Susan Todd/State v. Weakley Co. ( 1998 )


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  •                          IN THE COURT OF APPEALS OF TENNESSEE
    AT JACKSON
    SUSAN K. TODD,                    )
    )
    Plaintiff,             ) Trial Court No. 2718
    and                               )
    ) Appeal No. 02A01-9708-CV-00197
    STATE OF TENNESSEE,               )
    )
    Intervening Plaintiff/ )
    Appellant,             )
    )
    FILED
    VS.                               )
    )          July 16, 1998
    WEAKLEY COUNTY d/b/a WEAKLEY )
    COUNTY NURSING HOME,              )        Cecil Crowson, Jr.
    Appe llate Court C lerk
    )
    Defendant,             )
    and                               )
    )
    NINA SNYDER, Individually,        )
    DAVID BRADLEY, Individually,      )
    SHIRLEY INSCO, Individually, and  )
    SHARON JENNINGS, Individually,    )
    )
    Defendants/Appellees.  )
    APPEAL FROM THE CIRCUIT COURT OF WEAKLEY COUNTY
    AT DRESDEN, TENNESSEE
    THE HONORABLE WILLIAM B. ACREE, JUDGE
    JOHN KNOX WALKUP
    Attorney General & Reporter
    MICHAEL E. MOORE
    Solicitor General
    MARY BYRD FERRARA
    Assistant Attorney General
    Nashville, Tennessee
    Attorneys for Appellant State of Tennessee
    THOMAS H. RAINEY
    ANGELA C. YOUNGBERG
    RAINEY, KIZER, BUTLER, REVIERE & BELL, P.L.C.
    Attorneys for Defendants/Appellees
    AFFIRMED IN PART, REVERSED IN PART
    AND REMANDED
    ALAN E. HIGHERS, J.
    CONCUR:
    W. FRANK CRAWFORD, P.J., W.S.
    HOLLY KIRBY LILLARD, J.
    The State of Tennessee, as the intervenor in this medical malpractice action brought
    by Plaintiff Susan K. Todd, appeals the trial court’s order which granted the motion to
    dismiss filed by Defendants Nina Snyder, David Bradley, Shirley Insco, and Sharon
    Jennings. In granting the Defendants’ motion to dismiss, the trial court ruled that certain
    provisions of the Tennessee Governmental Tort Liability Act relating to health care
    practitioners were unconstitutional in that they were vague, they violated equal protection
    principles, and they violated the Defendants’ right to a jury trial. Contrary to the trial court’s
    ruling, we conclude that the challenged statutory provisions withstand constitutional
    scrutiny and, thus, we reverse that portion of the trial court’s judgment eliding the
    provisions.
    I. Factual and Procedural History
    In September 1995, Plaintiff Susan K. Todd filed this medical malpractice action
    against the individual Defendants and against Weakley County, d/b/a Weakley County
    Nursing Home, pursuant to the Tennessee Governmental Tort Liability Act (GTLA). Todd,
    a resident of the Weakley County Nursing Home, alleged that she was injured in May 1995
    when two nurse’s aides, Defendants Shirley Insco and Sharon Jennings, negligently
    dropped Todd as they attempted to move her from her wheelchair to her bed. The
    complaint further alleged that Defendant Nina Snyder, the Nursing Home’s administrator,
    and Defendant David Bradley, the licensed practical nurse who was the charge nurse at
    the time of Todd’s injury, negligently failed to provide and maintain adequate care and
    supervision of Todd. Todd’s complaint sought $750,000 in damages for her injuries.
    The individual Defendants responded by filing a motion to dismiss in which they
    asserted, inter alia, that they were immune from suit under the GTLA because they were
    employees of a governmental entity. The Defendants further contended that they were not
    subject to suit under the exception for “health care practitioners” found in section
    29-20-310 of the GTLA because the Defendants were not “health care practitioners.” See
    T.C.A. §§ 29-20-310(b), (c) (Supp. 1994). The Defendants later moved for summary
    2
    judgment, apparently on the same grounds asserted in their motion to dismiss. The trial
    court denied the Defendants’ motion for summary judgment, however, finding that the
    record contained insufficient evidence to determine whether the individual Defendants met
    the definition of “health care practitioner.”
