Requirement of Transactional Nexus for Relation Back Under Rule 15(c): Ex parte Air Evac EMS, Inc.

Introduction

In Ex parte Air Evac EMS, Inc., 2025 WL ______ (Ala. Mar. 21, 2025), the Supreme Court of Alabama addressed the narrow circumstances under which an amended complaint in a medical-liability action may “relate back” to the filing date of an original complaint for purposes of statutes of limitations and repose. The petition arose from a mandamus proceeding in which Air Evac EMS, Inc. (“Air Evac”) challenged the Dallas Circuit Court’s denial of its summary-judgment motion. The central dispute was whether claims first asserted nearly four years after the initial pleading—based on facts occurring a day before the originally alleged injury and implicating different actors—could escape the two-year limitation and four-year repose periods of the Alabama Medical Liability Act (AMLA), Ala. Code §§ 6-5-480 et seq.

Parties and procedural posture:

Plaintiffs: Earnest Charles Jones (through his wife Ovetta Jones).
Defendants: Bryan Heath Wester (flight nurse/paramedic) and Air Evac EMS, Inc.
Procedural vehicle: Petition for writ of mandamus after denial of summary judgment.

Summary of the Judgment

The Supreme Court of Alabama granted the writ of mandamus. It held that:

The AMLA’s two-year statute of limitations and four-year statute of repose apply to any action against health-care providers for liability, error, mistake, or failure to cure. (§ 6-5-482(a)).
An amended complaint filed long after those deadlines may “relate back” to the original complaint only if it “arose out of the conduct, transaction, or occurrence set forth or attempted to be set forth in the original pleading” under Rule 15(c)(2), Ala. R. Civ. P.
The new allegations—(a) theft and tampering of ketamine on August 26, 2018, and (b) negligent response by other flight nurses—were entirely distinct in time, actors, and operative fact from the original claim of forcible removal of a nasal-gastro tube by Wester on August 27, 2018.
Because the amended claims did not relate back, they were time-barred. The trial court erred in denying summary judgment; a writ was appropriate to vacate that order and direct entry of summary judgment for Air Evac.

Analysis

Precedents Cited

Rule 15(c)(2), Ala. R. Civ. P. — establishes the “relation back” test: amendments that “arise out of the conduct, transaction, or occurrence” of the original pleading may be treated as filed on the original date.
Ex parte Affinity Hospital, LLC, 373 So. 3d 180 (Ala. 2022) — applied the relation-back test in a medical-liability context. There the Court refused to allow new allegations about post-operative diabetic management and fall risk to relate back to an original complaint alleging surgical laceration and infection, because the amended claims addressed “conduct distinct in kind and in time.”
Prior v. Cancer Surgery of Mobile, P.C., 959 So. 2d 1092 (Ala. 2006) — recognized that Rule 15(c)(2) may save otherwise time-barred amendments if they stem from the same transaction or occurrence as the original complaint.
Mandamus standards and summary-judgment principles, as discussed in Ex parte Hodge, Ex parte Nall, Ex parte BOC Group, Ex parte Abbott Laboratories, Ex parte Simpson, Ex parte Sanderson, Ex parte Town of Dauphin Island, and Ex parte Yancey.

Legal Reasoning

1. Statutes of Limitations and Repose under the AMLA. The Court reiterated that medical-liability claims must be brought within two years of the act or omission (§ 6-5-482(a)) and in no event later than four years after the act. Both deadlines had expired when the Joneses filed their amended complaint in April 2024 for events occurring in August 2018.

2. Relation-Back Doctrine (Rule 15(c)(2)). The Joneses tried to invoke Rule 15(c)(2) to treat their April 2024 pleading as filed in August 2020. Under Prior and Affinity Hospital, the pivotal inquiry is whether the new allegations are merely a “refinement” of the original facts or instead posit a “different matter” or “another subject of controversy.” If the latter, relation back is unavailable.

3. Comparison of Original and Amended Claims.

Original complaint: On August 27, 2018, flight nurse Wester negligently or wantonly removed a nasal-gastro tube from Earnest’s throat, causing scarring, voice impairment, and emotional distress.
Amended complaint: On August 26, 2018, Wester stole ketamine from the aircraft and substituted saline; on August 27, 2018, two different flight nurses administered tampered medication and mismanaged Earnest’s pain; Air Evac failed to train, supervise, or follow drug-storage guidelines.

The Court held that these allegations differ as to date, actors, theory of liability, and operative facts. They do not “arise out of” the conduct of forcibly removing the tube, but instead focus on theft of controlled substances and subsequent care by other individuals. Under Affinity Hospital, such a “drastic departure” cannot relate back.

4. Mandamus Relief. Because the face of the complaints conclusively showed that the amended claims were time-barred and could not relate back, Air Evac demonstrated a clear right to summary judgment and lack of any adequate remedy by appeal.

Impact

This decision sharpens the boundary of Rule 15(c)(2)’s relation-back exception in medical-malpractice and health-care cases:

Plaintiffs cannot evade statutes of limitations and repose by tacking on entirely new facts, dates, and defendants under the guise of amendment.
Trial courts and litigants must compare amended and original pleadings carefully; any new claim that changes the “who,” “what,” “when,” or “how” of the alleged misconduct risks being time-barred.
The ruling reinforces certainty and finality in medical-liability litigation, preventing stale claims based on events or actors not encompassed by the initial pleadings.

Complex Concepts Simplified

Statute of limitations: A deadline (two years under the AMLA) to file suit after the wrongful act or omission occurs.
Statute of repose: A hard cutoff (four years under the AMLA) beyond which no claim can be pursued, regardless of when the harm is discovered.
Rule 15(c)(2) “relation back”: Allows an amendment to “relate back” to the original filing date if it arises from the same transaction or occurrence, thus preserving timeliness.
Mandamus: An extraordinary writ ordering a lower court to perform a clear legal duty when no adequate alternative remedy exists.

Conclusion

Ex parte Air Evac EMS, Inc. underscores that amended complaints in medical-liability cases must share a transactional nexus with the original pleading to escape statutes of limitations and repose. Claims based on new operative facts, dates, or actors—even if falling under the same general umbrella of patient care—will not “relate back” under Rule 15(c)(2). By granting mandamus and directing summary judgment for Air Evac, the Supreme Court of Alabama reaffirmed the importance of clear, timely pleadings and provided guidance to practitioners on the limits of post-deadline amendments.