Felisha Brown v. Karen L. Samples ( 2014 )


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  •                   IN THE COURT OF APPEALS OF TENNESSEE
    AT KNOXVILLE
    February 3, 2014 Session
    FELISHA BROWN ET AL. v. KAREN L. SAMPLES ET AL.
    Interlocutory Appeal from the Claims Commission
    of the State of Tennessee, Eastern Division
    No. T20120921       William O. Shults, Commissioner
    No. E2013-00799-COA-R9-CV-FILED-APRIL 29, 2014
    This is a medical malpractice1 action brought against the State of Tennessee and others. The
    issue as to the appealing State is whether the plaintiffs complied with the pre-suit notice
    requirements of Tenn. Code Ann. § 29-26-121 (2012 & Supp. 2013). The State argues that
    the plaintiffs were required to send the pre-suit notice applicable to their claim against the
    State to either (1) the Attorney General of Tennessee or an Assistant Attorney General, or
    (2) the Division of Claims Administration of the State. The Tennessee Claims Commission
    denied the State’s motion to dismiss, finding (1) no statutory authority requiring that pre-suit
    notice as to the State be served upon one of the parties alluded to by the State, and (2) that
    the State received adequate pre-suit notice in this case. We affirm and hold that the plaintiffs
    complied with Section 121’s pre-suit notice requirements by providing notice to the
    University of Tennessee Graduate School of Medicine, a health care provider, which entity
    is a division of an agency of the State of Tennessee and also a named defendant in this case.
    Tenn. R. App. P. 9 Interlocutory Appeal by Permission; Judgment of the Claims
    Commission Affirmed; Case Remanded
    C HARLES D. S USANO, J R., C.J., delivered the opinion of the Court, in which D. M ICHAEL
    S WINEY and T HOMAS R. F RIERSON, II, JJ., joined.
    Joshua R. Walker, Knoxville, Tennessee, for the appellant, State of Tennessee.
    1
    The legislature amended Tenn. Code Ann. § 29-26-121 to replace the term “medical malpractice”
    with “health care liability” effective April 23, 2012. See Act of April 23, 2012, ch. 798, 2012 Tenn. Pub.
    Acts. The complaint at issue here – in the form of a notice of claim filed with the Division of Claims
    Administration pursuant to Tenn. Code Ann. § 9-8-307 and -402 – was filed Feb. 9, 2012. In this opinion,
    we will refer to the statute as it existed on the date the complaint was filed.
    Robert E. Pryor, Jr., Knoxville, Tennessee, for the appellees, Felisha Brown and Donald
    Brown, individually and as parents and next of kin of Silas Brown, deceased.
    OPINION
    I.
    On October 13, 2010, plaintiff Felisha Brown went into labor at the University of
    Tennessee Medical Center (“UTMC”). According to the complaint, plaintiffs’ infant son
    Silas Brown died during or shortly after delivery as a result of the medical negligence of the
    defendants. On April 25, 2011, plaintiffs, seeking to comply with Tenn. Code Ann. § 29-26-
    121, provided pre-suit notice to the following defendants: (1) Dr. Karen Samples, who,
    according to the complaint, “practiced at [UTMC] as a medical resident and/or as a fellow
    practicing obstetrics and gynecology under the auspices of the University of Tennessee
    Graduate School of Medicine and University Health System, Inc.”; (2) the University of
    Tennessee Graduate School of Medicine; (3) UTMC; (4) Dr. Nirmala Upadhyaya, allegedly
    employed by University Obstetrics and Gynecology, who monitored and supervised the labor
    and also the medical resident, Dr. Samples; (5) University Obstetrics and Gynecology; and
    (6) University Health System dba University of Tennessee Medical Center. On July 19,
    2011, plaintiffs sent a second set of pre-suit notices to the above defendants, and also to Dr.
    Mark Hennessy and High Risk Obstetrical Consultants, LLC.
