Cornelia A. Clark, J., delivered the opinion of the Court, in which Sharon G. Lee, C.J., and Gary R. Wade, Jeffrey S. Bivins, and Holly Kirby, JJ., joined.
We granted review in this health care liability action to decide whether the trial court erred by failing to apply this Court's analysis in Estate of French v. Stratford House, 333 S.W.3d 546 (Tenn. 2011), in determining whether it was necessary for plaintiffs to provide pre-suit notice and a certificate of good faith under the Tennessee Health Care Liability Act ("THCLA"), Tenn. Code Ann. § 29-26-101 et seq. We hold that the Tennessee Civil Justice Act of 2011, which amended the THCLA, statutorily abrogated our decision in Estate of French by providing that "[a]ny such civil action or claim is subject to [the THCLA] regardless of any other claims, causes of action, or theories of liability alleged in the complaint." Because it is undisputed that the plaintiffs in this case failed to provide pre-suit notice or file a certificate of good faith, the judgment of the Court of Appeals is reversed and the judgment of the trial court dismissing the plaintiffs' complaint with prejudice is reinstated.
On July 11, 2013, Adam and Ashley Ellithorpe ("Parents")
Parents are the legal and biological parents of M.L. However, on February 1, 2012, the Juvenile Court of Sumner County, Tennessee, allegedly issued an order ("Juvenile Court's order") giving Ronda and Eugene Melton (collectively "the Meltons") temporary custody of M.L. The Meltons are the paternal great aunt and uncle of M.L. Notably, the Juvenile Court's order is neither attached to Parents' complaint nor included in the record
Parents' complaint alleges that on June 11, 2011, Ms. Weismark completed an intake form, signaling the beginning of Ms. Weismark's counseling with M.L. According to Parents, they were completely unaware that Ms. Weismark had begun counseling M.L. because they were never allowed to participate in the counseling. Ms. Weismark allegedly continued to hold counseling sessions with M.L. without informing Parents until at least April 9, 2013, but Parents believe that M.L. was still in counseling at the time they filed their complaint against Ms. Weismark. Consequently, Parents allege that Ms. Weismark "[was] negligent in providing health services without following the parameters of the court order by notifying [parents] and allowing them to participate in said counsel [sic]."
Parents' complaint further asserts that they first became aware of M.L.'s counseling sessions with Ms. Weismark on April 10, 2013, when the assigned Guardian Ad Litem "let the information slip out." Thereafter, Parents assert that the Guardian Ad Litem "was asked to disclose the name and phone number of the counselor. He reluctantly gave the name of [Ms. Weismark] and her phone number."
Parents further assert that, after they became aware that counseling was occurring, they asked Ms. Weismark to provide them with a copy of M.L.'s treatment records:
According to Parents, Ms. Weismark called back "within [twenty] minutes" and left a message that she had been "advised not to give out the records" but would not respond to further inquiries about who had advised that the records be withheld.
Parents assert that they received Ms. Weismark's treatment records only after this action was initiated and a subpoena was issued by the trial court. Parents contend that Ms. Weismark did not have a copy of the Juvenile Court's order as a part of her records for M.L. and that she neither confirmed Ms. Melton's identity nor verified any court-ordered restrictions on Ms. Melton's authority. However, Parents allege that Ms. Weismark knew that Ms. Melton was not M.L.'s biological parent because she was listed as a "great aunt" on the intake form. According to Parents, Ms. Weismark's actions "demonstrate[] her reckless disregard" for their rights.
Parents also state that Ms. Weismark wrote a letter on January 16, 2013, recommending that they be denied contact with M.L.
Finally, because of this allegedly "secret" counseling, Parents state that M.L. has been "harmed emotionally in not being allowed to counsel" with them and that they too have suffered emotional distress. Parents contend that the counseling is the direct and proximate cause of these injuries. Further, Parents allege
(Capitalization in original.)
