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THE SUPREME COURT OF APPEALS OF WEST VIRGINIA","paragraph_id":"para_1"},{"text":"January 2025 Term","paragraph_id":"para_2"},{"text":"_____________________","paragraph_id":"para_3"},{"text":"No. 24-27","paragraph_id":"para_4"},{"text":"_____________________","paragraph_id":"para_5"},{"text":"ELAINE NEIDIG, INDIVIDUALLY AND ON BEHALF OF ALL OTHERS","paragraph_id":"para_6"},{"text":"SIMILARLY SITUATED","paragraph_id":"para_7"},{"text":"Plaintiff Below, Petitioner,","paragraph_id":"para_8"},{"text":"v.","paragraph_id":"para_9"},{"text":"VALLEY HEALTH SYSTEM,","paragraph_id":"para_10"},{"text":"Defendant Below, Respondent.","paragraph_id":"para_11"},{"text":"___________________________________________________________","paragraph_id":"para_12"},{"text":"Certified Question from the","paragraph_id":"para_13"},{"text":"United States Court of Appeals for the Fourth Circuit","paragraph_id":"para_14"},{"text":"The Honorable James Andrew Wynn, United States Circuit Judge","paragraph_id":"para_15"},{"text":"Civil Action No. 22-2227","paragraph_id":"para_16"},{"text":"CERTIFIED QUESTION ANSWERED","paragraph_id":"para_17"},{"text":"_________________________________________________________","paragraph_id":"para_18"},{"text":"Submitted: February 18, 2025","paragraph_id":"para_19"},{"text":"Filed: June 10, 2025","paragraph_id":"para_20"},{"text":"Anthony J. Majestro, Esq. Charles F. Printz, Esq.","paragraph_id":"para_21"},{"text":"Powell & Majestro PLLC J. Tyler Mayhew, Esq.","paragraph_id":"para_22"},{"text":"Charleston, West Virginia Bowles Rice LLP","paragraph_id":"para_23"},{"text":"and Charleston, West Virginia","paragraph_id":"para_24"},{"text":"Steven G. Skinner, Esq. Counsel for Respondent","paragraph_id":"para_25"},{"text":"Skinner Law Firm","paragraph_id":"para_26"},{"text":"Charles Town, West Virginia","paragraph_id":"para_27"},{"text":"Counsel for Petitioner","paragraph_id":"para_28"},{"text":"FILED","paragraph_id":"para_29"},{"text":"June 10, 2025","paragraph_id":"para_30"},{"text":"released at 3:00 p.m.","paragraph_id":"para_31"},{"text":"C. CASEY FORBES, CLERK","paragraph_id":"para_32"},{"text":"SUPREME COURT OF APPEALS","paragraph_id":"para_33"},{"text":"OF WEST VIRGINIA","paragraph_id":"para_34"},{"text":"CHIEF JUSTICE WOOTON delivered the Opinion of the Court.","paragraph_id":"para_35"},{"text":"JUSTICE WALKER concurs and reserves the right to file a separate opinion.","paragraph_id":"para_36"},{"text":"JUSTICE ARMSTEAD dissents and reserves the right to file a separate opinion.","paragraph_id":"para_37"},{"text":"JUSTICE TRUMP, deeming himself disqualified, did not participate in the decision of this","paragraph_id":"para_38"},{"text":"case.","paragraph_id":"para_39"},{"text":"JUDGE PERRI JO DECHRISTOPHER sitting by temporary assignment.","paragraph_id":"para_40"},{"text":"i","paragraph_id":"para_41"},{"text":"SYLLABUS BY THE COURT","paragraph_id":"para_42"},{"text":"1. “A de novo standard is applied by this Court in addressing the legal","paragraph_id":"para_43"},{"text":"issues presented by a certified question from a federal district or appellate court.” Syl. Pt.","paragraph_id":"para_44"},{"text":"1, Light v. Allstate Ins. Co., 203 W. Va. 27, 506 S.E.2d 64 (1998).","paragraph_id":"para_45"},{"text":"2. “Where the issue on an appeal . . . is clearly a question of law or","paragraph_id":"para_46"},{"text":"involving an interpretation of a statute, we apply a de novo standard of review.” Syl. Pt. 1,","paragraph_id":"para_47"},{"text":"in part, Chrystal R.M. v. Charlie A.L., 194 W. Va. 138, 459 S.E.2d 415 (1995).","paragraph_id":"para_48"},{"text":"3. “The Medical Professional Liability Act, W. Va. Code §§ 55-7B-1 to","paragraph_id":"para_49"},{"text":"-12, applies only when two conditions are satisfied, that is, when a plaintiff (1) sues a","paragraph_id":"para_50"},{"text":"‘health care provider’ or ‘health care facility’ for (2) ‘medical professional liability’ as","paragraph_id":"para_51"},{"text":"those terms are defined under the Act. These are separate and distinct conditions. If either","paragraph_id":"para_52"},{"text":"of these two conditions is lacking, the Act does not apply.” Syl. Pt. 5, State ex rel. W. Va.","paragraph_id":"para_53"},{"text":"Div. of Corr. & Rehab. v. Ferguson, 248 W. Va. 471, 889 S.E.2d 44 (2023).","paragraph_id":"para_54"},{"text":"4. “The primary object in construing a statute is to ascertain and give","paragraph_id":"para_55"},{"text":"effect to the intent of the Legislature.” Syl. Pt. 1, Smith v. State Workmen’s Comp. Comm’r,","paragraph_id":"para_56"},{"text":"159 W. Va. 108, 219 S.E.2d 361 (1975).","paragraph_id":"para_57"},{"text":"ii","paragraph_id":"para_58"},{"text":"5. “‘Statutes in derogation of the common law are strictly construed.’","paragraph_id":"para_59"},{"text":"Syllabus Point 1, Kellar v. James, 63 W. Va. 139, 59 S.E. 939 (1907)” Syl. Pt. 3, Phillips","paragraph_id":"para_60"},{"text":"v. Larry’s Drive-In Pharm. Inc., 220 W. Va. 484, 647 S.E.2d 920 (2007).","paragraph_id":"para_61"},{"text":"6. The Medical Professional Liability Act does not apply to a suit against","paragraph_id":"para_62"},{"text":"a health care provider or health care facility when the plaintiff claims only economic","paragraph_id":"para_63"},{"text":"damages and disclaims all liability based on physical injury, emotional injury, or death.","paragraph_id":"para_64"},{"text":"1","paragraph_id":"para_65"},{"text":"WOOTON, Chief Justice:","paragraph_id":"para_66","court_paragraph":1},{"text":"Pursuant to West Virginia Code section 51-1A-6(a)(1) (2016), the United","paragraph_id":"para_67"},{"text":"States Court of Appeals for the Fourth Circuit (“Fourth Circuit”) certified the following","paragraph_id":"para_68"},{"text":"question to this Court in its January 9, 2024, order: “Whether a plaintiff’s claims can fall","paragraph_id":"para_69"},{"text":"under the West Virginia Medical Professional Liability Act if the plaintiff disclaims any","paragraph_id":"para_70"},{"text":"form of physical or emotional injury.” Neidig v. Valley Health Sys., 90 F.4th 300, 302 (4th","paragraph_id":"para_71"},{"text":"Cir. 2024). To align with the language of the Act, pursuant to West Virginia Code section","paragraph_id":"para_72"},{"text":"51-1A-4 (2016) we reformulate the certified question as follows: Does the Medical","paragraph_id":"para_73"},{"text":"Professional Liability Act apply to a suit against a health care provider or health care","paragraph_id":"para_74"},{"text":"facility when the plaintiff claims only economic damages and disclaims all liability based","paragraph_id":"para_75"},{"text":"on physical injury, emotional injury, or death?","paragraph_id":"para_76"},{"text":"Viewing the West Virginia Medical Professional Liability Act (“MPLA” or","paragraph_id":"para_77"},{"text":"“the Act”) in its entirety, and in particular the statutory definition of “medical professional","paragraph_id":"para_78"},{"text":"liability” as contained in West Virginia Code section 55-7B-2(i), the Act requires a","paragraph_id":"para_79"},{"text":"predicate claim arising from the death or injury of a person. Accordingly, where a plaintiff","paragraph_id":"para_80"},{"text":"seeks redress only for economic harm and specifically disclaims any form of physical or","paragraph_id":"para_81"},{"text":"emotional injury, the Medical Professional Liability Act does not apply. We therefore","paragraph_id":"para_82"},{"text":"answer the reformulated certified question in the negative.","paragraph_id":"para_83"},{"text":"2","paragraph_id":"para_84"},{"text":"I. Facts and Procedural Background","paragraph_id":"para_85","court_paragraph":2},{"text":"According to the Fourth Circuit’s order of certification, the facts are","paragraph_id":"para_86"},{"text":"relatively undisputed. Petitioner Elaine Neidig (“Ms. Neidig” or “the petitioner”) had three","paragraph_id":"para_87"},{"text":"mammograms at respondent Valley Health System’s (“Valley Health” or “respondent”)1","paragraph_id":"para_88"},{"text":"Outpatient Diagnostic Center at Winchester Medical Center in 2016, 2017, and 2019. In","paragraph_id":"para_89"},{"text":"2019 the Food and Drug Administration determined that some of the mammograms","paragraph_id":"para_90"},{"text":"performed at this facility had “image quality deficiencies” that posed a “serious risk to","paragraph_id":"para_91"},{"text":"human