Representative, Not Minor Beneficiaries, Is the “Claimant Authorizing the Notice” under Tenn. Code Ann. § 29-26-121(a)(2)(B)

Representative, Not Minor Beneficiaries, Is the “Claimant Authorizing the Notice” under Tenn. Code Ann. § 29-26-121(a)(2)(B)

Introduction

In Ashley Denson ex rel. Bobbie J. Denson v. Methodist Medical Center of Oak Ridge et al., the Supreme Court of Tennessee resolved a recurring question arising under the Health Care Liability Act’s pre-suit notice regime: when a wrongful death claim belongs to minor beneficiaries, who is “the claimant authorizing the notice” that must be identified in the pre-suit notice under Tennessee Code Annotated section 29-26-121(a)(2)(B)? The Court held that the “claimant authorizing the notice” is the person who actually asserts and authorizes the giving of notice—including a representative acting on behalf of minors—not the minor beneficiaries themselves. The Court further clarified that the statute does not require the notice to identify the beneficiaries of the claim.

The case arose from the death of Ashley Denson following hospital treatment. Her mother, Bobbie Jo Denson, took custody of Ashley’s two minor children and sent pre-suit notices that identified herself, not the minors, as “the claimant authorizing the notice.” After she filed suit initially in her own right and on the children’s behalf, defendants moved to dismiss, arguing that the notice was defective for failing to identify the children as the claimants. The trial court denied dismissal; the Court of Appeals reversed; and the Tennessee Supreme Court granted review and ultimately reversed the Court of Appeals.

The decision sets a clear, text-driven rule for future health care liability cases in which the real parties in interest are minors (or, by logical extension, others lacking capacity): the representative who approves and sends pre-suit notice is the “claimant authorizing the notice,” and strict identification of the minor beneficiaries in the notice is not required by the statute.

Summary of the Opinion

  • The Court held that under Tenn. Code Ann. § 29-26-121(a)(2)(B), “the claimant authorizing the notice” is the person who asserts the right and formally approves giving pre-suit notice. Where minor beneficiaries hold the wrongful death claim, they cannot authorize notice themselves; a representative may do so on their behalf.
  • Bobbie Jo Denson, the minors’ legal custodian and in loco parentis, qualified as a representative authorized to sue on the minors’ behalf under Tenn. R. Civ. P. 17.03. By identifying herself (and her relationship to the patient) in the pre-suit notice, she achieved actual compliance with § 29-26-121(a)(2)(B).
  • The statute does not require the notice to identify the beneficiaries of the claim (here, the minor children). Although such information may be helpful, it is not mandated by the text of § 29-26-121(a)(2)(B).
  • Because the Court found actual compliance with the content requirement, it did not reach substantial-compliance or prejudice analysis.
  • The Court also noted that “standing” is not the framework for pre-suit notice; who may give notice is governed by § 29-26-121, and Bobbie Jo was a proper representative to bring suit on behalf of the minors under Rule 17.03.
  • Result: Judgment of the Court of Appeals reversed; case remanded to the circuit court.

Analysis

Precedents and Authorities Cited

The Court’s reasoning synthesizes multiple lines of Tennessee authority:

  • Textual interpretation and methodology:
    • State v. Deberry, 651 S.W.3d 918 (Tenn. 2022) and State v. Frazier, 558 S.W.3d 145 (Tenn. 2018): Confirm the “original public meaning” approach and that ambiguity is not created merely by parties’ competing interpretations.
    • McNabb v. Harrison, 710 S.W.3d 653 (Tenn. 2025): Reinforces reliance on canons of construction in textual analysis.
    • Bidwell ex rel. Bidwell v. Strait, 618 S.W.3d 309 (Tenn. 2021); Runions v. Jackson-Madison County Gen. Hosp. Dist., 549 S.W.3d 77 (Tenn. 2018); Cunningham v. Williamson Cnty. Hosp. Dist., 405 S.W.3d 41 (Tenn. 2013): Emphasize applying plain and ordinary meaning when statutory text is clear.
    • Myers v. AMISUB (SFH), Inc., 382 S.W.3d 300 (Tenn. 2012): Reminds courts that it is not their role to rewrite statutes.
  • Pre-suit notice framework under HCLA:
    • Martin v. Rolling Hills Hosp., LLC, 600 S.W.3d 322 (Tenn. 2020): Confirms strict compliance with the timing requirement (§ 29-26-121(a)(1)) and substantial compliance with content requirements (§ 29-26-121(a)(2)).
    • Stevens ex rel. Stevens v. Hickman Cmty. Health Care Servs., Inc., 418 S.W.3d 547 (Tenn. 2013): Establishes substantial-compliance analysis for content and considers prejudice; here, the Court noted prejudice analysis is unnecessary when there is actual compliance.
  • Wrongful death succession and capacity of minors:
    • Beard v. Branson, 528 S.W.3d 487 (Tenn. 2017): Explains that while a wrongful death claim remains one claim of the decedent, the right of action passes by statute (here, to children if no spouse).
    • Busby v. Massey, 686 S.W.2d 60 (Tenn. 1984) and Childress v. Madison Cnty., 777 S.W.2d 1 (Tenn. Ct. App. 1989): Minors cannot act for themselves to contract with counsel or institute suits; they require a representative.
    • Tenn. R. Civ. P. 17.03; In re Lackey, 1991 WL 45394 (Tenn. Ct. App.); In re Leyna A., 2017 WL 4083644 (Tenn. Ct. App.): Authorize representatives—including parents, legal guardians, and legal custodians (as “other like fiduciary”)—to sue on behalf of minors or, absent a representative, to proceed by next friend.
    • Tenn. Code Ann. § 37-1-102(8) (in loco parentis) and § 37-1-140(a): Detail rights and duties of those standing in loco parentis, supporting a custodian’s authority to act for minors.
  • Standing and issue preservation:
    • City of Memphis v. Hargett, 414 S.W.3d 88 (Tenn. 2013): Clarifies that standing concerns proper parties to sue, not subject-matter jurisdiction; here, the Court notes that who may give pre-suit notice is a statutory question, not one of constitutional standing.
    • Hodge v. Craig, 382 S.W.3d 325 (Tenn. 2012) and Tenn. R. App. P. 27(b): Issues not raised in the principal brief are waived; defendants’ belated “standing” arguments were waived and, in any event, Bobbie Jo qualified under Rule 17.03.

