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KENDRA J. THIGPEN v. CORAZON NGO, M.D., MARSHALL B. FRINK, M.D.,
NATIONAL EMERGENCY SERVICES, INC., EMERGENCY PHYSICIANS
ASSOCIATION, INC., CP/NATIONAL, INC. a/k/a COMMUNITY
PHYSICIANS/NATIONAL, INC., and ONSLOW COUNTY HOSPITAL AUTHORITY
1. Medical Malpractice_certification_interplay of Rules 9(j)
and 15
It was not necessary to discuss the interplay between
N.C.G.S. § 1A-1, Rules 9(j) and 15 in an action involving the
required certification for filing a medical malpractice action
where the trial court dismissed the action for failure to comply
with Rule 9(j) and did not base its ruling on the interaction of
the two rules. Brisson v. Kathy A. Santoriello, M.D., P.A., 351
N.C. 589, is distinguished.
2. Medical Malpractice_certification_added to amended
complaint_improper
The trial court correctly dismissed a medical malpractice
complaint for failure to comply with N.C.G.S. § 1A-1, Rule 9(j)
where plaintiff requested and received a 120-day extension to
comply with the certification mandate on the day before the
statute of limitations would have expired, filed her complaint
without the certification, and filed an amended complaint which
included the certification after the statute of limitations had
expired. The specific mandate of Rule 9(j) prevails over other
general rules; permitting amendment of a complaint to add the
expert certification where the expert review occurred after the
suit was filed would conflict with the clear intent of the
legislature.
3. Medical Malpractice_certification_amended
complaint__allegation that review occurred before original
complaint_required
An amended medical malpractice complaint which failed to
allege that review of the medical care took place before the
filing of the original complaint did not satisfy the
certification requirements of N.C.G.S. § 1A-1, Rule 9(j).
Allowing a plaintiff to file a medical malpractice complaint and
then wait until after the filing to have the allegations reviewed
by an expert would pervert the purpose of Rule 9(j).
Appeal pursuant to N.C.G.S. § 7A-30(2) from the decision of
a divided panel of the Court of Appeals, 143 N.C. App. 209, 545
S.E.2d 477 (2001), reversing an order entered 17 November 1999 byHockenbury, J., in Superior Court, Onslow County. On 19 July
2001, the Supreme Court granted defendant Corazon Ngo's and
defendant Onslow County Hospital Authority's petitions for
discretionary review of additional issues. Heard in the Supreme
Court 13 November 2001.
Jimmy F. Gaylor for plaintiff-appellee.
Harris, Creech, Ward and Blackerby, P.A., by C. David Creech
and W. Gregory Merritt, for defendant-appellant Corazon Ngo,
M.D.
Smith, Anderson, Blount, Dorsett, Mitchell & Jernigan, LLP,
by John D. Madden and Deanna Davis Anderson, for defendant-
appellant Onslow County Hospital Authority.
WAINWRIGHT, Justice.
This case arises from an order of the trial court dismissing
plaintiff's complaint alleging medical malpractice because of
plaintiff's failure to comply with Rule 9(j) of the North
Carolina Rules of Civil Procedure and dismissing, pursuant to
Rule 12(b)(6) of the North Carolina Rules of Civil Procedure,
plaintiff's amendment to the complaint because it is barred by
the applicable statute of limitations, N.C.G.S. § 1-15(c)
(1999).
Kendra Thigpen (plaintiff) alleges defendants Dr. Corazon
Ngo (Ngo) and Onslow County Hospital Authority (OCHA) committed
medical malpractice in June 1996. On 8 June 1999, before the
three-year statute of limitations was to expire, plaintiff filed
a motion to extend the statute of limitations 120 days to file a
medical malpractice complaint against defendants. In her motion,
plaintiff stated she need[ed] additional time to comply withRule 9(j) of the North Carolina Rules of Civil Procedure and
move[d] to extend the statute of limitations for a period not to
exceed 120 days. (Emphasis added.) The motion was signed by
plaintiff's attorney. Pursuant to Rule 9(j), the trial court
granted plaintiff's motion. In the order extending the statute
of limitations, the trial court determined that good cause
exists for granting [plaintiff's motion and that] the ends of
justice will be served by an extension. The order specifically
extended the statute of limitations through 6 October 1999.