    After Todd was permitted to amend her complaint, the Defendants filed an answer
    and another motion to dismiss. This time, in support of their motion to dismiss, the
    Defendants contended that the GTLA’s exception for health care practitioners was
    unconstitutional because, inter alia, the exception was impermissibly vague and it violated
    the guaranty of equal protection and the right to a trial by jury. The State of Tennessee,
    through the Office of the Attorney General, then filed a motion requesting leave to
    intervene in this action for the sole purpose of defending the constitutionality of section
    29-20-310 of the GTLA. The trial court granted the State’s motion to intervene.
    After considering the arguments of the Defendants and the State, the trial court
    entered an order granting the individual Defendants’ motion to dismiss and ruling that the
    challenged portions of section 29-20-310 were unconstitutional. The trial court later
    entered an order directing the entry of a final judgment as to the individual Defendants
    pursuant to Tennessee Rule of Civil Procedure 54.02. This appeal by the State followed.
    II. The Challenged Provisions of the GTLA
    As pertinent, section 29-20-310 of the GTLA contains the following provisions:
    (b)    No claim may be brought against an employee or
    judgment entered against an employee for damages for which
    the immunity of the governmental entity is removed by this
    chapter unless the claim is one for medical malpractice brought
    against a health care practitioner. No claim for medical
    malpractice may be brought against a health care practitioner
    or judgment entered against a health care practitioner for
    damages for which the governmental entity is liable under this
    chapter, unless the amount of damages sought or judgment
    entered exceeds the minimum limits set out in § 29-20-403 or
    the amount of insurance coverage actually carried by the
    governmental entity, whichever is greater, and the
    3
    governmental entity is also made a party defendant to the
    action.
    (c)   No claim may be brought against an employee or
    judgment entered against an employee for injury proximately
    caused by an act or omission of the employee within the scope
    of the employee’s employment for which the governmental
    entity is immune in any amount in excess of the amounts
    established for governmental entities in § 29-20-403, unless
    the act or omission was willful, malicious, criminal, or
    performed for personal financial gain, or unless the act or
    omission was one of medical malpractice committed by a
    health care practitioner and the claim is brought against such
    health care practitioner.
    T.C.A. §§ 29-20-310(b), (c) (Supp. 1994). In essence, the challenged provisions of the
    GTLA remove the immunity of certain governmental employees in the event that (1) the
    governmental employee is a health care practitioner against whom a medical malpractice
    action has been brought, and (2) the amount of damages sought or judgment entered
    exceeds the GTLA’s minimum limits set out in section 29-20-403.                   See T.C.A.
    § 29-20-403(b)(2)(A) (for actions arising on or after July 1, 1987, minimum limits of “not
    less than one hundred thirty thousand dollars ($130,000) for bodily injury or death of any
    one (1) person in any one (1) accident, occurrence or act”). Although the GTLA creates
    this exception from immunity for health care practitioners, the GTLA does not specifically
    define the term “health care practitioner.”
    III. The Trial Court’s Ruling
    In granting the Defendants’ motion to dismiss, the trial court sustained three of the
    Defendants’ constitutional attacks on section 29-20-310's provisions relative to health care
    practitioners. The trial court first ruled that the challenged statutory provisions violated the
    constitutional guaranty of equal protection, reasoning that the court could not “conceive of
    any rational basis for classifying health care practitioners differently than other
    governmental employees or for classifying them with those who act willfully, maliciously,
    criminally, or for personal financial gain.” The trial court also ruled that the challenged
    statutory provisions were unconstitutionally vague because the legislature did not define
    the term “health care practitioner” and, thus, the determination of “whether or not a nursing
    4
    home administrator, a licensed practical nurse and two nurse’s aids are health care
    practitioners . . . would require conjecture as to the meaning of the term health care
    practitioner.”   Finally, the trial court ruled that the provisions violated the Defendants’
    constitutional right to a jury trial because, when read in conjunction with other provisions
    of the GTLA, the challenged provisions did not entitle the Defendants to a jury trial. To
    effectuate its ruling, the trial court applied the doctrine of elision and elided section
    29-20-310's provisions relating to health care practitioners.
