New York Law Review

Tag: continuous treatment doctrine

  • Plummer v. New York City Health & Hospitals Corp., 98 N.Y.2d 263 (2002): Continuous Treatment Doctrine and Gaps in Treatment

    Plummer v. New York City Health & Hospitals Corp., 98 N.Y.2d 263 (2002)

    The continuous treatment doctrine, which tolls the statute of limitations in medical malpractice cases, does not apply where there are significant gaps in treatment or an objective indication that treatment was not expected to continue.

    Summary

    This case addresses whether the continuous treatment doctrine applies to toll the statute of limitations in a medical malpractice action against the New York City Health and Hospitals Corporation (HHC). The infant plaintiff alleged negligence during his birth at North Central Bronx Hospital, part of HHC. The Court of Appeals held that the doctrine did not apply because the plaintiff’s treatment was not continuous, marked by missed appointments and a planned relocation that objectively indicated treatment would be interrupted. The plaintiffs failed to file a timely notice of claim, therefore, the action was dismissed.

    Facts

    The infant plaintiff was born at North Central Bronx Hospital with respiratory failure, allegedly causing brain damage and Erb’s Palsy. He received initial treatment at North Central’s neonatal intensive care unit. After discharge, he received care at multiple clinics, including North Central’s Pediatric Rehabilitation Medicine Clinic (for Erb’s Palsy) and Pediatric Clinic (for routine care). In September 1988, the plaintiff’s mother indicated an intent to relocate to Florida, and the clinic advised her to seek care at Miami Children’s Hospital. After a March 1989 visit, the plaintiff did not return to North Central until January 1990 after they had moved back to New York.

    Procedural History

    Plaintiffs filed a notice of claim in October 1990, alleging negligence and medical malpractice. The complaint was served in November 1991. HHC moved for summary judgment in August 1999, arguing the notice of claim was untimely. Supreme Court denied the motion based on equitable estoppel. The Appellate Division affirmed, finding the continuous treatment doctrine potentially applicable. The Court of Appeals reversed, granting summary judgment to HHC.

    Issue(s)

    Whether the continuous treatment doctrine applies to toll the statute of limitations for filing a notice of claim in a medical malpractice action against HHC, given the gaps in treatment and the indication that treatment would be discontinued due to relocation.

    Holding

    No, because the plaintiff’s course of treatment was not continuous due to missed appointments, a significant gap in time between visits, and the objectively manifested intention to discontinue treatment at North Central upon relocating to Florida.

    Court’s Reasoning

    The Court reasoned that the continuous treatment doctrine tolls the 90-day period for filing a notice of claim when treatment is sought for the same condition that gave rise to the claim. However, the doctrine requires a continuous course of treatment established for the specific condition at issue. The Court emphasized that “[e]ssential to the application of the continuous treatment doctrine is ‘a course of treatment established with respect to the condition that gives rise to the lawsuit’.” Here, the plaintiff’s treatment was interrupted, and the planned relocation to Florida indicated a clear intention to discontinue treatment at North Central. The Court stated: “Both parties objectively manifested an understanding that treatment of the child would not continue once he moved to Florida.” The mother’s later assertion of continued intent to treat at North Central was insufficient to overcome the contrary record evidence. Because the treatment was not continuous, the notice of claim was untimely, and the action was dismissed.

  • Allende v. New York City Health & Hosps. Corp., 90 N.Y.2d 333 (1997): Continuous Treatment Doctrine Requires Patient Awareness

    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.”

  • Cox v. Kingsboro Medical Group, 88 N.Y.2d 904 (1996): Continuous Treatment Doctrine Requires Explicit Anticipation of Further Treatment

    Cox v. Kingsboro Medical Group, 88 N.Y.2d 904 (1996)

    The continuous treatment doctrine tolls the statute of limitations in a medical malpractice action only when both the physician and patient explicitly anticipate further treatment related to the original condition, typically manifested by a scheduled appointment in the near future.

