HARRELL, J.
We wander here once more into the minefield of interpreting the Healthcare Malpractice Claims Act ("HCMCA") and its requirement that a plaintiff in a medical malpractice action file a proper Certificate of Merit ("Certificate").
Jeffery Breslin, M.D. ("Dr. Breslin" or "Petitioner"), attacks a judgment of the Court of Special Appeals, which reversed the earlier grant of summary judgment by the Circuit Court for Baltimore City in his favor. The intermediate appellate court held that filing a Certificate of an expert
Petitioner claims before us that the plain language of CJ § 3-2A-02 allows for summary judgment as proper relief because CJ § 3-2A-02 does not provide explicitly a remedy for failure to meet its requirements, but states explicitly that the Maryland Rules apply to the HCMCA (Md. Rule 2-501 provides for summary judgment). Accordingly, as the argument goes, because Respondent's attesting expert, Ronald Burt, M.D. ("Dr. Burt"), an anesthesiologist, was not qualified to attest to the standard of care breached allegedly by Dr. Breslin, a vascular surgeon, pursuant to CJ § 3-2A-02, summary judgment was a proper disposition of the case. Finally, Petitioner claims that the Court of Special Appeals's decision is inconsistent with the legislative purpose behind the need for a Certificate, which is to "weed out" frivolous medical malpractice claims.
We hold that, for reasons to be explained more fully infra, the plain language of the HCMCA, reading §§ 3-2A-02 and 3-2A-04 together, is clear, and requires dismissal without prejudice of the underlying claim for the filing of a non-compliant Certificate, regardless of the particular qualification or requirement the Certificate or its attestor fails to meet. Accordingly, we affirm the judgment of the Court of Special Appeals.
Jackie D. Powell
The present litigation, inspired by the death of Mr. Powell, originated on 30 July 2004 as a Health Claims Arbitration Proceeding pursuant to CJ § 3-2A-03. In conjunction with the claim, Powell filed with the Health Care Alternative Dispute Resolution Office ("HCADRO")
On 5 August 2005, Powell filed an Amended Statement of Claim with the HCADRO, adding as defendants Dr. Breslin and his professional association. A new Certificate accompanied this filing, which attested to departures from the standard of care by "Jeffery Breslin, M.D., . . . Drs. Kremen, Breslin & Fraiman, P.A., and Good Samaritan Hospital, Inc." Attested to by Ronald Burt, M.D. ("Dr. Burt"), a board-certified anesthesiologist, pursuant to CJ § 3-2A-02, the new Certificate stated, "I . . . certify that I have had clinical experience, provided consultation relating to the clinical practice, and [/] or taught medicine in the field of Anesthesiology and/or the related field of general surgery, within five (5) years of the date of the . . . acts or omissions giving rise to this claim." Powell filed subsequently a notice to waive arbitration and, on 25 August 2005, filed a Second Amended Complaint in the Circuit Court, adding a survival claim sounding in negligence, as well as a wrongful death claim against Dr. Breslin and his professional association.
After several attempts by the defense, beginning in March 2006, to depose Dr. Burt, his deposition was taken on 6 September 2006.
In light of the foregoing deposition revelation, Dr. Breslin filed a Motion to Dismiss or, in the Alternative, for Summary Judgment
Powell tendered three arguments why the action should not be dismissed, despite Dr. Burt's admission in deposition that he was unqualified to attest to the ability of a vascular surgeon to detect an epidural hematoma and, thus, was not qualified to attest to the standard of care of a vascular surgeon and the alleged breach thereof.
The Circuit Court, unpersuaded by Powell's arguments, granted summary judgment in favor of Dr. Breslin, explaining that, "[the] legislative directive, coupled with the Court of Appeals' signal that the [L]egislature's directives are to be strictly applied, convinces this Court that with the passage of the [HCMCA], Dr. Burt is not qualified to attest to the alleged breach of the post-operative standard of care of Dr. Breslin." Powell filed a Motion to Reconsider
(Citations, alterations, and quotation marks omitted.)
