Lead Opinion
Shannon Ranucci appealed the circuit court’s order dismissing her medical malpractice case for failure to contemporaneously file an expert witness affidavit with her Notice of Intent to File Suit (“NOI”) pursuant to section 15-79-125 of the South Carolina Code.
I. Factual/Procedural History
On June 7, 2006, Dr. Corey Crain performed a needle core breast biopsy on Ranucci. Following the procedure, Ranucci experienced pain while breathing. On June 10, 2006, an X-ray revealed that Ranucci had suffered a collapsed lung.
On June 8, 2009, Ranucci filed an NOI pursuant to section 15-79-125(A), which alleged her collapsed lung was a result of Dr. Crain’s negligent execution of the biopsy. The NOI stated that “time constraints” prevented Ranucci from contemporaneously filing an affidavit of a medical expert. The NOI further stated Ranucci would either file such an affidavit within the next forty-five days pursuant to section 15-36-
On July 23, 2009, Ranucci filed an affidavit of Dr. Richard Boortz-Marx, a medical doctor from North Carolina who was board certified in anesthesiology and anesthesiology pain management.
Dr. Crain filed an Answer to the NOI and a motion to dismiss Ranucci’s NOI on the ground the forty-five day extension for filing an expert affidavit, found in section 15-36-100(C)(1), does not apply to the filing of an NOI under section 15-79-125(A) because the statute expressly requires the expert affidavit be filed contemporaneously with the NOI. Additionally, Dr. Crain claimed Ranucci’s NOI was filed outside of the statute of limitations.
After a hearing, the circuit court granted Dr. Crain’s motion to dismiss, finding Ranucci did not comply with the plain language of section 15-79-125(A) because she did not file an expert affidavit contemporaneously with the NOI. However, because the NOI and affidavit did not constitute an “action,” the court denied Dr. Crain’s motion to dismiss on the alternative ground involving the statute of limitations.
Subsequently, Ranucci filed a motion for reconsideration pursuant to Rule 59(e) of the South Carolina Rules of Civil Procedure. Following a hearing, the circuit court denied the motion, but clarified that “S.C.Code Ann. § 15-79-125 and [§ ] 15-36-100 operate independently of each other, and that § 15-36-100 does not offer a procedural alternative to § 15-79-125.” Ranucci appealed to the Court of Appeals.
The Court of Appeals affirmed the circuit court’s order. Ranucci v. Crain,
Based on the foregoing analysis, the court ultimately affirmed the circuit court’s dismissal of Ranucci’s NOI for failure to comply with the contemporaneous affidavit filing requirement of section 15-79-125. Id. at 175,
II. Discussion
A. Arguments
Ranucci concedes the individual subsections of 15-79-125 and 15-36-100 are clear when viewed in isolation. However, she asserts a reviewing court must look beyond the plain language of individual subsections in order to discern the underlying purpose of the statutes and their operational effect. Because the “statutes have a shared purpose and were intended to completely incorporate one another,” Ranucci contends the Court of Appeals erred in affirming the dismissal of her pre-litigation NOI.
In support of this contention, Ranucci maintains that sections 15-79-125 and 15-36-100 operate together to establish a
B. Analysis
1. Rules of Statutory Construction
Because the disposition of the instant case is dependent on our interpretation of sections 15-79-125 and 15-36-100, we reference the well-established rules of statutory construction. “The cardinal rule of statutory interpretation is to ascertain and effectuate the intention of the legislature.” Sloan v. Hardee,
“If the statute is ambiguous ... courts must construe the terms of the statute.” Town of Mt. Pleasant v. Roberts,
2. Application of Statutory Construction Rules
Utilizing the above-outlined rules, the analysis begins with an examination of the legislative history of the statutes at issue. In 2005, the General Assembly passed Act No. 32 entitled “CIVIL REMEDIES — INSURANCE—PROFESSIONS AND OCCUPATIONS.” Act No. 32, 2005 S.C. Acts 133. In prefacing Act No. 32, the General Assembly included express findings stating that the statutes within the Act constitute one subject and are intended to operate together to achieve a common purpose.
