Court Opinion

ID: 9963320
Source: CourtListenerOpinion
Date Created: 2024-04-24 20:12:53.201391+00
Date Added: 2024-06-11T08:24:45.666792
License: Public Domain

04/24/2024
               IN THE COURT OF APPEALS OF TENNESSEE
                            AT JACKSON
                               February 13, 2024 Session

    EUGENE MOXLEY v. AMISUB SFH, INC. D/B/A SAINT FRANCIS
                      HOSPITAL ET AL.

                  Appeal from the Circuit Court for Shelby County
                   No. CT-4603-20     Cedrick D. Wooten, Judge
                     ___________________________________

                           No. W2023-00220-COA-R3-CV
                       ___________________________________

This is the second appeal in this healthcare liability case. In the first appeal, which was
taken under Tennessee Rule of Appellate Procedure 9, this Court reversed the trial court’s
denial of Appellees’/healthcare providers’ Tennessee Rule of Civil Procedure 12.02(6)
motion. The trial court held that, although Appellant/patient failed to substantially comply
with the pre-suit notice requirement of Tennessee Code Annotated section 29-26-
121(a)(2)(E), Appellant showed extraordinary cause to excuse the noncompliance. The
only question certified in the Rule 9 appeal was whether the trial court erred in finding
extraordinary cause. We determined that it did and reversed the extraordinary cause finding
but left undisturbed the trial court’s finding on substantial compliance. On remand, the
trial court granted Appellees’ motion to dismiss without hearing. Now, in this Tennessee
Rule of Appellate Procedure 3 appeal, we review the trial court’s initial finding that
Appellant did not substantially comply with the statutory requirements. Because the trial
court applied an incorrect legal standard in so finding, we vacate the order granting
Appellees’ motion to dismiss and remand for reconsideration of the question of substantial
compliance under the correct legal standard.

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

KENNY ARMSTRONG, J., delivered the opinion of the court, in which J. STEVEN STAFFORD,
P.J., W.S., and JEFFREY USMAN, J., joined.

William Bryan Smith, Memphis, Tennessee, and A. Wilson Wages, Millington, Tennessee,
for the appellant, Eugene Moxley.

Karen S. Koplon and Megan Lane, Memphis, Tennessee, for the appellees, Kirsna Norris
Chapman, and AMISUB (SFH), Inc. d/b/a St. Francis Hospital.
Joseph M. Clark and Raleigh Kent Francis, Memphis, Tennessee, for the appellees,
Zachary K. Corr and The Urology Group.

                                 MEMORANDUM OPINION1

                                           I. Background

      This is the second appeal in this healthcare liability case. The first appeal, Moxley
v. Amisub SFH, Inc., No. W2021-01422-COA-R9-CV, 2022 WL 3715056 (Tenn. Ct.
App. Aug. 29, 2022) (“Moxley I”), was a Tennessee Rule of Appellate Procedure 9 appeal.
Concerning the basis of the lawsuit, the Moxley I Court explained that

      [t]he complaint filed in this case alleges that Plaintiff Eugene Moxley was
      injured due to medical negligence during the course of a cancer treatment on
      July 5, 2019. On July 3, 2020, Plaintiff’s counsel, A. Wilson Wages, sent the
      statutorily required pre-suit notice of a potential health care liability claim to
      twelve possible defendants. Tennessee Code Annotated section 29-26-
      121(a)(2)(E) provides that pre-suit notice must include “[a] HIPAA
      compliant medical authorization permitting the provider receiving the notice
      to obtain complete medical records from each other provider being sent a
      notice.” (Emphasis added). Plaintiff admits that a mistake was made with
      respect to the HIPAA authorizations he sent to each provider.

                                                  ***

             On October 30, 2020, Plaintiff initiated this lawsuit by filing a
      complaint against four defendants—Nurse Chapman, The Urology Group,
      PC, Dr. Zachary Corr, and St. Francis Hospital [(together, “Appellees”)].
      Plaintiff’s counsel, Mr. Wages, attached an affidavit stating that he had
      complied with the pre-suit notice requirements and, among other things, sent
      “a HIPAA compliant medical authorization permitting the providers who
      were sent a notice to obtain medi[c]al records from the other providers.” He
      attached all of the pre-suit notice letters and enclosed authorization forms
      sent on the dates mentioned above.

