Eugene Moxley v. AMISUB (SFH), Inc. d/b/a Saint Francis Hospital

03/13/2026

IN THE COURT OF APPEALS OF TENNESSEE

AT JACKSON

January 14, 2026 Session

EUGENE MOXLEY v. AMISUB SFH INC. D/B/A SAINT FRANCIS

HOSPITAL ET AL.

Appeal from the Circuit Court for Shelby County

No. CT-4603-20 Cedrick D. Wooten, Judge

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No. W2025-00443-COA-R3-CV

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The trial court granted Appellees’ joint motion to dismiss Appellant’s healthcare liability

action based on its finding that Appellant failed to substantially comply with the pre-suit

notice requirements of Tennessee Code Annotated section 29-26-121(a)(2)(E). Appellant

appeals. We affirm.

Tenn. R. App. P. 3 Appeal as of Right; Judgment of the Circuit Court

Affirmed and Remanded

ROY B. MORGAN, JR., SR. J., delivered the opinion of the court, in which CARMA DENNIS

MCGEE and VALERIE L. SMITH, JJ., joined.

William Bryan Smith, Memphis, Tennessee, and A. Wilson Wages, Millington, Tennessee,

for the appellant, Eugene Moxley.

Karen S. Koplon and Megan Lane, Memphis, Tennessee, for the appellees, Kirsna Norris

Chapman, and AMISUB (SFH), Inc. d/b/a St. Francis Hospital.

Joseph M. Clark and Raleigh Kent Francis, Memphis, Tennessee, for the appellees,

Zachary K. Corr and The Urology Group.

MEMORANDUM OPINION1

1

Rule 10 of the Rules of the Court of Appeals of Tennessee provides:

This Court, with the concurrence of all judges participating in the case, may affirm, reverse

or modify the actions of the trial court by memorandum opinion when a formal opinion

would have no precedential value. When a case is decided by memorandum opinion it shall

be designated “MEMORANDUM OPINION”, shall not be published, and shall not be

I. Background

This is the third appeal in this case. See Moxley v. Amisub SFH, Inc., W2021-

01422-COA-R9-CV, 2022 WL 3715056 (Tenn. Ct. App. Aug. 29, 2022) (“Moxley I”);

Moxley v. Amisub SFH, Inc., No. W2023-00220-COA-R3-CV, 2024 WL 1765046 (Tenn.

Ct. App. April 24, 2024) (“Moxley II”). The relevant background facts are set out in

Moxley I as follows:

The complaint filed in this case alleges that [Appellant] Eugene Moxley was

injured due to medical negligence during the course of a cancer treatment on

July 5, 2019. On July 3, 2020, [Appellant’s] counsel, A. Wilson Wages, sent

the statutorily required pre-suit notice of a potential health care liability claim

to twelve possible defendants. Tennessee Code Annotated section 29-26-

121(a)(2)(E) provides that pre-suit notice must include “[a] HIPAA [i.e.,

Health Insurance Portability and Accountability Act] compliant medical

authorization permitting the provider receiving the notice to obtain complete

medical records from each other provider being sent a notice.” (Emphasis

added). [Appellant] admits that a mistake was made with respect to the

HIPAA authorizations he sent to each provider.

On October 30, 2020, [Appellant] initiated this lawsuit by filing a

complaint against four defendants—Nurse Chapman, The Urology Group,

PC, Dr. Zachary Corr, and St. Francis Hospital [(together, “Appellees”)].

[Appellant’s] counsel, Mr. Wages, attached an affidavit stating that he had

complied with the pre-suit notice requirements and, among other things, sent

“a HIPAA compliant medical authorization permitting the providers who

were sent a notice to obtain medi[c]al records from the other providers.” He

attached all of the pre-suit notice letters and enclosed authorization forms

sent on the dates mentioned above.