As part of this tort reform legislation, the General Assembly added section 15-36-100 “so as to establish standards for expert witnesses in professional malpractice actions ” and “chapter 79 to title 15 so as to define key terms, provide for mandatory mediation, and to permit binding arbitration in medical malpractice actions.” Act No. 32, 2005 S.C. Acts 133 (emphasis added).
Based on this legislative history, we conclude the General Assembly enacted: (1) section 15-36-100 to establish the general construct regarding expert witnesses for all professional negligence cases; and (2) section 15-79-125 as a supplement to section 15-36-100 to provide for pre-litigation requirements that are unique to medical malpractice cases, including mandatory mediation. Thus, even without delving into the specific text of each statute, it is evident the General Assembly intended for sections 15-36-100 and 15-79-125 to be read in pari materia. See Joiner ex rel. Rivas v. Rivas,
A review of the plain language of the statutes bolsters this interpretation as the statutes contain internal cross-references. Pursuant to section 15-79-125 a plaintiff is required,
Additionally, section 15-36-100 is applicable to all medical malpractice actions as it specifically includes and references suits against “medical doctors.” See S.C.Code Ann. § 15-36-100(G)(7) (Supp.2013) (“This section applies to the following professions: ... (7) medical doctors....”); id. § 15-36-100(B) (“Except as provided in Section 15-79-125, in an action for damages alleging professional negligence against a professional licensed by or registered with the State of South Carolina and listed in subsection (G) or against any licensed health care facility alleged to be liable based upon the action or inaction of a health care professional licensed by the State of South Carolina and listed in subsection (G), the plaintiff must file as part of the complaint an affidavit of an expert witness which must specify at least one negligent act or omission claimed to exist and the factual basis for each claim based on the available evidence at the time of the filing of the affidavit.”).
Thus, although sections 15-79-125 and 15-36-100 are distinct in their operational procedures, it is evident the General Assembly promulgated the statutes to work in concert for the common purpose of tort reform involving all professional negligence claims.
Furthermore, an absurd result is created when one fails to read the statutes in pari materia. As previously stated, section 15-79-125 governs the pre-litigation requirements for medical malpractice cases. Specifically, section 15-79-125, requires a plaintiff, prior to filing or initiating a medical malpractice claim, to “contemporaneously file a Notice of Intent to File Suit and an affidavit of an expert witness, subject to the affidavit requirements established in Section
Specifically, section 15-36-100 completes the pre-litigation process as it: (1) defines the term “expert witness” and identifies the requisite qualifications;
Therefore, without incorporating all provisions of section 15-36-100 into section 15-79-125, a plaintiff with a medical
Based on the foregoing, we expressly hold that section 15-79-125(A)’s reference to the “affidavit requirements established in Section 15-36-100” constitutes an adoption of all provisions of section 15-36-100.
3. Interpretation May Be Reconciled with Grier and Ross
Our holding is consistent with this Court’s recent decisions in Grier v. AMISUB of South Carolina, Inc.,
In Giier, which was decided four months after Ranucci, Willie James Fee died while in the care of AMISUB of South Carolina, Inc., d/b/a Piedmont Medical Center (“Piedmont”). Grier,
Piedmont filed a motion to dismiss on the ground the nurse was not qualified to render an opinion as to the cause of death, which meant the affidavit did not contain a competent causation opinion. Id. at 535,
On appeal, this Court considered the question of whether “the pre-suit affidavit a plaintiff statutorily is required to file before bringing a medical malpractice claim must contain an expert opinion on proximate cause.” Id. at 535,
The Court went on to explain, “While this statute supplies several requirements for the notice, it does not speak at all to what is required for the affidavit beyond stating that it is ‘subject to the affidavit requirements established in Section 15-36-100.’ ” Id. (quoting section 15-79-125(A)). The Court noted that section 15-79-125(A) “imposes no content requirements for the expert affidavit and specifically delegates that task to section 15-36-100.” Id. The Court ultimately held “the expert affidavit required by sections 15-36-100 and 15-79-125 does not need to contain an opinion as to proximate cause.” Id. at 540,
Accordingly, the Court reversed the circuit court’s order and remanded for further proceedings. Id. at 540-41,
Approximately one year after Grier, we issued our decision in Ross. In Ross, the Court addressed the penalties for failure to comply with the pre-litigation mediation requirement of section 15-79-125. Ross,
