This is аn appeal from an order granting a motion for summary judgment filed by the defendant below in a negligence action. Appellant contends that there are material factual issues in dispute and that therefore summary judgment was improperly granted. She also contends that the trial court committed reversible error by granting ap-pellee’s motion for summary judgment pri- or to the lapse of ten days from the time the motion was served on appellant. 1
Appellee contends that the ten-day notice requirement of Rule 56(c) is not applicable to renewals of summary judgment motions and was not triggered in the instant case, for the trial judge was acting on a simple renewal of an earlier motion for summary judgment to which appellant already had responded. Even if the ten-day rule were applicable, however, appellee contends that the lack of ten days’ notice did not prejudice the appellant. Appellee asserts that the pleadings, depositions, and affidavits before the court indicate that appellant could not establish a prima facie case of negligence; 2 that no reasonable juror could find for appellant on the merits; and that therefore any error on the part of the trial judge was harmless.
Appellant disagrees with the characterization of appellee’s second motion for summary judgment as a simple renewal and maintains that the requirements of Rule 56(c) are applicable. In the alternative, however, appellant argues that if the second motion for summary judgment were a simple renewal, and did not require the application of the ten-day requirement of Rule 56(c), then the entry of summary judgment in favor of appellee, which followed the first judge’s denial of the motion, violated the “law of the case” doctrine.
Our rеview of the record convinces us that the second motion for summary judgment was not a simple renewal of the first motion and that the trial judge did not violate the “law of the case” doctrine by entertaining and granting appellee’s second motion for summary judgment. The second motion, therefore, did trigger the ten-day notice requirement of Rule 56(c). We consider that summary judgment is a drastic measure that may be taken only upon strict adherence to proper procedure. The ten-day notice requirement of Rule 56(c) is essential to assure that the summary judgment process is fair, and, in this case, the trial court’s fаilure to comply with the ten-day notice requirement cannot be deemed “harmless error.” Accordingly, we reverse the trial court’s decision and remand for further proceedings.
I. FACTS AND PROCEDURAL HISTORY
Appellant Mrs. Laura Tompkins brought this wrongful death action against appellee Washington Hospital Center 3 and alleged *1096 that the hospital breached the applicable standard of care by failing to provide pressure monitoring equipment in its radiology room during the performance of a pulmonary angiogram on her husband, Dr. Tompkins. Appellant asserts that this breach of the standard of care was the proximate causе of her husband’s death.
Dr. Marder, one of appellant’s expert witnesses, and Dr. Oboler, the physician who performed the pulmonary angiogram, gave deposition testimony describing the medical procedure and the complications that developed during the treatment of Dr. Tompkins. To perform a pulmonary angiogram a catheter must be inserted in a vein of the arm. The catheter is then manipulated through the right atrium and ventricle of the patient’s heart and into the pulmonary artery where it should remain throughout the procedure. There are several methods to determine or confirm whether the catheter is properly positioned. These methods include: (1) pressure monitoring equipment; (2) giving a test dose of contrast material; (3) visual determination by using a fluoroscope; and (4) using and developing right angle “scout” x-ray films. Contrast medium is then injected through the catheter so that suspected emboli, or blood clots, might be visualized under x-ray.
In this case, Dr. Oboler testified that the patient, Dr. Tompkins, was taken to the catheterization room on the third floor where Dr. Oboler inserted a catheter into the main pulmonary artery. Pressures were monitored during the placing of the catheter and its position was cоnfirmed by injecting a test dose of contrast material.
Following the insertion of the catheter, the patient was placed on a liter and moved to the x-ray room in the basement of the hospital. After developing right angle “scout” x-ray films, Dr. Oboler determined that the catheter had moved. He then repositioned the catheter under visual inspection by using a fluoroscope and injected the contrast material. He did not use pressure monitoring equipment to aid him in repositioning the catheter. Such equipment was not immediately available in the radiology room. He did not confirm the position of the catheter by any other means, although he could have done so by two methods immediately available to him in the radiology department; (1) test dose of contrast material, and (2) right angle “scout” x-ray films. Dr. Oboler testified at his deposition that he had confidence in his ability to reposition the catheter by using a fluoroscope, and apparently he did not find it necessary to confirm the position of the catheter by the other methods. See note 11 infra.
