Lewis v. Heggie, Jr.

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF TENNESSEE
NASHVILLE DIVISION
STEPHANIE LEWIS,
Plaintiff,
and
INTREPID INSURANCE COMPANY,
Intervening Plaintiff,
v.
PATRICK HEGGIE, Administrator
ad Litem of the Estate of Samuel B.
Heggie, Jr.,
Defendant.
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Case No. 3:24-cv-00501
Judge Aleta A. Trauger
MEMORANDUM and ORDER
In this facially simple premises liability lawsuit, plaintiff Stephanie Lewis seeks to recover
damages incurred when she tripped and fell on the front walkway of Samuel B. Heggie, Jr.’s home
while she was delivering a pizza, as an employee of Papa John’s, in February 2020. Samuel Heggie
having died during the pendency of this lawsuit, the plaintiff now proceeds against the Estate of
Samuel B. Heggie, Jr., represented by Patrick Heggie as the Administrator ad Litem. For
simplicity, the court nonetheless refers to Samuel Heggie herein as the “defendant.” The case is
set for trial on January 5, 2026.
The parties have both filed numerous interrelated motions in limine concerning the issue
of the plaintiff’s medical expenses, including: (1) the plaintiff’s Motion in Limine No. 1 – to
Exclude References to Collateral Sources (Doc. No. 78); (2) the plaintiff’s Motion in Limine No.
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8 – Regarding Reasonableness of Medical Bills (Doc. No. 85); (3) the defendant’s Motion in
Limine to Exclude any Evidence of Plaintiff’s Medical Expenses (Doc. No. 100); and (4) the
defendant’s Motion in Limine to Exclude Portion of Deposition Testimony of Dr. Paul Grutter and
Exclude Certain Exhibits (Doc. No. 101). Each party has filed responses in opposition to the
other’s motions.
The court has diversity jurisdiction, and there is no dispute that Tennessee law governs
certain aspects of this case. The primary focus of the particular motions now before the court is
whether the plaintiff is entitled to the statutory presumption afforded by Tenn. Code Ann. § 24-5-
113(b)(1) and, further, whether she can present proof of her medical expenditures. As set forth
herein, the court finds that the plaintiff has not shown that she is entitled to invoke the statutory
presumption and has not produced any evidence of the reasonableness of her medical bills. Those
conclusions effectively moot the plaintiff’s Motion in Limine No. 1 and require that the defendant’s
Motion to Exclude Certain Exhibits be granted, at least in part.
I. 	LEGAL STANDARDS
District courts adjudicate pretrial motions in limine under their “inherent authority to
manage the course of trials.” Luce v. United States, 469 U.S. 38, 41 n.4 (1984). “The purpose of a
motion in limine is to allow a court to rule on issues pertaining to evidence prior to trial to avoid
delay and ensure an evenhanded and expedient trial.” In re E.I. du Pont de Nemours & Co. C-8
Pers. Inj. Litig., 348 F. Supp. 3d 698, 721 (S.D. Ohio 2016). Courts should grant a pretrial motion
to exclude evidence only when the evidence is “clearly inadmissible on all potential grounds.” Ind.
Ins. Co. v. Gen. Elec. Co., 326 F. Supp. 2d 844, 846 (N.D. Ohio 2004). Because courts are “almost
always better situated during the actual trial to assess the value and utility of evidence,” In re E.I.
du Pont de Nemours, 348 F. Supp. 3d at 721 (citation omitted), often the “better practice” is to
address questions regarding the admissibility of broad categories of evidence “as they arise,”
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Sperberg v. Goodyear Tire & Rubber Co., 519 F.2d 708, 712 (6th Cir. 1975).
Thus, the denial of a motion in limine does not necessarily mean that the evidence that is
the subject of the motion will be admissible at trial. Ind. Ins. Co., 326 F. Supp. 2d at 846. Rather,
“[a] ruling on a motion in limine is no more than a preliminary, or advisory, opinion that falls
entirely within the discretion of the district court.” U.S. v. Yannott, 42 F.3d 999, 1007 (6th Cir.
