### IN THE COURT OF APP EALS OF TENNESS EE AT JAC KSON Ja nua ry 20, 200 9 S es sio n LOU EL LA SHE RIL L, ET AL 

### . v. BO B T. SOUDE R, M.D., ET AL 

### . Direc t Appeal from the Circ uit Court forMadison Cou nty

No. C04-5 D onald H. Allen, Jud ge

No. W2008-00741-C OA-R3-C V - Filed February 27, 2009
This is a medical malpra ctice c ase. The trial court g rante d summary judgme nt in favor of Appellee doctor finding that, based upon the discovery rule, the one y ear

statute of limitations for a medica l malprac tice cla im had expired prior to the filing of the Appellants’ c omplaint. Finding no e rror , we a ff ir m.
Tenn. R. App . P. 3 Appeal as of Right; Judgment of the Cir cuit Court Af firme d
J. S TE VE N S TA FF O RD , J., delivere d the opinion of the court, in which H OL LY M. K I RBY , J., joined. D AVI D R. F ARMER , J., Not Participating. Edmund J. Schmidt, III, David Randolph Smith, Nashville, TN, Da niel J. McGlynn, Baton Rouge, LA, for Appellants, Lou Ella Sherill and Bar bara A. Pigg
Jef fr ey L . Lay, Dye rsburg, TN, f or Appe llees, Bob T. Souder, M.D., a nd Transouth He althcar e Ce nte r, P.C.

OP IN ION
I n Marc h 2002, L ou Ella Sherrill, a re sident of Will ow Spring s, Missouri, was visiti ng her daug hter, Appe llant Ba

rbar a A. Pig g in J ackson, Te nnessee . During her visit, Ms. Sherrill developed na us e a and vo mit ing . O n M arc h 11 , 20 02 , Ms. She rr ill we nt to Tr ans Sou th He a lth Care Ce nte r, P.C. and wa s seen by Michae l Br iley , F.N.P. Mr. Briley presc ribed Ms. S herr ill 30 mi lligra ms of Reg lan pe r day

. Th e nex t day , M s. Pig g c a lle d th e c lin ic to i nf or m Mr . B ri le y

that he r m oth e r w a s st ill experiencingnausea

and vomiting. I n addition to the Reg lan, Mr. B riley also presc ribed Phene g ran. On Marc h 17, 20 02 , Ms. Pig g a g a in c a lle d th e c lin ic to a dv ise that Ms . Sh e rr ill ’s sy mpt oms ha d n ot a bate d, and

tha t th e Phe ne g ra

n w a s c a us ing Ms. She rr ill to e xpe ri e nc e se ve re dr ow sin e ss. Mr. B riley

order ed an a

bdominal ultrasound, which wa s perf ormed on Mar ch 18, 2002. TheOn Febr uar y 28, 2008, M s
. Pi gg m oved t o a m end t he com pl ai nt t o s ubs t i t ut e her s el f as t he s ol e pl ai nt i f f due 1
t o M s
. She r r i l l ’ s de at h. -2- ultrasound s h o we d

gal l s t o n es i nt h e ga l l b l ad d er ; h o we v er , t h e ga l l b l ad d er wa l l wa s n o rm al

. No other abnorma lities were se en. Mr. B riley

ref err ed Ms. Sherrill to Dr. Ge org e Thomas f or surg ical consultation. On Marc h 19, 2002, Dr. Thomas sa

w Ms. Sherrill, who complained of nausea and vomiting f or the pre vious sixte e n d ay s. Dr . T ho ma s r e fe rr e d M s. She rr ill to D r. B ob Sou de r (t og e the r w ithTr ans Sou th Hea lthcare Center, P.C., “Appe llees”) . Dr. Souder pe rfor med an uppe r pane ndoscopy on Marc h 20, 2002. Dr. S ouder ulti mately diag nosed Ms

. Sherrill with severe g astroesopha g eal r eflux disorder, a 9 ce ntimeter hiatal he rnia, g astroparesis , and chr onic ac tive g astritis. Bec ause Ms. Sherr ill had fa ile d to re sp on d to the do sa g e of Re g lan p re sc ri be d b y