      1
          Rule 10 of the Rules of the Court of Appeals of Tennessee provides:

      This Court, with the concurrence of all judges participating in the case, may affirm, reverse
      or modify the actions of the trial court by memorandum opinion when a formal opinion
      would have no precedential value. When a case is decided by memorandum opinion it shall
      be designated “MEMORANDUM OPINION”, shall not be published, and shall not be
      cited or relied on for any reason in any unrelated case.
                                                  -2-
               On January 25, 2021, St. Francis and Nurse Chapman filed a motion
       to dismiss pursuant to Tennessee Rule of Civil Procedure 12.02(6), alleging
       failure to comply with Tennessee Code Annotated section 29-26-
       121(a)(2)(E). St. Francis and Nurse Chapman pointed out that the HIPAA
       authorization forms they received with pre-suit notice allowed each of them
       to “release” medical records but did not state that they could procure records
       from other providers. As such, they argued that Plaintiff had failed to
       substantially comply with the statute’s requirement that pre-suit notice
       include “[a] HIPAA compliant medical authorization permitting the provider
       receiving the notice to obtain complete medical records from each other
       provider being sent a notice.” Tenn. Code Ann. § 29-26-121(a)(2)(E).

Moxley I, 2022 WL 3715056, at *1-*2. The remaining Appellees subsequently joined in
the motion to dismiss. In opposing the motion, Mr. Wages asserted that he had
substantially complied with the statutory requirements. Specifically, “[h]e suggested that
each provider should have known that authorizations had been sent to all of the other
potential defendants allowing the ‘release’ of records, such that ‘everyone involved could
obtain copies of the relevant records’ if they simply called and requested them.” Id. at *3.
In the alternative, Mr. Wages submitted an affidavit outlining certain facts that he alleged
amounted to extraordinary cause to excuse any noncompliance. Id.

       The trial court (at that time Judge Jerry Stokes) denied Appellees’ motion to dismiss
in the July 26, 2021 order, which gave rise to the Rule 9 appeal in Moxley I. Therein,
Judge Stokes held that:

       If the defendant providers do not receive the benefit conferred to them under
       Tenn. Code Ann. § 29-26-121, that is the method by which prejudice is
       measured. In this case, the benefit conferred under § 29-26-121(a)(2) is that
       each defendant provider is to obtain all of the medical records of the Plaintiff
       from the other providers receiving pre-suit notice. The Defendants in this
       case were deprived of that benefit, and thus, were prejudiced. As a result,
       this Court finds that Plaintiff did not substantially comply with the pre-suit
       notice statute, Tenn. Code Ann. § 29-26-121(a)(2).

Although the trial court held that Mr. Moxley failed to substantially comply with the pre-
suit notice requirement of Tennessee Code Annotated section 29-26-121(a)(2)(E), it
ultimately denied the motion to dismiss on its holding that Mr. Moxley’s attorney had
shown extraordinary cause to excuse non-compliance with the statute. Specifically, Judge
Stokes held:

       This Court finds that each individual reason cited by Mr. Wages, standing
       alone, does not constitute extraordinary cause for not complying with the
       stat[ute]. However, the cumulative effect of all the reasons stated by Mr.
                                           -3-
       Wages under oath lead the Court to exercise its discretion to find that all of
       the events described by Mr. Wages, which are not disputed factually, and
       almost all of which occurred leading up to or near the time of the pre-suit
       notice deadline, constitute extraordinary cause to excuse [non-]compliance
       with Tenn. Code Ann. § 29-26-121(a)(2)(E).

       The sole issue certified in Moxley I was “whether the trial court erred in denying
the defendants’ motion to dismiss based on its finding that ‘extraordinary cause’ existed to
excuse the plaintiff’s failure to comply with the statutory pre-suit notice requirements.”
Moxley I, 2022 WL 3715056, at *1. Importantly, in Moxley I, we stated, “[T]he trial
court’s initial ruling that Plaintiff failed to substantially comply with the pre-suit
notice statute is not before us. We are only reviewing the trial court’s subsequent ruling
that the plaintiff demonstrated extraordinary cause for the noncompliance.” Id. at *6
(emphasis added). In short, we declined to review Judge Stokes’ ruling on substantial
compliance as set out in his July 26, 2021 order, supra.

       On January 11, 2023, the trial court (now Judge Cedric D. Wooten) held a status
hearing. No proof was taken, but each of the attorneys was allowed a statement, discussed
infra. By order of January 18, 2023, Judge Wooten granted the Appellees’ Tennessee Rule
of Civil Procedure 12.02(6) motion, dismissing Mr. Moxley’s case with prejudice. In
relevant part, Judge Wooten’s order reads:

       Upon receipt of the Tennessee Court of Appeals Opinion, Moxlev v. Amisub
       SFH. Inc., No. W2021-01422-COA-R9-CV, 2022 WL 3715056 (Tenn. Ct.
       App, Aug. 29, 2022), the Judgment entered on August 29, 2022, and the
       Mandate entered on November 2, 2022, this Court finds that . . . this matter
       should be dismissed with prejudice with costs assessed to the Plaintiff.

