In a case stemming from an injury to a child who was deaf and had been diagnosed with psychiatric conditions, the Florida Supreme Court tried to resolve questions about when lawsuits deal with medical malpractice — or ordinary negligence.

The questions are important legally because state law makes it harder to pursue medical-malpractice cases than other types of negligence claims.

The justices, in a 24-page opinion, sided with Cinnette Perry, who was a student in 2008 at the National Deaf Academy in Lake County when a confrontation with staff led to her needing to have part of her left leg amputated.

The Supreme Court unanimously ruled that the injury involved alleged negligence — not medical malpractice, as the academy argued — and tried to set a framework for deciding similar issues in other cases.

“Limiting medical malpractice claims to those that are directly related to medical care or services, which require the use of professional judgment or skill, ensures that plaintiffs bringing claims of ordinary negligence are not subjected to the complex pre-suit procedures for medical malpractice claims, while still advancing the Legislature's policy goals of encouraging early settlement and screening out frivolous medical malpractice claims,” said the opinion, written by Justice Barbara Pariente and joined fully by Chief Justice Jorge Labarga and Justices Peggy Quince, Charles Canady and Ricky Polston.

Justice R. Fred Lewis concurred in the result but did not sign onto the opinion. Justice Alan Lawson was recused.

Perry's aunt, Denise Townes, filed a lawsuit against the academy, a residential treatment facility for deaf people with psychiatric conditions. A psychiatrist at the facility evaluated Perry when she was admitted and came up with a plan of care that included techniques to physically restrain her if necessary.

Staff members used those techniques in August 2008 after an incident that included Perry throwing rocks at windows and academy employees and pulling cables and wires to try to disconnect them, the Supreme Court ruling said. But as staff tried to restrain Perry, she fell and was injured, ultimately requiring an amputation about her left knee.

Attorneys for the academy sought to dismiss the lawsuit, contending that it did not comply with presuit notice requirements involved in medical-malpractice cases, the Supreme Court opinion said. A circuit judge agreed, dismissing the case. But the Fifth District Court of Appeal overturned that decision and said the case involved allegations of ordinary negligence.

The Supreme Court agreed with the appeals court, saying the claim in the lawsuit “does not arise out of an act that is directly related to medical care or services, which require the use of professional judgment or skill.”

“[We] hold that for a claim to sound in medical malpractice, the act from which the claim arises must be directly related to medical care or services, which require the use of professional judgment or skill,” the opinion said. “This inquiry involves determining whether proving the claim requires the plaintiff to establish that the allegedly negligent act 'represented a breach of the prevailing professional standard of care,' as testified to by a qualified medical expert.”

The Supreme Court took up the case, at least in part, because of a conflict between the ruling by the Fifth District and a ruling in an Alachua County case by the First District Court of Appeal. The Alachua County case involved a patient who escaped from a psychiatric hospital after taking an employee's badge and keys and then was killed on Interstate 75.

The First District ruled that the Alachua County case involved an allegation of medical malpractice. In Thursday's opinion, the Supreme Court disagreed with the First District's conclusion.

“While it is true that the hospital failed to confine the patient to her locked unit, the estate's claim arose out of the hospital employee leaving her badge and keys unattended where the patient could access them, not out of any act directly related to medical care or services that required the use of professional judgment or skill,” the Supreme Court opinion said. “Thus, contrary to the First District's conclusion, medical expert testimony on the professional standard of care would not be necessary for the estate to prove its negligence claim.”

Jim Saunders reports for the News Service of Florida.