Title: Particia Ann Hankey v. Susan Yarian, M.D.
Citation: N/A
Docket Number: SC94-384
State: Florida
Issuer: Florida Supreme Court
Date: March 16, 2000

Supreme Court of Florida
 
____________
No. SC94384
____________
PATRICIA ANN HANKEY, et al.,
Petitioners,
vs.
SUSAN YARIAN, M.D., et al.,
Respondents.
[March 16, 2000]
ANSTEAD, J.
We have for review Hankey v. Yarian, 719 So. 2d 987 (Fla. 5th DCA 1998)
based on certified direct conflict with the decision in Rothschild v. NME Hospitals,
Inc., 707 So. 2d 952 (Fla. 4th DCA 1998).  We have jurisdiction.  See art. V, §
3(b)(4), Fla. Const.  For the following reasons, we quash Hankey and approve
Rothschild.
At issue is the calculation of the statutory time limitations for filing a
medical malpractice action under chapter 766 of the Florida Statutes.  Specifically,
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the question is whether the ninety-day "tolling" period under section 766.106(4),
Florida Statutes, plus any other extension agreed to by the parties as provided for
under that subsection, suspends the running of the two-year statutory limitation
period for filing suit.  In Hankey, the Fifth District held that the statutory
limitations period was not suspended during the tolling period provided for in
section 766.106(4).  In Rothschild, the Fourth District held that the running of the
limitations period was suspended.  We conclude that the tolling period provided by
section 766.106(4) does interrupt and suspend the running of the limitations period. 
Therefore, we approve Rothschild and disapprove Hankey. 
The trial court dismissed the complaint of Patricia Ann and Donald Hankey,
finding it was not timely filed, and the district court affirmed.  See Hankey, 719 So.
2d at 988.  The district court in Hankey relied on Pergrem v. Horan, 669 So. 2d
1150 (Fla. 5th DCA 1996), wherein three years after our decision in Tanner v.
Hartog, 618 So. 2d 1150 (Fla. 1993), the Fifth District concluded that under section
766.106(4), "if the notice of intent is mailed well in advance of the end of the
statute of limitations period, so that the ninety days and sixty days fall within it, the
claimant must file suit before the [original two-year] statute of limitations runs." 
Id. at 1151.  We find error in this interpretation of Tanner by Pergrem and Hankey. 
Further, applying the method of calculation set out herein to the facts of this case,
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we find that the Hankeys' complaint was timely filed and therefore quash the ruling
below.  
MEDICAL MALPRACTICE STATUTORY SCHEME
We begin with a review of the medical malpractice statutory scheme and its
purpose, both of which directly affect the resolution of this case.  It appears that the
Legislature adopted the presuit procedures of chapter 766 based upon a concern
about the perceived increase in the amount of medical malpractice claims paid and
a perceived corresponding increase in malpractice liability insurance premiums. 
See § 766.201(1)(b), Fla. Stat. (1997).  In section 766.201(2), the Legislature
expressly states it was their intent "to provide a plan for prompt resolution of
medical negligence claims."  Courts have often characterized the legislative intent
of the medical malpractice statutory scheme as promoting the “settlement of
meritorious claims at an early stage without the necessity of a full adversarial
proceeding."  Cohen v. Dauphinee, 739 So. 2d 68, 71 (Fla. 1999) (quoting
Williams v. Campagnulo, 588 So. 2d 982, 983 (Fla. 1991); see also Patry v. Capps,
633 So. 2d 9, 11-12 (Fla. 1994).  A key aspect of this statutory scheme is the
promotion of settlement options and negotiations between the parties out of court. 
The provisions for tolling and extending the limitations period are part of this
scheme.
1In Boyd v. Becker, 627 So. 2d 481, 483-84 (Fla. 1993), we held that the statute of
limitations is tolled from the time the defendant receives the notice of intent, not from the time the
claimant mails it.