The Court, however, emphasized that a dismissal is “a function of the court’s discretion based on the facts and circumstances, and not as a mandated one-size-fits-all result.” Id. The Court explained that “the Legislature enacted section 15-79-125 to provide an informal and expedient method of culling prospective medical malpractice cases by fostering the settlement of potentially meritorious claims and discouraging the filing of frivolous claims.” Id. at 63,
As evident from our decisions in Grier and Ross, this Court has sought to interpret sections 15-79-125 and 15-36-100 in a manner that effectuates the intent of the General Assembly to establish a unique two-step procedure that filters frivolous claims but permits the filing of potentially meritorious claims. Because the pre-litigation filtering process is not meant as an impassable boundary that denies a claimant access to the
4. Viability of Ranucci’s Case
Even if the Court incorporates section 15-36-100 in its entirety into section 15-79-125 and accepts Ranucci’s expert witness affidavit as timely, Dr. Crain asserts the circuit court’s order should nevertheless be affirmed. In support of this assertion, Dr. Crain raises the following additional sustaining grounds
We reject each of Dr. Crain’s additional sustaining grounds. Initially, we disagree with any assertion that the applicable statute of limitations began to run on the day the biopsy was performed. We find Ranucci was put on notice that she had a claim against Dr. Crain on June 10, 2006 when an X-ray revealed that she had suffered a collapsed lung. See Dunbar v. Carlson,
As to Dr. Crain’s assertions regarding defects in the authorship and content of Dr. Boortz-Marx’s affidavit, we find this is not an appropriate ground to affirm the circuit court’s order because the affidavit is facially sufficient given it is sworn and identifies a potentially meritorious medical malpractice claim. Moreover, there is no factual basis in the record to challenge either the expert’s qualifications or the content of the affidavit. Cf. Poch v. Bayshore Concrete Prods. /S.C., Inc.,
Finally, we find the failure to conduct mediation is not fatal to Ranucci’s case as the circuit court issued its order on
III. Conclusion
As we interpret the statutes at issue in the context of the legislative history, we conclude the General Assembly sought to promote tort reform by creating a more efficient process in resolving all professional negligence cases by enacting section 15-36-100. Because medical malpractice cases are generally the most complex professional negligence cases, the General Assembly created a unique pre-litigation period of discovery and mandatory mediation via section 15-79-125 in order to “provide an informal and expedient method of culling prospective medical malpractice cases by fostering the settlement of potentially meritorious claims and discouraging the filing of frivolous claims.” Ross,
Having found that section 15-79-125 incorporates section 15-36-100 in its entirety, we hold that Ranucci should have been permitted to invoke section 15-36-100(0(1), which extended the time for filing the expert witness affidavit and tolled the applicable statute of limitations under section 15-79-125(A). Accordingly, we reverse the decision of the Court of Appeals and remand the case to the circuit court for the parties to resume the proceedings by conducting mediation as mandated by section 15-79-125.
REVERSED AND REMANDED.
Notes
. Section 15-79-125 provides, in part, as follows:
Prior to filing or initiating a civil action alleging injury or death as a result of medical malpractice, the plaintiff shall contemporaneously file a Notice of Intent to File Suit and an affidavit of an expert witness, subject to the affidavit requirements established in Section 15-36-100, in a county in which venue would be proper for filing or initiating the civil action.... Filing the Notice of Intent to File Suit tolls all applicable statutes of limitations.
S.C.Code Ann. § 15-79-125(A) (Supp.2013) (emphasis added).
. Section 15-36-100 provides in relevant part:
(B) Except as provided in Section 15-79-125, in an action for damages alleging professional negligence against a professional licensed by or registered with the State of South Carolina and listed in subsection (G) or against any licensed health care facility alleged to be liable based upon the action or inaction of a health care professional licensed by the State of South Carolina and listed in subsection (G), the plaintiff must file as part of the complaint an affidavit of anexpert witness which must specify at least one negligent act or omission claimed to exist and the factual basis for each claim based on the available evidence at the time of the filing of the affidavit. (C)(1) The contemporaneous filing requirement of subsection (B) does not apply to any case in which the period of limitation will expire, or there is a good faith basis to believe it will expire on a claim stated in the complaint, within ten days of the date of filing and, because of the time constraints, the plaintiff alleges that an affidavit of an expert could not be prepared. In such a case, the plaintiff has forty-five days after the filing of the complaint to supplement the pleadings with the affidavit.