    On February 9, 2012, plaintiffs filed a notice of claim with the Division of Claims
    Administration pursuant to Tenn. Code Ann. § 9-8-307 and -402 (2012), in the form of a
    complaint that complied with Tennessee Rules of Civil Procedure 8 and 10 (“the
    complaint”). Named as defendants were Dr. Samples, a State employee; the UT Graduate
    School of Medicine, a division of an agency of the State; and the State of Tennessee.2
    Plaintiffs filed, with the complaint, a certificate of good faith as required by Tenn. Code Ann.
    § 29-26-122 (2012 & Supp. 2013). The complaint was filed one year and 119 days after the
    alleged malpractice. Plaintiffs relied upon the 120-day extension of the one-year statute of
    limitation provided by Tenn. Code Ann. § 29-26-121(c) for a plaintiff who provides pre-suit
    notice under the statutory scheme set forth in Section 121.3
    2
    Plaintiffs also filed a medical malpractice complaint in the Circuit Court for Knox County against
    Dr. Upadhyaya, University Obstetrics and Gynecology, Dr. Samples, University Health System dba UTMC,
    Dr. Hennessy, and High Risk Obstetrical Consultants, LLC. Attached to this complaint was a certificate of
    good faith as required by Tenn. Code Ann. § 29-26-122.
    3
    Tenn. Code Ann. § 29-26-121(c) provides that “[w]hen notice is given to a provider as provided in
    this section, the applicable statutes of limitations and repose shall be extended for a period of one hundred
    twenty (120) days from the date of expiration of the statute of limitations and statute of repose applicable
    to that provider.”
    -2-
    On May 9, 2012, plaintiffs’ claim was transferred from the Division of Claims
    Administration to the Tennessee Claims Commission, pursuant to Tenn. Code Ann. § 9-8-
    402(c).4 On July 12, 2012, the State filed a motion to dismiss on the ground that plaintiffs
    had not provided pre-suit notice to the State as required by Section 121, and that plaintiffs
    were therefore not entitled to the 120-day extension of the statute of limitation and thus their
    action was time-barred. The Claims Commission denied the motion, holding that plaintiffs
    complied with Section 121’s pre-suit notice requirements, and, in the alternative, that
    extraordinary cause existed to excuse the plaintiffs’ failure to comply with the requirements
    of the statute if there was any such failure. See Tenn. Code Ann. § 29-26-121(b) (“The court
    has discretion to excuse compliance with this section only for extraordinary cause shown.”).
    The State filed a motion for an interlocutory appeal pursuant to Tenn. R. App. P. 9, which
    the Commission granted. Subsequently, we granted the State’s timely filed application with
    us.
    II.
    The sole issue on this appeal is whether the Claims Commission correctly held that
    plaintiffs complied with the pre-suit notice requirements of Tenn. Code Ann. § 29-26-121
    as it pertains to plaintiffs’ claim against the State of Tennessee.
    III.
    There are no disputed facts relative to this appeal. “The trial court’s denial of
    [d]efendants’ motions to dismiss involves a question of law, and, therefore, our review is de
    novo with no presumption of correctness.” Stevens ex rel. Stevens v. Hickman Cmty.
    Health Care Servs., Inc., No. M2012-00582-SC-SO9-CV, 
    2013 WL 6158000
    at *2 (Tenn.,
    filed Nov. 25, 2013) (citing Graham v. Caples, 
    325 S.W.3d 578
    , 581 (Tenn. 2010)). In
    Stevens, the Supreme Court, construing Tenn. Code Ann. § 29-26-121, observed the
    following general principles:
    [W]e must interpret the meaning of various provisions of Tenn.
    Code Ann. § 29-26-121. Statutory interpretation is a question
    of law, which we review de novo. Pratcher v. Methodist
    Healthcare Memphis Hospitals, 
    407 S.W.3d 727
    , 734 (Tenn.
    2013). When interpreting a statute, our role is to ascertain and
    4
    Tenn. Code Ann. § 9-8-402(c) provides that “[t]he division of claims administration shall investigate
    every claim and shall make every effort to honor or deny each claim within ninety (90) days of receipt of the
    notice. . . . If the division fails to honor or deny the claim within the ninety-day settlement period, the
    division shall automatically transfer the claim to the administrative clerk of the claims commission.”