Washington Hospital Center originally moved for summary judgment on June 22, 1979, based on the failure of appellant to supply information concerning experts pursuant to Super.Ct.Civ.R. 26(b)(4). The hоspital submitted a memorandum in support of its motion which argued that appellant had made no showing that its experts would testify that the hospital had breached the applicable standard of care. Appellant filed a general written opposition to the motion for summary judgment and attached portions of the depositions of her two experts who indicated that if pressure monitoring equipment were not available to physicians in the radiology department, this probably would constitute a breach of the standard of care. Appellant also attached two affidavits relating to thе applicable standard of care. See note 4 infra. There was some question, however, as to whether appellant’s experts gave adequate foundations for their opinions. 4
*1097 The trial judge denied the motion for summary judgment on July 23, 1979, without hearing argument on the motion. He found that the affidavits filed by appellant constituted 26(b)(4) statements although they were ten months late, but awarded the hospital one hundred dollars costs and attorney’s fees because appellant’s delay prompted the hospital to file the motion for summary judgment. The court, however, explicitly reserved its ruling until the time of trial on an imрortant preliminary question — “The adequacy of the foundation for plaintiff’s experts’ opinions regarding the standard of care required of the Washington Hospital Center.”
The trial originally was scheduled for November 19, 1979 before another judge. On that date, the hospital orally “renewed” its previous motion for summary judgment. Appellee based its “renewed motion” on two main grounds. First, the appellee argued that under
Morrison v. MacNamara,
D.C.App.,
On November 26, appellee served appellant with a document entitled “Supplemental Memorandum of Points and Authorities in Support of Motion of Defendant, Washington Hospital Center.” Appellee also submitted the affidavits of James M. Bacos, M.D. and Juan Obolle, Chief Cardiovascular Technician of Washington Hospital Center. These new affidavits indicated that, as a matter of hospital policy, pressure monitoring equipment and other special monitoring equipment would have been transported and made available to the attending physician in the radiology room upon request. 5
On that afternoon, counsel for appellee presented oral argument on the second motion for summary judgment. Counsel for appellant again objected and insisted that pursuant to Rule 56(c), appellant was entitled to ten days from the time of service of the supplemental memorandum in support of appellee’s motion for summary judgment to respond to the motion. On November 27, 1979, the trial judge granted appellee’s motion for summary judgment.
II. THE “LAW OF THE CASE” DOCTRINE
Before focusing on the ten-day requirement of Rule 56(c), we briefly consider the *1098 “law of the case” doctrine. We conclude that, in the specific context of this case, the trial judge did not violate this doctrine by entertaining and granting appellee’s second motion for summary judgment after appel-lee’s initial motion for summary judgment had been denied by another judge.
The “law of the case” doctrine bars a trial court from reconsidering the same question of law that was presented to and decided by another court of coordinate jurisdiction
when (1) the motion under consideration is substantially similar to the one already raised before, and considered by, the first court; (2) the first court’s ruling is “sufficiently ‘final’;” and (3) the prior ruling is not “clearly erroneous in light of newly presented facts or a change in substantive law.”
Kritsidimas v. Sheskin,
D.C.App.,
In this case, a number of factors support our conclusion that the trial judge did not violate the “law of the case” by entertaining and granting appellee’s second motion for summary judgment. First, we note that the thrust of the first motion was that summary judgment was appropriate in light of appellant’s failure to provide information pursuant to Super.Ct.Civ.R. 26(b)(4) concerning appellant's expert witnesses and their testimony on the applicable standard of care. The second motion on the other hand, relied heavily on appellant’s inability to establish proximate cause. Secondly, along with its second motion for summary judgment, appellee filed material affidavits pertaining to appellee’s argument that appellant could not establish a breach of the applicable standard of care. Finally, appel-lee’s second motion for summary judgment took advantage of a significant, intervening change in substantive law on an important preliminary issue.
See Morrison v. MacNamara, supra
at 560-65 (requiring that plaintiff establish a national, rather than a local standard of care). Under these circumstances, the second motion for summary judgment was not “substantially similar” to the first motion
6
and the trial judge did not violate the “law of the case.”
Accord, Brownfield v. Landon,
III. TEN-DAY NOTICE REQUIREMENT OF RULE 56(c)
We begin our discussion of the ten-day notice requirement by noting that summary judgment is only appropriate when no genuine issue of material fact exists. Super.Ct. Civ.R. 56(c).
See, e. g., Sullivan
v.