Legal Reasoning

The Court’s analysis proceeds from the statutory text. Section 29-26-121(a)(2)(B) requires pre-suit notice to include “[t]he name and address of the claimant authorizing the notice and the relationship to the patient, if the notice is not sent by the patient.” Because the statute does not define “claimant” or “authorize,” the Court looked to authoritative contemporaneous dictionaries: a “claimant” is one who asserts a right, and to “authorize” is to formally approve. Combining these, “the claimant authorizing the notice” is the person who asserts the claim and formally approves the giving of notice.

In wrongful death cases, although the claim is unitary and belongs to the decedent, the right of action passes by statute. Here, with no surviving spouse, the right passed to the minor children. But minors cannot act on their own behalf—they cannot contract with counsel or institute litigation. They require a representative to assert the claim and to authorize the steps necessary to bring it, including pre-suit notice.

Bobbie Jo Denson, the children’s legal custodian standing in loco parentis and charged by court order with their care and decisionmaking, qualified under Rule 17.03 as an “other like fiduciary” authorized to sue on behalf of the minors. Thus, she was the person who asserted the right and formally approved sending pre-suit notice. Identifying herself—and her relationship to the patient—as the “claimant authorizing the notice” strictly conformed to the text of § 29-26-121(a)(2)(B). That amounts to actual, not merely substantial, compliance.

The Court rejected the contention that the statute required the notice to identify the minor beneficiaries. While such identification may be practically helpful, the statute’s content list in § 29-26-121(a)(2) requires the claimant’s name and relationship, not the beneficiaries’ identities. The Court emphasized that it would not “rewrite the statute” to add a requirement the legislature did not include.

Because actual compliance was found, the Court did not engage in substantial-compliance and prejudice analysis under Stevens. It also noted that the “standing” rubric does not govern who may issue pre-suit notice; the statute itself does. Even so, and to the extent it mattered, Bobbie Jo was a proper representative under Rule 17.03.

Impact and Implications

The decision supplies needed clarity on a threshold procedural requirement that frequently triggers early motion practice in health care liability cases. Key implications include:

  • Representative identification suffices: When minors (or other persons lacking capacity) are the wrongful death beneficiaries or the real parties in interest, the pre-suit notice complies with § 29-26-121(a)(2)(B) if it identifies the representative who actually authorizes the notice and states the representative’s relationship to the patient. The beneficiaries themselves need not be named in the notice.
  • Reduced dismissal risk on technical content challenges: Defendants can no longer win dismissal merely because a notice failed to list minor beneficiaries as “claimants,” where a duly authorized representative authorized the notice. Dispositive motions must focus on whether the person identified truly had authority to act, not on whether beneficiaries were enumerated.
  • Guidance for “who may authorize”: The ruling strongly signals that custodians, guardians, conservators, personal representatives, and next friends—so long as they qualify under Rule 17.03 or analogous authority—may serve as the “claimant authorizing the notice” when the real party in interest lacks capacity.
  • Interaction with tolling and timing: Valid notice by a qualified representative should trigger the HCLA’s tolling and timing protections without fear that omission of beneficiaries’ names will defeat tolling. Challenges will more likely arise where the purported authorizer lacked legal capacity to act.
  • Continuing role of substantial compliance: Although the Court found actual compliance and bypassed prejudice analysis, Martin and Stevens remain controlling on the broader substantial-compliance framework for other content elements (e.g., HIPAA authorization). This case narrows one category of content disputes by defining the necessary “claimant” identification.
  • Textualist trend: The Court’s dictionary-driven, original-public-meaning analysis reinforces a steady jurisprudential pattern in Tennessee statutory interpretation, signaling that additional requirements won’t be implied into the HCLA’s notice statute.