On August 15, 2013, Ms. Weismark answered Parents' complaint by denying that Parents were entitled to any relief. She also asserted several affirmative defenses in her answer, including that Parents failed to comply with the pre-suit notice and certificate of good faith requirements of the THCLA. See Tenn. Code Ann. §§ 29-26-121 to -122 (2012 & Supp. 2014).
On November 15, 2013, Ms. Weismark filed a motion to dismiss, also based on Parents' failure to comply with the THCLA's procedural requirements. Parents filed their response to the motion to dismiss on November 27, 2013, arguing that their claims were not subject to the THCLA's procedural requirements because their claims sounded in ordinary negligence.
On February 7, 2014, Parents filed a notice of appeal raising only one issue, which was restated
The Court of Appeals, relying primarily on Estate of French v. Stratford House, held that the trial court had failed to utilize the correct analysis when determining if Parents' claims sounded in ordinary negligence or health care liability. Weismark, 2014 WL 5511773, at *10. The Court of Appeals noted that in Estate of French, this Court "abandoned the broad `gravamen of the complaint' test ... in favor of `a more nuanced approach' in which the trial court must examine the claims individually to determine whether they sound in ordinary negligence or health care liability. Weismark, 2014 WL 5511773, at *9 (quoting Estate of French, 333 S.W.3d at 560). The Court of Appeals further determined that the trial court had not considered the standard outlined in Estate of French and instead "relied on the gravamen of the complaint standard rejected in Estate of French" when dismissing the complaint. Id. at *10. Thus, the Court of Appeals vacated the trial court's order dismissing Parents' claims and remanded for reconsideration of the entire complaint pursuant to the standard articulated in Estate of French." Id.
We granted Ms. Weismark's Tennessee Rule of Appellate Procedure 11 application for permission to appeal.
A motion to dismiss for failure to state a claim is the proper method for challenging whether a plaintiff has complied with the THCLA's pre-suit notice and certificate of good faith requirements. Myers v. AMISUB (SFH), Inc., 382 S.W.3d 300,
A defendant filing a motion to dismiss "admits the truth of all the relevant and material allegations contained in the complaint, but ... asserts that the allegations fail to establish a cause of action." Id. (quoting Webb, 346 S.W.3d at 426 (alteration in original) (internal quotation marks omitted)). The resolution of such a motion is determined by examining the pleadings alone. Id.
In adjudicating such motions, courts "must construe the complaint liberally, presuming all factual allegations to be true and giving the plaintiff the benefit of all reasonable inferences." Id. (citing Webb, 346 S.W.3d at 426; Cullum v. McCool, 432 S.W.3d 829, 832 (Tenn. 2013)). A motion to dismiss should be granted only if it appears that "`the plaintiff can prove no set of facts in support of the claim that would entitle the plaintiff to relief.'" Webb, 346 S.W.3d at 426 (quoting Crews v. Buckman Labs. Int'l, Inc., 78 S.W.3d 852, 857 (Tenn. 2002)). We review a lower court's decision on such a motion de novo without any presumption of correctness. Phillips, 442 S.W.3d at 237 (citing Cullum, 432 S.W.3d at 832).
Ms. Weismark asserts that the Legislature's 2011 amendments to the THCLA precludes application of the "nuanced" approach found in Estate of French and that the Court of Appeals erred by reversing the trial court's dismissal of Parents' complaint and by remanding the case for analysis consistent with Estate of French. Conversely, Parents assert that Estate of French is still good law, and that under the Estate of French analysis, their claims sound in ordinary negligence instead of health care liability. Alternatively, Parents assert that, even if the THCLA is applicable to their claims, dismissal with prejudice is not compulsory. Finally, Parents assert for the first time before this Court a constitutional challenge to the THCLA.