1994). The district court may change its ruling on the motion in limine, whether prior to trial or at
trial, “where sufficient facts have developed to warrant the change.” Id.
II. 	PLAINTIFF’S MOTION IN LIMINE NO. 8 – REGARDING REASONABLENESS
OF MEDICAL BILLS
A. 	Background
Generally speaking, an individual “injured by another’s negligence may recover damages
from the other person for all past, present, and prospective harm.” Rye v. Women’s Care Ctr. of
Memphis, MPLLC, 477 S.W.3d 235, 267 (Tenn. 2015) (quoting Singh v. Larry Fowler Trucking,
Inc., 390 S.W.3d 280, 287–88 (Tenn. Ct. App. 2012)). Two types of damages are recoverable:
“economic (or pecuniary) damages and non-economic (or personal) damages.” Dedmon v.
Steelman, 535 S.W.3d 431, 437 (Tenn. 2017) (citation omitted). Economic damages include,
among other things, past medical expenses. Id. Of course, “[t]he party seeking damages has the
burden of proving them.” Overstreet v. Shoney’s, Inc., 4 S.W.3d 694, 703 (Tenn. Ct. App. 1999).
The Tennessee Supreme Court has explained that, to recover an award of past medical
expenses, the plaintiff must “prove that the medical bills paid or accrued because of the defendant’s
negligence were both ‘necessary and reasonable.’” Dedmon, 535 S.W.3d at 438 (quoting Borner
v. Autry, 284 S.W.3d 216, 218 (Tenn. 2009)). Typically, the plaintiff “must present competent
expert testimony to meet this burden of proof.” Id. (quoting Borner, 284 S.W.3d at 218). “A
physician who is familiar with the extent and nature of the medical treatment a party has received
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may give an opinion concerning the necessity of another physician’s services and the
reasonableness of the charges.” Id. (quoting Long v. Mattingly, 797 S.W.2d 889, 893 (Tenn. Ct.
App. 1990)). The testifying physician providing such an opinion must demonstrate “(1) knowledge
of the [plaintiff’s] condition, (2) knowledge of the treatment [she] received, (3) knowledge of the
customary treatment options for the condition in the medical community where the treatment was
rendered, and (4) knowledge of the customary charges for the treatment.” Id. (citation omitted).
However, under Tennessee law, a plaintiff in a personal injury case may, in certain
circumstances, be entitled to a rebuttable presumption as to the reasonableness of the medical
expenditures incurred in the treatment of the injuries, without the necessity of expert testimony.
The procedures for invoking this presumption are set out by statute:
[I]n any civil action for personal injury brought by an injured party against the
person or persons alleged to be responsible for causing the injury, if an itemization
of or copies of the medical, hospital or doctor bills which were paid or incurred
because of such personal injury are served upon the other parties at least ninety (90)
days prior to the date set for trial, there shall be a rebuttable presumption that such
medical, hospital or doctor bills are reasonable.
Tenn. Code Ann. § 24-5-113(b)(1). To rebut this presumption, the defendant must serve on the
plaintiff, “at least forty-five (45) days prior to the date set for trial, a statement of that party’s
intention to rebut the presumption. Such statement shall specify which bill or bills the party
believes to be unreasonable.” Id. § 24-5-113(b)(2).
The plaintiff in this case seeks to invoke § 24-5-113(b)(1) to establish the reasonableness
of her medical expenditures. She asserts that she “complied with this provision by serving an
itemization of the Plaintiff’s medical expenses on the Defendant on May 23, 2023” and that she
supplied a “subsequent itemization which contains the current style of the case but [is] otherwise
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identical was made an exhibit to Dr. Grutter’s deposition.” (Doc. No. 85 at 3.)1 She further states
that the original itemization was “served in the case which had been filed in the Sumner County
Circuit Court,” and she claims that, per this court’s Initial Case Management Order (“ICMO”),
“the discovery conducted in that prior suit was extended to the present lawsuit.” (Id. at 3 n.1 (citing
Doc. No. 30).) The ICMO indeed provides that the “parties’ discovery completed in the prior case
may be used but need not be supplemented.” (Doc. No. 30 at 4.)