    IV. The Defendants’ Vagueness Challenge
    In light of the GTLA’s failure to define the term “health care practitioner,” we first
    address the trial court’s ruling that the challenged provisions are unconstitutionally vague.
    When a party attacks a statute on constitutional grounds, such as vagueness, the trial
    court and this court are required to indulge every presumption in favor of the statute’s
    validity and to resolve any doubt in favor of, rather than against, the constitutionality of the
    statute. Dorrier v. Dark, 
    537 S.W.2d 888
    , 891 (Tenn. 1976); Estrin v. Moss, 
    430 S.W.2d 345
    , 351 (Tenn. 1968), appeal dismissed, 
    393 U.S. 318
     (1969). Despite this presumption
    of validity, however, the courts must declare a statute void for vagueness if persons “of
    common intelligence must necessarily guess at its meaning and differ as to its application.”
    Williams v. Department of Health & Env’t, 
    880 S.W.2d 955
    , 959 (Tenn. App. 1994) (quoting
    Leech v. American Booksellers Ass’n, 
    582 S.W.2d 738
    , 746 (Tenn. 1979)).
    In the present case, the trial court ruled that the challenged provisions of the GTLA
    were void for vagueness because the legislature failed to define the term “health care
    practitioner” and, thus, persons of common intelligence must necessarily guess at the
    term’s meaning and differ as to the statute’s application. We respectfully disagree with the
    trial court’s ruling on this issue. The legislature’s failure to define a specific statutory term
    is not fatal to a statute which has been challenged on vagueness grounds. Paty v.
    McDaniel, 
    547 S.W.2d 897
    , 908 (Tenn. 1977), rev’d on other grounds, 
    435 U.S. 618
    (1978); Dorrier v. Dark, 
    537 S.W.2d 888
    , 893 (Tenn. 1976); Arutanoff v. Metropolitan Gov’t,
    5
    
    448 S.W.2d 408
    , 412 (Tenn. 1969). When the legislature fails to define a statutory term,
    the undefined term must be given its usual and ordinary meaning. Woods Lumber Co. v.
    MacFarland, 
    355 S.W.2d 448
    , 451 (Tenn. 1962); Brookside Mills, Inc. v. Atkins, 
    322 S.W.2d 217
    , 218 (Tenn. 1959); Carbide & Carbon Chems. Corp. v. Carson, 
    239 S.W.2d 27
    , 37 (Tenn. 1951), aff’d, 
    342 U.S. 232
     (1952); Southern Coal Co. v. McCanless, 
    192 S.W.2d 1003
    , 1005 (Tenn. 1946).
    Black’s Law Dictionary defines “practitioner” as one “who is engaged in the exercise
    or employment of any art or profession.” Black’s Law Dictionary 1172 (6th Ed. 1990).
    Another source defines “practitioner” as “one who practices a profession.” Webster’s Ninth
    New Collegiate Dictionary 923 (1990). These sources, in turn, define “profession” as a
    “vocation or occupation requiring special, usually advanced, education, knowledge, and
    skill” and “a calling requiring specialized knowledge and often long and intensive academic
    preparation.” Black’s Law Dictionary 1210 (6th Ed. 1990); Webster’s Ninth New Collegiate
    Dictionary 939 (1990).
