Full Opinion

11/03/2026 IN THE COURT OF APPEALS OF TENNESSEE AT NASHVILLE Assigned on Briefs June 2, 2026 STEPHANIE HATCHETT, ET AL. v. NHC HEALTHCARE/COOL SPRINGS, LLC ET AL. Appeal from the Circuit Court for Williamson County No. 24CV-342 David Henry Veile, Judge ___________________________________ No. M2025-01941-COA-R3-CV ___________________________________ The plaintiffs filed a wrongful death suit following the death of their mother at a nursing home facility. They nonsuited their action and subsequently sought to refile in accordance with the savings statute. Though their second pre-suit notice was sent before the one-year statute of limitations, their re-filed complaint was not refiled within a year. The plaintiffs, however, claimed the facility spoliated evidence by concealing a pertinent document and sought the sanction of striking the nursing home facility’s statute of limitations affirmative defense. The trial court found no intentional misconduct and no prejudice to the plaintiffs, and it declined to impose the requested sanction. The plaintiffs appeal. We affirm. Tenn. R. App. P. 3 Appeal as of Right; Judgment of the Circuit Court Affirmed JEFFREY USMAN, J., delivered the opinion of the court, in which THOMAS R. FRIERSON, II, and VALERIE L. SMITH, JJ., joined. Patrick Shea Callahan, Cookeville, Tennessee, for the appellants, Stephanie C. Hatchett, and Stephen Cantrell, DDS, M.D. John B. Curtis, Jr., Sharel V. Hooper, and Brie Allaman Stewart, Chattanooga, Tennessee, for the appellees, NHC Healthcare/Cool Springs, LLC, Anthony Todd Moore, and National Health Corporation d/b/a National Healthcare Corporation. OPINION I. Stephanie C. Hatchett and Stephen Cantrell brought a wrongful death suit in connection with the death of their mother, Nancy Cantrell, at a nursing home facility. Following Ms. Cantrell’s death, the plaintiffs sued the nursing home facility, NHC Healthcare/Cool Springs, LLC, and multiple affiliated entities and individuals.1 Ms. Cantrell received care at NHC’s nursing home facility from November 17, 2021, to November 21, 2021, for rehabilitation after being treated at a local hospital for fall-related injuries. According to the plaintiffs, Ms. Cantrell was a high-fall-risk patient. During her first night at NHC, staff found Ms. Cantrell wandering outside of her room. This occurred again the following night. Sometime late in the evening on November 19 or in the early hours of November 20, 2021, Ms. Cantrell fell in the hallway, and she was discovered lying down in the hallway at 2:00 a.m. Later that same day Ms. Cantrell was left unattended at the dining table during the lunch hour. She fell and hit her head on the table when she attempted to leave. When she fell, she sustained a head injury and fractured her right femur. NHC records indicate that Licensed Practical Nurse (LPN) Taija Thigpen called the plaintiffs to inform them that Ms. Cantrell had fallen and hit her head. She reported that Ms. Cantrell had a bruise on her forehead but otherwise was walking and had no other apparent injuries. Once the plaintiffs arrived, they did not observe any staff performing neurological checks on Ms. Cantrell. Nurse Practitioner Elizabeth Coughlin told the plaintiffs that she had not been notified that Ms. Cantrell was found in the hallway after her first fall. Ms. Cantrell passed away from her injuries the next day, November 21, 2021. The plaintiffs subsequently requested her medical records from NHC. NHC provided Ms. Cantrell’s medical records on December 17, 2021, which included an Event Report for both falls. The plaintiffs observed that one of the Event Reports contradicted Ms. Coughlin’s statement that she was not contacted after Ms. Cantrell’s first fall, noting the report indicated that “Nurse Joy did contact the attending, Nurse Practitioner Coughlin, following the first fall.” The plaintiffs sent the required pre-suit notice to the potential defendants on November 10, 2022, to which NHC responded by sending another set of medical records. The parties agree that the plaintiffs timely filed their original complaint on February 19, 2023. The plaintiffs asserted claims of negligence; gross negligence, willful, wanton, 1 The initial complaint was filed against NHC Place at Cool Springs d/b/a NHC HealthCare/Cool Springs, LLC; several companies that own and manage the nursing home facility including: Tennessee