Powell noted timely an appeal to the Court of Special Appeals. In a reported opinion, Powell v. Breslin, 195 Md.App. 340, 6 A.3d 360 (2010), the intermediate appellate court reversed the Circuit Court's judgment, explaining that:
Powell, 195 Md.App. at 355, 6 A.3d at 368-69. Dr. Breslin filed a Petition for Writ of Certiorari, which we granted, Breslin v. Powell, 418 Md. 190, 13 A.3d 798 (2011), to consider, in our own words:
This case presents a question of statutory interpretation, and therefore, we review the trial court's disposition through summary judgment under a non-deferential standard of review.
Over the past four decades, the Maryland marketplace has undergone three major medical liability insurance "crises," each of which engendered legislative responses changing the statutory scheme regulating medical malpractice suits. See Final Report, November 2004 Governor's Task Force on Medical Malpractice and Health Care Access, at 7 [hereinafter TASK FORCE REPORT], available at http://images.ibsys.com/2004/1125/3949201. pdf.
In 1974, reacting to the upwardly spiraling cost of servicing medical malpractice insurance policies, St. Paul Fire & Marine Insurance Company ("St. Paul") notified the Maryland Medical and Chirugical Faculty ("MedChi"), the leading professional organization of doctors in the State, that St. Paul would not allow doctors to renew insurance coverage plans that expired as of 1 January 1975. See Terry L. Trimble, The Maryland Survey: 1994-1995: Recent Development: The Maryland General Assembly: Torts, 55 MD. L.REV. 893, 895 (1996); Kevin G. Quinn, The Health Care Malpractice Claims Statute: Maryland's Response to the Medical Malpractice Crisis, 10 U. BALT. L.REV. 74, 77 (1980). St. Paul, at the time providing medical malpractice insurance to approximately eighty-five percent of physicians based in Maryland, explained its withdrawal as caused by a deficit of nearly ten-million dollars in providing medical malpractice insurance in Maryland at the then-current rates. See Quinn, supra, at 77. The company was unable to offset these massive losses, assertedly because the Insurance Commissioner of Maryland had refused its prior requested rate increase.
Although the trial court's order mandating that St. Paul renew all applications and outstanding policies at current rates was overturned eventually by this Court, the General Assembly used the time while the litigation was ongoing to respond to the crisis. See Trimble, supra, at 895. In its 1975 legislative session, the General Assembly created the Medical Mutual Liability Insurance Society of Maryland ("Medical Mutual"), a physician-owned mutual insurance company, in response to St. Paul's threatened exit from the Maryland medical malpractice insurance market. See Md.Code (1957, 1972 Repl.Vol., 1977 Cum.Supp.), Art. 48A, §§ 548-56; TASK FORCE REPORT, supra, at 7. The creation of Medical Mutual, however, was merely a bridge to greater relief in the 1976 session. In 1976, the General Assembly sought to treat more effectively the malaise that was ailing the medical malpractice insurance market. See Witte v. Azarian, 369 Md. 518, 527, 801 A.2d 160, 165 (2002) ("The General Assembly understood that the collapse of the malpractice insurance market was rooted, to some extent in the manner in which malpractice
The General Assembly passed the Health Care Malpractice Claims Act, HCMCA, in 1976 to alter the manner in which malpractice claims were brought and resolved. See Witte, 369 Md. at 526, 801 A.2d at 165; see also Quinn, supra, at 81. The HCMCA modified the existing medium in three main ways: (1) it created the Health Claims Arbitration Office "to facilitate and expedite the resolution of malpractice claims"; (2) it created, through an arbitration panel, an exclusive arbitration procedure for resolving all claims over $5,000; and (3) it provided that the arbitration panel's award would not be binding and all awards could be rejected and recourse had thereafter to traditional judicial actions and remedies. See Quinn, supra, at 81. Over the next two years, much litigation ensued, challenging the constitutionality of the HCMCA and causing the arbitration scheme not to take effect until 1978, when the Court upheld ultimately as constitutional the HCMCA in Attorney General v. Johnson, 282 Md. 274, 313-14, 385 A.2d 57, 80 (1978), appeal dismissed, 439 U.S. 805, 99 S.Ct. 60, 58 L.Ed.2d 97 (1978).