Moxley I, 2022 WL 3715056, at *1-*2. As discussed in Moxley I,

The pre-suit notice letter sent to Nurse Chapman included twelve separate

HIPAA authorization forms. Each of the twelve forms Ms. Chapman

received designated her as the “releasing provider.” Thus, the forms she

received contained language stating that she could “release” medical records

to other entities. For example:

“I, Eugene T. Moxley, . . . do hereby authorize Kirsna J. Norris- Chapman,

cited or relied on for any reason in any unrelated case.

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R.N., to release to The Urology Group, the medical records . . . relating to

my treatment[.]”

“I, Eugene T. Moxley, . . . do hereby authorize Kirsna J. Norris- Chapman,

R.N., to release to St. Francis Hospital-Memphis, the medical records . . .

relating to my treatment[.]”

“I, Eugene T. Moxley, . . . do hereby authorize Kirsna J. Norris-Chapman,

R.N., to release to Zachary K. Corr, M.D., the medical records . . . relating

to my treatment[.]”

However, none of the twelve forms Nurse Chapman received contained

language stating that she could “obtain” any medical records, although

[Appellant] did send one authorization to Nurse Chapman that included her

name in both fields as follows:

“I, Eugene T. Moxley, . . . do hereby authorize Kirsna J. Norris-Chapman,

R.N., to release to Kirsna J. Norris-Chapman, R.N., the medical records . . .

relating to my treatment[.]”

The same mistake was repeated with the forms sent to all twelve potential

defendants.

Moxley I, at *1.

On January 25, 2021, St. Francis and Nurse Chapman filed a motion

to dismiss pursuant to Tennessee Rule of Civil Procedure 12.02(6), alleging

failure to comply with Tennessee Code Annotated section 29-26-

121(a)(2)(E). St. Francis and Nurse Chapman pointed out that the HIPAA

authorization forms they received with pre-suit notice allowed each of them

to “release” medical records but did not state that they could procure records

from other providers. As such, they argued that [Appellant] had failed to

substantially comply with the statute’s requirement that pre-suit notice

include “[a] HIPAA compliant medical authorization permitting the provider

receiving the notice to obtain complete medical records from each other

provider being sent a notice.” Tenn. Code Ann. § 29-26-121(a)(2)(E).

Moxley I, at *2. The remaining Appellees joined in the motion to dismiss. In opposing the

motion, Appellant asserted that he had substantially complied with the statutory

requirements. Specifically, “[h]e suggested that each provider should have known that

authorizations had been sent to all of the other potential defendants allowing the ‘release’

of records, such that ‘everyone involved could obtain copies of the relevant records’ if they

simply called and requested them.” Moxley II, at *1 (citing Moxley I, at *3). Following

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a hearing, the trial court denied Appellees’ Tennessee Rule of Civil Procedure 12.02

motion on its finding that, although Mr. Moxley did not substantially comply with

Tennessee Code Annotated section 29-26-121(a)(2)(E), extraordinary cause excused his

noncompliance. See Tenn. Code Ann. §29-26-121(b) (allowing the trial court to exercise

“discretion to excuse compliance [with the statutory pre-suit notice requirement] . . . only

for extraordinary cause shown”). In the Moxley I appeal, which was taken under Tennessee

Rule of Appellate Procedure 9, this Court reversed the trial court’s denial of Appellees’

Rule 12.02(6) motion. As discussed in Moxley II:

The only question certified in the Rule 9 appeal [i.e., Moxley I] was whether

the trial court erred in finding extraordinary cause. We determined that it did

and reversed the extraordinary cause finding but left undisturbed the trial

court’s finding on substantial compliance.2 On remand, the trial court granted

Appellees’ motion to dismiss without hearing.

Moxley II, at *1. Mr. Moxley then filed a Tennessee Rule of Appellate Procedure 3 appeal,

i.e., Moxley II. In Moxley II, we reviewed the trial court’s initial finding that Appellant

did not substantially comply with the statutory requirements and held that the trial court

applied an incorrect legal standard to that question. Specifically, the Moxley II Court

concluded that the trial court erroneously held Mr. Moxley to strict compliance with the

statutory requirements as opposed to substantial compliance. Moxley II, at *5. As we

explained:

[T]he trial court [erroneously] focused on whom Appellees could obtain the

records from, and not on whether Appellees could obtain the records at all .