A brief history of the THCLA and its judicial interpretations is beneficial to our analysis. In 2008, Tennessee's Medical Malpractice Act
One year later, in 2009, the Act was again amended to clarify these new requirements. See Act of June 4, 2009, ch. 425, 2009 Tenn. Pub. Acts 472; see generally John A. Day, Med Mal Makeover: 2009 Act Improves on '08, 45 Tenn. B.J. 14 (2009). Tennessee Code Annotated section 29-26-121(a)(1) was amended to require that pre-suit notice only be given to persons or entities named as defendants in the action, see Tenn. Code Ann. § 29-26-121(a)(1) (Supp. 2009), and section 121(a)(2) was amended to specify what information was required to be included in the pre-suit notice. See id. § 29-26121(a)(2). Additionally, Tennessee Code Annotated section 29-26-122 was amended to require the filing of the certificate of good faith with the complaint instead of within ninety days after its filing. See id. § 29-26-122.
While the 2008 and 2009 amendments to the Tennessee Medical Malpractice Act established new procedural requirements for plaintiffs seeking to file medical malpractice actions, these amendments failed to sufficiently define a medical malpractice claim and left Tennessee courts to distinguish between claims sounding in ordinary negligence and those involving medical malpractice. In January 2011, this Court decided Estate of French, which provided a comprehensive and detailed analysis of the interaction between ordinary negligence principles and the Tennessee Medical Malpractice Act, as then enacted.
In Estate of French, the administratrix of the estate of a deceased nursing home resident brought a wrongful death suit against the nursing home alleging claims of ordinary negligence, negligence per se, and violations of the Tennessee Adult Protection Act. 333 S.W.3d at 549. The trial court granted partial summary judgment for the nursing home, holding that the Tennessee Medical Malpractice Act applied to the administratrix's ordinary negligence claims and precluded allegations of negligence per se or violations of the Tennessee Adult Protection Act. Id. at 549-50. The Court of Appeals affirmed, holding that "the gravamen of the case sounds in medical malpractice." Id. at 553 (internal quotation marks omitted). This Court granted the administratrix's application for permission to appeal to address whether the administratrix's claims were "based upon ordinary common law negligence, medical malpractice, or both." Id. at 554.
We explained that, "[b]ecause medical malpractice is a category of negligence, the distinction between medical malpractice and negligence claims is subtle; there is no rigid analytical line separating the two causes of action." Id. at 555 (citations omitted). Thus, the Court resolved that "whether claims should be characterized as ordinary negligence or medical malpractice claims obviously depends heavily on the facts of each individual case." Id. at 556. However, the Court provided the following guidance in distinguishing between ordinary negligence and medical malpractice:
Id. at 555-56 (alteration in original) (citations omitted); see also Draper v. Westerfield, 181 S.W.3d 283, 290 (Tenn. 2005) ("[I]n determining whether an action is for medical malpractice or for common law negligence, the issue is whether the alleged negligent conduct `bears a substantial relationship to the rendition of medical treatment by a medical professional.'" (citing Gunter v. Lab. Corp. of Am., 121 S.W.3d 636, 641 (Tenn. 2003))). The Court ultimately concluded that it is "the responsibility of the courts to ascertain the nature and substance of a claim" and that the "designation given those claims by either the plaintiff or the defendant is not determinative." Estate of French, 333 S.W.3d at 557.
However, roughly four months after this Court's decision in Estate of French, at its next session, the Legislature passed the Tennessee Civil Justice Act of 2011, further amending the Tennessee Medical Malpractice Act. See Tennessee Civil Justice Act of 2011, ch. 510, 2011 Tenn. Pub Acts 1505 (codified at Tenn. Code Ann. 29-26-101 et seq. (Supp. 2011)). Notably, the Tennessee Civil Justice Act of 2011 amended the existing Tennessee Medical Malpractice Act by removing all references to "medical malpractice" from the Tennessee Code and replacing them with "health care liability" or "health care liability action" as applicable. See id. Furthermore, section 29-26-101 was added to the Code which defined "health care liability action" as "any civil action, including claims against the state or a political subdivision thereof, 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, regardless of the theory of liability on which the action is based." Tenn. Code Ann. 29-26-101(a)(1) (Supp. 2011) (emphasis added). This same section went on to provide that "[a]ny such civil action or claim is subject to the provisions of this part regardless of any other claims, causes of action, or theories of liability alleged in the complaint." Id. § 29-26-101(c).
