Healthcare Professionals and the Alabama Medical Liability Act (2024)
The Alabama Medical Liability Act (AMLA) governs actions against health care providers in connection with the provision of health care. Ala. Code § 6-5-540, et al. As the political target of the plaintiffs’ bar, the AMLA has a number of health care provider-friendly provisions including:
Detailed pleading requirements Ala. Code § 6-5-551.
Plaintiff has the burden of proving the health care provider failed to exercise such reasonable care, skill, and diligence as other similarly situated health care providers in the same general line of practice ordinarily have and exercise in a like case. Ala. Code § 6-5-548(a).
Strict definitions of “similarly situated health care providers”. Ala. Code § 6-5-548(b) and (c).
Standard of proof is by substantial evidence. Ala. Code § 6-5-549.
Liability insurance limits are not discoverable. Ala. Code § 6-5-548.
The plaintiff must show the health care provider’s negligence “probably caused” rather than “possibly caused”, the plaintiff’s injuries. Sorrell v. King, 946 So. 2d 854 (Ala. 2006).
As a general rule, the plaintiff must proffer expert testimony from a health care provider similarly situated to the defendant’s health care provider. Sorrell v. King, 946 So. 2d 854 (Ala. 2006).
Discovery of other acts or omissions not specifically set out in the complaint is prohibited. Ala. Code § 6-5-551.
Additionally, credentialing, quality assurance, and peer review information is not discoverable as to some health care providers. Ala. Code § 6-5-333(d); Ala. Code §22-21-8
AMLA and the Allied Health Care Professional
Alabama’s favorable treatment of health care professionals makes applying AMLA a high priority on any defense lawyer’s litigation checklist. Although there is little doubt that a conventional hospital, doctor, or dentist are healthcare providers under AMLA, there is a surprising vagueness in the law (and in some cases an absence of authority) on whether certain allied healthcare professionals are healthcare providers under the AMLA.
Allied health professionals are health care professions distinct from medicine and nursing. Allied health care involves services related to identifying, evaluating, and preventing diseases and disorders; dietary and nutrition services; rehabilitation and health systems management; and additional services. Professions commonly associated with allied health include:
Audiologists and speech-language pathologists;
Physical therapists, occupational therapists, and respiratory therapists;
Diagnostic medical personnel (medical laboratory scientists, cytogenetic technologists, diagnostic molecular scientists, histotechnologists, and pathologists’ assistants);
Imaging specialists (radiographers, nuclear medicine technologists, and sonographers); nutritionists and dietitians;
Health educators (asthma educators, diabetes educators);
Counselors (genetic counselors, mental health counselors, family therapists);
Specialists in cancer diagnosis and treatment (medical physicists, medical dosimetrists, and radiation therapists); and,
Pharmacy personnel (pharmacy technicians and assistants).
See 42 U.S.C.S. § 295p(5).
Courts have applied the AMLA to some allied health care professionals through the AMLA’s “other health care providers” provision. The AMLA defines a “health care provider” as “[a] medical practitioner, dental practitioner, medical institution, physician, dentist, hospital, or other health care provider as those terms are defined in Section 6-5-481.” § 6-5-542(1), Ala. Code 1975.
Alabama Code § 6-5-481(8) defines “other health care providers” as “[a]ny professional corporation or any person employed by physicians, dentists, or hospitals who are directly involved in the delivery of health care services.”
Unfortunately, the Alabama Supreme Court’s interpretation of “other healthcare providers” under AMLA has not always been uniform. See Ex parte Partners in Care, Inc.,986 So. 2d 1145, 1148 (Ala. 2007). However, an employment relationship with a physician, dentist, or hospital is not necessarily required: “[A]t a minimum, a physician, dentist, or hospital must have madeuseof that corporation … in the physician’s, or dentist’s, or hospital’sdelivery of health-care services to the plaintiff-patient.”Id.(emphasis in original). “[I]t is not a person’s or corporation’s occupation or type of business that determines whether AMLA applies, it is whether that person or corporation was used by a physician, dentist, or hospital in delivering health-care services to a patient.” Ex parte Partners in Care, Inc., 986 So.2d 1145, 1149 (Ala. 2007).
