CYNTHIA E. YEBUAH, ET AL. v. CENTER FOR UROLOGICAL TREATMENT, PLC
No. M2018-01652-SC-R11-CV
IN THE SUPREME COURT OF TENNESSEE
June 2, 2021
January 6, 2021 Session; Circuit Court for Davidson County No. 14C4972 Joseph P. Binkley, Jr., Judge
This
Tenn. R. App. P. 11 Appeal by Permission; Judgment of the Court of Appeals Reversed in Part
ROGER A. PAGE, J., delivered the opinion of the Court, in which JEFFREY S. BIVINS, C.J., and HOLLY KIRBY, J., joined. SHARON G. LEE, J., filed a dissenting opinion in which CORNELIA A. CLARK, J., joined.1
Marty R. Phillips, Dale Conder, Jr., and Craig P. Sanders, Jackson, Tennessee, and Wendy L. Longmire and T. William A. Caldwell, Nashville, Tennessee, for the appellant, Center for Urological Treatment, PLC.
Randall L. Kinnard, Mary Ellen Morris, Donald Capparella, Tyler Chance Yarbro, and Kimberly Macdonald, Nashville, Tennessee, for the appellees, Cynthia E. Yebuah and Eric N. Yebuah.
Herbert H. Slatery III, Attorney General and Reporter, Andree Sophia Blumstein, Solicitor General, and Joseph P. Ahillen, Assistant Attorney General, for the appellant/intervenor, State of Tennessee.
W. Bryan Smith, Memphis, Tennessee, and Brian G. Brooks, Greenbrier, Arkansas, for amicus curiae, Tennessee Trial Lawyers Association.
OPINION
This appeal concerns a jury award of noneconomic damages after part of a Gelport device was left inside a surgery patient. The underlying facts of the case are largely undisputed. In March 2005, Dr. Frank Lohrasbi performed surgery on Cynthia Yebuah to remove her left kidney after a CT scan revealed the kidney contained a potentially malignant mass. It was a laparoscopic procedure, which was performed with the assistance of a Gelport device. Mrs. Yebuah recovered from surgery routinely.
Over the next couple of years, Mrs. Yebuah underwent several CT scans to detect whether the cancer had returned. In July 2005, Dr. Edward Priest, a radiologist, interpreted Mrs. Yebuah‘s CT scan as showing no sign of cancer. Dr. Lohrasbi reviewed Dr. Priest‘s report and passed the information along to Mrs. Yebuah. In February 2006 and in February 2007, Mrs. Yebuah‘s radiology reports again found no sign of cancer, but both reports noted there was a “tubular structure” in her abdominal cavity—a structure that was not mentioned in the July 2005 report. Dr. Lohrasbi informed Mrs. Yebuah that the CT scans showed no sign of cancer but did not mention the tubular structure.
In 2012, Mrs. Yebuah notified her doctor that she was experiencing abdominal pain and was referred to Dr. Leonardo Espinel for possible gallbladder disease. In July 2013, Dr. Espinel performed a laparoscopic procedure to remove Mrs. Yebuah‘s gallbladder. During this surgery, Dr. Espinel discovered a foreign cylindrical object inside her abdominal cavity. Dr. Espinel did not attempt to remove the object at that time but informed Mrs. Yebuah that her small bowel was looped around a fourteen-centimeter ring. It was later determined that during the March 2005 laparoscopic surgery to remove her kidney, a portion of a Gelport device was unintentionally left inside Mrs. Yebuah‘s abdomen. Thus, the foreign object remained inside Mrs. Yebuah‘s body for eight years before it was discovered during an unrelated surgery to remove her gallbladder.
On November 4, 2013, Mrs. Yebuah underwent surgery to remove the fourteen-centimeter ring from her abdominal cavity. She returned to work shortly thereafter.
In November 2014, the Yebuahs filed a complaint in the Circuit Court for Davidson County, Tennessee, seeking damages against Dr. Lohrasbi, Dr. Priest, and their employers, chiefly the Center for Urological Treatment, PLC (the “Center“) and Radiology Alliance, P.C. The Yebuahs alleged that Dr. Lohrasbi negligently left a portion of the Gelport device in Mrs. Yebuah‘s abdominal cavity, negligently failed to inform Mrs. Yebuah of the ring‘s presence, and negligently failed to remove the ring once it was discovered. The Yebuahs further alleged that Dr. Priest negligently failed to identify the foreign object after Mrs. Yebuah‘s initial CT scan. Mrs. Yebuah did not claim any permanent injury related to the Gelport device but instead sought recovery for noneconomic damages. Her husband, Eric Yebuah, likewise sought recovery for noneconomic damages in the form of loss of consortium. The individual doctors were later voluntarily dismissed, and the Yebuahs only pursued vicarious liability claims against the employers.