    In Tennessee, the practice of the healing arts is governed and regulated by Title 63
    of the Tennessee Code Annotated. T.C.A. §§ 63-1-102(2), 63-1-115, 63-1-119 (1997).
    Although they do not specifically define the term “health care practitioner,” Title 63 and
    other Code provisions generally use the terms “health care practitioner,” “health
    practitioner,” “practitioner of a health care discipline,” and “practitioner of the healing arts”
    to refer to persons who practice one of the professions of the healing arts licensed and
    regulated under Title 63. See, e.g., T.C.A. § 36-3-621 (Supp. 1997) (referring to “[a]ny
    health care practitioner licensed or certified under title 63"); T.C.A. § 63-1-116 (1997)
    (authorizing the boards of the respective branches of the healing arts to regulate
    advertising by “practitioners of such healing arts who are under the jurisdiction of such
    boards”), T.C.A. § 63-1-120(6) (1997) (referring to “practitioners of such healing arts”);
    T.C.A. § 63-1-122 (1997) (referring to “practitioners of the various branches of the healing
    arts”), T.C.A. § 63-1-136(a) (1997) (referring to “health practitioners”), T.C.A. § 63-6-703(1)
    (1997) (defining “health care provider” as, inter alia, any “other practitioner of a health care
    6
    discipline, the professional practice of which requires licensure or certification under the
    provisions of [Title 63]”); see also Richardson v. Board of Dentistry, 
    913 S.W.2d 446
    , 449
    (Tenn. 1995) (noting that T.C.A. § 63-1-134 authorizes health related boards to assess civil
    penalties against “unlicensed practitioners in health related professions”); Spunt v.
    Fowinkle, 
    572 S.W.2d 259
    , 262 (Tenn. App. 1978) (noting that, under T.C.A. § 63-122
    (now § 63-1-122), the Licensing Board of Healing Arts has jurisdiction of all “licensed
    practitioners of the healing arts in Tennessee”).
    In light of these authorities, we hold that the term “health care practitioner” is not
    unconstitutionally vague and that the trial court erred in so ruling. In accordance with the
    usual and ordinary meaning of the term “health care practitioner,” and in accordance with
    the legislature’s use of this term in the Code, we conclude that the term “health care
    practitioner” means one who is engaged in the exercise or employment of a health care
    vocation or occupation which requires advanced or specialized education, knowledge, and
    skill, and which requires licensure or certification under the provisions of Title 63. This
    definition includes, but is not limited to, physicians, physician assistants, pharmacists,
    psychologists, physical therapists, and registered nurses.       See T.C.A. §§ 63-6-201,
    63-6-207, 63-6-209, 63-7-105, 63-9-104, 63-10-506, 63-11-208, 63-13-301 to -303,
    63-19-105, 63-19-202 (1997). As pertinent to this appeal, this definition also includes
    licensed practical nurses and nursing home administrators, but it does not include nurse’s
    aides. See T.C.A. §§ 63-7-110, 63-16-104 to -108 (1997).
    Defendants David Bradley and Nina Snyder are included in this definition of “health
    care practitioner” because both are engaged in the exercise or employment of an
    advanced or specialized health care vocation or occupation, the practice of which requires
    licensure or certification under the provisions of Title 63. Defendant David Bradley is a
    licensed practical nurse (LPN). See T.C.A. § 63-7-110 (1997) (governing the licensure of
    practical nurses). In order to become licensed as an LPN, Bradley attended nursing school
    at Dresden Vocational Technical School, completed a practical experience requirement,
    and passed a written examination. Defendant Nina Snyder is the licensed nursing home
    7
    administrator who was in charge of all operations at the Weakley County Nursing Home,
    including health care operations, at the time of Todd’s injury. See T.C.A. §§ 63-16-104 to
    -108 (1997) (governing the licensure of nursing home administrators). In order to obtain
    her license, Snyder worked for a period of time with another licensed nursing home
    administrator, took a correspondence course through George Washington University, and
    passed a state-administered examination. To maintain her license, Snyder must fulfill
    minimum continuing education requirements each year.
