Economic-Damages Exception to the West Virginia Medical Professional Liability Act
(Commentary on Elaine Neidig v. Valley Health System, No. 24-27, 2025)

1. Introduction

The Supreme Court of Appeals of West Virginia has squarely addressed whether the West Virginia Medical Professional Liability Act (“MPLA”) governs a lawsuit where the plaintiff seeks only economic damages and expressly disclaims any form of physical, emotional, or wrongful-death injury. By answering the certified question from the U.S. Court of Appeals for the Fourth Circuit, the Court has carved out a clear doctrinal boundary: the MPLA does not apply in the absence of alleged personal injury or death. The decision arises from a class-action consumer claim filed by Elaine Neidig after the FDA found “serious image quality deficiencies” in mammograms performed at Valley Health System’s Winchester Medical Center.

2. Summary of the Judgment

Applying de novo review, the Court reformulated the Fourth Circuit’s certified question to read:

Does the Medical Professional Liability Act apply to a suit against a health care provider or health care facility when the plaintiff claims only economic damages and disclaims all liability based on physical injury, emotional injury, or death?

In a detailed statutory-construction analysis, Chief Justice Wooton, writing for the majority, held that the definition of “medical professional liability” in W. Va. Code § 55-7B-2(i) contains a predicate requirement: damages must result from the “death or injury of a person.” Where a complaint seeks purely economic relief―such as restitution, disgorgement, or contract damages―and disavows any personal injury, the MPLA’s notice, certificate-of-merit, and statute-of-limitations provisions are inapplicable.

3. Detailed Analysis

3.1 Precedents Cited and Their Influence

• Syl. Pt. 5, State ex rel. DCR v. Ferguson (2023) – Established the two-part gateway for MPLA applicability: (1) defendant must be a “health care provider/facility,” and (2) claim must constitute “medical professional liability.” Neidig refines part (2).
• State ex rel. WVU Hospitals v. Scott (2021) – Introduced the “anchor vs. ancillary claim” framework. Neidig adopts that taxonomy but holds that no anchor exists where no personal injury is pled.
• Blankenship v. Ethicon (2007) – Warned against “creative pleading” to escape the MPLA. Valley Health leaned on this case, but the Court distinguished it because Blankenship involved bodily-injury allegations.
• Phillips v. Larry’s Drive-In Pharmacy (2007), Kellar v. James (1907) – Reiterated that statutes in derogation of the common law (including the MPLA) must be strictly construed. The Court used this principle to resist broad reading of the Act.
• Light v. Allstate (1998) and Chrystal R.M. v. Charlie A.L. (1995) – Confirmed the de novo standard for certified questions/statutory interpretation.

3.2 The Court’s Legal Reasoning

1. Textual Analysis
   • The operative language (“liability for damages resulting from the death or injury of a person for any tort or breach of contract”) requires an injury-to-person nexus before the Act activates.
   • Valley Health’s reading would necessitate inserting an additional “from” and a comma—judicial rewriting the Court refused to do.
   • Use of “or” simply distinguishes types of claims (tort vs. contract); it does not sever them from the “death or injury” qualifier.
2. Legislative Purpose
   • MPLA’s declaration of purpose repeatedly pairs “injury” with “death,” signaling that “injury” means personal, not economic, harm.
   • The Act’s procedural mechanisms (certificate of merit by a healthcare expert, specialized statute of limitations) make sense only for injury-based litigation.
3. Strict Construction Doctrine
   • Because the MPLA abrogates common-law rights, it must be narrowly interpreted; ambiguities resolve against extending its reach.
4. Anchor & Ancillary Claims Doctrine Expanded
   • Without at least one injury-based anchor claim, no ancillary claim can ride into MPLA territory. Hence, Neidig’s consumer-protection and contract theories remain outside the Act.

3.3 Likely Impact of the Decision

• Consumer and Contract Litigation – Plaintiffs alleging fraudulent medical marketing, overbilling, or other economic harms may proceed without the MPLA’s procedural hurdles (pre-suit notice, expert certificate, two-year statute).
• Statute of Limitations – Such cases will default to the ordinary limitations periods for consumer claims (e.g., four years under the WVCCPA) or written contracts (ten years), potentially reviving claims previously thought untimely under the MPLA’s two-year bar.
• Pleading Strategies Clarified – Courts must look not at labels but at substance; if no personal injury claim exists, the economic-only claim is outside the Act—by operation of law, not by artful pleading.
• Insurance & Risk Allocation – Medical liability carriers may see reduced exposure for pure economic claims; conversely, health-care providers could face class-action consumer suits with broader damages theories.
• Future Certified Questions – The decision provides a clear rule; federal courts sitting in diversity now have controlling authority on when the MPLA applies.

4. Complex Concepts Simplified

• Certified Question – A formal mechanism allowing a federal court to ask a state supreme court to interpret state law when that interpretation is crucial to the federal case and no controlling precedent exists.
• MPLA – A West Virginia statute that regulates medical-malpractice suits: shorter limitations period, pre-suit notice, expert screening certificate, and certain damages caps.
• Anchor vs. Ancillary Claims
  • Anchor claim: a claim based on negligent health-care services resulting in personal injury/death.
  • Ancillary claim: accompanying claims (e.g., informed consent, battery, contract) that are “contemporaneous to or related to” the anchor.
• Strict Construction of Statutes in Derogation – When a law curtails common-law rights or procedures, courts interpret it narrowly to avoid unintended encroachment.
• Disjunctive “or” vs. Conjunctive “and” – “Or” typically denotes alternatives. In statutes, context may show that a preceding qualifier (here, “death or injury”) applies to every element after it, despite the “or.”

5. Conclusion

Neidig v. Valley Health System establishes a pivotal precedent: the MPLA’s scope stops where purely economic harm begins. By tethering MPLA applicability to “death or injury of a person,” the Court preserves consumer-protection and contract remedies free from the Act’s procedural gatekeeping. Health-care defendants can no longer invoke the MPLA as a universal shield; plaintiffs must, however, accept the trade-off—foregoing any later pivot to personal-injury damages if they disclaim them at the outset.

Practitioners should now conduct an early “injury audit:” if the complaint alleges any physical or emotional harm, MPLA procedures remain mandatory; if it seeks only economic relief, the MPLA is off the table. Legislators, insurers, and courts will watch closely to see whether this carve-out shifts the balance of health-care litigation in West Virginia.