Can You Sue a Public Hospital in Virginia? Sovereign Immunity Is a Defense They Have to Prove
If medical care at a Virginia hospital left you or someone in your family catastrophically injured, and you then learn that the hospital is run by a public authority rather than a private company, you will usually hear some version of the same sentence: we are a government entity, so you cannot sue us.
Sometimes that is true. It is true far less often than it sounds, and it is never true simply because someone says it. In Virginia, sovereign immunity is not a wall around everything with a government connection. It is a sliding scale, and the party invoking it has to earn its place on that scale.
The Supreme Court of Virginia made that unusually clear earlier this year.
The case, briefly
The decision itself was not an injury case. In Sentara Medical Group v. Klena, Record No. 250671 (Va. Feb. 26, 2026), two health systems were fighting over a cardiovascular surgeon and a noncompete clause. When Sentara sued Chesapeake Regional Medical Group for interfering with that contract, CRMG answered that it was a subsidiary of the Chesapeake Hospital Authority, that the Authority is immune from suit, and that its immunity therefore passed down to CRMG automatically. The circuit court agreed and dismissed the claim with prejudice. The Supreme Court of Virginia reversed, holding that an agent does not automatically share in the immunity of its principal, and that because CRMG "bore the burden of proving its entitlement to immunity" and elected to put on no evidence at all, its immunity plea failed. You can read the opinion here: Sentara Medical Group v. Klena.
Strip away the contract dispute and what remains is a rule that matters enormously to injured people and grieving families.
Immunity in Virginia runs on a sliding scale
The Court described a doctrine that runs from absolute protection at one end to none at all at the other, and it stated the organizing principle plainly: "the further away a person or entity is from the sovereign, the less likely it is that the person or entity will be entitled to immunity."
The layers look roughly like this, from most protected to least.
The Commonwealth and its agencies. Absolute immunity from tort liability, waived only where the General Assembly has said so. The principal waiver is the Virginia Tort Claims Act, discussed below.
Counties. As political subdivisions of the Commonwealth, counties share the same broad tort immunity.
Cities and towns. Immune for the governmental functions they perform, but not for proprietary ones. We wrote about where that line falls in our post on suing a Virginia city or county for an injury.
Corporate affiliates of immune entities. This is what Klena adds. A corporation created by a public hospital authority does not inherit immunity by birth. It has to prove entitlement, and the Court said the four-factor test from James v. Jane is the starting framework: the nature of the function performed, the extent of the immune entity's interest and involvement in that function, the degree of control and direction the immune entity exercises, and whether the act complained of involved the use of judgment and discretion. For a corporate defendant, the Court added more to weigh: the nature and structure of the corporate agent, its actual relationship with the immune entity, and whether it was genuinely necessary to performing a governmental function or merely convenient. It is a totality-of-the-circumstances inquiry, and the Court cautioned that a single factor will rarely decide it.
Individual doctors, nurses, and staff. At most qualified immunity, decided case by case on those same factors. This is the point most worth knowing. As the Klena Court recounted, James v. Jane held that an attending physician at the University of Virginia Hospital was not entitled to sovereign immunity for a claim of medical negligence. Working at a public hospital does not, by itself, make a physician untouchable.
The burden is on them, not on you
The practical heart of Klena is a burden-of-proof point that is easy to skim past. CRMG did not lose because the Court decided it could never be immune. The Court expressly said sufficient facts might exist to establish that it shares the Authority's immunity. CRMG lost because it never put those facts in the record. It relied on the label of "subsidiary" and rested.
For an injured person, that is the difference between a case and no case. Immunity is an affirmative defense that the defendant has to establish with evidence about how it is structured, who controls it, and what it was actually doing. It is not a magic word. If the only thing a hospital system offers is that it is somehow connected to a public authority, that is an assertion, not a defense.
The Court also noted a real limit on how far the protection travels: a corporate agent that "acts beyond the scope of" its agency and "exceeds [its] authority and discretion" does not share in its principal's immunity at all.
What this means if you were seriously hurt
A few things follow directly.
The corporate chart matters as much as the medicine. In modern health systems, the hospital building, the physician group that staffs it, the anesthesia company, the radiology group, and the emergency department contractor are frequently separate legal entities with different owners and different relationships to any public authority. Some may have a colorable immunity argument. Many will have none. Sorting that out early shapes who gets named and when.
Do not accept the first answer. "We're a public hospital" is where the analysis starts, not where it ends. The questions that follow are which entity actually employed the people who treated you, how much control the public authority truly exercises over that entity, and whether the specific conduct that hurt you involved the kind of governmental discretion the doctrine protects.
Immunity fights take time, and deadlines do not pause for them. This is the trap. While everyone argues about who is immune, the clock on your claim keeps running.
The deadlines that actually control
In Virginia, most personal injury claims must be filed within two years of the date the cause of action accrues, under Va. Code § 8.01-243(A). Claims for injury from sexual abuse suffered as a child get twenty years under subsection (D).
If the defendant really is the Commonwealth or one of its agencies, the Virginia Tort Claims Act applies, and it is unforgiving. Va. Code § 8.01-195.6 requires a written statement of the claim within one year after the cause of action accrues, filed with the Director of the Division of Risk Management or the Attorney General (or the Commissioner of Highways for claims involving the Department of Transportation). And Va. Code § 8.01-195.3 caps recovery against the Commonwealth at $100,000 for causes of action accruing on or after July 1, 1993, or the limits of any applicable liability insurance, whichever is greater. The Act does not apply to counties, cities, or towns; those are governed by the common-law rules described above.
How D.C., Maryland, and Virginia compare
| Where the claim is | Notice you must give the government | Cap on what you can recover | The wrinkle to watch |
|---|---|---|---|
| District of Columbia | Written notice to the Mayor within 6 months of the injury, stating the approximate time, place, cause, and circumstances. A Metropolitan Police Department report made in the regular course of duty can satisfy it. | No cap. | The shortest window of the three by a wide margin, and it runs from the injury, not from when you hire a lawyer. |
| Maryland | Written notice within 1 year of the injury under the Local Government Tort Claims Act, delivered in person or by certified mail to the specific official named for that locality. | $400,000 per individual claim and $800,000 for all claims from the same occurrence, with higher tiers for certain intentional torts and constitutional violations. No punitive damages against a local government. | A court may excuse defective notice for good cause unless the local government affirmatively shows its defense was prejudiced. |
| Virginia | Against the Commonwealth, a written statement within 1 year of accrual to the Division of Risk Management or the Attorney General. Counties, cities, and towns are outside the Tort Claims Act and follow common-law immunity instead. | Against the Commonwealth, $100,000 for causes of action accruing on or after July 1, 1993, or the limits of applicable liability insurance, whichever is greater. | Immunity is an affirmative defense the defendant must prove with evidence. A corporate affiliate of a public authority does not inherit it automatically. |
The pattern is worth noticing. The District has no damages cap but the shortest notice window by a wide margin. Maryland gives you a year to give notice but caps what a local government can be made to pay. Virginia splits the difference and, for claims against the Commonwealth itself, pairs a one-year notice requirement with the lowest cap of the three.
If this is your situation
If you or a family member suffered a serious injury or died because of medical care in Virginia, Maryland, or the District of Columbia, and you have been told that the hospital or provider cannot be sued, the answer deserves more scrutiny than a phone call from a claims office. We would be glad to look at it with you. Call Posey Lebowitz PLLC at (202) 524-0123, or use our contact form to set up a free consultation.
This is general information, not legal advice about your case.