With the foregoing history in mind we turn to the issues raised in this appeal.
It is undisputed that Parents failed to comply with the pre-suit notice and certificate of good faith provisions of Tennessee Code Annotated sections 29-26-121 and 122. See Weismark, 2014 WL 5511773, at *4. Moreover, after a thorough review of the trial court's ruling on Ms. Weismark's motion to dismiss, we agree with the Court of Appeals that [n]othing in the trial court's written order or oral ruling indicates that the trial court considered the standard outlined in Estate of French in dismissing the complaint. Id. at *9. The trial judge relied solely on the plain language of Tennessee Code Annotated sections 29-26-101, -121, and -122 to determine that all causes of action alleged in the complaint were covered by the THCLA. Specifically, the trial court stated that the THCLA is "very broad" and encompasses Parents' claims because they relate to the provision of "health care services" by a "health care provider" as those terms are
When determining the meaning of statutes, our primary goal "is to carry out legislative intent without broadening or restricting the statute beyond its intended scope." Johnson v. Hopkins, 432 S.W.3d 840, 848 (Tenn. 2013) (quoting Lind v. Beaman Dodge, Inc., 356 S.W.3d 889, 895 (Tenn. 2011)). We presume that every word in a statute has meaning and purpose and that each word's meaning should be given full effect as long as doing so does not frustrate the General Assembly's obvious intention. Id. 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.'" Id. (quoting Mills v. Fulmarque, Inc., 360 S.W.3d 362, 368 (Tenn. 2012)). When a statute's meaning is clear, we "`apply the plain meaning without complicating the task' and enforce the statute as written." Id. (quoting Lind, 356 S.W.3d at 895). Finally, we presume that the Legislature knows the law and makes new laws accordingly. Lee Med., Inc. v. Beecher, 312 S.W.3d 515, 527 (Tenn. 2010).
Tennessee Code Annotated section 29-26-101(a)(1) defines 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, regardless of the theory of liability on which the action is based." Furthermore subsection 101(a)(2) defines a health care provider as "[a] health care practitioner licensed, authorized, certified, registered, or regulated under any chapter of title 63 or title 68...." Finally, subsection 101(c) makes "[a]ny such civil action or claim [] subject to this part regardless of any other claims, causes of action, or theories of liability alleged in the complaint."
Giving every word in this section its full effect and plain meaning, we hold that section 29-26-101 establishes a clear legislative intent that all civil actions alleging that a covered health care provider or providers have caused an injury related to the provision of, or failure to provide health care services be subject to the pre-suit notice and certificate of good faith requirements, regardless of any other claims, causes of action, or theories of liability alleged in the complaint. Furthermore, we are mindful of the fact that the Tennessee Civil Justice Act of 2011 was enacted mere months after this Court's decision in Estate of French. Under the canons of statutory construction, we presume that the Legislature was aware of this Court's decision in Estate of French and acted accordingly in passing an act that rendered it effectively moot. We need not engage in further statutory interpretation in the face of this clear legislative edict. Thus, we hold that the "nuanced" approach for distinguishing ordinary negligence and health care liability claims as outlined in Estate of French has been statutorily abrogated.