“Other health providers” Under AMLA
Medical laboratory. A medical laboratory qualified as an “other health care provider” under AMLA because its testing of a specimen was integral to the physician’s delivery of health care services to the patient. Anderson v. Ala. Reference Labs, 778 So. 2d 806, 810 (Ala. 2000); Akins v. Lab. Corp. of Am., 2012 U.S. Dist. LEXIS 199852; Billingsley v. Labcorp, Inc., 2006 U.S. Dist. LEXIS 63573; Marsh v. Wenzel, 732 So. 2d 985 (Ala. 1998);Guthrie v. Bio-Medical Lab., Inc., 442 So. 2d 92 (Ala. 1983)
Drug Manufacturer. A company that produced a defective drug used by a physician was not an “other health care provider” because the physician was not using the company’s product to deliver health care services to patients. Ex parte Partners in Care, 986 So. 2d 1145 (Ala. 2007).
A pharmacist is an “other health care provider” under AMLA. Cackwoski v. Wal-Mart, 767 So. 2d 319 (Ala. 2000). See alsoEx parte Rite Aid of Ala., Inc., 768 So. 2d 960 (Ala. 2000)
Registered Nurse. An RN is an “other health care provider” where the RN’s contractual relationships with a hospital and physician were “sufficiently analogous to employment relationships. Ex parte Main, 658 So. 2d 384, 387 (Ala. 1995)
Red Cross: Red Cross is an “other health care provider,” in part because it was “directly involved in the delivery of health care services”. Wilson v. American Red Cross, 600 So. 2d 216, 218 (Ala. 1992)
An orthotist is an “other health care provider” under AMLA. Tuscaloosa Orthopedic Appliance Co. v. Wyatt, 460 So. 2d 156 (Ala. 1984)
Are health care providers under Ala. Code §6-5-549.1
Are health care providers under Ala. Code §6-5-549.1
Are health care providers under Ala. Code §6-5-549.1
A pharmacy was not an “other health care provider” because the pharmacy shipped bulk orders to physicians to use on patients who might need treatment. Ex parte Partners in Care, Inc., 986 So. 2d 1145 (Ala. 2007)(pharmacy not other healthcare provider because pharmacy shipping bulk order the physicians to use on patients who might need treatment)
Nursing home management. AMLA applies to a professional corporation that was under contract to manage a nursing home where the management company was responsible for hiring employees as well as supervising, managing, and operating the nursing home. Because the company was employed to manage the nursing home, the court concluded that it was “directly involved in the delivery of health-care services. Crowne, 740 So.2d 400, 405 (Ala. 1999)
Psychological associate. A psychological associate with a master’s degree in rehabilitation counseling and a bachelor’s degree in social work working for the Alabama Department of Corrections who decided whether inmates should be placed in a crisis cell, removed from a crisis cell, or referred to the mental health professionals was not an “other health care provider” under AMLA. Glenn v. Corizon LLC, 2022 US. App. LEXIS 9320
Patient Monitoring. The defendants’ monitoring of the plaintiff was inextricably linked to the physician’s treatment of patients; therefore, the defendants were “other health care providers” under AMLA. Verret v. Ala. Dep’t of Mental Health, 2007 U.S. Dist. LEXIS
Rehabilitation Supervisor. A registered nurse assigned by an insurance underwriter to supervise the patient’s rehabilitation was an “other health care provider”); Ex parte Main, 658 So. 2d 384, 387 (Ala. 1995)
Worker’s Compensation Claims Adjuster. AMLA “other health care provider” provision did not apply to a claims adjuster who made a determination that a plaintiff’s injuries were not work-related because no physician, dentist or hospital used the claims adjuster in delivering health care. Raye v. Employer’s Ins., 345 F. Supp. 2d 1313 (S.D. Ala. 2004)
Allied Health Care Facilities and AMLA
The AMLA defines a “health care provider” as “[a] medical practitioner, dental practitioner, medical institution, physician, dentist, hospital, or other health care provider as those terms are defined in Section 6-5-481.” § 6-5-542(1), Ala. Code 1975. Alabama Code § 6-5-481(7), in turn, cites § 22-21-20:
(1) Hospitals. — General and specialized hospitals, including ancillary services; independent clinical laboratories; rehabilitation centers; ambulatory surgical treatment facilities for patients not requiring hospitalization; end-stage renal disease treatment and transplant centers, including freestanding hemodialysis units; abortion or reproductive health centers; hospices; health maintenance organizations; and other related health care institutions when such institution is primarily engaged in offering to the public generally, facilities and services for the diagnosis and/or treatment of injury, deformity, disease, surgical or obstetrical care. Also included within the term are long-term care facilities such as, but not limited to, skilled nursing facilities, intermediate care facilities, assisted living facilities and specialty care assisted living facilities rising to the level of intermediate care. The term “hospitals” relates to health care institutions and shall not include the private offices of physicians or dentists, whether in individual, group, professional corporation, or professional association practice. This section shall not apply to county or district health departments.
