Joshlin Renee Woodruff by and through Dorothy Cockrell v. Armie Walker, M.D.Joshlin Renee Woodruff by and through Dorothy Cockrell v. Armie Walker, M.D.
Tenn. R. App. P. 3 Appeal as of Right; Judgment of the Circuit Court Affirmed in Part, Reversed in Part, and Remanded
ARNOLD B. GOLDIN, J., delivered the opinion of the Court, in which J. STEVEN STAFFORD, P.J., W.S., and KENNY ARMSTRONG, J., joined.
Joe Bednarz, Sr. and Joe Bednarz, Jr., Hendersonville, Tennessee, for the appellants, Beverly Woodruff and Dorothy Cockrell.
Marty R. Phillips and Craig P. Sanders, Jackson, Tennessee, for the appellee, Armie Walker.
Darrel E. Baker, Jr., Deborah Whitt, and M. Jason Martin, Memphis, Tennessee, for the appellees, Timothy Hutchinson, Michael Martindale, and Professional Anesthesia Associates, P.C.
Jennifer S. Harrison, James E. Looper, Jr., and Lauren Dunavin Callins, Memphis, Tennessee, for the appellee, Elliott Clifton Roberts, Jr.
Dixie W. Cooper and Kaycee L. Weeter, Nashville, Tennessee, for the appellees, Nathan John Hoeldtke and Mid-South Perinatal Associates, P.C.
Patrick W. Rogers, Jackson, Tennessee, for the appellees, West Tennessee OB-GYN Services aka West Tennessee OB-GYN Clinic, Jackson-Madison County General Hospital District, West Tennessee Healthcare, Inc., Anna McIntyre, Kara Carter, Lisa L. Johnson, Jessica Perry, and Dena Etheridge.
OPINION
BACKGROUND AND PROCEDURAL HISTORY
Joshlin Renee Woodruff (“Mother“) was approximately 17 weeks pregnant when she was first evaluated by OB-GYN specialist Dr. Armie Walker on January 24, 2012. During the visit, Mother disclosed to Dr. Walker that she suffered from a neuromuscular condition known as myasthenia gravis. Because of that condition and gestational hypertension, Dr. Walker referred Mother to a maternal fetal specialist-Dr. Nathan John Hoeldtke of Mid-South Perinatal Associates, P.C. Dr. Hoeldtke met with and evaluated Mother on January 31, 2012, March 13, 2012, April 12, 2012, May 16, 2012, and June 4, 2012. Mother also continued to receive treatment from Dr. Walker and his partner, Dr. Elliot Clifton Roberts, throughout her pregnancy.
On May 31, 2012, at approximately 36 weeks gestation, Mother was admitted to Jackson-Madison County General Hospital with exacerbated symptoms of myasthenia gravis that included extreme muscle weakness and shortness of breath. Dr. Hoeldtke evaluated Mother at the hospital and made recommendations for her labor and delivery. Dr. Hoeldtke‘s recommendations included, among other things, consultation with an anesthesia service to develop anesthesia plans in case it became necessary to deliver the child by cesarean section. Mother‘s condition improved with medication and treatment, and she was discharged from the hospital on June 6, 2012.1
Mother went into labor in the early morning hours of June 21, 2012. She was admitted to Jackson-Madison County General Hospital at 3:42 a.m. where she was evaluated initially by Dr. Roberts. Dr. Roberts managed Mother‘s care until 8:00 a.m., at which time she came under the care of Dr. Walker for the remainder of her labor and delivery.
Mother‘s labor progressed slowly throughout the day on June 21, 2012. At 6:10 a.m., Dr. Michael Martindale was called to give Mother an epidural anesthesia. Initially, Dr. Martindale declined to administer the anesthetic in light of Mother‘s myasthenia gravis condition. Later that morning, however, Dr. Timothy
As the day wore on, Mother began to exhibit symptoms of exacerbated myasthenia gravis that made it unsafe to continue the labor and deliver the child vaginally. Pulse oximeter readings indicated low levels of oxygen in Mother‘s blood. Additionally, Mother reported difficulty breathing on several occasions. At 8:05 p.m., Dr. Martindale entered the room to give Mother an epidural anesthetic. Although Mother expressed difficulty breathing, Dr. Walker insisted on doing a vaginal exam at 8:16 p.m. During the exam, Mother stopped breathing and went into respiratory and cardiac arrest. Mother was rushed to an operating room where an emergency caesarian section was performed while doctors worked to revive her. Braylon Woodruff (“Child“) was delivered by cesarean section at approximately 8:30 p.m.
