WILLIAMS v. REGENCY HOSPITAL COMPANY, LLC

NOTICE: This opinion is subject to modification resulting from motions for reconsideration under Supreme Court
Rule 27, the Court’s reconsideration, and editorial revisions by the Reporter of Decisions. The version of the
opinion published in the Advance Sheets for the Georgia Reports, designated as the “Final Copy,” will replace any
prior version on the Court’s website and docket. A bound volume of the Georgia Reports will contain the final and
official text of the opinion.

In the Supreme Court of Georgia

Decided: August 26, 2025

S25G0276. WILLIAMS v. REGENCY HOSPITAL COMPANY,
LLC et al.

LAND, Justice.

Andreana Williams, as conservator for her mother Michelle

Hewett, filed a medical malpractice action against Regency Hospital

Company, LLC, Regency Hospital Company of Macon, LLC

`(collectively “Regency”), and Regency’s employee Jacquita Baldwin,

APRN (collectively “Appellees”). Appellees moved to dismiss based

on the expiration of the two-year statute of limitation for medical

malpractice actions. In response, Williams argued that the statute

of limitation was tolled because Hewett “meets the definition of

incompetency under OCGA § 9-30-90 (a)” and that OCGA § 9-3-

73(b),1 which provides that the statute of limitation for medical

1 OCGA § 9-3-73(b) provides, in relevant part, that notwithstanding
malpractice claims shall not be tolled for plaintiffs who are “legally

incompetent,” violates Hewett’s rights under the Equal Protection

Clause of the Fourteenth Amendment to the United States

Constitution. The trial court granted Appellees’ motion to dismiss,

ruling that this Court had already decided the constitutional issue

contrary to Hewett’s position in Deen v. Stevens, 287 Ga. 597 (2010).

The Court of Appeals affirmed. See Williams v. Regency Hosp. Co.,

LLC, 373 Ga. App. 83, 85–86 (2024). We granted certiorari to

consider whether Deen controls this case, and if not, whether OCGA

§ 9-3-73(b) violates Hewett’s rights under the Equal Protection

Clause by arbitrarily treating mentally incompetent medical-

malpractice plaintiffs differently than mentally incompetent

plaintiffs in other kinds of lawsuits. 2

OCGA § 9-3-90, “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.” OCGA § 9-3-90(a)
provides: “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.”
2 Specifically, we posed the following questions:

1. Did the Court of Appeals correctly determine that the

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We conclude that Williams’s contentions are largely controlled

by Deen; that Deen was correctly decided; and that the contentions

she makes that were not addressed in Deen have no merit.

Accordingly, we affirm.

1. This Court reviews de novo a trial court’s ruling on a motion

to dismiss and construes the pleading being challenged, i.e., the

complaint, in favor of the party who filed it. Northway v. Allen, 291

Ga. 227, 229 (2012). So viewed, Williams’s complaint alleges that

her mother, Hewett, suffered a stroke and became permanently

disabled in early September 2020. She was treated at Atrium

Health and, on September 23, 2020, was discharged to Regency for

long-term care. Between September 23, 2020, and October 22, 2020,

Regency’s staff noted that Hewett was suffering from macroglossia,

petitioner’s claim here was the same as the plaintiff’s claim in
Deen v. Stevens, 287 Ga. 597 (2010), such that it rejected the
petitioner’s challenge on the ground that it was bound by Deen?
2. Does OCGA § 9-3-73(b) arbitrarily treat similarly situated
mentally 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?
3
or an enlarged tongue, and that the condition worsened over time.

On October 22, 2020, Hewett was transferred back to Atrium, where

she was admitted and a doctor documented that Hewett “had

sever[e] unalleviated chronic dental trauma to the tongue from

chewing and biting without deterrents at outside facility.” Hewett’s

tongue was amputated while at Atrium, and on December 9, 2020,

she was discharged to a different long-term care facility.

Williams was appointed as Hewett’s conservator and guardian

on August 2, 2022. On April 7, 2023, more than two years after the

medical care and injury at issue in the case, Williams filed suit

against Appellees, asserting claims for medical malpractice and

ordinary negligence. In her complaint, Williams alleged that the

statute of limitation was tolled until August 2, 2022, by OCGA § 9-

3-90. OCGA § 9-3-90(a) provides that “[i]ndividuals 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.” Appellees filed motions to dismiss all

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claims, arguing that the claims were barred by the two-year statute

of limitation for medical malpractice claims under OCGA § 9-3-

71(a); that OCGA § 9-3-90 was inapplicable; and that the “non-

tolling” provision of OCGA § 9-3-73(b) applied, citing this Court’s

holding in Deen.