Less than ten years after the first medical malpractice insurance crisis, in 1983,
In 1986, the General Assembly enacted Senate Bill 559, which made several amendments to the HCMCA in response to the task force report. See Ch. 640 of the Acts of 1986; Witte, 369 Md. at 531, 801 A.2d at 168. Several provisions aimed to reduce total amounts paid by insurers on claims or judgments—(1) a "cap" was placed on non-economic tort damages at $350,000; (2) a reduction of damages was allowed if the plaintiff received benefits from a collateral source (i.e., health or disability insurance); and (3) the statute of limitations was decreased for a minor to bring a claim.
Additionally, Senate Bill 559 amended provisions of the HCMCA relating to the use of experts in medical malpractice cases. As proposed initially in S.B. 16 (1984), the arbitration process was changed to require the filing of a qualified expert certificate and to mandate that such an attesting expert receive no more than fifty percent of his or her income directly from testimony in personal injury cases.
At common law, prior to the 1986 amendment to the HCMCA, a claimant was not required to file a certificate of a qualified expert and no similarly-stringent qualifications were placed on the testifying expert in medical malpractice actions. See Walzer, 395 Md. at 577, 911 A.2d at 435 ("We acknowledge that, at common law, prior to the General Assembly's enactment of the [HCMCA], a claimant was not required to file a certificate of qualified expert in a medical malpractice case."); Radman v. Harold, 279 Md. 167, 171, 367 A.2d 472, 475 (1977) ("[W]e have never treated expert medical testimony any differently than other types of expert testimony."). In adding such requirements, the certificate requirement is in derogation of the common law,
TASK FORCE REPORT, supra, at 31.
The third medical malpractice insurance "crisis" followed a near twenty-year period of relative stability. Throughout the late 1980s and continuing into the 1990s, the medical malpractice insurance market remained fairly stable. See TASK FORCE REPORT, supra, at 7. The most relevant change to the HCMCA during this period came during the 1995 legislative session when the General Assembly enacted a bill permitting waiver by either party of the entire arbitration process. See Ch. 582 of the Acts of 1995, codified as Md.Code (1974, 2002 Repl.Vol.), CJ § 3-2A-06B; see also Debbas, 389 Md. at 380-81, 885 A.2d at 812. This relative stability in the market led to "fiercely competitive pricing on premiums," and "[p]rofitability was made possible by slow claims growth coupled with favorable economic conditions." TASK FORCE REPORT, supra, at 7. In 1999, however, medial malpractice premium rates increased dramatically throughout the country. See id. Maryland physicians and hospitals felt the effects of these increases in premiums in the early 2000s, with only four insurers providing malpractice insurance to the entirety of the State's physicians and hospitals, after ten insurers abandoned the State beginning in 1995. See TASK FORCE REPORT, supra, at 7-8.
In 2004, the General Assembly called a special legislative session to address the latest medical malpractice insurance crisis and enacted several changes to the HCMCA. Most relevant to the present case, the 2004 amendments added qualifications for the expert attesting in the Certificate or testifying before the arbitration panel or court regarding the compliance with, or departure from, the standard of care by the defendant. The amended CJ § 3-2A-02(c)(2)(ii) states:
The legislative history illuminating the purpose of this amendment is scant. In his letter vetoing the proposed House Bill 2 of 2004, which was adopted over the veto, then-Governor Robert L. Ehrlich, Jr. stated that the provisions dealing with expert witnesses were intended to "prevent the prevalent use of `hired gun' experts who do not practice medicine but instead have become experts for hire." Letter from Robert L. Ehrlich, Jr., Governor, to Michael
With this "family" history of the HCMCA in mind, we turn to the present case.
