90 N.Y.2d 333 (1997)
The continuous treatment doctrine, which tolls the statute of limitations in medical malpractice cases, requires that the patient be aware of the need for further treatment for the relevant condition.
Summary
Allende sued New York City Health & Hospitals Corp. (HHC) for failing to timely diagnose her breast cancer. The key issue was whether the continuous treatment doctrine tolled the 90-day notice of claim period. Allende had a mammogram in April 1990, revealing abnormalities, but she wasn’t informed of the results until November 1990. She argued her treatment was continuous from her initial complaint in March 1990 through post-operative care in July 1991. The Court of Appeals held that the continuous treatment doctrine did not apply because Allende was unaware of the need for further breast treatment until November 1990. The court emphasized that the doctrine protects patients from interrupting treatment, a concern that only arises when the patient knows further treatment is necessary.
Facts
Allende visited Sydenham Clinic (part of HHC) in March 1990, complaining of breast pain and was referred for a mammogram at Harlem Hospital (also part of HHC). The mammogram in April 1990 revealed nodular densities, recommending a biopsy or follow-up. The report was sent to Sydenham Clinic, but Allende wasn’t informed. Allende returned to the clinic in June and September 1990 for unrelated issues, still without being told of the mammogram results, leading her to believe the mammogram was negative. In November 1990, the clinic contacted her about the mammogram. She was informed of the abnormalities on November 17, 1990, had a repeat mammogram in January 1991, a biopsy revealing cancer, a mastectomy in March 1991, and received post-operative care until July 1991.
Procedural History
Allende filed a notice of claim in June 1991 and sued HHC in February 1992. HHC moved to dismiss for failure to file a timely notice of claim. The Supreme Court granted the motion in part, finding the continuous treatment doctrine applicable only from November 17, 1990. The Appellate Division reversed, holding the doctrine tolled the period. The Court of Appeals reversed the Appellate Division and reinstated the Supreme Court’s order.
Issue(s)
Whether the continuous treatment doctrine tolls the 90-day notice of claim period in a medical malpractice suit when the plaintiff is unaware of the need for further treatment of the condition giving rise to the claim?
Holding
No, because the continuous treatment doctrine requires the patient to be aware of the need for further treatment for it to apply and toll the statute of limitations or notice of claim period.
Court’s Reasoning
The Court reasoned that to sue HHC, a timely notice of claim is required, generally within 90 days of accrual (General Municipal Law § 50-e(1)). The continuous treatment doctrine, codified in CPLR 214-a, tolls the statute of limitations (and the notice of claim period) when there is continuous treatment for the same illness that gave rise to the alleged malpractice. The doctrine exists to prevent patients from having to interrupt treatment and undermine trust in the physician to ensure a timely claim. Quoting Rizk v. Cohen, 73 N.Y.2d 98, 104, the Court stated that the doctrine protects the “continuing trust in the physician-patient relationship.” Because the patient must be aware of the need for further treatment for the doctrine’s purpose to be served, the focus is on the patient’s understanding. Routine check-ups or a general relationship with a physician are insufficient. Here, Allende wasn’t informed of the abnormal mammogram results until November 1990 and believed the mammogram was negative. Thus, she wasn’t in a position where she would have to interrupt treatment, and the toll doesn’t apply for the period before November 17, 1990. As the Court noted, “Given plaintiff’s lack of awareness of a condition warranting further treatment, the purpose of the continuous treatment doctrine would not be served by its application here.”