ANDREANA WILLIAMS, CONSERVATOR v. REGENCY HOSPITAL COMPANY, LLC

318 Ga. 145
FINAL COPY

S24A0312. WILLIAMS V. REGENCY HOSPITAL COMPANY,

LLC ET AL.

ORDER OF THE COURT.

In April 2023, the appellant filed this action on behalf of her

mentally incapacitated ward for the respondents’ alleged medical

malpractice between September 23, 2020, and October 22, 2020. The

respondents filed separate motions to dismiss, arguing that the

general two-year statute of limitation for medical malpractice

actions in OCGA § 9-3-71 (a) barred the claims because, under § 9-

3-73 (b), “[n]otwithstanding Article 5 of [Title 9, Chapter 3], all

persons who are legally incompetent because of intellectual

disability or mental illness . . . shall be subject to the periods of

limitation for actions for medical malpractice provided in [Title 9,

Chapter 3, Article 4].” See OCGA § 9-3-90 (a) (“Individuals who are

legally incompetent because of intellectual disability or mental

illness, who are such when the cause of action accrues, shall be

entitled to the same time after their disability is removed to bring
an action as is prescribed for other persons.”). The respondents

specifically noted that in Deen v. Stevens, 287 Ga. 597 (698 SE2d

321) (2010), this Court rejected a challenge to the constitutionality

of OCGA § 9-3-73 (b), in which the appellant argued that the statute

irrationally discriminated against the mentally incompetent in

violation of the Equal Protection Clauses of the Fourteenth

Amendment to the United States Constitution and Article I, Section

I, Paragraph II of the Georgia Constitution of 1983. In Deen, we held

that the non-tolling provision of OCGA § 9-3-73 (b) is rationally

related to the General Assembly’s objectives set out in OCGA § 9-3-

73 (f) “of providing quality health care, assuring the availability of

physicians, preventing the curtailment of medical services,

stabilizing insurance and medical costs, preventing stale medical

malpractice claims, and providing for the public safety, health, and

welfare as a whole.” In response, the appellant argued that OCGA

§ 9-3-73 (b) is unconstitutional under the Equal Protection Clause of

the Fourteenth Amendment to the United States Constitution

because the statute’s distinction between mentally incompetent
medical malpractice plaintiffs and mentally incompetent plaintiffs

in other types of cases is not rationally related to the statute’s stated

objective of ensuring access to affordable healthcare by stemming

the filing of stale medical malpractice claims. In its order granting

the motions to dismiss in this case, the trial court concluded that the

ward’s incapacity did not toll the statute of limitation and

summarily stated as to the appellant’s federal equal protection

argument that “[t]he Supreme Court of Georgia has already decided

this issue against the Plaintiff. Deen v. Stevens, 287 Ga. 597, 602

(2010).”

In directing her appeal to this Court, the appellant asserts that

this Court has jurisdiction over the direct appeal because “it involves

an issue of the constitutionality of a Georgia Statute.” In her brief to

this Court, the appellant concedes that “ensuring access to

affordable healthcare is a legitimate legislative objective” but

asserts that “[t]here is no evidence that medical malpractice

lawsuits are the substantial cause of increased healthcare costs.”

The appellant argues that “empirical studies” show that the stated
government objective for the non-tolling provision of OCGA § 9-3-73

(b) “is no longer reasonably furthered by discriminating against

mentally incompetent medical malpractice [p]laintiffs” and “has

been rendered constitutionally invalid as it is arbitrary, and thus no

longer serves a rational purpose.”

This Court has exclusive jurisdiction over all cases “in which

the constitutionality of a law, ordinance, or constitutional provision

has been drawn in question.” See Ga. Const. of 1983, Art. VI, Sec.

VI, Par. II (1); Atlanta Independent School System v. Lane, 266 Ga.

657, 657 (469 SE2d 22) (1996). To invoke this Court’s jurisdiction

over cases involving such questions, the constitutional question

must have been raised and distinctly ruled upon in the trial court.