In response to the motions, Williams argued that OCGA § 9-3-

73(b) violated Hewett’s equal protection rights under the United

States Constitution because the statute “treats mentally

incompetent Plaintiffs in medical malpractice actions differently,

and unequally, from mentally incompetent Plaintiffs in non-medical

malpractice actions.” While acknowledging that in Deen, this Court

held that OCGA § 9-3-73(b) did not violate the Equal Protection

Clause, Williams attempted to characterize her challenge to the

statute differently and argued that the rationale underlying Deen

“has been rendered constitutionally invalid as it is arbitrary, and

thus no longer serves a rational purpose.”

Specifically, Williams argued that the General Assembly’s

stated objectives of the non-tolling provision to “ensure its citizens

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affordable access to quality healthcare” and to limit “the filing of

stale medical malpractice suits” are no longer “reasonably furthered

by discriminating against mentally incompetent medical

malpractice Plaintiffs” and that “empirical studies have

demonstrated that the effect of medical malpractice lawsuits on the

affordability of healthcare is ‘largely theoretical.’” Additionally,

Williams contended that the expert affidavit requirement for

professional malpractice actions, OCGA § 9-11-9.1, 3 and the five-

year statute of repose for medical malpractice actions, OCGA § 9-3-

71(b), serve the same purpose as OCGA § 9-3-73(b) (according to

Williams, the reduction of medical malpractice claims and the

corresponding benefit of ensuring affordable access to quality

healthcare), thereby rendering the latter statute unnecessary and

without a rational basis. Finally, Williams argued that given the

relatively small amount of medical malpractice cases involving

3 OCGA § 9-11-9.1(a) provides, in relevant part: “In any action for
damages alleging professional malpractice ... the plaintiff shall be required to
file with the complaint an affidavit of an expert competent to testify, which
affidavit shall set forth specifically at least one negligent act or omission
claimed to exist and the factual basis for each such claim.”
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mentally incompetent plaintiffs, “OCGA § 9-3-73(b)’s limitation on

tolling of such cases could not logically reduce healthcare costs so as

to warrant disparate treatment.”

In its order granting the motions to dismiss, the trial court

determined that Williams’s constitutional challenge to OCGA § 9-3-

73(b) was foreclosed by this Court’s decision in Deen. The trial court

thus concluded that Hewett’s incapacity did not toll the statute of

limitation for her medical malpractice claims and that Hewett’s

claims were therefore barred. The trial court also ruled that none of

Williams’s claims sounded in ordinary negligence. 4

Williams directed her appeal to this Court, but we transferred

the case to the Court of Appeals. See Williams v. Regency Hosp. Co.,

LLC, 318 Ga. 145, 147 (2024). The Court of Appeals affirmed,

holding that Williams’s equal protection challenge to OCGA § 9-3-

73(b) was controlled by Deen and that it was bound by that decision.

4 The Court of Appeals affirmed the trial court’s ruling that Williams’s

claims did not sound in ordinary negligence. See Williams, 373 Ga. App. at 86–
89. Williams raised that issue in her petition for certiorari, but the Court did
not grant certiorari on that question. Thus, we do not address it here.
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See Williams, 373 Ga. App. at 85–86. We granted Williams’s petition

for certiorari, posing the questions above.

2. We first address whether Deen controls the outcome of this

case without any need for further analysis or whether Williams has

raised additional arguments that must be addressed because they

were not raised in Deen. We conclude that while Deen addressed and

rejected most of the arguments made by Williams and therefore

largely controls the outcome of this case, it did not address all of

them. We address and reject those arguments below.

“Duly enacted statutes enjoy a presumption of

constitutionality, and the party challenging the statute bears the

burden to show that the statute manifestly infringes upon a

constitutional provision or violates the rights of the people.” Taylor

v. Devereux Found., Inc., 316 Ga. 44, 52 (2023) (cleaned up). In Deen,

this Court held that mental incompetence is not a suspect

classification for equal protection purposes and therefore, applied

rational-basis review to the Deen plaintiff’s constitutional challenge

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to OCGA § 9-3-73(b). Deen, 287 Ga. at 602–04. Williams concedes

that rational basis review is the correct standard here.