Health Care Advisers, LLC; National Healthcare Corporation, NHC/OP, L.P., National Healthcorp, L.P., NHC, Inc.; the administrator of the nursing home, Anthony Todd Moore; and five John Does whose identity would be revealed during discovery. The parties named in the second suit are NHC HealthCare/Cool Springs, LLC, d/b/a NHC Place Cool Springs; the corporation that manages and controls the nursing home facility, National Health Corporation d/b/a National Healthcare Corporation; and the administrator of NHC Cool Springs, Anthony Todd Moore. We refer to the nursing home facility individually and to the defendants in the first and second lawsuits collectively as “NHC.” -2- reckless, malicious and/or intentional conduct; negligence pursuant to the Tennessee Health Care Liability Act codified in Tennessee Code Annotated section 29-26-115 et seq.; and violations of the Tennessee Adult Protection Act codified in Tennessee Code Annotated section 71-6-101 et seq. The plaintiffs included the following factual allegations: 22. [Ms. Cantrell] was found in the hallway floor at 2:00 a.m. on Saturday, November 20, 2021, after being on the floor for an unknown period of time. The plaintiffs were notified at 4:39 a.m. of this first fall. Defendants’ staff documented that a physician was notified, and that their Falls Prevention Program was initiated after this 2:00 a.m. fall. Upon information and belief, Defendants failed to take either of those actions. In fact, Defendants’ own records document that at the time of a second fall just ten hours later, no safety protocols were in place. 23. Despite the knowledge that [Ms. Cantrell] was wandering and had just sustained an unwitnessed fall, Defendants’ employees did not contact the on- call physician or Nurse Practitioner Elizabeth Coughlin, either of whom could have evaluated her and perhaps adjusted her anti-coagulation therapy or instituted other measures, if necessary. 24. NP Coughlin denied being informed of the 2:00 a.m. fall, and indicated her staff repeatedly deceived her about [Ms. Cantrell’s] continual declining status after the second fall. Ms. Coughlin did not come in at any time to examine [Ms. Cantrell], and only offered to do so after learning from [one of the plaintiffs] (at 8:28 p.m.) that [Ms. Cantrell] was in a comatose state. In the section detailing the causes of action they were bringing, the plaintiffs included the following claims: 57. Defendants failed to meet the standard of care and violated their duty of care to [Ms. Cantrell] through mistreatment, abuse and neglect. The medical negligence of Defendants includes, but is not limited to, the following acts and omissions: .... e) the failure to properly, timely, and truthfully notify [Ms. Cantrell’s] attending physician and NP Coughlin of significant changes in her physical condition and injuries . . . . The plaintiffs voluntarily nonsuited the case, and the trial court entered an order of dismissal on March 7, 2023. -3- In January 2024, the plaintiffs emailed NHC a request for amended medical records, to which NHC responded on February 16, 2024. A representative for NHC stated that after receiving the plaintiffs’ request, “NHC conducted a search of records which had a wider range of dates than the admission of [Ms. Cantrell]” and uncovered a new document and some “late entries” to Ms. Cantrell’s medical record that had not yet been provided to the plaintiffs. NHC sent an amended medical record to the plaintiffs with a newly discovered SBAR Communication Form, which is a document used for communications between the patient’s night nurse and the on-call provider. The form would be placed in the “[Nurse Practitioner] book” and later read by the Nurse Practitioner upon his or her return to the care center. Once the Nurse Practitioner read the report, it would be scanned into the patient’s medical record. In this case, NHC stated that their records indicated that the Nurse Practitioner did not return until the day after Ms. Cantrell’s death, so the form was not entered into her medical records until then and thus was not within NHC’s search parameters of medical records. The SBAR Form indicated that Ms. Coughlin was not notified of Ms. Cantrell’s first fall, in contrast to the information in the Event Report previously provided by NHC but in keeping with her own statement to the plaintiffs made at the facility. The plaintiffs