The team at Dodson Parker Behm & Capparella, PC shares updates and thoughts on developments in the law.

More Guidance from COA on the Scope of Healthcare Liability Claims

March 2, 2018

Whenever any kind of injury claim arises in a medical setting, or involves a health care provider, expect a motion to dismiss claiming that the case is one governed by the Tennessee Health Care Liability Act. While the parameters of what falls under the restrictive healthcare liability law (or what we still sometimes refer to as medical malpractice cases) seem to have expanded in recent years, a recent Tennessee Court of Appeals opinion provides some guidance on where the line is drawn…


C.D. v. Keystone Continuum, LLC  arose after C.D., a minor receiving court-ordered behavioral treatment at Mountain Youth Academy, was assaulted by one of the facility’s night guards.  C.D. claimed to have been injured after a night guard had pushed him to the ground and stomped on his foot.  C.D.’s mother filed this suit against Keystone Continuum, the operator of Mountain Youth Academy, on her son’s behalf, alleging (1) assault and battery, and (2) negligent supervision and training of its employees.

Keystone responded by arguing that both allegations qualified as “health care liability” claims under the Tennessee Health Care Liability Act (THCLA), and were therefore subject to the statutory requirements that plaintiffs file (1) pre-suit notice, and (2) a certificate of good faith.  Since neither procedural requirements were met, Keystone moved to dismiss.  The trial court agreed, finding that both claims fell within the THCLA.  It dismissed the assault and battery claim without prejudice, and dismissed the negligent supervision claim with prejudice.

The defendants appealed, arguing that both claims should have been dismissed with prejudice.  On appeal, the plaintiffs argued that neither claim fell within the ambit of the THCLA and that therefore the trial court had erred in dismissing the case.


The Court of Appeals began by addressing whether the first claim of assault and battery fell within the THCLA. The THCLA defines a health care liability action as any civil action “alleging that a health care provider or providers have caused an injury related to the provision of, or failure to provide, health care services to a person.” While it was undisputed that here that the defendant qualified as a healthcare provider under the statute, the Court noted that this fact alone did not automatically mean that the disputed incident related to the provision of healthcare services.

The Court cited several recent cases in which it had held that willful or malicious assault or battery cannot be related to the provision of health care services, even when perpetrated by a physician in a medical facility.  Here, regardless of whether the night guard had qualified as a “health care provider” under the act, his attack on the plaintiff had been willful; therefore, the trial court had erred in dismissing the claim, since it could not be considered a healthcare liability action.

Next, the Court considered the second claim that the defendant had negligently supervised its staff and failed to provide adequate protection for its residents.  Since the defendant in this case met the general definition of a health care provider and did provide health care services to the residents living at the facility, the Court found that the negligent supervision claim did qualify as a health care liability action and therefore was subject to the pre-suit notice requirement.  However, the Court noted that an exception to the requirement that the plaintiff file a certificate of good faith does exist in situations where a lay person could determine whether the defendant met the standard of care without the assistance of an expert.  Here, since a layperson “could assess by their common knowledge, without the need for expert medical testimony assistance,” whether the facility had provided adequate protection for its minor residents, the Court found that this claim fell within the exception.

The Court noted that, while the appropriate remedy for failure to file a certificate of good faith is dismissal with prejudice, the proper sanction for noncompliance with the pre-suit notice requirement alone is dismissal without prejudice.  Since the plaintiff here had failed to comply with the latter requirement but had not been subject to the certificate of good faith requirement, the Court held that the trial court had erred in dismissing the second claim with prejudice.

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