Summary
applying discovery rule to patient's medical malpractice claim against after-care urologists for negligent treatment of infection where patient had "no reasonable basis to suspect that her crippling condition was caused by anything other than the original surgery"
Summary of this case from Yarchak v. Trek Bicycle Corp.Opinion
No. A-94.
Argued: November 8, 1999.
Decided: February 16, 2000.
On appeal from the Superior Court, Appellate Division, whose opinion is reported at 318 N.J. Super. 485, 723 A.2d 1256 (1999).
Melvin Greenberg argued the cause for appellants (Greenberg Dauber Epstein Tucker and Stahl DeLaurentis, attorneys).
Gregory P. Saputelli argued the cause for respondents (Obermayer, Rebmann, Maxwell Hippel, attorneys; Mr. Saputelli and Kimberly D. Sutton, on the brief).
William L. Gold argued the cause for amicus curiae Association of Trial Attorneys-New Jersey (Brown Gold, attorneys; Mr. Gold andAbbott S. Brown, on the brief). Herbert J. Stern submitted a brief on behalf of amicus curiae The Medical Society New Jersey (Stern Greenberg, attorneys).
The opinion of the Court was delivered by
This case, like Mancuso v. Neckles, 163 N.J. 26, 747 A.2d 255 (2000), also decided today, involves the application of the discovery rule to a claim of medical malpractice that would otherwise be barred by the statute of limitations. The principles that we apply are set forth in that opinion. Briefly stated, this case involves surgery that was undertaken to alleviate a woman's incontinence problem. The treatment resulted in a debilitating condition of health. Anna Gallagher has been made totally incontinent. At the time of these proceedings, she was under constant care to alleviate her condition.
I
The question is whether the malpractice of certain of the patient's doctors brought about the bad result and whether she had timely filed a claim against them. The alleged deviations from accepted standards of care involved treatment of a post-operative infection that developed into an abdominal abscess due to the lack of timely antibiotic therapy. The injury allegedly evolved as the result of a two-week delay in the treatment of the infection. The facts are more fully set forth in the reported opinion of the Appellate Division, 318 N.J. Super. 485, 723 A.2d 1256 (App.Div. 199 9). Here is the time line of the events: Date The Medical Procedures or The Indicators to the Patient Legal Steps Taken of Fault or Neglect of a Treating Doctor
The patient was also allowed to amend her complaint to add the family doctors, Dr. Maro and Dr. Todt. During her deposition, expert Dr. Jacobs specifically expressed the opinion that the after-care and treatment of the patient by Dr. Maro and Dr. Todt was inadequate because they failed to treat the infectious osteomyelitis that Dr. Steeb identified in his August 24, 1994 report. While she did not specifically name Drs. Goldstein and Phillips, Dr. Jacob's opinion alerted the patient that Drs. Goldstein and Phillips' concurrent failure to treat the infection may have further contributed to the patient's problems.
II
As explained in Mancuso v. Neckles, also decided today, for discovery rule purposes, the justification for a delayed claim will depend on the "type of case" involved. 163 N.J. 34, 747 747 A.2d 260 (quoting Vispisiano v. Ashland Chem. Co., 107 N.J. 416, 434, 527 A.2d 66 (1987)). This "type of case" involving medical causation demands special attention due to the intrinsic hardship facing a potential medical malpractice claimant in determining fault. The patient here had no reasonable basis to suspect that her crippling condition was caused by anything other than the original surgery. "Not only is the nature of the injury generally unclear, its very existence is frequently masked." Vispisiano,supra, 107 N.J. at 434, 527 A.2d 66.
Defendant insists that Baird v. American Optical, 155 N.J. 54, 713 A.2d 1019 (1998), created a new bright-line discovery rule for medical malpractice cases that starts the statute of limitations running for all potentially responsible parties when a patient knows that she has been injured and knows or has reason to know that someone has probably been at fault. Defendant relies on the language in Baird: "The discovery rule prevents the statute of limitations from running when injured parties reasonably are unaware that they have been injured, or, although aware of the injury, do not know that the injury is attributable to the fault of another." Id. at 66, 713 A.2d 1019. We disagree that that generic statement was ever intended to mean that statutes of limitations could not run at different times for different defendants. An example will suffice to explain. Let us assume that a patient suffered a poor result from a knee replacement and started a suit against the surgeon for malpractice. Assume that more than two years after the initial surgery, the patient undergoes corrective surgery at which time it is discovered that an object was left in her knee by one other than the surgeon whom she had sued. Would such a claim be precluded by the language of Baird? We think not.
We agree with the court below that plaintiff exercised "reasonable diligence and intelligence" in asserting her claim.Lopez v. Swyer, 62 N.J. 267, 272, 300 A.2d 563 (1973). The benefit of the discovery rule should be available to this plaintiff who remained reasonably "unaware . . . that the injury [wa]s due to the fault or neglect of an identifiable individual or entity." Abboud v. Viscomi, 111 N.J. 56, 62, 543 A.2d 29 (1988) (citing Vispisiano,supra, 107 N.J. at 426-27, 527 A.2d 66). No readily apparent indication of Drs. Phillips and Goldstein's potential contribution to the patient's medical deterioration materialized until Dr. Jacobs brought the failure to treat plaintiff's infection to light. Competent experts retained by her did not express any opinion on the care and treatment of plaintiff provided by Drs. Phillips and Goldstein.
The unfairness of denying plaintiff leave to amend her complaint was compounded in this case by the discovery posture taken by the initial defendants. Plaintiff filed suit in May 1995. Defendants pleaded by way of answer that others than they had caused plaintiff's injuries. Plaintiff promptly demanded, by way of interrogatories, to know the basis of those allegations. Defendants furnished no reasonable medical support for their contentions. Dr. Jacobs' report, furnished before the statute of limitations had expired, made no mention of the fault of the after-care physicians. Not until the statute of limitations had passed did Dr. Steeb's expert suggest the fault of the after-care physicians. Invoking the principles of Young v. Latta, 123 N.J. 584, 589 A.2d 1020 (1991) (that require parties seeking to diminish their share of fault to "give prompt notice"), the trial court reasoned that it would be especially unfair to deny plaintiff the benefit of the discovery rule. Unlike a products-liability action in which one potentially responsible party may seek contribution from a jointly responsible party, it is almost never the case that one physician will seek contribution from another. Had Dr. Steeb, within the period of limitations, sought contribution from the after-care physicians as third-party defendants, Anna Gallagher could have asserted a timely claim against them under the "relating back" principles of Rule 4:9-3. Although plaintiff's ability to establish the actual fault of Drs. Phillips and Goldstein will depend on the proofs to be offered at trial, she should be given the opportunity to explore their potential liability as a cause of her injuries.
We affirm the Appellate Division judgment upholding the trial court's dismissal of defendants' motion for summary judgment.
For affirmance — CHIEF JUSTICE PORITZ and JUSTICES O'HERN, GARIBALDI, STEIN, COLEMAN, and VERNIERO — 6.
Opposed — None.