The plaintiff further asserts that, because she provided an itemization in accordance with
the statute, the burden shifted to the defendant to serve notice of an intent to rebut along with the
specific bill or bills the defendant believes to be unreasonable within forty-five days prior to trial.
(Doc. No. 85 at 3.) She acknowledges that the defendant sent the plaintiff a notice of intent to rebut
on November 24, 2025, but she claims that the defendant did not identify any specific bills he
believes to be unreasonable and has not disclosed a medical expert to provide rebuttal testimony.
She argues that the defendant’s notice was therefore insufficient and that she is entitled to a
statutory presumption that her medical expenditures as itemized are reasonable, pursuant to § 24-
5-113(b)(1), without the need for expert testimony to that effect, and that the defendant should not
be permitted to introduce evidence to rebut that presumption. (Id. at 4.)
The defendant has filed a Response in Opposition to Plaintiff’s Motion in Limine No. 8.
(Doc. No. 111.) He argues that (1) the plaintiff has never complied with Tenn. Code Ann. § 24-5-
113, in either the prior state court lawsuit or in this lawsuit; (2) even if she had complied with it in
the state court case, a notice provided in a state court case that was subsequently nonsuited does
not entitle the plaintiff to a presumption in a subsequently filed federal lawsuit; and (3) a provision
1 The plaintiff identifies Paul Grutter, M.D. as a treating physician on her Witness List.
(Doc. No. 117 at 2.)
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for the use of prior discovery from the state court lawsuit does not entitle her to rely on a statutory
evidentiary presumption at trial, because a statutory evidentiary presumption is not discovery.
Additionally, the defendant argues that the plaintiff has never actually produced or authenticated
her unredacted medical bills in discovery in this case and, in any event, never properly “served”
them on him.
More specifically, the defendant maintains that the plaintiff did not “serve” her medical
expenditure itemization in the nonsuited state court case, and the only time she did conceivably
serve it was during the deposition of Dr. Grutter, which took place on November 24, 2025, less
than ninety days prior to trial. Instead, by referencing May 23, 2023 as the date on which she
supposedly “served” the prior itemization, the plaintiff “admits” that the “service” to which she
refers was actually a “demand letter emailed to Defendant’s counsel,” to which the itemization
was attached. (Doc. No. 111 at 4 n.1.) The defendant apparently concedes receipt of this demand
letter, but he further argues that, even if an attachment to a settlement demand emailed to defense
counsel could satisfy the “service” requirement incorporated in the statute, such notice did not
carry over to this lawsuit. The defendant also maintains that the plaintiff has never produced, in
discovery or otherwise, complete and unredacted copies of her medical bills.
B. 	Discussion
Section 24-5-113(b)(1), as set forth above, includes two key requirements: (1) that the
itemization or actual medical bills be “served” upon the defendant; and (2) that such service occur
at least ninety days prior to trial. Neither party has identified a Tennessee state or federal case
addressing these requirements. Indeed, it appears that in most cases in which the statute has been
invoked, there is no dispute as to whether the plaintiff complied with the service requirement. See,
e.g., Boettcher v. Shelter Mut. Ins. Co., No. 2:14-cv-02796-JPM-dkv, 2016 WL 3212184, at *3
(W.D. Tenn. June 8, 2016) (“In the instant case, the parties do not dispute that Plaintiffs served
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Shelter with itemized medical bills at least ninety days before trial.”); Wilson v. Monroe Cnty., 411
S.W.3d 431, 442 (Tenn. Ct. App. 2013) (no dispute as to whether the plaintiff complied with § 24-
5-113(b)); Iloube v. Cain, 397 S.W.3d 597, 604 (Tenn. Ct. App. 2012) (“In this case, Mr. Cain did
not challenge the reasonableness of the medical expenses allegedly incurred by Mr. Iloube.”). The
court has located no court opinions in which service of the itemization (or bills) was at issue.