Mr. Bril ey , Dr . So ud e r i nc re a se d M s. She rr ill ’s Re g lan, and

sc he du le d a

fo llo w- up vis it f

or Ap ri l 18 , 2 00 2. At th at app oi ntme nt, Ms. Sherrill was seen by nurse practicione r S tace y Hodg es. At t his visit , Ms. Sherrill was not having any vomiting or other

complaints. Ms. Sherrill soon returne d to he r home in Missouri, and reque sted that he r m e dic a l r e c or ds be fo rw ard e d to he r f a mil y ph y sic ian, Dr . Ra

mon d L e wa

nd ow sk i.
I n the summer of 2002, Ms. Sherr ill developed a move ment disorder that involved her fa ce, jaw a nd e xtre mit ie s. De sp ite tr e a tme nt f ro m D r. L e wa

nd ow sk i, t

he mov e me nt d iso rd e r b e c ame prog ressively

worse. B y

Aug ust of 2002, Ms. Sherrill’s leg movements wer e so dra stic that she was constantly

patting he r fe et and kicking her leg s. Ms. Sher rill a lso suf

fer ed from consta

nt chewing motions. During this entire per iod, Ms. Sherrill continued to take the Reg lan as pre scribed by Dr. Souder.
Dr . L e wa

nd ow sk i r e fe rr e d M s. She rr ill to D r. Cla ra Ap ple g a te , a ne ur olo g ist in We st Pl a ins , Missouri, who saw Ms. Sherrill for the first time on Dec ember 18, 2002. At that appointment, Dr. Ap p le g a te a ll e g e d ly in f

o r me d M s
. Sh e r

r il l th a t th e mo v e me n t d is o r d e r mi g h t h a v e b e e ntrig g ere d by the Reg lan, and that stopping the medication might abate t h e s y mptoms. Ms . Sherrill was ul ti mat ely

di agnos ed w it h t ardi ve d y sk in esi a
. S h e c o n t in uedto be t reat ed b y Dr. App legat e. By Marc h 18 , 20 04 , M s. She rr ill ’s tard ive dy sk ine sia sy mpt oms ha d r e so lve d. Whe n D r. Ap ple g a te la st saw Ms. Sherr ill in December 2005, she wa s fre e of any sy mptoms. Ms. Sher

rill die d of unre lated conditions on September 26, 2007.
On Janu ary 8, 20 04 , Ms. She rr ill and Ms. Pig g fi le d s uit a g a ins t D r. Sou de r a

nd Tr ans Sou th Hea lthcare Center, P.C., alleg ing tha t Dr

. Souder had br eac hed the a cce pted standar d or ca re by pr e sc ri bin g Re g lan f

or lon g -t e rm

us e , a nd that D r. Sou de r’ s ne g lig e nc e ha d c a us e d M s. She rr ill to develop tar dive dy skinesia. An Amende d Complaint was filed on April 8, 2004. 1
On Fe bruar

y 11, 2008, Dr. Souder a

nd TransSouth moved for summary judgme nt pursuant to T enn. Code Ann. §§ 29-26-116 and 28-3-104. The g rava men of the moti o n wa s t h at t he Appellants’ suit was time-ba rre d beca use Dr. A p p l ega t e had diag nosed Ms. Sherrill with tardiveOn Au g u s t 3, 20 0 5 , Ap p e l l e e s fi l e d a n i n i t i a l mo t i o n f o r s u mm a r y j u d g me n t o n t h e me r i t s o f l i a b i l i t y . On 2 Fe br uar y 8, 2006, A ppel l ee s m oved t o s t r i ke t hi s m ot i on. -3- dy sk ine sia

on De c e mbe r 1 8, 20 02

. On Februar y 21 , 2 00 8, Ap pe lla

nts fi le d d oc ume ntatio n in 2 opposition t o the m otion for summ ary judgme nt. Specifica lly Appellants assert that there are issues of ma te ri a l f

