Case Title: JEAN LEON JAUREGUI and JOSEPHINE C. JAUREGUI V. MEMORIAL HOSPITAL OF SWEETWATER COUNTY; and JOSEPH J. OLIVER, M.D.

Citation: 

Docket Number: 04-64

State: wyoming

Court: Wyoming Supreme Court

Date: 2005-05-13T00:00:00Z

Document:
JEAN LEON JAUREGUI and JOSEPHINE C. JAUREGUI V. MEMORIAL HOSPITAL OF SWEETWATER COUNTY; and  JOSEPH J. OLIVER, M.D.2005 WY 59111 P.3d 914Case Number: 04-64Decided: 05/13/2005
 
 
APRIL 
TERM, A.D. 2005

 
 
                                                                                                            

 
 
JEAN 
LEON JAUREGUI and

JOSEPHINE 
C. JAUREGUI,

 
 
Appellants

(Plaintiffs),

 
 
v.

 
 

MEMORIAL 
HOSPITAL OF 
SWEETWATER

COUNTY; 
and JOSEPH J. OLIVER, M.D.,

 
 
Appellees

(Defendants).

 
 
 
 
Appeal 
from the DistrictCourtofSweetwaterCounty

 
 

Representing 
Appellant:

Jeremy 
D. Michaels of Michaels and Michaels, Gillette, 
Wyoming; Philip White, Jr., Laramie, Wyoming.  
Argument by Mr. Michaels.

 
 

Representing 
AppelleeMemorialHospital of SweetwaterCounty:

George 
E. Powers, Jr., and Isaac N. Sutphin of Sundahl, Powers, Kapp & Martin, 
Cheyenne, Wyoming.  
Argument by Mr. Powers.

 
 

Representing 
Appellee Joseph J. Oliver, M.D.:

W. Henry 
Combs, III, and Kathleen J. Swanson of Murane & Bostwick, LLC, Casper, Wyoming.  
Argument by Ms. Swanson.

 
 
Before 
HILL, C.J., and GOLDEN and VOIGT, JJ., and PERRY and BURKE, 
DJJ.

 
 
GOLDEN, 
J., delivers the opinion of the Court; BURKE, D.J., files a specially concurring 
opinion.

 
 
 
 

GOLDEN, 
Justice.

 
 

[¶1]          
Appellants 
Jean Leon and Josephine Jauregui brought a medical malpractice action against 
Memorial Hospital of Sweetwater County (the Hospital) and Dr. Joseph 
Oliver.  The district court 
dismissed the action as to the Hospital, holding that the action was barred as 
to the Hospital because the Jaureguis had not filed a governmental claim within 
the time frame established by Wyo. Stat. Ann. § 1-39-113 (LexisNexis 2003).  The district court granted summary 
judgment in favor of Dr. Oliver because the Jaureguis had not filed their 
complaint within the time mandated by the malpractice statute of limitations, 
Wyo. Stat. Ann. § 1-3-107 (LexisNexis 2003).  We affirm the dismissal of the claim 
against the hospital but reverse the grant of summary judgment in favor of Dr. 
Oliver and remand.

 
 
 
 
ISSUES

 
 

[¶2]          
The 
Jaureguis present the following three issues for this Court's 
review:

 
 
1.  As to both the Hospital and Dr. Oliver, 
did the continuing treatment rule and/or the continuing tort rule toll the 
running of the malpractice statute of limitation and the notice of claim statute 
at least until the date of the second surgery on February 26, 1999, only a month 
and a half after the initial surgery?

 
 
2.  As to both the Hospital and Dr. Oliver, 
did the district court commit an error of law in its interpretation of the 
discovery exception [to] the applicable statutes?

 
 
3.  If the district court's interpretation 
of the discovery exception in the applicable statutes of limitation was correct, 
do those statutes violate the equal protection provisions (Art. I, §§ 2 and 3), 
the due process provision (Art. I, § 6), the open courts provision (Art. I, § 
8), the uniform operation of laws provision (Art. I, § 34) and/or other 
provisions of the Wyoming Constitution?

 
 
Both Dr. 
Oliver and the Hospital generally join these issues, although both question 
whether the constitutional challenges presented by the Jaureguis in their third 
issue are properly before this Court.