health.”","paragraph_id":"para_92"},{"text":"The petitioner received a Patient and Referring Healthcare Provider","paragraph_id":"para_93"},{"text":"Notification (“PPN”) letter from respondent on December 16, 2019, notifying her of the","paragraph_id":"para_94"},{"text":"quality issues with mammograms performed at Winchester Medical Center between June","paragraph_id":"para_95"},{"text":"20, 2017, and August 31, 2019.2 The PPN informed the petitioner of the “recommended","paragraph_id":"para_96"},{"text":"actions for [the recipient] to take” depending on the date of her last mammogram.","paragraph_id":"para_97"},{"text":"On August 3, 2022, the petitioner brought a putative class action lawsuit in","paragraph_id":"para_98"},{"text":"the Circuit Court of Jefferson County, West Virginia, against Valley Health. The complaint","paragraph_id":"para_99"},{"text":"alleged that Valley Health advertised that it “is proud to offer the latest technology in breast","paragraph_id":"para_100"},{"text":"1 Respondent operates Winchester Medical Center and six other hospitals.","paragraph_id":"para_101"},{"text":"2 Winchester Medical Center participates in the Mammography Accreditation","paragraph_id":"para_102"},{"text":"Program governed by the American College of Radiology. The Center temporarily lost its","paragraph_id":"para_103"},{"text":"accreditation to perform mammography, but its accreditation has since been reinstated.","paragraph_id":"para_104"},{"text":"3","paragraph_id":"para_105"},{"text":"imaging, including 3D Mammography, Breast Ultrasound, Breast MRI and Molecular","paragraph_id":"para_106","court_paragraph":3},{"text":"Breast Imaging (BGSI).” Further, Valley Health advertised “[t]he new, free-standing","paragraph_id":"para_107"},{"text":"Valley Health Cancer Center has a dedicated Breast Center, which houses a comprehensive","paragraph_id":"para_108"},{"text":"program for our patients . . . . The Breast Center is also conveniently located 100 steps","paragraph_id":"para_109"},{"text":"away from the Winchester Medical Center Diagnostic Center.” Per the complaint, “[the","paragraph_id":"para_110"},{"text":"petitioner initially] chose to go to Winchester Medical for [a] mammogram based on the","paragraph_id":"para_111"},{"text":"marketing and advertising of Valley Health into West Virginia.” According to the","paragraph_id":"para_112"},{"text":"complaint, “Winchester Medical Center, during the dates in question, represented itself as","paragraph_id":"para_113"},{"text":"an accredited mammography center under the Mammography Quality Standards Act","paragraph_id":"para_114"},{"text":"(“MQSA”)”; “represented itself as being able to perform proper and correct mammography","paragraph_id":"para_115"},{"text":"examinations”; and further alleged that, “[b]ut for the above representations, [the","paragraph_id":"para_116"},{"text":"petitioner] would not have had Winchester Medical Center perform her mammograms.”","paragraph_id":"para_117"},{"text":"The complaint alleged that “[i]n July 2019, federal accreditation inspectors","paragraph_id":"para_118"},{"text":"found that Winchester Medical staff were not accurately positioning or compressing","paragraph_id":"para_119"},{"text":"women’s breasts during mammograms[]” and “[t]his resulted in the Food and Drug","paragraph_id":"para_120"},{"text":"Administration (“FDA”) declaring that select mammograms performed by Winchester","paragraph_id":"para_121"},{"text":"Medical Center had ‘serious image quality deficiencies,’ and that these deficiencies were","paragraph_id":"para_122"},{"text":"a ‘serious risk to human health.’” The petitioner alleged that the PPN confirms that","paragraph_id":"para_123"},{"text":"“[Valley Health] adopted the view that the mammograms performed between June 20,","paragraph_id":"para_124"},{"text":"2017 and August 31, 2019, would be of questionable accuracy and quality” and that “[t]he","paragraph_id":"para_125"},{"text":"mammograms provided to [the petitioner] and others were of different, deficient, inferior","paragraph_id":"para_126"},{"text":"4","paragraph_id":"para_127"},{"text":"and lesser value compared to what [Valley Health] had represented them to be.” According","paragraph_id":"para_128","court_paragraph":4},{"text":"to the complaint, “[d]espite the fact that [the petitioner] paid the market rate for the","paragraph_id":"para_129"},{"text":"mammograms, the mammograms were worthless[]” and “[Valley Health] never","paragraph_id":"para_130"},{"text":"reimbursed, refunded, or rebated the costs paid by [the petitioner].”","paragraph_id":"para_131"},{"text":"The complaint asserted consumer protection claims for unfair and deceptive","paragraph_id":"para_132"},{"text":"acts and practices pursuant to the West Virginia Consumer Credit Protection Act","paragraph_id":"para_133"},{"text":"(“CCPA”); unjust enrichment; and breach of contract based on Valley Health’s provision","paragraph_id":"para_134"},{"text":"of mammography services that were “different, deficient, inferior, and of lesser value” than","paragraph_id":"para_135"},{"text":"promised. The complaint did not claim damages for any physical or emotional injury or","paragraph_id":"para_136"},{"text":"death to the petitioner or to any of the putative class members. The petitioner’s complaint","paragraph_id":"para_137"},{"text":"sought the following damages: actual damages; statutory damages for violation of the","paragraph_id":"para_138"},{"text":"CCPA; the petitioner’s cost of litigation; compensatory damages for the unjustly","paragraph_id":"para_139"},{"text":"depreciated value of purchased mammograms; disgorgement of wrongfully obtained and","paragraph_id":"para_140"},{"text":"retained profits; contract damages; and such other relief as the court deemed just and","paragraph_id":"para_141"},{"text":"proper.","paragraph_id":"para_142"},{"text":"Respondent removed the case to the United States District Court for the","paragraph_id":"para_143"},{"text":"Northern District of West Virginia and moved to dismiss the complaint, arguing that the","paragraph_id":"para_144"},{"text":"petitioner failed to comply with the pre-suit notice requirements of the MPLA and that the","paragraph_id":"para_145"},{"text":"complaint was barred by the MPLA’s two-year statute of limitations. In response, the","paragraph_id":"para_146"},{"text":"petitioner argued that her claim was a consumer claim pursuant to the CCPA’s bar against","paragraph_id":"para_147"},{"text":"5","paragraph_id":"para_148"},{"text":"unfair and deceptive practices in the conduct of trade or commerce.3 In addition, she","paragraph_id":"para_149","court_paragraph":5},{"text":"contended that her claim was for an economic injury to which the MPLA did not apply;","paragraph_id":"para_150"},{"text":"more precisely, that her claim was not based on an “injury of a person” as required by the","paragraph_id":"para_151"},{"text":"MPLA.","paragraph_id":"para_152"},{"text":"After considering the arguments of the parties, the United States District","paragraph_id":"para_153"},{"text":"Court for the Northern District of West Virginia (“district court”) concluded that the","paragraph_id":"para_154"},{"text":"petitioner’s claims fell within the MPLA’s statutory framework.4 Since the complaint was","paragraph_id":"para_155"},{"text":"filed beyond the MPLA’s statute of limitations, the district court granted respondent’s","paragraph_id":"para_156"},{"text":"motion to dismiss on statute of limitations grounds. In so ruling, the district court found","paragraph_id":"para_157"},{"text":"that the West Virginia Legislature has defined “medical professional liability” broadly and","paragraph_id":"para_158"},{"text":"3 The CCPA definition of “unfair or deceptive acts or practices” includes:","paragraph_id":"para_159"},{"text":"(E) Representing that goods or services have","paragraph_id":"para_160"},{"text":"sponsorship, approval, characteristics, ingredients, uses,","paragraph_id":"para_161"},{"text":"benefits or quantities that they do not have or that a person has","paragraph_id":"para_162"},{"text":"a sponsorship, approval, status, affiliation or connection that he","paragraph_id":"para_163"},{"text":"does not have;","paragraph_id":"para_164"},{"text":". . . .","paragraph_id":"para_165"},{"text":"(G) Representing that goods or services are of a","paragraph_id":"para_166"},{"text":"particular standard, quality or grade, or that goods are