first case is if the moon is four thirteen zero one six one two thousand and six mitchell were fifty two year old he came to my client had a partner in a primary care physician in arthur illinois i thought he was perhaps diabetic and wanted to be checked out so working up for that  diabetes hypertension personal requiring referral but after three years mr worth took his treatment to another physician and then was later diagnosed with prostate cancer  unfortunately mr worth passed away during the pendency of this appeal from prostate cancer his wife now is the named plaintiff happen here the lawsuit centers around a failure to screen for prostate cancer affirmative defense i mean that part of this three year period was barred by the statute that required the circuit court to consider the case of cunningham vs which i would say correctly and house of law or  dealt with the rule of law that if there is a genius course treatment such that we can say that force is really one continuing wrong the statute of limitations is scheduled riposte starts running at the end of that   yes and your honor perhaps some of the questions that arise in this case are both interesting and worthwhile but yet not posed in this question for example is it negligent not to screen that's not the case before the question before the court and i'm not even contesting that issue for the purposes of this argument also it can screening be done negligently that's an interesting question too but it's also up before the cour of course blood test could be misread over a three year period again and again but this involves is whether there is a lack of treatment or that question that we probably all had this first year law students that senator running to black's law dictionary  if we didn't get it right in contracts we got to do it again and towards that question of whether nonfeasance is the same as misfeasance because there is a difference a very qualitative difference  pros and cons of the screen neither one of them as they interacted on these eighteen occasions over three years ever approached the subject symptoms didn't arise brought to medical attention medical attention  rash on my neck from my hearing is go away or something like that at the end of the three years and the doctor sent me a bill for not treating prostate cancer under the authority of cunningham versus huffman which for medicare fraud but if it never rises in the first place then we should be applying the rule of law it's a legislative rule in has an attempted that is to put an end to litigation at a certain her failure to conduct a specific prostate screening test with a fifty ish male who is overweight hypertensive diabetic or pre diabetic and someone would say well of course it is they ought to be and what one experience would say of course it is that's bad in itself is negligent in the continuous course of treatment was he was your you knew how old he was when you knew that he already had various physical complaints and i don't know if there's studies that show if you've got physical ailments another witness are more likely to show up  which side of the issue i would come down at the trial court level but i'm not contesting that issue i willing to say let the plaintiff approach for this court today that it is an explanation to the question is still a different one conceding i'm not testing for the point this argument today i'm not contesting at all i can i'll never concede in the trial court that is one of the central issue the supreme court however is the one who gave us this phrase and and that's why it's criteria but to get to your concern which you've defined for me well at this point the supreme court set the standard it's continuous a negative course of treatment or specific condition i'm afraid i'm stuck with that language so comply that be different than the general practitioner yes we're on zero so that's what i'm trying to emphasize it's not before the court today standard of care is not my opinion implicated in this in this in this question i'm not we're quoting the plaintiff's expert  didn't all of his care and treatment his universe of treatment did not include prostate cancer i think that's correct to let you know that your question also she said that's true and then here's the question the whole gist of this lawsuit and your testimony is he of this case and whether or not there was any negligence in the standard of care etc and deal with the question of  dismiss considered all well thanks but well played facts is true and in each of the eighteen visits it was described in the complaint in the amended complaint plaintiff alleged not only that he was there for whatever condition but was there for a general physical examination until you have just began i went past time fortunate on the evidence in this case at this point is that there is authority on the part of the general practitioner which was the defendant  each time a patient comes to him in this risk category a male over fifty two oftentimes whether they screen tests or walk or screening to offer a p s a so that's the underlying issue that we're looking at here  opinion and it's the plaintiff is in that case just the one who put the question before the court to ask whether there was a continuing course of care or your specific vision the court said we agreed but went to court and cunningham went on to say on given the circumstances appointees not part if she can't demonstrate there was an ongoing course of continuing negligent medical treatment the court did not say anything about a specific condition and its opinion doesn't hold back in for in hand really stands only for the proposition that has to be a continuous i'm going course of continuous medical treatment i guess the question here then has is medical treatment somehow different patient i think that's what that's what the hospital is telling the story that even though it is i think they are agreeing that mr worthless there is a patient who is getting care but they want to divorce or cut off patient care which would presumably include the duty to offer screening to the patient from the from the concept of medical treatment and i would suggest to the end this problem comes up because the statute that's showing by the facts of the the our point is that they've been in the hospital refer to cases where the the person was there was a general set of complaints and i think you're one of your coming i did not have to address a situation where it was a failure to screen and it's not just a failure to treat it's not just the failure to diagnose which is where i thought they might go we have got this such a very specific instance of a duty to screen for even know they have a duty to screen for glaucoma i had no idea that with the case of play found that he's now so you've got your talking by the very specific to hear this doctor yeah and that duty should be patient care and if he did it wrong it would be treatment if he doesn't one little thing that didn't come up that might change if the courts can actually answer the question here's a reminder that this doctor did in fact perform blood tests and he was criticized for not including the p s a test with simple blood so now we've got some actual care we've got a blood test being given and we've got the doctor not telling the hospital to run that additional tax that brings us even within the definition of the hospital this specific condition language is not a necessary fine that's correct i believe it is not part of the holding the court starts out with the plaintiff says and has the words necessary have a specific condition and then a simple words really and then when the court of course you when you go into the court's holding that disappears the court's holding doesn't talk about specific conditions the word specific conditions keep popping up down the road in other appellate cases but but nobody ever challenged it it was never relevant goes back to the cancer then because that's what we're not concerned with the same treatment thirty edition for once in my life i actually thought of a question before i stepped up to the picture on the difference there and that's why i raised it before we're talking about a separate qu a every time to the client the patient comes in when you come from diagnosis it's not clear at least surely not an issue here but it's not clear across the board it's that same doctor have a duty to make the diagnosis each time that's the distinction between  treatment there it has to be in the same condition that's just not there i'm my point is they're talking about a specific condition they want to specific conditions we've just and the risk the specific condition until you make a diagnosis that's i understand because there's no connection between the first error and the last error if you will worsen this case there is a connection between the first error is the same error all the way through should diagnoses just effective so often the screening exists all the way through whether there's a failure looking for a huge bright line rule i think the problems we're having here is that every time you try to do a bright line rule somebody comes up with a different set of facts if the lawyers don't the doctors well and realize that we have got to all of us yes thank you for the opportunity again the four specific condition language came when versus where there's just one we had a case their treatment over three years for multiple conditions and the court focus specifically on that language supreme court picked it up there so that's what the origin of that phrase secondly i found it again here and i want to leave this this word with you this is the new york court that we cited in our grief considering a similar issue they said this other 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