Schwartz v. Selig, 81 N.Y.2d 883 (1993)
The continuous treatment doctrine tolls the statute of limitations for medical malpractice claims only when there is a continuing effort by a doctor to treat a particular condition, not when consultations are independent and lack an expectation of future contact.
Summary
In this medical malpractice case, the New York Court of Appeals held that the continuous treatment doctrine did not apply to toll the statute of limitations. The plaintiff alleged that the defendant physician negligently failed to diagnose liver cancer during initial consultations. However, the court found that these consultations, conducted to assess the impact of psoriasis treatment on the decedent’s liver, were distinct from a later consultation nine months later when cancer was detected. Because the initial consultations were independent and did not contemplate ongoing treatment or future contact, the continuous treatment doctrine was inapplicable, and the malpractice claim was time-barred.
Facts
In January and February 1987, Dr. Selig (defendant) examined the decedent at the request of her dermatologist to determine if a psoriasis drug would harm her liver. Dr. Selig detected a nodule but concluded the drug wouldn’t be harmful. No further examinations or follow-up consultations were proposed or contemplated at that time. Nine months later, in November 1987, the decedent consulted her internist, who referred her back to Dr. Selig. Dr. Selig then detected liver cancer, from which the decedent died shortly after.
Procedural History
The plaintiff commenced a medical malpractice action more than two years after the November examination, alleging negligent failure to diagnose cancer during the initial consultations. The defendant moved for summary judgment based on the statute of limitations. The plaintiff argued the continuous treatment doctrine tolled the statute. The lower courts ruled in favor of the plaintiff, but the Court of Appeals reversed, granting the defendant’s motion for summary judgment.
Issue(s)
Whether the decedent’s visits to the defendant constituted a single course of treatment, thereby invoking the continuous treatment doctrine to toll the 2.5-year statute of limitations for medical malpractice claims under CPLR 214-a.
Holding
No, because the initial consultations were for a purpose wholly independent of the later consultation and involved neither ongoing provision of services by the defendant nor the expectation of any future contact between the patient and physician after discharge from the hospital.
Court’s Reasoning
The Court of Appeals reasoned that the continuous treatment doctrine applies only when there are “continuing efforts by a doctor to treat a particular condition.” The court distinguished this case from situations where there is an ongoing relationship between the doctor and patient. The court emphasized that the initial consultations were undertaken for a purpose wholly independent of the later consultation, specifically to assess the impact of psoriasis treatment on the liver. There was no ongoing provision of services or expectation of future contact after the initial consultations were completed. The court cited Davis v City of New York, 38 NY2d 257, 259 and McDermott v Torre, 56 NY2d 399, 406 to further emphasize the requirements of continuing treatment and expectation of future contact. The court also stated, “The fact that the condition allegedly overlooked in the first consultations was the condition ultimately diagnosed in the later consultation does not bring this case within the continuous treatment doctrine even if a correct diagnosis would have led to an ongoing course of treatment (see, Nykorchuck v Henriques, 78 NY2d 255, 259).” The court explicitly rejected the argument that a missed diagnosis, even if related to a later-diagnosed condition, automatically triggers the continuous treatment doctrine. The court’s decision emphasizes the importance of a clear and continuous doctor-patient relationship for the doctrine to apply.