    -3-
    effectuate the legislature’s intent. Sullivan ex rel. Hightower v.
    Edwards Oil Co., 
    141 S.W.3d 544
    , 547 (Tenn. 2004). We must
    not broaden or restrict a statute’s intended meaning. Garrison
    v. Bickford, 
    377 S.W.3d 659
    , 663 (Tenn. 2012) (quoting U.S.
    Bank, N A. v. Tenn. Farmers Mut. Ins. Co., 
    277 S.W.3d 381
    ,
    386 (Tenn. 2009)). We also presume that the legislature
    intended to give each word of the statute its full effect. In re
    Estate of Trigg, 
    368 S.W.3d 483
    , 490 (Tenn. 2012). When
    statutory language is unambiguous, we accord the language its
    plain meaning and ordinary usage. Glassman, Edwards, Wyatt,
    Tuttle & Cox, P.C. v. Wade, 
    404 S.W.3d 464
    , 467 (Tenn. 2013).
    Where the statutory language is ambiguous, however, we
    consider the overall statutory scheme, the legislative history, and
    other sources. Mills v. Fulmarque, Inc., 
    360 S.W.3d 362
    , 368
    (Tenn. 2012); Colonial Pipeline Co. v. Morgan, 
    263 S.W.3d 827
    , 836 (Tenn. 2008).
    
    2013 WL 6158000
    at *2.
    IV.
    The statute formerly known as the Medical Malpractice Act, and currently called the
    Health Care Liability Act, contains a number of procedural requirements that a plaintiff must
    satisfy to bring an action against a health care provider. Among these “hurdles” is the pre-
    suit notice requirements of Tenn. Code Ann. § 29-26-121(a), which statute provides, in
    pertinent part, as follows:
    (a)(1) Any person . . . asserting a potential claim for health care
    liability shall give written notice of the potential claim to each
    health care provider that will be a named defendant at least
    sixty (60) days before the filing of a complaint based upon
    health care liability in any court of this state.
    (2) The notice shall include:
    (A) The full name and date of birth of the patient whose
    treatment is at issue;
    (B) The name and address of the claimant authorizing the notice
    and the relationship to the patient, if the notice is not sent by the
    patient;
    -4-
    (C) The name and address of the attorney sending the notice, if
    applicable;
    (D) A list of the name and address of all providers being sent a
    notice; and
    (E) A HIPAA compliant medical authorization permitting the
    provider receiving the notice to obtain complete medical records
    from each other provider being sent a notice.
    (3) The requirement of service of written notice prior to suit is
    deemed satisfied if, within the statutes of limitations and statutes
    of repose applicable to the provider, one of the following occurs,
    as established by the specified proof of service, which shall be
    filed with the complaint:
    (A) Personal delivery of the notice to the health care
    provider . . . ; or
    (B) Mailing of the notice:
    (i) To an individual health care provider at both the address
    listed for the provider on the Tennessee department of health
    web site and the provider’s current business address, if different
    from the address maintained by the Tennessee department of
    health; . . . or
    (ii) To a health care provider that is a corporation or other
    business entity at both the address for the agent for service of
    process, and the provider’s current business address, if different
    from that of the agent for service of process; provided, that, if
    the mailings are returned undelivered from both addresses, then,
    within five (5) business days after receipt of the second
    undelivered letter, the notice shall be mailed in the specified
    manner to the provider’s office or business address at the
    location where the provider last provided a medical service to
    the patient.
    (4) Compliance with subdivision (a)(3)(B) shall be demonstrated
    by filing a certificate of mailing from the United States postal
    service stamped with the date of mailing and an affidavit of the
    party mailing the notice establishing that the specified notice
    -5-
    was timely mailed by certified mail, return receipt requested. A
    copy of the notice sent shall be attached to the affidavit. . . .
