Case Name: Barbara HUSS and Rodney Huss v. John Overton GAYDEN, M.D. and Memphis Obstetrics and Gynecological Association, Inc.
Court: Mississippi Supreme Court
Jurisdiction: Mississippi
Decision Date: 2008-09-25
Citations: 991 So. 2d 162
Docket Number: No. 2007-FC-02165-SCT
Parties: Barbara HUSS and Rodney Huss v. John Overton GAYDEN, M.D. and Memphis Obstetrics and Gynecological Association, Inc.
Judges: SMITH, C.J., WALLER, P.J., EASLEY, CARLSON AND DICKINSON, JJ., CONCUR. EASLEY, J., CONCURS WITH SEPARATE WRITTEN OPINION JOINED BY WALLER, P.J. GRAVES, J., DISSENTS WITH SEPARATE WRITTEN OPINION JOINED BY DIAZ, P.J. LAMAR, J., NOT PARTICIPATING.
Reporter: Southern Reporter, Second Series
Volume: 991
Pages: 162–175

Head Matter:
Barbara HUSS and Rodney Huss v. John Overton GAYDEN, M.D. and Memphis Obstetrics and Gynecological Association, Inc.
No. 2007-FC-02165-SCT.
Supreme Court of Mississippi.
Sept. 25, 2008.
Jenny M. Virden, John H. Daniel, III, Greenville, Ralph E. Chapman, Clarksdale, attorneys for appellants.
Mark P. Caraway, Jackson, Meta S. Copeland, attorneys for appellees.

Opinion:
RANDOLPH, Justice,
for the Court.
¶ 1. This is a certified question from the United States Court of Appeals for the Fifth Circuit. The underlying facts and legal proceedings were aptly summarized by the Fifth Circuit in Huss v. Gayden, 508 F.3d 240, 242-44 (5th Cir.2007), and do not bear repeating. Pursuant to Mississippi Rule of Appellate Procedure 20(a), this Court accepts the following certified question:
[w]hen the alleged negligence is (1) administration of a drug by a physician, or (2) failure to disclose what a reasonable practitioner would have disclosed about the risks of a drug, and experts disagree as to whether the drug caused the plaintiffs injuries, is the date that the alleged act, omission or neglect might, with reasonable diligence, have been first known or discovered by the plaintiff the date her condition or illness is diagnosed by non-defendant physicians or experts, or the date the pertinent facts are available in medical records, or is limitations tolled until one in a series of physicians or other experts the plaintiff consults first tells her that the drug caused her condition or illness? [ ]
Id. at 241-42.
CERTIFICATION
¶ 2. Mississippi Rule of Appellate Procedure 20(a) provides, in part, that:
[w]hen it shall appear to the . United States Court of Appeals that there may be involved in any proceeding before it questions or propositions of law of this state which are determinative of all or part of that cause and there are no clear controlling precedents in the decisions of the Mississippi Supreme Court, the federal court may certify such questions or propositions of law of this state to the Mississippi Supreme Court....
Miss. R.App. P. 20(a) (emphasis added). The rule further states that "[t]he Supreme Court may, in its discretion, decline to answer the questions certified to it." Id. This Court finds itself in a bit of a quandary, for in some respects we agree with the panel dissent that there is "no ambiguity in the case law that warrants certification." Huss, 508 F.3d at 249 (Higginbotham, J., dissenting). Notwithstanding that conclusion, out of comity and respect for the judges of the Fifth Circuit who seek our input, this Court humbly offers the following response to their inquiry.
RESPONSE
¶ 3. The illusion of uncertainty and tension described by the panel majority regarding our Court's application of Mississippi Code Annotated Section 15 — 1— 36 is produced by factual distinctions, rather than conflicting interpretations of the same controlling law. Statutes of limitation reflect the legislative decision to extinguish a remedy, if a claim is not filed within a prescribed period. Unfortunately for Mississippi courts analyzing the statute of limitations in the medical-malpractice genre of cases, determining the commencement of the statute is seldom a mechanical or routine task. Given the inherent complexity of many medical-malpractice cases, the commencement date of the legislatively-enacted limitations period requires a case-by-case analysis. See Sarris v. Smith, 782 So.2d 721, 725 (Miss.2001).