of a","paragraph_id":"para_167"},{"text":"particular style or model if they are of another;","paragraph_id":"para_168"},{"text":"W. Va. Code § 46A-6-102(7) (2023).","paragraph_id":"para_169"},{"text":"4 In dismissing the complaint, the district court relied on the second sentence","paragraph_id":"para_170"},{"text":"of West Virginia Code section 55-7B-2(i), which provides “[i]t also means other claims","paragraph_id":"para_171"},{"text":"that may be contemporaneous to or related to the alleged tort or breach of contract or","paragraph_id":"para_172"},{"text":"otherwise provided, all in the context of rendering health care services.”","paragraph_id":"para_173"},{"text":"6","paragraph_id":"para_174"},{"text":"that “[a]lthough [the petitioner’s] claims are for unfair and deceptive acts and practices,","paragraph_id":"para_175","court_paragraph":6},{"text":"breach of contract and unjust enrichment, she may not ‘avoid the MPLA with creative","paragraph_id":"para_176"},{"text":"pleading[,]’” referencing this Court’s opinion in State ex rel. West Virginia University","paragraph_id":"para_177"},{"text":"Hospitals, Inc. v. Scott, 246 W. Va. 184, 193, 866 S.E.2d 350, 359 (2021).","paragraph_id":"para_178"},{"text":"The petitioner timely appealed the dismissal order to the Fourth Circuit. In","paragraph_id":"para_179"},{"text":"her appeal the petitioner again argued that this is a consumer case, not a medical","paragraph_id":"para_180"},{"text":"malpractice case. The petitioner disclaimed any physical injury, maintained that the","paragraph_id":"para_181"},{"text":"damages she sustained were strictly economic, and therefore contended that her claims fall","paragraph_id":"para_182"},{"text":"outside of the scope of the MPLA.","paragraph_id":"para_183"},{"text":"The Fourth Circuit reasoned that the question before the court was whether","paragraph_id":"para_184"},{"text":"the petitioner’s “claims—although styled as consumer-protection claims for unfair and","paragraph_id":"para_185"},{"text":"deceptive acts and practices, unjust enrichment, and breach of contract—nevertheless fall","paragraph_id":"para_186"},{"text":"within the ambit of the [MPLA].” Accordingly, pursuant to the Uniform Certification of","paragraph_id":"para_187"},{"text":"Questions of Law Act, West Virginia Code §§ 51-1A-1 to -13 (2016), 5 the Fourth Circuit","paragraph_id":"para_188"},{"text":"asked this Court to exercise its discretion to answer the following unsettled question of","paragraph_id":"para_189"},{"text":"5 This Court’s review of a certified question is authorized by West Virginia","paragraph_id":"para_190"},{"text":"Code section 51-1A-3 (1996) which provides:","paragraph_id":"para_191"},{"text":"The Supreme Court of Appeals of West Virginia may answer a","paragraph_id":"para_192"},{"text":"question of law certified to it by any court of the United States . . . if the","paragraph_id":"para_193"},{"text":"answer may be determinative of an issue in a pending cause in the certifying","paragraph_id":"para_194"},{"text":"court and if there is no controlling appellate decision, constitutional provision","paragraph_id":"para_195"},{"text":"or statute of this state.","paragraph_id":"para_196"},{"text":"7","paragraph_id":"para_197"},{"text":"law: “[w]hether a plaintiff’s claims can fall under the West Virginia Medical Professional","paragraph_id":"para_198","court_paragraph":7},{"text":"Liability Act if the plaintiff disclaims any form of physical or emotional injury.” Neidig,","paragraph_id":"para_199"},{"text":"90 F.4th at 302. By order entered August 20, 2024, we accepted the certified question and","paragraph_id":"para_200"},{"text":"set this matter for oral argument.6","paragraph_id":"para_201"},{"text":"II. Standard of Review","paragraph_id":"para_202"},{"text":"It is well established that “[a] de novo standard is applied by this Court in","paragraph_id":"para_203"},{"text":"addressing the legal issues presented by a certified question from a federal district or","paragraph_id":"para_204"},{"text":"appellate court.” Syl. Pt. 1, Light v. Allstate Ins. Co., 203 W. Va. 27, 506 S.E.2d 64 (1998);","paragraph_id":"para_205"},{"text":"accord Syl. Pt. 1, Bower v. Westinghouse Elec. Corp., 206 W. Va. 133, 522 S.E.2d 424","paragraph_id":"para_206"},{"text":"(1999) (“This Court undertakes plenary review of legal issues presented by certified","paragraph_id":"para_207"},{"text":"question from a federal district or appellate court.”). Similarly, “[w]here the issue on an","paragraph_id":"para_208"},{"text":"appeal . . . is clearly a question of law or involving an interpretation of a statute, we apply","paragraph_id":"para_209"},{"text":"a de novo standard of review.” Syl. Pt. 1, in part, Chrystal R.M. v. Charlie A.L., 194 W.","paragraph_id":"para_210"},{"text":"6 Respondent asked this Court to use its discretion as afforded by West","paragraph_id":"para_211"},{"text":"Virginia Code section 51-1A-4 and our established jurisprudence to reformulate the","paragraph_id":"para_212"},{"text":"certified question as follows:","paragraph_id":"para_213"},{"text":"Whether a claim that arises from “health care” rendered to a","paragraph_id":"para_214"},{"text":"“patient,” and that necessarily depends upon proof that a","paragraph_id":"para_215"},{"text":"“health care provider” or “health care facility” failed to follow","paragraph_id":"para_216"},{"text":"the accepted standard of care, falls under the West Virginia","paragraph_id":"para_217"},{"text":"Medical Professional Liability Act, regardless of how it has","paragraph_id":"para_218"},{"text":"been pled or the type of damages being sought.","paragraph_id":"para_219"},{"text":"We decline to adopt respondent’s proposed reformulated question and instead adopt the","paragraph_id":"para_220"},{"text":"reformulated question discussed supra, which follows the language of the “medical","paragraph_id":"para_221"},{"text":"professional liability” definition.","paragraph_id":"para_222"},{"text":"8","paragraph_id":"para_223"},{"text":"Va. 138, 459 S.E.2d 415 (1995). Guided by these standards of review, we address the","paragraph_id":"para_224","court_paragraph":8},{"text":"certified question before us.","paragraph_id":"para_225"},{"text":"III. Discussion","paragraph_id":"para_226"},{"text":"This Court has the power to reformulate certified questions. See W. Va. Code","paragraph_id":"para_227"},{"text":"§ 51-1A-4 (“The Supreme Court of Appeals of West Virginia may reformulate a question","paragraph_id":"para_228"},{"text":"certified to it.”). See also Syl. Pt. 3, in part, Kincaid v. Mangum, 189 W. Va. 404, 432","paragraph_id":"para_229"},{"text":"S.E.2d 74 (1993) (“When a certified question is not framed so that this Court is able to","paragraph_id":"para_230"},{"text":"fully address the law which is involved in the question, then this Court retains the power","paragraph_id":"para_231"},{"text":"to reformulate questions certified to it under . . . the Uniform Certification of Questions of","paragraph_id":"para_232"},{"text":"Law Act found in W. Va. Code, 51-1A-1, et seq. . . .”). Accordingly, we reformulate the","paragraph_id":"para_233"},{"text":"certified question presented by the Fourth Circuit as follows: Does the Medical","paragraph_id":"para_234"},{"text":"Professional Liability Act apply to a suit against a health care provider or health care","paragraph_id":"para_235"},{"text":"facility when the plaintiff claims only economic damages and disclaims all liability based","paragraph_id":"para_236"},{"text":"on physical injury, emotional injury, or death?","paragraph_id":"para_237"},{"text":"Medical professional liability actions are governed by the MPLA. See, e.g.,","paragraph_id":"para_238"},{"text":"W. Va. Code § 55-7B-6(a) (stating, in relevant part, that “no person may file a medical","paragraph_id":"para_239"},{"text":"professional liability action against any health care provider without complying with the","paragraph_id":"para_240"},{"text":"provisions of this section”); State ex rel. Morgantown Operating Co., LLC v. Gaujot, 245","paragraph_id":"para_241"},{"text":"W. Va. 415, 421, 859 S.E.2d 358, 364 (2021) (“[T]he MPLA applies to all actions alleging","paragraph_id":"para_242"},{"text":"medical professional liability as that term is defined in the MPLA[.]” (emphasis omitted)).","paragraph_id":"para_243"},{"text":"9","paragraph_id":"para_244"},{"text":"Indeed, this Court has recognized that