See In re K. R. S., 284 Ga. 853, 853 (672 SE2d 622) (2009). Even

presuming that this case raises a novel constitutional question, the

trial court did not distinctly rule on any such question because it

concluded that the appellant’s arguments were foreclosed by this

Court’s existing precedent in Deen, and the court did not address the

appellant’s arguments to the extent that they raised an issue
distinct from the one addressed in Deen. See generally City of

Decatur v. DeKalb County, 284 Ga. 434, 435-437 (668 SE2d 247)

(2008).

Accordingly, as there is no other basis for the exercise of this

Court’s jurisdiction over this appeal, see Ga. Const. of 1983, Art. VI,

Sec. VI, Par. II-III; OCGA § 15-3-3.1, it is transferred to the Court

of Appeals. If the Court of Appeals, following its review of the appeal,

disagrees with the trial court’s rationale for granting the

respondents’ motions to dismiss, it may vacate that portion of the

trial court’s order and remand the case to the trial court for

consideration in the first instance of any novel constitutional

question.

All the Justices concur, except Bethel, McMillian, Colvin, and

Pinson, JJ., who dissent.

MCMILLIAN, Justice, dissenting.

Because this case presents a novel constitutional question,

which was distinctly ruled upon below, such that this Court’s
exclusive jurisdiction over constitutional questions is invoked, I

respectfully dissent to the Court’s transfer of this case to the Court

of Appeals.

On April 7, 2023, Andreana Williams as guardian and

conservator of Michelle Hewett filed a medical malpractice action

against Regency Hospital Company, LLC, Regency Hospital

Company of Macon, LLC, and Jacquita Baldwin (collectively

“Defendants”) based on the care and treatment that Hewett received

between September 23, 2020 and October 22, 2020, and alleged that

Hewett was permanently mentally incapacitated as of September 4,

2020. Defendants filed separate motions to dismiss based, in part,

on the expiration of the two-year statute of limitation. See OCGA §§

9-3-71 (a); 9-3-73 (b).1 In response, Williams argued:

In the present action, there is no dispute that OCGA
§ 9-3-73 (b) treats mentally incompetent Plaintiffs in

1 OCGA § 9-3-71 (a) provides: “Except as otherwise provided in this
article, an action for medical malpractice shall be brought within two years
after the date on which an injury or death arising from a negligent or wrongful
act or omission occurred.” OCGA § 9-3-73 (b) provides in relevant part:
“Notwithstanding Article 5 of this chapter, all persons who are legally
incompetent because of intellectual disability or mental illness . . . shall be
subject to the periods of limitation for actions for medical malpractice provided
in this article.”
medical malpractice actions differently, and unequally,
from mentally incompetent Plaintiffs in non-medical
malpractice actions. See OCGA § 9-3-90. As such the
question before this Court is whether the statutory
distinction between similarly situated mentally
incompetent Plaintiffs is rationally related to a legitimate
government objective.

In support of her argument, Williams pointed to Deen v. Stevens, 287

Ga. 597 (698 SE2d 321) (2010), to show that the disparate treatment

of mentally incompetent medical malpractice plaintiffs from such

plaintiffs in other types of lawsuits was not rationally related to the

legitimate government objective “to ensure to its citizens affordable

access to quality healthcare.” Id. at 602 (2) (b).

The trial court granted the Defendants’ motions to dismiss and

dismissed the case with prejudice, explaining that: “Plaintiff argues

that OCGA § 9-3-73 (b) violates Ms. Hewett’s equal protection rights

under the 14th Amendment to the United States Constitution. The

Supreme Court of Georgia has already decided this issue against the

Plaintiff. [Deen, 287 Ga. at 602].”2 This appeal followed in which

Williams challenges the constitutionality of OCGA § 9-3-73 (b) on

2 The trial court did not conduct any further analysis of the equal
protection claim.
the same grounds as she did in the trial court.

