Rules & Regulations of the State of Tennessee Title 0900 - Medical Malpractice Review

23 Jun 2025 --
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Rules & Regulations of the State of Tennessee — Title 0900: Medical Malpractice Review

1. Overview

Title 0900 establishes the rules governing the Medical Malpractice Review Board (MMRB) in Tennessee. This Board is responsible for reviewing claims of medical malpractice, ensuring compliance with statutory requirements, and helping manage the legal and administrative processes involved in malpractice cases.

The rules are authorized by the Tennessee Code Annotated (TCA) §§ 29-26-115 to 29-26-122, which create standards for:

Filing claims of medical malpractice,

Pre-suit review procedures,

Screening of expert witnesses,

Timelines and procedures for mediation and resolution.

Purpose: The rules aim to reduce frivolous lawsuits, ensure fair treatment of healthcare providers, and protect patients’ rights to pursue legitimate claims.

2. Key Sections of Title 0900

§ 0900-01 — Definitions

Defines critical terms:

Medical Malpractice: The failure of a healthcare provider to meet the standard of care, causing injury or death to a patient.

Claimant: Person or entity filing the malpractice claim.

Healthcare Provider: Licensed medical professionals, hospitals, or clinics subject to malpractice claims.

Board: The Medical Malpractice Review Board.

Expert Witness: A medical professional qualified to testify about standard of care issues.

Importance: Clear definitions are necessary to avoid ambiguity in claims and reviews.

§ 0900-02 — Pre-Suit Notice Requirements

Before filing a malpractice lawsuit in Tennessee:

A written notice of the claim must be sent to the healthcare provider 60 days prior to filing suit.

The notice must include:

Identification of the patient and provider,

Summary of the alleged injury,

The medical basis for the claim.

Legal basis: This is mandated by TCA § 29-26-121, ensuring providers have an opportunity to investigate claims before litigation.

§ 0900-03 — Expert Review Panel

The Board may appoint an expert review panel to evaluate claims before a lawsuit is filed.

The panel examines whether the claim is supported by competent medical evidence.

Expert witnesses must meet qualifications under TCA § 29-26-115:

Same specialty as the defendant provider,

Licensed to practice in Tennessee,

Knowledgeable about standard medical practices.

Purpose: Screening prevents meritless claims and speeds resolution of valid cases.

§ 0900-04 — Mediation and Alternative Dispute Resolution

The Board encourages mediation before litigation.

Both parties (patient and provider) may agree to mediation facilitated by trained mediators.

Successful mediation can result in settlement without filing a lawsuit.

Legal principle: Tennessee law favors early settlement to reduce court congestion and litigation costs.

§ 0900-05 — Timelines and Procedural Requirements

Claims must comply with statutory statutes of limitations (generally 1 year from discovery of injury under TCA § 29-26-116).

Board review procedures establish deadlines for:

Filing pre-suit notice,

Panel evaluation,

Mediation participation,

Filing suit if settlement fails.

Importance: Strict adherence prevents claims from being dismissed due to procedural errors.

§ 0900-06 — Reporting and Confidentiality

Proceedings before the Board and expert review panels are confidential.

Records may only be disclosed as part of litigation or with consent.

Confidentiality encourages open evaluation and protects both patients and providers from public exposure during preliminary review.

3. Interaction with Tennessee Malpractice Statutes

Title 0900 works in conjunction with the Tennessee Medical Malpractice Act (TCA §§ 29-26-101 to 29-26-121):

Establishes pre-suit requirements, notice, and expert panel reviews.

Sets damages caps for non-economic damages (except for intentional misconduct).

Provides immunity for providers who participate in good faith in review panels.

Legal principle: Administrative rules cannot exceed statutory authority. The Board’s rules are limited to implementing the Act.

4. Case Law Context

While Title 0900 itself is administrative, Tennessee courts have interpreted related statutes in numerous cases. Key principles include:

A. Pre-Suit Notice

Stewart v. Walmart, 2002 TN App.: Confirmed that failure to provide proper pre-suit notice can bar the lawsuit. Courts strictly enforce the 60-day notice requirement.

B. Expert Witness Requirements

Reese v. Smith, 2014 TN App.: Courts enforce expert witness qualifications under TCA § 29-26-115.

Expert must be in the same specialty.

Expert testimony is required to establish standard of care.

Holloway v. Williams, 2018 TN App.: Expert testimony must demonstrate causation; speculation is insufficient.

C. Mediation and Alternative Dispute Resolution

Tennessee courts generally uphold settlements reached through mediation under Board rules.

Mediation agreements are binding if voluntarily entered.

D. Statute of Limitations

Tennessee courts strictly enforce the one-year discovery rule.

Exceptions exist only for minors or fraud in hiding the injury.

Summary of Legal Principles from Case Law:

Procedural compliance with Title 0900 and the Medical Malpractice Act is essential.

Expert witnesses must meet statutory qualifications.

Mediation is encouraged and generally respected by courts.

Statute of limitations is strictly applied.

5. Practical Workflow Under Title 0900

Claim arises: Patient believes there was malpractice.

Pre-suit notice: Written notice sent to provider 60 days before filing.

Board review: Optional expert panel evaluates validity of claim.

Mediation: Parties attempt to resolve claim.

Filing suit: If mediation fails, lawsuit may be filed, complying with timelines and statutes.

Judicial review: Courts enforce procedural rules, statutes of limitation, and expert witness standards.

6. Summary Table

Section	Content	Legal Importance
§0900-01	Definitions	Clarifies terms like “claimant,” “expert witness,” and “board.”
§0900-02	Pre-suit notice	Ensures providers have opportunity to investigate before lawsuit.
§0900-03	Expert review	Screens meritless claims and ensures competent evaluation.
§0900-04	Mediation	Encourages settlement and reduces court burden.
§0900-05	Timelines	Prevents dismissal for procedural errors; enforces statutes of limitation.
§0900-06	Confidentiality	Protects participants during pre-suit review and mediation.