Tennessee Supreme Court holds that the Health Care Liability Act’s statute of limitations is not extended if a plaintiff sends pre-suit notice to the wrong defendant.
Tiffinne Runions, a Madison County mother who lost her child five days after childbirth, has also lost her day in court based on a misaddressed pre-suit notice. As a result, Ms. Runions’ lawsuit did not fail based on a judge or jury rejecting the merits of her claim that “the defendants’ negligent conduct . . . caused the baby’s death.” Instead, her lawsuit never even made it past the courthouse doors due to her attorney’s mistake about who owned the hospital that delivered her baby.
Over the past decade, one medical malpractice claim after another in Tennessee has been derailed following plaintiffs’ unsuccessful attempts to comply with certain pre-suit notice requirements mandated by Tennessee’s Health Care Liability Act (HCLA). As a result, the Tennessee Supreme Court’s unanimous decision to dismiss Ms. Runions’ lawsuit even before its merits could be considered represents only the latest casualty in a long line of medical malpractice cases—known as “healthcare liability” claims in Tennessee—that have been doomed from their inception due to attorneys’ procedural mistakes.
As this author previously explained in a 2015 Nashville Bar Journal article:
In 2009, interest groups representing both healthcare providers and injured patients worked together “to draft and pass” several amendments to Tennessee’s medical malpractice statute that aimed to improve medical malpractice litigation for all involved. According to the Tennessee Supreme Court, the goals of the 2009 amendments were “to give defendants written notice that a potential healthcare liability claim may be forthcoming,” to “facilitate early resolution of healthcare liability claims,” and to “equip defendants with the actual means to evaluate the substantive merits of a plaintiff’s claim by enabling early discovery of potential co-defendants and early access to a plaintiff’s medical records.” To accomplish these goals, the legislature required medical malpractice plaintiffs to satisfy six pre-suit “notice requirements,” and it further required plaintiffs to file a “certificate of good faith” with their complaints in cases in which expert testimony would eventually be required.
Due to the myriad technical dismissals that resulted from these reforms, however, the 2009 amendments unexpectedly turned out to be red tape with fangs for medical malpractice plaintiffs. . . . Thus, what began as a laudable effort to improve medical malpractice litigation in Tennessee has instead created new procedural barriers that cause many cases to be dismissed on grounds that are completely unrelated to the merits of a plaintiff’s claim.
Critically, the HCLA provides that a plaintiff who complies with the statute’s mandatory pre-suit notice requirements automatically receives a 120-day extension to the one-year statute of limitations for filing suit. In theory, this extension benefits both parties by affording them a longer period of time to negotiate a potential settlement before contentious litigation begins. In practice, however, the extension functions as a “fatal booby trap for unwary plaintiffs,” because “if a plaintiff’s attorney has erred in complying with one or more of the HCLA’s pre-suit notice requirements, then he almost invariably will not discover his error until the initial one-year statute of limitations has expired.”
The Court’s opinion in Runions v. Jackson-Madison County General Hospital District makes clear that this “fatal booby trap” has just claimed another victim. In Runions, the aggrieved mother (or, more accurately, her attorney) attempted to comply with all of the HCLA’s pre-suit notice requirements before filing her lawsuit. Critically, however, her attorney made one significant misstep: he misidentified the hospital’s owner and operator. As the Court explains:
“Ms. Runions knew that she and her baby received medical treatment at Jackson-Madison County General Hospital, but she did not correctly identify the District as the owner and operator of Jackson-Madison County General Hospital. Instead, she identified and gave pre-suit notice to Bolivar General Hospital, Inc.; West Tennessee Healthcare, Inc.; and West Tennessee Healthcare Network through their registered agent, Ms. Higgs, who also served as general counsel for the District.”
