Opinion
No. CV01-0809553S
December 16, 2005
MEMORANDUM OF DECISION ON MOTION FOR SUMMARY JUDGMENT
This is a medical malpractice case. The minor plaintiff, Brandy Compton (Compton), was diagnosed with sickle cell anemia when she was four months old. From her diagnosis until December 1998, her mother, Mary Hardy (Hardy), sought treatment at the Comprehensive Sickle Cell Service program at St. Francis Hospital (St. Francis), one of the defendants. At some point, Dr. Lee Pachter (Pachter), the other defendant and a physician at St. Francis, began to oversee Compton's treatment. In December 1998, Hardy sought treatment elsewhere because she was dissatisfied with her daughter's care at St. Francis. Hardy was dissatisfied, among other reasons, because she believed Pachter was unqualified to treat her daughter, neither Pachter or St. Francis consulted with a pulmonologist when Compton exhibited lung problems, the Sickle Cell program did not have a pediatric hematology specialist, Pachter did not oversee a blood transfusion that was performed improperly, and because no one kept Hardy abreast of her daughter's treatment options or progress.
Sometime in January 1999 Hardy took her daughter to a different treatment center and a physician, Dr. Hagstrom (Hagstrom), determined that Compton had lung scarring as a result of Acute Chest Syndrome (A.C.S.). Hagstrom also opined that Compton had asthma secondary to A.C.S. that was not treated, but should have been treated, at St. Francis. Thereafter, Hardy wrote a letter to the Connecticut Department of Public Health (DPH) that was received on June 16, 1999, asking the Department to perform an investigation of Compton's treatment at St. Francis. Upon receiving a response from the DPH, in March 2000, that it believed that St. Francis had not followed the appropriate treatment protocol, Hardy sued the defendants.
St. Francis was served on July 17, 2001 and Pachter was served on July 20, 2001. The initial complaint was filed July 30, 2001. The defendants assert that the statute of limitation began to run by or before January 1999 when Hardy suspected negligent and improper care at St. Francis and left its' Sickle Cell program. The defendants assert that during this time, Hardy "discovered" the injury and its' causal connection to the defendants.
Hardy admits suspecting the defendants of improper care, and that she knew about the lung scarring in January 1999, but asserts that she did not know that the lung scarring was caused by the defendants negligence, because she did not know that the defendants breached a duty until March 2000, when she received notice from the DPH that the defendants had committed violations of the standard of care while treating her child. In other words, Hardy alleges that she could not have not known whether her daughter's lung scarring occurred naturally, as a result of having A.C.S. or whether the defendants, in their treatment, contributed to the development of the A.C.S. and caused the lung scarring. When Hardy learned of the lung scarring, she claims she did not know of the appropriateness, in terms of a breach of duty, of the defendants' decisions in treating her daughter, only that they didn't meet her expectations of top-quality care at a specialized program for sickle cell patients.
A letter from the DPH was sent to Hardy in early July 1999, but the letter did not specify which patients it claimed had been subjected to improper care. Compton was not identified by DPH as a patient whose care had allegedly been compromised until March 2000.
The defendants have moved for summary judgment, claiming that the applicable statute of limitation, Conn. Gen. Stat. § 52-584, had expired before plaintiff brought this action. Their argument is primarily supported by Lagassey v. State, 268 Conn. 723 (2004). The plaintiffs also rely on Lagassey in opposing summary judgment.
In Lagassey, the Supreme Court discussed past inconsistencies in interpreting the language of Section 52-584, and articulated the correct legal standard for assessing statute of limitation claims in negligence cases:
[W]e take this opportunity to restate the correct legal standard by which to evaluate the timeliness of causes of action in negligence. The limitation period for actions in negligence begins to run on the date when the injury is first discovered or in the exercise of reasonable care should have been discovered . . . In this regard, the term "injury" is synonymous with "legal injury" or "actionable harm." "Actionable harm" occurs when the plaintiff discovers, or in the exercise of reasonable care, should have discovered the essential elements of a cause of action . . . A breach of duty by the defendant and a causal connection between the defendant's breach of duty and the resulting harm to the plaintiff are essential elements of a cause of action in negligence; they are therefore ingredients for "actionable harm.". . . Furthermore, "actionable harm" may occur when the plaintiff has knowledge of facts that would put a reasonable person on notice of the nature and extent of an injury, and that the injury was caused by the negligent conduct of another. In this regard, the harm complained of need not have reached its fullest manifestation in order for the limitation period to begin to run; a party need only have suffered some form of "actionable harm.". . . Finally, the determination of when a plaintiff in the exercise of reasonable care should have discovered "actionable harm" is ordinarily a question reserved for the trier of fact.
(Citations omitted.) Lagassey v. State, supra, 268 Conn. 723, 748-49. The Court based this articulation, in part, on its analysis of three earlier, fact-dependent decisions. The facts involved in those cases need to be compared to the facts of this case to determine whether defendants are entitled, under the Lagassey standard, to summary judgment.
In Merly v. State, 211 Conn. 199 (1989), a patient at a state mental hospital committed suicide. Subsequently, the plaintiff administrator sued the hospital for failure to prevent the suicide. However, because the plaintiff did not begin an investigation against the hospital until a year and a half after the suicide, summary judgment for the defendant was affirmed. As the Lagassey court reiterated, in discussing Merly, "because the plaintiff did not start any investigation into the matter until one and one-half years after the decedent's suicide, he did not exercise reasonable care to discover the claim as a matter of law." Lagassey v. State, supra, 268 Conn. 744.
