In a lawsuit against a Davidson County physician, the Tennessee Supreme Court today upheld the trial court’s pre-trial ruling prohibiting the defendant doctor from using evidence that another physician, who was not in the lawsuit, caused the plaintiff’s injuries, because the defendant doctor did not give the plaintiffs notice that he intended to shift the blame for the injuries to the other doctor. In a split opinion, the Court also held that Tennessee law prohibited the defendant doctor from putting on evidence of the plaintiff’s insurance or related discounts on his medical bills.
In this case, urologist Mark Flora performed surgery on Robert Crotty to treat a kidney stone. After the surgery, Mr. Crotty’s pain got worse, so he returned to the hospital. Dr. Flora’s colleague, urologist Mitchell Wiatrak, performed a second surgery, and noted that Mr. Crotty’s ureter was leaking fluid. Ultimately, it became necessary to remove Mr. Crotty’s kidney. Mr. Crotty and his wife sued Dr. Flora in Davidson County Circuit Court, alleging negligence. Dr. Flora filed an answer in which he denied he was negligent in treating Mr. Crotty, but never said he believed anyone else caused Mr. Crotty’s injuries.
Before the trial, Dr Flora said he intended to put on evidence that Dr. Wiatrak caused Mr. Crotty’s injuries. The plaintiffs asked the trial court to bar Dr. Flora from putting on evidence about Dr. Wiatrak because Dr. Flora never gave the plaintiffs notice he was going to claim that someone else caused the injuries. Dr. Flora argued he should be able to use the evidence because he did not intend to argue that Dr. Wiatrak was negligent or at fault, only that Mr. Crotty’s injury occurred during the surgery by Dr. Wiatrak. The trial court held Dr. Flora could not present evidence at trial that Dr. Wiatrak caused Mr. Crotty’s injuries because court rules required Dr. Flora to disclose that assertion in his answer to the plaintiffs’ complaint.
Dr. Flora also asked the trial court to prevent the Crottys from presenting evidence of the full amount of Mr. Crotty’s medical bills. Because Mr. Crotty had health insurance, Dr. Flora argued, he should be allowed to put on evidence that Mr. Crotty’s medical bills were discounted. The trial court disagreed. It held that Tennessee law allowed the Crottys to put on evidence of their undiscounted medical bills and prohibited Dr. Flora from putting on evidence about the Crottys’s insurance or insurance-related discounts.
The trial court gave Dr. Flora permission to ask the appellate courts to review both rulings before the trial. The Court of Appeals declined the appeal, but the Tennessee Supreme Court granted Dr. Flora permission to appeal.
The Tennessee Supreme Court first affirmed the trial court’s decision to prohibit Dr. Flora from putting on evidence that Dr. Wiatrak caused Mr. Crotty’s injuries. It explained that if a defendant wants to argue that someone else caused the plaintiff’s injuries, Tennessee rules require the defendant to be transparent and give the plaintiff notice and a fair opportunity to bring everyone into the lawsuit who may have contributed to the plaintiff’s injury. Here, Dr. Flora waited to accuse Dr. Wiatrak of causing the injury until it was too late for the Crottys to bring Dr. Wiatrak into the lawsuit as a defendant. The Court held that Dr. Flora’s allegation about Dr. Wiatrak amounted to “blame-shifting” even if he did not accuse Dr. Wiatrak of negligence, so the trial court was correct to bar Dr. Flora from putting on evidence at trial about Dr. Wiatrak.
On the evidence of Mr. Crotty’s medical bills, the Tennessee Supreme Court interpreted a 1975 Tennessee statute on evidence that can be used to prove damages in a health care liability lawsuit. In most personal injury lawsuits, a longstanding Tennessee rule bars the defendant from putting on evidence of the plaintiff’s insurance or related discounts on medical services. The 1975 statute does away with that rule in some circumstances in health care liability cases. But the majority of the Court read the statute as having an exception when the plaintiff has paid for insurance. In other words, if the plaintiff paid for the benefit of insurance, the statute does not do away with the usual rule in personal injury lawsuits, and defendants are still barred from putting on evidence of the plaintiff’s insurance or related discounts on medical bills. For that reason, the majority held that the trial court was correct in prohibiting Dr. Flora from using evidence of Mr. Crotty’s insurance or related discounts on his medical bills.
Justice Roger A. Page wrote a separate opinion concurring in part and dissenting in part. Justice Page concurred with the majority’s holding regarding the trial court’s order prohibiting Dr. Flora from putting on evidence that Dr. Wiatrak caused Mr. Crotty’s injuries. However, he disagreed with the Court’s interpretation of the 1975 statute involving damages in health care liability cases. In his view, the plain meaning of the statutory phrase “actual economic losses suffered” does not permit a plaintiff to recover discounts applied to medical bills that are not paid or payable. He believes that the language of the statute is sufficiently clear to abrogate the collateral source rule in health care liability cases and only permits recovery of the amounts actually paid or payable by Plaintiffs or their insurance rather than the full, undiscounted amounts.
To read the Court’s opinion in Robert Crotty, et al. v. Mark Flora, M.D., authored by Justice Holly Kirby, and the separate opinion authored by Justice Roger A. Page, go to the opinions section of TNCourts.gov.