Mother and Child both suffered serious permanent injuries and brain damage resulting from a lack of oxygen during the delivery. On June 28, 2012, the Madison County Juvenile Court entered an order granting temporary legal custody of Child to his maternal grandmother, Beverly Woodruff. On November 29, 2012, the Madison County General Sessions Court entered an order appointing Mother‘s aunt, Dorothy Cockrell, as Mother‘s conservator.
On April 17, 2015, pursuant to
On September 29, 2015, Plaintiffs filed a health care liability complaint against Defendants.2 The complaint alleged that Defendants caused Plaintiffs to suffer permanent injuries by negligently failing to recognize and take appropriate action in response to Mother‘s deteriorating condition during her labor on June 21, 2012. The complaint alleged that Plaintiffs had complied with the pre-suit notice requirements of
Notes
In response to the complaint, Defendants filed motions to dismiss pursuant to
In June 2016, Plaintiffs filed a motion to amend their complaint to add allegations aimed at avoiding dismissal of Mother‘s claims based on expiration of the statute of limitations. Plaintiffs’ proposed amended complaint alleged that they did not discover their claims until Dr. Walker revealed previously unknown factual information during a deposition in March 2015. Plaintiffs therefore asserted that the one-year statute of limitations began to run in March 2015 and their claims were timely filed.
Plaintiffs also filed a separate response opposing Defendants’ motions to dismiss. In the response, Plaintiffs argued that Mother‘s claims were not barred by the one-year statute of limitations because
Following a hearing, the trial court entered five separate orders granting Defendants’ motions to dismiss. As an initial matter, the court held that Mother‘s claims were barred by the one-year statute of limitations. The court explained that the discovery rule did not delay the limitations period because Plaintiffs were alerted of the need to investigate their injuries on June 21, 2012. The court further explained that
ISSUES
Plaintiffs raise the following issues on appeal, restated:
- Whether the trial court erred in dismissing Mother‘s claims based on expiration of the one-year statute of limitations in
Tennessee Code Annotated section 29-26-116(a)(1) . - Whether the trial court erred in dismissing Plaintiffs’ claims based on expiration of the three-year statute of repose in
Tennessee Code Annotated section 29-26-116(a)(3) . - Whether the trial court erred in failing to consider Plaintiffs’ motion to amend their complaint.
STANDARD OF REVIEW
In ruling on a motion to dismiss pursuant to
Here, the trial court‘s orders indicate that it dismissed Plaintiffs’ claims pursuant to
STATUTE OF LIMITATIONS
Plaintiffs argue that the trial court erred in dismissing Mother‘s claims based on expiration of the statute of limitations. In reviewing a dismissal based on expiration of the statute of limitations, we must consider three elements-the length of the limitations period, the accrual of the cause of action, and the applicability of any tolling doctrines. See Redwing v. Catholic Bishop for Diocese of Memphis, 363 S.W.3d 436, 456 (Tenn. 2012). Ascertaining the length of the limitations period is fairly straightforward in this case. Health care liability actions in Tennessee are subject to a one-year statute of limitations that runs from the date on which the claim accrues.