       IT IS, THEREFORE, ORDERED, ADJUDGED AND DECREED that . . .

       Plaintiff’s Complaint is DISMISSED WITH PREJUDICE as to all
       Defendants, with costs assessed to the Plaintiff.

Mr. Moxley appeals.

                                         II. Issues

       Mr. Moxley raises the following issues for review as stated in his brief:

       1. The trial court erred when it held Moxley failed to comply substantially
       with the requirements of Tenn. Code Ann. § 29-26121(a)(2)(E) where his
       HIPAA-compliant medical release allowed each potential defendant
       receiving notice of intent to sue to obtain medical records from every other
                                            -4-
       potential defendant receiving notice simply by requesting those records.
       2. The trial court erred when it dismissed the case with prejudice holding that
       Moxley was not entitled to the extension of the limitations period available
       to an HCLA plaintiff giving notice to all potential defendants under Tenn.
       Code Ann. § 29-26-121(c) where each potential defendant received pre-suit
       notice of suit.
       3. The trial court erred when it refused to excuse any errors in the content of
       Moxley’s HIPAA-complaint release when the defects in his factual
       presentation identified by this Court in [Moxley I], were addressed by a
       supplemental affidavit on remand.
       4. With the supplemental facts produced on remand, the constellation of
       issues confronted by Moxley’s counsel at or near the time pre-suit notice of
       this Health Care Liability Action was due to be served amounted to
       extraordinary cause excusing compliance with Tenn. Code Ann. § 29-26-
       121(a)(2)(E).

                                 III. Standard of Review

       In Martin v. Rolling Hills Hospital, LLC, 600 S.W.3d 322, 334-35 (Tenn. 2020),
the Tennessee Supreme Court explained that the proper avenue to challenge a plaintiff’s
compliance with the pre-suit notice requirements of Tennessee Code Annotated section 29-
26-121 is by a Tennessee Rule of Civil Procedure 12.02(6) motion to dismiss. A trial
court’s grant of a motion to dismiss is a question of law, which we review de novo with no
presumption of correctness. Ellithorpe v. Weismark, 479 S.W.3d 818, 824 (Tenn. 2015).

                                       IV. Analysis

                                 A. Substantial Compliance

        In Moxley I, we took up only the question of whether Judge Stokes’ finding of
extraordinary cause was correct and found that it was not. However, as set out above, we
specifically declined to address Judge Stokes’ substantial compliance ruling, i.e., “[T]he
trial court’s initial ruling that Plaintiff failed to substantially comply with the pre-suit
notice statute is not before us. We are only reviewing the trial court’s subsequent ruling
that the plaintiff demonstrated extraordinary cause for the noncompliance.” Moxley I, 2022
WL 3715056, at *6 (emphasis added). In stating the disposition of the case, the Moxley I
Court held that, “The decision of the circuit court is reversed. . . .” Id. at *14. However,
we did not specify that only the trial court’s ruling on extraordinary cause was reversed,
although extraordinary cause was the only question we addressed in Moxley I. This led to
some confusion on remand.

      Following remand in Moxley I, Judge Wooten conducted a status hearing on
January 11, 2023. As noted above, no evidence was adduced at the hearing, but the parties’
                                         -5-
attorneys were given an opportunity to argue. The Appellant argued that the trial court
could reconsider its decision regarding extraordinary cause based on Mr. Wage’s second
affidavit. In addition, Appellant argued that the pre-suit notices “allowed all of the
defendants to obtain the records and they were fully in substantial compliance.” Appellees
did not address either of Appellant’s arguments. Rather, they argued that this Court’s
holding in Moxley I mandated the trial court to grant their Rule 12 motion to dismiss the
case. Appellant countered that the Moxley I Court’s decision merely addressed the
question of extraordinary cause, but did not address substantial compliance. Thus,
Appellant argued that the trial court was in a position to take up the question of substantial
compliance on remand from Moxley I. Appellant’s interpretation of our holding in Moxley
I was correct; however, it appears that the trial court adopted Appellees’ reading of Moxley
I. As discussed above, in Moxley I, we certified the sole question of whether Judge Stokes’
erred in finding extraordinary cause, so our reversal extended only to the extraordinary
cause finding. In short, our intent in Moxley I was to reverse Judge Stokes’ extraordinary
cause ruling and to leave undisturbed his substantial compliance ruling—which question
could then be revisited on remand or in a Tennessee Rule of Appellate Procedure 3 appeal.
However, in granting Appellees’ motion to dismiss, Judge Wooten interpreted our mandate
to require “reversal” of Judge Stokes’ order, i.e., entry of an order granting the motion to
dismiss without further inquiry. Accordingly, Judge Wooten did not revisit the question
of substantial compliance, so we do so now.