When undertaking an exercise in statutory interpretation, as in the present case, the goal is to "ascertain and effectuate the intent of the Legislature." Mayor and Town Council of Oakland v. Mayor and Town Council of Mountain Lake Park, 392 Md. 301, 316, 896 A.2d 1036, 1045 (2006). In attempting to discern the intent of the Legislature, courts "look first to the plain language of the statute, giving it its natural and ordinary meaning." State Dep't of Assessments and Taxation v. Maryland-Nat'l Capital Park & Planning Comm'n, 348 Md. 2, 13, 702 A.2d 690, 696 (1997). If the language of the statute is clear and unambiguous, courts will give effect to the plain meaning of the statute and no further sleuthing of statutory interpretation is needed. See Marriott Employees Fed. Credit Union v. MVA, 346 Md. 437, 445, 697 A.2d 455, 458 (1997) ("When the statutory language is clear, we need not look beyond the statutory language."); Kaczorowski v. Mayor and City Council of Baltimore, 309 Md. 505, 515, 525 A.2d 628, 633 (1987) ("Sometimes the language in question will be so clearly consistent with apparent purpose . . . that further research will be unnecessary."). If the sense of the statute is either unclear or ambiguous under the plain meaning magnifying glass, courts will look for other clues—e.g., the construction of the statute, the relation of the statute to other laws in a legislative scheme, the legislative history, and the general purpose and intent of the statute. See Lewis v. State, 348 Md. 648, 653, 705 A.2d 1128, 1131 (1998) ("If . . . the meaning of the plain language is ambiguous or unclear, we seek to discern legislative intent from surrounding circumstances, such as legislative history, prior case law, and the purposes on which the statutory framework was based.").
It is well-settled that a court must read a statute in the context of its statutory scheme, ensuring that "no word, clause, sentence, or phrase is rendered surplusage, superfluous, meaningless, or nugatory," and that any illogical or unreasonable interpretation is avoided. Mayor of Oakland, 392 Md. at 316, 896 A.2d at 1045; see also Whiting-Turner Contracting Co. v. Fitzpatrick, 366 Md. 295, 302-03, 783 A.2d 667, 671 (2001) ("[S]tatutes on the same subject are to be read together and harmonized to the extent possible, reading them so as to avoid rendering either of them, or any portion, meaningless, surplusage, superfluous or nugatory." (quotation marks and citations omitted)). Additionally, "`[s]tatutes in derogation of the common law are strictly construed, and it is not to be presumed that the [L]egislature by creating statutory assaults intended to make any alteration in the common law other than what has been specified and plainly pronounced.'" Walzer, 395 Md. at 573-74, 911 A.2d at 433 (quoting Gleaton v. State, 235 Md. 271, 277, 201 A.2d 353, 356 (1964)). With this in mind, courts may consider with caution the cannon of construction, expressio unius est exclusio alterius, meaning "to express or include one thing implies the exclusion of the other, or of the alternative," BLACK'S LAW DICTIONARY 661 (9th ed.2009). See Kirkwood v. Provident Sav. Bank of Baltimore, 205 Md. 48, 55, 106 A.2d 103, 107 (1954) ("[This maxim] should be used with caution, and should never be applied to override the manifest intention of the Legislature or a provision of the Constitution."). That that narrow interpretation is applicable to statutes purporting to repeal the common law does not mean that a court will refuse to give effect
Section 3-2A-04(b)(1)(i) provides:
Later provisions of CJ § 3-2A-04(b) provide requirements for the Certificate and the "qualified expert" attesting to the Certificate:
As noted above, CJ § 3-2A-04(b)(1)(i) requires that a claimant or plaintiff with a medical malpractice case file a certificate from a qualified expert; the sanction for failing to file a certificate of a qualified expert is dismissal without prejudice of the "claim or action." This provision was added to the HCMCA in 1986. In 2004, the Legislature added additional qualifications for the attesting expert in CJ § 3-2A-02 with the knowledge that the section added in 1986 already required dismissal without prejudice for failure to file a proper Certificate. See Bd. of Educ. of Garrett County v. Lendo, 295 Md. 55, 63, 453 A.2d 1185, 1189 (1982) ("The General Assembly is presumed to have had, and acted with respect to, full knowledge and information as to prior and existing law and legislation on the subject of the statute and the policy of the prior law.").