    In contrast, we conclude that Defendants Shirley Insco and Sharon Jennings do not
    qualify as “health care practitioners.” Title 63 of the Code regulates the “[p]ractice of
    professional nursing” and, thus, governs the licensure of registered nurses and licensed
    practical nurses, as well as the certification of nurse practitioners; however, Title 63 does
    not provide for the licensure or certification of nurse’s aides. T.C.A. §§ 63-7-103(a)(1),
    63-7-105, 63-7-110, 63-7-123 (1997). In general, nurse’s aides are workers who assist
    “trained nurses in a hospital by performing unspecialized services,” such as “making beds
    or giving baths.” Merriam-Webster’s Medical Desk Dictionary 485 (1993). Specifically, in
    the nursing home setting, nurse’s aides, also known as nursing assistants, are persons
    who are trained to assist licensed nurses (both registered nurses (RN’s) and LPN’s) by
    performing “functions which can safely, efficiently and lawfully be done by unlicensed
    personnel.”   Tenn. Comp. R. & Regs. 1200-8-6-.04(1)(b) (revised Aug. 1997).              By
    definition, therefore, nurse’s aides are not health care practitioners because they are not
    licensed to practice professional nursing pursuant to Title 63 and because their job is to
    perform unspecialized services for which a licensed practitioner is not needed. See also
    Tenn. Op. Att’y Gen. 96-112 (opining that certified nursing assistants employed by local
    school board could not provide health care procedures under T.C.A. § 49-5-415(b)
    because statute required such procedures to be performed by “appropriately licensed
    health care professionals”).
    In concluding that nurse’s aides are not health care practitioners, we have
    considered the requirement that all nurse’s aides who work in Tennessee nursing homes
    8
    must be “certified” by the Board for Licensing Health Care Facilities.           See T.C.A.
    §§ 68-11-209(e)(1), 68-11-803(c)(22) (1996 & Supp. 1997); Tenn. Comp. R. & Regs.
    1200-8-6-.04(1)(h), (2)(e) (revised May 1995). A nursing home may not employ an
    individual as a nurse’s aide unless the individual has satisfactorily completed a seventy-five
    hour training and testing program approved by the Board. T.C.A. §§ 68-11-209(e)(1),
    68-11-803(c)(22) (1996 & Supp. 1997); Tenn. Comp. R. & Regs. 1200-8-6-.04(2)(e)
    (revised May 1995). We note, however, that this certification requirement is imposed on
    the nursing home itself and does not appear to be an attempt to regulate any recognized
    “profession” of “nurse’s aides.” See T.C.A. §§ 68-11-209(e)(1), 68-11-803(c)(22) (1996 &
    Supp. 1997). This observation is buttressed by the fact that the same certification
    requirement does not apply to nurse’s aides who work in the hospital setting, as opposed
    to the nursing home setting.       Although a hospital is authorized to employ “[o]ther
    personnel,” such as nurse’s aides, “to assist the licensed personnel in patient care
    activities,” the rules and regulations apparently impose no minimum requirements for the
    hospital’s training of such personnel. Tenn. Comp. R. & Regs. 1200-8-3-.03(3)(c), (f)
    (revised Aug. 1997).
    In sum, we conclude that nurse’s aides are not engaged in the exercise of the
    profession of nursing and that they are not health care practitioners as that term is used
    in the Code. Inasmuch as Insco and Jennings are not health care practitioners, we further
    hold that they can have no individual liability under the provisions of Tennessee Code
    Annotated section 29-20-310 and that the trial court properly dismissed Todd’s complaint
    as to these two Defendants.
    V. The Defendants’ Equal Protection Challenge
    As for the two remaining Defendants, the trial court also ruled that section 29-20-310
    was unconstitutional on equal protection grounds. Both the United States Constitution and
    the Tennessee Constitution guarantee to citizens the equal protection of the laws.