recommenced litigation by sending the pre-suit notice required by Tennessee Code Annotated section 29-26-121(a) to the potential defendants on March 4, 2024. Relying on the savings statute and the 120-day extension in section -121(c), the plaintiffs filed a Complaint on July 1, 2024. NHC filed a Motion to Dismiss on August 7, 2024, in which NHC argued, inter alia, that the plaintiffs’ claims were barred by the statute of limitations. NHC noted that before the plaintiffs refiled their suit, this court had released its decision in Richards v. Vanderbilt University Medical Center, in which this court held that a plaintiff could not use the 120-day extension of Tennessee Code Annotated section 29-26-121(c) more than once against a health care provider. M2022-00597-COA-R3-CV, 2023 WL 4451631, at *3 (Tenn. Ct. App. July 11, 2023). Because the Tennessee Supreme Court had granted permission to appeal in Richards, the parties agreed to postpone argument on NHC’s motion until the Supreme Court issued its opinion. After the opinion was released in January 2025, NHC filed an amended motion to dismiss, citing the holding that a plaintiff may never rely on the 120-day extension in section -121(c) when refiling under the savings statute. Richards v. Vanderbilt Univ. Med. Ctr., 706 S.W.3d 319, 320, 325 (Tenn. 2025). NHC asserted a statute of limitations defense because the plaintiffs had relied on the 120- day extension to refile their complaint. The plaintiffs filed a response to NHC’s motion to dismiss and a countermotion to strike NHC’s statute of limitations affirmative defense as a sanction for spoliation of evidence under Tennessee Rules of Civil Procedure 34A.02 and 37. Rule 34A.02 provides that “Rule 37 sanctions may be imposed upon a party or an agent of a party who discards, destroys, mutilates, alters, or conceals evidence.” Tenn. R. Civ. P. 34A.02. Rule 37 gives -4- trial courts the authority to impose sanctions, including an “order striking out pleadings” for discovery violations. Tenn. R. Civ. P. 37.02. The plaintiffs argued that the Tennessee Supreme Court’s holding in Richards would not bar their case if NHC had timely produced all of Ms. Cantrell’s medical records as statutorily required because they would have been able to file the case sooner. The plaintiffs were required to send pre-suit notice in January 2024, in order to refile the action by March 7, 2024, so the plaintiffs insisted that even providing the document eight weeks earlier would have prevented the case from being barred. The plaintiffs asserted that the delayed production by NHC constituted spoliation of evidence and that sanctions were warranted in the form of striking the statute of limitations defense. The plaintiffs argued the evidence was spoliated because NHC “altered” the medical records by purporting previous sets to be complete and “concealed” the form. They claimed that the “SBAR Form was evidence that Nurse Joy had falsified the Event Report by stating she had contacted Nurse Practitioner Coughlin and the ‘late entries’ exacerbate NHC’s suspect record keeping with regard to a patient who experienced a fatal fall under its care.” The plaintiffs indicated that the SBAR Form was the reason they reinitiated suit. NHC filed a response, denying that the amended medical records provided in February 2024 contained any information “new” to the plaintiffs. NHC submitted an affidavit from Rick Sample, the Assistant Vice President for Health Information for NHC, as support for their contentions that any “spoliation” was unintentional. The affidavit states in pertinent part: 6. Prior to January 29, 2024, NHC had provided [Ms. Cantrell’s] medical records to the plaintiffs in 2021 and 2022. For the 2022 record production, NHC complied with its customary practice of searching for records scanned and/or created during the patient’s dates of admission, and NHC provided all of the medical records within the search parameters. 7. Prior to January 29, 2024, no document related to [Ms. Cantrell’s] admission to NHC Cool Springs in November of 2021 was intentionally withheld from the plaintiffs or concealed or altered. 8. After the January 29, 2024, request to amend [Ms. Cantrell’s] medical records was received from Plaintiff Hatchett, NHC conducted a search of records which had a wider range of dates than the admission of [Ms. Cantrell], and an SBAR Communication Form was discovered. 