Many of the aforementioned facilities qualifying as hospitals under AMLA utilize allied health care professionals. Defense counsel should carefully examine whether the medical facility qualifies as a hospital under AMLA. Alabama appellate courts carefully examined whether several facilities qualify as hospitals under AMLA:
Nursing homes. A nursing home, though not explicitly included in the list of hospitals in the AMLA, was a skilled intermediate-care nursing facility and was a hospital for purposes of the AMLA Rosemont, Inc. v. Marshall, 481 So. 2d 1126, 1129 (Ala. 1986); Ex parte Northport Health Serv., 682 So. 2d 52 (Ala. 1996)
Mental Health Facilities. The AMLA does not apply to mental health facilities because they are not “health care providers” within the definition of the Act. Ex parte Alabama Department of Mental Health & Mental Retardation, 723 So. 2d 11, 13 (Ala. 1998) But, see Ex parte Sawyer, 892 So. 2d 898, 902 (Ala. 2004).
Conclusion
Doctors, nurses, and hospitals are archetypal medical malpractice defendants. However, the Alabama Medical Liability Act, and its health care-friendly provisions, may apply to many allied healthcare professionals. When defending an allied health professional, defense counsel should establish a physician, dentist, or hospital made use of the allied health care professional’s services in rendering health care to the patient/plaintiff. Next, defense counsel should conduct a detailed assessment of the allied health care professional’s education and training. Then, they should examine the defendant’s provision of care to the patient/plaintiff. Finally, in applying AMLA in the defense of allied health professionals, defense counsel should establish the defendant’s relationship with a physician, dentist, or hospital in the provision of health care to the patient/plaintiff.
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Alabama has a specific statute that governs claims of medical malpractice called the Alabama Medical Liability Act (“AMLA”). The Act addresses venue, the Plaintiff's burden of proof, qualifications required for an expert witness to testify against a healthcare provider and discovery.
In Alabama, a medical malpractice plaintiff must prove that the healthcare provider “failed to exercise such reasonable care, skill, and diligence as other similarly situated health care providers in the same general line of practice ordinarily have and exercise in a like case.”Ala. Code § 6-5-548(a).
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The relevant Alabama statute describes malpractice as when a doctor, hospital, or other medical party: “[Fails] to exercise such reasonable care, skill, and diligence as other similarly situated health care providers in the same general line of practice ordinarily have and exercise in a like case.”
(1) An application to the court for an order shall be by motion which, unless made during a hearing or trial, shall be made in writing, shall state with particularity the grounds therefor, and shall set forth the relief or order sought.
A person commits the crime of burglary in the second degree if he/she unlawfully enters a lawfully occupied dwelling-house with intent to commit a theft or a felony therein.
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Current through Act 218 of the 2023 Regular Session. Section 13A-11-9 - Loitering (a) A person commits the crime of loitering if he or she does any of the following: (1) Loiters, remains, or wanders about in a public place for the purpose of begging. (2) Loiters or remains in a public place for the purpose of gambling.
Section 13A-8-43 - Robbery in the third degree (a) A person commits the crime of robbery in the third degree if in the course of committing a theft he: (1) Uses force against the person of the owner or any person present with intent to overcome his physical resistance or physical power of resistance; or (2) Threatens ...
It shall be the duty of any person who has been convicted more than twice of a felony under the laws of any state or the United States, who has not been restored to his civil rights by competent legal authority, and who resides within any county in the State of Alabama, to register within 24 hours after his arrival in ...
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Breach of duty occurs when a person's conduct fails to meet an applicable standard of care. It is one of the four elements of negligence. If the defendant's conduct fails to meet the required standard of care, they are said to have breached that duty.
Medical bills are usually unsecured debts. Often the debt is referred to a collections agency. If the debt is minor, collections efforts may include harassment and negative credit ratings. However, when medical bills are sizeable enough, a creditor may bring a lawsuit to collect the medical debt.
Under Alabama law, pain and suffering (also referred to as mental anguish) damages are compensable for the mental sensation of physical pain and the emotional distress that accompanies an injury. It can also include the loss of enjoyment of life and an inability to carry on with normal activities.
Most hospital negligence lawsuits in Alabama are subject to the standard two-year statute of limitations. This means you have two years to file a lawsuit against a hospital or hospital employee (in most cases).
who can and cannot be guilty of malpractice? you fail to do what you were trained to do; health care workers who are trained to do a specific job. could a dentist assistant ever be guilty of negligence? yes, not properly sterilizing tools.