    Brown v. Campbell County Bd. of Educ., 
    915 S.W.2d 407
    , 412 (Tenn. 1995) (citing U.S.
    9
    Const. amend. XIV; Tenn. Const. art. I, § 8, art. XI, § 8), cert. denied, 
    517 U.S. 1222
    (1996). The concept of equal protection guarantees that all persons similarly situated shall
    be treated alike. Doe v. Norris, 
    751 S.W.2d 834
    , 841 (Tenn. 1988) (citing F.S. Royster
    Guano Co. v. Virginia, 
    253 U.S. 412
    , 415 (1920)). Conversely, the guaranty of equal
    protection does not require things which are different in fact or opinion to be treated the
    same. Doe v. Norris, 751 S.W.2d at 841.
    The “drawing of lines that create distinctions is peculiarly a legislative task and an
    unavoidable one,” and “[p]erfection in making the necessary classifications is neither
    possible nor necessary.” Harrison v. Schrader, 
    569 S.W.2d 822
    , 825 (Tenn. 1978)
    (quoting Massachusetts Bd. of Retirement v. Murgia, 
    427 U.S. 307
    , 314 (1976)). As our
    supreme court has stated, “‘[t]he initial discretion to determine what is ‘different’ and what
    is ‘the same’ resides in the legislatures of the States,’ and legislatures are given
    considerable latitude in determining what groups are different and what groups are the
    same.” Doe v. Norris, 751 S.W.2d at 841 (quoting Plyler v. Doe, 
    457 U.S. 202
    , 216
    (1982)). Accordingly, statutes which create classifications are presumed valid, and they
    will be upheld if “some reasonable basis can be found for the classification, or if any state
    of facts may reasonably be conceived to justify it.” Harrison v. Schrader, 569 S.W.2d at
    825.
    Our supreme court has summarized the test to be applied as follows:
    The test to be applied has been set forth in numerous
    cases. The classification must rest upon a reasonable basis.
    If it has a reasonable basis, it is not unconstitutional merely
    because it results in some inequality. Reasonableness
    depends upon the facts of the case and no general rule can be
    formulated for its determination. . . .
    The burden of showing that a classification is
    unreasonable and arbitrary is placed upon the individual
    challenging the statute; and if any state of facts can reasonably
    be conceived to justify the classification or if the
    reasonableness of the class is fairly debatable, the statute
    must be upheld. . . .
    Before the classification will be held to violate the equal
    protection guaranty, it must be shown that it has no reasonable
    or natural relation to the legislative objective. . . . In addition,
    10
    the statute must apply alike to all who fall within, or can
    reasonably be brought within the classification.
    Harrison v. Schrader, 569 S.W.2d at 825-26 (citations omitted).
    Applying the foregoing standard, we cannot say that no reasonable or rational basis
    exists for the legislature’s distinction between medical malpractice actions against health
    care practitioners and actions against other governmental employees under the GTLA.
    The “[c]lassification of businesses and occupations and callings . . . and other things of the
    kind which deal with the public may be classified by ordinance whenever the partial
    application or discrimination in the classification is based on real and reasonable
    distinctions existing and affects all persons of the same class or pursuing the same
    conditions under the same circumstances.” Hughes v. Board of Comm’rs, 
    319 S.W.2d 481
    , 485 (Tenn. 1958). Our supreme court previously has upheld a statute which, for
    limitation of actions purposes, treats “health care providers” differently than other tort
    defendants by imposing a three-year statute of repose, or “cap,” on medical malpractice
    actions. Harrison v. Schrader, 
    569 S.W.2d 822
    , 825-27 (Tenn. 1978) (upholding the
    constitutionality of T.C.A. § 23-3415 (now § 29-26-116)). In Harrison v. Schrader, the
    supreme court noted the legislature’s concern with the rising costs of medical malpractice
    insurance and the potential effects of this increase on the cost and availability of health
    care. Id. at 826-27. In upholding the validity of the challenged classification, the court held
    that the classification was reasonably related to the legislature’s “objective of reducing and
    stabilizing insurance and health costs and protecting the public as a whole.” Id. at 827.
