On January 18, 2018, Douglas Williford was involved in a motor vehicle accident and drove himself to the AnMed Health emergency room (ER) in Anderson County. Williford arrived in the ER at approximately 9:08 p.m. and was discharged at 10:39 p.m., “ten minutes after his brief examination” by nurse practitioner (NP) Kevin Morton. Williford was discharged despite presenting with a “significantly elevated” blood pressure of 244/130, an initial pain level of 9 out of 10, and mid-back pain he described as a “‘catch’ in his left back near his left shoulder blade.” Two weeks later, Williford returned to the AnMed ER at 6:57 a.m., reporting “the pain had gotten worse causing him to be unable to sleep.” He was discharged with pain medication at 10:44 a.m. that same day. Williford was later found “unresponsive, not breathing, and pulseless in his car in the emergency room parking lot and was brought back into the ER at 3:45 p.m. Despite aggressive treatment and resuscitative efforts,” Williford was pronounced dead at 3:52 p.m.
An autopsy revealed he had suffered a rupture of an aortic aneurysm resulting in an aortic dissection in the ascending aorta. The cause of death was cardiac tamponade due to a ruptured aortic aneurysm.
On November 5, 2020, the NOI required by section 15-79-125 of the South Carolina Code (Supp. 2024) was filed against AnMed Health; nurse practitioner (NP) Morton; Anderson Emergency Associates, P.A. (AEA); registered nurse Jamie B. Moon; and RN Betty A. Boyles. Attached with the NOI was the affidavit of Richard Kevin High, a practicing emergency nurse; a proposed complaint setting out the requisite short and plain statement of facts alleging claims for wrongful death, survival, and loss of consortium; and answers to standard interrogatories.
The defendants moved to dismiss, arguing the plaintiffs “failed to file an affidavit from a qualified medical expert regarding the medical providers‘ treatment in this case: to wit, [NP] Morton and AEA.” Although the defendants acknowledged High was qualified to render an opinion as to the acts of the nursing co-defendants, they sought dismissal based on the plaintiffs’ failure “to provide an affidavit against the physicians and physician extender, [NP] Morton, as required as a mandatory prerequisite to bring [a] medical malpractice action under the S.C. Medical Malpractice Act. S.C. Code Section 15-79-125 and Section 15-36-100.”
One week after the defendants moved to dismiss, the plaintiffs filed a supplemental affidavit from emergency physician Michael A. Chansky. Dr. Chansky noted that in his thirty years practicing emergency medicine, he has both treated patients and taught resident physicians “the proper work up for emergency medicine patients.” After reviewing Williford’s medical records, Dr. Chansky opined, to a reasonable degree of medical certainty, that AEA and NP Morton committed specified negligent acts or omissions in treating Williford, and that these breaches of the standard of care caused or contributed to Williford’s injuries and death.
Following a hearing, the circuit court granted the defendants’ motion to dismiss, with prejudice. The plaintiffs appealed.
Section 15-36-100
Section 15-36-100(B) requires: “Except as provided in Section 15-79-125, in an action for damages alleging professional negligence against a professional licensed by or registered with the State of South Carolina and listed in subsection (G) or against any licensed health care facility alleged to be liable based upon the action or inaction of a health care professional licensed by the State of South Carolina and listed in subsection (G), the plaintiff must file as part of the
complaint an affidavit of an expert witness which must specify at least one negligent act or omission claimed to exist and the factual basis for each claim based on the available evidence at the time of the filing of the affidavit.”
Section 15-36-100(A) defines an expert witness as “an expert who is qualified as to the acceptable conduct of the professional whose conduct is at issue” and who meets the criteria listed in subsections 15-36-100(A)(1) and (2), or (3).
The South Carolina Court of Appeals stated in its July 16, 2025 Opinion: “Here, the circuit court erred in finding High’s affidavit failed to satisfy the requirements of sections 15-79-125 and 15-36-100 on topics within the realm of emergency nursing and emergency room “work up” care. High is board certified in emergency nursing, has practiced emergency nursing for over thirty years, and has taught medical personnel—including medical students, residents, and faculty—”the proper work up for emergency medicine patients” for over fifteen years. Based on this experience, education, and training, High is qualified to render an expert opinion regarding the basic care and work up Williford should have received upon his presentation to the AnMed emergency room.”
“And, while we agree with the circuit court that High might not be qualified to render an expert opinion as to all of the breaches Appellants allege because High is not licensed, board certified, or specifically educated as a nurse practitioner, we find High is qualified to render an opinion as to one or more of the breaches alleged in his affidavit based on his “scientific, technical, or other specialized knowledge” in the emergency medicine context.”
“We agree with the circuit court that High is not a nurse practitioner, nor is he educated as one. But this is not dispositive as to whether High is qualified to render an opinion addressing any of the breaches alleged as to the care Morton provided (or failed to provide) to Williford.”
“We also agree that High did not specifically allege Morton committed the negligent acts or omissions at issue; however, he stated “within a reasonable degree of medical certainty, that agents, and/or employees of AnMed Health and/or private practices staffing the . . . [ER] committed negligent acts or omissions in their care and treatment of” Williford. Morton falls within this group. High opined the medical providers who treated Williford committed one or more negligent acts or omissions in breaching the standard of care. This is precisely what section 15-36-100(B) requires.”
The South Carolina appellate court held: “For these reasons, the circuit court erred in finding High’s affidavit insufficient to satisfy the pre-filing requirements of sections 15-79-125 and 15-36-100, in labeling High’s affidavit “unqualified and unlawful,” and in dismissing this matter.”
If you or a loved one suffered serious harm as a result of medical negligence in South Carolina or in another U.S. state, you should promptly find a South Carolina medical malpractice lawyer, or a medical malpractice lawyer in your state, who may investigate your medical negligence claim for you and represent you or your loved one in a medical malpractice case, if appropriate.
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