       As noted above, Appellees’ motion to dismiss asserts that the HIPAA-authorization
forms they received with pre-suit notice allowed each of them to “release” medical records
but did not state that they could procure records from other providers. As such, they argued
that Mr. Moxley failed to substantially comply with the statute’s requirement that pre-suit
notice include “[a] HIPAA compliant medical authorization permitting the provider
receiving the notice to obtain complete medical records from each other provider being
sent a notice.” Tenn. Code Ann. § 29-26-121(a)(2)(E); Moxley I, at *2. As explained in
Moxley I:

       The pre-suit notice letter sent to Nurse Chapman included twelve separate
       HIPAA authorization forms. Each of the twelve forms Ms. Chapman
       received designated her as the “releasing provider.” Thus, the forms she
       received contained language stating that she could “release” medical records
       to other entities. For example:

              “I, Eugene T. Moxley, ... do hereby authorize Kirsna J. Norris-
              Chapman, R.N., to release to The Urology Group, the medical
              records ... relating to my treatment[.]”

              “I, Eugene T. Moxley, ... do hereby authorize Kirsna J. Norris-
              Chapman, R.N., to release to St. Francis Hospital-Memphis,
              the medical records ... relating to my treatment[.]”
                                             -6-
                 “I, Eugene T. Moxley, ... do hereby authorize Kirsna J. Norris-
                 Chapman, R.N., to release to Zachary K. Corr, M.D., the
                 medical records ... relating to my treatment[.]”

       However, none of the twelve forms Nurse Chapman received contained
       language stating that she could “obtain” any medical records, although
       Plaintiff did send one authorization to Nurse Chapman that included her
       name in both fields as follows:

                 “I, Eugene T. Moxley, . . . do hereby authorize Kirsna J. Norris-
                 Chapman, R.N., to release to Kirsna J. Norris-Chapman, R.N.,
                 the medical records ... relating to my treatment[.]”

       The same mistake was repeated with the forms sent to all twelve potential
       defendants.

Moxley I, at *1. So, Mr. Moxley’s notices allowed the Appellees’ to release information
to other Appellees but did not specify that the Appellees could obtain the records from the
other Appellees. The gravamen of Judge Stokes’ ruling that Mr. Moxley failed to
substantially comply with section 29-26-121 was that Appellees were deprived of the
benefit “conferred under § 29-26-121(a)(2) [] that each defendant provider is to obtain all
of the medical records of the Plaintiff from the other providers receiving pre-suit
notice.” (Emphases added). In this regard, Judge Stokes held Mr. Moxley to strict
compliance with the statute as opposed to substantial compliance, i.e. the trial court focused
on whom Appellees could obtain the records from, and not on whether Appellees could
obtain the records at all. Respectfully, the standard applicable to the question of substantial
compliance is more complex than strict compliance with the statute. Indeed, the Tennessee
Supreme Court has held that the requirements contained in section 29-26-121(a)(2) (which
include “[a] HIPAA compliant medical authorization permitting the provider receiving the
notice to obtain complete medical records from each other provider being sent a notice,”
Tenn. Code Ann. § 29-26-121(a)(2)(E)) are “directory” and may be satisfied by
“substantial compliance.” Stevens ex rel Stevens v. Hickman Community Healthcare
Services, Inc., 418 S.W.3d 547, 555 (Tenn. 2013) (evaluating whether a plaintiff
substantially complied with Section 121(a)(2)(E)); see also Arden v. Kozawa, 466 S.W.3d
758, 762-64 (Tenn. 2015) (holding that the requirements of Section 121(a)(3)(B) and (a)(4)
may be satisfied through substantial compliance); Thurmond v. Mid-Cumberland
Infectious Disease Consultants, PLC, 433 S.W.3d 512, 520 (Tenn. 2014) (holding that the
affidavit requirement of Section 121(a)(3)(B) and (a)(4) may be satisfied by substantial
compliance). So, strict compliance with section 121 is not required for substantial
compliance.2 Indeed, the ultimate purpose of the pre-suit notice requirement is to allow

