## Facts

- Otis J. Vest, a West Virginia resident with Parkinson’s disease, sought outpatient treatment in Beckley, West Virginia, at St. Albans Mental Health Services to adjust his medication.
- The Beckley facility referred patients needing hospitalization to St. Albans Psychiatric Hospital in Radford, Virginia, a Virginia corporation licensed to do business in West Virginia.
- Vest was hospitalized at the Radford facility from May to September 1984; the Vests alleged negligent treatment caused severe deterioration and that Vest was near death upon discharge.
- On September 18, 1986, Otis and Pauline Vest sued the hospital in the Circuit Court of Raleigh County, West Virginia, asserting medical malpractice and loss of consortium.
- The Vests did not provide pre-suit written notice to trigger Virginia’s medical malpractice review panel process under Va. Code § 8.01-581.1 et seq.
- The circuit court dismissed the action, concluding Virginia’s pre-suit notice/review panel requirement applied because the alleged malpractice occurred in Virginia.

## Issues

1. Whether a West Virginia plaintiff suing a Virginia health care provider in West Virginia for malpractice allegedly occurring in Virginia must comply with Virginia’s pre-suit notice and medical review panel procedure.
2. Whether West Virginia should, as a matter of public policy and comity, allow out-of-state plaintiffs with minimal West Virginia contacts to sue in West Virginia to avoid Virginia’s review panel procedure.

## Decision

- The Supreme Court of Appeals of West Virginia reversed the dismissal and remanded.
- A West Virginia plaintiff suing in West Virginia a Virginia health care provider subject to West Virginia jurisdiction under the long-arm statute need not first proceed before a Virginia medical review panel.
- The court cautioned it would not permit Virginia citizens with few West Virginia contacts to sue Virginia providers in West Virginia merely to avoid Virginia’s review panel procedure.

## Legal Principles

- In conflict-of-laws, the forum applies another state’s substantive tort law when appropriate, but generally applies its own procedural law to actions litigated in its courts.
- Virginia’s medical malpractice review panel scheme, including pre-suit notice, is treated as a procedural prerequisite tied to access to Virginia courts rather than a substantive element of liability.
- A state’s procedural prerequisites to suit are not automatically enforceable in a different forum, even when the forum applies the other state’s substantive law.
- Public policy and comity may justify limiting access to the forum to deter suits by nonresidents with minimal forum contacts aimed primarily at evading another state’s pre-suit screening procedure.

## Conclusion

West Virginia courts may hear a West Virginia resident’s Virginia-based malpractice claim against a Virginia provider subject to West Virginia jurisdiction without requiring compliance with Virginia’s pre-suit medical review panel notice procedure, while reserving authority to bar suits that amount to forum shopping by nonresidents with minimal West Virginia connections.


Vest v. St. Albans Psychiatric Hosp., Inc., 182 W. Va. 228, 387 S.E.2d 282 (W. Va. 1989)