To determine the date on which the one-year statute of limitations began to run, we must ascertain when Plaintiffs’ claims accrued. Generally, a cause of action accrues and the statute of limitations begins to run on the date when the injury occurs. Vandergriff v. ParkRidge East Hosp., 482 S.W.3d 545, 556 (Tenn. Ct. App. 2015). However,
Here, Plaintiffs seek to invoke the discovery rule with regard to their claims against Dr. Hoeldtke and his employer, Mid-South Perinatal Associates, P.C.5 Specifically, Plaintiffs argue that they did not have information sufficient to alert them of Dr. Hoeldtke‘s wrongful conduct until March 2015. According to Plaintiffs, Dr. Hoeldtke testified in a May 2013 deposition that he did not have any involvement in Mother‘s treatment on June 21, 2012. Although Dr. Hoeldtke admitted to seeing Mother in the hospital that day, he testified that he was just in her hospital room for a “social visit” and was not asked to evaluate her or participate in her care. Plaintiffs submit that they did not learn the true extent of Dr. Hoeldtke‘s involvement in Mother‘s treatment until they took Dr. Walker‘s deposition in March 2015. According to Plaintiffs, Dr. Walker testified that he consulted Dr. Hoeldtke during Mother‘s labor and that Dr. Hoeldtke recommended supplementing Mother‘s medication with Mestinon. Plaintiffs argue that Dr. Walker‘s March 2015 testimony directly contradicted Dr. Hoeldtke‘s May 2013 testimony and alerted them of their potential claims against Dr. Hoeldtke for the first time. They therefore contend that that their claims against Dr. Hoeldtke and Mid-
South Perinatal Associates, P.C. accrued in March 2015 and the trial court erred in dismissing Mother‘s claims against those defendants based on expiration of the one-year statute of limitations.
In our view, the record conclusively establishes that Plaintiffs knew or should have known that they were injured as a result of Dr. Hoeldtke‘s wrongful conduct on June 21, 2012. Plaintiffs do not dispute that they were aware of their injuries on that date. Additionally, Plaintiffs do not dispute that they were aware of Dr. Hoeldtke‘s presence in the hospital room during Mother‘s labor on that date. Those two facts alone were sufficient to alert a reasonable person of the need to investigate any potential wrongful conduct by Dr. Hoeldtke. In any event, Plaintiffs’ contention that they initially misunderstood the nature of Dr. Hoeldtke‘s presence during Mother‘s labor is not relevant to their claims against him. The only allegations of wrongful conduct by Dr. Hoeldtke in Plaintiffs’ complaint concern his failure to recognize and take action in response to Mother‘s deteriorating condition at approximately 5:00 p.m. on June 21, 2012. However, Plaintiffs do not contend that they were ever unaware of Dr. Hoeldtke‘s presence in the hospital room at that time. As the trial court observed, Mother‘s medical records indicate that Dr. Hoeldtke was at her bedside at approximately 4:52 p.m. We therefore agree with the trial court‘s conclusion that the discovery rule did not delay the accrual of Plaintiffs’ claims in this case.6
Having determined that Plaintiffs’ claims accrued on June 21, 2012, we must consider whether Tennessee‘s legal incapacity statute-Tennessee Code Annotated section 28-1-106-applied to toll the statute of limitations as to their claims. The parties agree that the statute tolled the limitations period as to Child‘s claims because of his minority; however, they dispute whether it also tolled the limitations period as to Mother‘s claims. As it applies to this case, the statute provides:
If the person entitled to commence an action is, at the time the cause of action accrued, either under eighteen (18) years of age, or adjudicated incompetent, such person . . . may commence the action, after legal rights are restored, within the time of limitation for the particular cause of action, unless it exceeds three (3) years, and in that case within three (3) years from restoration of legal rights.
Plaintiffs contend that the legislature‘s 2011 amendments to
The Tennessee Supreme Court has explained the principles that guide our construction of Tennessee statutes as follows:
Our role is to determine legislative intent and to effectuate legislative purpose. The 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. When the language of the statute is clear and unambiguous, courts look no farther to ascertain its meaning. When necessary to resolve a statutory ambiguity or conflict, courts may consider matters beyond the statutory text, including public policy, historical facts relevant to the enactment of the statute, the background and purpose of the statute, and the entire statutory scheme.
However, these non-codified external sources “cannot provide a basis for departing from clear codified statutory provisions.”
Mills v. Fulmarque, Inc., 360 S.W.3d 362, 368 (Tenn. 2012) (emphasis added) (internal citations omitted).
In our view, the language of the incapacity statute is clear and unambiguous. The phrase “adjudicated incompetent” clearly contemplates a judicial determination of incompetence. See Black‘s Law Dictionary 50 (10th ed. 2014) (defining the word “adjudicate” as “[t]o rule on judicially“). The legislature‘s use of the past tense “adjudicated” and the phrase “at the time the cause of action accrued” clearly indicates that the judicial determination of incompetence must occur prior to accrual of the cause of action. In the absence of ambiguity, we must therefore decline Plaintiffs’ invitation to consider the statute‘s legislative history.