a c t a s to wh e n th e y

we re fu lly

inf or me d o f M s. She rr ill ’s tard ive dy sk ine sia dia g no sis , as we ll as to when they

discovere d that Dr. Souder’ s presc ribing long- term Reg lan use c onstitut ed ne g lig e nt c on du c t. The motion for summary

judgme nt was hea

rd on Marc h 7, 2008. On April 2, 2008, t he trial court g rante d the motion for s ummary judgme nt, finding that “Ms. Sherrill’s ca use of a ction acc rued and the one y ear statute of l imitations commence d to run on Dec ember 18, 2002; that the Complaint was filed mor e than one y ear later on January

8, 2004; and, that Ms. Sherrill was not suffe ring from any disability at the time the ca

use of a ction acc rued which would justify the tolling of the one y ear statute of limitations.” Ms. Pigg appea ls. The sole issue befor e this Court is whether the tria l court er red in g ranting summary judgme nt in favor of

Appellee s finding that the statute of limitations had ex pired.
I t is well settled that a motion for summary judgmen t s h o u l d b e g rante d when the mova nt demonstrates that there a

re no g enuine issues of material fa ct and that the movingparty is entitled t o a judgment as a

matter of la

w. See T e n n
. R. Ci v
. P. 5 6

. 0 4

. T h e p arty mo v in g f

o r s u mm ary judgme nt bear s the burden of demonstrating that no g enuine issue of m ater ial fac t exi sts. Se eBai n v . W e lls , 936 S.W .2d 618, 622 (Tenn.1997) . On a motion for summary judgme nt, the court must take the str on g e st l e g iti ma te vie w o f e vid e nc e in f a vo r o f t he no nmo vin g party , a llo w a ll r e a so na ble infere nces in f

avor of that par

ty , and disca

rd all counte rvailing evidenc e. See id. I n By rd v . Ha ll , 847 S.W .2d 208 (Tenn.1993) , our Supreme Court state d:

Once it is shown by

the m o v i n g p ar ty

that there is no ge nuine issue of mater ial fac t, the nonmoving pa rty must then demonstrate, by aff idavits or discovery materia l, that there is a g enuine, mate rial fa ct dispute to war

rant a trial. I n this reg ard, Rule 56.05 pr ovides that the nonmoving pa

rty cannot simply

rely upon his pleading s but must s et forth specific facts s howing that there is a genuine issue of mater ial fa c t f or tr ia l. Id . at 211 (c itations omi tted). Summary judgme nt is only appropr iate when the fac ts and the leg al conc lusions drawn fr om t h e facts rea sonably

permit only

one conc lusion. S

e eC a r v e l l v . B o t t o ms , 9 0 0 S. W. 2 d 2 3 , 26 (T e nn .1 99 5). Becaus e on ly qu e sti on s o f l aw a

re inv olv e d, the re is n o p re su mpt ion of c or re c tne ss reg ardinga trial c ourt' s g rant or de nial of summary judgme nt. Se eBai

n , 926 S.W .2d at 622. Th e re fo re , our re vie w of the tr ia l c ourt ' s g ra nt o f s umm ary

jud g me nt i s de novo on the record be fore this Court. Se eWa rre n v . Es tat eof Kir k , 954 S.W .2d 722, 723 (Tenn.1997)

.The di s cove r y r ul e w as de em ed nec es s ar y t o “ al l evi at e t he i nt ol er abl e r es ul t of bar r i ng a ca us e of a ct i on by 3 ho l di ng t hat i t ‘ acc r ued’ befor e t he di s covery of t he i n j u ry o r t h e w ro n g, ” Sha dri ck v. Co ker , 963 S. W

. 2d 726, 733 ( Tenn. 1998) ( quot i ng F o ste r v . H a rris , 633 S. W

. 2d 304 , 305 ( T enn. 198 2))