The case against the Center and Radiology Alliance went to trial in February of 2018. Because the remaining defendants admitted fault, the case was presented to the jury solely on the issues of causation and damages. The trial court entered a directed verdict in favor of Radiology Alliance at the conclusion of the proof. Thus,
After trial, the Center and the Yebuahs submitted competing proposed judgments to the trial court. The Yebuahs’ proposed order included a judgment for the total jury award of $4,500,000. In contrast, the Center submitted a competing order that applied the statutory noneconomic damages cap, which is codified at
The trial court ultimately adopted the Center‘s proposed judgment. The Yebuahs filed a motion to alter or amend the judgment, arguing that the statutory cap was unconstitutional and, alternatively, that the trial court had incorrectly applied the statutory cap. According to the Yebuahs, the trial court should have interpreted the statute to apply the damages cap separately to each plaintiff‘s award. Meanwhile, the Center filed a motion for a new trial or a remittitur.
The trial court denied the Center‘s motion but granted, in part, the Yebuahs’ motion to amend the judgment. It determined that the Yebuahs waived their constitutional challenge to
In considering the issues on appeal, the Court of Appeals concluded that the trial court erred in determining that the Yebuahs had waived their challenge to the constitutionality of the statutory cap. Yebuah v. Ctr. for Urological Treatment, PLC, No. M2018-01652-COA-R3-CV, 2020 WL 2781586, at *4 (Tenn. Ct. App. May 28, 2020), perm. app. granted, (Tenn. Oct. 8, 2020). However, the Court of Appeals explained that this Court‘s recent decision in McClay v. Airport Management Services, LLC, 596 S.W.3d 686 (Tenn. 2020), resolved the majority of the Yebuahs’ constitutional claims. Yebuah, 2020 WL 2781586, at *4. The intermediate appellate court further determined the trial court properly interpreted and applied
We granted the ensuing application for permission to appeal to address whether the statutory cap on noneconomic damages applies separately to a spouse‘s loss of consortium claim.
II. STANDARD OF REVIEW
The issue presented for review concerns statutory construction. Statutory construction presents a question of law, and we review such questions de novo with no presumption of correctness. State v. Dycus, 456 S.W.3d 918, 924 (Tenn. 2015) (citing State v. Springer, 406 S.W.3d 526, 532-33 (Tenn. 2013); State v. Marshall, 319 S.W.3d 558, 561 (Tenn. 2010); State v. Wilson, 132 S.W.3d 340, 341 (Tenn. 2004)); Carter v. Bell, 279 S.W.3d 560, 564 (Tenn. 2009).
We look to “the language of the statute, its subject matter, the object and reach of the statute, the wrong or evil which it seeks to remedy or prevent, and the purpose sought to be accomplished in its enactment.” Spires v. Simpson, 539 S.W.3d 134, 143 (Tenn. 2017) (quoting State v. Collins, 166 S.W.3d 721, 726 (Tenn. 2005)). Courts seek a reasonable interpretation “in light of the purposes, objectives, and spirit of the statute based on good sound reasoning.” Beard v. Branson, 528 S.W.3d 487, 496 (Tenn. 2017) (quoting Scott v. Ashland Healthcare Ctr., Inc., 49 S.W.3d 281, 286 (Tenn. 2001)). The words in a statute “must be given their natural and ordinary meaning in the context in which they appear and in light of the statute‘s general purpose.” Coffee Cnty. Bd. of Educ. v. City of Tullahoma, 574 S.W.3d 832, 839 (Tenn. 2019) (quoting Mills v. Fulmarque, Inc., 360 S.W.3d 362, 368 (Tenn. 2012)).
III. ANALYSIS
The issue on appeal to this Court is whether
(a) In a civil action, each injured plaintiff may be awarded:
(1) Compensation for economic damages suffered by each injured plaintiff; and
(2) Compensation for any noneconomic damages suffered by each injured plaintiff not to exceed seven hundred fifty thousand dollars ($750,000) for all injuries and occurrences that were or could have been asserted, regardless of whether the act is based on a single act or omission or on a series of acts or omissions that allegedly caused the injuries or death.
. . . .
(e) All noneconomic damages awarded to each injured plaintiff, including damages for pain and suffering, as well as any claims of a spouse or children for loss of consortium or any derivative claim for noneconomic damages, shall not exceed in the aggregate a total of seven hundred fifty thousand dollars ($750,000), unless subsection (c) applies, in which case the aggregate amount shall not exceed one million dollars ($1,000,000).