. . . [The trial court’s] ruling was that Mr. Moxley’s pre-suit notice prejudiced

Appellees insofar as they were denied the benefit of ‘obtain[ing] all of [Mr.

Moxley’s] medical records from the other providers receiving pre-suit

notice.’ (Emphasis added). Respectfully, “the conclusion that a deficient

medical authorization would ordinarily deprive a defendant of the benefit of

Section 121 does not mean that such deficiency will always result in such

deprivation. . . . If a defective medical authorization automatically meant a

plaintiff failed to comply with section 121 pre-suit notice, there would be no

reason to consider prejudice.” Hayward [v. Chattanooga-Hamilton Cty.

Hosp. Auth., d/b/a Erlanger Health Systems, et al.], 680 S.W.3d [250, at]

261 [(Tenn. Ct. App. 2023), perm. app. denied (Tenn. Oct. 13, 2013)].

However, “[I]f the plaintiff’s noncompliance neither frustrates nor interferes

with the purposes of Section 121 nor prevents a defendant from receiving a

benefit the statute confers, then a court is more likely to determine that the

plaintiff has substantially complied.” Martin [v. Rolling Hills Hospital,

2

No appeal was taken from Moxley I. As such, the Moxley I holding that no extraordinary

cause exists is res judicata.

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LLC, 600 S.W.3d [322,] at 334 [(Tenn. 2020)], (citing Stevens [ex rel.

Stevens v. Hickman Community Healthcare Services, Inc., 418 S.W.3d

[547], at 555 [(Tenn. 2013)]. To date, the trial court has not resolved this

question.

Id. Because the trial court applied an incorrect legal standard, the Moxley II Court vacated

its order granting Appellees’ motion to dismiss and remanded for further proceedings,

“including consideration of the question of substantial compliance under the correct

standard.” Id. at *6.

Pursuant to this Court’s mandate in Moxley II, on remand, the trial court was to

determine whether Mr. Moxley’s pre-suit notices, which did not authorize his providers to

“obtain” medical records from other providers, constituted substantial compliance with the

statutes. Following a hearing on October 25, 2024, the trial court entered an order on

March 5, 2025. Therein, the trial court held that Mr. Moxley failed to substantially comply

with the pre-suit notice statutes and that Appellees were prejudiced by the non-compliance.

Accordingly, the trial court granted Appellees’ joint motion to dismiss the lawsuit. Mr.

Moxley appeals.

II. Issues

Mr. Moxley raises two issues for review as stated in his brief:

1. The trial court erred when it held Moxley failed to comply substantially

with the requirements of Tenn. Code Ann. § 29-26-121(a)(2)€ where his

HIPAA-compliant medical release allowed each potential defendant

receiving notice of intent to sue to obtain medical records from every other

potential defendant receiving notice simply by requesting those records.

2. The trial court erred when it dismissed the case with prejudice holding that

Moxley was not entitled to the extension of the limitations period available

to an HCLA plaintiff giving notice to all potential defendants under Tenn.

Code Ann. 29-26-121€ where each potential defendant received pre-suit

notice of suit.

As an initial matter, in his second issue, Appellant asks us to review the trial court’s

dismissal of the case WITH PREJUDICE. As set out in the order appealed, the trial court

dismissed Mr. Moxley’s lawsuit WITHOUT PREJUDICE, i.e., “Plaintiff’s Complaint is

dismissed without prejudice as to all Defendants. . . .” Accordingly, Appellant’s second

issue is a mere hypothetical and, as such, is not justiciable. Therefore, we will not address

it. Hurd v. Flores, 221 S.W.3d 14, 30 (Tenn. 2000) (citing State v. Brown & Williamson

Tobacco Corp., 18 S.W.3d 186, 193 (Tenn.2000)) (explaining that courts “will not render

an opinion in an appeal which . . . involves a purely hypothetical or theoretical set of

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facts”).3 Rather, the sole question before us is whether the trial court erred in granting

Appellees’ motion to dismiss on its finding that Mr. Moxley failed to substantially comply

with the pre-suit notice requirements of Tennessee Code Annotated section 29-26-

121(a)(2)€.