However, courts in Tennessee and elsewhere generally hold that statutes in derogation of
the common law, including those creating presumptions, must be narrowly construed. See, e.g.,
Garramone v. Dugger, No. M2023-00677-COA-R3-CV, 2024 WL 4880377, at *10 (Tenn. Ct.
App. Nov. 25, 2024) (statutory fee shifting statute in derogation of Tennessee common law must
be construed narrowly); Limbaugh v. Coffee Med. Ctr., 59 S.W.3d 73, 83 (Tenn. 2001) (waiver of
governmental immunity narrowly construed); Maysay v. Hickman, 297 S.W.2d 662, 664 (Tenn.
Ct. App. 1936) (statutory evidentiary presumption as to automobile ownership narrowly
construed); accord Miller v. Mylan Inc., 741 F.3d 674, 678 (6th Cir. 2014) (“It is axiomatic that
statutes in derogation of the common law should be narrowly construed.” (quoting Badaracco v.
Comm’r, 464 U.S. 386, 403 n.3 (1984) (Stevens, J., dissenting))).
Specifically regarding § 24-5-113, the Tennessee Supreme Court has stated:
Our role in construing a statute is to ascertain and give effect to the legislative intent
without unduly restricting or expanding the statute’s coverage beyond its intended
scope. In fulfilling this role, we presume that every word in the statute has meaning
and purpose and should be given full effect if the obvious intention of the General
Assembly is not violated by so doing. When the language of the statute is clear, we
apply its plain meaning, without complicating the task.
Borner, 284 S.W.3d at 219 (Tenn. 2009) (internal citations omitted). Applying these principles,
the court held that the plaintiff failed to comply with the statute and was not entitled to the statutory
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presumption in that case, because she attached redacted medical bills to her complaint.2 This court
believes that the Tennessee Supreme Court would apply the same principles to conclude that a
plaintiff seeking to benefit from the presumption afforded by § 24-5-113(b) must strictly comply
with its unambiguous provisions. And the plaintiff clearly has the burden of proving such
compliance, since she has the burden of proving reasonableness. Here, the plaintiff has not attached
to her motion a copy of the itemization she supposedly served on the defendant in 2023. According
to the defendant, the itemization was supplied in the course of a different lawsuit and was not
“served” as that term is defined by Tennessee law. Instead, it was attached as an exhibit to an
emailed settlement demand.
In May 2023, Rule 5.02 of the Tennessee Rules of Civil Procedure stated that “service” of
a document upon an attorney could be made by “delivering to the attorney a copy of the document
to be served, or by mailing it to such person’s last known address, or if no address is known, by
leaving the copy with the clerk of the court.” Tenn. R. Civ. P. 5.02(1) (2020). “Delivery” under
this provision meant “handing it to the attorney or to the party; or leaving it at such person’s office
2 That case involved a different subsection of § 24-5-113 which states that, if a plaintiff
attaches an itemization or copies of bills paid or incurred as an exhibit to a complaint, such “bills
itemized and attached as an exhibit shall be prima facie evidence that the bills so paid or incurred
were necessary and reasonable.” Tenn. Code Ann. § 24-5-113(a)(1). This “prima facie
presumption” of reasonableness based on an itemization or bills attached to a complaint only
applies if “the total amount of such bills does not exceed the sum of four thousand dollars.” Id.