The additional qualifications for the Certificate added in 2004 are found in CJ § 3-2A-02(c)(2)(ii), which provides that:
(Emphasis added.) The use of the words "in addition to any other qualifications" in
Dr. Breslin alleges that the plain language of the HCMCA allows for the grant of summary judgment when an unqualified expert is exposed (after a claim reaches the courts) because CJ § 3-2A-04(b)(2) and CJ § 3-2A-02(d) both refer to the "liability" of the defendant, which, according to Dr. Breslin, "clearly implies summary judgment," while CJ § 3-2A-04(b)(1) makes no mention of liability and mandates dismissal only when no certificate is filed at all.
In D'Angelo, the Court of Special Appeals stated that "failure to file a proper certificate is tantamount to not having filed a certificate at all." 157 Md.App. at 645, 853 A.2d at 822. We adopted this statement in subsequent cases and agree with its continuing correctness. See Kearney, 416 Md. 628, 635, 7 A.3d 593, 597 (2010) (quoting favorably the statement in D'Angelo); Walzer, 395 Md. at 582, 911 A.2d at 438 ("While based on somewhat different facts, we agree with the Court of Special Appeals' general statement in D'Angelo."). We imagine several ways in which a plaintiff could "fail to file a certificate of a qualified expert," including but not limited to: (1) not filing a certificate at all; (2) filing a certificate of an unqualified expert who does not have the requisite training; (3) filing a certificate of an otherwise qualified expert who devotes more than twenty percent of his professional activities to testimony in personal injury cases; or (4) filing a certificate of a qualified expert that does not include the required report. These and other ways in which a claimant or plaintiff can "fail to file" are not distinguished in the statute. To recognize such a distinction creates a dichotomy that is not included, either expressly or impliedly, in the statute. See D'Angelo, 157 Md.App. at 646, 853 A.2d at 822 (dismissing appellant's argument that he was not required
Dr. Breslin claims further that CJ § 3-2A-02 makes no reference to the dismissal without prejudice provision and, therefore, that provision is not controlling. This argument ignores the plain language of the statute. Section 3-2A-02(c) states "[i]n addition to any other qualifications" and then delineates a list of qualifications; this implies clearly that the Legislature intended CJ § 3-2A-02(c) to work together with other provisions in Subtitle 3-2A that provide additional qualifications for the attesting experts. Moreover, the provision incorporating the Maryland Rules begins, "[e]xcept as otherwise provided," which evinces the Legislature's intent to allow for other sections of the HCMCA to provide practices and procedures specific to medical malpractice claims that would supersede general provisions of the Maryland Rules. See CJ § 3-2A-02(d); see also Curry v. Hillcrest Clinic, Inc., 337 Md. 412, 416, 653 A.2d 934, 936 (1995) (stating that where a "procedure . . . is not proscribed in the [HCMCA] or in rules adopted by the [HCADRO] Director . . . [the] Maryland Rule[s] govern[]"). Dr. Breslin focuses on the words "shall apply to all practice and procedure issues arising under this subtitle," (emphasis added), ignoring the earlier qualifying language, "[e]xcept as otherwise provided." As the statute provides for a remedy of dismissal without prejudice when a claimant or plaintiff fails to file a proper certificate in CJ § 3-2A-04(b)(1), that remedy, and not the Maryland Rules, governs the failure to file a certificate meeting the requirements of CJ § 3-2A-02(c).
