IN THE SUPREME COURT OF THE STATE OF DELAWARE

GI ASSOCIATES OF DELAWARE, 

P.A., ADVANCE ENDOSCOPY 

CENTER, LLC, and NATWARLAL 

RAMANI, M.D.,

Defendants Below,

Appellants,

v.

MONICA KING ANDERSON, 

Individually and as the Personal 

Representative of the ESTATE OF 

WILLIAM KING, STEPHANIE 

KING, HEATHER GUERKE, and 

AMBER WITHROW,

Plaintiffs Below,

Appellees.

§

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§ No. 355, 2022

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§ Court Below—Superior Court

§ of the State of Delaware

§ 

§ C.A. No. N18C-04-158

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 Submitted: September 23, 2022

Decided: October 21, 2022

Before SEITZ, Chief Justice; VALIHURA and VAUGHN, Justices.

ORDER

After careful consideration of the notice of interlocutory appeal and the

exhibits, it appears to the Court that:

(1) The appellants, GI Associates of Delaware, P.A., Advance Endoscopy 

Center, LLC, and Dr. Natwarlal Ramani, M.D. (collectively, the “Medical 

Providers”), have filed this interlocutory appeal from the Superior Court’s opinion,
2

dated August 24, 2022, denying the Medical Providers’ second motion for summary 

judgment (“the Opinion”).

1

 The appeal arises from a medical negligence action.

(2) Dr. Ramani is a gastroenterologist who performed colonoscopies on 

William King, a patient at high risk of developing colorectal cancer. In April 2011, 

Dr. Ramani performed a colonoscopy that showed benign tumors in King’s colon. 

On April 26, 2011, Dr. Ramani directed King to return for another colonoscopy in 

three to five years. King returned for a colonoscopy on March 23 2016,

2

but Dr. 

Ramani could not complete the procedure on that date because a malignant growth 

had formed in King’s colon. King died a few months later. The Estate of William 

King and members of King’s family (together, the “Plaintiffs”) filed a medical 

negligence action against the Medical Providers on April 16, 2018.

(3) In their first motion for summary judgment, the Medical Providers

argued that the statute the statute of limitations under 18 Del. C. § 6856 had expired 

by April 26, 2014, three years after the date that Dr. Ramani told King to return for 

a colonoscopy in three to five years. Applying the doctrine of continuous negligent 

medical treatment, the Superior Court denied the motion for summary judgment.3 

The court determined that Dr. Ramani’s recommendation on April 26, 2011 that 

1 Anderson v. GI Assocs. of Delaware, P.A., 2022 WL 3696776 (Del. Super. Ct. Aug. 24, 2022).

2 Previous decisions refer to the attempted colonoscopy as occurring on March 26, 2016, but the 

parties agree that the attempt took place on March 23, 2016. 

3 Anderson v. GI Assocs. of Delaware, P.A., 2020 WL 2070342, at *4-6 (Del. Super. Ct. Apr. 28, 

2020).
3

King return for a colonoscopy in three to five years and the attempted colonoscopy 

in March 2016—which the Plaintiffs did not contend was negligently performed—

constituted a continuous wrong.4 The court rejected the Medical Providers’ 

contention that the last act in the continuum must be a negligent act and held that the 

last act occurred in March 2016, when Dr. Ramani attempted but could not complete 

the repeat colonoscopy.5

(4) On interlocutory appeal, this Court reversed the Superior Court’s ruling 

that the statute of limitations began to run in March 2016 under the continuous 

negligent medical treatment doctrine.

6

 The Court held that the doctrine did not apply

in this case because the statute of limitations runs from the last act in the continuum 

of negligent treatment under that doctrine and there was no allegation of negligence 

associated with the colonoscopy attempted in March 2016.7 The Court also held that 

Section 6856 did not require the date of the alleged negligent act (April 26, 2011 in 

this case) to be the same as the date of the injury.