9. The Form was an accepted means of communication between the patient’s night nurse, Nurse Joy, and the on-call provider. Such Forms would be placed in the “NP book’ and would be seen by the NP upon the NP’s return to the Center. It would only then be scanned into the medical record. The records indicate the NP returned to the Center on Monday after the patient’s -5- death on Sunday, so this Form was not located during a search for the records scanned during the patient’s dates of admission. 10. NHC did not intentionally withhold or conceal the Form from the 2022 record production or otherwise alter or conceal this patient’s medical record. The Form was promptly provided to the plaintiffs when it was discovered in February of 2024. Following a hearing, the trial court declined to impose sanctions after considering the factors set forth by the Tennessee Supreme Court in Tatham v. Bridgestone Americas Holding, Inc., 473 S.W.3d 734 (Tenn. 2015). The trial court explained its decision as follows: In determining whether to impose this drastic sanction, the Court has considered the requisite factors set forth in Tatham and makes the following findings: (1) the culpability of the spoliating party in causing the destruction of the evidence, including evidence of intentional misconduct or fraudulent intent; The Court finds that although disclosure of the SBAR document was delayed, it was not destroyed and was ultimately provided to the plaintiffs. The Court does not find any evidence of intentional misconduct or fraudulent intent. As such, this factor weighs against the requested sanction. (2) the degree of prejudice suffered by the non-spoliating party as a result of the absence of the evidence; The Court finds that although the SBAR document supports the plaintiffs’ claim that Nurse Practitioner Coughlin was not notified after the decedent’s first fall, the plaintiffs suffered little if any prejudice as a result of the failure to produce the document, as Plaintiff Dr. Cantrell was on notice as of November 20, 2021, that Nurse Practitioner Coughlin had not been notified. The Court finds that any prejudice suffered by the plaintiffs was minimal, as it did not introduce any additional cause of action or contain additional facts or support the plaintiffs’ cause of action. Rather, it provided evidence to support an allegation of which Plaintiffs were already aware and had already asserted, to wit: Nurse Practitioner Coughlin had not been notified following the decedent’s first fall, which Plaintiff Dr. Cantrell had known as of November 20, 2021. As such, this factor weighs against the requested sanction. (3) whether, at the time the evidence was destroyed, the spoliating party -6- knew or should have known that the evidence was relevant to pending or reasonably foreseeable litigation; The Court finds that because the Order of Voluntary Dismissal was entered on March 7, 2023, the statute of limitations for refiling the action was March 7, 2024. The Court further finds that the SBAR document was not destroyed and was ultimately provided to Plaintiffs prior to the expiration of the statute of limitations. The Defendants knew or reasonably should have known that the SBAR document was relevant to reasonably foreseeable litigation; however, there is no evidence to support the conclusion that the Defendants were aware of the existence of the SBAR document but intentionally concealed or otherwise failed to disclose the document in an attempt to attain an unfair advantage in the reasonably foreseeable litigation. As such, the Court finds this factor is neutral in determining whether the requested sanction is appropriate. (4) the least severe sanction available to remedy any prejudice caused to the non-spoliating party. The requested sanction of precluding Defendants from asserting the statute of limitations is severe, and the Court finds that this sanction would be far too severe to remedy what little prejudice the Plaintiffs may have suffered as a result of the delayed disclosure of the SBAR document. As such, this factor weighs against the requested sanction. As a result, the trial court found the plaintiffs’ lawsuit was barred by the statute of limitations and granted NHC’s motion to dismiss. The plaintiffs appealed. On appeal before this court, the plaintiffs challenge the trial court’s application of the Tatham factors and its decision not to bar the defendants from using the statute of limitations defense. They raise the following issues on appeal: 1. Whether the trial court properly applied the factors set forth [in] Tatham v. Bridgestone Ams. Holding, Inc., 473 S.W.3d 734, 747 (Tenn. 2015), to the defendants’ conduct in deciding whether to impose sanctions against the defendants. 