    Summary

    In this medical malpractice case, the New York Court of Appeals addressed whether the continuous treatment doctrine tolled the statute of limitations. The Court held that the plaintiff failed to demonstrate that both he and his doctor explicitly anticipated further treatment, as required for the doctrine to apply. The plaintiff’s amorphous expectation of future diagnostic testing was insufficient. Additionally, the Court found no basis to impute treatment from one medical group to another based solely on a referral and a vague “consulting” relationship, absent evidence demonstrating a relevant connection between the groups.

    Facts

    Winston Cox received treatment from Dr. Levowitz, a member of Brookdale Surgical Group, after being referred by a physician at Kingsboro Medical Group, Cox’s primary care provider. Cox later claimed that Dr. Levowitz committed medical malpractice. Cox argued that the statute of limitations should be tolled under the continuous treatment doctrine because he expected further diagnostic testing and because of the relationship between Kingsboro and Brookdale.

    Procedural History

    Cox filed a medical malpractice suit. The defendants moved for summary judgment, arguing that the statute of limitations had expired. The lower court granted the motion. The Appellate Division affirmed. The New York Court of Appeals granted leave to appeal.

    Issue(s)

    1. Whether the continuous treatment doctrine applies to toll the statute of limitations when the patient has an amorphous expectation of future treatment, but no explicit agreement with the physician for such treatment?

    2. Whether treatment rendered by one medical group can be imputed to a physician in another medical group based solely on a referral and a “consulting” relationship for the purpose of tolling the statute of limitations under the continuous treatment doctrine?

    Holding

    1. No, because the continuous treatment doctrine requires explicit anticipation of further treatment by both the physician and the patient, manifested by a regularly scheduled appointment or similar indication.

    2. No, because a mere referral and vague “consulting” relationship, without further evidence demonstrating a relevant connection between the medical groups, is insufficient to impute treatment for the purpose of tolling the statute of limitations.

    Court’s Reasoning

    The Court of Appeals affirmed the lower court’s decision, holding that the plaintiff failed to meet the burden of demonstrating a triable issue of fact regarding continuous treatment. The Court reiterated the established standard for continuous treatment, stating that it exists only “when further treatment is explicitly anticipated by both physician and patient as manifested in the form of a regularly scheduled appointment for the near future, agreed upon during that last visit, in conformance with the periodic appointments which characterized the treatment in the immediate past” (quoting Richardson v. Orentreich, 64 N.Y.2d 896, 898-899). The Court found that Cox only possessed an “amorphous expectation” of future testing, which did not satisfy the explicit anticipation requirement. Furthermore, the court declined to impute treatment from Kingsboro to Levowitz based on the referral and consulting relationship. It emphasized the lack of evidence demonstrating a relevant relationship between the two groups sufficient to justify imputation. The Court stated that the record did not contain any evidence demonstrating a relevant relationship between Kingsboro and Brookdale sufficient to impute treatment by Kingsboro physicians to Levowitz.

  • Ganess v. City of New York, 85 N.Y.2d 733 (1995): Continuous Treatment Doctrine and Medical Malpractice

    85 N.Y.2d 733 (1995)

    The continuous treatment doctrine tolls the statute of limitations in medical malpractice cases only when there is an established, ongoing course of treatment related to the original condition; mere monitoring or a continuing relationship is insufficient.

    Summary

    Sean Ganess, born with Erb’s palsy, sued the City of New York for alleged medical malpractice during his birth. He claimed the continuous treatment doctrine should toll the statute of limitations, as he received follow-up care at the hospital’s pediatric clinic for 11 years. The Court of Appeals held that Ganess failed to demonstrate continuous treatment throughout the entire period. Vague assertions of yearly visits without specific dates or treatment details were insufficient to invoke the doctrine. The court affirmed the dismissal of the case, emphasizing the need for concrete evidence of ongoing, related treatment to justify tolling the statute of limitations.