. O t herw i s e, a pl ai nt i f f w ou l d be re qu i r ed to su e to v in d ic a te a w ro n g a t a tim e w h e n th e in ju ry w a s “ u n k n o w n o r u n k n o w a b le .” Id

. ( quot i ng St anbur y v. Bacar di , 9 5 3 S.W

. 2 d 67 1 (T en n
. 1 9 9 7 ))

.
-4- Tenn. C o d e An n . § 28-3-104 mandates a one y ear statute of limitations from the date of acc rual of a

medical malpr actice claim. Concer ning the acc rual of the ac t ion, Tenn. Code Ann. § 29 -2 6- 11 6 s ta te s, in r e le va nt p art : (a) (1) The statute of limitations i n malprac tice ac tions shall be one (1) y ear as set for th in § 28-3-104. (2) In the eve nt the alleg ed injury is not discove red within such one (1) y ear period, the period of limitation shall be one (1) y ear from the d a t e o f s u c h d i s c o v e r

y. (3) In no event shall any such action be brought more than t hree (3) y ear s after

the date on w hich t he neglig ent act or omission occurre d except wher e ther e is fra udulent conce alment o n the par t of the defe ndant, i n which case the action shall be commenced within one (1 ) y e ar a ft e r d isc ov e ry

that th e c a

us e of a c tio n e xists

. Under this statute, which is known as the “disc overy rul e, ” t h e s t atute of limitations “commenc es to run whe n the patient ‘discove rs, or re ason ab l y s h o u l d have disc overe d, (1) the oc c a sio n, the mann e r, and the me ans by wh ic h a br e a c h of du ty oc c ur re d th a t pr od

uc e d [th e patie nt' s] injuries; a nd (2) the identity of the defe ndant who brea ched t h e d u t y
. ’” Shadr ick v. Coker , 963 3 S

. W

. 2 d 7 2 6 , 7 3 3 (T en n
. 1 9 9 8 ) ( qu o t i n g Stan bury v. Bacardi , 953 S.W .2d 671, 677 (Tenn.1997) ).
The discove ry

rule, whic h is at the ce nter of this issue, is succinc tly expla i ned by

the Te nn e sse e Sup re me Court a s f oll ow s: Th e pla int if

f may no t ... de lay fi lin g su it unt il all the inj ur iou s e ff e c ts an d c o n s e qu e n c e s o f th e a ll e g e d w r o n g ar e a c tu a ll y kn o w nto the plaintiff. Wyatt v

. A- Be st C ompan y , 910 S.W .2d 851, 855 (Tenn.1995) . Simi larly , the statute of limitations is not tolled until t he plaintiff ac tually

knows the “sp ec i fi c t y

pe of le g al claim he or

she has,” Sta nbur

y , 953 S.W .2d at 678, or that “the injury constituted a brea ch of the appropr iate leg al standar d,” Roe v. Je ffe rson , 875 S.W. 2d 653, 657 ( Te nn .1 99 4) . Rathe r, a s w e have re c e ntl y emphasized, the statute of limitations begins to run whe n the plaintiff kn ow s o r i n th e e xer c ise of reas on abl e c are and

dil ig e nc e sh ou ld know that an injury

has bee n sustained as a

result of wr o n gfu l or tortious conduct by

the def endant. Sta nbur

y , 9 53 S.W. 2d

a t 67 7; see also Roe , 875 S.W .2d at 657 (“ The plaintiff i s deeme d to have-5- discovere d the rig ht of action if he is awa re of fac ts sufficient to put a re a so na ble pe rs on

on no tic e tha

t he ha s suf

fe re d an inj ur

y a s a re su lt o f w r o n g f u l c o n d u c t

. ” )

. “ I ti s k

n o w l e d g e o f

f a c t s s u f f i c i e n t to puta plaintiff on notice that an injury has bee n sustained which is cr ucial.” Sta nbur y , 953 S.W .2d at 678. Such knowledge includes not only an awa rene ss of the i njury , but also the t ortious orig in or wrong ful nature of t hat injury