    We similarly uphold the validity of the classification of “health care practitioners”
    under the GTLA. Although some of the policy considerations behind the distinction made
    in the GTLA are different from those present in imposing a statute of repose for medical
    malpractice actions, both classifications may be justified by the legislative objective of
    protecting the public health. As recognized in Harrison v. Schrader, the legislature has an
    interest in ensuring the availability of quality health care to the citizens of this state.
    Harrison v. Schrader, 569 S.W.2d at 826. One method of achieving this legislative
    11
    objective is to hold the health care practitioner who also happens to be a governmental
    employee to the same standard of care as health care practitioners who are employed in
    the private sector. By exposing governmental health care practitioners to personal liability
    for any recovery in excess of the GTLA limits, the legislature has created an added
    incentive for such practitioners to conform with the standard of care applicable to their
    professions. Inasmuch as a reasonable justification exists for the classification or, at the
    very least, the reasonableness of the class is fairly debatable, we must uphold the
    challenged statute. Accordingly, we reverse that portion of the trial court’s judgment
    invalidating the challenged statutory provisions on equal protection grounds.
    VI. The Defendants’ Right to Jury Trial Challenge
    We also reverse that portion of the trial court’s judgment which invalidated the
    challenged statutory provisions on the ground that they violated the individual Defendants’
    right to a jury trial. The circuit courts have jurisdiction over actions brought under the
    GTLA, and they are required to hear and decide such actions “without the intervention of
    a jury, except as otherwise provided in § 29-20-313(b).” T.C.A. § 29-20-307 (Supp. 1994).
    Section 29-20-313, in turn, contains the following provisions:
    (a)    When one (1) or more defendants to a lawsuit
    claims to be an employee of a governmental entity as defined
    by § 29-20-107 and is therefore entitled to the governmental
    immunity granted by this chapter, it shall be a question of fact
    whether the defendant claiming immunity is such an employee.
    If the trier of fact determines that the defendant claiming
    immunity is not a governmental entity employee, the lawsuit as
    to that defendant shall proceed like any other civil case. If the
    trier of fact determines that the defendant claiming immunity is
    a governmental entity employee, the lawsuit as to that
    defendant shall proceed in accordance with the provisions of
    this chapter.
    (b)     When suit is brought in circuit court in a case in
    which there are multiple defendants, one (1) or more of which
    is a governmental entity or a governmental entity employee
    whose liability or lack thereof is to be determined based upon
    the provisions of this chapter and one (1) or more of which is
    not such governmental entity or governmental entity employee,
    the case shall be heard and decided by a jury upon the
    demand of any party. Nothing in this section shall be
    construed to abridge the right of any party to a trial by jury
    12
    otherwise granted by the state or federal constitution or any
    statute.
    T.C.A. § 29-20-313 (Supp. 1994).
    The trial court ruled that the provisions of section 29-20-310 relating to health care
    practitioners are unconstitutional because, under sections 29-20-307 and 29-20-313 of the
    GTLA, health care practitioners who are employees of a governmental entity are not
    entitled to a jury trial. Section 29-20-313(a) provides that if the defendant is a governmental
    employee, the lawsuit as to that defendant shall proceed in accordance with the provisions
    of the GTLA, i.e. by the circuit court without the intervention of a jury. T.C.A. §§ 29-20-307,
    29-20-313(a) (Supp. 1994). Nevertheless, we believe that the trial court’s ruling is
    erroneous for two reasons.