Moreover, in Johnson v. UHS Lakeside, LLC, this Court determined that a judicial determination of incompetence is required to toll the statute of limitations based on a contextual analysis of the same statutory language:
[O]ur review of the statute at issue demonstrates that the meaning of the phrase “adjudicated incompetent” is clarified by the surrounding language in the statute. Specifically, the statute provides that the plaintiff may commence the action “after legal rights are restored” within the applicable statute of limitations unless that time exceeds three years and, in that case, within three years “from restoration of legal rights.”
Tenn. Code Ann. § 28-1-106 . Pursuant to nosicur a sociis, the term “adjudicated incompetent” must be read in conjunction with the other parts of the statute that clearly contemplate a loss and restoration of “legal rights.” Undoubtedly, it is the courts, rather than physicians, who can adjudicate an individual‘s legal rights. Furthermore, our holding is supported by this Court‘s Opinion in Foster v. Allbright, 631 S.W.2d 147, 150 (Tenn. Ct. App. 1982), which previously used the term “adjudication of incompetency” to refer to an order appointing a conservatorship, implying that this term denotes judicial action. Based on the foregoing, we conclude that the statutory language clearly contemplates that judicial intervention is necessary in order for an individual to be “adjudicated incompetent.”
No. W2015-01022-COA-R3-CV, 2015 WL 9426034, at *6 (Tenn. Ct. App. Dec. 23, 2015); see also Jones v. City of Franklin, 675 F.App‘x. 548, 2017 WL 383383, at *8 (6th Cir. 2017); Cobb v. Tenn. Valley Auth., 595 F.App‘x. 458, 459 (6th Cir. 2014). While Plaintiffs contend that this case is factually distinguishable from Johnson because, unlike the plaintiff in that case, Mother was rendered incompetent by the wrongful conduct on which her claims are based, there is no basis for making such a distinction in the statute. Mother‘s claims accrued on June 21, 2012. She was “adjudicated incompetent” on November 29, 2012. As such, we agree with the trial court‘s conclusion that
Having ascertained the length of the limitations period, the date on which Plaintiffs’ claims accrued, and the applicability of the tolling statute, we conclude that Mother‘s claims are barred by the statute of limitations. Mother‘s claims accrued on the date of her injuries-June 21, 2012. The one-year statute of limitations began to run on that date, and the limitations period was not tolled by
STATUTE OF REPOSE
Next, Plaintiffs argue that the trial court erred in dismissing their claims based on the expiration of the statute of repose. Except in certain circumstances not applicable to this case,
The dispositive issue in this case, as it relates to the statute of repose, is whether Plaintiffs provided Defendants with pre-suit notice of their claims as provided in
despite the importance of the requirement, the Tennessee Supreme Court has held that “less-than-perfect compliance with
[T]he intended meaning of the phrase “complete medical records,” as used in
§ 29-26-121(a)(2)(E) , was not to grant defendants access to a plaintiff‘s entire medical history. Instead, we believe that the purpose of this requirement is to afford defendants access to all medical records that are relevant to the particular claim at issue. In determining whether medical records are relevant for purposes of litigation, defendants should continue to adhere to the “minimum necessary” standard that traditionally applies to a provider‘s use and disclosure of a patient‘s private health records under45 C.F.R. § 164.502(b)(1) : “When using or disclosing protected health information or when requesting protected health information from another covered entity or business associate, a covered entity or business associate must make reasonable efforts to limit protected health information to the minimum necessary to accomplish the intended purpose of the use, disclosure, or request.”
In this case, the trial court held that Plaintiffs’ medical authorizations failed to substantially comply with
In their appellate briefs, the parties dispute the relevance of Mother‘s prenatal and hospitalization records at length. Plaintiffs argue that those records were not relevant to Defendants’ evaluation of their claims because all of the wrongful conduct alleged in their complaint occurred on June 21, 2012. Defendants, on the other hand, argue that the records were relevant because they contain information regarding Mother‘s myasthenia gravis condition and the plans for her labor and delivery that Dr. Hoeldtke developed during her hospitalization.
