A proposed compromise had been hashed out between Republican sponsors and House Judiciary Chairman Rob Briley, D-Nashville, since January. The Senate unanimously passed a similar measure last month.
But Republican lawmakers on Wednesday objected to a amendment by Briley that would insert language to change the "locality rule" for medical experts testifying in malpractice trials.
The change would allow medical experts to qualify based on an understanding of statewide medical standards in an effort to be able to draw witnesses from a wider geographical area.
A request by House Minority Leader Jason Mumpower, R-Bristol, to reject the amendment passed 54-43 and began some parliamentary sparring between the parties.
Rep. Doug Overbey, a Maryville Republican and primary sponsor of the bill, then requested that the legislation be sent back to the House Judiciary Committee and House Speaker Jimmy Naifeh granted his request.
But Rep. Glen Casada made an official challenge to the speaker's ruling, saying there should have been a motion and then a vote.
"I disagree with the ruling. I believe you made a mistake and I believe the majority does," Casada, R-Franklin, told Naifeh. Casada's challenge failed on a 56-37 vote
"The speaker was out of order," he said after the vote. The bill seeks to limit lawsuits by requiring more notice to be given to defense lawyers about potential medical malpractice cases, and to require plaintiffs' lawyers to get certification from medical experts that their claims are legitimate. In the case of Briley's change, current law allows witnesses to come from any state bordering Tennessee, but requires them to be experts on the medical standards of the same or similar community where the defendant doctor practices. Briley has argued that those rules make it too easy to discredit doctors who don't know many specific details of how a local hospital operates, but are otherwise soundly grounded in standard statewide medical practices. Before the rejection vote, both Briley and Overbey acknowledged the bill had changed significantly from the first version, but they said the current legislation is better and a step in the right direction. "This amendment was the product of lots of hard work," Briley said. "Is everybody getting everything they want? No. Does it improve the system? Yes it does."