections of the statutory provision 
 
29
independently was in accordance with the intent of the 
General Assembly. 
When the General Assembly uses two different 
terms in the same act, it is presumed to mean two 
different things. As evident in subsection (A), 
the General Assembly knew how to broaden the 
range of liability, and the absence of any such 
provisions in subsection (B) indicates the 
General Assembly's intent to limit those from 
whom borrowers may obtain restitution. To 
determine otherwise would be to rewrite the 
statute and to contradict the General Assembly's 
express intent. 
 
Id. 255 Va. at 601-02, 499 S.E.2d at 270 (citation and 
internal quotation marks omitted); see also Level 3 
Commcn's of Va., Inc. v. State Corp. Comm'n, 268 Va. 471, 
476-78, 604 S.E.2d 71, 73-74 (2004) (reading subsections of 
Code § 56-265.4:4 independently in accordance with the 
plain language of the statute). 
 
In Halifax Corp. v. First Union Nat'l Bank, 262 Va. 
91, 100, 546 S.E.2d 696, 702 (2001), we noted that the duty 
imposed upon a customer to exercise reasonable promptness 
to examine a bank statement to determine whether any 
payment was unauthorized under Code § 8.4-406(c), existed 
whether or not the bank had paid those items in good faith.  
We declined to adopt the appellant's argument that the 
requirement that a bank pay an item in good faith in order 
to assert a statutory bar against a customer claim under 
Code § 8.4-406(d) and (e), should be read into the 
 
30
customer's duty to examine his bank statement under Code 
§ 8.4-406(c).  Id. at 101, 546 S.E.2d at 702-03.  This 
Court specifically noted that "when the General Assembly 
includes specific language in one section of a statute, but 
omits that language from another section of the statute, we 
must presume that the exclusion of the language was 
intentional."  Id. at 100, 546 S.E.2d at 702. 
 
To accurately represent the majority's interpretation 
of subsection B of Code § 8.01-581.18, the General Assembly 
would have written it as follows: 
Any physician shall be immune from civil 
liability for any failure to review, or to take 
any action in response to the receipt of, any 
report of the results of any [such] laboratory 
test [under Subsection A] or other examination of 
the physical or mental condition of any person, 
which test or examination such physician neither 
requested nor authorized in writing . . . . 
 
(Emphasis added.)  The General Assembly, however, did not 
include any such limitation.  Clearly, the General Assembly 
knew how to reference such non-physician ordered laboratory 
tests as it did so specifically five times in subsection A: 
[A]ny report of the results of such test . . . 
shall be provided by the person conducting such 
test . . .to the . . . subject of such test 
. . . .  Such report shall state in bold type 
that it is the responsibility of the recipient to 
arrange with his physician for consultation and 
interpretation of the results of such test or 
examination. 
 
 
31
Code § 8.01-581.18(A) (emphasis added).  Had the General 
Assembly wished to limit the scope of subsection B immunity 
to "such" non-physician ordered tests of subsection A, it 
could have done so, but it did not. 
The General Assembly unquestionably knows how to 
connect the various provisions of a statute when it desires 
to make them interdependent.  The fact that the Legislature 
did not choose to do so in Code § 8.01-581.18 "represents 
an unambiguous manifestation of a contrary intention."  
Halifax Corp. v. Wachovia Bank, 268 Va. 641, 654, 604 
S.E.2d 403, 408; see also Couplin v. Payne, 270 Va. 129, 
135-36, 613 S.E.2d 592, 594-95 (2005).  For example, Code 
§ 2.2-514(A) empowers the Attorney General to "compromise 
and settle disputes . . . involving all interests of the 
Commonwealth . . . ."  Subsection B of that statute 
provides that "[n]o settlement under subsection A shall be 
made subject to a confidentiality agreement that prohibits 
the Commonwealth . . .from disclosing the amount of such 
settlement."  Code § 2.2-514(B) (emphasis added). 
Finally, the majority contends that "grant[ing] Dr. 
Oraee immunity under Code § 8.01-581.18(B) would lead to 
consequences the General Assembly could not have intended."  
What the majority does not recognize is that the 
elimination of unintended consequences is a matter for 
 
32
legislative, not judicial, remedy.  We have repeatedly held 
that 
we determine the General Assembly's intent from 
the words contained in the statute. When the 
language of a statute is unambiguous, courts are 
bound by the plain meaning of that language and 
may not assign a construction that amounts to 
holding that the General Assembly did not mean 
what it actually has stated. 
 
Williams v. Commonwealth, 265 Va. 268, 271, 576 S.E.2d 468, 
470 (2003) (citations omitted).  As we noted in Auer, 
"Whether a statute is wise is . . . a matter for the 
legislature and not for a court." 270 Va. at 177, 613 
S.E.2d at 423 (citing Horner v. Dept. of Mental Health, 268 
Va. 187, 193, 597 S.E.2d 202, 205 (2004)). 
For these reasons, I believe the construction of Code 
§ 8.01-581.18(B) set forth in Auer was correct and that 
stare decisis dictates that our decision be followed.  The 
majority's new construction of the statute does not comport 
with its plain meaning and adds language to the statute not 
written by the General Assembly.  If the General Assembly 
chooses to amend the statute it may do so, but we cannot.  
Therefore, I respectfully dissent from the majority 
opinion, and would reverse the judgment of the trial court 
and enter final judgment for Dr. Oraee.