¶ 4. Additionally, identifying the commencement and expiration dates of the statute of limitations is only part of the equation. When a plaintiff brings suit, a defendant is obligated to affirmatively assert a statute-of-limitations defense, in or der to receive its benefit. See Miss. R. Civ. P. 8(c) ("[i]n pleading to a preceding pleading, a party shall set forth affirmatively . statute of limitations . and any other matter constituting an avoidance or affirmative defense."); Fed.R.Civ.P. 8(c)(1) ("[i]n responding to a pleading, a party must affirmatively state any avoidance or affirmative defense, including . statute of limitations^]"). While the obvious benefit of this affirmative defense is sought procedurally, its effect (i.e., extinguishing the remedy) is a substantive right to which Mississippi law applies. Under Mississippi law, the plea of statute of limitations is an affirmative defense for which the party asserting it has the burden of proof. See Smith, 485 So.2d at 1053 (citations omitted); Natchez Electric v. Johnson, 968 So.2d 358, 361 (Miss.2007). The panel dissent observed:
[t]he defendants requested no jury instruction regarding limitations and did not argue before the jury that the Huss-es had sufficient knowledge to trigger the running of the statute of limitations; rather, they argued causation, that not even the defendant doctors could have known whether Terbutaline caused, or could have caused, Huss's condition — an idiopathic phenomenon. As the magistrate judge noted in rejecting defendants' post-judgment motion, which raised the statute of limitations defense, "[the] defendants failed to establish the approximate date on which the statute of limitations began to run" because "there was no proof of the date by which plaintiff knew or should have known [that Terbutaline was probably the cause of her injury and that her physicians should not have given her the drug]." Having chosen not to pursue the statute of limitations at trial and, therefore, having failed to develop evidence on the defense, defendants make the tendentious request that this court conclude as a matter of law that the defense, which is by its very nature a fact driven inquiry, bars Huss's claim.
Huss, 508 F.3d at 248-49 (Higginbotham, J., dissenting). The success vel non of this disputed affirmative defense requires a jury determination, but only if actually presented. Under Mississippi law, Gay-den's failure to establish factually the proof necessary to be accorded the protection created by this substantive right, precludes Gayden from prevailing upon it as a matter of law. This substantive issue should not be confused with the separate procedural issue of whether the defense is raised, preserved or should be barred, all of which are controlled by federal procedural law.
¶ 5. Under either subsection (1) or (2) of Mississippi Code Annotated Section 15-1-36, a medical-malpractice action must be "filed within two (2) years from the date the alleged act, omission or neglect shall or with reasonable diligence might have been first known or discovered." Miss.Code Ann. § 15-1-36(1) & (2) (Rev.2003). In passing Mississippi Code Annotated Section 15-1-36, the Legislature shortened the limitation period for bringing a medical-malpractice suit, but adopted a " 'discovery' standard" for triggering the running of the statute. Sweeney v. Preston, 642 So.2d 332, 333 (Miss.1994). Under the "discovery rule," which tolls the statute of limitations, see Sarris, 782 So.2d at 724, the central inquiry is:
the time that the patient discovers, or should have discovered by the exercise of reasonable diligence, that he probably has an actionable injury. The operative time is when the patient can reasonably be held to have knowledge of the injury itself, the cause of the injury, and the causative relationship between the injury and the conduct of the medical practitioner.
There may be rare cases where the patient is aware of his injury prior to the two years immediately preceding the filing of his claim, but does not discover and could not have discovered with reasonable diligence the act or omission which caused the injury. In such cases, the action does not accrue until the latter discovery is made.
Smith, 485 So.2d at 1052-53 (emphasis added). In Sutherland, this Court recently focused the inquiry "on when a plaintiff, exercising reasonable diligence, should have first discovered the negligence, rather than the injury." Sutherland, 959 So.2d at 1008 (emphasis added). There, the plaintiff admitted knowledge of the injury, and this Court found that:
[i]n applying the unambiguous language of Miss.Code Ann. § 15-1-36(2), although a hidden or unseen injury might very well serve to trigger the discovery rule and toll the statute of limitations, it is not because the injury itself is hidden or unknown, but rather because the negligence which caused the injury is unknown. Furthermore, in the medical malpractice context, the discovery rule may apply in cases where the injury is not latent at all, but where the negligence which caused the injury is unknown. For instance, a patient who undergoes a medical procedure may develop serious complications which are clearly known. However, if the patient has no reason to know that the doctor's negligence in performing the procedure caused the complications, the discovery rule will apply, even though the injury itself is not latent at all.
Id. at 1008-09 (emphasis added). This Court has consistently utilized the aforementioned application of the "discovery rule." As the panel dissent noted, "Sutherland and the other case law reflect that all three factors are involved when applying the discovery rule.... " Huss, 508 F.3d at 250 (Higginbotham, J., dissenting).