This Court has exclusive jurisdiction over “all cases in which

the constitutionality of a law, ordinance, or constitutional provision

has been drawn in question.” Ga. Const. of 1983, Art. VI, Sec. VI,

Par. II (1). To fall within our jurisdiction, the constitutional issue

raised on appeal must not have already been resolved by this Court.

See Atlanta Independent School System v. Lane, 266 Ga. 657, 658

(1) (469 SE2d 22) (1996); Phillips v. State, 229 Ga. 313, 313 (191

SE2d 61) (1972). And the constitutional issue must have been

“raised in and ruled upon by the trial court.” Lane, 266 Ga. at 658

(1). See Senase v. State, 258 Ga. 592 (372 SE2d 813) (1988). A ruling

in the trial court by necessary implication is sufficient to meet this

standard. See Wilkes & McHugh, P.A. v. LTC Consulting, L.P., 306

Ga. 252, 257 (1) (c) & n.6 (830 SE2d 119) (2019) (trial court implicitly

rejected plaintiff’s First Amendment challenge to statute by denying

the defendant’s motion).

Here, Williams argues that OCGA § 9-3-73 (b) arbitrarily

treats similarly situated incompetent medical malpractice plaintiffs
differently from incompetent plaintiffs in other kinds of lawsuits by

not allowing the benefit of tolling to the medical malpractice

plaintiffs in violation of the Equal Protection Clause of the United

States Constitution. Although Deen considered a similar issue, the

plaintiff there argued that applying OCGA § 9-3-73 (b) “to her

complaint violates equal protection by arbitrarily discriminating

against mentally incompetent adults” as a class. Deen, 287 Ga. at

600 (2). Williams, in contrast, complains of discrimination between

subclasses of mentally incompetent adults. Because this specific

issue has not been considered by Deen or any other case by this

Court, the requirement for a novel constitutional question has been

met for purposes of determining this Court’s jurisdiction. See Lane,

266 Ga. at 658 (1); Phillips, 229 Ga. at 313.

Although the Court in its transfer order presumes that this

case raises a novel constitutional question, the Court concludes that

“the trial court did not distinctly rule on any such question because

it concluded that the appellant’s arguments were foreclosed by this

Court’s existing precedent in Deen, and the court did not address the
appellant’s arguments to the extent that they raised an issue

distinct from the one addressed in Deen.” (Order at 147.) However,

in granting the motions to dismiss on statute of limitation grounds

and dismissing the case with prejudice, the trial court necessarily

rejected the constitutional claim that Williams raised even though

the court did not expound on its reasoning. See Wilkes & McHugh,

306 Ga. at 257 (1) (c) & n.6. Cf. City of Decatur v. DeKalb County,

284 Ga. 434, 436 (1) (668 SE2d 247) (2008) (noting that “the

appellate record clearly reflect[ed] that the trial court did not

specifically or directly pass upon the [constitutional] question”).

And to the extent the trial court may have mistakenly

determined that Williams’s argument was foreclosed by Deen such

that it need not further consider the merits of Williams’s argument,3

it is clear from the filings that Williams is asserting a different equal

protection claim than the one in Deen. It is equally clear from the

3 Notably, the trial court did not conclude that Deen squarely foreclosed

Williams’s equal protection claim. The order can be reasonably read as
extending Deen to reject Williams’s claim that there is no rational relationship
to a legitimate government objective for the disparate treatment of subclasses
of mentally incompetent adult plaintiffs.
trial court’s order that the trial court rejected that claim. That is all

that is needed to invoke this Court’s jurisdiction.

For these reasons, I dissent from the Court’s order determining

that there is no basis for the exercise of this Court’s jurisdiction over

this appeal and would retain the appeal for consideration on the

merits.

I am authorized to state that Justices Bethel, Colvin, and

Pinson join in this dissent.

Ordered January 17, 2024.

OCGA § 9-3-73 (b); constitutional question. Bibb State Court.

Before Judge Hanson.

Mayo Hill, Michael B. Hill, for appellant.

Chambless Higdon Richardson Katz & Griggs, David N.

Nelson; Huff Powell & Bailey, Sharonda B. Barnes, for appellees.