Medical Injury: Davis v. Frostburg

The Baltimore Medical Malpractice Lawyer Blog delves into the intricate issues that arise in Maryland medical malpractice cases. In this post, I unravel the complexity of determining when a medical injury necessitates filing in HCADRO, the Health Care Alternative Dispute Resolution Office, before transfer to the circuit court for a medical malpractice case. The case under scrutiny is the Court of Appeals of Maryland’s reported opinion in Davis v. Frostburg Facility Operations, LLC, 457 Md. 275 (2018).

Factual Background on Medical Injury in Medical Malpractice

The plaintiffs filed a complaint in the Circuit Court for Allegany County relating to injuries received while at a nursing care facility after back surgery. There were two incidents. The first occurred when the plaintiff fell out of bed while sleeping. Her allegation was that the defendant failed to secure the mattress to the frame. The second instance occurred when the defendants attempted to get the plaintiff from the floor back into the bed. A nurse used a mechanical lift to drop the plaintiff back onto the floor again. (Op. at 2).

The defendant filed a motion to dismiss, arguing that the plaintiffs failed to file their claims first in the HCADRO under CJP 3-2A-04(a)(1)(i). (Id. at 3). The circuit court granted the motion to dismiss. The Court of Special Appeals affirmed, and the plaintiffs appealed to the Court of Appeals. The Court of Appeals, in a significant decision, reversed some and upheld other of the lower courts’ rulings, establishing a precedent for similar cases in the future. (Id. at 5).

Court of Appeals

The plaintiffs argued that their claims were not for medical negligence. (Id.). Maryland’s Health Claims Act has several requirements for a medical malpractice lawsuit. A plaintiff claiming medical malpractice for “medical injury” committed by a “health care provider” seeking more than $30,000 in damages must first file in HCADRO. CJP 3-2A-02(a)(1). A medical injury is an injury “arising or resulting from the rendering or failure to render health care.” CJP 3-2A-01(g).

Prior Cases

The CA discussed prior Maryland cases.

Nichols v. Wilson, 296 Md. 154 (1983): Plaintiff alleged Dr. slapped her during suture removal. It was not a medical injury because it did not involve a professional’s duty to exercise care.

Jewell v. Malamet, 322 Md. 262 (1991): Plaintiff claimed the doctor sexually assaulted her during a medical exam. The doctor claimed it was a legitimate examination. The court required HCADRO filing because it could not rule out the involvement of the professional standard of care for examination.

Goicochea v. Langworthy, 345 Md. 719 (1997): Plaintiff sued for battery for the way a doctor conducted a hernia exam. The plaintiff had to file in HCADRO because the plaintiff failed to show the doctor’s actions had no conceivable medical validity.

Afamefune v. Suburban Hosp., Inc., 385 Md. 677 (2005): A psychiatric patient claimed that negligence resulted in sexual assault by another hospital patient. HCADRO filing is not required because the plaintiff did not allege a breach of professional standard of care, and it did not happen during the rendering of medical care.

Swam v. Upper Chesapeake Med. Ctr, Inc., 397 Md. 528 (2007): A hospital visitor alleged she was stuck by a hypodermic needle when she put her hand on a counter in a waiting room next to an operating room. HCADRO filing is unnecessary because the claim concerns waste disposal, not medical treatment.

The CA summarized: For the HCA to apply, a plaintiff must allege a breach of a professional duty of care while rendering medical care. (Id. at 14).\

Rulings on Medical Injury in Medical Malpractice

The CA first examined each of the counts of the plaintiffs’ complaint. In count one, the plaintiffs alleged negligence. The plaintiff was sleeping and not receiving any medical care when the mattress on her bed detached, and she fell. No healthcare provider was present. An expert witness would not be helpful to explain why the mattress became detached from the bed. HCADRO filing was not necessary. (Id. at 16-18).

Count two alleged that the defendant was negligent in supplying a malfunctioning lift and dropped the plaintiff onto the floor.  The CA concluded that this claim would require a detailed examination of medical procedures. The case would scrutinize the nurse’s operation of the lift. The plaintiff had to file this claim in HCADRO.

Count three for respondeat superior similarly had to be filed in HCADRO first because the same proof that count two required for the employee would be part of the employer’s liability in count three.

The CA allowed the remaining claims of breach of contract, Consumer Protection Act violation, and loss of consortium. Plaintiffs must generally file closely related claims in HCADRO to avoid piecemeal litigation. However, the professional claims were now time-barred, so there would be no piecemeal litigation here. (Id. at 21-22).

Commentary by Baltimore Medical Malpractice Lawyer Mark Kopec on Medical Injury in Medical Malpractice Cases

The Court of Appeals, in my opinion, arrived at the correct conclusion in this case. The ongoing debate over what constitutes a medical injury, necessitating a claim in HCADRO, is a testament to the multiple interpretations of the law. The extensive discussions in the courts over the years provide parties with various aspects to support their desired outcome.

Potential Arguments

The following observations should help determine the medical injury issue when examining these cases. The plaintiff’s choice of claims and characterization of the allegations are not dispositive. In other words, a plaintiff’s decision to pursue intentional torts does not automatically mean it is not a medical injury. In addition, in this case, the plaintiff’s allegation that the lift malfunctioned was not enough to take it out of medical injury. The court recognized that a healthcare provider was operating the machine. As a result, the case could involve assessing whether that healthcare provider complied with a professional standard of care when operating the lift. The ‘professional standard of care’ refers to the level of care and skill that a reasonably competent healthcare professional in the same field would provide under similar circumstances.

Similarly, a plaintiff bringing an action for negligence does not automatically mean that it is a medical injury. In this case, negligence may have resulted in the mattress not being attached to the bed. However, the absence of a professional standard of care involvement led the court to conclude that the plaintiff did not have to file the case in HCADRO.

Focusing on whether the defendant was providing medical care may not lead to consistent results. The defendant may argue that it provided medical care to the plaintiff because the plaintiff was in the hospital or other medical facility. The plaintiff may say that the defendant did not give medical care concerning the specific incident that caused the injury.

Standard

The most reliable way to make the medical injury determination is to examine the plaintiff’s allegations and determine whether the pursuit of the claim or defense of the claim is likely to properly involve a medical expert witness who gives an opinion on a professional standard of care. HCADRO is specifically where plaintiffs have to file claims for medical malpractice for medical injury, along with a certificate of a qualified expert.

For discussion of another case on medical injury, read the Blog post on HCADRO Medical Injury: Waugh v. Dimensions.

Mark Kopec is a top-rated Baltimore medical malpractice lawyer. Contact us at 800-604-0704 to speak directly with Attorney Kopec in a free consultation. The Kopec Law Firm is in Baltimore and helps clients throughout Maryland and Washington, D.C. Thank you for reading the Baltimore Medical Malpractice Lawyer Blog.