medical professional liability is one of the two","paragraph_id":"para_245","court_paragraph":9},{"text":"conditions that must exist for the MPLA to apply. See Syl. Pt. 5, State ex rel. W. Va. Div. of","paragraph_id":"para_246"},{"text":"Corr. & Rehab. v. Ferguson, 248 W. Va. 471, 889 S.E.2d 44 (2023) (“The Medical","paragraph_id":"para_247"},{"text":"Professional Liability Act, W. Va. Code §§ 55-7B-1 to -12, applies only when two","paragraph_id":"para_248"},{"text":"conditions are satisfied, that is, when a plaintiff (1) sues a ‘health care provider’ or ‘health","paragraph_id":"para_249"},{"text":"care facility’ for (2) ‘medical professional liability’ as those terms are defined under the","paragraph_id":"para_250"},{"text":"Act. These are separate and distinct conditions. If either of these two conditions is lacking,","paragraph_id":"para_251"},{"text":"the Act does not apply.”). The MPLA defines “medical professional liability” as","paragraph_id":"para_252"},{"text":"any liability for damages resulting from the death or injury of","paragraph_id":"para_253"},{"text":"a person for any tort or breach of contract based on health care","paragraph_id":"para_254"},{"text":"services rendered, or which should have been rendered, by a","paragraph_id":"para_255"},{"text":"health care provider or health care facility to a patient. It also","paragraph_id":"para_256"},{"text":"means other claims that may be contemporaneous to or related","paragraph_id":"para_257"},{"text":"to the alleged tort or breach of contract or otherwise provided,","paragraph_id":"para_258"},{"text":"all in the context of rendering health care services.","paragraph_id":"para_259"},{"text":"W. Va. Code § 55-7B-2(i) (emphasis added).","paragraph_id":"para_260"},{"text":"The definition of “medical professional liability” is divided into two parts. In","paragraph_id":"para_261"},{"text":"Scott this Court discerned between anchor claims, described in the first sentence of the","paragraph_id":"para_262"},{"text":"statute, and ancillary claims, described in the second. 246 W. Va. at 194, 866 S.E.2d at","paragraph_id":"para_263"},{"text":"360. If no claim espoused by the plaintiff meets the statutory criteria of an anchor claim, it","paragraph_id":"para_264"},{"text":"follows that no ancillary claim may be appended to it. See id. (“[To bring ancillary claims","paragraph_id":"para_265"},{"text":"under the MPLA,] you must have the anchor claim (fitting the definition of ‘health care’)","paragraph_id":"para_266"},{"text":"and then make the showing that the ancillary claims are (1) contemporaneous with or","paragraph_id":"para_267"},{"text":"10","paragraph_id":"para_268"},{"text":"related to that anchor claim; and (2) despite being ancillary, are still in the context of","paragraph_id":"para_269","court_paragraph":10},{"text":"rendering health care.”).","paragraph_id":"para_270"},{"text":"We have had numerous occasions to analyze and discuss the Act and its","paragraph_id":"para_271"},{"text":"provisions in the context of whether the claims asserted fit the statutory definition of","paragraph_id":"para_272"},{"text":"“health care”7 as an anchor claim, as well as whether the broader language “all in the","paragraph_id":"para_273"},{"text":"context of rendering health care” was consistent with asserted ancillary claims. See e.g.,","paragraph_id":"para_274"},{"text":"Scott, 246 W. Va. at 193-96, 866 S.E.2d at 359-62. Neither party disputes that this claim","paragraph_id":"para_275"},{"text":"fits the “health care” portion of an anchor claim, nor do we. But each of our prior cases has","paragraph_id":"para_276"},{"text":"contained at least one other claim of bodily injury, emotional injury, or death that resulted","paragraph_id":"para_277"},{"text":"7 West Virginia Code § 55-7B-2(e) defines “health care” as:","paragraph_id":"para_278"},{"text":"(1) Any act, service, or treatment provided under,","paragraph_id":"para_279"},{"text":"pursuant to, or in the furtherance of a physician’s plan of care,","paragraph_id":"para_280"},{"text":"a health care facility’s plan of care, medical diagnosis, or","paragraph_id":"para_281"},{"text":"treatment;","paragraph_id":"para_282"},{"text":"(2) Any act, service, or treatment performed or","paragraph_id":"para_283"},{"text":"furnished, or which should have been performed or furnished,","paragraph_id":"para_284"},{"text":"by any health care provider or person supervised by or acting","paragraph_id":"para_285"},{"text":"under the direction of a health care provider or licensed","paragraph_id":"para_286"},{"text":"professional for, to, or on behalf of a patient during the","paragraph_id":"para_287"},{"text":"patient’s medical care, treatment, or confinement, including,","paragraph_id":"para_288"},{"text":"but not limited to, staffing, medical transport, custodial care, or","paragraph_id":"para_289"},{"text":"basic care, infection control, positioning, hydration, nutrition,","paragraph_id":"para_290"},{"text":"and similar patient services; and","paragraph_id":"para_291"},{"text":"(3) The process employed by health care providers and","paragraph_id":"para_292"},{"text":"health care facilities for the appointment, employment,","paragraph_id":"para_293"},{"text":"contracting, credentialing, privileging, and supervision of","paragraph_id":"para_294"},{"text":"health care providers.","paragraph_id":"para_295"},{"text":"11","paragraph_id":"para_296"},{"text":"from the health care provider’s negligent care; accordingly, the requisite damages portion","paragraph_id":"para_297","court_paragraph":11},{"text":"of the statute was satisfied. Had the petitioner in this case claimed a missed diagnosis or","paragraph_id":"para_298"},{"text":"emotional distress alongside her breach of contract claim, the parties would not be before","paragraph_id":"para_299"},{"text":"this Court or any other arguing whether the Act applied to any of her claims. To be clear,","paragraph_id":"para_300"},{"text":"we do not here decide that each of a plaintiff’s claims must be based upon bodily injury or","paragraph_id":"para_301"},{"text":"death; instead, we determine whether the Act may be applied in the total absence of any","paragraph_id":"para_302"},{"text":"claim based upon bodily injury or death.","paragraph_id":"para_303"},{"text":"Because we have never considered the MPLA’s application to a case with no","paragraph_id":"para_304"},{"text":"claim for physical or emotional injury or death, we find our Act-specific precedent on the","paragraph_id":"para_305"},{"text":"scope of “health care” of no practical use here as it pertains to a wholly separate portion of","paragraph_id":"para_306"},{"text":"the statute. Thus, the reformulated certified question presents an issue of first impression:","paragraph_id":"para_307"},{"text":"Does the Medical Professional Liability Act apply to a suit against a health care provider","paragraph_id":"para_308"},{"text":"or health care facility when the plaintiff claims only economic damages and disclaims all","paragraph_id":"para_309"},{"text":"liability based on physical injury, emotional injury, or death?","paragraph_id":"para_310"},{"text":"Addressing the operative statutory language, defining an anchor claim for","paragraph_id":"para_311"},{"text":"medical professional liability as “any liability for damages resulting from the death or","paragraph_id":"para_312"},{"text":"injury of a person for any tort or breach of contract based on health care services rendered,","paragraph_id":"para_313"},{"text":"or which should have been rendered, by a health care provider or health care facility to a","paragraph_id":"para_314"},{"text":"patient,” the petitioner equates “injury of a person” with personal injury. She contends that,","paragraph_id":"para_315"},{"text":"by defining “medical professional liability,” in relevant part, as liability for “the death or","paragraph_id":"para_316"},{"text":"12","paragraph_id":"para_317"},{"text":"injury of a person,” the Legislature expressed its intention that the MPLA apply to personal","paragraph_id":"para_318","court_paragraph":12},{"text":"injuries. W. Va. Code § 55-7B-2(i) (emphasis added). By extension, the MPLA has no","paragraph_id":"para_319"},{"text":"application to claims for purely economic losses such as those governed by the CCPA. The","paragraph_id":"para_320"},{"text":"petitioner maintains that the MPLA does not apply to her claims because she seeks