Heritage Foundation,
D.C.App.,
We turn now to appellant’s contention that the trial court erred in granting summary judgment prior to the lapse of ten (lays from the lime the motion was served
8
as required by Super.Ct.Civ.R. 56(c). That rule explicitly provides that a motion for summary judgment
9
“shall be served at least 10 days before the time fixed for the hearing.” This ten-day notice provision is not an unimportant technicality, but safeguards the substantial interests of litigants. An opposition tо a summary judgment motion often requires extensive preparation of both legal and factual arguments as well as affidavits, and the results of failing to win on an opposition to a motion for summary judgment are drastic. This ten-day notice provision is needed to assure that the summary judgment process is fair.
See Hanson
v.
Polk County Land, Inc.,
*1100 In this case, the trial judge construed the second motion for summary judgment as simply a renewal of the earlier motion and apparently did not view a renewal as falling within the ten-day notice requirement of Rule 56(c). As a matter of common sense, of course, there may be times when a purely formal renewal of a motion for summary judgment does not require adherence to the ten-day notice provision. 10 In this case, however, there were significant differences between the first and second motions for summary judgment. These differences support our conclusion that the trial judge did not violate the “law of the case” by granting appellee’s second motion for summary judgment. See Part II supra. The same differences preclude the characterization of the second motion as a “simple renewal” that is not subject to the ten-day notice requirement of Rule 56(c). We conclude, therefore, that the trial judge erred by failing to allow appellant ten days from the time the “supplemental memorandum” was served to respond to appellee’s second expanded motion for summary judgment.
Having determined that the trial judge erred by failing to comply with the ten-day notice requirement of Rule 56(c), we consider whether the application of a “harmless error” rule is appropriate under these circumstances. We notе that some courts employ a kind of “harmless error” analysis to mitigate the harshness of an inflexible rule requiring reversal in any case where the procedural requirements of Rule 56(c) have not been strictly followed. In
Oppenheimer v. Morton Hotel Corp.,
As a number of courts have recognized, the purpose of the advance notice provision in Rule 56(c) is to permit the non-moving party a reasonable and mеaningful opportunity to challenge the motion.
See, e. g., Winfrey v. Brewer,
In this case, appellant called the ten-day notice requirement of Rule 56(c) to the trial judge’s attention and did not waive the rule, but vigorously asserted her right to ten-days’ notice. Appellant did not expressly represent that she could adduce no further evidence or that additional research would not be helpful in opposing the motion. Moreover, an examination of the pleadings, depositions, and affidavits in this case does not demonstrate that there are not material facts in dispute and that appellant could not have established a prima facie case of negligence, i. e., that the hospital breached the applicable standard of care and that this breach was the proximate cause of Dr. Tompkins’ death. The deposition testimony of the expert witnesses is ambiguous on the issues of the standard of care and breach of the applicable standard of care. Although these witnesses indicated that pressure monitoring equipment should be “available” to physicians while in the radiology room, they did not actually define the term “available.” Along with its second motion for summary judgment, ap-pellee filed two affidavits, signed by cardiologists at the Washington Hospital Center, indicating that pressure monitoring equipment would have been made available in the radiology suite if requested by the attending physician. It is not at all clear that had the appellant’s expert witnesses been informed that such equipment would have been transported to the radiology room upon request, they would have testified that this constituted a breach of the applicable standard of care. Appellant, however, had no opportunity to file counter-affidavits addressing this issue, for a hearing was held on the same day that the “supplemental memorandum” and affidavits were served and a decision was rendered on the following day. Similarly, appellant has no meaningful opportunity to consider and address the proximate cause issue presented in apj>ellee’s second motion. 11
We conclude, then, that Rule 56(c) mandates strict compliance with the ten-day *1102 notice requirement. In this case, appellee’s second motion for summаry judgment triggered the ten-day notice requirement. Appellant did not waive Rule 56(c) and did not represent that she could adduce no further evidence. Nevertheless, the trial judge granted appellees’ motion for summary judgment prior to the lapse of ten days and deprived appellant of the opportunity of filing additional materials to oppose the motion. Under these circumstances, we are unable to say that failure to comply with the ten-day notice requirement of Rule 56(c) constitutes “harmless error.” We cannot say that there are no material facts in dispute and that appellee is entitled to summary judgment as a matter of law. We therefore reverse the judgment of the trial court and remand for further proceedings.
Reversed and remanded.
Notes
. Rule 56(c) provides in pertinent part:
The motion shall be served at least 10 days before the time fixed for the hearing. The adverse party prior to the day of hearing may serve opposing affidavits. The judgment sought shall be rendered forthwith if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law....
. A prima facie case of medical malpractice or hospital negligence must consist of evidence which establishes the applicable standard of care, demonstrates that this standard has been violated, and develops a causal relationship between the breach of the standard of care and the alleged harm.