    (b) If a complaint is filed in any court alleging a claim for health
    care liability, the pleadings shall state whether each party has
    complied with subsection (a) and shall provide the
    documentation specified in subdivision (a)(2). The court may
    require additional evidence of compliance to determine if the
    provisions of this section have been met. The court has
    discretion to excuse compliance with this section only for
    extraordinary cause shown.
    (Emphasis added.) Regarding the eight named non-State defendants, all of whom received
    pre-suit notice, plaintiffs fully complied with all of the pre-suit notice requirements of
    Section 121.5 The State’s argument that plaintiffs’ cause of action as to it must be dismissed
    with prejudice rests solely on its assertion that plaintiffs failed to provide effective pre-suit
    notice to the State. As previously noted, the State argues that plaintiffs must provide pre-suit
    notice to (1) either the Attorney General of Tennessee or an Assistant Attorney General, or
    (2) the Division of Claims Administration. Plaintiffs did not send pre-suit notice to any of
    these individuals/entity.
    In a thorough 30-page order denying the State’s motion, the Commission disagreed
    with the State’s position. The Commission held, in pertinent part, as follows:
    [I]t is clear that on April 25, 2011, notice was sent personally to
    the resident, Dr. Samples, to University Health System, Inc., a
    separate entity which now operates UTMC, as well as UTMC
    itself, to the University of Tennessee Graduate School of
    Medicine, . . . and to Dr. Upadhyaya who now contends, in a
    related Knox County Circuit Court action, that in December
    2010 she too was a State employee and not a private practitioner
    ...
    *        *         *
    Nevertheless, the State argues that even though all of these
    individuals or entities received pre-suit notice at least 60 days
    5
    Plaintiffs also complied with Tenn. Code Ann. § 29-26-122 by filing a certificate of good faith with
    their complaint.
    -6-
    before a Claim for Damages was filed with the Division, the
    requirements of Tenn. Code Ann. § 29-26-121 were not
    complied with. The State asserts that the notice should have
    been sent to . . . the Office of the Attorney General and Reporter
    and/or the Department of Treasury’s Division of Claims
    Administration. The State reasons that these overwhelming
    efforts by [plaintiffs] to advise the State that a medical
    malpractice action was being seriously contemplated – because
    of the actions of a young doctor which allegedly contributed to
    the death of a newborn baby – were inadequate and failed to
    gain [plaintiffs] the additional 120 days for filing suit authorized
    by Tenn. Code Ann. § 29-26-121(c).
    *       *         *
    We believe the State’s position fails to properly acknowledge
    the overwhelming evidence that the State had more than
    adequate pre-suit notice that this claim was going to be filed and
    that consequently [plaintiffs’] case was filed within the statute
    of limitations.
    *       *         *
    [I]t seems more then disingenuous for the State to argue in this
    case that the pre-suit notice was defective when in fact it was
    received by Dr. Samples, the resident physician and a state
    employee; Dr. Howard[,] the chief of the Obstetrics and
    Gynecology Department at UTMC, also an employee of the
    state; by Drs. Upadhyaya and Hennessy, who for we believe are
    obvious reasons are now claiming in the Circuit Court that they
    were also employees of the state on October 13, 2010; by Mr.
    Keeting, the Risk Officer for UHS, whose offices are housed in
    the same building as those of the Graduate School of Medicine;
    by the UTMC and finally, by the University of Tennessee
    Graduate School of Medicine[.]
    *       *         *
    The efforts of [plaintiffs’] counsel here have not obfuscated the
    purposes behind either the Medical Malpractice Act or the
    -7-
    Tennessee Claims Commission Act. The “essence” of Tenn.
    Code Ann. § 29-26-121 is not to authorize dismissal of a claim
    such as this because, as the State argues, service of pre-suit
    notice should have been made on the Attorney General (or one
    of his assistants) or the Division. The State has identified no
    statutory or administrative regulation identifying either of those
    offices as the required recipient of pre-suit notice at the time this
    claim was instituted.