only","paragraph_id":"para_321"},{"text":"monetary damages related to her deficient mammograms, i.e., statutory damages for CCPA","paragraph_id":"para_322"},{"text":"violations, her cost of litigation, compensatory damages for the depreciated value of her","paragraph_id":"para_323"},{"text":"mammograms, disgorgement of wrongfully obtained and retained profits, and contract","paragraph_id":"para_324"},{"text":"damages.","paragraph_id":"para_325"},{"text":"Respondent contends that in expressly disclaiming a bodily injury, the","paragraph_id":"para_326"},{"text":"petitioner relies on artful pleading to avoid application of the Act, a practice this Court has","paragraph_id":"para_327"},{"text":"explicitly condemned as futile, since courts are instructed to apply the Act when the claim","paragraph_id":"para_328"},{"text":"asserted is within the Act’s scope, regardless of how it is pled. See Syl. Pt. 4, Blankenship","paragraph_id":"para_329"},{"text":"v. Ethicon, Inc., 221 W. Va. 700, 656 S.E.2d 451 (2007) (“The failure to plead a claim as","paragraph_id":"para_330"},{"text":"governed by the Medical Professional Liability Act, W. Va. Code § 55-7B-1, et seq., does","paragraph_id":"para_331"},{"text":"not preclude application of the Act. Where the alleged tortious acts or omissions are","paragraph_id":"para_332"},{"text":"committed by a health care provider within the context of the rendering of ‘health care’ as","paragraph_id":"para_333"},{"text":"defined by W. Va. Code § 55-7B-2(e) (2006) (Supp. 2007), the Act applies regardless of","paragraph_id":"para_334"},{"text":"how the claims have been pled.”). However, we disagree that this case may be resolved","paragraph_id":"para_335"},{"text":"based on the petitioner’s alleged artful pleading. The petitioner’s lack of bodily injury or","paragraph_id":"para_336"},{"text":"death as a damage calls into question whether she has asserted a medical professional","paragraph_id":"para_337"},{"text":"liability claim as defined by the Act, which has little to do with the way she pled or labeled","paragraph_id":"para_338"},{"text":"13","paragraph_id":"para_339"},{"text":"her claims. If the petitioner’s pleading was indeed strategic to the point of eliminating an","paragraph_id":"para_340","court_paragraph":13},{"text":"entire basis of liability in tort, she has made that choice to her detriment and may not","paragraph_id":"para_341"},{"text":"recover those damages in contract, but that does not obviate our need to grapple with the","paragraph_id":"para_342"},{"text":"statutory requirements for the Act’s application.","paragraph_id":"para_343"},{"text":"Having limited the scope of our analysis to that portion of the statute","paragraph_id":"para_344"},{"text":"pertaining to “death or injury to a person,” we are asked whether a claim may still fit the","paragraph_id":"para_345"},{"text":"definition of an anchor claim when the plaintiff seeks no damages for any physical or","paragraph_id":"para_346"},{"text":"emotional injury. Respondent’s arguments in this respect are two-fold. First, respondent","paragraph_id":"para_347"},{"text":"argues that for breach of contract claims, specifically, death or injury of a person is not a","paragraph_id":"para_348"},{"text":"prerequisite to the Act’s application. Second, respondent argues that, if death or injury of","paragraph_id":"para_349"},{"text":"a person is a prerequisite, “injury” encompasses both personal and legal injuries.","paragraph_id":"para_350"},{"text":"Respondent would read the first sentence of the statute as creating one class","paragraph_id":"para_351"},{"text":"of Act-applicable claims as “health care”-based8 liability for damages in tort resulting from","paragraph_id":"para_352"},{"text":"the death or injury of a person, and another, second class of Act-applicable claims as","paragraph_id":"para_353"},{"text":"8 Insofar as the statutory definition of “health care” is not at issue, we","paragraph_id":"para_354"},{"text":"abbreviate that portion of the statute but do not intend to diminish the nuances of that","paragraph_id":"para_355"},{"text":"statutory definition as contrasted with “in the overall context of rendering health care” in","paragraph_id":"para_356"},{"text":"the portion of the statute relating to ancillary claims.","paragraph_id":"para_357"},{"text":"14","paragraph_id":"para_358"},{"text":"“health care”-based liability stemming from a breach of contract that does not require the","paragraph_id":"para_359","court_paragraph":14},{"text":"death or injury of a person.9","paragraph_id":"para_360"},{"text":"The language at issue is the injection of the additional modifier “for any tort","paragraph_id":"para_361"},{"text":"or breach of contract” in the middle of an otherwise straightforward sentence: “any liability","paragraph_id":"para_362"},{"text":"for damages resulting from the death or injury of a person for any tort or breach of contract","paragraph_id":"para_363"},{"text":"based on health care services rendered, or which should have been rendered, by a health","paragraph_id":"para_364"},{"text":"care provider or health care facility to a patient.” Without it, the relevant portion of the","paragraph_id":"para_365"},{"text":"statute would apply the Act to “any liability for damages resulting from the death or injury","paragraph_id":"para_366"},{"text":"of a person based on health care services rendered . . . .” But the Legislature specifically","paragraph_id":"para_367"},{"text":"included the interjecting claim-specific language and we are bound to give it effect. See","paragraph_id":"para_368"},{"text":"Syl. Pt. 3, Meadows v. Wal–Mart Stores, Inc., 207 W. Va. 203, 530 S.E.2d 676 (1999) (“A","paragraph_id":"para_369"},{"text":"cardinal rule of statutory construction is that significance and effect must, if possible, be","paragraph_id":"para_370"},{"text":"given to every section, clause, word or part of the statute.”).","paragraph_id":"para_371"},{"text":"9 Per respondent, the MPLA’s definition of “medical professional liability”","paragraph_id":"para_372"},{"text":"includes liability for damages resulting from three types of claims: (1) the “death or injury","paragraph_id":"para_373"},{"text":"of a person for any tort . . . based on health care services rendered, or which should have","paragraph_id":"para_374"},{"text":"been rendered, by a health care provider or health care facility to a patient”; (2) “breach of","paragraph_id":"para_375"},{"text":"contract based on health care services rendered, or which should have been rendered, by","paragraph_id":"para_376"},{"text":"any health care provider to a patient”; and (3) “other claims that may be contemporaneous","paragraph_id":"para_377"},{"text":"to or related to the alleged tort or breach of contract or otherwise provided, all in the context","paragraph_id":"para_378"},{"text":"of rendering health care. To the extent that respondent argues that Petitioner’s claims may","paragraph_id":"para_379"},{"text":"also fall within the “otherwise” portion of the definition of medical professional liability,","paragraph_id":"para_380"},{"text":"we observe that the portion of the statute containing the “otherwise” catchall pertains to","paragraph_id":"para_381"},{"text":"ancillary claims. Here, our analysis does not reach that question because we conclude that","paragraph_id":"para_382"},{"text":"in the absence of a death or personal injury, there is no anchor claim to which it may be","paragraph_id":"para_383"},{"text":"tethered, and thus need not decide whether Petitioner’s claim would fit the statutory","paragraph_id":"para_384"},{"text":"definition of an ancillary claim.","paragraph_id":"para_385"},{"text":"15","paragraph_id":"para_386"},{"text":"While the parties both assert that the language is clear and unambiguously","paragraph_id":"para_387","court_paragraph":15},{"text":"skewed to their respective interpretations of the statute, we find the statute’s phrasing","paragraph_id":"para_388"},{"text":"warrants a closer look, cognizant that “[a] statute is open to construction only where the","paragraph_id":"para_389"},{"text":"language used requires interpretation because of ambiguity which renders it susceptible of","paragraph_id":"para_390"},{"text":"two or more constructions or of such doubtful or obscure meaning that reasonable minds","paragraph_id":"para_391"},{"text":"might be uncertain or disagree as to its meaning.” Sizemore v. State Farm