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LIMITATIONS SCHEME
Pursuant to section 95.11(4)(b), Florida Statutes (1997), an action for
medical malpractice must be commenced within two years from the time the
incident giving rise to the action occurred or within two years from the time the
incident is discovered or should have been discovered with the exercise of due
diligence.  However, before a claimant can file a medical malpractice suit, chapter
766 prescribes a number of requirements and provisions which seek to enhance the
prospect of a settlement, and which affect the running of the limitations period.
First, a claimant must conduct a reasonable investigation to determine if
there are grounds for a good faith belief that there was negligence in his care or
treatment.  See § 766.104(1), Fla. Stat. (1997).  After the completion of this presuit
investigation, and during the two-year period provided for in section 95.11(4)(b),
the claimant must serve a notice of intent to initiate litigation to each prospective
defendant.  See § 766.106(2), Fla. Stat. (1997).  Importantly, as it relates to the
limitations issue before us, no suit may be filed for a period of ninety days after
this notice of intent is mailed to any prospective defendant.1  See § 766.106(3)(a),
Fla. Stat. (1997).  In this regard, section 766.106(4) provides:
2The wording of section 766.106(4) makes it appear that the "60 days or the remainder of
the period of the statute of limitations" language only applies when the parties have stipulated to
an extension of the ninety-day tolling provision.  However, this argument was raised and rejected
in Rhoades v. Southwest Florida Regional Medical Center, 554 So. 2d 1188, 1190-91 (Fla. 2d
DCA 1989), wherein the court held that the sixty days or the remainder of the statute of
limitations applies to the ninety-day tolling provision, even when no extension has been agreed to. 
We approved this interpretation in Tanner. 
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[D]uring the 90-day period, the statute of limitation is
tolled as to all potential defendants.  Upon stipulation by
the parties, the 90-day period may be extended and the
statute of limitations is tolled during any such extension. 
Upon receiving notice of termination of negotiations in
an extended period, the claimant shall have 60 days or the
remainder of the period of the statute of limitations,
whichever is greater, within which to file suit.2
Finally, by filing a petition to the clerk of the circuit court, a claimant is entitled to
an automatic ninety-day extension to the statute of limitations.  See § 766.104(2),
Fla. Stat. (1997).  All of these provisions impact the running of the limitations
period, and appear designed to facilitate negotiations between the parties.
CALCULATING THE TIME LIMITATIONS
Initially, the claimant, Patricia Hankey, maintains that the use of the word
"tolled" in section 766.106(4) means that the two-year statute of limitations is
suspended during the ninety-day period and during any other agreed extension. 
She maintains that an alternative reading of that statutory provision will effectively
and substantially reduce the statutory limitations period in medical malpractice
cases.  On the other hand, the respondents urge us to find that the statute only has
3Respondents cite the first part of the definition of the word “toll” in Black's Law
Dictionary:  “To bar, defeat, or take away; thus to toll the entry, means to deny or take away the
right of entry.”  Black's Law Dictionary 1488 (6th ed. 1990).  However, the remainder of the
definition provides:  “To suspend or stop temporarily as the statute of limitations is tolled during
the defendant's absence from that jurisdiction and during the plaintiff's minority.”  Id.  
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the limited application discussed in Pergrem; or, alternatively, that the word "toll"
means only "to bar."3  Therefore, the respondents maintain that the statute simply
provides that a claimant is barred from filing suit during this period, but the time
that passes during this time period is still to be counted against the two years
allowed for bringing suit.   
PLAIN MEANING
It has long been a rule of statutory construction that statutes must be given
their plain and obvious meaning and courts should assume that the legislature knew
the plain and ordinary meaning of words when it chose to include them in a statute. 
See Aetna Cas. & Surety Co. v. Huntington Nat’l Bank, 609 So. 2d 1315, 1317
(Fla. 1992); Thayer v. State, 335 So. 2d 815, 817 (Fla. 1976); Sheffield v. Davis,
562 So. 2d 384, 386 (Fla. 2d DCA 1990).  In Sheffield, as was the case with the
Fourth District in Rothschild, the Second District applied the plain meaning of the
word “toll” to conclude that the word “tolled” in section 768.57(4), Florida Statutes
(1987), the predecessor of section 766.106(4), should be interpreted to mean a
4In 1988, section 768.57 was renumbered as 766.106.  See § 766.106, Fla. Stat. (Supp.