(D) This section does not extend an applicable period of limitation, except that, if the affidavit is filed within the period specified in this section, the filing of the affidavit after the expiration of the statute of limitations is considered timely and provides no basis for a statute of limitations defense.
S.C.Code Ann. § 15-36-100(B), (C)(1), (D) (Supp.2013) (emphasis added).
. Although section 15-79-125(D) states that ‘‘[t]he circuit court has jurisdiction to enforce the provisions of this section,” it provides no specific remedy or procedure.
. S.C.Code Ann. § 15-36-100(A)(l)-(3) (Supp.2013).
. Id. § 15-36-100(B).
. Id. § 15-36-100(0(1), (D).
. Id. § 15-36-100(0(2) ("The contemporaneous filing requirement of subsection (B) is not required to support a pleaded specification of negligence involving subject matter that lies within the ambit of common knowledge and experience, so that no special learning is needed to evaluate the conduct of the defendant.”).
. Id. § 15-36-100(E).
. Id. § 15-36-100(F).
. See Rule 220(c), SCACR ("The appellate court may affirm any ruling, order, decision or judgment upon any ground(s) appearing in the Record on Appeal.”); I'On, L.L.C. v. Town of Mt. Pleasant,
. See S.C.Code Ann. § 15-3-545(A) (2005) ("In any action, other than actions controlled by subsection (B), to recover damages for injury to the person arising out of any medical, surgical, or dental treatment, omission, or operation by any licensed health care provider as defined in Article 5, Chapter 79, Title 38 acting within the scope of his profession must be commenced within three years from the date of the treatment, omission, or operation giving rise to the cause of action or three years from date of discovery or when it reasonably ought to have been discovered, not to exceed six years from date of occurrence, or as tolled by this section.”).
Dissenting Opinion
I respectfully dissent. While I do not agree completely with the Court of Appeals, I do agree that S.C.Code Ann. § 15-79-125(A) (Supp.2013) requires a potential medical malpractice plaintiff to file an expert witness affidavit contemporaneously with her Notice of Intent to File Suit (NOI). I first explain my construction of § 15-79-125, the medical malpractice prelitigation statute and of S.C.Code Ann. § 15-36-100 (Supp. 2013), the professional negligence complaint statute. I then explain why I do not agree with the majority’s reading of these two statutes.
A. Statutory Construction
As the Court of Appeals correctly stated, the medical malpractice pre-litigation statute, § 15-79-125, and the professional negligence complaint statute, § 15-36-100, operate “in distinct time frames” Ranucci v. Crain,
The medical malpractice pre-litigation statute and the professional negligence complaint statute reference each other and thus we must interpret them in tandem. The medical malpractice pre-litigation statute provides the expert affidavit accompanying the NOI is “subject to the affidavit requirements established in Section 15-36-100,” the professional negligence complaint statute. I would hold this reference in § 15-79-125(A) incorporates only the provisions of § 15-36-100(A) which define “expert” for purposes of the professional
Under my reading of § 15-36-100(B), there is no requirement that medical malpractice complaints be accompanied by an expert affidavit. It follows, then, that the grace period found in § 15-36-100(0(1) and the common knowledge exception of § 15-36-100(0(2), which by their own terms apply only to “the contemporaneous [complaint and expert affidavit] filing requirements of § 15-36-100(B),” are irrelevant in a medical malpractice case. I therefore agree with the Court of Appeals that since Ranucci did not file an expert affidavit along with her NOI, her NOI was properly dismissed.