See Kosberg v. Wash. Hosp. Center,
.The instant case is a direct negligence action against the hospital. Traditionally, hospitals have owed a direct duty to their patients to furnish equipment and facilities that are not defective, improper, or inadequate.
See Alden v. Providence Hosp.,
. Dr. Marder stated that he was not familiar with the procedures generally followed in other hospitals at that time. Dr. Ashley stated that in every hospital he knew of in the District of Columbia and in the United States pressure monitoring equipment was available throughout the entire catheterization procedure, but that he did not know whether the equipment was available in the Washington Hospital Cen *1097 ter’s radiology room at that time. Appellant also attached two affidavits signed by appellant’s attorney that stated when these two experts were later informed by appellant’s attorney that pressure monitoring equipment was available to the radiology departments of local hospitals, but not available to the radiology department of the Washington Hospital Center, they both indicated that the Washington Hospital Center had breached the standard of care. The only other deposition testimony relevant to the hospital’s breach of the standard of care is the testimony of Dr. Bowen. Dr. Bowen testified that “[i]deally one should have either a pressure monitor or a test injection prior to doing the injection [of the contrast material]” and that he was not aware of any hospital where pressure monitoring equipment was not available for all phases of the pulmonary angio-gram.
. In the memorandum opinion of the trial judge a rather vague footnote reference is made to these affidavits. These affidavits contain material assеrtions and are in the record.
See Turner
v. Am.
Motors Gen.
Corp., D.C.App.,
. Moreover, we note that, because the trial judge who denied the first motion for summary judgment explicitly reserved until the time of trial his ruling on an important preliminary question — "the adequacy of the foundation for plaintiffs experts’ opinions regarding the standard of care required of the Washington Hosрital Center” — there is some question as to whether his ruling was sufficiently final to bar a subsequent motion for summary judgment. See Kritsidimas v. Sheskin, supra at 372.
.We also note that, despite the heavy burden placed on the party moving for summary judgment in negligence or other actions generally presenting factual questions, it is clear that there may be no genuine material factual issue even though there is a formal issue. Neither a purely formal denial, nor general allegations necessarily defeat a summary judgment motion.
See Dewey
v.
Clark,
When a motion for summary judgment is made and supported as provided in this rule, an adverse party may not rest upon the mere allegations or denials of his pleading, but his response, by affidavits or as otherwise provided in this rule, must set forth specific facts showing that there is a genuine issue for trial. If he does not so respond, summary judgment, if appropriate, shall be entered against him.
Thus, where on the basis of the materials presented by the movant’s affidavits the mov-ant would be entitled to a directed verdict and the opposing party fails either to offer counter-affidavits or other materials that raise a credible issue or to show that he had evidence not yet available, summary judgment may be rendered for the moving party.
See, e. g., Orvis v. Brickman,
. In this case the second motion was actually made orally on November 19 and again on November 26. It was a copy of the “supplemental memorandum” in support of the second motion that was served on appellant on November 26.
. Superior Ct.Civ.R. 12-I(e) requires that each motion be accompanied by specific points and authorities to support the motion.
. In such cases, however, the “law of the сase” doctrine may preclude a trial judge from entertaining or granting a second motion for summary judgment. See Part II supra.
. In granting appellee’s motion for summary judgment, the trial judge seemed to rely exclusively on the fact appellant could not possibly establish the causation element of a prima facie case of negligence, because Dr. Oboler stated in his deposition that he does not use pressure monitoring to determine catheter location. The trial judge quoted what he viewed as a crucial portion of Dr. Oboler’s deposition:
Once the pressures have been obtained and the cаtheter position has been visually found, it is most unusual to have this kind of problem. It is very unusual for the catheter to move. When it does move, it is very simple just to advance in the same way we did. Even at this point in time we don’t keep the patient on pressure when we are doing this, because we have to disconnect and connect *1102 up the Hobbs-Viamonte injector. It would be disconnecting from the injector, hooking back up to the pressure, and disconnecting from the pressure and rehooking up to the Hobbs. When you rehook to the injector, you have to be careful not to get air back. You have to have a procedure to suck back. It is like a big deal hooking up to the injector. You have to have an airtight system. Even now when we are in the cath lab after we get our pressures and position our catheter, that is it for pressure. We don’t pressure monitoring again.
We note that, although appellant addressed the question of proximate cause very generally in her written opposition to the first motion for summary judgment, appellant had no opportunity to consider and carefully prepare a written argument demonstrating that Dr. Oboler’s deposition testimony should not foreclose imposition of liability on the hospital.