. Hat

hawa y v . Mid dle Te nne sse e Ane sthe sio log y , P . C. , 724 S.W .2d 355, 359 (Tenn.A pp.1986). [ Shadr ick , 9 6 3 S. W. 2 d

a t 7 3 3

- 3 4 ].
In t h e i r s t a t e m e n to f

u n d i s p u t e d

m a t e r i a l f

a c t s i ns u

p p o rto f t h e m o t i o nf

o r s u m m ar y, Appellee s contend that Appe llant’s cause of ac tion accr ued on De cembe r 18, 2002. On that date, Ap pe lle es ass e rt

that “ Dr . App le g a te fu lly inf or me d b oth Ms. She rr ill and

Ms. Pig g that Ms

. Sherrill’s movement disorder was tar dive dy skinesia that was c aused by taking the drugReg lan.” Appellee s further

contend that, on that date, Dr. A ppleg ate instructe d Ms. Sherrill to discontinue the Reg lan, and infor

med her that so doing w ould likely end her sy mptoms.
On Fe bruar

y 21, 2008, Appellant filed a st atement of undisputed materia l fac ts in oppositi on to the motion for summary judgme nt. There in, Ms. Pigg asser ts that she did not attend her mother ’s Dec ember

18, 2002 appointment with Dr. Appleg ate. Although Ms. Pi g g states that she did attend Ms. Sherrill’s J anuar

y 16, 2003 appointment with Dr. Appleg ate, she contends that ne ither Dr. Ap p l ega t e, n o r h er

p h y s i ci an ’s as s i s t an t , Br i an L en ah an , m en t i o n edt h at p re s cr i b i n g R egl an for longterm use wa s in violation of the professional standard of car e. I n fac t, in the statement of undisputed ma te ri a l f a c ts, Ms. Pig g a sse rt s th a t sh e did no t disc ov e r the c on ne c tio n unti l th e la te sp ri ngor e arl y summer of 2003 throug h her ow n internet re sear ch. We note that Ms. Piggcontra dicts this assertion i nh e r d e p o s i t i o nt e s t i m o n y: Q [to Ms. P igg] . When

did y ou –w he n w e re y ou

fi rs t–O r w he n d id y ou first lear

n that Reg lan might be a

possible cause of y our mother’ s movement disorder ?
A. B rian L enaha

n told me that it was the ca use. Q. Whe n d id h e te ll you

that? A. At the January , Fe bruar y visit.... Q. So it would have bee n J anuar y of 2003?
A. Ye s.-6- Q. Up un til that ti me ha d a ny on e tol d y ou

the re mig ht b e any

a dv e rs e eff ect of taking Reg lan?
A. No.
Dr. Clara Appleg ate wa s also deposed. She te stifies that Ms. Pigg did attend Ms.Sherrill’s Dec ember 18, 2002 appointment. Dr. Appleg ate testifies as follows conce rning what tra nspired at the De c e mbe r 1 8, 20 02 vis it:

Q.

.. .A s far as sittin g do wn and ta lki ngwi th M s. She rr ill on that f ir st v is it , w a s s h e a

b le to ta lk

w it h y o uin a n o r ma l w ay an d u n derstand what y ou wer e telling her?
A. She wa s. She g a ve the his tor y and he r d a ug hte r h e lpe d h e r. Ms. Sherrill did the majority

of the talking

.... Q. I t a p p e ar s f r o m yo u r o f f ic e n o te o nth a t f

ir s t v is it th a t y ou diag nosed Ms. Sherrill’s condition as tar dive dy skinesia?
A. I did.
* * * Q. I s stopping the of

fendingmedication the primary treatment of choice for this condition?
A. I t is

. Q

. A n d b a s e d u

p o n yo u r r e v i e w o f M s
. S h e r r i l l ’ s m e d i c a t i o nh i s t o r