B. The Majority’s Reasoning
The majority advances four reasons to support its conclusion that the provisions of § 15-36-100 must be incorporated wholesale into § 15-79-125. As explained below, I do not find any of the reasons support the majority’s interpretation of the two statutes. I note at the outset that the majority does not
The majority first asserts that without the wholesale incorporation of the professional negligence complaint statute into the medical malpractice pre-litigation statute, a medical malpractice plaintiff is deprived of the forty-five day grace period found in § 15-36-100(C)(l). The purpose of this grace period is to toll the statute of limitations when a professional negligence plaintiff files her complaint within ten days of the running of the statute in order to allow her time to procure an expert affidavit. The majority fails to acknowledge that in a medical malpractice case the statute is tolled much earlier, that is, when the NOI and expert witness affidavit are filed under the medical malpractice pre-litigation statute which states the contemporaneous filing of these two documents “tolls all applicable statutes of limitations.” § 15-79-125(A). Moreover, under § 15-36-100(0(1), the forty-five day grace period does not commence until “the filing of the complaint,” an event which cannot occur in a medical malpractice action until after the NOI and its affidavit have been filed, discovery materials exchanged, and mediation attempted. See § 15-79-125(E). I do not agree that the lack of a “grace period” in the medical malpractice pre-litigation statute, which contains its own tolling provision, mandates that we implant this separate, more limited tolling provision from the professional negligence complaint statute. Further, under my reading of § 15-36-100(B) the medical malpractice plaintiff is exempt from the requirement that her complaint be accompanied by an expert witness affidavit, and therefore she will never have need of the grace period found in § 15-36-100(0(1).
The majority next expresses concern that unless we hold that § 15-36-100(0(2) is incorporated into § 15-79-125, a medical malpractice plaintiff need always produce an expert witness affidavit at the NOI stage, even if her claim otherwise falls within the common knowledge exception. I do not understand why the requirement that an expert affidavit accompany every medical malpractice NOI, even where the subject matter is within a layperson’s common knowledge, leads to the conclusion that the pre-litigation statute must be read to
As a third reason to incorporate all of § 15-36-100 into § 15-79-125 the majority asserts that absent such incorporation, there is no mechanism for a defendant to challenge the plaintiffs compliance with the medical malpractice pre-litigation statute. I disagree, and need only point to the present matter before the Court as proof. The provision allowing the present pre-litigation challenge is § 15-79-125(D), which states “The circuit court has jurisdiction to enforce the provisions of this section.” Under this subsection of the medical malpractice pre-litigation statute, for example, a court could require a plaintiff to file her standard interrogatories under § 15-79-125(A), or compel either party to comply with a subpoena issued pursuant to § 15-79-125(B). Under the majority’s view, however, if a medical malpractice plaintiff failed to file the pre-litigation affidavit required by § 15-79-125(A), filed a non-compliant one, or refused to participate in discovery, then the defendant would be powerless to do anything until the plaintiff filed her complaint, since it is only at that juncture that the sanctions in the professional negligence complaint statute can be invoked. See § 15-36-100(0(1), (E), (F). Requiring a defendant to wait until litigation has commenced to compel the medical malpractice complainant to comply with § 15-79-125 negates the entire pre-litigation scheme created by that statute. Moreover, the majority’s decision to incorporate the remedial portions of § 15-36-100, all of which address only the plaintiffs obligations when commencing her suit, ignores the fact that under the medical malpractice pre-litigation statute obligations are placed on both the plaintiff and the defendant. If the majority is correct, and the exclusive remedies for failure to comply with the medical malpractice pre-litigation statute are those found
Finally, the majority explains that unless we incorporate all of § 15-36-100 into § 15-79-125, “a plaintiff would be required to file two expert witness affidavits, i.e., one with the pre-litigation NOI pursuant to § 15-79-125(A) and another affidavit with the complaint pursuant to Section 15-36-100(B).” As explained above, I believe the first clause of § 15-36-100(B), “Except as provided in Section 15-79-125,” relieves a medical malpractice plaintiff from filing an expert affidavit along with her complaint. Even if the medical malpractice plaintiff were required to file an expert witness affidavit at two separate points in the litigation, I do not agree that such a seemingly unnecessary step requires that we construe the statutes as would the majority.
I respectfully dissent and would affirm the decision of the Court of Appeals as modified.
. The Court of Appeals would import some but not all of (B) into § 15-79-125. This is where I part ways with that court’s decision. Further, my analysis requires a modification of our decision in Grier v. AMISUB of South Carolina, Inc.,