Upon discovering the error, “Ms. Runions moved to amend her complaint to substitute the District for Bolivar General Hospital, Inc. d/b/a Jackson-Madison County General Hospital.” Normally, permitting such an amendment is standard practice; Tennessee Rule of Civil Procedure 15.01 makes clear that permission to amend pleadings should be “freely given” early on in a case, and the error at issue in Ms. Runions’ case was identified almost immediately. Additionally, when a plaintiff has sued the wrong party, Tennessee Rule of Civil Procedure 15.03 provides further that “[a]n amendment changing the party or the naming of the party by or against whom a claim is asserted” should be treated as if it occurred on the date when the plaintiff’s original complaint was filed.
The entire purpose of Tennessee Rule of Civil Procedure 15.03 is to prevent a claim from becoming time-barred by the statute of limitations due to a mere “mistake concerning the identity of the proper party.” In Runions, however, by the time the mistake was discovered, the harm was incurable.
After providing pre-suit notice to the hospital, Ms. Runions’ attorney believed that the statute of limitations had been extended by 120 days based on the HCLA’s automatic extension provision. Because her pre-suit notice had identified the wrong hospital owner, however, the extension was never triggered—something that she did not discover until it was too late. Accordingly, by the time that Ms. Runions learned that her pre-suit notice was defective, the one-year, unextended statute of limitations had already elapsed, and Ms. Runions’ lawsuit was forever time-barred.
As this author has previously noted, this framework conflicts with both Tennessee law generally and the stated purposes of the HCLA specifically. From a broad perspective, “Tennessee law reflects a longstanding, consistent public policy that favors resolving litigation on its merits, rather than promoting dismissals based on purely procedural grounds.” Further, based on an information asymmetry concerning whether the applicable statute of limitations has been extended, mandating strict compliance with the HCLA’s notice provisions in order to trigger the 120-day extension “function[s] to undermine dialogue between litigants by creating perverse litigation incentives that facilitate only mock settlement negotiations and delusive discovery.” As a result, significant reform is in order.
Notably, although Ms. Runions will not be able to pursue a medical malpractice claim against the hospital that delivered her child, she may well be able to pursue a legal malpractice claim against the attorney who represented her. According to practitioners in the space, such claims are rapidly increasing in frequency. Indeed, given how easily attorneys can find themselves on the receiving end of such claims due to the HCLA’s significant procedural complexities, most plaintiff’s lawyers no longer take medical malpractice cases at all.
Read the Tennessee Supreme Court’s unanimous opinion in Tiffinne Wendalyn Gail Runions v. Jackson-Madison County General Hospital District, authored by Justice Sharon G. Lee, here.
 Daniel A. Horwitz, The Law of Unintended Consequences: Avoiding the Health Care Liability Act Booby Trap, Nashville Bar Journal (June 2015), available at https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2577156 (citations omitted).
 Id. at 3.
 Id. at n. 28 (citing Brown v. Samples, No. E2013-00799-COA-R9-CV, 2014 WL 1713773, at *8 (Tenn. Ct. App. Apr. 29, 2014) (collecting cases and holding that “Tennessee courts have long recognized that the interests of justice are promoted by providing injured persons an opportunity to have their lawsuits heard and evaluated on the merits”); Givens v. Vanderbilt Univ., No. M2013-00266-COA-R3-CV, 2013 WL 5773431, at *4 (Tenn. Ct. App. Oct. 24, 2013) (“We conclude that section 121 does not require a court to dismiss a complaint with prejudice for noncompliance with the notice requirement of that section. This conclusion is in keeping with the general principle that ‘Tennessee law strongly favors the resolution of all disputes on their merits.’” (quoting Henley v. Cobb, 916 S.W.2d 915, 916 (Tenn.1996))); Bowers v. Gutterguard of Tennessee, Inc., M2002-02877-COA-R3-CV, 2003 WL 22994302, at *5, (Tenn. Ct. App. Dec. 17, 2003) (“[I]t is the general rule that courts are reluctant to give effect to rules of procedure . . . which prevent a litigant from having a claim adjudicated upon its merits.” (quoting Childress v. Bennett, 816 S.W.2d 314, 316 (Tenn. 1991))). See also Chambers, 2014 WL 1266101 at *5.).
 Id. at p. 7.