    Facts

    Sean Ganess was born in 1973 with Erb’s palsy, affecting his left shoulder and arm. He received treatment at Elmhurst General Hospital’s Pediatric Neuromuscular Rehabilitation Clinic from shortly after birth. Doctors explained to his parents when he was 3 1/2 years old that his condition was likely permanent. On May 18, 1984, almost 11 years after his birth, Ganess filed a notice of claim against the City of New York, alleging negligence during his delivery.

    Procedural History

    The plaintiff filed a notice of claim nearly 11 years after the alleged malpractice. The lower courts ruled against the plaintiff, finding the claim time-barred. The Court of Appeals reviewed the case to determine whether the continuous treatment doctrine applied to toll the statute of limitations, allowing the claim to proceed despite the late filing. The Court of Appeals affirmed the lower court’s decision.

    Issue(s)

    Whether the continuous treatment doctrine applies to toll the statute of limitations in a medical malpractice case when the plaintiff alleges ongoing monitoring and treatment for a condition stemming from the initial negligent act, but fails to provide concrete evidence of treatment throughout the entire period.

    Holding

    No, because the plaintiff failed to provide sufficient evidence to demonstrate a continuous course of treatment related to the original condition for the entire period claimed. The plaintiff’s vague assertions of yearly visits were insufficient to rebut the evidence showing a lapse in treatment.

    Court’s Reasoning

    The Court of Appeals emphasized that the continuous treatment doctrine requires a continuous course of treatment related to the original condition. “[T]he time in which a plaintiff must bring an action alleging malpractice is stayed `when the course of treatment which includes the wrongful acts or omissions has run continuously and is related to the same original condition or complaint’.” The court noted that neither a continuing relationship nor a continuing diagnosis is sufficient. While acknowledging that individuals with chronic conditions and those being monitored are not necessarily excluded from the doctrine’s protection, the court found that Ganess failed to prove continuous treatment for the entire 11-year period. The last documented treatment was in August 1983, and the father’s affidavit lacked specific details about any treatment after that date. The court held that the conclusory assertion of continuous treatment was insufficient to establish entitlement to the doctrine. Judge Titone, in a concurring opinion, raised concerns about whether treatment by a different medical specialty (neurology versus obstetrics) could satisfy the continuous treatment doctrine, but the court did not address this issue as it was not raised by the defendants.

  • Schwartz v. Selig, 81 N.Y.2d 883 (1993): Application of the Continuous Treatment Doctrine

    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.

  • Glamm v. New York City Health and Hospitals Corp., 77 N.Y.2d 955 (1991): Continuous Treatment Doctrine and Genetic Testing

    Glamm v. New York City Health and Hospitals Corp., 77 N.Y.2d 955 (1991)

    The continuous treatment doctrine, which tolls the statute of limitations in medical malpractice cases, applies only when the ongoing treatment is directly related to the alleged wrongful act or omission.

    Summary

    This case addresses whether the continuous treatment doctrine applies to toll the statute of limitations in a medical malpractice action where the alleged malpractice (misreading genetic test results) occurred during, but was not directly related to, the plaintiff’s ongoing prenatal care. The New York Court of Appeals held that the continuous treatment doctrine did not apply because the misreading of the genetic test was not part of the continuous obstetric care. Therefore, the plaintiff’s action was time-barred. The decision highlights the limits of the continuous treatment doctrine, emphasizing the required nexus between the alleged malpractice and the ongoing treatment.

    Facts

    In January 1985, the plaintiff, who carries the genetic trait for sickle cell anemia, began receiving prenatal care at a hospital operated by the defendant. Aware of the risk of her child being born with sickle cell anemia, she arranged for the child’s father to be tested for the trait. On January 16, 1985, the father’s test results were incorrectly read as negative. Relying on this incorrect result, the plaintiff continued her pregnancy and gave birth on August 30, 1985. Two weeks later, the infant was diagnosed with sickle cell anemia.