Given the current procedural posture of this case, however, we do not need to resolve that issue. As we stated above, our discussion of this issue is limited to Child‘s claims. As such, we are concerned only with the sufficiency of the medical authorizations provided with Child‘s pre-suit notice. As Plaintiffs point out in their brief, records pertaining to the care Mother received during her pregnancy and her hospitalization from May 31 to June 6, 2012 are Mother‘s separate medical records. Defendants have not cited any legal authority that would authorize Child or Child‘s guardian to release medical records that belong to Mother. In our view, the medical authorizations provided with Child‘s pre-suit notice cannot be deemed insufficient solely because they do not authorize the release of medical records that Child had no authority to release. Defendants argue that, even if Child was not authorized to release Mother‘s prenatal and hospitalization records, his medical authorizations were insufficient because they did not permit the release of records from his hospitalization after the birth. In support of that argument, Defendants point out that Plaintiffs’ appellate brief states Child was transferred to a non-party hospital on June 23, 2012; the implication being that Child received further treatment from Defendants for two days after June 21, 2012. Defendants argue that Child‘s medical records from that treatment would have also been relevant to their evaluation of his claims and, because his medical authorizations did not permit them to obtain those records, they failed to substantially comply with
In sum, we conclude that the trial court erred in dismissing Child‘s claims based on expiration of the statute of repose. The negligent acts and omissions on which Plaintiffs’ claims are based occurred on June 21, 2012, and the three-year statute of repose began to run on that date. While Child did not file his claims within three years of that date, he provided Defendants with pre-suit notice of his claims as provided in
MOTION TO AMEND COMPLAINT
Finally, Plaintiffs argue that the trial court erred in failing to consider the motion to amend their complaint they filed in response to Defendants’ motions to dismiss.
Although it does not appear that the trial court made an express ruling on Plaintiffs’ motion to amend their complaint, its failure to do so does not constitute reversible error in this case. The only substantive change that the proposed amended complaint would have made to Plaintiffs’ original complaint was the addition of the allegation that they did not discover their claims until Dr. Walker revealed previously unknown factual information during a deposition in March 2015. The trial court considered those allegations in ruling on Defendants’ motions to dismiss and concluded that they did not affect its analysis. In their appellate brief, Plaintiffs concede that point, stating, “It does not appear that this issue had any bearing on the trial court‘s decision.” Thus, while it is not clear whether the trial court implicitly granted the motion to amend or implicitly denied it as futile, we see no reason to disturb its decision.
CONCLUSION
The judgment of the trial court is affirmed in part and reversed in part, and this case is remanded for further proceedings consistent with this opinion. The costs of this appeal are taxed one-half to the appellants, Dorothy Cockrell and Beverly Woodruff, and their sureties and one-half to the appellees, Armie Walker, M.D., Elliott Clifton Roberts, Jr., M.D., West Tennessee OB-GYN Services aka West Tennessee OB-GYN Clinic, Nathan John Hoeldtke, M.D., Mid-South Perinatal Associates, P.C., Timothy Hutchinson, M.D., Michael Martindale, M.D., Professional Anesthesia Associates, P.C., Jackson Madison County General Hospital, West Tennessee Healthcare, Inc., Anna McIntyre, R.N., Kara Carter, R.N., Lisa L. Johnson, R.N., Jessica Perry, R.N., and Dena Etheridge, R.N., for all of which execution may issue if necessary.
ARNOLD B. GOLDIN, JUDGE
- A description of the information to be used or disclosed that identifies the information in a specific and meaningful fashion.
- The name or other specific identification of the person(s), or class of persons, authorized to make the requested use or disclosure.
- The name or other specific identification of the person(s), or class of persons, to whom the covered entity may make the requested use or disclosure.
- A description of each purpose of the requested use or disclosure[.]
- An expiration date or an expiration event that relates to the individual or the purpose of the use or disclosure[.]
- Signature of the individual and date. If the authorization is signed by a personal representative of the individual, a description of such representative‘s authority to act for the individual must also be provided.