III. Standard of Review

As explained in Moxley II:

In Martin v. Rolling Hills Hospital, LLC, 600 S.W.3d 322, 334-35 (Tenn.

2020), the Tennessee Supreme Court explained that the proper avenue to

challenge a plaintiff’s compliance with the pre-suit notice requirements of

Tennessee Code Annotated section 29-26-121 is by a Tennessee Rule of

Civil Procedure 12.02(6) motion to dismiss. A trial court’s grant of a motion

to dismiss is a question of law, which we review de novo with no presumption

of correctness. Ellithorpe v. Weismark, 479 S.W.3d 818, 824 (Tenn. 2015).

Moxley II, at *3.

IV. Analysis

In Moxley II, we explained:

[T]he standard applicable to the question of substantial compliance is more

complex than strict compliance with the statute. Indeed, the Tennessee

Supreme Court has held that the requirements contained in section 29-26-

121(a)(2) (which include “[a] HIPAA compliant medical authorization

permitting the provider receiving the notice to obtain complete medical

records from each other provider being sent a notice,” Tenn. Code Ann. §

29-26-121(a)(2)€) are “directory” and may be satisfied by “substantial

compliance.” Stevens ex rel. Stevens v. Hickman Community Healthcare

Services, Inc., 418 S.W.3d 547, 555 (Tenn. 2013) (evaluating whether a

plaintiff substantially complied with Section 121(a) (2)€); see also Arden v.

Kozawa, 466 S.W.3d 758, 762-64 (Tenn. 2015) (holding that the

requirements of Section 121(a)(3)(B) and (a)(4) may be satisfied through

substantial compliance); Thurmond v. Mid-Cumberland Infectious Disease

Consultants, PLC, 433 S.W.3d 512, 520 (Tenn. 2014) (holding that the

3

To receive the additional 120-day extension of the statute of limitations under Tennessee Code

Annotated section 29-21-121(c), a plaintiff must substantially comply with Tennessee Code Annotated

section 29-26-121. See, e.g., Byrge v. Parkwest Medical Ctr., 442 S.W.3d 245, 250 (Tenn. Ct. App. 2014),

perm. app. denied (Tenn. June 24, 2014). Here, we conclude that Mr. Moxley did not comply with section

29-26-121(a)(2)(E). Accordingly, even if we could address issue two substantively, Mr. Moxley would not

be entitled to the 120-day extension.

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affidavit requirement of Section 121(a)(3)(B) and (a)(4) may be satisfied by

substantial compliance). So, strict compliance with section 121 is not

required for substantial compliance. Indeed, the ultimate purpose of the pre-

suit notice requirement is to allow potential defendants to investigate the

merits of the claims against them and to pursue settlement negotiations prior

to the lawsuit being filed. See Martin, 600 S.W.3d at 331; Runions v.

Jackson-Madison Cnty. Gen. Hosp. Dist., 549 S.W.3d 77, 86 (Tenn. 2018).

In short, “[n]ot every non-compliant HIPAA medical authorization will

result in prejudice.” Stevens, 418 S.W.3d at 556. Concerning the question of

prejudice, the Martin [v. Rolling Hills Hosp., LLC, 600 S.W.3d 322, 331

(Tenn. 2020)] Court clarified that prejudice is not a separate and independent

analytical element; rather, as Stevens explained, prejudice is a consideration

relevant to determining whether a plaintiff has substantially complied.

Prejudice, or the absence of prejudice, is especially relevant to evaluating the

extent and significance of the plaintiff’s noncompliance. If a plaintiff’s

noncompliance with Section 121 frustrates or interferes with the purposes of

Section 121 or prevents the defendant from receiving a benefit Section 121

confers, then the plaintiff likely has not substantially complied with Section

121. On the other hand, if the plaintiff’s noncompliance neither frustrates or

interferes with the purposes of Section 121 nor prevents a defendant from

receiving a benefit the statute confers, then a court is more likely to determine

that the plaintiff has substantially complied. Martin, 600 S.W.3d at 333-34

(internal citations omitted); see also Hayward v. Chattanooga-Hamilton

Cty. Hosp. Auth., d/b/a Erlanger Health Systems, et al., 680 S.W.3d 252,

260 (Tenn. Ct. App. 2023), perm. app. denied (Tenn. Oct. 13, 2013) (citing

Martin, 600 S.W.3d at 334).

