The Court of Appeals of Tennessee, in the case McCall Brister v. HCA Health Services of Tennessee, reversed a trial court's dismissal of Brister's claims against Skyline Medical Center. The trial court had dismissed the case on the grounds that Brister's claims were classified as medical malpractice, which required compliance with the Tennessee Medical Malpractice Act's pre-suit notice and certificate of good faith. However, the appellate court determined that Brister's allegations, which included failures in supervision and safety measures that led to her sexual assault by a male patient, constituted claims of ordinary negligence and premises liability, not medical malpractice. The court remanded the case for further proceedings. The procedural history included Brister's initial complaint filed on January 8, 2010, and her subsequent motions related to the dismissal. The court's opinion emphasized the nature of the claims as pertaining to general negligence, thereby negating the need for the specific medical malpractice requirements.
The Court determined that the claims presented by the Plaintiff are classified as "medical malpractice" claims and dismissed the case with prejudice due to the Plaintiff's non-compliance with Tennessee Code Annotated sections 29-26-121 and 29-26-122, which mandate Pre-Suit Notice and the filing of a Certificate of Good Faith. After the Plaintiff filed a motion to alter or amend the judgment on July 2, 2010, Skyline responded on August 16, 2010. Following a hearing on August 20, 2010, the Court denied the Plaintiff's motions, stating that amending the complaint to include a medical malpractice claim would be futile given the prior ruling on non-compliance. The Plaintiff failed to show "extraordinary cause" for the non-compliance and did not present new facts, new law, or evidence of a clear legal error or injustice. The Plaintiff's appeal raises questions regarding the trial court's classification of the claims and the denial of the motion to amend. The appellate review will consider the legal sufficiency of the complaint, with all allegations treated as true and reasonable inferences granted to the Plaintiff, adhering to established legal standards regarding motions to dismiss for failure to state a claim. The Court must clarify whether the complaint alleges ordinary negligence, medical malpractice, or both, noting that the nature of the claim is determined by its substance rather than its label.
Tennessee law allows for claims to be based on both ordinary negligence and medical malpractice within a single complaint. A claim qualifies as medical malpractice if the alleged negligent conduct is substantially related to medical treatment by a professional. In contrast, if the conduct is unrelated to medical treatment, the medical malpractice statute does not apply. The distinction relies on whether the breach of duty is based on medical expertise. Not all health-related cases constitute medical malpractice.
In this case, the Plaintiff alleges that Skyline negligently allowed a male patient to sexually assault her due to inadequate supervision and staffing, asserting that these failures created a dangerous environment. Skyline argues that these claims are rooted in medical malpractice because they relate to the quality of medical treatment. The trial court agreed and dismissed the case for lack of compliance with the pre-suit requirements of the Tennessee Medical Malpractice Act (TMMA), which governs claims involving medical science requiring specialized knowledge.
The court referenced Conley v. Life Care Centers, where the plaintiff claimed negligence related to a patient’s admission and retention, concluding those claims were medical in nature. However, the current case differs as the Plaintiff does not allege issues with the admission or retention of the assailant but rather with Skyline's failure to supervise adequately. Therefore, the dismissal based on Conley is not warranted. Recent judicial interpretations reflect a more nuanced approach to TMMA issues.
The Court distinguished between allegations of medical malpractice and ordinary negligence in the plaintiff’s complaint, referencing *Estate of French*. Claims involving medical decision-making, such as patient feeding and hydration assessments, risk evaluations for pressure sores, and treatment for pressure ulcers, were classified as medical malpractice due to the need for specialized medical training. In contrast, allegations against CNAs for failing to adhere to a care plan and provide basic care were categorized as ordinary negligence, as CNAs lack the comprehensive training of medical professionals. Additionally, claims of understaffing were found to relate to ordinary negligence principles. The complaint was assessed to lack a substantial relationship to medical treatment, instead suggesting supervision akin to non-medical safeguards. The Court concluded that the claims constituted ordinary negligence or premises liability, thus not falling under the Tennessee Medical Malpractice Act (TMMA). The elements of negligence were outlined, emphasizing the need for duty of care, breach, injury, and causation. The Court reversed the trial court's decision and remanded the case for further proceedings.
