Last week, the Sixth Circuit reversed a district court opinion dismissing personal injury claims brought by the estate of a patient of who died following an allergic reaction to heparin. In Shuler et al v. Garrett et al, Pauline Shuler’s heirs appealed the decision of the United States District Court for the Western District of Tennessee dismissing their negligence and medical battery claims stemming from Shuler’s death at Intensive Care Unit of Baptist Memorial Hospital-Memphis. The complaint, founded on diversity jurisdiction and invoking Tennessee law, alleged that the hospital administered injections of heparin (an anticoagulant) in contravention of Shuler’s specific instructions and the hospital’s knowledge of Shuler’s allergy to heparin—as exhibited in both her medical records and on her medical bracelet. The complaint attributes Shuler’s death to her allergic reaction to heparin.

Relying on Cary v. Arrowsmith, 777 S.W.2d 8 (Tenn. Ct. App. 1989), the District Court dismissed the cause of action for medical battery, holding that “the heparin injections were not ‘procedures’ or ‘treatments’ for the purposes of medical battery; rather, the injections were ‘therapeutic drug’ treatment[s]” and, therefore, could not qualify as medical battery, but only medical malpractice.  Under the Tennessee Medical Malpractice Act (“TMMA”), medical malpractice actions are subject to heightened notice and pleading requirements, which plaintiffs failed to meet.

Reversing the dismissal of plaintiffs’ medical battery claim, the Sixth Circuit held that Cary, an informed consent case, did not apply here, where the allegations provide that “the heparin injections were administered despite Pauline’s explicit refusal.”  Because the patient did not authorize the procedure, the Sixth Circuit rejected appellees’ contention that Shuler gave a general authorization to treatment.  “We cannot find, and the defendants do not offer any Tennessee caselaw that supports the proposition that, absent exigency or incapacity, a prior general grant of consent could trump a subsequent, explicit refusal to submit to the procedure at issue.”

Therefore, the Sixth Circuit reversed the district court’s judgment and allowed the claim of medical battery to proceed.  This decisions shows that the Sixth Circuit will carefully scrutinize a plaintiff’s claims on a motion to dismiss.