Applying the clear language of the THCLA to Parents' complaint, we conclude that the allegations contained therein meet the definition of a health care liability action as defined in section 29-26-101(a)(1). Parents' complaint alleges that Ms. Weismark "is a licensed clinical social worker." Social workers are a group licensed and regulated under title 63 of the Tennessee Code. See Tenn. Code Ann. § 63-23-105 (2010 & Supp. 2014). Thus, Ms. Weismark meets the definition of a "health care provider" under section 29-26101(a)(2). Parents recognized Ms. Weismark's status as a health care provider
Additionally, Parents' complaint is rife with allegations relating to Ms. Weismark's provision of health care services to M.L. Paragraph 9 of the complaint alleges that Ms. Weismark "did an intake for counseling for [M.L.]". Paragraphs 17 and 18 allege that Ms. Weismark did not have consent to counsel M.L. Paragraph 25 alleges that M.L. "has been harmed emotionally in not being allowed to counsel with her [p]arents" and that Parents "will seek an independent mental health examination of the child to assess the harm caused by failing to counsel with them towards reunification." Paragraph 26 of the complaint alleges that "the secreted counseling with [M.L.] is the direct and proximate harm and injury to [parents] and [M.L.]." Paragraph 29 alleges that Ms. Weismark "should be keenly aware that providing this secret counseling for the child is a gross deviation from the standard of care." Finally, Paragraph 31 alleges that "[Parents] would show that [Ms.] Weismark is
We next consider Parents' assertion that, even if the THCLA is applicable to their complaint, dismissal with prejudice is not mandatory. Parents rely upon the language of sections 29-26-121 and -122 as support for this argument. Section 29-26-122 requires a certificate of good faith only in health care liability actions "in which expert testimony is required by [section 29-26-115]." Furthermore, under 29-26-122(c), "[t]he failure of a plaintiff to file a certificate of good faith in compliance with this section shall, upon motion, make the action subject to dismissal with prejudice." (Emphasis added.).
However, section 29-26-121 includes no similar provision requiring dismissal with prejudice for failure to provide pre-suit notice. This Court has interpreted the disparity between sections 29-26-121 and -122 as indicative of the Legislature's intent that failure to provide pre-suit notice result only in dismissal without prejudice:
Foster v. Chiles, 467 S.W.3d 911, 916 (Tenn.2015) (internal citations omitted).
Parents argue that because the acts alleged in their complaint do not require expert testimony by a medical professional, dismissal with prejudice under section 29-26-122(c) is not required. At most, Parents say, the dismissal should be without prejudice under section 29-26-121, based on their failure to file pre-suit notice. If the only failing was lack of pre-suit notice then dismissal without prejudice would be the proper remedy. See Foster, 467 S.W.3d at 916. But that is not the only failing.
As stated earlier and reiterated below, Parents have alleged health care liability claims based on allegations that Ms. Weismark deviated from the standard of care. In health care liability actions, such as this one, expert proof is required to establish the recognized standard of acceptable professional practice in the profession, unless the claim falls within the "common knowledge" exception that is not applicable here. See Tenn. Code Ann. § 29-26-115 (2012); Shipley v. Williams, 350 S.W.3d 527, 537 & n. 5 (Tenn. 2011) (discussing the statutory expert proof requirements and citing Seavers v. Methodist Med. Ctr. of Oak Ridge, 9 S.W.3d 86, 92 (Tenn.1999), which discussed the "common knowledge" exception). Parents' attempt to couch their health care liability claims in the guise of a violation of a court order is not convincing.
Parents have also raised a constitutional challenge to the THCLA for the first time in this Court. Parents assert that if this Court interprets the THCLA as abrogating Estate of French, "[t]he Forfeiture provisions of Title 29, Section 26 are unconstitutional in that they restrict the [Parents'] property right in their cause of
"It is axiomatic that parties will not be permitted to raise issues on appeal that they did not first raise in the trial court." Powell v. Cmty. Health Sys., Inc., 312 S.W.3d 496, 511 (Tenn. 2010) (citing Barnes v. Barnes, 193 S.W.3d 495, 501 (Tenn. 2006)). This principle applies equally to constitutional challenges. See 394 (Tenn. 2009) ("Because Father did not properly raise [his constitutional challenge] in the trial court, he has waived his right to argue this issue for the first time on appeal."). Thus, Parents waived their constitutional challenge, and we will not address it in this appeal.
For the reasons stated herein, we hold that Estate of French has been abrogated by statute. We further hold that Parents' complaint is subject to the THCLA, which required them to file pre-suit notice and a certificate of good faith. Accordingly, due to Parents' undisputed failure to meet either requirement, the judgment of the Court of Appeals is reversed, and the judgment of the trial court dismissing Parents' complaint with prejudice is reinstated. Costs of this appeal are taxed to Adam and Ashley Ellithorpe, for which execution, if necessary, may issue.