    Procedural History

    On September 11, 1986, the plaintiff filed a medical malpractice action, seeking damages for the child’s medical expenses. The defendant moved to dismiss the action as untimely, arguing that the one-year-and-90-day statute of limitations had expired. The Supreme Court granted the motion. The Appellate Division reversed, finding that the continuous treatment doctrine tolled the statute of limitations. The New York Court of Appeals then reversed the Appellate Division, dismissing the action.

    Issue(s)

    Whether the continuous treatment doctrine tolled the statute of limitations in a medical malpractice action where the alleged malpractice (misreading genetic test results) occurred during, but was not directly related to, the plaintiff’s ongoing prenatal care.

    Holding

    No, because the misreading of the genetic test results was not performed in relation to the ongoing obstetric care received by the plaintiff. Therefore, the continuous treatment doctrine does not apply, and the action is time-barred.

    Court’s Reasoning

    The Court of Appeals reasoned that the continuous treatment doctrine applies only when the course of treatment, including the wrongful act or omission, has run continuously and is related to the same original condition. Citing prior precedent, including Nykorchuck v Henriques, 78 NY2d 255, 258-259; McDermott v Torre, 56 NY2d 399, 405; and Borgia v City of New York, 12 NY2d 151, 155, the court emphasized the requirement of a direct relationship between the alleged malpractice and the ongoing treatment. The court stated, “Here, however, the alleged act of malpractice — the misreading of the father’s genetic test results — was simply not committed in relation to the ongoing obstetric care that plaintiff received.” Because the genetic testing was a discrete event not integral to the continuous prenatal care itself, the doctrine did not apply. This highlights that merely receiving continuous care is insufficient; the malpractice must be intertwined with that care. This case clarifies that the continuous treatment doctrine is not a blanket exception to the statute of limitations for all medical care provided over time. It serves to protect a patient who continues seeking treatment for the same condition from the same provider; it is not designed to cover unrelated negligent acts occurring during a period of otherwise proper treatment. The policy consideration is to avoid disrupting the physician-patient relationship where ongoing treatment is reasonably expected.

  • Massie v. Crawford, 78 N.Y.2d 516 (1991): Application of the Continuous Treatment Doctrine in Medical Malpractice

    78 N.Y.2d 516 (1991)

    The continuous treatment doctrine tolls the statute of limitations for medical malpractice actions when the course of treatment, including wrongful acts or omissions, runs continuously and relates to the same original condition or complaint.

    Summary

    This case addresses the application of the continuous treatment doctrine to toll the statute of limitations in a medical malpractice action. The plaintiff, Massie, claimed the defendant, Crawford, committed malpractice by prescribing birth control pills despite her history of phlebitis. The defendant moved to dismiss based on the statute of limitations. The Court of Appeals held that the continuous treatment doctrine did not apply because the record did not establish a continuing patient/physician relationship related to the initial prescription. The Court emphasized that the policy behind the doctrine is to allow physicians to correct their own malpractice without interruption, a rationale inapplicable when continuous treatment is absent.

    Facts

    The plaintiff, Massie, alleged that the defendant, Crawford, committed medical malpractice by prescribing birth control pills, despite knowing her prior history of phlebitis while taking similar medication. The prescription was allegedly given nearly three years before the commencement of the lawsuit.

    Procedural History

    The defendant moved to dismiss the action as untimely under the statute of limitations. The plaintiff argued that the continuous treatment doctrine tolled the statute. The lower courts ruled against the plaintiff. The Court of Appeals affirmed the lower court’s decision, finding no basis in the record to support the application of the continuous treatment doctrine.

    Issue(s)

    Whether the continuous treatment doctrine applies to toll the statute of limitations in a medical malpractice action where the plaintiff alleges the defendant prescribed medication despite a known contraindication, and where the record does not establish a continuing physician-patient relationship related to that prescription.