    *      *         *
    [I]t is clear to this Commission that with regard to the Medical
    Malpractice Act alone, there were serious unresolved procedural
    issues in the area of medical malpractice cases filed against
    governmental entities which motivated the Legislature in its
    2011 Session to proclaim clearly for the first time in Tenn. Code
    Ann. § 29-26-102(c) that indeed the 2008 and 2009 amendments
    to the Act did apply in cases brought against such entities –
    including the State – because of the alleged actions of State-
    employed medical providers and institutions. Governor Haslam
    signed that legislation into law on June 16, 2011, but it is
    effective only for causes of action accruing on or after October
    1, of that year. That same legislation, in Tenn. Code Ann. § 29-
    26-101(2), also made it clear that medical resident physicians,
    such as Dr. Samples, are healthcare providers under the
    definitional provisions of the Medical Malpractice Act and thus
    entitled to receive [pre-suit notice].
    These [plaintiffs] in April and July 2011 were in the difficult
    situation of not knowing exactly when and what they were
    required to do under the Medical Malpractice and Claims
    Commission Acts, read in tandem, in a case where their cause of
    action accrued on October 13, 2010, well before the clarifying
    legislation which went into effect on October 1, 2011.
    *      *         *
    Finally, nowhere in either the Tennessee Claims Commission
    Act or the Medical Malpractice Act, or any implementing
    legislation, was a potential claimant informed that the proper
    -8-
    method of giving pre-suit notice under Tenn. Code Ann. § 29-
    26-121 was either to serve the Attorney General and/or the
    Division. The State now advises that it will not raise defenses
    such as the one now before the Commission if pre-suit notice is
    sent to either or both of those offices. However, any claimant
    seeking to find such a directive in April or July 2011 would have
    been unsuccessful since it simply did not exist.
    *      *         *
    In closing, we feel confident in finding that the General
    Assembly never intended that the amendments to the Medical
    Malpractice Act would completely strip away the rights of
    Tennessee citizens, who might have legitimate medical
    malpractice claims, because of some minor and hyper-technical
    error in initiating such a claim. Surely, that is not the intent of
    our elected representatives.
    *      *         *
    In light of the reasons discussed above, we find categorically
    that the [plaintiffs] have complied not only with the legislative
    intent behind Tenn. Code Ann. § 29-26-121 but also with its
    specific requirements, and that the Defendant State was
    afforded, through numerous avenues, more than adequate notice
    that this claim might be filed. The State has suffered no
    prejudice whatsoever under either the Claims Commission Act
    or the Medical Malpractice Act in the manner in which pre-suit
    notice was given and accordingly, this is a perfect example of
    why, in situations such as this, the General Assembly did not
    mandate, as it did with the failure to meet the Certificate of
    Good Faith requirement, dismissal of the claim.
    (Emphasis added; bold font in original.)
    The applicable subsection of Section 121 in this case provides that notice must be
    given “[t]o a health care provider that is a corporation or other business entity at both the
    address for the agent for service of process, and the provider’s current business address, if
    different from that of the agent for service of process.” Tenn. Code Ann. § 29-26-
    121(a)(3)(B)(ii). As already stated, the State argues that its agent for service of process for
    -9-
    the purpose of the pre-suit notice requirements in a medical malpractice case is the Attorney
    General or an Assistant Attorney General. The sole authority cited by the State for this
    proposition is Tenn. R. Civ. P. 4.04(6), which provides as follows:
    The plaintiff shall furnish the person making the service with
    such copies of the summons and complaint as are necessary.
    Service shall be made as follows:
    *       *          *
    (6) Upon the state of Tennessee or any agency thereof, by
    delivering a copy of the summons and of the complaint to the
    attorney general of the state or to any assistant attorney general.
    (Emphasis added). As is readily seen, however, Rule 4.04, by its own clear terms, applies
    to the service of a summons and complaint in a lawsuit. It does not address the concept of
    pre-suit notice in a medical malpractice action. Moreover, the Claims Commission Rules,
    Tenn. Comp. R. & Regs. 0310-01-01-.01, provide as follows:
    Proceedings before the Tennessee Claims Commission shall be
    conducted pursuant to the Tennessee Rules of Civil Procedure
    (TRCP) and subsequent amendments and interpretations where
    applicable except where specifically modified by these rules.
