Statute of Limitations – Inquiry Notice: Hitt v. Dimensions
The statute of limitations regularly appears in appeals in Maryland medical malpractice cases. This Maryland Medical Malpractice Lawyer Blog has a post on it. On March 21, 2024, the Appellate Court of Maryland issued an unreported opinion on the statute of limitations in Hitt v. Dimensions Healthcare Corp, a medical malpractice case. The issue was when the plaintiff was on inquiry notice under the statute of limitations.
Circuit Court Facts
On January 16, 2017, the plaintiff was in a one car accident that resulted in severe injuries. He was in the hospital for over six weeks, much of it under sedation. (Op. at 1). One of the injuries was an open comminuted-fracture of the right femur. This case concerns fractures of the second and third metatarsals in the foot of the same leg. (Id. at 2).
On January 27, the care providers observed bruising and discoloration of the foot, and an x-ray then revealed the fractures with mild angulation for the first time. A doctor ordered a hard cast shoe, which the medical providers did not give to the plaintiff. (Id. at 2).
A second doctor believed that the fractures would heal normally without stabilization or immobilization, especially since the plaintiff would be on bed rest due to the leg injury. (Id. at 3).
On February 27, the hospital transferred the plaintiff to a rehab facility. The plaintiff claims that he did not know about his foot fractures at this time, and the medical records provided to rehab did not reference the fractures. (Id.).
When Was Inquiry Notice for the Statute of Limitations
On April 27, the plaintiff complained that his foot turned red when he sat up. An x-ray indicated a “prior” fracture of the foot. On May 2, the plaintiff saw a defense orthopedist. The doctor opined that the foot was healing properly and believed the discoloration was due to vascular problems. The doctor cleared the plaintiff for weight bearing, but the plaintiff was unable to bear weight on his foot. (Id. at 3-4).
Later providers took x-rays in October of 2017 and February of 2018, and read them as healed fractures. (Id. at 4). The plaintiff, however, continued to have pain and difficulty bearing weight on his right foot. In February 2018, the plaintiff sought a second opinion from doctors at another hospital, the University of Maryland. Several doctors there considered that a bunion deformity or metatarsophalangeal osteoarthritis could be the problem but did not make a definitive diagnosis. They characterized the old fractures as healed. (Id. at 5-6).
Statute of Limitations – Inquiry Notice
In January 2019, the plaintiff had increased pain and more difficulty bearing weight on his foot. A CT scan showed a healed fracture deformity. He went to a foot and ankle specialist who confirmed the diagnosis of fracture malunion and presented the plaintiff with treatment options, including surgery. (Id. at 6).
In February 2020, the plaintiff filed a complaint against Dimensions and two emergency room providers. In November 2021, the plaintiff filed an amended complaint against the Dimension Orthopedists. (Id. at 7).
The orthopedist defendants filed a motion for summary-judgment, arguing that the statute of limitations barred the amended complaint, and the circuit court granted the motion. (Id. at 7-8). The trial proceeded against the emergency room defendants, and the jury found for them. (Id. at 8 n. 1).
Appellate Court: Statute of Limitations – Inquiry Notice
The issue on appeal was when the plaintiff’s claim accrued. CJP 5-109(a)(2) requires the plaintiff to file an action within three years of discovering the injury. Here, the claims had to accrue on or after November of 2018. (Id. at 9-10).
The Appellate Court found that the evidence did not support summary judgment. The plaintiff’s knowledge in May 2017 that his foot was discolored and the difficulty weight bearing was insufficient to alert the plaintiff that the defendants may have negligently treated his foot. (Id. at 23). The Court also held that UM’s discussion of potential foot problems did not, as a matter of law, require the plaintiff to investigate further. A reasonable jury could find that they were unrelated to the treatment of the foot fractures. (Id. at 25-26).
Lastly, the Court rejected the defense argument that a reasonably diligent investigation by the plaintiff would have discovered a causal relationship between his right foot symptoms and the defendants’ alleged negligence. The Court observed that at least five different providers reviewed the plaintiff’s medical records between April 2017 and March 2018. All five failed to diagnose malunion of the metatarsal fractures. Rather, they believed that the fractures had healed without complications. (Id. at 28-29).
The Appellate Court concluded that a genuine dispute existed on the issue of when the plaintiff was on inquiry notice about his claims against the defendants. As a result, the circuit court erred in granting summary judgment to the defense on the basis of the statute of limitations. The Appellate Court reversed the judgment and remanded the case to the circuit court for trial. (Id. at 33).
Commentary
I believe the Appellate Court made the right decision in this case. Although the plaintiff knew he continued to have foot problems, his initial treatment and second-opinion doctors determined that the foot fractures had correctly healed. As a result, a jury could find (and probably will find) that the plaintiff did not have inquiry notice that the defendants may have negligently treated his foot until the foot and ankle specialist told him in January 2019 that the foot fractures had not healed properly.
However, the plaintiff has a bigger problem. The same facts that relieve his inquiry notice of the potential malpractice also help the defense establish that there was no malpractice. Five orthopedic providers determined that the fractures had healed properly. That is probably going to make it difficult for the plaintiff to prove malpractice by the defendants.
Mark Kopec is a top-rated medical malpractice lawyer. The Kopec Law Firm is located in Baltimore and helps clients throughout Maryland and Washington, D.C. You can contact him at 800-604-0704 for a free consultation. Thank you for reading the Maryland Medical Malpractice Lawyer Blog.