    Holding

    No, because the record did not reflect that plaintiff contemplated, or had, a continuing patient/physician relationship with defendant concerning the original condition or complaint.

    Court’s Reasoning

    The Court of Appeals affirmed the order dismissing the case, holding that the continuous treatment doctrine did not apply. The court emphasized that the doctrine tolls the 2 ½-year limitations period when the course of treatment, including the wrongful acts, runs continuously and is related to the same original condition or complaint, citing CPLR 214-a; Nykorchuck v Henriques, 78 NY2d 255; and McDermott v Torre, 56 NY2d 399, 408. The court stated, “The premise underlying the doctrine is that a plaintiff should not have to interrupt ongoing treatment to bring a lawsuit, because the doctor not only is in a position to identify and correct the malpractice, but also is best placed to do so.”

    However, the court found that the plaintiff’s complaint and affidavits lacked support for her counsel’s assertions that the defendant supplied a six-month prescription, that she complained of leg pain, and that he advised her to continue the medication. Crucially, the court stated, “Indeed, the record does not reflect that plaintiff contemplated, or had, a continuing patient/physician relationship with defendant.” Therefore, the court did not reach the legal question of whether the conduct argued by counsel could constitute continuous treatment.

  • Nykorchuck v. Henriques, 78 N.Y.2d 26 (1991): The Continuous Treatment Doctrine Requires an Established Course of Treatment for the Specific Condition

    Nykorchuck v. Henriques, 78 N.Y.2d 26 (1991)

    The continuous treatment doctrine tolls the statute of limitations in medical malpractice cases only when there is an established course of treatment for the specific condition that gives rise to the lawsuit, not merely a continuing relationship between physician and patient.

    Summary

    Diane Nykorchuck sued Dr. Henriques for medical malpractice, alleging failure to properly diagnose and monitor a lump in her breast, which was ultimately diagnosed as cancer. The suit was filed more than 2.5 years after the last appointment related to her endometriosis, the prior condition Henriques treated. Nykorchuck argued the continuous treatment doctrine tolled the 2.5-year statute of limitations. The court held that the doctrine was inapplicable because the alleged negligence related to her breast condition, for which no continuous treatment was established. The court emphasized that a continuing doctor-patient relationship or the continuing nature of a diagnosis, without an actual course of treatment, is insufficient to invoke the doctrine.

    Facts

    Diane Nykorchuck consulted Dr. Henriques starting in 1974 for infertility problems due to endometriosis, which he treated over several years, including surgery in April 1982.

    During a July 1979 visit, Nykorchuck mentioned a lump in her right breast. Dr. Henriques examined it and allegedly said it was noncancerous fibrocystic disease, stating, “we will have to keep an eye on it.”

    Lumps in both breasts were noted during a pre-surgery examination in April 1982, but no further evaluation was conducted at that time.

    After the surgery, Nykorchuck saw Dr. Henriques three times until September 1983 for post-operative care and estrogen replacement medication adjustments.

    Dr. Henriques renewed prescriptions for Nykorchuck in 1984 and June 1985.

    In December 1985, Nykorchuck scheduled an appointment due to enlargement of the breast mass.

    In January 1986, Dr. Henriques examined her and immediately referred her to an oncologist, who diagnosed breast cancer.

    Procedural History

    Nykorchuck commenced the medical malpractice action in December 1987.

    The Supreme Court denied the motion to dismiss, finding questions of fact regarding the continuous treatment doctrine.

    The Appellate Division reversed, holding the doctrine inapplicable because Nykorchuck failed to show Dr. Henriques undertook treatment for her breast condition.

    The New York Court of Appeals affirmed the Appellate Division’s decision.

    Issue(s)

    Whether the continuous treatment doctrine applies to toll the statute of limitations in a medical malpractice case when the alleged malpractice concerns a failure to treat a specific condition (breast lump) where the doctor-patient relationship existed primarily for treatment of a different condition (endometriosis) and where examinations of the untreated condition were infrequent and isolated.