1988), notes.  However, the relevant language of the statute remained unchanged.  
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"suspension" of the statute of limitations.4  
OTHER STATUTES
Another way of determining the Legislature’s intent in using the word
“tolled” in section 766.106(4), is by examining other uses of the word in similar
contexts.  The Second District also applied this rule in Sheffield.  See Sheffield,
562 So. 2d at 386.  For example, section 95.051, Florida Statutes (1997), provides
generally for the tolling of statutory limitations periods:
     (1) The running of the time under any statute of
limitations except ss. 95.281, 95.35, and 95.36 is tolled
by:
     (a) Absence from the state of the person to be sued.
     (b) Use by the person to be sued of a false name that
is unknown to the person entitled to sue so that process
cannot be served on the person to be sued.
     (c) Concealment in the state of the person to be sued
so that process cannot be served on him or her.
     (d) The adjudicated incapacity, before the cause of
action accrued, of the person entitled to sue.  In any
event, the action must be begun within 7 years after the
act, event, or occurrence giving rise to the cause of
action.
     (e) Voluntary payments by the alleged father of the
child in paternity actions during the time of the payments.
     (f) The payment of any part of the principal or interest
of any obligation or liability founded on a written
instrument.
     (g) The pendency of any arbitral proceeding pertaining
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to a dispute that is the subject of the action.
     (h) The minority or previously adjudicated incapacity
of the person entitled to sue during any period of time in
which a parent, guardian, or guardian ad litem does not
exist, has an interest adverse to the minor or incapacitated
person, or is adjudicated to be incapacitated to sue;
except with respect to the statute of limitations for a
claim for medical malpractice as provided in s. 95.11.  In
any event, the action must be begun within 7 years after
the act, event, or occurrence giving rise to the cause of
action.
The "tolling" language in section 90.051 has been routinely and consistently
interpreted as suspending the running of the statute of limitations time clock until
the identified condition is settled.  See Abbott v. Kiser, 654 So. 2d 640 (Fla. 4th
DCA 1995) (finding wife's suit timely filed because husband's absence from
country tolled statute of limitations period applicable to wife's actions to enforce
property settlement); Glantzis v. State Auto. Mut. Ins. Co., 573 So. 2d 1049 (Fla.
4th DCA 1991) (preventing defendant from relying on the statute of limitations
when defendant had accepted a demand for arbitration thereby suspending the
statute of limitations under section 95.051(1)(g)). 
Because the word “toll” has been consistently used by the Legislature and
interpreted by the courts to mean “suspend” when used in a statutory limitations
context, we conclude that it was intended to have the same meaning in section
766.106(4).  See Sheffield, 562 So. 2d at 386.  We agree with the Fourth District’s
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concise explanation in Rothschild that: “Since a tolling provision interrupts the
running of the statutory limitations period, the statutory time is not counted against
the claimant during that ninety-day period.  In essence, the clock stops until the
tolling period expires and then begins to run again.”  Rothschild, 707 So. 2d at 953. 
This construction is also consistent with judicial pronouncements suggesting
that the purpose of the ninety-day tolling period in section 766.106 should be
liberally construed to give the parties an opportunity to investigate claims, to
promote presuit settlement, and to reduce the number of malpractice actions filed
in the courts.  See Boyd v. Becker, 627 So. 2d 481, 484 (Fla. 1993); Stone v.