As set forth above, the first rule of statutory interpretation is to effectuate legislative intent. Beard, 528 S.W.3d at 496. In so doing, “[t]he text of the statute is of primary importance, and the words must be given their natural and ordinary meaning in the context in which they appear and in light of the statute‘s general purpose.” Mills, 360 S.W.3d at 368 (citing Lee Med., 312 S.W.3d at 528; Hayes v. Gibson Cnty., 288 S.W.3d 334, 337 (Tenn. 2009); Waldschmidt v. Reassure Am. Life Ins. Co., 271 S.W.3d 173, 176 (Tenn. 2008)). We must, therefore, begin our inquiry by looking at the text of the statute.
The parties to this appeal assert that the phrase “each injured plaintiff” is important to understanding the legislature‘s intent in this matter. The Yebuahs’ interpretation does not distinguish between “plaintiffs” and “injured plaintiffs.” It does not consider the difference between a plaintiff with a personal injury and a plaintiff with a derivative claim, such as one for loss of consortium. We agree with the Center that the phrase “each injured plaintiff” is not synonymous with “each plaintiff.” Otherwise, the word “injured” would be unnecessary, and “a legislature is presumed to have used no superfluous words.” In re Hogue, 286 S.W.3d 890, 896 (Tenn. 2009) (quoting Platt v. Union Pac. R.R. Co., 99 U.S. 48, 58 (1878)). This canon of statutory interpretation prevents any word from being “inoperative, superfluous, void, or insignificant.” Young v. Frist Cardiology, PLLC, 599 S.W.3d 568, 571 (Tenn. 2020) (quoting City of Caryville v. Campbell Cnty., 550 S.W.2d 510, 512 (Tenn. Ct. App. 1983)); see also Baker v. State, 417 S.W.3d 428, 439 n.11 (Tenn. 2013).
The Yebuahs further assert that the concept of an “uninjured spouse” is in derogation of the common law. However, there are several other examples in Tennessee law of the distinction between an “injured plaintiff” and a spouse with a loss of consortium claim. See Ki v. State, 78 S.W.3d 876, 880 (Tenn. 2002) (“[I]n a spousal injury action two ‘claimants’ may exist because the non-injured spouse may maintain a separate cause of action or claim for loss of consortium pursuant to statute.“); see also Hunley v. Silver Furniture Mfg. Co., 38 S.W.3d 555, 557 (Tenn. 2001) (“Loss of consortium is ‘a separate claim from that of an injured spouse.‘” (quoting Tuggle v. Allright Parking Sys., Inc., 922 S.W.2d 105, 108 (Tenn. 1996))); Jackson v. Miller, 776 S.W.2d 115, 117 (Tenn. Ct. App. 1989) (“Despite being a separate claim from that of an injured spouse for other damages, loss of consortium is also a derivative claim in that the physical injuries or incapacities of one‘s spouse give rise to and establish the claim.“); McPeek v. Lockhart, 174 S.W.3d 751, 755 (Tenn. Ct. App. 2005) (“[I]t does not necessarily follow that simply because the injured spouse is found to have a legitimate claim that there then must be loss of consortium for the non-injured spouse.“). Courts must presume that the legislature knew of this distinction at the time it enacted
Consistent with this authority, the Tennessee Pattern Jury Instructions make a similar distinction between the “injured
The Yebuahs also argue that distinguishing between the spouse with the physical injury and the spouse with the loss of consortium claim somehow gives loss of consortium claimants less than full plaintiff status. We disagree. A loss of consortium claim is clearly a separate injury and cause of action. Hunley, 38 S.W.3d at 557. But for purposes of clarity in cases such as this—where Mrs. Yebuah suffered medical negligence and Mr. Yebuah did not—it is helpful to distinguish between the plaintiffs by using the word “injured” to modify “plaintiff” when discussing the party with the primary cause of action. A loss of consortium claim is a derivative claim, and recovery is dependent on the spouse‘s recovery. See Tuggle, 922 S.W.2d at 109 (“There must be a tort which gives rise to a cause of action that must be maintained by the [physically] injured spouse in order for the non-injured spouse to claim a loss of consortium. In other words, the loss of consortium claim is dependent upon the negligent injury of the other spouse who has the primary tort cause of action.” (alterations in original) (quoting Mist v. Westin Hotels, Inc., 738 P.2d 85, 90 (Haw. 1987))). In a situation in which the damages are capped, the consortium spouse does not “lose” his or her claim as is suggested by the Yebuahs. Their damages are simply limited. Indeed, “one could view the statutory cap on noneconomic damages as a limitation on the
available remedy . . . or as an abrogation of causes of action for claims exceeding the statutory limit.” McClay, 596 S.W.3d at 691. “Under either view, the General Assembly was within its legislative authority to . . . enact[] the statutory cap on noneconomic damages.” Id.