¶ 6. "Application of the discovery rule is a fact-intensive process." Sarris, 782 So.2d at 725. See also PPG Architectural Finishes, Inc. v. Lowery, 909 So.2d 47, 51 (Miss.2005). Of particular import, this Court has stated that:
"the question of what knowledge should put a claimant on notice of the existence of a viable claim is not soluble by any precise formula." [Waits v. United States, 611 F.2d 550, 552 (5th Cir.1980)]. Some plaintiffs might need medical records in order to know of negligent conduct, and yet might still be barred if they failed to diligently seek those records. Others might gain actual knowledge of negligent conduct through personal observation or other means; such plaintiffs are not entitled to wait until they have medical records before the statute begins to run.
Sarris, 782 So.2d at 725. In determining the applicability of the "discovery rule," a review of Mississippi cases reveals the existence of dissimilar factual patterns which prevent application of a rote formula, despite adherence to the statutory language. Thus, the "uncertainty" and "tension" alluded to by the panel majority is not a product of the alteration of settled principles, but rather driven by diversity of facts. Ipso facto, not all medical-malpractice cases are subject to summary treatment, especially if the operative facts are disputed. See Smith, 485 So.2d at 1053. Thus, in Mississippi, when a valid factual dispute exists, the issue is settled by the finder of fact, a jury. It is only when reasonable minds cannot differ that it becomes settled as a matter of law. See footnote 3 supra.
¶ 7. Other actions can toll the statute. For instance, the statute of limitations can be tolled when an individual is aware of a wrongful act or omission, but unaware, in the exercise of reasonable diligence, of the injury itself. See Smith, 485 So.2d at 1054 ("the patient knew of the act or omission which he alleged caused him injury. However, there is nothing in the record that shows when he first discovered with reasonable diligence, that he was injured or damaged by the act or omission"). The "discovery rule" also can apply when an individual has knowledge of the injury, but cannot by reasonable diligence determine its cause and/or the resulting causative relationship. See Sarris, 782 So.2d at 724 ("while Sarris knew that her husband was dead, under the facts of this case, she could not reasonably have known that the death was the result of negligence.") (emphasis added); Barnes v. Singing River Hosp. Sys., 733 So.2d 199, 206 (Miss.1999) (a Mississippi Tort Claims Act case in which this Court found that "[wjhile the Barneses may have been aware of Lisa's injuries before the one year time limit was up, they could not reasonably have known that Singing River was responsible, for those injuries until their medical expert notified them of the possible negligence . ").
¶ 8. Likewise, in a slightly different vein, the statute of limitations can be tolled when an individual reasonably relies upon a physician's estimate and/or opinion as to recovery and/or risk. See Neglen v. Breazeale, 945 So.2d 988, 991 (Miss.2006) ("[u]nder these circumstances, we cannot conclude as a matter of law that Lillian did not act diligently by trusting the doctors' opinions and waiting over two years before requesting James' medical records."); Parham v. Moore, 552 So.2d 121, 124 (Miss.1989) ("[a]ccording to Dr. DeShazo, the minimum recuperative period would be 12 months. Therefore, the earliest date at which Parham could have known or with reasonable diligence discovered that she had a compensable injury was . 12 months following her surgery."); Pittman v. Hodges, 462 So.2d 330, 333 (Miss.1984) ("Hodges was entitled to rely upon Dr. Pittman's statements that the numbness would temporarily last from two to six weeks or even longer, and only thereafter could Hodges then by the exercise of reasonable diligence have known or discovered that his numbness was permanent. .").
¶ 9. On the other hand, we have rejected application of the "discovery rule" when there is an absence of reasonable diligence. See Wright v. Quesnel, 876 So.2d 362, 367 (Miss.2004); Wayne Gen. Hosp. v. Hayes, 868 So.2d 997, 1001 (Miss.2004) ("[t]he intent of the discovery rule is to protect potential plaintiffs who cannot, through reasonable diligence, discover injuries done to them.") (emphasis added). Furthermore, an individual may not take shelter in the "discovery rule" when reasonable minds could not differ that the plaintiff possessed sufficient information to bring a claim. See Sutherland, 959 So.2d at 1009 ("[b]y his own admission, Sutherland knew who, when, how and by what he had been injured soon after receiving treatment and the Zyprexa prescription from Dr. Ritter, and certainly, no later than the date of his discharge from St. Dominic.") (emphasis added); Lowery, 909 So.2d at 51-52 (a products liability case involving exposure to harmful paint vapors in which this Court found "using the standards outlined in Hayes, Quesnel, and Sanders, Lowery did not require absolute certainty nor an expert opinion to vest the right to a cause of action under this state's products liability statute."); Powe v. Byrd, 892 So.2d 223, 228 (Miss.2004) (in defending dismissal of a 2002 filing, Powe argued that the statute of limitations did not begin to run until December 1, 2000, the date of receipt of the expert opinion report. How ever, Powe originally had filed a complaint on August 3, 2000, which was subsequently dismissed. This Court found Powe's argument "to be disingenuous and without merit."); Wright, 876 So.2d at 367 ("Wright . had enough information at the time of the death such that she knew or reasonably should have known that negligence had occurred. She had been to see Dr. Quesnel twice and received no treatment but an order to rest-her symptoms and discomfort continued, however. When she discovered that her child had died in the womb, Wright should have known that there was some causal connection between the death and Dr. Quesnel's treatment."); Hayes, 868 So.2d at 1001 (Mississippi Tort Claims Act case). Each of these decisions presents unique factual distinctions which prevent a static application of the statute. Justice Higginbotham's panel dissent clearly recognized these distinctions. This Court agrees with his conclusion that "[facial similarities . create the appearance of inconsistency when results differ, but the truth is that those similarities belie greater differences that a careful examination of the facts in each case reveals. These cases all turn on questions relating to what the plaintiff knew and when." Huss, 508 F.3d at 253 (Higginbotham, J., dissenting). This is, and has been, the state of the law in Mississippi. This Court readily appreciates the difficulty courts experience in navigating this perplexing path, particularly for courts in jurisdictions which may have more definite parameters.