    In the first place, even if section 29-20-313 is construed as denying these
    Defendants the right to a jury trial, we fail to see why the challenged provisions of section
    29-20-310 (as opposed to section 29-20-313) should be declared unconstitutional. Section
    29-20-310 does not deprive the Defendants of the right to a jury trial; it merely removes the
    immunity of health care practitioners for any damages sought or judgments entered in
    excess of the GTLA’s minimum limits. T.C.A. §§ 29-20-310(b), (c) (Supp. 1994). Rather
    than striking the challenged provisions of section 29-20-310 on the ground that they
    unconstitutionally deny the Defendants the right to a jury trial, we think that the more
    appropriate judicial approach would be merely to hold that section 29-20-313(a), as applied
    to these Defendants, impermissibly infringes on their right to a jury trial. In that case, the
    proper remedy would be to uphold section 29-20-310's provisions relative to health care
    practitioners but to grant such defendants a jury trial upon a timely demand therefor. 1 See,
    e.g., B.J.Y. v. M.A., 
    617 So. 2d 1061
    , 1064 (Fla. 1993) (invalidating portion of statute which
    denied putative father right to jury trial in paternity proceeding, but expressly upholding
    remainder of paternity statute).
    1
    In this regard, the State appears to concede that these individual Defendants do have a constitutional
    right to a jury trial, provided such right is timely as serted. See, e.g., Johnson v. King, 
    426 S.W.2d 196
    , 199
    (Tenn. 1968) (indicating that litigant in tort case has right to jury trial).
    13
    Secondly, and perhaps more importantly, we do not construe section 29-20-313 as
    denying the Defendants the right to a jury trial. The last sentence of subsection (b) of the
    statute provides that “[n]othing in this section shall be construed to abridge the right of any
    party to a trial by jury otherwise granted by the state or federal constitution or any statute.”
    T.C.A. § 29-20-313(b) (Supp. 1994) (emphasis added). The Defendants contend that this
    sentence’s reference to “this section” refers only to section 29-20-313(b) and not to the
    entire section 29-20-313 and that, therefore, the sentence does not save section
    29-20-313(a) from being declared unconstitutional.
    We disagree. This court has the obligation to uphold the constitutionality of the
    challenged statutory provisions “if there exists any reasonable construction which would
    satisfy the requirements of the constitution.” Shelby County Election Comm’n v. Turner,
    
    755 S.W.2d 774
    , 777 (Tenn. 1988); see also NLRB v. Jones & Laughlin Steel Corp., 
    301 U.S. 1
    , 30 (1937) (indicating that the “cardinal principle of statutory construction is to save
    and not to destroy” and that, “as between two possible interpretations of a statute, by one
    of which it would be unconstitutional and by the other valid, our plain duty is to adopt that
    which will save the act”). In enacting statutes, the legislature routinely refers to individual
    statutes as “sections” and to subparts thereof as “subsections.”            See, e.g., T.C.A.
    §§ 1-3-113, -116 (1985 & Supp. 1997). We conclude, therefore, that a reasonable
    construction of the final sentence of subsection (b) of section 29-20-313 is that the
    sentence applies to the entire section 29-20-313 and not just to subsection (b). Inasmuch
    as this construction of section 29-20-313 preserves a defendant’s constitutional right to a
    jury trial under both subsections (a) and (b), we conclude that neither section 29-20-313
    nor section 29-20-310 is unconstitutional.
    VII. Conclusion
    Having upheld the constitutionality of the challenged provisions of the GTLA relating
    to health care practitioners, we reverse the trial court’s judgment to the extent that it
    dismisses Defendants Snyder and Bradley from this lawsuit, and we remand this cause for
    14
    further proceedings consistent with this opinion. The trial court’s dismissal of Defendants
    Insco and Jennings, however, is hereby affirmed.         Costs on appeal are taxed to
    Defendants Snyder and Bradley, for which execution may issue if necessary.
    HIGHERS, J.
    CONCUR:
    CRAWFORD, P.J., W.S.
    LILLARD, J.
    15