Gen. Ins. Co.,","paragraph_id":"para_392"},{"text":"202 W. Va. 591, 596, 505 S.E.2d 654, 659 (1998) (internal quotations and citation omitted).","paragraph_id":"para_393"},{"text":"Accord Hereford v. Meek, 132 W. Va. 373, 386, 52 S.E.2d 740, 747 (1949). “A statute that","paragraph_id":"para_394"},{"text":"is ambiguous must be construed before it can be applied.” Syl. Pt. 1, Farley v. Buckalew,","paragraph_id":"para_395"},{"text":"186 W. Va. 693, 414 S.E.2d 454 (1992).","paragraph_id":"para_396"},{"text":"“The primary object in construing a statute is to ascertain and give effect to","paragraph_id":"para_397"},{"text":"the intent of the Legislature.” Syl. Pt. 1, Smith v. State Workmen’s Comp. Comm’r, 159 W.","paragraph_id":"para_398"},{"text":"Va. 108, 219 S.E.2d 361 (1975). “It has been emphasized repeatedly that ‘[t]he starting","paragraph_id":"para_399"},{"text":"point in every case involving construction of a statute is the language itself.’” Gustafson v.","paragraph_id":"para_400"},{"text":"Alloyd Co., Inc., 513 U.S. 561, 584 (1995) (Thomas, J., dissenting), quoting Landreth","paragraph_id":"para_401"},{"text":"Timber Co. v. Landreth, 471 U.S. 681, 685 (1985). See also Bullman v. D & R Lumber Co.,","paragraph_id":"para_402"},{"text":"195 W. Va. 129, 135 n.9, 464 S.E.2d 771, 777 n.9 (1995). We therefore turn first to the","paragraph_id":"para_403"},{"text":"language of the statute itself, to answer whether the phrase “resulting from the death or","paragraph_id":"para_404"},{"text":"injury of a person” applies only to “torts” or whether the Legislature intended to extend","paragraph_id":"para_405"},{"text":"that requirement to “breach of contract.”","paragraph_id":"para_406"},{"text":"16","paragraph_id":"para_407"},{"text":"Here, the structure of the statute operates to apply the language “resulting","paragraph_id":"para_408","court_paragraph":16},{"text":"from death or injury of a person” to both tort and breach of contract claims. W. Va. Code","paragraph_id":"para_409"},{"text":"§ 55-7B-2(i). Use of the disjunctive “or” is the fulcrum of respondent’s argument. See","paragraph_id":"para_410"},{"text":"Carper v. Kanawha Banking & Trust Co., 157 W. Va. 477, 517, 207 S.E.2d 897, 921 (1974)","paragraph_id":"para_411"},{"text":"(“Recognizing the obvious, the normal use of the disjunctive ‘or’ in a statute connotes an","paragraph_id":"para_412"},{"text":"alternative or option to select.”). Courts, however, have recognized that “conjunctions are","paragraph_id":"para_413"},{"text":"versatile words, which can work differently depending on context.” Pulsifer v. United","paragraph_id":"para_414"},{"text":"States, 601 U.S. 124, 151 (2024). The Legislature’s use of “or” between “any tort” and","paragraph_id":"para_415"},{"text":"“breach of contract” in West Virginia Code § 55-7B-2(i) simply designates alternative types","paragraph_id":"para_416"},{"text":"of claims, it does not convey that the phrase “resulting from death or injury of a person”","paragraph_id":"para_417"},{"text":"applies only to “any tort.” Upon review, respondent’s approach asks this Court to read a","paragraph_id":"para_418"},{"text":"word and punctuation into the statute that are not there.","paragraph_id":"para_419"},{"text":"We restate the operative language before examining it: “any liability for","paragraph_id":"para_420"},{"text":"damages resulting from the death or injury of a person for any tort or breach of contract","paragraph_id":"para_421"},{"text":"based on health care services rendered, or which should have been rendered, by a health","paragraph_id":"para_422"},{"text":"care provider or health care facility to a patient.” W. Va. Code § 55-7B-2(i).","paragraph_id":"para_423"},{"text":"While neither party disputes that any liability under this portion of the","paragraph_id":"para_424"},{"text":"definition must be “based on health care services rendered, or which should have been","paragraph_id":"para_425"},{"text":"rendered,” respondent’s reading does not apply this fundamental criterion to the “any tort”","paragraph_id":"para_426"},{"text":"17","paragraph_id":"para_427"},{"text":"segment of the definition. Id. Respondent’s construction requires the insertion of the word","paragraph_id":"para_428","court_paragraph":17},{"text":"“from” and an additional comma, which do not appear in the statute, to clarify that","paragraph_id":"para_429"},{"text":"liability—whether grounded in contract or tort—must be “based on health care services","paragraph_id":"para_430"},{"text":"rendered, or which should have been rendered.” Thus, the definitional language would have","paragraph_id":"para_431"},{"text":"to be modified to state: any liability for damages resulting from the death or injury of a","paragraph_id":"para_432"},{"text":"person for any tort or [from] breach of contract[,] based on health care services rendered,","paragraph_id":"para_433"},{"text":"or which should have been rendered, by a health care provider or health care facility to a","paragraph_id":"para_434"},{"text":"patient. Of course, the word “from” and the additional comma do not appear where","paragraph_id":"para_435"},{"text":"respondent needs them to appear for its position to be grammatically or legally correct.","paragraph_id":"para_436"},{"text":"Modifying a statute in this way to change its meaning exceeds this Court’s authority. See","paragraph_id":"para_437"},{"text":"Syl. Pt. 11 Brooke B. v. Ray C., 230 W. Va. 355, 738 S.E.2d 21 (2013) (“It is not for this","paragraph_id":"para_438"},{"text":"Court arbitrarily to read into a statute that which it does not say. Just as courts are not to","paragraph_id":"para_439"},{"text":"eliminate through judicial interpretation words that were purposely included, we are","paragraph_id":"para_440"},{"text":"obliged not to add to statutes something the Legislature purposely omitted.”); Syl. Pt. 1,","paragraph_id":"para_441"},{"text":"Consumer Advoc. Div. v. Pub. Serv. Comm’n, 182 W. Va. 152, 386 S.E.2d 650 (1989) (“A","paragraph_id":"para_442"},{"text":"statute, or an administrative rule, may not, under the guise of ‘interpretation,’ be modified,","paragraph_id":"para_443"},{"text":"revised, amended or rewritten.”).","paragraph_id":"para_444"},{"text":"This is particularly true here, where the Act is in derogation of the common","paragraph_id":"para_445"},{"text":"law. Phillips v. Larry’s Drive-In Pharm. Inc., 220 W. Va. 484, 491, 647 S.E.2d 920, 927","paragraph_id":"para_446"},{"text":"(2007) (“[B]y its own terms, the entire MPLA is an act designed to be in derogation of the","paragraph_id":"para_447"},{"text":"common law.”). We have long held that “‘[s]tatutes in derogation of the common law are","paragraph_id":"para_448"},{"text":"18","paragraph_id":"para_449"},{"text":"strictly construed.’ Syllabus Point 1, Kellar v. James, 63 W. Va. 139, 59 S.E. 939 (1907).”","paragraph_id":"para_450","court_paragraph":18},{"text":"Phillips, 220 W. Va. at 486, 647 S.E.2d at 922, Syl. Pt. 3. Thus, “‘[s]tatutes in derogation","paragraph_id":"para_451"},{"text":"of the common law are allowed effect only to the extent clearly indicated by the terms used.","paragraph_id":"para_452"},{"text":"Nothing can be added otherwise than by necessary implication arising from such terms.’","paragraph_id":"para_453"},{"text":"Syllabus Point 3, Bank of Weston v. Thomas, 75 W. Va. 321, 83 S.E. 985 (1914).” Phillips,","paragraph_id":"para_454"},{"text":"220 W. Va. at 486, 647 S.E.2d at 922, Syl. Pt. 4.","paragraph_id":"para_455"},{"text":"Even though we conclude the statutory language itself demonstrates that","paragraph_id":"para_456"},{"text":"liability based on “death or injury to a person” is a threshold requirement for an MPLA","paragraph_id":"para_457"},{"text":"anchor claim, this conclusion is further bolstered by considering legislative intent as","paragraph_id":"para_458"},{"text":"expressed in the stated purpose for the Act and as reflected in other language used therein.","paragraph_id":"para_459"},{"text":"In the introductory “[l]egislative findings and declaration of purpose” of the","paragraph_id":"para_460"},{"text":"MPLA, the Legislature emphasizes the need to protect West Virginia citizens from, and","paragraph_id":"para_461"},{"text":"compensate them for, injuries or death caused from negligence or incompetence by health","paragraph_id":"para_462"},{"text":"care providers. W. Va. Code § 55-7B-1. This emphasis reflects the Legislature’s