    Modifications are:
    *       *          *
    (2) TRCP Rule 3 is not followed. The following language is
    substituted in its place:
    COMMENCING A CLAIM AND PROCEDURE 6
    Claims before the Commission are commenced in the manner
    described in T.C.A. §§ 9-8-301 et seq. and 401 et seq. especially
    402.
    (a) TAX CLAIMS – COMMENCED
    6
    It is not disputed that plaintiffs followed the procedures required by the Tennessee Claims
    Commission Act for commencing an action in the Division of Claims Administration.
    -10-
    Claims for taxes paid under protest are commenced by filing an
    original complaint and two copies with the Clerk of the
    Tennessee Claims Commission.
    (b) ALL OTHER CLAIMS – COMMENCED
    All other actions are commenced by filing a written notice of
    claim (see T.C.A. § 9-8-402 for requirements) with the Division
    of Claims Administration.
    (c) FROM THE DIVISION OF CLAIMS ADMINISTRATION
    TO THE CLAIMS COMMISSION:
    A claim proceeds from the Division of Claims Administration
    to the Claims Commission after the time periods set out in
    T.C.A. § 9-8-402(c) by either transfer from the Division of
    Claims Administration (no action required by claimant) or by
    filing with the Claims Commission (claimant is required to act)
    within the time limit set out in T.C.A. § 9-8-402(c).
    *      *          *
    (3) TRCP Rule 4 - Committee Comment: The rule on summons
    is retained for use by the state when bringing in third parties,
    and the like. The summons is not used by original claimants.
    (Footnote and emphasis added; capitalization in original.) Tenn. R. Civ. P. 3, which “is not
    followed” in actions filed with the Division of Claims Administration pursuant to the above
    regulation, provides that “[a]ll civil actions are commenced by filing a complaint with the
    clerk of the court.” The State further argues that Tenn. Comp. R. & Regs., ch. 0310-01-01-
    .01 establishes an “alternate” agent for service of process of pre-suit notice, i.e., that a
    claimant may also satisfy the requirements of Tenn. Code Ann. § 29-26-121(a)(3)(B)(ii) to
    mail notice to the agent for service of process by sending pre-suit notice to the Division of
    Claims Administration. There is nothing in the language of the regulation that says this, or
    that discusses the concept of pre-suit notice in a medical malpractice action, or that
    establishes an agent for the State to accept service of process.
    Similarly, there is no provision in the Medical Malpractice (currently Health Care
    Liability) Act that addresses the issue of who is the proper agent for service of process upon
    the State for providing pre-suit notice of a medical malpractice action. The Commission
    correctly held that, at the time plaintiffs’ cause of action accrued, the applicable statutory
    scheme contained no requirement that pre-suit notice be provided to the Attorney General
    -11-
    or an Assistant Attorney General, or the Division of Claims Administration. The Act does
    require pre-suit notice “[t]o a health care provider that is a corporation or other business
    entity at both the address for the agent for service of process, and the provider’s current
    business address, if different from that of the agent for service of process.” Tenn. Code Ann.
    § 29-26-121(a)(3)(B)(ii) (emphasis added). At the time plaintiffs’ action accrued, “health
    care provider” was not defined.7 Plaintiffs mailed pre-suit notice to the University of
    Tennessee Graduate School of Medicine, which, according to the State’s brief, is a division
    of an agency of the State of Tennessee.