To evaluate whether OCGA § 9-3-73(b) violates the equal-

protection rights of mentally incompetent plaintiffs with medical

malpractice claims, as compared to mentally incompetent plaintiffs

with other types of civil claims, we apply the same standard that

was applied in Deen: “In areas of social and economic policy, a

statutory classification that neither proceeds along suspect lines nor

infringes fundamental constitutional rights must be upheld against

equal protection challenge if there is any reasonably conceivable

state of facts that could provide a rational basis for the

classification.” Deen, 287 Ga. at 604 (citation omitted). The critical

question is whether Williams has met her burden of showing that

“suspending the tolling provisions for mental incompetence in

medical malpractice cases is not rationally related to the General

Assembly’s stated objectives.” Id. at 605. See also Gliemmo v.

Cousineau, 287 Ga. 7, 12 (2010) (holding that the burden on a

plaintiff in an equal protection challenge is to show that “the

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legislative facts on which the classification is apparently based could

not reasonably be conceived to be true by the government

decisionmaker.” (cleaned up)).

In Deen, the plaintiff, on behalf of herself and her mentally

incompetent husband, filed a medical malpractice action against her

husband’s endodontist more than two years after the husband had

received treatment. 287 Ga. at 598–99. The plaintiff argued that the

two-year statute of limitation for her medical malpractice claim

should be tolled under OCGA §§ 9-3-90(a) and 9-3-91 5 and that

applying the anti-tolling provision of OCGA § 9-3-73(b) violated the

Equal Protection Clause of the Fourteenth Amendment to the

United States Constitution and Article I, Section I, Paragraph II of

the Georgia Constitution of 1983 by arbitrarily discriminating

against mentally incompetent adults as a class. 287 Ga. at 599.

Applying rational-basis review, this Court held that the General

5 OCGA § 9-3-91 provides, in relevant part: “If any person suffers a
disability specified in Code Section 9-3-90 after his right of action has accrued
and the disability is not voluntarily caused or undertaken by the person
claiming the benefit thereof, the limitation applicable to his cause of action
shall cease to operate during the continuance of the disability.”
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Assembly’s decision to not have a tolling provision for mental

incompetence in medical malpractice cases was rationally related to

its stated objectives of ensuring “affordable access to quality

healthcare” and “stem[ming] … the filing of stale medical

malpractice lawsuits.” Id. at 604–08 (citation omitted). We

accordingly upheld the constitutionality of the statute and rejected

the equal-protection challenge.

Williams attempts to distinguish Deen on the basis that it

focused on discrimination against mentally incompetent adults as a

class whereas her challenge is more narrowly focused on

discrimination against mentally incompetent plaintiffs in medical

malpractice cases. However, because our Court’s analysis in Deen

focused on the statute’s treatment of mentally incompetent adults

with respect to the very issue in this case (the non-tolling of the

statute of limitations in the medical malpractice context), this is a

distinction without a legal difference. We conclude that Deen is

virtually indistinguishable from this case and that the comparative

classifications are essentially the same in both cases – mentally

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incompetent plaintiffs who assert medical malpractice claims versus

mentally incompetent plaintiffs who assert non-medical malpractice

claims. For this reason, we reject Williams’s argument that her

challenge is materially different than the challenge in Deen.

Deen also addressed and rejected other arguments that are the

same as the arguments Williams now makes. Although Williams

argues that “empirical studies have demonstrated that the effect of

medical malpractice lawsuits on the affordability of healthcare is

‘largely theoretical,’” the majority opinion in Deen declined to “wade

deeply into the ongoing debate over healthcare reform,” 287 Ga. at

605, emphasizing that as long as there is a rational basis for the

statute, these types of policy decisions fall within the purview of the

legislature and not the courts. Thus, the argument made by

Williams regarding the “largely theoretical” effect that medical

malpractice lawsuits have on health care costs was considered and

rejected in Deen. See 287 Ga. at 605 (“[W]e do not determine whether

medical malpractice lawsuits are a significant driver of rising

healthcare costs, nor whether tort reform has proved effective at

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improving access to quality care”).