intent that","paragraph_id":"para_463"},{"text":"the MPLA apply only to medical professional liability actions against health care providers","paragraph_id":"para_464"},{"text":"or health care facilities that involve the death or injury of a person. For example, in this","paragraph_id":"para_465"},{"text":"declaration of purpose, the Legislature recognizes that “[a]s in every human endeavor the","paragraph_id":"para_466"},{"text":"possibility of injury or death from negligent conduct commands that protection of the","paragraph_id":"para_467"},{"text":"public served by health care providers be recognized as an important state interest[.]” Id.","paragraph_id":"para_468"},{"text":"(emphasis added). The Legislature further pronounces that","paragraph_id":"para_469"},{"text":"19","paragraph_id":"para_470"},{"text":"Our system of litigation is an essential component of","paragraph_id":"para_471","court_paragraph":19},{"text":"this state’s interest in providing adequate and reasonable","paragraph_id":"para_472"},{"text":"compensation to those persons who suffer from injury or death","paragraph_id":"para_473"},{"text":"as a result of professional negligence, and any limitation","paragraph_id":"para_474"},{"text":"placed on this system must be balanced with and considerate","paragraph_id":"para_475"},{"text":"of the need to fairly compensate patients who have been","paragraph_id":"para_476"},{"text":"injured as a result of negligent and incompetent acts by health","paragraph_id":"para_477"},{"text":"care providers[.]","paragraph_id":"para_478"},{"text":"Id. (emphasis added). See also id. (observing the “unpredictable nature of traumatic injury","paragraph_id":"para_479"},{"text":"health care services often results in a greater likelihood of unsatisfactory patient outcomes,","paragraph_id":"para_480"},{"text":"a higher degree of patient and patient family dissatisfaction and frequent malpractice","paragraph_id":"para_481"},{"text":"claims, creating a financial strain on the trauma care system of our state”). Finally, after","paragraph_id":"para_482"},{"text":"acknowledging health care providers’ need for “reasonably priced and extensive liability","paragraph_id":"para_483"},{"text":"coverage,” the Legislature lists three purposes for the MPLA, one of which is to provide","paragraph_id":"para_484"},{"text":"West Virginia citizens with “[c]ompensation for injury and death.” Id. (emphasis added).10","paragraph_id":"para_485"},{"text":"By associating the term “injury” with the term “death,” the Legislature shows","paragraph_id":"para_486"},{"text":"that it uses “injury” in the context of a physical or personal injury. See Syl. Pt. 4, in part,","paragraph_id":"para_487"},{"text":"Wolfe v. Forbes, 159 W. Va. 34, 217 S.E.2d 899 (1975) (“It is a fundamental rule of","paragraph_id":"para_488"},{"text":"construction that, in accordance with the maxim Noscitur a sociis, the meaning of a word","paragraph_id":"para_489"},{"text":"or phrase may be ascertained by reference to the meaning of other words or phrases with","paragraph_id":"para_490"},{"text":"which it is associated.”). See also Antonin Scalia & Bryan A. Garner, Reading Law: The","paragraph_id":"para_491"},{"text":"10 Notably absent from the statement of legislative intent is any expression","paragraph_id":"para_492"},{"text":"of a need to protect patients from the economic pitfalls of bad contracts with health care","paragraph_id":"para_493"},{"text":"providers – that is, except to the extent contract-based liability has caused an injury or death","paragraph_id":"para_494"},{"text":"along the lines of lack of informed consent. But see supra note 9 regarding ancillary claims.","paragraph_id":"para_495"},{"text":"20","paragraph_id":"para_496"},{"text":"Interpretation of Legal Texts 197 (2012) (commenting that [a]lthough most associated-","paragraph_id":"para_497","court_paragraph":20},{"text":"words cases involve listings . . . [a]n association is all that is required.”). In this regard, it","paragraph_id":"para_498"},{"text":"is noteworthy that pursuant to the MPLA, the term “injury” is synonymous with “medical","paragraph_id":"para_499"},{"text":"injury” and both terms are defined as “injury or death to a patient arising or resulting from","paragraph_id":"para_500"},{"text":"the rendering of or failure to render health care.” W. Va. Code § 5-7B-2(h) (emphasis","paragraph_id":"para_501"},{"text":"added) (defining “injury” and “medical injury”).11","paragraph_id":"para_502"},{"text":"The association of “injury” with “death” is repeated throughout the Act. See,","paragraph_id":"para_503"},{"text":"e.g., W. Va. Code § 55-7B-3(a) (establishing the “necessary elements of proof that an","paragraph_id":"para_504"},{"text":"injury or death resulted from the failure of a health care provider to follow the accepted","paragraph_id":"para_505"},{"text":"standard of care” (emphasis added); Id. at -3(a)(2) (requiring proof that a failure to follow","paragraph_id":"para_506"},{"text":"the accepted standard of care “was a proximate cause of the injury or death” (emphasis","paragraph_id":"para_507"},{"text":"added)); Id. § 55-7B-4(a) (using the term “injury or death” in stating the limitations period","paragraph_id":"para_508"},{"text":"for a medical professional liability action against a health care provider other than a nursing","paragraph_id":"para_509"},{"text":"home (emphasis added)); Id. at -4(b) (referring to “injury or death” when identifying the","paragraph_id":"para_510"},{"text":"limitations period for a medical professional liability action against a nursing home or","paragraph_id":"para_511"},{"text":"similar facility (emphasis added)); Id. § 55-7B-5(d) (permitting an MPLA action based on","paragraph_id":"para_512"},{"text":"the prescription or dispensation of controlled substances only when certain facts are alleged","paragraph_id":"para_513"},{"text":"11 “Medical injury” was added as a term being defined along with “injury” in","paragraph_id":"para_514"},{"text":"the 2022 amendments to the MPLA, thereby clarifying that “injury” is synonymous with","paragraph_id":"para_515"},{"text":"“medical injury.” W. Va. Code § 5-7B-2(h). Notably, the language of the definition was not","paragraph_id":"para_516"},{"text":"changed. See State Auto. Mut. Ins. Co. v. Youler, 183 W. Va. 556, 569-70, 396 S.E.2d 737,","paragraph_id":"para_517"},{"text":"750-51 (1990) (clarification of Legislature’s original intent permissible to inform pre-","paragraph_id":"para_518"},{"text":"amendment application).","paragraph_id":"para_519"},{"text":"21","paragraph_id":"para_520"},{"text":"and proven by a preponderance of the evidence and when the prescription or dispensation","paragraph_id":"para_521","court_paragraph":21},{"text":"“was a proximate cause of the injury or death” (emphasis added)); Id. § 55-7B-7a(c)","paragraph_id":"para_522"},{"text":"(providing for a rebuttable presumption “that inadequate staffing or inadequate supervision","paragraph_id":"para_523"},{"text":"was a contributing cause of the patient’s fall and injuries or death arising therefrom,” when","paragraph_id":"para_524"},{"text":"certain criteria is met (emphasis added)); Id. § 55-7B-9b (acknowledging that the Act’s","paragraph_id":"para_525"},{"text":"limitations on third-party claims does not “prevent a derivative claim for loss of consortium","paragraph_id":"para_526"},{"text":"arising from injury or death to the patient arising from the negligence of a health care","paragraph_id":"para_527"},{"text":"provider within the meaning of this article” (emphasis added).","paragraph_id":"para_528"},{"text":"The Legislature’s intent that the death or injury of a person is a required","paragraph_id":"para_529"},{"text":"element of medical professional liability claims pursuant to the Act is further reflected in","paragraph_id":"para_530"},{"text":"the limitations period for MPLA actions, which is phrased in terms of a “medical injury to","paragraph_id":"para_531"},{"text":"a person.” See id. § 55-7B-4(a) (addressing the limitations period for a “cause of action for","paragraph_id":"para_532"},{"text":"medical injury to a person alleging medical professional liability against a health care","paragraph_id":"para_533"},{"text":"provider” (emphasis added)); Id. at -4(b) (discussing the limitations period for a “cause of","paragraph_id":"para_534"},{"text":"action for medical injury to a person alleging medical