Throughout his analysis, Dr. Breslin relies heavily on the maxim expressio unius est exclusio alterius as his default position. The Circuit Court also relied on this maxim in its grant of summary judgment, stating that CJ § 3-2A-02 allows for summary judgment as it does not refer specifically to whether dismissal should be with or without prejudice. Because, according to the Circuit Court and Dr. Breslin, CJ § 3-2A-04 refers to dismissal without prejudice and CJ § 3-2A-02 does not, expressio unius est exclusio alterius implies that dismissal with prejudice, cloaked as summary judgment, is an appropriate remedy. We cautioned, however, that this particular canon of construction should be applied with extreme caution, as
Walzer, 395 Md. at 579, 911 A.2d at 436 (quoting Hylton v. Mayor and City Council of Baltimore, 268 Md. 266, 282, 300 A.2d 656, 664 (1972)). Where the plain meaning of the statute is clear, as we believe the provisions relevant to the present case are, the maxim is of no weight. See Walzer, 395 Md. at 579, 911 A.2d at 436.
In rendering the plain meaning of a statute, the legislative intent may be considered. See State v. Pagano, 341 Md. 129, 133, 669 A.2d 1339, 1341 (1996) ("We may always consider evidence of legislative intent beyond the plain language of the statute."). The to file a proper Certificate.
As stated by the Maryland Association for Justice, which filed an Amicus Curiae brief in the present case, another purpose of the HCMCA is to balance "the preservation of rights of those injured through malpractice with the rights of those alleged to have committed the malpractice." By dismissing a claim or action without prejudice where the claimant or plaintiff fails to meet the requirements regarding the Certificate listed in the HCMCA, either in CJ § 3-2A-02 or CJ § 3-2A-04, the court is balancing these rights by weeding out non-meritorious claims while still allowing the plaintiff, if he or she can, to re-file a claim or action with a proper certificate. Dr. Breslin is correct in stating that a claimant or plaintiff has an affirmative duty to choose a proper expert to attest to the standard of care in the Certificate; however, he states incorrectly that the result sought here by Powell allows a claim or action to go forward even if it lacks merit. Dismissing this case without prejudice would not have allowed the case to go forward with Dr. Burt's Certificate, but rather would have given Powell an opportunity to re-file with a proper Certificate. Although Dr. Breslin claims that this is an unjust result because Powell knew purportedly that Dr. Burt was unqualified before the filing of the Certificate, Dr. Breslin ignores the multiple plausible arguments proposed by Powell in the trial court as to why Powell believed originally Dr. Burt was, in fact, qualified. See, supra, 421 Md. 266, 26 A.3d 878 (slip op. at 271-73, 26 A.3d at 881-82).
The requirements added in 2004 to CJ § 3-2A-02(c) emphasize further the importance of a proper Certificate and the Legislature's intent to screen claims, if possible, before they are filed in court. Ch. 5 of
Because the Certificate is vital, an action in circuit court (or federal court) will be dismissed without prejudice if any of the Certificate's material requirements are not met.
Dismissing Powell's claim without prejudice does not undermine the legislative intent behind requiring a Certificate and stringent requirements for the attesting expert. Instead, such an outcome supports the legislative purpose by not allowing a claim or action to go forward with an unqualified expert, and, therefore, an insufficient Certificate. Further, dismissing the case without prejudice allows for protection of a plaintiff's rights in a medical malpractice case by providing the opportunity to re-file (assuming the limitations period has not expired) if a qualified expert can attest in a Certificate to departures from the standard of care and causation between such departure and the injury.
Section 3-2A-02(c) and 3-2A-04(b) both provide qualifications for the expert attesting to the Certificate; therefore, the two must be read together, which compels the conclusion that any deficiency in the Certificate requires the arbitration panel or court to dismiss the claim or action without prejudice.