2. Whether the trial court erred in concluding the “culpability” factor weighed in favor of the defendants and against the plaintiffs. 3. Whether the trial court erred in its assessment of the degree of prejudice to the plaintiffs resulting from the defendants’ failure to timely produce a complete set of the decedent’s medical records to the plaintiff. -7- 4. Whether the trial court erred in concluding the defendants’ knowledge of the evidence and its relevance to pending litigation was “neutral” under Tatham. 5. Whether the trial court erred in concluding that striking the defendants’ statute of limitations defense would be a far too severe sanction under the circumstances. NHC states the issue on appeal as “Whether the Trial Court abused its discretion in denying Plaintiffs-Appellants’ Countermotion to Strike Defendants’ Statute of Limitations Affirmative Defense Pursuant to Tenn. R. Civ. P. 34A.02 and 37.” II. A trial court bases its decision to impose sanctions for spoliation of evidence through evaluating the unique circumstances of each case, using the factors set forth in Tatham in making its determination. 473 S.W.3d at 746-47; Gardner v. R&J Express, LLC, 559 S.W.3d 462, 469-70 (Tenn. Ct. App. 2018). The Tennessee Supreme Court set forth the following factors for courts to consider: (1) the culpability of the spoliating party in causing the destruction of the evidence, including evidence of intentional misconduct or fraudulent intent; (2) the degree of prejudice suffered by the non-spoliating party as a result of the absence of the evidence; (3) whether, at the time the evidence was destroyed, the spoliating party knew or should have known that the evidence was relevant to pending or reasonably foreseeable litigation; and (4) the least severe sanction available to remedy any prejudice caused to the non-spoliating party. Tatham, 473 S.W.3d at 747 (footnotes omitted). This court reviews a trial court’s decision to award or decline the imposition of sanctions for an abuse of discretion. Caldwell v. Ruby Falls, LLC, 674 S.W.3d 899, 908 (Tenn. Ct. App. 2023); Alexander v. Jackson Radiology Assocs., P.A., 156 S.W.3d 11, 14 (Tenn. Ct. App. 2004). “An abuse of discretion occurs when the trial court applies incorrect legal standards, reaches an illogical conclusion, bases its decision on a clearly erroneous assessment of the evidence, or employs reasoning that causes an injustice to the complaining party.” West v. Schofield, 460 S.W.3d 113, 120 (Tenn. 2012). This standard does not allow for appellate courts to “substitute their discretion for that of the trial court.” Little v. City of Chattanooga, 650 S.W.3d 326, 367 (Tenn. Ct. App. 2022); see Lee Med., Inc. v. Beecher, 312 S.W.3d 515, 524 (Tenn. 2010). -8- III. The plaintiffs challenge the trial court’s determinations for each of the four Tatham factors as well as its overall decision not to impose sanctions as a result of those findings. NHC defends the trial court’s analysis, insisting that it did not err.2 A. The plaintiffs assert the trial court erred by concluding the “culpability of the spoliating party” factor weighed against imposing sanctions. The plaintiffs argue that federal and state law required NHC to maintain and keep accurate medical records and that Tennessee Code Annotated section 29-26-121 required NHC to provide all medical records to the plaintiffs for an evaluation of potential claims. For purposes of Rule 34A sanctions, they insist NHC spoliated evidence by concealing the SBAR Form and that it altered the evidence by presenting a set of medical records NHC purported to be complete.3 The plaintiffs contend that NHC frustrated the purpose of the Tennessee Health Care Liability Act (THCLA) by failing to provide the complete set of medical records until February 2024. See Martin v. Rolling Hills Hosp., LLC, 600 S.W.3d 322, 334 (Tenn. 2016); see also Curtis ex rel Curtis v. Sharp. No. E2023-01583-COA-R3-CV, 2025 WL 326388, at *7 (Tenn. Ct. App. Jan. 29, 2025), perm. app. granted, 2025 WL 1733852 (Tenn. June 