    Holding

    No, because the continuous treatment doctrine requires an established course of treatment for the specific medical condition giving rise to the lawsuit, and isolated examinations do not constitute such a course of treatment when the primary treatment is for a separate condition. The court stated, “While the failure to treat a condition may well be negligent, we cannot accept the self-contradictory proposition that the failure to establish a course of treatment is a course of treatment.”

    Court’s Reasoning

    The court emphasized that the continuous treatment doctrine tolls the statute of limitations only when the treatment is continuous and related to the same original condition or complaint. CPLR 214-a explicitly requires continuous treatment “for the same illness, injury or condition which gave rise to the…act, omission or failure complained of.”

    The court found that the treatment for endometriosis was a separate medical condition, and there was no alleged connection between that treatment and the breast condition. The court reasoned that the isolated breast examinations, only one of which was performed by Dr. Henriques during the relevant period, did not establish a course of continuous treatment for the breast condition, citing Davis v. City of New York, 38 N.Y.2d 257. The court stated the examinations were “discrete and complete” and separated by a significant time.

    The court stated that applying the continuous treatment doctrine in this case would fundamentally extend and alter it. The gravamen of the claim was the failure to establish a course of treatment, not negligent acts or omissions during an existing course of treatment.

    The court held: “In the absence of continuing efforts by a doctor to treat a particular condition, none of the policy reasons underlying the continuous treatment doctrine justify the patient’s delay in bringing suit.”

  • Daniel J. v. New York City Health and Hospitals Corp., 77 N.Y.2d 630 (1991): Accrual of Infant’s Medical Malpractice Claim

    Daniel J. v. New York City Health and Hospitals Corp., 77 N.Y.2d 630 (1991)

    The 10-year statutory toll for infancy in medical malpractice actions runs from the date of the original negligent act or omission, not from the end of subsequent continuous treatment.

    Summary

    This case addresses whether the 10-year extension of the statute of limitations for infants in medical malpractice cases runs from the initial negligent act or the end of continuous treatment. The New York Court of Appeals held that the 10-year period runs from the initial negligent act, aligning the accrual date with the general rule established in McDermott v. Torre. This decision prevents an unwarranted exception for infants’ claims, ensuring prompt disposition of medical malpractice claims and avoiding the illogical consequences of previous accrual rules.

    Facts

    In November 1978, Ann Mary J. gave birth to Daniel J. at Cumberland Hospital. Daniel underwent emergency surgery in December 1978 to correct a strangulated hernia. After follow-up visits, he was readmitted with a diagnosis of inguinal hernia and undescended left testis, requiring further surgery and treatment for three months. Daniel was ultimately left without either testicle, necessitating lifelong hormonal treatment. The petitioner claimed malpractice due to the hospital’s failure to diagnose the undescended testicle immediately after birth and a potential compromise of the right testicle during surgery.

    Procedural History

    Petitioner sought leave to serve a late notice of claim and to serve a summons and complaint, arguing the action was timely under the 10-year infancy toll (CPLR 208) because Daniel received continuous treatment until March 15, 1979. The Supreme Court granted the petition. The Appellate Division affirmed. The New York Court of Appeals granted leave to appeal.

    Issue(s)

    Whether the maximum 10-year extension of the statute of limitations afforded to infants by CPLR 208 runs from the initial negligent act or from the end of any period of subsequent continuous treatment.

    Holding

    No, because a medical malpractice action accrues at the date of the original negligent act or omission, and subsequent continuous treatment serves only to toll the running of the statute of limitations, not to change the accrual date.