 
 
 
 
 
 
 
 
 
 
FACTS

 
 

[¶3]          
The 
pertinent allegations in the Jaureguis' complaint are that Dr. Oliver operated 
on Mr. Jauregui at the Hospital, and was assisted by Hospital staff, to repair a 
torn rotator cuff tendon on January 11, 1999.  A week later Mr. Jauregui returned to 
Dr. Oliver to have the stitches removed.  
At that time, an infection was present.  On February 26, 1999, Dr. Oliver again 
operated on Mr. Jauregui's shoulder at the Hospital.1 During this operation, a surgical 
sponge was found that had been left inside Mr. Jauregui's shoulder during the 
first operation.  Deposition 
testimony revealed that the Jaureguis were informed of the presence of the 
surgical sponge immediately following the February surgery.  The Jaureguis contended that all parties 
were negligent in leaving the sponge in Mr. Jauregui's shoulder.  The Jaureguis filed both a governmental 
claim form with the Hospital and their complaint in district court on February 
26, 2001.  

 
 
 
 
STANDARD 
OF REVIEW

 
 

[¶4]          
The 
district court dismissed the cause of action against the Hospital finding that 
it lacked subject matter jurisdiction.  
This Court reviews issues concerning subject matter jurisdiction de 
novo.  Nyberg v. State Military 
Dept., 2003 WY 43, ¶8, 65 P.3d 1241, ¶8 (Wyo. 2003) ("We review 
jurisdictional questions de novo pursuant to our power and duty to address 
jurisdictional defects.").

 
 

[¶5]          
The 
district court granted summary judgment in favor of Dr. Oliver.  The scope of our review of the granting 
of a motion for summary judgment is plenary.  "In reviewing summary judgment orders, 
we have the same duty, review the same materials, and follow the same standards 
as the district court."  Merrill 
v. Jansma, 2004 WY 26, ¶6, 86 P.3d 270, ¶6 (Wyo. 2004).  In this appeal, no factual issues are 
contested.  This Court reviews 
issues of law de novo, according no deference to the district court's decision 
on issues of law.  Id. at 
¶7.

 
 
 
 
DISCUSSION

 
 
The 
Hospital

 
 

[¶6]          
Because 
the Hospital qualifies as a governmental entity, any action against it must 
comply with the Wyoming Governmental Claims Act, Wyo. Stat. Ann. §§ 1-39-101 
through 1-39-121 (LexisNexis 2003), as well as requirements of the Wyoming 
Constitution.  The argument of the 
parties, and the decision by the district court dismissing the complaint, 
revolve solely around whether the notice of claim was brought within the time 
frame of § 1-39-113.  However, this 
Court can affirm on any lawful reason reflected in the record.  Pasenelli v. Pasenelli, 2002 WY 
159, ¶16, 57 P.3d 324, ¶16 (Wyo. 2002) ("This Court may affirm a judgment or 
order on any legal ground appearing in the record.").  We therefore choose not to discuss the 
time frame set by the claims procedure but rather affirm the dismissal for a 
much more simple reason.  The notice 
of claim submitted to the Hospital and attached to the complaint of the 
Jaureguis, while signed by the Jaureguis, is not certified to under penalty of 
perjury as required by the Wyoming Constitution.

 
 

[¶7]          
Article 
16, § 7 of the Wyoming Constitution commands: 

 
 
No money 
shall be paid out of the state treasury except upon appropriation by law and on 
warrant drawn by the proper officer, and no bills, claims, accounts or demands 
against the state, or any county or political subdivision, shall be audited, 
allowed or paid until a full itemized statement in writing, certified to 
under penalty of perjury, shall be filed with the officer or officers 
whose duty it may be to audit the same.

 

(Emphasis 
added).  Failure to adhere to the 
constitutional requirement that the notice of claim be certified to under 
penalty of perjury prevents the district court from acquiring subject matter 
jurisdiction over the claim.  
Yoak v. Ide, 2004 WY 32, ¶8, 86 P.3d 872, ¶8 (Wyo. 2004) ("We have 
affirmed dismissal of the appellant's complaint because her underlying 
governmental claim did not meet the constitutional signature and certification 
requirements."); Beaulieu v. Florquist, 2004 WY 31, ¶15, 86 P.3d 863, ¶15 
(Wyo. 2004) ("The courts do not have subject matter jurisdiction over a 
governmental claim that has not met the . . . constitutional signature and 
certification requirements.").  For 
the foregoing reason, we affirm the dismissal of the complaint against the 
Hospital. 