20, 2025) (plaintiff’s language in the HIPAA authorization form limiting potential defendants from communicating with other potential defendants frustrated the purpose of the HIPAA authorization form requirement). The plaintiffs contend that NHC’s actions frustrate the purpose of the THCLA because they were required “by Section 121, the Tennessee Medical Records Act, [HIPAA], and by the Rules and Regulations . . . to create, maintain, and produce accurate and complete medical records to the plaintiffs.” Additionally, the plaintiffs claim NHC acted intentionally to conceal the evidence when it failed to provide complete medical records. The plaintiffs maintain that the affidavit of Mr. Sample “establishes facts that prove NHC was intentionally limit[ing] its search while knowing it would fail to capture the SBAR communication form.” They assert NHC limited its search of Ms. Cantrell’s medical records through the time of her death, despite knowing that the SBAR Form would only be scanned into the record after 2 NHC also disputes that Rule 34A sanctions are even available where the evidence was not destroyed but instead simply provided late. The plaintiffs contend that the SBAR Form was “essentially destroyed” to them because they were unable to re-file within the statute of limitations period after receiving the document. They assert it was concealed. Because we conclude that, even if Rule 34A relief was transgressed in this instance, the court did not abuse its discretion in denying the relief sought by the plaintiffs, we exercise judicial restraint and decline to consider whether NHC’s actions could fall within Rule 34A. 3 As addressed in footnote 2, we proceed with an assumption for purposes of argument that the plaintiffs are correct that NHC’s actions could fall within Rule 34A without deciding whether they do. -9- the Nurse Practitioner returned to the clinic, and in this case, it was not scanned until the day after Ms. Cantrell’s death. The plaintiffs further argue late entries to medical records are “common following a patient’s discharge from a health care facility and that is well- known to NHC. NHC knew it would find additional records by ‘broadening its search.’” The plaintiffs aver these statements indicate that NHC intentionally limited its production of Ms. Cantrell’s medical records and made this “mistake” twice. Accordingly, the plaintiffs insist that the trial court incorrectly found the culpability factor weighed against sanctions. They maintain that this factor should be weighed in favor of sanctions because NHC was “culpable and its acts were intentional. [NHC] had a duty to produce complete records under multiple federal and state laws, and they are ‘culpable’ for failing to do so as a matter of law.” NHC disagrees. NHC argues that the trial court correctly found this factor weighed against imposing sanctions because there was no “destruction” of evidence here; instead, its production was delayed. NHC also notes that Mr. Sample’s affidavit shows there was no fraudulent intent and, further, no evidence in the record that the SBAR Form was intentionally withheld. They rebut the plaintiffs’ contention that the delay frustrated the purpose of the THCLA because the plaintiffs already knew the “new” information from Ms. Coughlin’s previous statement to the plaintiffs that she was not contacted after Ms. Cantrell’s first fall. The plaintiffs argue that the record requires a finding that NHC acted intentionally when it failed to provide the SBAR Form. We cannot agree. Mr. Sample’s affidavit indicates that the failure to produce was an inadvertent mistake. The plaintiffs did not sufficiently rebut this assertion with evidence that NHC acted with intent to prevent the discovery of the SBAR Form. Based on the record before us, we cannot conclude that the trial court applied an incorrect legal standard, reached an illogical decision, or based its decision on a clearly erroneous assessment of the evidence. Lee Med., Inc., 312 S.W.3d at 524. We do not find any abuse of discretion by the trial court, which determined the error was inadvertent, in finding that this factor weighed against the imposition of sanctions. B. The plaintiffs next contend that the trial court erred by concluding there was “little if any” prejudice to the plaintiffs. The plaintiffs assert that they only chose to refile their suit against NHC