    In Hinkle v. Kindred Hospital, No. M2010-02499-COA-R3-CV, 
    2012 WL 3799215
    at *6 (Tenn. Ct. App. M.S., filed Aug. 31, 2012) (perm. app. denied, Dec. 10, 2013), this
    Court recently addressed an argument similar to the State’s assertion here, i.e., that pre-suit
    notice was defective because of a failure to mail it to a defendant’s agent for service of
    process. Rejecting this argument, we stated:
    7
    The General Assembly subsequently amended the Medical Malpractice Act in 2011 to provide as
    follows:
    (1) “Health care liability action” means 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;
    (2) “Health care provider” means:
    (A) A health care practitioner licensed, authorized, certified, registered, or
    regulated under any chapter of title 63 or title 68, including, but not limited
    to, medical resident physicians, interns, and fellows participating in a
    training program of one of the accredited medical schools or of one of such
    medical school’s affiliated teaching hospitals in Tennessee;
    (E) . . . or any legal entity that is not itself required to be licensed but which
    employs one or more health care practitioners licensed, authorized,
    certified, registered, or regulated under any chapter of title 63 or title 68.
    See Act of May 20, 2011, ch. 510, § 8, 2011 Tenn. Pub. Acts. 510, 1506 (codified as amended at Tenn. Code
    Ann. § 29-26-101(a) (2012)) (emphasis added). The 2011 amendment became effective on October 1, 2011.
    The Supreme Court has observed that “the 2011 amendment does not apply retroactively[.]” Cunningham
    v. Williamson Cnty. Hosp. Dist., 
    405 S.W.3d 41
    , 45 n.2 (Tenn. 2013).
    -12-
    As another example of Ms. Hinkle’s failure to strictly comply
    with each provision of the notice statute, the hospital points out
    that the notice (the November 5, 2009 letter) was addressed to
    the administrator of the defendant hospital at the hospital’s
    business address, but not to its agent for service of process, as
    is required by Tenn. Code Ann. § 29–26–121(a)(3)(B)(ii).
    *      *          *
    In this case, the November 5 letter was sent to the hospital,
    which is the business address where Mr. Hinkle received the
    medical care that is the subject of the lawsuit. No objection was
    made to any alleged failure of service on the agent for service of
    process, and it is clear there was no confusion as to which entity
    was the anticipated defendant in any future lawsuit. The hospital
    received actual notice. It seems to us that the technical
    requirements in the statute are intended to provide just that:
    notice of the claim. Any arguments regarding the method of
    giving notice would be relevant where the defendant asserts no
    notice was received. They are not, however, where there is no
    dispute that the defendant received actual notice.
    Accordingly, we conclude that Ms. Hinkle complied with the
    notice requirements of the statute as to the defendant hospital.
    Id., 
    2012 WL 3799215
    at *6-7; see also Haley v. State, No. E2012-02484-COA-R3-CV,
    
    2013 WL 5431998
    at *1, *11 (Tenn. Ct. App. E.S., filed Sept. 25, 2013) (holding that
    “plaintiff complied with section 121(a)’s notice requirement by complying with the claim
    notice requirements of Tennessee Code Annotated section 9-8-402” and observing that “[t]he
    statute does not preclude proof [of pre-suit notice] by other means. The State had actual
    notice of the lawsuit months before the complaint was filed in the Claims Commission.”).
    Here, the Commission held that “the State had more than adequate pre-suit notice that
    this claim was going to be filed.” We agree. Plaintiffs fully complied with Section 121’s
    pre-suit notice requirements by mailing sufficient notice to the UT Graduate School of
    Medicine, an agent of the State and, arguably a “health care provider” under the statute. This
    holding comports with the interests of justice and avoids a harsh and unfair result. Tennessee
    courts have long recognized that the interests of justice are promoted by providing injured
    persons an opportunity to have their lawsuits heard and evaluated on the merits. The
    Supreme Court observed in 1937 that “[w]e have stated repeatedly that it is the policy of this
    -13-
    court to have controversies between litigants determined upon their merits.” Fiske v. Grider,
    
    106 S.W.2d 553
    , 555 (Tenn. 1937); see also 
    Henry, 104 S.W.3d at 481
    (“in the interests of
    justice, courts express a clear preference for a trial on the merits”); Henley v. Cobb, 
    916 S.W.2d 915
    , 916 (Tenn. 1996) (“It is well settled that Tennessee law strongly favors the
    resolution of all disputes on their merits”); Childress v. Bennett, 
    816 S.W.2d 314
    , 316 (Tenn.