§ 24-5-113(a)(3). The Tennessee Supreme Court held that “[a] plaintiff may not rely on the
presumption, however, if the medical bills itemized with copies attached to the complaint have
been altered to reflect a total of $4,000 or less.” Borner, 284 S.W.3d at 220. In that case, the
plaintiffs altered the bills attached to the complaint to bring the total amount of the bills within the
$4,000 limit. The Tennessee Supreme Court held that the statute “refers to ‘bills,’ not ‘charges’ or
‘portions of bills,’” and that it “requires “‘copies of bills’ to be attached to the complaint.” Id. at
219. The court held that a redacted bill did not qualify as a “copy” and that the “reliability of such
bills as prima facie evidence of necessity and reasonableness is diminished if the plaintiff is
permitted to alter such bills unilaterally.” Id. Because the plaintiffs had redacted the bills attached
to the complaint, and because the original bills exceeded the $4,000 maximum, the court held that
the plaintiffs were not entitled to rely on the presumption afforded by § 24-5-113(a). Id. at 220.
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with a clerk or other person in charge thereof; or, if there is none in charge, leaving it in a
conspicuous place therein; or, if the office is closed or the person to be served has no office, leaving
it at the person’s dwelling house or usual place of abode with some person of suitable age and
discretion then residing therein.” Id. In addition, service was permitted by “emailing the attorney
the document in Adobe PDF to the attorney’s email address,” but, for service by email to be
effective, the sender had to “include language in the subject line designed to alert the recipient that
a document is being served under this rule.” Tenn. R. Civ. P. 5.02(2)(a) (2020). In addition, in
May 2023, the rule further provided that, to effect service of a document by email, the sender also
had to “send by mail, facsimile or hand-delivery a certificate that advises that a document has been
transmitted electronically” on the same date as the electronic transmission. Id. The rule was
amended in July 2023, shortly after the “service” in question here, to omit this latter requirement,
but, even as amended, the rule required notice in the subject line “designed to alert the recipient
that a document is being served under this rule.”3
The plaintiff here has not established that she “served” the itemization, as the term was
defined in Rule 5.02 in May 2023 or as defined in Rule 5.02 as amended in July 2023. Therefore,
she has not shown that the May 2023 itemization purportedly attached to a settlement demand
complied with the “service” component of § 24-5-113(b), even though it took place substantially
more than ninety days prior to the date set for trial. As for the service of the itemization that the
defendant concedes occurred during Dr. Grutter’s deposition on November 24, 2025, that service
did not comply with the “at least ninety days” requirement, since trial is set for January 6, 2026.
3 The Federal Rule of Civil Procedure governing service in this context permitted service
of a document by email only if the receiving attorney consented to service by email. This rule
would not have pertained to a lawsuit then pending in state court. Regardless, the plaintiff has
presented no evidence that defense counsel consented to service of documents by email.
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The provision of unredacted medical bills during the course of discovery in the state court
lawsuit would have satisfied the service requirement and would likely have permitted the plaintiff
to invoke the statutory presumption in this lawsuit, particularly because the ICMO expressly
stipulated that discovery would carry over. But a settlement demand is not discovery, and the
plaintiff also has not established that she supplied the defendant with unredacted copies of her
medical bills in discovery more than ninety days prior to trial. As noted above, the Supreme Court
has expressly held that redacted, edited versions of medical bills are not “copies” for purposes of
§ 24-5-113. See Borner, 284 S.W.3d at 219 (“A ‘copy’ is commonly understood as ‘[a]n imitation
or reproduction of an original.’ Black’s Law Dictionary 360 (8th ed. 2004). Applying this
definition, a redacted bill is clearly not a ‘copy’ of the original bill.”). Therefore, redacted versions
would not qualify as copies of bills for purposes of § 24-5-113(b) either.
In short, the plaintiff has not produced evidence that she served an itemization of her
medical expenditures or unredacted copies of her medical bills upon the defendant at least ninety
days prior to the date set for trial. Accordingly, she has not, for purposes of her motion at least,
established that she is entitled to benefit from the presumption afforded by § 24-5-113(b)(1). Her
Motion in Limine No. 8 – Regarding Reasonableness of Medical Bills (Doc. No. 85) will therefore
be denied.