after receiving the SBAR Form in February 2024 and would have been able to file within the statute of limitations if NHC had provided the form when it was required to do so. Though they acknowledge that Ms. Coughlin had previously indicated to the plaintiffs that she was not informed of Ms. Cantrell’s first fall, the plaintiffs argue that the SBAR Form provided “new information” that was admissible and which “corroborated” her previous statements that were made “orally and outside the context of litigation.” - 10 - NHC counters that the trial court properly held that the information in the SBAR Form did not provide any new information to the plaintiffs and cites to several instances in the record where the plaintiffs mention the fact that Ms. Coughlin was not informed of Ms. Cantrell’s first fall in support of their claims, before they received the SBAR Form. NHC notes that in the plaintiffs’ first complaint they included factual allegations and causes of action relating to the fact that Ms. Coughlin indicated she was not aware of the first fall. Additionally, NHC points to the affidavit of Plaintiff Cantrell prepared July 12, 2022, as further evidence that the plaintiffs knew before receipt of the SBAR Form that Ms. Coughlin was not informed of Ms. Cantrell’s first fall. The affidavit states, “At 8:28 pm . . . I received a phone call from Elizabeth Coughlin, Nurse Practitioner, expressing concern about Mother . . . She was completely unaware of the fall that had occurred around 2:00 am and confirmed that it had not been reported to her.” The trial court’s conclusion is supported by the record. In their first complaint, the plaintiffs brought claims of negligence based on Ms. Coughlin’s statement that she was not informed of Ms. Cantrell’s first fall. The causes of action the plaintiffs purportedly brought as a result of the “new information” from the SBAR Form are almost identical to the ones in their initial complaint. In the second complaint they filed after receiving the SBAR Form, the plaintiffs again included in their causes of action a portion which reads in pertinent part as follows: 82. The defendants failed to meet the standard of care and violated their duty of care to [Ms. Cantrell] through mistreatment, abuse and neglect. The medical negligence of the defendants includes, but is not limited to, the following acts and omissions: .... e. failure to properly, timely, and truthfully notify [Ms. Cantrell’s] attending physician and NP Coughlin of significant changes in her physical condition and injuries. . . . We observe no additional causes of action in the second complaint stemming from Ms. Coughlin not being informed of Ms. Cantrell’s fall. Additionally, the plaintiffs had already been informed by Ms. Coughlin that she had not been told. The trial court concluded failure to disclose the SBAR Form did not actually inhibit the plaintiffs from earlier refiling of their suit. The plaintiffs have failed to demonstrate that the trial court erred in reaching this conclusion. The record supports the trial court’s finding that this factor weighed against imposing the requested sanction. We cannot conclude that the trial court abused its discretion in its analysis of this factor. - 11 - C. The plaintiffs object to the trial court’s determination that the factor addressed to whether NHC knew or should have known the relevance of the SBAR Form to the pending litigation was “neutral.” The plaintiffs first assert that the trial court’s finding that the SBAR Form “was not destroyed and was ultimately provided to the plaintiffs prior to the expiration of the statute of limitations” was untrue because it was provided after the “effective statute of limitations following the nonsuit.” The plaintiffs also contend that the document was “effectively destroyed” from their perspective. To show there was evidence that NHC was aware of the existence of the SBAR Form and missing entries, the plaintiffs point to NHC’s assertion that it found the missing documents when it broadened the search. The plaintiffs assert that the “only plausible explanation for NHC’s behavior is that it was attempting to avoid liability, which it has thus far accomplished.” They suggest NHC’s statement that once they received the request from the plaintiffs to provide records, they “broadened their search” to dates outside of Ms. Cantrell’s admission at the facility was “nothing less than an admission that NHC deliberately violated the law and ‘customarily’ does so.” NHC counters that the trial court correctly concluded this factor was neutral because the form was not destroyed and there was no evidence NHC knew of the form and intentionally withheld it from the plaintiffs. NHC further argues that the record supports the trial court’s conclusion because there is no evidence that NHC knew of the form’s existence or of its relevance to the plaintiffs’ case. The trial court concluded that NHC “knew or reasonably should have known that the SBAR document was relevant to reasonably foreseeable litigation.” In finding this factor to be neutral, though, the trial court emphasized that the SBAR Form “was ultimately provided to the plaintiffs prior to the expiration of the statute of limitations.” Though technically the document was provided before the expiration of the statute of limitations, the trial court neglected to consider that the plaintiffs were again required to comply with pre-suit notice requirements, which include a requirement that notice be sent at a minimum of 60 days in advance of refiling the complaint. Tenn. Code Ann. § 29-26-121; Foster v. Childes, 467 S.W.3d 911, 916 (Tenn. 2015). Even if the plaintiffs had sent the required pre-suit notice on the date they received the SBAR Form on February 16, it would have been impossible to comply with the 60-day waiting period and also refile their suit by March 7. Accordingly, we are wary of the basis for the trial court’s reasoning regarding this factor. Nevertheless, as discussed further below, we cannot conclude that the trial court erred as to its ultimate conclusion to decline to grant the requested sanction. D. The plaintiffs also assert the trial court erred in determining the proposed sanction— striking the statute of limitations affirmative defense—would be too severe a remedy for - 12 - “what little prejudice the plaintiffs may have suffered.” The plaintiffs contend that striking the affirmative defense is the only remedy available to rid the plaintiffs of the prejudice resulting from the late production of the SBAR Form and is also the least severe sanction to NHC, as NHC would suffer no prejudice if the plaintiffs proceeded with their claim. The plaintiffs maintain that Tennessee precedent, as well as the Tennessee Rules of Civil Procedure and the Health Care Liability Act, stand for the proposition that cases are to be heard on the merits and not disposed of based on procedural technicalities. NHC asserts the trial court correctly concluded the sanction would be too severe of a remedy and points to the trial court’s findings that there was no actual destruction of evidence, no prejudice to the plaintiffs, and no intentional misconduct on behalf of NHC as sufficient support for its conclusion. We find no abuse of discretion in the trial court’s decision to decline the requested sanction. Considering the totality of the circumstances of the present case, the record supports the trial court’s findings that there was no evidence of intentional misconduct by NHC, and, importantly, no significant prejudice at this state of the proceedings to the plaintiffs, who were aware throughout the litigation of the pertinent facts in the late- produced document. While wary of the trial court’s analysis as to the third factor, the trial court’s ultimate conclusion to refuse to impose sanctions on NHC in the form of striking the statute of limitations affirmative defense was “within the range of acceptable alternative dispositions.” Lee Med., Inc., 312 S.W.3d at 524. That is critical because the question before this court is not whether the members of this court would have reached the same decision as the trial court were we deciding the matter anew but instead whether the trial court abused its discretion in reaching the decision that it did. Accordingly, we affirm the trial court’s denial of the plaintiffs’ request to strike NHC’s statute of limitations defense. IV. For the aforementioned reasons, we affirm the judgment of the Circuit Court for Williamson County. Costs of this appeal are taxed to the appellants, Stephanie C. Hatchett and Stephen Cantrell, for which execution may issue if necessary. The case is remanded for such further proceedings as may be necessary and consistent with this opinion. s/ Jeffrey Usman JEFFREY USMAN, JUDGE - 13 -