 
 
 
 
Dr. 
Oliver

 
 

[¶8]          
The time 
for bringing a legal action against Dr. Oliver is governed by the malpractice 
statute of limitation, § 1-3-107, which in pertinent part 
reads:

 
 
Act, 
error or omission in rendering professional or health care 
services.

 
 
(a) A 
cause of action arising from an act, error or omission in the rendering of 
licensed or certified professional or health care services shall be brought 
within the greater of the following times:

(i) 
Within two (2) years of the date of the alleged act, error or omission, except 
that a cause of action may be instituted not more than two (2) years after 
discovery of the alleged act, error or omission, if the claimant can establish 
that the alleged act, error or omission was:

(A) Not 
reasonably discoverable within a two (2) year period; or

(B) The 
claimant failed to discover the alleged act, error or omission within the two 
(2) year period despite the exercise of due diligence.

 
 
* * * 
*

(iv) If 
under paragraph (i) or (ii) of this subsection, the alleged act, error or 
omission is discovered during the second year of the two (2) year period from 
the date of the act, error or omission, the period for commencing a lawsuit 
shall be extended by six (6) months.

 
 
In 
applying this statute, the district court determined that any potential 
negligent "act, error or omission" occurred during the January 11, 1999, 
surgery, and therefore the action should have been filed no later than January 
11, 2001.  The Jaureguis argue that 
the time for filing the action should run from the date the alleged negligence 
was discovered, which was when the sponge was discovered and removed on February 
26, 1999.

 
 

[¶9]          
While 
the district court engaged in statutory interpretation in reaching its decision, 
we find it unnecessary to engage in such an exercise.  Prior precedent from this Court is 
directly applicable and determinative of the outcome of this appeal.  This Court has held on many occasions 
that § 1-3-107 is a discovery statute.  
Almost twenty years ago, this Court, in Metzger v. Kalke, 709 P.2d 414 (Wyo. 1985), in construing § 1-3-107, defined the "act, error or omission 
which starts the running of the statute of limitations against malpractice 
actions" as "the termination of the course of treatment for the same or related 
illnesses or injuries."  Id. at 417.  This is commonly referred to as the 
"continuous treatment" doctrine.  
The legislature has not changed the statute since Metzger was 
decided.  The continuous treatment 
doctrine remains applicable in Wyoming.

 
 

[¶10]      
The 
continuous treatment doctrine is founded upon sound policy.  The nature of the physician-patient 
relationship requires the patient to rely on the knowledge and skill of the 
doctor. At the stage where the physician is providing a diagnosis and advice for 
the patient's medical care, the patient cannot be expected to know that the 
doctor's actions might be negligent and result in harm or to question them.  The continuous treatment doctrine 
directly applies to the instant case.  
Dr. Oliver's treatment to repair Mr. Jauregui's torn rotator cuff tendon 
did not end with the first surgery.  
Dr. Oliver continued to treat Mr. Jauregui specifically with regard to 
his rotator cuff tendon surgery.  
Dr. Oliver treated the immediately ensuing infection, and Dr. Oliver 
performed the second surgery wherein the surgical sponge was removed.  Each treatment up to the second surgery 
on February 26 was directly connected to the initial surgery.  Thus, the act constituting the final act 
in the course of treatment for the surgical repair of Mr. Jauregui's torn 
rotator cuff was the second surgery.  
The statute of limitation thus began to run as of the date of the second 
surgery.  The underlying malpractice 
action, brought within two years of that date, is not time 
barred.

 
 

[¶11]      
Dr. 
Oliver argues that the "single-act" exception to the continuous treatment 
doctrine applies to the facts of this case.  Dr. Oliver argues that the continuous 
treatment doctrine applies only when there is no single identifiable act of 
malpractice from which the statute of limitation can be said to run.  Dr. Oliver contends that, in the instant 
case, any alleged malpractice was a single act that, if it occurred at all, 
occurred during the January 11, 1999, surgery.  Thus, according to Dr. Oliver, the 
continuous treatment doctrine does not apply and the statute of limitation began 
to run on January 11, 1999.