Complex Concepts Simplified

  • Pre-suit notice (HCLA): Before filing a health care liability complaint, a claimant must send written notice to each provider at least 60 days in advance. The notice must contain specific items, including the name and address of the “claimant authorizing the notice” and the relationship to the patient, if the patient isn’t the sender.
  • “Claimant authorizing the notice”: The person who both asserts the right to sue and formally approves giving the notice. If the real party in interest can’t act (e.g., a minor), a legally authorized representative may be (and here, was) the “claimant authorizing the notice.”
  • Strict vs. substantial compliance:
    • Strict compliance: The timing requirement (60 days’ notice before suit) must be met exactly.
    • Substantial compliance: The content requirements can be satisfied if the plaintiff’s notice, in substance, provides what the statute requires; prejudice (or lack thereof) is relevant. In this case, the Court found actual compliance with the specific content provision at issue.
  • Wrongful death succession: In Tennessee, a wrongful death claim is a single claim of the decedent, but the right to bring it passes by statute (e.g., to a surviving spouse, then to children if no spouse). The beneficiaries are the “real parties in interest,” but if they are minors, they cannot act without a representative.
  • Rule 17.03 representation: When a minor or incompetent has a representative (guardian, conservator, custodian, or similar), that representative may sue or defend on the minor’s behalf. If none exists, the minor may proceed by next friend. This rule provides the vehicle for the representative to be the “claimant authorizing the notice.”
  • In loco parentis and legal custody: A legal custodian standing in loco parentis has rights and duties akin to a parent’s for the child’s care and can act on the child’s behalf, including authorizing litigation steps when consistent with court orders and Rule 17.03.
  • Standing vs. statutory authority: “Standing” concerns whether a party is a proper plaintiff in court, not who may send pre-suit notice. Here, the statute itself (and Rule 17.03) supplied the authorization to send the notice and file suit, and any broader “standing” issue was waived in the appellate briefing.

Practical Guidance

  • For plaintiffs/representatives:
    • Identify in the notice the representative who is authorizing notice and clearly state the relationship to the patient (e.g., “legal custodian of decedent’s minor children,” “conservator of the patient”).
    • Although not required, consider voluntarily listing known beneficiaries to facilitate early evaluation and settlement; however, omitting such information will not, under this decision, invalidate the notice.
    • Ensure the representative’s authority is documented (court orders of custody/guardianship or conservatorship) and consistent with Rule 17.03.
    • Continue to substantially comply with all other content elements, including a HIPAA-compliant authorization.
  • For defendants:
    • Focus threshold challenges on whether the person identified truly had legal authority to act as a representative at the time notice was sent.
    • Do not rely on failure to list minor beneficiaries as a basis to dismiss; the statute, as construed, does not require it.
    • Evaluate prejudice arguments carefully; they remain relevant to other content defects under Stevens if actual compliance is absent.
  • For courts:
    • Apply a textual approach to § 29-26-121(a)(2) content requirements; refrain from adding non-textual identification requirements.
    • When actual compliance is found, dismissal for content defects is inappropriate and prejudice analysis is unnecessary.

Conclusion

The Tennessee Supreme Court’s decision articulates a clear rule grounded in statutory text: under § 29-26-121(a)(2)(B), the “claimant authorizing the notice” is the person who asserts the claim and formally approves sending notice. Where minors hold the wrongful death right of action, they cannot authorize notice; a duly authorized representative—such as a legal custodian—may do so and may be identified as the claimant authorizing the notice. The statute does not require naming the beneficiaries in the notice.

By resolving this question, the Court reduces technical dismissals in health care liability actions and brings coherence to pre-suit notice practice, especially in cases involving minors or others lacking capacity. The opinion reinforces Tennessee’s textualist interpretive approach and preserves the substantial-compliance framework for content requirements while clarifying that, when the text is satisfied as written, courts will not graft additional obligations onto the statute. The case is a significant touchstone for practitioners navigating wrongful death claims and pre-suit notice under the HCLA.

Case: Ashley Denson ex rel. Bobbie J. Denson v. Methodist Medical Center of Oak Ridge et al. (No. E2023-00027-SC-R11-CV). Supreme Court of Tennessee. Opinion by Justice Dwight E. Tarwater; Chief Justice Jeffrey S. Bivins and Justices Holly Kirby, Sarah K. Campbell, and Mary L. Wagner joined. Decided Oct. 13, 2025.

Case Details

Year: 2025
Court: Supreme Court of Tennessee

Judge(s)

Justice Dwight E. Tarwater

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