On 6 October 1999, the final day of the extended deadline,
plaintiff filed a medical malpractice complaint. The complaint
did not contain the certification required by Rule 9(j). See
N.C.G.S. § 1A-1, Rule 9(j) (1999). Namely, the complaint did not
specify that the medical care had been reviewed by an expert
prior to filing. On 12 October 1999, six days after the statute
of limitations expired, plaintiff filed an amended complaint
including a certification that the medical care has been
reviewed by someone who would qualify as an expert.
Defendants Ngo and OCHA filed motions to dismiss on 4 and
10 November 1999, respectively, because plaintiff's amended
complaint was not filed prior to the court-extended statute of
limitations. On 17 November 1999, the trial court granted both
defendants' motions to dismiss pursuant to Rules 9(j) and
12(b)(6). The trial court dismissed plaintiff's complaint with
prejudice, finding that Plaintiff's original Complaint did not
contain a certification that the care rendered by Defendants had
been reviewed by an expert witness reasonably expected to testifythat the care rendered to Plaintiff did not comply with the
applicable standard of care as required by Rule 9(j).
The Court of Appeals reversed the trial court and reinstated
plaintiff's cause of action. Thigpen v. Ngo, 143 N.C. App. 209,
219, 545 S.E.2d 477, 483 (2001). The Court of Appeals held
plaintiff was entitled to amend her initial complaint to include
the necessary Rule 9(j) certification. Id. We disagree.
[1]At the outset, we note the Court of Appeals discussed
the interplay between Rule 9(j) and Rule 15 of the North Carolina
Rules of Civil Procedure. Id. at 211-19, 545 S.E.2d at 479-83.
We find the relationship between these two rules to be neither
dispositive nor relevant to this case. The trial court dismissed
plaintiff's complaint with prejudice because it did not comply
with Rule 9(j) and was therefore filed outside the statute of
limitations. The trial court did not base its ruling on the
interaction between Rules 9(j) and 15, and we find it unnecessary
to address that relationship here.
The Court of Appeals also relied on this Court's decision in
Brisson v. Kathy A. Santoriello, M.D., P.A., 351 N.C. 589, 528
S.E.2d 568 (2000), to assist its analysis of the interaction
between Rules 9(j) and 15. Thigpen, 143 N.C. App. at 213, 545
S.E.2d at 480. In Brisson, we held the plaintiffs in a medical
malpractice case who failed to include the 9(j) expert
certification could take a voluntary dismissal pursuant to Rule
41(a)(1) of the North Carolina Rules of Civil Procedure to
effectively extend the statute of limitations. Brisson, 351 N.C.
at 597, 528 S.E.2d at 573. We find the facts in Brissondistinguishable from those in the present case. Specifically, in
Brisson, this Court noted the trial judge reserved ruling on
defendants' motion to dismiss, and plaintiffs subsequently took
a voluntary dismissal. Id. at 592, 528 S.E.2d at 570.
Additionally, the plaintiffs in Brisson did not request the
120-day extension provided by Rule 9(j). Brisson, 351 N.C. 589,
528 S.E.2d 568. In Brisson, we stated, Had the trial court
involuntarily dismissed plaintiffs' complaint with prejudice
pursuant to defendants' motion before plaintiffs had taken the
voluntary dismissal, then plaintiffs' claims set forth in the
second complaint would be barred by the statute of limitations.
Id. at 595, 528 S.E.2d at 572. Any reliance by the Court of
Appeals on our decision in Brisson was thus flawed.
[2]Defendants first argue the trial court's dismissal of
plaintiff's complaint was mandatory under Rule 9(j). We agree.
The North Carolina Rules of Civil Procedure address pleadings in
medical malpractice suits. Rule 9(j) mandates:
(j) Medical malpractice. -- Any complaint alleging
medical malpractice by a health care provider . . .
shall be dismissed unless:
(1) The pleading specifically asserts that the
medical care has been reviewed by a person
who is reasonably expected to qualify as an
expert witness under Rule 702 of the Rules of
Evidence and who is willing to testify that
the medical care did not comply with the
applicable standard of care;
(2) The pleading specifically asserts that the
medical care has been reviewed by a person
that the complainant will seek to have
qualified as an expert witness by motion
under Rule 702(e) of the Rules of Evidence
and who is willing to testify that the
medical care did not comply with the
applicable standard of care, and the motion
is filed with the complaint . . . .