 
 

[¶12]      
While it 
is true that the continuous treatment doctrine applies to cases involving a 
continuous course of treatment where no single act can be pointed to as the act 
of malpractice, see Sharsmith v. Hill, 764 P.2d 667 (Wyo. 1988) 
(negligent misdiagnosis); Metzger v. Kalke, 709 P.2d 414 (Wyo. 1985) 
(negligent misdiagnosis), the doctrine is not so strictly limited.  Minnesota courts have offered a very complete 
definition of the "single-act" exception:

 
 
At the 
time Doyle filed her May 6, 1999, claim, the medical malpractice statute of 
limitations required that claims be commenced within two years of the accrual of 
the cause of action. See Minn. Stat. § 541.07(1) (1998).  Generally, the "cause of action accrues 
when the physician's treatment for a particular condition ceases." Grondahl 
v. Bulluck, 318 N.W.2d 240, 243 (Minn. 1982) (citation omitted). This is the 
general termination of treatment rule.

But 
where there is a single act of allegedly negligent conduct, the statute of 
limitations begins to run at the time the plaintiff sustains damage from the 
act. Offerdahl v.    University of    Minn. Hosps. & Clinics, 426 N.W.2d 425, 428-29 (Minn. 1988).  More precisely, the cause of action 
begins to run at the time of the negligent act (and not at the end of the course 
of treatment) when the alleged tort consists of (1) a single act; (2) which is 
complete at a precise time; (3) which no continued course of treatment can 
either cure or relieve; and (4) where the plaintiff is actually aware of the 
facts upon which the claim is based; that is, the plaintiff is aware of the 
malpractice prior to the end of treatment. Swang v. Hauser, 288 
Minn. 306, 
309, 180 N.W.2d 187, 189-90 (1970). We refer to this rule as the "single-act" 
exception.

 
 

Doyle v. 
Kuch, 611 N.W.2d 28, 31 (Minn. App. 2000).  

 
 

[¶13]      
While 
the underlying facts of the instant case support a finding of the first two 
factors, it is factors three and four that are not supported.  Dr. Oliver's continued treatment did in 
fact relieve the problem created by the alleged malpractice, and neither the 
Jaureguis nor Dr. Oliver knew of the alleged act of malpractice prior to the 
date Dr. Oliver completed his surgical treatment of Mr. Jauregui.  The single-act exception does not apply 
to these facts.

 
 

[¶14]      
Even if 
this Court were to determine that a single act of negligence occurred, the 
definition of a single act of negligence is not limited to the initial January 
11, 1999, surgery.  The term 
"single-act" is misleading.  In 
Haberle v. Buchwald, 480 N.W.2d 351 (Minn. App. 1992), Dr. Buchwald 
performed gastric bypass surgery on Haberle on January 13, 1986. Severe 
complications arose, and two emergency surgeries were conducted within days of 
the initial surgery, the first on January 17 and the second on January 21.  During the January 21 surgery, necrotic 
tissue was discovered, and the surgeon had no choice but to remove 80% of 
appellant's stomach.  The surgeon 
also had to disconnect appellant's esophagus from her bowel, place a tube in her 
neck to drain her esophagus, and place a feeding tube in her abdomen.  Haberle continued treatment with Dr. 
Buchwald with regard to the gastric bypass surgery and the ensuing 
complications.  Id. at 
353-54.

 
 

[¶15]      
In 1989, 
Haberle sued Dr. Buchwald.  Haberle 
asserted the continuous treatment doctrine tolled the two-year statute of 
limitations.  The Minnesota court applied 
the four factors of the single-act exception to the facts of Haberle's 
malpractice claim and determined that the single-act exception 
applied:

 
 
Following 
the January 21 surgery, appellant either knew or should have known that there 
had been substantial and unforeseen complications. She had lost 80% of her 
stomach, and was being fed through a tube in her abdomen. From a common sense 
viewpoint, it is clear appellant knew or should have known the facts upon which 
her claim could be based as of January 21, 1986. Accrual of a cause of 
action need not wait until a plaintiff in fact has sought an expert opinion 
stating there was a departure from accepted medical practice. Acceptance of such 
a position would emasculate the single act exception. 