Moxley II, at *5 (footnote omitted). Here, the trial court held that Appellant “has NOT

substantially complied with Tenn. Code Ann. § 29-26-121(a)(2)€ and defendants suffered

prejudice as they were not able to have access to plaintiff’s medical records which would

allow defendants to investigate the merits of the claim, thus frustrating and interfering with

the purpose of the statute” (capitalization in original). We agree with the trial court’s

conclusions.

As noted above, Tennessee Code Annotated section 29-26-121(a)(2)(E) requires

“[a] HIPAA compliant medical authorization permitting the provider receiving the notice

to obtain complete medical records from each other provider being sent a notice”

(emphases added). As the Tennessee Supreme Court has explained:

Because HIPAA itself prohibits medical providers from using or disclosing

a plaintiff’s medical records without a fully compliant authorization form, it

is a threshold requirement of the statute that the plaintiff’s medical

authorization must be sufficient to enable defendants to obtain and review a

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plaintiff’s relevant medical records. See 45 C.F.R. § 164.508(a)(1) (“a

covered entity may not use or disclose protected health information without

an authorization that is valid under this section”). Tenn. Code Ann. § 29-26-

121(d)(1) creates a statutory entitlement to the records governed by § 29-26-

121(a)(2)(E). See Tenn. Code Ann. § 29-26-121(d)(1) (“All parties in an

action covered by this section shall be entitled to obtain complete copies of

the claimant’s medical records from any other provider receiving notice . . .

.”) (emphasis added).

Stevens, 418 S.W.3d at 555 (footnote omitted) (emphasis in original). As this Court has

cautioned,

[b]ecause the penalties imposed on entities that wrongfully disclose or obtain

private health information in violation of HIPAA are severe, the sufficiency

of the plaintiffs’ medical authorizations is imperative. [Stevens., 418 S.W.3d

at 555] (citing 45 C.F.R. § 164.508(a)(1) (“[A] covered entity may not use

or disclose protected health information without an authorization that is valid

under this section.”)).

Woodruff by and through Cockrell v. Walker, 542 S.W.3d 486 at 499 (Tenn. Ct. App.

2017), perm. app. denied (Tenn. Oct. 6, 2017). Indeed, “[e]ntities that wrongfully disclose

or obtain private health information in violation of HIPAA may face fines of up to $50,000

per offense and/or imprisonment of up to one year.” Id. at fn. 9 (citing 42 U.S.C.A. §

1320d–6). Here, Appellant argues that the authorizations “were not deficient” and “were

wholly and completely HIPAA-compliant” because Appellees

were able to obtain complete copies of [Appellant’s medical] records by

simply asking for them. What matters is that the authorization is effective to

allow listed medical providers to obtain medical records from each other.

The word “obtain” is not magical. If an authorization permits a defendant to

obtain medical records but does not say “obtain,” it is compliant all the same.

All Defendants had to do to “obtain” the records was ask for them. And

because they could “obtain” records from one another by way of the releases

provided, Defendants incurred no prejudice from Moxley’s method.

Appellant’s argument is incorrect insofar as it ignores the plain language of Tennessee

Code Annotated section 29-26-121(a)(2)(E), which requires a HIPAA authorization

specifically “permitting the provider . . . to obtain complete medical records.” (Emphasis

added).4 As correctly noted in Appellees’ brief, “a facially valid authorization allowing

4

In Bray v. Khuri, 523 S.W.3d 619 (Tenn. 2017), the Tennessee Supreme Court established two

exceptions to requirements of Tennessee Code Annotated section 29-26-121(a)(2)(E): (1) “a plaintiff need

not provide a HIPAA-compliant authorization when a single healthcare provider is given pre-suit notice of

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Provider A to release its records to Provider B does not allow Provider A to use that same

authorization to obtain records from Provider B.” Such is the case here. Although “less-

than-perfect compliance with Tenn. Code Ann. § 29-26-121(a)(2)(E) [] should not derail a

healthcare liability claim,” Stevens, 418 S.W.3d at 555, the required notice must still “be

sufficient to enable defendants to obtain and review a plaintiff’s relevant medical records.”