N.C.G.S. § 1A-1, Rule 9(j), para. 1(1), (2) (emphasis added).
Further, Rule 9(j) allows a plaintiff to extend the filing
time to comply with the expert certification requirement:
Upon motion by the complainant prior to the
expiration of the applicable statute of limitations, a
resident judge . . . may allow a motion to extend the
statute of limitations for a period not to exceed 120
days to file a complaint in a medical malpractice
action in order to comply with this Rule, upon a
determination that good cause exists for the granting
of the motion and that the ends of justice would be
served by an extension.
Id., para. 2 (emphasis added).
When the language of a statute is clear and unambiguous, it
must be given effect and its clear meaning may not be evaded by
an administrative body or a court under the guise of
construction. State ex rel. Util. Comm'n v. Edmisten, 291 N.C.
451, 465, 232 S.E.2d 184, 192 (1977). Rule 9(j) clearly provides
that [a]ny complaint alleging medical malpractice . . . shall be
dismissed if it does not comply with the certification mandate.
N.C.G.S. § 1A-1, Rule 9(j), para. 1 (emphasis added). Contrary
to the holding of the Court of Appeals, we find the inclusion of
shall be dismissed in Rule 9(j) to be more than simply a
choice of grammatical construction. Thigpen, 143 N.C. App. at
215, 545 S.E.2d at 481. While other subsections of Rule 9
contain requirements for pleading special matters, no other
subsection contains the mandatory language shall be dismissed.
This indicates that medical malpractice complaints have a
distinct requirement of expert certification with which
plaintiffs must comply. Such complaints will receive strict
consideration by the trial judge. Failure to include thecertification necessarily leads to dismissal.
Rule 9(j) grants a trial judge the discretion to permit a
120-day extension of the statute of limitations in order to
comply with this Rule. N.C.G.S. § 1A-1, Rule 9(j), para. 2
(emphasis added). The extension of the statute of limitations is
not automatic. The trial judge may allow a motion to extend the
statute of limitations only upon a determination that good cause
exists for the granting of the motion and that the ends of
justice would be served by an extension. Id.
Additionally, the plain language of Rule 9(j) requires
dismissal but does not specify whether the dismissal shall be
with or without prejudice. The trial court's authority to order
an involuntary dismissal without prejudice is . . . in the broad
discretion of the trial court. . . . Whedon v. Whedon, 313 N.C.
200, 213, 328 S.E.2d 437, 445 (1985). When acting pursuant to
Rule 9(j), trial judges, with their unique perspective, have the
discretion to dismiss without prejudice if they see fit.
While our Rules of Civil Procedure contain many rules
addressing pleadings generally, Rule 9(j) specifically addresses
extensions of time to file a medical malpractice complaint where
the complaint lacks expert certification. The title of Rule 9,
Pleading special matters, plainly signals the statute's
tailoring to address distinct situations set out in the statute.
We have stated:
Where there is one statute dealing with a subject
in general and comprehensive terms, and another dealing
with a part of the same subject in a more minute and
definite way, the two should be read together and
harmonized, if possible, with a view to giving effect
to a consistent legislative policy; but, to the extentof any necessary repugnancy between them, the special
statute, or the one dealing with the common subject
matter in a minute way, will prevail over the general
statute, according to the authorities on the question,
unless it appears that the legislature intended to make
the general act controlling . . . .
National Food Stores v. N.C. Bd. of Alcoholic Control, 268 N.C.
624, 628-29, 151 S.E.2d 582, 586 (1966) (quoting 82 C.J.S.
Statutes § 369, at 839-43 (1953)), quoted in McIntyre v.
McIntyre, 341 N.C. 629, 631, 461 S.E.2d 745, 747 (1995).
Accordingly, the specific mandate of Rule 9(j) that a medical
malpractice claim shall be dismissed if it does not contain the
expert certification prevails over other general rules.