y, did y ou de te rm ine wh a t y ou

fe lt t o b e the of

fe nd ingme dic a tio n in

thi s case
. A. I did. She was on [Regla

n]...and i t wa s m y t h eory that that was the ca use of he r movement disorde r. * * * Q. All rig ht. A fter you made your asse ssment in this initial vis it on De c e mbe r 1 8, 20 02 , w hat di d y ou te ll M s. She rr ill ?
A. Ia sk e d M s. She rr ill to s top takin g the Re g lan a nd tol d h e r Iwo uld see he r bac k in two to three we eks....-7- * * * Q. No w l e t me a sk

y ou a lit tle mor e abo ut y our c on ve rs a tio n w ith Ms. She rr ill and

he r d a ug hte r o n D e c e mber 18 , 20 02 . D id you te ll them that, even though it’s a medical term, did you tell them that y ou thought she had tar dive dy skinesia?
A. I think I probably

did. Iprobably

said, no, I

didn’t. I wouldn’t have sa id that. Iwould have sa id– Q. What w ou ld you

have tol d th e m?
A. I would h ave told them that I thought she had a move ment disorde r th a t m ig h t h a v e b e e ntr ig g e r e d b y th e me d ic a ti o nan d

that sto pp ingthe me dic a tio n mi g ht t a ke c are of it. Q. I n havin g su c h a c on ve rs a tio n wo uld y ou e mph a size to t

he patie nt, and in this case did y ou emphasize to the patient the importanc e of stopping the Reg lan?
A. Ye s. Q. Did y ou g o into a

ny detail at that time or g ive t h em any explanation as to how Reg lan or other drugs can cause this movement disorder?
A. I explained that any

exposure to these medications can trig g er su c h a dis or de r an d tha t the sid e e ff e c ts loo k like Park ins on ’s Di se a se in many case s and I

felt that that wa s what wa s wrongwith her.
Dr . App le g a te ’s te sti mony that App e lla nt wa s inf or me d of he r co nd iti on and the lik e ly c a us e on De c e mbe r 1 8, 20 02 is f

ur the r s up po rt e d b y

Ms. Pig g ’s de po sit ion tes ti mo ny that Ms . Sh e rr ill executed a dur able powe r of attorney on J anuar

y 6, 2003: Q. [T] here ’s a dur able powe r of attorney that Ms. Sherrill executed, making y ou her attorney

in fac t–
A. Um -h um. Q. –that was dated J anuar y 6, 2003. A. (The witness nodded.)-8- Q. Why did y ou have that dur a

ble po we r o f– Or

wh y did sh e e xec ute that durable power

of attorne y , if you know?
A. Tha t was aft

e r she was dia

gno se d with the t

ardiv edy skine sia

.... (Emphasis adde d).
The re cord indicates that, following the Dec ember 1 8 , 2 0 02 appointment with Dr. Appleg ate, Ms. Sherrill’s next appointm ent was not until at least January 16, 2003. Although Ms. Piggcontends that neither she , nor her mother, knew about t he tardive dy skinesia, or its cause , until at least J anuar y 16, 2003, Ms. Pigg ’s testimony ab o v e indicate s otherwise. Ms. Pig g ’s statement that he r mother executed the January

6, 2003 power

of attorne y

based, in pa

rt, upon the diag nosis of tardive dy skinesia, indicates that Ms. Sherrill knew about the diag nosis at the time she executed the pow er of a tto rn e y
. Gi vin g e ve ry inf e re nc e in fa

vo r of the Ap pe lla

nt a s the no n- mov ing pa

rty , at late st, Appellant knew

about the diag nosis on January 6, 2003. Even if the one y ear statute of limitations beg an t o ru n o n t h at day , the complaint in this case wa s not filed until J anuar y 8, 2004. Consequently , we ag ree with the trial court’s conclusion that the expiration of t h e s t at u t e of limit ations bars Appe llant’s case

. For the fore g oing r easons, we aff irm the o rd er o f t h e trial c ourt. Costs of this appeal ar e a s s e s s e d a g a i n s tt h e A p p e l l an t , B ar b ar a A

. P i g g a n d h e r s u r e t y.

___________________________________ J. STE VE N ST AFF OR D, J.