¶ 10. Mississippi substantive jurisprudence requires questions of disputed fact to be decided by juries, such as when Huss "with reasonable diligence might have first known or discovered" the "alleged act, omission, or neglect[.]" Miss. Code Ann. § 15-1-36 (Rev.2003). See also Parham, 552 So.2d at 125. Gayden asserts the operative date is May 10, 1998, when Huss was diagnosed with cardiomyo-pathy, pulmonary edema, and congestive heart failure. Huss responds that the applicable date is less than a year before suit was filed, when she, through reasonable diligence, first learned "that the administration of Terbutaline and the course of treatment by the defendants constituted negligence and caused or contributed to her cardiomyopathy, pulmonary edema, and congestive heart failure." Huss, 508 F.3d at 244.
¶ 11. On certified questions this Court "will restrict its review . 'to the performance when properly requested of the function of declaring in general terms the controlling rules' of state law,[ ] and not the application of law to fact." Miss. R.App. P. 20 cmt. (quoting Boardman v. United Services Auto. Ass'n, 470 So.2d 1024, 1031 (Miss.1985)). Therefore, having responded to the certified question tendered, this Court finds that if this case had been tried in Mississippi state court, Gay-den could not prevail as a matter of law.
CONCLUSION
¶ 12. "[T]he date the alleged act, omission or neglect shall or with reasonable diligence might have been first known or discovered[,]" Miss.Code Ann. § 15 — 1— 36(1) & (2) (Rev.2003), is often an issue that must be resolved by a finder of fact on a case-by-case basis. Based upon the record presented, this Court concludes that the medical-malpractice claims of Huss were not barred, as a matter of law, by the applicable statute of limitations out lined in Mississippi Code Annotated Section 15-1-36. This Court will not further extend its review to "the application of law to fact." Miss. R.App. P. 20 cmt.
¶ 13. CERTIFIED QUESTION ANSWERED.
SMITH, C.J., WALLER, P.J., EASLEY, CARLSON AND DICKINSON, JJ., CONCUR. EASLEY, J., CONCURS WITH SEPARATE WRITTEN OPINION JOINED BY WALLER, P.J. GRAVES, J., DISSENTS WITH SEPARATE WRITTEN OPINION JOINED BY DIAZ, P.J. LAMAR, J., NOT PARTICIPATING.
. The panel majority added that "[i]n certifying the limitations question, and in our discussion of that question, we disclaim any intention or desire that the Supreme Court of Mississippi confine its reply to the precise form or scope of the questions certified." Huss, 508 F.3d at 248.
. According to the panel majority, "we are certifying an issue regarding limitations for resolution by the Mississippi Supreme Court in light of the uncertainty as to Mississippi law." Huss, 508 F.3d at 244 (emphasis added).
.The exception lies in those cases where the relevant dates are either undisputed by admission or pleading, or are so manifest that reasonable minds could not differ. See Sutherland v. Ritter, 959 So.2d 1004, 1009 (Miss.2007); Smith v. Sanders, 485 So.2d 1051, 1053 (Miss.1986). For example, a medical-malpractice action arising after an individual is admitted for removal of his gangrenous right foot, and the procedure is instead performed on his only remaining good foot, the left, leaves little doubt as to when the statute begins to run.
. The applicable "controlling rul[e]" is clearly outlined in Justice Carlson's well-reasoned opinion in Sutherland. See Sutherland, 959 So.2d at 1008-09.
. For exceptions, see footnote 3 supra.