John v. Saint Francis Hospital, Inc., 405 P.3d 681

Background

Patient (John) underwent cervical decompressive laminectomies and alleged post-operative paralysis and other injuries, then filed a medical negligence action without attaching the statutorily required affidavit of merit under 12 O.S. § 19.1.
Defendants (Saint Francis, Neurological Surgery, Inc., and Dr. Koontz) moved to dismiss for failure to attach the affidavit or, alternatively, to require compliance or an indigency exception.
The district court rejected the special-law challenge but found § 19.1 an unconstitutional impediment to court access and declined to enforce it, certifying the interlocutory order for immediate review.
The Oklahoma Supreme Court reviewed de novo whether § 19.1 (the expert-opinion affidavit requirement) is constitutional under the Oklahoma Constitution (Art. II § 6 — access to courts; Art. V § 46 — prohibition on special laws) and prior precedent.
The Court concluded § 19.1 functionally replicates prior invalidated affidavit statutes, creates a financially coercive pre-filing barrier for a subclass of plaintiffs, improperly removes judicial discretion, and restricts admissibility of the pre-filing expert opinion.
Holding: § 19.1 is an unconstitutional special law and an impermissible barrier to court access; the district court order affirmed in part and reversed in part and the case remanded for further proceedings consistent with the opinion.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether § 19.1's affidavit-of-merit requirement violates the Oklahoma constitutional right of access to courts	Affidavit requirement conditions court access on ability to obtain and pay for pre-filing expert review, creating an unconstitutional monetary barrier	Requirement is a legitimate procedural gate to deter frivolous claims and applies broadly to all actions needing expert testimony	Held unconstitutional: § 19.1 imposes an impermissible impediment to access to courts and is invalid
Whether § 19.1 is an unconstitutional special law under Art. V, § 46	Targets plaintiffs who need expert testimony, creating a subclass and unequal treatment compared to general negligence plaintiffs	Statute applies uniformly to all actions requiring expert testimony and thus is a general law	Held a special law: it singles out a subclass and impermissibly regulates judicial practice/evidence
Whether § 19.1's definitions and scope cure prior defects (vagueness re: "qualified expert" and class coverage)	Legislature intended § 19.1 to be broader and cure prior infirmities (removed indigency fee, extended scope)	Statute's text and cross-references supply definitions and show broader applicability	Held inadequate: class remains vague and the statute functionally mirrors prior invalid enactments; ambiguity shifts determinations to plaintiffs rather than courts
Whether mandatory dismissal provisions and limits on admissibility improperly usurp judicial discretion	Plaintiff argued mandatory dismissals and prohibitions on using the pre-filing opinion deprive courts of adjudicative authority and render the pre-filing opinion useless	Defendants argued statutory limits standardize procedure and protect pre-suit opinions while creating prompt case management	Held improper: statute removes judicial discretion, mandates dismissal absent indigency, and paradoxically limits use of compelled pre-filing opinions, further supporting unconstitutionality

Key Cases Cited

Zeier v. Zimmer, 152 P.3d 861 (Okla. 2006) (struck down a medical-affidavit statute as an unconstitutional special law and barrier to court access)
Wall v. Marouk, 302 P.3d 775 (Okla. 2013) (held a professional-negligence affidavit statute created an impermissible subclass and economic barrier)
Reynolds v. Porter, 760 P.2d 816 (Okla. 1988) (articulated the three-prong test for determining special vs. general laws)
Robinson v. Oklahoma Nephrology Assoc., Inc., 154 P.3d 1250 (Okla. 2007) (described elements of a prima facie medical malpractice/negligence claim)