The Court of Appeals upheld the constitutionality of the statute in the face of each challenge. First, the Court held that "the statute merely requires that malpractice claims be submitted to nonbinding arbitration before suit may be filed," and neither must the parties accept the award nor can the panel enforce the award. Johnson, 282 Md. at 287, 385 A.2d at 65. The panel, therefore, "exercise[s] no portion of the judicial power of this State in the constitutional sense." Johnson, 282 Md. at 288, 385 A.2d at 65. As to the second issue, the Court held that the statute did not deprive individuals of either trial by jury or access to the courts because the statute secures trial by jury upon pursuit of a claim in a circuit court. See Johnson, 282 Md. at 299-301, 385 A.2d at 72-73. Finally, the Court concluded that "the [HCMCA] bears a fair and substantial relation to its purpose and is thus not in contravention of the fourteenth amendment or our Declaration of Rights." Johnson, 282 Md. at 308, 385 A.2d at 77.
(Quoting Final Report, December 1985 Joint Executive/Legislative Task Force on Medical Malpractice Insurance, at 31)(second emphasis added). The fifty percent requirement was struck by the Senate Judicial Proceedings Committee and changed to the current requirement that the attesting expert "may not devote annually more than 20% of the expert's professional activities that directly involve testimony in personal injury claims." CJ § 3-2A-04(b)(4) (emphasis added); see also Witte, 369 Md. at 530, 801 A.2d at 167-68.
Section 3-2A-04(b)(1)(i) reads:
(Emphasis added.) The section later states, in subsection (b)(1)(ii), that "[i]n lieu of dismissing the claim or action, the panel chairman or the court shall grant an extension," if certain conditions are met. (Emphasis added.) The parallel use of terms such as "claimant or plaintiff," "claim or action," and "panel chairman or the court" throughout CJ § 3-2A-04 implies that the General Assembly intended this section to address triggering events that come to light in either fora.
Although many of the earlier cases considering the relevant statutory scheme involved issues that arose out of determinations by the arbitration panel, several recent cases, such as Kearney v. Berger, 416 Md. 628, 634-35, 7 A.3d 593, 596 (2010), Carroll v. Konits, 400 Md. 167, 175-76, 929 A.2d 19, 24 (2007), and Walzer v. Osborne, 395 Md. 563, 569, 911 A.2d 427, 430 (2006), have dealt with issues that occurred after the claim was waived into circuit court. All of these more recent cases involved deficient Certificates and the result of each was dismissal without prejudice. These cases were decided in this manner because the Certificate is an "indispensable" step in the arbitration process such that arbitration cannot occur without the filing of a proper certificate. See Carroll, 400 Md. at 181, 929 A.2d at 28. Because a claim cannot be in circuit court without meeting all of the requirements for arbitration laid out in CJ § 3-2A-04, including filing a Certificate, filing of a proper certificate is a condition precedent to filing an action in circuit court (or federal district court). See id. ("[I]f a proper Certificate has not been filed, the condition precedent to maintain the action has not been met and dismissal is required by the statute once the allotted time has passed."). Therefore, if a proper Certificate has not been filed, the case should not have been in a court in the first place and should be dismissed without prejudice in accordance with the HCMCA.
Furthermore, Dr. Breslin supports his argument that summary judgment is required by noting that CJ § 3-2A-02(d) incorporates the Maryland Rules, which gives the court access to every remedy available under those Rules. See Md. Rule 2-501 (summary judgment). As to the statute providing expressly that the Maryland Rules of Procedure apply to issues arising under the HCMCA, the Senate Judicial Committee Report stated that the intent was "to codify the existing practice regarding the applicability of the Maryland Rules to arbitration proceedings." Committee Report on S.B. 559, at 2 (1986).