       2
           In contrast, the Martin Court held that for a medical authorization to be HIPAA compliant, the
                                                  -7-
potential defendants to investigate the merits of the claims against them and to pursue
settlement negotiations prior to the lawsuit being filed. See Martin, 600 S.W.3d at 331;
Runions v. Jackson-Madison Cnty. Gen. Hosp. Dist., 549 S.W.3d 77, 86 (Tenn. 2018).
In short, “[n]ot every non-compliant HIPAA medical authorization will result in
prejudice.” Stevens, 418 S.W.3d at 556. Concerning the question of prejudice, the Martin
Court clarified that

        prejudice is not a separate and independent analytical element; rather, as
        Stevens explained, prejudice is a consideration relevant to determining
        whether a plaintiff has substantially complied. Prejudice, or the absence of
        prejudice, is especially relevant to evaluating the extent and significance of
        the plaintiff’s noncompliance. If a plaintiff’s noncompliance with Section
        121 frustrates or interferes with the purposes of Section 121 or prevents the
        defendant from receiving a benefit Section 121 confers, then the plaintiff
        likely has not substantially complied with Section 121. On the other hand, if
        the plaintiff’s noncompliance neither frustrates or interferes with the
        purposes of Section 121 nor prevents a defendant from receiving a benefit
        the statute confers, then a court is more likely to determine that the plaintiff
        has substantially complied.

Martin, 600 S.W.3d at 333-34 (internal citations omitted); see also Hayward v.
Chattanooga-Hamilton Cty. Hosp. Auth., d/b/a Erlanger Health Systems, et al., 680
S.W.3d 252, 260 (Tenn. Ct. App. 2023), perm. app. denied (Tenn. Oct. 13, 2013) (citing

authorization must include all six core elements required by federal law. 600 S.W.3d at 334. In other words,
while the plaintiff may satisfy the requirements of Tennessee Code Annotated section 29-26-121(a)(2) by
substantial compliance, it must strictly comply with the relevant federal regulation, 45 C.F.R. §
164.508(c)(1). The regulation provides that a valid HIPAA-compliant medical authorization must contain
the following core 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.

A medical authorization is not HIPAA compliant under federal law “if ‘[t]he authorization has not been
filled out completely, with respect to ‘a core element.” Martin, 600 S.W.3d at 334 (quoting 45 C.F.R.
§ 164.508(b)(2)(ii)).
                                                    -8-
Martin, 600 S.W.3d at 334). Again, Judge Stokes’ ruling was that Mr. Moxley’s pre-suit
notice prejudiced Appellees insofar as they were denied the benefit of “obtain[ing] all of
[Mr. Moxley’s] medical records from the other providers receiving pre-suit notice.”
(Emphasis added). Respectfully, “the conclusion that a deficient medical authorization
would ordinarily deprive a defendant of the benefit of Section 121 does not mean that such
deficiency will always result in such deprivation. . . . If a defective medical authorization
automatically meant a plaintiff failed to comply with section 121 pre-suit notice, there
would be no reason to consider prejudice.” Hayward, 680 S.W.3d at 261. However, “[I]f
the plaintiff’s noncompliance neither frustrates or interferes with the purposes of Section
121 nor prevents a defendant from receiving a benefit the statute confers, then a court is
more likely to determine that the plaintiff has substantially complied.” Martin, 600 S.W.3d
at 334 (citing Stevens, 418 S.W.3d at 555). To date, the trial court has not resolved this
question.

                                B. Supplemental Affidavit

       Following remand in Moxley I, Mr. Wages submitted a second affidavit, which he
alleges contains additional facts that would support a finding of extraordinary cause, or at
least would allow the trial court to revisit that issue. We have reviewed the affidavit and
conclude that the facts contained therein were known, or could have been know, to Mr.
Wages at the outset of this lawsuit. In fact, Mr. Wages’ initial affidavit (filed before
Moxley I) contains ostensibly the same facts that he reiterates and expands upon in his
second affidavit. In short, the material facts surrounding Mr. Wages failure to comply with
the pre-suit notice requirements were considered by Judge Stokes in finding extraordinary
cause. So, having reversed Judge Stokes’ extraordinary cause finding, the Moxley I
decision precludes the trial court’s reconsideration of extraordinary cause on the reiterated
facts outlined in Mr. Wages’ second affidavit.

                                       V. Conclusion

       For the foregoing reasons, the trial court’s order is vacated, and all remaining issues
are pretermitted. The case is remanded for such further proceedings as may be necessary
and are consistent with the opinion, including consideration of the question of substantial
compliance under the correct standard. Costs of the appeal are assessed one-half to
Appellant, Eugene Moxley, and one-half to Appellees, Kirsna Norris Chapman, AMISUB
(SFH), Inc. d/b/a St. Francis Hospital, Zachary K. Corr, and The Urology Group.
Execution for costs issue if necessary.

                                                  s/ Kenny Armstrong
                                                  KENNY ARMSTRONG, JUDGE

                                            -9-