III. DEFENDANT’S MOTION IN LIMINE TO EXCLUDE EVIDENCE OF
PLAINTIFF’S MEDICAL EXPENSES
The defendant has filed a motion to exclude evidence of the plaintiff’s medical expenses
or the reasonableness of such expenses, on the grounds that the plaintiff has failed to identify any
expert competent to testify as to reasonableness, and the court has already stated, in the context of
ruling on the parties’ summary judgment motions, that the plaintiff would need expert proof to
establish both the reasonableness and necessity of her medical expenses. (Doc. No. 100 at 1.) The
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defendant points out that the only medical expert the plaintiff has identified is Dr. Grutter, and Dr.
Grutter testified unequivocally that he had not reviewed the medical bills and could not provide
any opinion as to the reasonableness or necessity of any particular charge. (Id. at 2–3 (citing Doc.
No. 100-1, Grutter Dep. 65–66).)
In her Response, the plaintiff expressly concedes that evidence that medical bills are
reasonable and necessary “typical[ly] requires expert proof” and that her “treating physician did
not testify concerning the reasonableness of her bills.” (Doc. No. 130 at 1.) She maintains,
however, that she is entitled to the presumption of reasonableness provided by Tenn. Code Ann.
§ 24-5-113(b)(1). She further maintains that Dr. Grutter is competent to testify about, and has
testified in his deposition about, the necessity and reasonableness of the plaintiff’s treatment, as
distinct from the cost of that treatment. In a footnote, she adds that the defendant “obtained a copy
of Plaintiff’s medical records which included the bills in question” and obtained a copy of the
“entire worker’s compensation file from the Intervening Plaintiff.” (Doc. No. 130 at 2 n.2.)
Notably, as discussed above, the plaintiff has not argued—or presented evidence
showing—that she served the defendant an itemization of medical expenditures or complete copies
of her medical bills within ninety days prior to trial, for purposes of the § 24-5-113(b)(1)
presumption of reasonableness. And her only response to the defendant’s motion to exclude
evidence of the reasonableness of her expenses is that she relies on the statutory presumption of
reasonableness. Without a witness qualified to testify as to their reasonableness, the medical bills
themselves are not relevant and are not admissible. Accord Holzmer v. Est. of Walsh, No. M2022-
00616-COA-R3-CV, 2023 WL 4836691, at *7 & n.8 (Tenn. Ct. App. July 28, 2023) (finding that
the trial court did not abuse its discretion in excluding the plaintiff’s medical bills “because there
was no expert testimony on the necessity of the expenses,” as distinct from the necessity of the
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treatment, and also noting that it had no need to consider the evidence of reasonableness, since the
plaintiff was required to prove both the reasonableness and necessity of the expenses, and she
could not prove necessity).
The plaintiff argues that, in any event, Tennessee courts do not view medical expenses as
hearsay and that medical bills can be introduced by a plaintiff. (Doc. No. 130 at 4 (citing Russell
v. Crutchfield, 988 S.W.2d 168 (Tenn. Ct. App. 1998)).) Indeed, in Russell, the court held that the
medical bills were not hearsay and could be introduced by the plaintiff, but that was because the
plaintiff testified that she received the bills for services actually provided to her. The bills were not
hearsay because they were not being admitted for the truth of the matter asserted but were, instead,
direct evidence of the charges incurred by the plaintiff, regarding which the plaintiff had firsthand
knowledge. Russell, 988 S.W.2d at 171; see id. (“The bills were not hearsay. Their probative value
in showing [the plaintiff’s] damages did not depend upon an out-of-court assertion, but upon [the
plaintiff’s] assertion, based on an adequate foundation, that [s]he received them for the services
provided [her]. Thus, the bills were not merely reports of what the service providers charged, they
were the charges themselves.” (quoting approvingly Walters v. Littleton, 290 S.E.2d 839, 841 (Va.