Furthermore, our analysis reveals the legislature intended
Rule 9(j) to control pleadings in medical malpractice claims.
Legislative intent is determined by examining the statute as a
whole including the spirit of the act and the objectives the
statute seeks to accomplish. Brown v. Flowe, 349 N.C. 520, 522,
507 S.E.2d 894, 895 (1998). In the interpretation of statutes
the legislative will is the controlling factor. State v. Hart,
287 N.C. 76, 80, 213 S.E.2d 291, 294 (1975).
The General Assembly added subsection (j) of Rule 9 in 1995
pursuant to chapter 309 of House Bill 730, entitled, An Act to
Prevent Frivolous Medical Malpractice Actions by Requiring that
Expert Witnesses in Medical Malpractice Cases Have Appropriate
Qualifications to Testify on the Standard of Care at Issue and to
Require Expert Witness Review as a Condition of Filing a Medical
Malpractice Action. Act of June 20, 1995, ch. 309, 1995 N.C.
Sess. Laws 611. The legislature specifically drafted Rule 9(j)
to govern the initiation of medical malpractice actions and torequire physician review as a condition for filing the action.
The legislature's intent was to provide a more specialized and
stringent procedure for plaintiffs in medical malpractice claims
through Rule 9(j)'s requirement of expert certification prior to
the filing of a complaint. Accordingly, permitting amendment of
a complaint to add the expert certification where the expert
review occurred after the suit was filed would conflict directly
with the clear intent of the legislature.
In the case at bar, in her original complaint, plaintiff
failed to comply with the Rule 9(j) certification mandate. No
party disputes that plaintiff requested and received the 120-day
extension to comply with the certification mandate on the very
day before the three-year statute of limitations would have
expired. In spite of the lengthy extension, plaintiff still
failed to include any certification in her complaint. In light
of the specific, unambiguous, and plain language of Rule 9(j);
the legislative intent of the statute; and the record and facts
in this particular case, we hold the trial court correctly
dismissed plaintiff's complaint.
[3]This Court also granted discretionary review to
determine if an amended complaint which fails to allege that
review of the medical care in a medical malpractice action took
place before the filing of the original complaint satisfies the
requirements of Rule 9(j). We hold it does not. To survive
dismissal, the pleading must specifically assert[] that the
medical care has been reviewed. N.C.G.S. § 1A-1, Rule 9(j),
para. 1(1), (2) (emphasis added). Significantly, the rule refersto this mandate twice (in subsections (1) and (2)), and in both
instances uses the past tense. Id. In light of the plain
language of the rule, the title of the act, and the legislative
intent previously discussed, it appears review must occur before
filing to withstand dismissal. Here, in her amended complaint,
plaintiff simply alleged that [p]laintiff's medical care has
been reviewed by a person who is reasonably expected to qualify
as an expert witness. (Emphasis added.) There is no evidence
in the record that plaintiff alleged the review occurred before
the filing of the original complaint. Specifically, there was no
affirmative affidavit or date showing that the review took place
before the statute of limitations expired. Allowing a plaintiff
to file a medical malpractice complaint and to then wait until
after the filing to have the allegations reviewed by an expert
would pervert the purpose of Rule 9(j).
As a final matter, this Court allowed discretionary review
of the issue of whether a plaintiff who files a complaint without
expert certification pursuant to Rule 9(j) can cure that defect
after the applicable statute of limitations expires by amending
the complaint as a matter of right and having that amendment
relate back to the date of the original complaint. In light of
the particular facts and record before us, we hold discretionary
review was improvidently allowed as to this issue.
In sum, based on this record, we hold that once a party
receives and exhausts the 120-day extension of time in order to
comply with Rule 9(j)'s expert certification requirement, the
party cannot amend a medical malpractice complaint to includeexpert certification. Further, we hold that Rule 9(j) expert
review must take place before the filing of the complaint. We
therefore reverse the decision of the Court of Appeals with
instructions for that court to reinstate the trial court's order
dismissing plaintiff's complaint.
REVERSED IN PART; DISCRETIONARY REVIEW IMPROVIDENTLY ALLOWED
IN PART.
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