Rosenthal, 665 So. 2d 276 (Fla. 4th DCA 1995); Shands Teaching Hosp. &
Clinics, Inc. v. Barber, 638 So. 2d 570 (Fla. 1st DCA 1994).  Additionally, in the
medical malpractice statutory context presented here, this Court has stated that
medical malpractice statutes should be construed not only in favor of requiring
parties to engage in meaningful presuit investigation but also in favor of providing
access to courts.  See Kukral v. Mekras, 679 So. 2d 278, 284 (Fla. 1996) (stating
that "the medical malpractice statutory scheme must be interpreted liberally so as
not to unduly restrict a Florida citizen's constitutionally guaranteed access to the
courts, while at the same time carrying out the legislative policy of screening out
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frivolous lawsuits and defenses"); Boyd v. Becker, 627 So. 2d 481, 483 (Fla. 1993)
(resolving conflict between two statutory provisions in a manner that allows a
claim to be considered on its merits rather than banned by judicial construction that
applies a more limiting statutory provision).  We also agree with the Hankeys that
to construe the statute otherwise would effectively reduce the two-year limitations
period since a claimant cannot lawfully file an action during the period of
suspension and, hence, is deprived of that time to file suit.
Accordingly, we hold the two-year statute of limitations under section
95.11(4)(b) is suspended ("tolled") for ninety days under section 766.106(4) and
any extended time agreed to by the parties under that same section.
ADDITIONAL PROVISIONS AFFECTING LIMITATIONS PERIOD
Section 766.106(4) of the statutory scheme also provides that if there are less
than sixty days remaining to file suit before the end date of the original two-year
limitations period at the time the claimant filed the notice of intent to initiate
litigation, then the claimant shall have sixty days from the time when the notice of
termination of negotiations is received by him to file suit.  If, however, there were
more than sixty days remaining to file suit before the end date of the original two-
year limitations period when the claimant filed the notice, then the claimant only
has the time remaining in the original two-year period to file suit.  This provision
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provides additional time to the limitations period separate and apart from the ninety
days of tolling, but only in the limited circumstances set out in the statute where
less than sixty days remain to file suit at the time the claimant files the notice of
intent.  See Tanner v. Hartog, 618 So. 2d 177, 183 (Fla. 1993).  Those
circumstances are not present here.   
SECTION 766.104(2)
Finally, in addition to the two scenarios involved in section 766.106(4)
discussed above, a claimant can also automatically secure an additional ninety-day
extension under section 766.104(2) that will be added to the end of both periods
described above.  Section 766.104(2) provides: 
Upon petition to the clerk of the court where the suit will
be filed and payment to the clerk of a filing fee not to
exceed $25.00, . . . an automatic 90-day extension of the
statute of limitations shall be granted . . . .
Section 766.104(2) specifically provides that this ninety-day period “shall be in
addition to other tolling provisions.”  Again, we agree with the Fourth District that
the “extension” provided for under section 766.104(2) is a genuine extension of
time to be added to the limitations period, rather than a tolling (suspension) as
provided for under section 766.106(4).  In fact, we approved this interpretation of
section 766.104(2) in Tanner.  See id. at 182.  Hence, this time period is to be
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tacked on to the end of the limitations period and does not run simultaneously with
the separate ninety-day tolling period provided in section 766.106(4).  See id. 
(“This automatic extension is separate and additional to any other tolling period.”)
(citing Novitsky v. Hards, 589 So. 2d 404 (Fla. 5th DCA 1991)); Rothschild, 707
So. 2d at 953; Kalbach v. Day, 589 So. 2d 448, 449-50 (Fla. 4th DCA 1991).
