Opinion ID: 3008909
Heading Depth: 3
Heading Rank: 1

Heading: The Tennessee Health Care Liability Act

Text: A brief history of the THCLA and its judicial interpretations is beneficial to our analysis. In 2008, Tennessee‟s Medical Malpractice Act6 was amended, introducing new requirements into medical malpractice litigation. See Act of April 24, 2008, ch. 919, 2008 Tenn. Pub. Acts 434; see generally Rebecca C. Blair, Med-Mal Obstacles, 44 Tenn. B.J. 14 (2008). The 2008 amendment required a party initiating a medical malpractice claim to give sixty days‟ pre-suit notice to the implicated health care providers. See Tenn. Code Ann. § 29-26-121(a)(1) (Supp. 2008). Furthermore, the amendment contained a certificate-of-good-faith provision requiring a plaintiff filing a medical malpractice action, in which expert testimony was required, to file a certificate of good faith within ninety days of the filing of the initial complaint. Id. § 29-26-122. This certificate served to confirm that one or more experts had been consulted and provided a signed written statement of their belief that there was a good faith basis for filing the complaint. Id. One year later, in 2009, the Act was again amended to clarify these new requirements. See Act of June 4, 2009, ch. 425, 2009 Tenn. Pub. Acts 472; see generally John A. Day, Med Mal Makeover: 2009 Act Improves on „08, 45 Tenn. B.J. 14 (2009). Tennessee Code Annotated section 29-26-121(a)(1) was amended to require that pre-suit notice only be given to persons or entities named as defendants in the action, see Tenn. Code Ann. § 29-26-121(a)(1) (Supp. 2009), and section 121(a)(2) was amended to specify what information was required to be included in the pre-suit notice. See id. § 29-26121(a)(2). Additionally, Tennessee Code Annotated section 29-26-122 was amended to 6 In 2011, pursuant to the Tennessee Civil Justice Act of 2011, Tennessee Code Annotated sections 29-26-115 through 122 and 202 of the Medical Malpractice Act were amended to replace the term “medical malpractice” with the term “health care liability.” Tennessee Civil Justice Act of 2011, ch. 510 § 9, 2011 Tenn. Pub Acts 1505. It is important to note that because the title “Tennessee Medical Malpractice Act” and the term “medical malpractice” were used in the discussed statutes prior to 2011, the terms will continue to be appropriately used throughout this opinion. -7- require the filing of the certificate of good faith with the complaint instead of within ninety days after its filing. See id. § 29-26-122. While the 2008 and 2009 amendments to the Tennessee Medical Malpractice Act established new procedural requirements for plaintiffs seeking to file medical malpractice actions, these amendments failed to sufficiently define a medical malpractice claim and left Tennessee courts to distinguish between claims sounding in ordinary negligence and those involving medical malpractice. In January 2011, this Court decided Estate of French, which provided a comprehensive and detailed analysis of the interaction between ordinary negligence principles and the Tennessee Medical Malpractice Act, as then enacted. In Estate of French, the administratrix of the estate of a deceased nursing home resident brought a wrongful death suit against the nursing home alleging claims of ordinary negligence, negligence per se, and violations of the Tennessee Adult Protection Act. 333 S.W.3d at 549. The trial court granted partial summary judgment for the nursing home, holding that the Tennessee Medical Malpractice Act applied to the administratrix‟s ordinary negligence claims and precluded allegations of negligence per se or violations of the Tennessee Adult Protection Act. Id. at 549-50. The Court of Appeals affirmed, holding that “the gravamen of the case sounds in medical malpractice.” Id. at 553 (internal quotation marks omitted). This Court granted the administratrix‟s application for permission to appeal to address whether the administratrix‟s claims were “based upon ordinary common law negligence, medical malpractice, or both.” Id. at 554. We explained that, “[b]ecause medical malpractice is a category of negligence, the distinction between medical malpractice and negligence claims is subtle; there is no rigid analytical line separating the two causes of action.” Id. at 555 (citations omitted). Thus, the Court resolved that “whether claims should be characterized as ordinary negligence or medical malpractice claims obviously depends heavily on the facts of each individual case.” Id. at 556. However, the Court provided the following guidance in distinguishing between ordinary negligence and medical malpractice: [W]hen a claim alleges negligent conduct which constitutes or bears a substantial relationship to the rendition of medical treatment by a medical professional, the medical malpractice statute is applicable. Conversely, when the conduct alleged is not substantially related to the rendition of medical treatment by a medical professional, the medical malpractice statute does not apply. .... -8- Medical malpractice cases typically involve a medical diagnosis, treatment or other scientific matters. The distinction between ordinary negligence and malpractice turns on whether the acts or omissions complained of involve a matter of medical science or art requiring specialized skills not ordinarily possessed by lay persons or whether the conduct complained of can instead be assessed on the basis of common everyday experience of the trier of fact. Id. at 555-56 (alteration in original) (citations omitted); see also Draper v. Westerfield, 181 S.W.3d 283, 290 (Tenn. 2005) (“[I]n determining whether an action is for medical malpractice or for common law negligence, the issue is whether the alleged negligent conduct „bears a substantial relationship to the rendition of medical treatment by a medical professional.‟” (citing Gunter v. Lab. Corp. of Am., 121 S.W.3d 636, 641 (Tenn. 2003))). The Court ultimately concluded that it is “the responsibility of the courts to ascertain the nature and substance of a claim” and that the “designation given those claims by either the plaintiff or the defendant is not determinative.” Estate of French, 333 S.W.3d at 557. However, roughly four months after this Court‟s decision in Estate of French, at its next session, the Legislature passed the Tennessee Civil Justice Act of 2011, further amending the Tennessee Medical Malpractice Act. See Tennessee Civil Justice Act of 2011, ch. 510, 2011 Tenn. Pub Acts 1505 (codified at Tenn. Code Ann. § 29-26-101 et seq. (Supp. 2011)). Notably, the Tennessee Civil Justice Act of 2011 amended the existing Tennessee Medical Malpractice Act by removing all references to “medical malpractice” from the Tennessee Code and replacing them with “health care liability” or “health care liability action” as applicable. See id. Furthermore, section 29-26-101 was added to the Code which defined “health care liability action” as “any civil action, including claims against the state or a political subdivision thereof, alleging that a health care provider or providers have caused an injury related to the provision of, or failure to provide, health care services to a person, regardless of the theory of liability on which the action is based.” Tenn. Code Ann. 29-26-101(a)(1) (Supp. 2011) (emphasis added). This same section went on to provide that “[a]ny such civil action or claim is subject to the provisions of this part regardless of any other claims, causes of action, or theories of liability alleged in the complaint.” Id. § 29-26-101(c). With the foregoing history in mind we turn to the issues raised in this appeal. -9-