    Court’s Reasoning

    The Court of Appeals relied on the established rule that a medical malpractice action accrues at the time of the original negligent act or omission, as established in McDermott v. Torre. The continuous treatment doctrine only tolls the statute of limitations; it does not alter the accrual date. The court rejected the petitioner’s argument that the accrual date should be the end of the continuous treatment, citing the legislative intent behind the 1975 amendments to CPLR 208, which aimed to ensure prompt disposition of medical malpractice claims. The court noted that while a prior case, Borgia v. City of New York, held that the cause of action in continuous treatment cases accrued at the conclusion of treatment, the legislature did not intend to codify this definition of accrual in CPLR 208. Applying the Borgia definition would perpetuate the illogical consequences the court corrected in McDermott and create an unwarranted exception for infants’ claims. The court emphasized that CPLR 208 was enacted as part of a legislative package designed to address a perceived medical malpractice insurance crisis. To allow the infancy toll to run from the end of continuous treatment would undermine this legislative intent and delay the resolution of malpractice claims. Therefore, the court held that the 10-year infancy toll runs from the date of the initial negligent act or omission, aligning with the general rule for accrual in medical malpractice cases.

  • Richardson v. Orentreich, 64 N.Y.2d 896 (1985): Continuous Treatment Doctrine and Scheduled Appointments

    64 N.Y.2d 896 (1985)

    The continuous treatment doctrine tolls the statute of limitations in medical malpractice cases when further treatment is explicitly anticipated by both physician and patient, as manifested in a regularly scheduled appointment for the near future.

    Summary

    This case addresses the continuous treatment doctrine in medical malpractice, specifically focusing on whether a scheduled appointment extends the period of continuous treatment for statute of limitations purposes. The Court of Appeals held that the continuous treatment doctrine applies when a patient has a scheduled follow-up appointment, even if the patient misses that appointment, because the intention of continued care exists. The court reasoned that requiring a patient to interrupt corrective efforts between scheduled appointments would be absurd.

    Facts

    Plaintiff, Richardson, received medical treatment from Defendant, Dr. Orentreich, from January 1973 through October 8, 1974. During the October visit, a follow-up appointment was scheduled for December 4, 1974. Richardson did not attend the December appointment and had no further contact with Orentreich. Richardson filed a medical malpractice suit on November 30, 1977, alleging injuries from treatment received between August 1973 and December 1974. Orentreich argued that the statute of limitations had expired because the last actual treatment was on October 8, 1974, more than three years prior to the suit.

    Procedural History

    The Supreme Court, Special Term, denied Orentreich’s motion for summary judgment, finding unresolved issues regarding the termination of treatment. The Appellate Division affirmed. The Court of Appeals affirmed the denial of summary judgment, holding that no factual questions existed to sustain the statute of limitations defense, given the scheduled follow-up appointment.

    Issue(s)

    Whether the continuous treatment doctrine applies to toll the statute of limitations in a medical malpractice case when a follow-up appointment is scheduled, but not kept, by the patient.

    Holding

    Yes, because the “continuing trust and confidence” between doctor and patient extends to the scheduled appointment, indicating an intention for ongoing care, even if the patient does not attend.

    Court’s Reasoning

    The Court of Appeals emphasized that the Statute of Limitations does not begin to run until the continuous course of treatment ends, citing Borgia v. City of New York, 12 N.Y.2d 151, 155. The court reasoned that the “continuous treatment doctrine” hinges on the “continuing trust and confidence” between the physician and patient, which extends beyond the last physical visit. The court stated that “It would be absurd to require a wronged patient to interrupt corrective efforts by deeming treatment to be considered terminated in between scheduled appointments.” Because a follow-up appointment was scheduled for December 4, 1974, there was a clear expectation and intention of continued treatment until at least that date. The court distinguished this situation from cases where the patient independently decides to terminate the relationship or where no future treatment is contemplated. The mere fact that the patient missed the appointment does not automatically terminate the continuous course of treatment when the appointment itself signifies the ongoing nature of the physician’s care. The court emphasized that Orentreich didn’t raise any factual issues suggesting any action that ended the course of care between the last appointment and the cancelled one.