The Yebuahs’ and the Court of Appeals’ interpretation also renders subsection (e) superfluous. According to the Court of Appeals, subsection (e) limits an injured plaintiff‘s recovery to $750,000 “[w]hen one injured plaintiff seeks compensation for both personal injuries and loss of consortium.” Yebuah, 2020 WL 2781586, at *7. But this conclusion is undercut by the fact that the legislature already defined the phrase “noneconomic damages” to include “loss of society, companionship, and consortium.”
Further evidence of the legislature‘s intent is found in the words “in the aggregate.” The crucial language here is that “[a]ll noneconomic damages awarded to each injured plaintiff . . . as well as any claims of a spouse . . . for loss of consortium or any derivative claim for noneconomic damages, shall not exceed in the
The Yebuahs also claim that the language of the Tennessee Governmental Tort Liability Act (“GTLA“) supports their reading of the noneconomic damages cap statute, specifically that a plaintiff bringing a claim for loss of consortium is not limited by the damages cap applicable to his or her spouse. See Swafford v. City of Chattanooga, 743 S.W.2d 174, 178-79 (Tenn. Ct. App. 1987) (holding that a wife could recover for loss of consortium even though her husband had exhausted the liability limit under the GTLA); Hunt v. Fayette Cnty. Bd. of Educ., 1990 WL 62834, at *4 (Tenn. Ct. App. May 16, 1990) (same). We do not find the statutory language in the GTLA to be helpful in interpreting the statute at issue in this case. The definitions are codified in
The Yebuahs further assert policy reasons in favor of their reading of the statute. They argue that the Center‘s interpretation is problematic because the statutory language does not set forth a manner by which to allocate reduced damages. According to the Yebuahs, allowing only one cap on noneconomic damages between Mrs. and Mr. Yebuah has the potential to create marital discord between spouses over how they should share damages awarded under a single cap—which they assert is contrary to the public policy of fostering marital harmony. However, a loss of consortium award presupposes the existence of an intact marital relationship. See Tuggle, 922 S.W.2d at 109 (noting that the basis for recovery of loss of consortium is an “interference with the continuance of a healthy and happy marital life and injury to the conjugal relation“). Moreover, it does not matter whether this Court believes the statute to be wise or artfully written—our duty is simply to interpret the statute. See Lavin v. Jordon, 16 S.W.3d 362, 369 (Tenn. 2000) (noting that generally the “wisdom” of enacting a particular statute “lies solely with the Legislature and is not the concern of the Court.” (quoting Hoover Motor Express Co. v. Hammer, 298 S.W.2d 724, 726 (Tenn. 1957))).
Courts in other states have concluded that a single cap applies when considering similar statutes. Michigan‘s products liability statute states that “the total amount of damages for noneconomic loss shall not exceed $280,000.00.”
In Maryland, a van passenger who was injured in an automobile accident and her husband brought suit for negligence against the vehicle‘s driver and his employer. Oaks v. Connors, 660 A.2d 423, 425 (Md. 1995). The plaintiffs’ claims included damages for the wife‘s personal injuries and damages to the couple‘s marriage. Id. Like Tennessee, the Maryland statute includes “loss of consortium” in the definition of “noneconomic loss.” See
As a final note, we acknowledge that the Tennessee Attorney General filed an intervening brief on appeal before this Court as he did before the Court of Appeals. During the trial court proceedings, the Yebuahs served the Attorney General with a copy of a proposed amended complaint in which the Yebuahs notified the Attorney General of their intention to allege that the statutory cap on noneconomic damages was unconstitutional. However, the Yebuahs ultimately did not include the constitutional issues in their amended complaint.
As stated above, the trial court determined that the Yebuahs had waived their constitutional challenge to the statute at issue. The Court of Appeals, however, disagreed and elected to review the constitutional issues raised before it, including due process, the right to trial by jury, separation of powers, the equal protection clause, and the takings doctrine. See Yebuah, 2020 WL 2781586, at *4. After considering the issues, the Court of Appeals determined that the statute was constitutional. Id. at *5-6. The Court of Appeals properly noted that it was bound by this Court‘s recent decision in McClay v. Airport Management Services, LLC, which resolved most of the constitutional issues presented. See 596 S.W.3d at 696 (holding “that the statutory cap on noneconomic damages in
In their brief before this Court, the Yebuahs very briefly touch on “a due process issue” and a “potential[] . . . violation of the Takings Doctrine.” However, these issues were not mentioned
IV. CONCLUSION
For the reasons set forth herein, we hold that
ROGER A. PAGE, JUSTICE