Catherine J. Hollahan v. Tennessee Department of Health
M2017-00629-COA-R3-CV
| Tenn. Ct. App. | Dec 19, 2017Background
- Catherine J. Hollahan was a Tennessee RN (1993) and advanced practice nurse (APN) (2006) who worked at three testosterone clinics (Ageless, Body for Life, New Life) between 2008–2014.
- The Tennessee Board of Nursing charged Hollahan with multiple violations: failing to file required APN notice/formulary; consuming alcohol/being impaired on duty; unauthorized self-injection/removal of clinic testosterone; prescribing outside scope and failing to chart/assess; an inappropriate sexual relationship with a patient; fraudulent billing; and providing incompetent care (no labs/assessments).
- After an administrative hearing the Board found numerous factual violations, revoked Hollahan’s APN certificate, RN license and multistate privilege, assessed civil penalties totaling $7,200, and assessed hearing costs (up to $20,000).
- The chancery court affirmed the Board (with a minor modification of the characterization of the patient relationship), and Hollahan appealed to the Court of Appeals of Tennessee.
- The Court of Appeals reviewed under the UAPA substantial-and-material-evidence and arbitrary-or-capricious standards and affirmed the Board’s factual findings, legal conclusions, and sanctions.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Board added a new charge during deliberations without notice | Hollahan: Board added a prescription-based charge (self-prescribing testosterone) during deliberations without notice or chance to defend | Dept. of Health: Final Order controls; deliberative comments do not alter formal charges; Order found unauthorized use, not self-prescription | Held: No prejudicial procedural error — the Final Order’s finding (unauthorized removal/self-injection) was within notice and supported by evidence |
| Sufficiency of evidence for unauthorized removal/self-injection of testosterone | Hollahan: Owners authorized use; testimony conflicted so finding insufficient | Dept. of Health: Witness testimony and an owner affidavit contradicted Hollahan; evidence supports finding | Held: Substantial and material evidence supports Board’s finding of unauthorized use/self-injection |
| Sufficiency of evidence for on-duty alcohol/impaired behavior and inappropriate patient relationship/prescribing outside scope | Hollahan: Witnesses unreliable; some documents inconsistent; disputed whether conduct occurred | Dept. of Health: Multiple staff testified to observed drinking, smell, slurred speech, missed assessments, improper prescriptions, and sexually explicit texts with a patient | Held: Record contains substantial and material evidence to support findings of impairment, inappropriate romantic/sexual relationship with a patient, and prescribing outside authorized protocols |
| Sanctions (revocation, penalties, costs) — whether unwarranted | Hollahan: Requested reinstatement; argued sanctions excessive or unsupported | Dept. of Health: Board has statutory authority to revoke and assess penalties/costs to protect public health | Held: Sanctions were warranted in law and justified by facts; court will not substitute its judgment for agency in sanction selection |
Key Cases Cited
- StarLink Logistics Inc. v. ACC, LLC, 494 S.W.3d 659 (Tenn. 2016) (deference to agency fact-finding; substantial-and-material-evidence standard explained)
- Wayne Cnty. v. Tenn. Solid Waste Disposal Control Bd., 756 S.W.2d 274 (Tenn. Ct. App. 1988) (review under UAPA limited to administrative record; no de novo review)
- Clay Cnty. Manor, Inc. v. State Dep’t of Health & Env’t, 849 S.W.2d 755 (Tenn. 1993) (definition of substantial and material evidence)
- Mosley v. Tenn. Dep’t of Commerce & Ins., 167 S.W.3d 308 (Tenn. Ct. App. 2004) (courts should not substitute judgment for administrative tribunal when sanctions are legally warranted and factually justified)
- Robertson v. Tenn. Bd. of Soc. Worker Certification & Licensure, 227 S.W.3d 7 (Tenn. 2007) (review of agency remedies limited to whether the sanction is unwarranted in law or without justification in fact)