33(c)] allows a responding party to substitute access to documents or electronically stored information for an answer only if the burden of deriving the answer will be substantially the same for either party. Rule 33(d) [Ala. R.
Alabama Rules of Appellate Procedure Rule 40. Applications for rehearing. (a) Who may file. A party who has not prevailed may apply for a rehearing by filing an application for rehearing.
Interpleader. (a) Plaintiff or defendant. Persons having claims against the plaintiff may be joined as defendants and required to interplead when their claims are such that the plaintiff is or may be exposed to double or multiple liability.
A person commits the crime of installing an eavesdropping device if he/she intentionally installs or places a device in a private place with knowledge it is to be used for eavesdropping and without permission of the owner and any lessee or tenant or guest for hire of the private place.
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Except as otherwise provided in this Code, a person who carries concealed about his person a bowie knife or knife or instrument of like kind or description or a pistol or firearm of any other kind or an air gun shall, on conviction, be fined not less than $50.00 nor more than $500.00, and may also be imprisoned in the ...
The following definitions apply to this article: (1) Eavesdrop. To overhear, record, amplify or transmit any part of the private communication of others without the consent of at least one of the persons engaged in the communication, except as otherwise provided by law. (2) Private place.
Section 13A-10-9 - False reporting to law enforcement authorities (a) A person commits the crime of false reporting to law enforcement authorities if he knowingly makes a false report or causes the transmission of a false report to law enforcement authorities of a crime or relating to a crime.
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Section 13A-8-8.1 - Theft of lost property in the third degree (a) The theft of lost property which exceeds five hundred dollars ($500) in value but does not exceed one thousand four hundred and ninety-nine dollars ($1,499) in value constitutes theft of lost property in the third degree.
Section 13A-12-21 - Simple gambling (a) A person commits the crime of simple gambling if he knowingly advances or profits from unlawful gambling activity as a player. (b) It is a defense to a prosecution under this section that a person charged with being a player was engaged in a social game in a private place.
A person commits the crime of criminal mischief in the first degree if, with intent to damage property, and having no right to do so or any reasonable ground to believe that he/she has such a right, he/she inflicts damage to the property in an amount exceeding $2,500.00.
A person commits the crime of assault in the second degree if, with intent to cause physical injury to another person, he/she causes physical injury to any person by means of a deadly weapon or dangerous instrument.
(a) A person commits the crime of criminal littering if he or she engages in any of the following acts: (1) Knowingly deposits in any manner litter on any public or private property or in any public or private waters without permission to do so.
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The standard of care is that level of such reasonable care, skill, and diligence as other similarly situated health care providers in the same general line of practice, ordinarily have and exercise in like cases.
The doctor or facility owed a professional duty of care. There was a breach of duty. The victim suffered injuries as a result of the negligence. There were financial or intangible losses.
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Alabama's population struggles with chronic health challenges. The state has the highest prevalence of stroke, the third-highest rate of diabetes and kidney disease, and consistently high levels of heart disease and obesity. Fruit and vegetable consumption and physical activity levels are low.
The standard of care refers to the level of care a person or entity must exhibit to prevent others from harm. The standard of care comes into play in medical malpractice cases when a healthcare provider fails to provide the level of care a similarly-trained professional would have offered under the same circ*mstances.
The hardest element of a medical malpractice case to prove is the breach of the duty of care, the second element. This is because proving that the medical provider acted in a way that was not reasonable can be difficult.
To do so, four legal elements must be proven: (1) a professional duty owed to the patient; (2) breach of such duty; (3) injury caused by the breach; and (4) resulting damages.
These elements, the “4 Ds” of medical negligence, are (1) duty, (2) deviation from the standard of care, (3) damages, and (4) direct cause. If you suffered serious injuries due to a doctor or other healthcare professional's negligence, you could be entitled to compensation for your losses.
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A breach exists when another healthcare provider in the same or similar circ*mstances would have treated a patient differently than the provider in question. Proving that a breach of the medical standard of care occurred is one of the four elements that must exist to pursue a medical malpractice claim.
Failure to diagnose, such as missing the symptoms of serious heart disease. Failure to perform or order appropriate medical testing. Failure to adequately monitor a patient. Anesthesia mistakes.
Introduction: My name is Tish Haag, I am a excited, delightful, curious, beautiful, agreeable, enchanting, fancy person who loves writing and wants to share my knowledge and understanding with you.
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