TANNER v. HARTOG
We are not unsympathetic with the Fifth District’s interpretation of section
766.106(4) in Hankey and Pergrem.  Essentially, the court applied its interpretation
of the analysis we adopted in Tanner.  The main issue resolved in Tanner
concerned the commencement of the limitations period and is unrelated to the
issues discussed here.  However, in Tanner, the claimants also argued that all of the
time periods provided for in section 766.106(4) were to be simply added on to the
end of the basic two-year limitations period.  See id. at 183.  Moreover, because the
claimants received the notice of termination from the defendants with less than
sixty days remaining before the original statute of limitations was set to expire,
they also claimed they were entitled to have the sixty-day additional period under
section 766.106(4) also simply added, along with the ninety days aforementioned,
to the end of the two-year period.  See id.  Notwithstanding, we disagreed with
their argument and instead adopted the method of calculation employed by the
5The Court approved the following calculation:  
[T]he statute of limitations commenced running when the
appellants were aware of the stillbirth on April 1, 1988.  On
February 12, 1990, 47 days prior to the running of the limitations
period, the appellants tolled the statute 90 days by filing a notice of
intent to initiate medical malpractice litigation pursuant to section
766.104, Florida Statutes.  Thereafter, the appellants were entitled
to file suit within 90 days plus the greater of either the remainder of
the statute of limitations (47 days) or 60 days.  Since there were
fewer than 60 days remaining on the statute of limitations when the
notice of intent letters were mailed, the appellants had 150 days (90
plus 60) from February 12, 1990, or until July 12, 1990, to file suit. 
Id. at 183 (quoting Tanner v. Hartog, 593 So. 2d 249, 252-53 (Fla. 2d DCA 1992)).  Obviously,
this calculation allowed for the suspension of the two-year limitation period during the ninety
days since the end date of the limitations period was pushed well beyond the original end date of
the two-year limitations period.  However, the significant issue in our Tanner computation was
determining when the sixty-day provision commenced to run.  We held that it commenced to run
at the end of the ninety-day suspension.  Indeed, section 766.106(4) explicitly provides: “Upon
receiving notice of termination of negotiations . . . , the claimant shall have 60 days . . . .”  The net
effect of our calculation and suspension of the limitations period was to grant the claimants an
additional thirteen days, the thirteen days being the difference between the forty-seven days
remaining on the two-year statute and the sixty days provided in section 766.106(4).  Hence, the
Tanners were given the entire two-year period they were entitled to under the statute to file suit,
not counting the period of suspension, plus an additional thirteen days for having filed their notice
of intent with less than 60 days remaining in the original limitations period.  
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district court in that case.5  
However, in Tanner we were concerned primarily with the calculation and
application of the sixty-day provision in the statute.  Specifically, we wrote: 
From the date the notice of intent is filed, the plaintiff has
ninety days (the amount of the tolling) plus either sixty
days or the time that was remaining in the limitations
period, whichever is greater, to file suit.  We believe the
language of section 766.106(4) was intended to provide
extra time to a claimant who files a notice of intent
shortly before the limitations period expires.  This
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permits the claimant to have the full ninety days in which
to try to negotiate a settlement and provides an additional
sixty days to file a complaint if a settlement cannot be
accomplished.  However, the time remaining must be
computed from the date the notice of intent was filed,
rather than simply adding on the extra time to the end of
the limitations period . . . .
Id. at 183-84 (emphasis added).  The Fifth District in Pergrem construed our
comment about the intent of the “language” in section 766.106(4) as meaning that
the only purpose of the entire section was to affect claims filed “shortly before the
limitations period expires.”  We did not intend such a result, but concede that our
words may have been less than precise.  It is true that the entitlement to any extra
time under the sixty-day provision of section 766.106(4) is entirely dependent on
when the notice of intent is filed in relation to the time remaining in the original
two-year limitations period as discussed earlier.  However, the ninety-day tolling
provision of section 766.106(4) applies to all cases regardless of when the notice of
intent is filed.  Thus, the tolling provisions should not be limited to apply only to
claims filed “shortly” before the limitations period expires.  
THIS CASE
The Fifth District candidly acknowledged that if the limitations period was
suspended under the tolling provisions of section 766.106(4), then the Hankeys’
complaint was timely filed; whereas if the limitations period was not suspended,
6Although we recognize that we have held that the limitations period is tolled when the
defendant received the notice of intent rather then when it is filed by the claimant, see supra, note
1, unfortunately the record in this case does not reflect when this notice of intent was received by
the defendants.  Notwithstanding, this does not affect the end result of our calculation in this case. 