    1991) (“it is the general rule that courts are reluctant to give effect to rules of procedure
    which seem harsh and unfair, and which prevent a litigant from having a claim adjudicated
    upon its merits”); Tenn. Dep’t of Human Servs. v. Barbee, 
    689 S.W.2d 863
    , 866 (Tenn.
    1985) (“the interests of justice are best served by a trial on the merits”); Stevens, 
    2013 WL 6158000
    at *8 (quoting and reaffirming general rule stated in Childress). As fully discussed
    herein, nothing in the Medical Malpractice Act or the Claims Commission Act requires the
    dismissal of plaintiffs’ case before its merits can be evaluated and before the State has even
    filed an answer.
    The State relies upon Shockley v. Mental Health Cooperative, Inc., No. M2013-
    00494-COA-R3-CV, 
    2013 WL 5947764
    (Tenn. Ct. App. W.S., filed Nov. 4, 2013). In
    Shockley, the Western Section of this Court affirmed the dismissal of the plaintiffs’
    complaint for failure to comply with the pre-suit notice requirements where the plaintiffs sent
    pre-suit notice to “the Mental Health Cooperative Foundation, Inc.” instead of the correct
    defendant, “the Mental Health Cooperative, Inc.” 
    Id. at *2.
    The Shockley Court stated that
    “[h]ere, it is undisputed that the Foundation was neither a health care provider, nor was the
    Foundation a proper defendant to this lawsuit.” 
    Id. at *6.
    We concluded, “[w]hile we
    recognize that this holding produces a harsh result, we are constrained by the plain language
    of the Tennessee Medical Malpractice Act to affirm the trial court’s dismissal of this action.”
    
    Id. at *11.
    We are not so constrained in this case, however, for Shockley is distinguishable
    and inapposite. Here, the UT Graduate School of Medicine is a health care provider, a
    proper defendant, and an agent of the State. Moreover, the State received pre-suit notice in
    a timely manner in this case. Consequently, plaintiffs were entitled to the 120-day extension
    of the statute of limitations pursuant to Tenn. Code Ann. § 29-26-121(c), and their complaint
    was timely filed.
    The Claims Commission ruled, in the alternative, that plaintiffs demonstrated
    extraordinary cause to excuse any failure to comply with Section 121. The Commission
    opined as follows:
    [W]ith regard to the Medical Malpractice Act, . . . there were
    serious unresolved procedural issues in the area of medical
    malpractice cases filed against governmental entities[.]
    *      *          *
    -14-
    [N]owhere in either the Tennessee Claims Commission Act or
    the Medical Malpractice Act, or any implementing regulation,
    was a potential claimant informed that the proper method of
    giving pre-suit notice under Tenn. Code Ann. § 29-26-121 was
    either to serve the Attorney General or the Division. . . . [A]ny
    claimant seeking to find such a directive in April or July 2011
    would have been unsuccessful since it simply did not exist.
    This unsettled, uncharted, and evolving state of the law at the
    time the Browns were required to initiate this very serious
    medical malpractice action constitutes the sort of extraordinary
    cause provided for under Tenn. Code Ann. § 29-26-121(c)
    which warrants excusing any relatively minor technical flaws –
    if there were any – in the manner in which this litigation was
    commenced before the Claims Commission.
    As the Commission correctly discerned, the state of the law on the question of how
    to serve Section 121 pre-suit notice on the State was unsettled, unclear, and potentially
    confusing. As the Commission further noted, there was no statutory or regulatory guidance
    on this issue at the time plaintiffs were required to provide pre-suit notice. We agree with
    and affirm the Commission’s ruling that plaintiffs demonstrated extraordinary cause. We do
    so as an alternative holding to our primary decree that plaintiffs fully complied with Section
    121.
    V.
    The judgment of the Tennessee Claims Commission is affirmed. Costs on appeal are
    assessed to the appellant, the State of Tennessee. This case is remanded to the Claims
    Commission, pursuant to applicable law, for further proceedings.
    _____________________________________
    CHARLES D. SUSANO, JR., CHIEF JUDGE
    -15-