professional liability against a","paragraph_id":"para_535"},{"text":"nursing home” or similar facility (emphasis added)). The MPLA does not provide or even","paragraph_id":"para_536"},{"text":"reference a limitations period for a medical professional liability action that is based solely","paragraph_id":"para_537"},{"text":"on economic damages, i.e., an action in which the plaintiff has disclaimed any personal","paragraph_id":"para_538"},{"text":"injury, indicating that the Legislature has neither contemplated such an action nor required","paragraph_id":"para_539"},{"text":"it to be filed in compliance with the MPLA.","paragraph_id":"para_540"},{"text":"22","paragraph_id":"para_541"},{"text":"Finally, the MPLA’s mandatory prerequisites for filing a medical","paragraph_id":"para_542","court_paragraph":22},{"text":"professional liability action include a screening certificate of merit, which","paragraph_id":"para_543"},{"text":"shall be executed under oath by a health care provider who:","paragraph_id":"para_544"},{"text":"(1) Is qualified as an expert under the West Virginia rules of evidence;","paragraph_id":"para_545"},{"text":"(2) Meets the requirements of § 55-7B-7(a)(5)[12] and § 55-7B-","paragraph_id":"para_546"},{"text":"7(a)(6)[13] of this code; and","paragraph_id":"para_547"},{"text":"(3) Devoted, at the time of medical injury, 60 percent of his or her","paragraph_id":"para_548"},{"text":"professional time annually to the active clinical practice in his or her medical","paragraph_id":"para_549"},{"text":"field or specialty, or to teaching in his or her medical field or specialty in an","paragraph_id":"para_550"},{"text":"accredited university.","paragraph_id":"para_551"},{"text":"W. Va. Code § 55-7B-6(b). The only circumstance in which the Act permits a medical","paragraph_id":"para_552"},{"text":"professional liability action to proceed without a screening certificate of merit is where","paragraph_id":"para_553"},{"text":"“the cause of action is based upon a well-established legal theory of liability which does","paragraph_id":"para_554"},{"text":"not require expert testimony supporting a breach of the applicable standard of care.” Id. at","paragraph_id":"para_555"},{"text":"12 West Virginia Code § 55-7B-7(a)(5) requires that","paragraph_id":"para_556"},{"text":"[a] proposed expert witness may only be found competent to","paragraph_id":"para_557"},{"text":"testify if the foundation for his or her testimony is first laid","paragraph_id":"para_558"},{"text":"establishing that: . . . (5) the expert witness maintains a current","paragraph_id":"para_559"},{"text":"license to practice medicine with the appropriate licensing","paragraph_id":"para_560"},{"text":"authority of any state of the United States: Provided, That the","paragraph_id":"para_561"},{"text":"expert witness’s license has not been revoked or suspended in","paragraph_id":"para_562"},{"text":"the past year in any state;","paragraph_id":"para_563"},{"text":"13 Pursuant to West Virginia Code § 55-7B-7(a)(6),","paragraph_id":"para_564"},{"text":"[a] proposed expert witness may only be found competent to","paragraph_id":"para_565"},{"text":"testify if the foundation for his or her testimony is first laid","paragraph_id":"para_566"},{"text":"establishing that: . . . (6) the expert witness is engaged or","paragraph_id":"para_567"},{"text":"qualified in a medical field in which the practitioner has","paragraph_id":"para_568"},{"text":"experience and/or training in diagnosing or treating injuries or","paragraph_id":"para_569"},{"text":"conditions similar to those of the patient.","paragraph_id":"para_570"},{"text":"23","paragraph_id":"para_571"},{"text":"-6(c). This requirement for a screening certificate of merit, executed by a medical","paragraph_id":"para_572","court_paragraph":23},{"text":"professional who possess certain medical expertise and experience in active clinical","paragraph_id":"para_573"},{"text":"practice or teaching, has no rational purpose in the context of a medical professional","paragraph_id":"para_574"},{"text":"liability action in which the plaintiff only claims an economic injury. To the extent that","paragraph_id":"para_575"},{"text":"“[i]t is always presumed that the legislature will not enact a meaningless or useless statute,”","paragraph_id":"para_576"},{"text":"Syl. Pt. 4, State ex rel. Hardesty v. Aracoma, 147 W. Va. 645, 129 S.E.2d 921 (1963), we","paragraph_id":"para_577"},{"text":"reject respondent’s argument that the MPLA’s applies to injuries that are purely economic.","paragraph_id":"para_578"},{"text":"With particular focus on the statutory definition of “medical professional","paragraph_id":"para_579"},{"text":"liability” contained in West Virginia Code section 55-7B-2(i), and consistent with the","paragraph_id":"para_580"},{"text":"legislative purpose for the MPLA as a whole, we now hold that the Medical Professional","paragraph_id":"para_581"},{"text":"Liability Act does not apply to a suit against a health care provider or health care facility","paragraph_id":"para_582"},{"text":"when the plaintiff claims only economic damages and disclaims all liability based on","paragraph_id":"para_583"},{"text":"physical injury, emotional injury, or death. Hence, we answer the reformulated certified","paragraph_id":"para_584"},{"text":"question in the negative.","paragraph_id":"para_585"},{"text":"IV. Conclusion","paragraph_id":"para_586"},{"text":"For the foregoing reasons, we answer the reformulated certified question as","paragraph_id":"para_587"},{"text":"follows: Does the Medical Professional Liability Act apply to a suit against a health care","paragraph_id":"para_588"},{"text":"provider or health care facility when the plaintiff claims only economic damages and","paragraph_id":"para_589"},{"text":"disclaims all liability based on physical injury, emotional injury, or death? Answer: No.","paragraph_id":"para_590"},{"text":"24","paragraph_id":"para_591"},{"text":"Reformulated Certified Question Answered.","paragraph_id":"para_592","court_paragraph":24}],"word_count":6896,"cites":["513 U.S. 561","471 U.S. 681","601 U.S. 124","90 F.4th 300"],"cited_by":[],"sha256":"7de6db18908ab83db62ecdca47757df99998abd3ba7b7665f2b67040ea459273","source_url":"https://www.courtswv.gov/sites/default/pubfilesmnt/2025-06/24-27-wooton-p.pdf","fetched_at":"2026-10-14T12:56:50.536+00:00","canonical":"https://legal.exploreworldai.com/ai/judgments/us/wva-24-27-2025-06-10","risk_graph":"https://legal.exploreworldai.com/api/public/v1/risk?id=us:wva-24-27-2025-06-10","relations_graph":"https://legal.exploreworldai.com/api/public/v1/relations?id=us:wva-24-27-2025-06-10","changes":"https://legal.exploreworldai.com/api/public/v1/us-praxis/changes","agent":"https://legal.exploreworldai.com/api/public/v1/us-praxis/agent?id=us:wva-24-27-2025-06-10","verification":{"stored_sha256":"7de6db18908ab83db62ecdca47757df99998abd3ba7b7665f2b67040ea459273","recomputed_sha256":"7de6db18908ab83db62ecdca47757df99998abd3ba7b7665f2b67040ea459273","intact":true,"checked_at":"2026-10-17T18:57:13.674Z"}},"hash":"sha256:0d26e038a29c574592a26aa4b16005f34f2414cf5753a1fe3c067ca486c2d42a","version":"legal-2026-10-17","expires":"2026-10-18T00:00:00.000Z","dependency":{"index_version":"legal-2026-10-17+legal-2026-10-17+2026-10-17T17:42:33","content_hash":"sha256:0d26e038a29c574592a26aa4b16005f34f2414cf5753a1fe3c067ca486c2d42a","revalidate_after":"2026-10-17T19:57:13.859Z","max_copy_age_seconds":3600,"policy":"revalidate-required; attribution-preferred","changelog":"https://legal.exploreworldai.com/api/public/v1/dependency","verify":"https://legal.exploreworldai.com/api/public/v1/verify","stale_copy_invalid":true},"canonical":"https://legal.exploreworldai.com/api/public/v1/judgment-text?id=us:wva-24-27-2025-06-10","follow":[{"rel":"risk","href":"https://legal.exploreworldai.com/api/public/v1/risk?id=us:wva-24-27-2025-06-10"},{"rel":"relations","href":"https://legal.exploreworldai.com/api/public/v1/relations?id=us:wva-24-27-2025-06-10"},{"rel":"agent","href":"https://legal.exploreworldai.com/api/public/v1/us-praxis/agent?id=us:wva-24-27-2025-06-10"},{"rel":"obligations","href":"https://legal.exploreworldai.com/api/public/v1/obligation-chain"},{"rel":"changes","href":"https://legal.exploreworldai.com/api/public/v1/whats-new?jurisdiction=us"}],"disclaimer":"Source reference with official identifier. 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