In contrast to the facts in Merly, Hardy was allegedly adamant about protesting and investigating her daughter's treatment, demanding specialists that the Sickle Cell program didn't provide, taking her daughter to a second physician, and contacting the DPH to uncover any possible violations at St. Francis. Merly, therefore, provides little support for defendants' position.
In Burns v. Hartford Hospital. 192 Conn. 451 (1984), a case the defendants submit is analogous to the present case, the plaintiff was being treated for injuries sustained in an automobile accident. As part of his treatment, the plaintiff was receiving fluids intravenously into his lower legs. When the plaintiff began to complain of soreness in one his legs, his treating physician told him that the pain was caused by an infection from contaminated intravenous tubes. The court, in affirming summary judgment, reasoned that as soon as the doctor disclosed the causal connection between the injury and the admitted to negligence, the plaintiff "discovered" the injury and the statute of limitations had began to run.
Based on the documents before the court for purposes of this motion, things are not nearly so clear-cut in this case. When Hardy went to Dr. Hagstrom, Hagstrom informed her that her daughter had lung scarring from Acute Chest Syndrome and that she had asthma, secondary to A.C.S., that wasn't being treated at St. Francis. Importantly, Hagstrom did not state that A.C.S. was caused by anything St. Francis did or failed to do, or that asthma could cause lung scarring. Thus, unlike the situation in Burns, where the doctor not only admitted negligent conduct, but also explicitly stated that the negligent conduct caused the injury, Hagstrom did not inform Hardy that her daughter's injuries were caused by the negligent conduct of St. Francis. It could well be argued that Hardy's knowledge of St. Francis' failure to treat the child's asthma could be seen as evidence that she should have discovered a causal connection between the plaintiff's lung scarring and Pachter's treatment, but that issue would clearly have to be resolved by the trier of fact.
The defendants also argue that the plaintiff had discovered her "actionable harm," the injury and the causal connection, as evidenced in her June 1999 letter to DPH. In this letter, Hardy wrote: "I'm afraid that [Compton's] current condition is due to the neglect and care by Dr. Lee Pachter at Saint Francis Hospital."
Hardy's state of mind, in June of 1999, as to what was going on with her daughter's health and what had happened to her at St. Francis, is obviously subject to interpretation. Her letter to DPH could be seen as evidence that she believed, at that time, that there was a causal connection between Compton's current condition and Pachter's treatment, which, in turn, would mean that she impliedly knew that the defendants had been negligent. Conversely, Hardy does not specifically state that she knows or that she discovered that Pachter's treatment was the cause of Compton's injury, only that she questions Pachter's treatment. In other words, Compton may have been asking DPH whether Dr. Pachter breached a duty owed to her daughter. A jury could well find that Hardy, in writing to the DPH, was seeking answers about Pachter's performance and didn't know whether Pachter had done anything inappropriate. The letter described what happened in several situations in which her daughter didn't seem to have received quality care, and asked the Department to tell her whether Pachter's actions were inappropriate; i.e., did a breach in duty occur based on the treatment?
To make matters more confusing, when Hardy used the term "neglect," it is unclear if she was using the term in the legal sense, as in "I have a cause of action in negligence" or in the layperson's term, as in "Dr. Pachter is not seeing my daughter as often as I'd like him to." Although Hardy had criticized Pachter and St. Francis, her criticism was not necessarily evidence of the discovery of the injury. Indeed, there is a difference between criticizing a hospital for not meeting a subjective standard of care and criticizing the hospital for being negligent in the legal sense. For instance, when Hardy complains that a pulmonologist, a lung specialist, did not tend to her daughter's chest condition, it could be said that she was criticizing the hospital for not meeting her expectations of top-quality care, but that certainly does not infer that Hardy also believed that this omission alone meant that she and her daughter had a cause of action against the hospital. Likewise, when Hardy complained that the sickle cell center did not have a pediatric hematologist it could be viewed as a mother demanding the most qualified specialists to look after her daughter and not as evidence of a conclusion that this omission was actionable negligence.
Defendants contend that because Ms. Hardy has a medical background (she worked as a medical assistant for several years), she was better able to understand what was going on with her daughter's medical condition and, if the defendants had done anything wrong in treating her child, more capable of discovering that actionable negligence had occurred. Our Supreme Court has held that "there is no heightened duty for health care professionals to investigate claims of medical malpractice under the statute." Taylor v. Winsted Memorial Hospital, 262 Conn. 797, 800 (2003).
This case is a close one. The defendants have thoroughly pointed out all the times that Hardy questioned, criticized, and complained about Compton's treatment at St. Francis. Hardy even went to speak with a lawyer about a possible legal action against the defendants. However, it is entirely conceivable that plaintiff did complain about her daughter's treatment, and even listened to others complain about the treatment, and still did not understand or conclude that a breach of duty had occurred. If Hardy did not have knowledge that a legal breach of duty occurred, then she could not have knowledge of a causal connection between the supposed breach and any injury her daughter suffered.
Because reasonable minds could differ about when Ms. Hardy "discovered" what she believes was the defendants' professional negligence, this issue can only be resolved at trial.
The motion for summary judgment is therefore denied.