The legislative history is minimal with regard to this provision. Prior interpretations of this Court have made clear, however, that Dr. Breslin's statement is not supported by the purpose of the provision. In Newman v. Reilly, 314 Md. 364, 550 A.2d 959 (1988), we first faced interpreting this incorporation by reference provision. The Court found that "[b]ecause § 3-2A-07(a) more particularly expresses the legislative purpose with respect to sanctions than does the general reference to the rules of procedure in § 3-2A-02(c), the conflict must be resolved in favor of the former, more specific statute." Newman, 314 Md. at 379, 550 A.2d at 966. Later, in Curry v. Hillcrest Clinic, Inc., 337 Md. 412, 416, 653 A.2d 934, 936 (1995), we implied that where the statute provides for a specific remedy or action, the Maryland Rules do not apply:
These cases stand for the proposition that where the HCMCA provides for a specific procedure, that procedure prevails over the more general procedures provided by the Maryland Rules.
Carroll states, "if a proper Certificate has not been filed, the condition precedent has not been met and dismissal is required by the Statute once the allotted time period has elapsed," but does not state expressly that dismissal is with or without prejudice. Carroll, 400 Md. at 181, 929 A.2d at 28. Powell explains properly in his brief why the conclusion that dismissal without prejudice is the proper remedy:
This explanation applies equally to the other cases, such as Kearney, where the court failed to distinguish between dismissal with or without prejudice and stated simply that "dismissal is required" pursuant to the HCMCA. See e.g., Kearney, 416 Md. at 653, 7 A.3d at 607.
Powell, 195 Md.App. at 355, 357, 6 A.3d at 368, 370 (citations omitted).
Dr. Breslin looks to Debbas v. Nelson, 389 Md. 364, 885 A.2d 802 (2005) to support his proposition that discovery is not allowed to invalidate an otherwise valid Certificate, and allowing for such would be inconsistent with the plain language of the statute. The facts of Debbas, however, are distinguishable from the present case. The Certificate filed by the plaintiff in Debbas was valid facially and substantively, and later, at a deposition, the defense discovered that the expert attesting to the standard of care in the Certificate did not intend to testify at trial regarding the standard of care of any of the defendants. See Debbas, 389 Md. at 368-69, 885 A.2d at 805-06. This Court held that discovery did not invalidate the Certificate because the revelations arose subsequent to filing of the Certificate. See Debbas, 389 Md. at 371, 885 A.2d at 807. In the present case, however, the invalidating circumstances—that Dr. Burt is an unqualified expert in the field of vascular surgery—existed at the time of filing.
Furthermore, Dr. Breslin's argument ignores two cases distinguished by the Court in Debbas—Witte, and D'Angelo v. St. Agnes Healthcare, Inc., 157 Md.App. 631, 853 A.2d 813 (2004)—both of which are more similar factually to the present case and allowed discovery revelations to invalidate "facially valid" certificates. In Witte, the defendant challenged a Certificate based on deposition testimony that showed the attesting expert did not meet the twenty percent rule. See Witte, 369 Md. at 523, 801 A.2d at 163. In D'Angelo, the plaintiff filed Certificates that did not name individually the defendant physicians but instead stated that "I have concluded that the foregoing medical providers failed to comply with the standards of care and that such failure was the proximate cause of the injuries to Claimant, Vincent D'Angelo." See D'Angelo, 157 Md.App. at 637, 853 A.2d at 817. In both of these cases, a challenge to the Certificate was allowed, pursuant to CJ § 3-2A-04(b)(3)(ii), "because it was based upon a statutory prerequisite for a valid certificate and only examined the circumstances in existence at the time of the Certificate's filing." Debbas, 389 Md. at 384, 885 A.2d at 814. Because the issue in the present case is one regarding the statutory prerequisites of the Certificate and circumstances in existence at the time the Certificate was filed (i.e., that Dr. Burt was an anesthesiologist attesting to the standard of care of a vascular surgeon), Dr. Breslin's arrow falls short of the mark.