Id. (citing 45 C.F.R. § 164.508(a)(1)). As this Court recently explained:

HIPAA authorizations are required to provide “[t]he name or other specific

identification of the person(s), or class of persons, authorized to make the

requested use or disclosure” as well as the “[t]he name or other specific

identification of the person(s), or class of persons, to whom the covered

entity may make the requested use or disclosure.” 45 C.F.R. § 164.508(c)(ii)-

(iii).

Crenshaw on behalf of Murphy v. Methodist Healthcare-Memphis Hosp., et al.,

No. W2024-00682-COA-R3-CV, 2025 WL 1336350, at *4 (Tenn. Ct. App. May 7, 2025),

perm. app. denied (Tenn. Oct. 9, 2025). Indeed, in J.A.C. by & through Carter v.

Methodist Healthcare Memphis Hospitals., 542 S.W.3d 502, 513-14 (Tenn. Ct. App.

2016), this Court held that the plaintiff’s authorizations were “clearly ineffective to allow

the Providers to receive medical records from one another” where “[t]he forms merely

contained blanks where” they were supposed to disclose the “person(s), or class of persons,

that were authorized to disclose protected health information” and the “person(s) or class

of persons, to whom a disclosure of information could be made.” Because the

authorizations tendered by Appellant do not contain the identifying information of each

person or entity able to receive/obtain Mr. Moxley’s medical information, the

authorizations are incomplete and ineffective. Crenshaw, 2025 WL 1336350, at *4 (citing

45 C.F.R. § 164.508(c)(ii)-(iii)). In this regard, Appellant failed to substantially comply

with the requirements of Tennessee Code Annotated section 29-26-121(a)(2)(E), and

Appellees were deprived of the ability to obtain and review the applicable medical records.

This Court has held that, “Defendants are clearly prejudiced when unable, due to a form

procedural error, to obtain medical records needed for their legal defense.” Lawson, 544

S.W.3d at 709-710 (citing Hamilton v. Abercrombie Radiological Consultants, Inc., 487

S.W.3d 114, 120 (Tenn. Ct. App. 2014), perm. app. denied (Tenn. May 15, 2015));

Stevens, 418 S.W.3d at 556; Lott v. Mallett, No. W2020-01233-COA-R3-CV, 2022 WL

894755, at *7 (Tenn. Ct. App. March 25, 2022) (holding that appellant failed to

substantially comply with Tennessee Code Annotated section 29-26-121(a)(2)(E) because

her authorization did not allow defendant/doctor to obtain medical records from the other

health care provider receiving pre-suit notice.); Wenzler v. Xiao Yu, No. W2018-00369-

a healthcare liability claim,” and (2) a health care provider may use or disclose protected health information

for its health care operations and does not need to obtain a medical authorization in order “to use a patient's

medical records in [its] possession and consult with counsel to evaluate the merits of a potential claim.” Id.

at 622-23. Neither of the Bray exceptions is applicable here.

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COA-R3-CV, 2018 WL 6077847, *11 (Tenn. Ct. App. Nov. 20, 2018 (citing Hamilton,

487 S.W.3d at 120) (same).

V. Conclusion

For the foregoing reasons, the trial court’s order dismissing Appellant’s lawsuit is

affirmed. The case is remanded for such further proceedings as may be necessary and are

consistent with this opinion. Costs of the appeal are assessed to the Appellant, Eugene

Moxley. Execution for costs may issue if necessary.

s/ Roy B. Morgan, Jr.

ROY B. MORGAN, JR., SENIOR JUDGE

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