1982))). In this case, however, it appears that the plaintiff’s medical bills were received and paid
by her employer’s workers’ compensation insurer. The plaintiff has not suggested that she herself
received the bills or has first-hand knowledge about them.
In short, the plaintiff has not satisfied the requirements of § 24-5-113(b) and, therefore, is
not entitled to a presumption as to the reasonableness of her medical expenses. She has offered no
other viable basis for introducing the billing records into evidence. Because she cannot establish
the reasonableness of her medical expenses, the court need not even reach the question of whether
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the expenditures were necessary. Accordingly, the court will grant the defendant’s Motion in
Limine to Exclude Evidence of Plaintiff’s Medical Expenses. (Doc. No. 100.)
This ruling, however, has no effect on the question of whether Dr. Grutter can testify about
the plaintiff’s medical treatment and the necessity of that treatment, which is a wholly different
question from the cost of that treatment.
IV. DEFENDANT’S MOTION IN LIMINE TO EXCLUDE PORTION OF
DEPOSITION TESTIMONY OF DR. PAUL GRUTTER
Separately, the defendant moves to exclude a portion of Dr. Paul Grutter’s testimony,
which the plaintiff seeks to introduce through his deposition, as well as certain exhibits to Grutter’s
deposition, specifically including (1) Exhibit 17, an itemization of the plaintiff’s medical expenses
that was prepared specifically as an exhibit to Grutter’s deposition (though the plaintiff maintains
that it is identical to the one she sent plaintiff’s counsel in May 2023, except that she changed the
case caption to the caption for this case instead of the nonsuited state court case); (2) any actual
medical bills that were the source of the itemization; (3) medical records that were not from Dr.
Grutter’s practice but from other practitioners, including Emergency Room records, a radiology
report, and others; and (4) a Papa John’s manual.
Regarding the itemization and the billing records, the plaintiff’s Response focuses on
whether the itemization is a proper “summary” exhibit under Federal Rule of Evidence 1006 and
continues to maintain, based on Russell, that the plaintiff herself can introduce the billing records
into evidence. (Doc. No. 131 at 1–2.) As set forth above, the plaintiff cannot introduce the
itemization or the billing records through Dr. Grutter, based on his testimony that he had never
seen any of the medical bills prior to his deposition and could not say whether any particular charge
was necessary, had never done any independent research or investigation into hospital billing
practices, and had no idea of the customary charges for the services the plaintiff received. (See
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Doc. No. 101-1, Grutter Dep. 65–66.) The plaintiff also is not entitled to introduce the medical
bills into evidence herself, because she has not shown that she actually received or incurred those
bills. The motion to exclude the itemization and any underlying medical bills will be granted.
As for the Papa John’s manual, the manual appears to have been introduced into the record
because it was in Dr. Grutter’s medical file for the plaintiff. Plaintiff’s counsel asked him during
his deposition only whether, after he “give[s] the restrictions for a patient to the employer,” he has
“any control over whether or not the employer has a job that works within their restrictions or not.”
(See Doc. No. 101-1, Grutter Dep. 29.) The defendant argues that the manual should be excluded
based on lack of foundation, since Dr. Grutter did not testify that he relied on it and was not even
asked about how it came to be in his files. In her Response, the plaintiff maintains that the
document was authenticated by Dr. Grutter as a part of his medical records and that is relevant to
his treatment plan. She argues that the manual falls within an exception to the hearsay rule, Fed.
R. Evid. 803(4), and is a business record under Rule 803(6). (Doc. No. 131 at 3–4.)
The court notes that Dr. Grutter was not asked during his deposition about anything the
manual said, and the manual clearly does not qualify as a statement made for medical diagnosis or
treatment under Rule 803(4). However, the manual appears to be a business record contained
within Dr. Grutter’s files. The court, at this juncture, cannot conclude that the manual is excludable
as hearsay. The motion to exclude the Papa Johns manual will be denied, but without prejudice.