8

 If the Medical Providers pursued 

a statute of limitations defense on remand, this Court stated that the Superior Court 

should make a factual finding as to when the date of injury occurred and apply 18 

Del. C. § 6856 to that finding.9 

4

Id. at *6.

5

Id. at *5-6. 

6 GI Assocs. of Delaware, P.A. v. Anderson, 247 A.3d 674 (Del. 2021).

7

Id. at 681.

8

Id. at 685.

9

Id.
4

(5) On February 15, 2022, the Medical Providers filed their second motion 

for summary judgment. Relying on the deposition testimony of Plaintiffs’ expert, 

the Medical Providers argued that the date of King’s injury was on or before April

26, 2014 because if a colonoscopy had been performed by that date, then the cancer 

would have been diagnosed and more treatable. Under either a two-year or threeyear statute of limitations, the complaint would therefore be time-barred. The

Medical Providers argued in the alternative that Plaintiffs had not established the 

requisite causal connection between breach and injury. Plaintiffs opposed the 

motion, arguing that the date of injury coincided with the occurrence of metastatic 

cancer identified by Plaintiffs’ expert—sometime between April 11, 2016 and June 

23, 2016.

(6) On August 24, 2022, the Superior Court issued an opinion denying the 

motion for summary judgment.10 The court rejected the injury date offered by the 

Medical Providers, finding “no support under 18 Del. C. § 6856, case law, or this 

record that would allow it to determine an occurrence of injury existed on or before 

April 26, 2014.”11 The court emphasized that it could not make such a factual 

finding where the “only medical proffer” as to that date was “Plaintiffs’ expert 

opinion that if the colonoscopy had been performed on or before this date (three 

10 Anderson, 2022 WL 3696776, at *1.

11 Id. at *6.
5

years after Dr. Ramani found the benign tumors), then the cancer, if diagnosed at 

that time, would have been more treatable.”12 As between the two dates offered by 

the parties and considering all facts and reasonable inferences in a light most 

favorable to Plaintiffs under Superior Court Civil Rule 56, the court accepted 

Plaintiffs’ argument that King “suffered an occurrence of injury of metastatic 

disease” as early as April 11, 2016 for purposes of “personal injury” under Section 

6856.13 Based on the notice of intent provided by Plaintiffs under Section 6856(4), 

the court found Plaintiffs’ claims timely.14 Finally, the court found there was a 

genuine issue of material fact as to the causal nexus between Dr. Ramani’s alleged 

negligence and King’s death.15

(7) The Medical Providers filed a timely application for certification of an 

interlocutory appeal. Plaintiffs took no position on the application. The Superior 

Court granted certification on September 21, 2022. The found that the Opinion 

decided a substantial issue of material importance. As to the Rule 42(b)(iii) criteria, 

the court found that Rule 42(b)(iii)(A) (question of law resolved for first time in 

Delaware), Rule 42(b)(iii)(C) (question of law relating to construction of statute that 

has not been, but should be, settled in advance of final order), Rule 42(B)(iii)(G) 

12 Id. at *5-*6.

13 Id. at *7.

14 Id.

15 Id. at *7-8.
6

(interlocutory review may terminate the litigation), and Rule 42(b)(iii)(H) 

(considerations of justice) weighed in favor of certification.

(8) Applications for interlocutory review are addressed to the sound 

discretion of the Court.16 In the exercise of its discretion and giving due weight to 

the Superior Court’s analysis, this Court has concluded that the application for 

interlocutory review does not meet the strict standards for certification under 

Supreme Court Rule 42(b). There appear to be genuine issues of material fact that 

remain unresolved. Under these circumstances, the potential benefits of 

interlocutory review do not outweigh the inefficiency, disruption, and probable costs 

caused by an interlocutory appeal.17 

NOW, THEREFORE, IT IS ORDERED that the interlocutory appeal is 

REFUSED. 

BY THE COURT:

/s/ Karen L. Valihura

Justice

16 Supr. Ct. R. 42(d)(v).

17 Supr. Ct. R. 42(b)(iii).