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When medical malpractice and ordinary negligence are in one case.

IN 2000, MARTHA FRENCH, AGE 54, SUFFERED A DEBILITATING STROKE, HER SECOND, AND WAS ADMITTED TO TOTALCARE AT HIGHLAND MANOR NURSING HOME. She was also afflicted with diabetes, arterial fibrillation, depression, hypertension, and anxiety. She periodically experienced pressure ulcers. After Martha had been at Highland Manor for three years, her daughter, Kimberly French, who was the Administratrix of her mother's estate, arranged for her transfer to Stratford House, a long-term care facility. At the time of her admittance on April 3, 2003, Martha had no pressure ulcers. Because of her immobility, however, she was at significant risk of developing ulcers. The facilities Patient Transfer Form, Resident Assessment Protocol (RAP) Summary, and Care Plan all documented her susceptibility to pressure ulcers, a course of treatment was prescribed in order to prevent a reoccurrence of the condition. According to the plan of care established at the facility, she had to be turned by nursing home personnel and repositioned frequently, kept clean and dry after incontinence, and provided with adequate hydration and nutrition. Her condition deteriorated during her time at Stratford House. By the middle of July 2003, she had both a low-grade fever and low blood pressure and, on July 23, the Administratrix arranged for a transfer to Erlanger Medical Center where physicians attempted to increase he blood pressure by hydrating her intravenously. When she was admitted to Erlanger, she had a urinary tract infection and a number of pressure ulcers that had become infected. She developed pulmonary swelling after her admission, and medical devices were required to assist with her breathing. A feeding tube was inserted. When the Administratrix discovered the gravity of her mother's condition, she instructed the physicians to halt aggressive measures, including breathing assistance and the feeding tube. Martha French died on July 26, 2003. Sepsis was listed as cause of death. On March 22, 2004, the Administratrix filed suit on behalf of the decedent's estate against Stratford House and its parent corporations. She alleged ordinary negligence, negligence per se, and violations of the Tennessee Adult Protection Act (TAPA). The complaint sought both ordinary and punitive damages. The defendants contended that all of the claims sounded in medical malpractice under Tennessee's Medical Malpractice Act TMMA. The defendants filed several motions for partial summary judgment. After a hearing, the trial court concluded that the suit sounded in medical malpractice, classifying the ordinary negligence claims as medical malpractice claims and dismissing the negligence per se and TAPA claims. The Court of Appeals reversed the trial court's grant of summary judgment with regard to punitive damages. An appeal followed.

THE SUPREME COURT OF TENNESSEE HELD THAT BECAUSE THE COMPLAINT INCLUDED CLAIMS THAT THE DEFENDANTS WERE NEGLIGENT AS TO BOTH THE MEDICAL TREATMENT AND THE ORDINARY CARE THEY PROVIDED, THE TRIAL COURT ERRED BY GRANTING THE MOTION FOR PARTIAL SUMMARY JUDGMENT ON GROUNDS THAT THE GRAVAMEN OF THE COMPLAINT SOUNDED IN MEDICAL MALPRACTICE. The court held that the Administratrix may pursue recovery under a negligence per se theory and the TAPA for her claims based upon ordinary negligence. The court affirmed the Court of Appeals on the punitive damages issue. The case was remanded to the trial court for proceedings consistent with the court's opinion. The costs of the appeal were taxed one-half to the Administratrix and one-half to the defendants.

BECAUSE MEDICAL MALPRACTICE IS ACATEGORY OF NEGLIGENCE, THE DISTINCTION BETWEEN MEDICAL MALPRACTICE AND NEGLIGENCE CLAIMS IS SUBTLE: THERE IS NO RIGID ANALYTICAL LINE SEPARATING THE TWO CAUSES OF ACTION. The court cited a case, which involved laboratory paternity testing in which the court stated, inter alia, that "the distinguishing feature between ordinary negligence and medical malpractice cases is whether 'a plaintiff's claim is for injuries resulting from negligent medical treatment." The court observed that it had embraced the standard adopted by New York courts for distinguishing an ordinary negligence claim from one based upon medical malpractice. Simply put, the New York courts hold that when a claim alleges negligent conduct, which constitutes or bears a substantial relationship to the rendition of medical treatment by a medical professional, the medical malpractice statute is applicable. Conversely, when the conduct alleged is not substantially related to the rendition of medical treatment by a medical profession, the medical malpractice statute does not apply. Thus, the court concluded that because the complaint included claims that the defendants were negligent as to both the medical treatment and the ordinary care provided the decedent, the trial court erred by granting the defendants' motion for partial summary judgment on the grounds that the gravamen of the suit sounded in medical malpractice. Moreover, the Administratrix could pursue recovery under a negligence per se theory and the TAPA for her claims based on ordinary negligence. A dissenting opinion was filed by one judge who dissented in part. Estate of French v. Stratford House, E2008-00539 (1/26/2011) - TN
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Publication:Medical Law's Regan Report
Date:Jan 1, 2011
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