7We reach this date by adding 263 days (the time remaining in the original two-year
limitations period at the time when the notice of intent was filed), to July 18, 1996, (the date when
the limitations period began to run again).  This calculation reflects the suspension of the
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then the complaint was untimely.  See Hankey, 719 So. 2d at 988.  The application
of the tolling to the facts proves the court correct in its acknowledgment.  The
limitations period in this case began to run on December 6, 1994, and was
scheduled to end on December 6, 1996.  The notice of intent, filed on March 19,
1996, suspended the limitations period for ninety days as of the date it was
received by the defendants.6  Additionally, before the defendants responded, the
parties agreed to a thirty-day extension, which continued to suspend the limitations
period for another thirty days or until the defendants responded to the notice of
intent.  By July 18, 1996, all the potential defendants had responded to the notice
of intent, prompting the limitations period to begin running again.  Because as of
March 19, 1996, the date the notice of intent was served, more than sixty days
remained until the expiration date of the original limitations period (December 6,
1994), the Hankeys were not entitled to any of the sixty days provided under
section 766.106(4).  Therefore, when the limitations period began running again on
July 18, it was set to expire on April 6, 1997.7  However, as noted, the Hankeys had
limitations period under section 766.106(4) and provides the claimants with the entire two-year
period in which to file suit.   
8Two of the three respondents allege that the ninety-day period in section 766.104(2) is
only intended to allow further time for the reasonable investigation prescribed in section
766.104(1), and the reasonable investigation must occur before the notice of intent is filed. 
Because the Hankeys did not file for the automatic extension until after they had filed their notice
of intent, the respondents maintain that the Hankeys were not entitled to the extension.  However,
while we agree that the statutory language is somewhat confusing, we cannot accept the
respondents’ construction in view of the Legislature’s express direction that the ninety-day
extension may be secured automatically and is in addition to other tolling provisions.
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filed a petition with the clerk of the court for an automatic ninety-day extension
under section 766.104(2) on November 20, 1996; thus, the Hankeys had until July
5, 1997, to file suit.8  The suit in this case was filed on June 19, 1997; therefore, it
was timely. 
CONCLUSION
In summary, we conclude that the two-year limitations period is suspended
temporarily and begins to run again under section 766.106(4) at the expiration of
the stated time period or when the defendant responds to the notice of intent.  The
time of suspension provided under the tolling provision of section 766.106(4) is
merely a “time out” that the prospective claimant was allotted by the Legislature
that is not to be counted against the two-year limitations period.  On the other
hand, any additional times added under section 766.106(4) if the notice of intent is
filed by the claimant with less than sixty days remaining in the original statute of
limitations, or under the automatic ninety-day extension pursuant to section
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766.104(2), are actually statutorily granted additions to the initial two years allotted
by the statute. 
For the foregoing reasons, we approve the decision in Rothschild and quash
the Fifth District's decision in Hankey.  
It is so ordered.
HARDING, C.J., and SHAW, WELLS, PARIENTE, LEWIS and QUINCE, JJ.,
concur.
NOT FINAL UNTIL TIME EXPIRES TO FILE REHEARING MOTION, AND IF
FILED, DETERMINED.
Application for Review of the Decision of the District Court of Appeal - Certified
Direct Conflict of Decisions
Fifth District - Case No. 5D98-543
(St. Johns County)
Charles Daniel Sikes and Thomas F. Nordlie, Starke, Florida,
for Petitioners
H. Joseph McGuire and M. Kathleen Roddenberry of Smith, Schoder & Roddenberry,
P.A., Daytona Beach, Florida; Kurt M. Spengler and Michael R. D’Lugo of Wicker,
Smith, Tutan, O’Hara, McCoy, Graham & Ford, P.A., Orlando, Florida; Lee W.
Marcus, Terese M. Latham and Martin B. Unger of Unger, Swartwood, Indest &
Acree, P.A., Orlando, Florida, 
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for Respondents