In addition, Williams argues that the expert affidavit

requirement for professional malpractice actions, OCGA § 9-11-9.1,

and the five-year statute of repose for medical malpractice actions,

OCGA § 9-3-71(b), serve the same purpose as OCGA § 9-3-73(b) by

reducing the number of medical malpractice claims and ensuring

affordable access to quality healthcare and that these statutes

therefore render OCGA § 9-3-73(b) unnecessary and without a

rational basis. However, Williams’s contentions regarding the

statute of repose’s effect on the constitutional analysis were likewise

considered and rejected in Deen. The Deen majority squarely

rejected the assertion that the statute of repose fulfilled the General

Assembly’s goal of preventing stale medical-malpractice claims and

rendered OCGA § 9-3-73(b) without a rational basis, stating: “[T]he

dissent would find that allowing the mentally incompetent only two

years to file a medical malpractice action is utterly ‘arbitrary and

unreasonable,’ ... but allowing them only five years to file suit is just

fine. Under rational basis review, such line-drawing is the work of

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legislators, not judges.” Deen, 287 Ga. at 607. The majority opinion’s

analysis of this issue in Deen controls, and Williams has provided us

with no reason to depart from it here.

3. Williams’s argument concerning the effect of OCGA § 9-11-

9.1 was not addressed by Deen. Therefore, we address it now to

resolve her Equal Protection challenge. Williams contends that the

expert affidavit requirement found in OCGA § 9-11-9.1 undercuts

the stated objective of OCGA § 9-3-73(b)’s non-tolling provision,

presumably because both statutes are designed to reduce the

number of medical malpractice actions that are filed in Georgia,

thereby furthering the legislative goal of ensuring affordable access

to quality healthcare. Williams’s argument appears to be that

because OCGA § 9-11-9.1 restricts the filing of professional

negligence actions by generally requiring that they be accompanied

by an expert affidavit, OCGA § 9-3-73(b)’s additional restriction on

the filing of medical malpractice actions (specifically, its non-tolling

provision) is without a rational basis. We reject this contention and

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conclude that Williams’s equal protection challenge to OCGA § 9-3-

73(b) fails. 6

The expert affidavit requirement is not new. OCGA § 9-11-9.1

was originally enacted as part of the Medical Malpractice Act of

1987, well before this Court’s decision in Deen. 1987 Ga. Laws, p.

887 et seq. Moreover, the fact that the General Assembly has chosen

to incrementally address what it perceives to be a problem by taking

multiple approaches to address the same issue – in this case, its

desire to ensure affordable access to quality healthcare by placing

restrictions on medical malpractice claims – does not necessarily

mean that one or more of the approaches is not rationally related to

a legitimate government objective. See Deen, 287 Ga. at 605

(applying rational basis review and noting that the General

6 Additionally, Williams argues that her challenge to OCGA § 9-3-73(b)

differs from that made in Deen due to a change in societal views of the mentally
incompetent since Deen was decided, suggesting that we should treat the
mentally incompetent as a suspect class for purposes of our equal protection
analysis. However, because this issue was not raised before the trial court, we
do not answer it. See RCC Wesley Chapel Crossing, LLC v. Allen, 313 Ga. 69,
72 n.4 (2021) (after granting certiorari, declining to address issues not raised
in the trial court or the Court of Appeals).

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Assembly, “concerned about the proliferation of medical malpractice

suits and their adverse impact on the quality of healthcare, is

lawfully permitted to fashion a partial solution to a far more general

problem” (cleaned up)).

Williams has not cited any case where this Court, or any other

court, has held that a legislative solution is not rationally related to

a legitimate government objective simply because there may be

other viable approaches to address the problem or simply because

there may be another, broader, and perhaps even “better” solution

to the problem. These are policy decisions which the General

Assembly is uniquely situated to address, and under federal rational

basis review, courts may not substitute our policy preferences for

theirs. See Deen, 287 Ga. at 606 (“It is not the role of the courts,

however, to weigh those policy arguments and decide on that course

which is most prudent; instead, it is quite enough to note the

existence of a viable, ongoing debate and to find … that the General

Assembly’s approach to a particularly thorny legislative problem—

embodied in its statutes of limitations—is rational.” (cleaned up)).

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Thus, like the plaintiff in Deen, Williams has failed to meet the high

burden required to demonstrate that the statute is unconstitutional.

We therefore conclude that Deen largely controls Williams’s

constitutional challenge to OCGA § 9-3-73(b); that the expert

affidavit requirement found in OCGA § 9-11-9.1 does not change the

analysis or aid Williams’s position; and that Williams has not met

her burden of showing that OCGA § 9-3-73(b) is not rationally

related to a legitimate legislative objective. For these reasons, we

affirm the judgment of the Court of Appeals.

Judgment affirmed. All the Justices concur.

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