Any argument as to authenticity and relevance can be raised at trial.
Finally, the defendant contends that Dr. Grutter is not competent to testify about or to
authenticate medical records from other providers and that his testimony and those records should
be excluded. He argues that these records constitute hearsay and that plaintiff’s counsel failed to
lay a proper foundation for them. The plaintiff does not actually respond to this aspect of the
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defendant’s motion. (See generally Doc. No. 131.) The court, however, will not rule at this juncture
on the admissibility of medical records from providers other than Dr. Grutter. The motion
addressed to other medical records will be denied, but the defendant can renew his objections based
on authenticity and hearsay at trial. As a generally matter, the court finds that Dr. Grutter will be
permitted to testify as to the reasonableness of the plaintiff’s medical treatment based on his own
treatment of her injuries.
In sum, this motion (Doc. No. 101) will be granted in part, and the itemization entered as
Exhibit 17 and any underlying billing records will be excluded. Otherwise, the motion is denied,
but without prejudice to the defendant’s ability to raise objections based on hearsay and
authenticity at trial.
V. 	PLAINTIFF’S MOTION TO EXCLUDE REFERENCE TO COLLATERAL
SOURCES
In her Motion in Limine No. 1, the plaintiff seeks to exclude from trial “any reference to or
evidence of payments made to or on behalf of the Plaintiff from collateral sources, including but
not limited to health insurance, Medicare, Medicaid, workers’ compensation, or any third-party
payments, reductions, or gratuities.” (Doc. No. 78 at 1.) The plaintiff argues that the Tennessee
Supreme Court has made it clear that “evidence of payments made . . . by a collateral source are
not admissible to reduce a defendant’s damages.” (Doc. No. 78 at 2 (citing Dedmon v. Steelman,
535 S.W.3d 431, 433 (Tenn. 2017)).) The defendant argues that this motion is effectively moot,
because collateral source evidence is only relevant to the adjustment of medical bills, and the
plaintiff will not be able to present any evidence regarding her medical bills.
The court agrees, for the reasons set forth above. Because the plaintiff will not be able to
present evidence of her medical bills, the question of whether they were paid by another source is
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irrelevant. The motion, at least insofar as it pertains to the issue of medical bills, will be denied as
moot.
VI. CONCLUSION AND ORDER
For the reasons set forth herein:
(1) The plaintiff’s Motion in Limine No. 8 – Regarding Reasonableness of Medical
Bills (Doc. No. 85) is DENIED, because the plaintiff has not established that she
satisfied the requirements of Tenn. Code Ann. § 24-5-113(b)(1) and therefore has
not shown that she is entitled to a presumption that her medical bills are reasonable.
(2) The defendant’s Motion in Limine to Exclude any Evidence of Plaintiff’s
Medical Expenses (Doc. No. 100) is GRANTED.
(3) The defendant’s Motion in Limine to Exclude Portion of Deposition Testimony
of Dr. Paul Grutter and Exclude Certain Exhibits (Doc. No. 101) is GRANTED IN
PART, with respect to Exhibit 17 (billing itemization) to Dr. Grutter’s deposition
and any underlying billing records. Otherwise, the motion is DENIED WITHOUT
PREJUDICE to the defendant’s ability to renew objections based on hearsay and
authenticity at trial.
(4) The plaintiff’s Motion in Limine No. 1 – to Exclude References to Collateral
Sources (Doc. No. 78) is DENIED AS MOOT. Since the plaintiff will not be
introducing into evidence any medical bills or any evidence regarding the
reasonableness, necessity, or, indeed, payment of her medical bills, the issue of
payment of her medical bills through a collateral source should not come up and,
in any event, would be irrelevant.
It is so ORDERED.
ALETA A. TRAUGER
United States District Judge
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