 
 
In 
conclusion, we note that the phrase "a single act of malpractice" is a 
misleading title for the legal concept it identifies. The rule applies, not to 
conduct that starts and ends in a moment, but rather to a course of malpractice 
which terminates at a specific point in time. In this instance, the alleged 
malpractice clearly ended on January 17, with the emergency exploratory 
operation. All subsequent treatment was independent of the alleged malpractice 
and in no way negligent. Following the January 21 surgery, appellant's injuries 
were obvious, and the facts upon which her claims are based were readily 
obtainable and discoverable at that point.

 
 
A 
literal interpretation of the "single act" requirement would mean the statute of 
limitations would never run for a physician who continued to provide treatment. 
A rule of law that would force a doctor to terminate treatment in order to have 
the benefit of the statute of limitations would be unfair, protecting all 
doctors except those who continue to provide care. It is unfortunate that this 
exception acquired the name "single act" when what was intended is quite a 
different matter, termination of the episode of malpractice at an identifiable 
point in time.

 
 

Id. 
at 
356-57.  Thus, the "single act" was 
actually a course of treatment culminating with obvious damages at a time 
certain.  Applying this analysis to 
Mr. Jauregui's situation, the "single act" was the course of treatment 
terminating in the second surgery on February 26, 1999.  Again, the underlying action, filed by 
the Jauregui's on February 26, 2001, is timely.

 
 
 
 
CONCLUSION

 
 

[¶16]      
The 
Jaureguis failed to file a notice of claim against the Hospital that was sworn 
to under penalty of perjury as required by the Wyoming Constitution.  This failure deprived the district court 
of jurisdiction over the potential claim.  
The cause of action against the Hospital was correctly 
dismissed.

 
 

[¶17]      
The 
district court erred, however, in granting summary judgment in favor of Dr. 
Oliver.  The finding by the district 
court that the "act, error or omission" that triggers the running of the statute 
of limitation under § 1-3-107 was the first surgery when the sponge was left in 
Mr. Jauregui's shoulder ignores almost twenty years of precedent of this 
Court.  This Court has clearly 
defined the "act, error or omission" under § 1-3-107 as being "the termination 
of the course of treatment for the same or related illnesses or injuries."  In this case, the February 26, 1999, 
surgery was a direct continuation of the course of treatment begun by the 
initial January surgery.  The 
Jaureguis' action, brought on February 26, 2001, is 
timely.

 
 

[¶18]      
Affirmed 
in part and reversed in part.  This 
case is remanded to the district court for further proceedings consistent with 
this opinion.

  

BURKE, 
District Judge, specially concurring.

 
 
[¶19]   I agree with the result reached by the 
majority.  I write separately 
because I disagree with the rationale provided by the majority for dismissal of 
the Jaureguis' claim against the Hospital.

 
 

[¶20]   The majority dismisses the claim against the 
Hospital for failure to comply with the certification requirements of 
Article 16, § 7 of the Wyoming Constitution.  This defense was not asserted by the 
Hospital.  Such defense was 
waived.  See my dissent in 
Wooster v. Carbon Co. School Dist. No. 1, 2005 WY 47, 109 P.3d 893 (Wyo. 
2005).

 
 
[¶21]   I would affirm dismissal of the 
Jaureguis' claim against the 
Hospital because it was untimely.  
It is undisputed that the Jaureguis' claim was not filed within two years 
of the original surgery performed at the Hospital on January 11, 1999.  The Jaureguis did not file their Notice 
of Claim against the Hospital until February 26, 2001.  The complaint does not allege facts 
which, if interpreted in the light most favorable to the Jaureguis, would 
warrant application of the continuous treatment doctrine to the claim against 
the Hospital.  The Jaureguis' claim 
against the Hospital is barred by their failure to comply with the two year time 
limitation for filing a claim as required by Wyo. Stat. Ann. § 1-39-113.  

 
 
FOOTNOTES

 
 

1The 
Complaint incorrectly states that the February surgery occurred on February 27, 
1999.  All parties agree that the 
second surgery occurred on February 26, 1999. The variance is irrelevant to the 
issues raised.