Opinion ID: 1869666
Heading Depth: 2
Heading Rank: 2

Heading: negligent follow-up treatment claim

Text: The court of appeals determined that the summary-judgment evidence demonstrated a course of treatment that Dr. Shah administered for Moss's retina problems. 7 S.W.3d at 693. It further concluded that, because there was some evidence that the November 1994 visit related to the continuing relationship between Dr. Shah and Moss to treat Moss's retinal problems, there was a fact issue about when the course of treatment ended. 7 S.W.3d at 694. It thus rejected Dr. Shah's argument that the last date on which limitations could begin for Moss's negligent follow-up treatment claim was October 21, 1993, the last recheck visit. 7 S.W.3d at 694. Again, we disagree with the court of appeal's analysis. The court of appeals dismissed Dr. Shah's argument that the same analysis we applied to the plaintiffs' claims in Husain and Rowntree applies to Moss's negligent follow-up treatment claim. 7 S.W.3d at 694. Instead, it concluded these cases are distinguishable because they involved an alleged duty to perform specific tests during specific office visits rather than an alleged duty to monitor or continue treatment. 7 S.W.3d at 694. The dissent also concludes that Husain and Rowntree do not apply for the same reason. 67 S.W.3d at 849. But the court of appeals' and dissent's distinction ignores the rule applied in those cases; that is, if the date the alleged tort or breach took place is ascertainable, a course-of-treatment analysis is immaterial to determining when limitations begins to run. In Rowntree , the plaintiff alleged that the doctor did not diagnose, monitor, and otherwise properly treat her occluded artery when he treated and prescribed medication for her high blood pressure. 833 S.W.2d at 104. This Court had to determine if the plaintiff's taking the prescribed medication created a course of treatment absent any other office visits or medical services. Rowntree, 833 S.W.2d at 104. We concluded there was no course of treatment because the plaintiff's allegation was her doctor breached a duty to perform certain exams that would have detected the occluded artery. Rowntree, 833 S.W.2d at 108. Thus, we held that limitations began to run on the last date the doctor actually saw the plaintiff and had the opportunity to perform his alleged duties. Rowntree, 833 S.W.2d at 108. Further, in Husain , the plaintiff alleged that her doctor was negligent in not performing certain medical exams, after she complained about a lump in her breast, to detect her breast cancer. 964 S.W.2d at 919. We concluded that the dates on which the doctor's alleged negligence took place were readily ascertainable because the doctor did not perform the necessary exams during specific office visits. Husain, 964 S.W.2d at 919. Moreover, we held that, because the doctor's alleged negligence occurred on ascertainable dates, it [was] therefore immaterial whether [the doctor] established a course of treatment for [the patient's condition]. Husain, 964 S.W.2d at 919. This Court's holding in Kimball is also instructive. 741 S.W.2d at 372. In that case, the plaintiff was admitted into the hospital for chest pains. His surgery was postponed, however, because the defendant doctor was unable to intubate and the plaintiff suffered respiratory and cardiac failure. After this incident, the doctor performed no other procedures on the plaintiff and did not see him again though the plaintiff stayed in the hospital for six more days. Kimball, 741 S.W.2d at 372. The plaintiff sued the doctor for negligence two years after the last day he stayed in the hospital. This Court affirmed the trial court's summary judgment for the doctor on limitations grounds, concluding that the precise date of the alleged tort was ascertainable from the case's facts. That is, the alleged tort occurred on the only date the doctor had contact with the plaintiff. Accordingly, we held that the plaintiff could not invoke the second or third categories in section 10.01 to measure the limitations period and, therefore, the claims were time-barred. Kimball, 741 S.W.2d at 372. That a course-of-treatment analysis is immaterial if the tort date is ascertainable is further exemplified in Chambers v. Conaway , a case upon which Moss relies. See 883 S.W.2d 156 (Tex.1993). There, the plaintiff alleged that her doctor did not diagnose her breast cancer despite her complaint about a lump in her breast and her numerous visits to the doctor for ailments unrelated to that complaint. Chambers, 883 S.W.2d at 159. The plaintiff presented summary-judgment evidence establishing that her doctor had a duty to perform follow-up tests and to monitor any conditions of which he had noticeincluding a lump in the plaintiff's breast. Chambers, 883 S.W.2d at 158. We concluded that the doctor allegedly breached this duty on the specific dates when the plaintiff visited the doctor. Chambers, 883 S.W.2d at 159. Because the tort dates were ascertainable, we refused to apply a course-of-treatment analysis, and we held that limitations began to run from the date the plaintiff last saw the doctor. Chambers, 883 S.W.2d at 159; see also Bala, 909 S.W.2d at 892 (holding that doctor could have breached duty to conduct follow-up medical tests only when he examined the plaintiff on specific dates and thus limitations ran from the plaintiff's last office visit). Here, Moss's expert's affidavit opines that Dr. Shah had a duty to provide careful follow-up treatment on a weekly or monthly basis after he surgically removed the scleral buckle in November 1992. We must take this evidence as true. See American Tobacco Co., 951 S.W.2d at 425. Accordingly, we assume that the proper standard of care was as Moss's expert opinedweekly or monthly follow-up visits after the November 1992 surgery. Applying the duty the alleged standard of care imposes, we would conclude that limitations began to run each time Dr. Shah saw Moss, beginning with the first post-surgery visit in November 1992. This is because Dr. Shah breached the alleged duty to provide weekly or monthly follow-up treatment on every date he actually saw Moss. See Husain, 964 S.W.2d at 919; Rowntree, 833 S.W.2d at 108. But we view the summary-judgment evidence in the light most favorable to Moss. See KPMG Peat Marwick, 988 S.W.2d at 748; Lear, 819 S.W.2d at 471. Therefore, the last date Dr. Shah could have ordered additional weekly or monthly office visits was during the last recheck visit on October 21, 1993. The court of appeals and the dissent arrive at a contrary conclusion and hold that the yearly exam in November 1994 was part of Dr. Shah's course of treatment for Moss's retina problems. 67 S.W.3d at 848, 7 S.W.3d at 694. However, the court of appeals' and the dissent's course-of-treatment analysis ignores the rule that, if the date the alleged negligence occurred is readily ascertainable, whether a course of treatment existed is immaterial. Husain, 964 S.W.2d at 919-20; Chambers, 883 S.W.2d at 159. And it ignores that it is the breach of the duty the alleged standard of care imposesweekly or monthly follow-up treatmentwhich, when applied to this case's facts, dictates when limitations began to run. See Husain, 964 S.W.2d at 919-20; Chambers, 883 S.W.2d at 159. Moss's medical records demonstrate that Moss's last recheck visit was on October 23, 1993, and Dr. Shah did not diagnose the second detached retina until Moss visited Dr. Shah more than twelve months later on November 22, 1994. Because of the standard of care alleged, the last date Dr. Shah could have breached the alleged duty to provide weekly or monthly visits was on October 23, 1993. Consequently, the November 22, 1994 visit is immaterial to our statute-of-limitations analysis. Additionally, the dissent incorrectly suggests that Kimball's language supports the conclusion that limitations runs from the completion of Moss's alleged course of treatment. 67 S.W.3d at 848. But that language expressly states that article 4590i's course-of-treatment limitations prong applies only if the patient's injury occurs during a course of treatment for a particular condition and the only readily ascertainable date is the last day of treatment. Kimball, 741 S.W.2d at 372 (emphasis added). Here, because we must assume Moss's alleged standard of care is true and apply the duty that arises from it to the facts, we can identify an ascertainable tort dateOctober 23, 1993. Therefore, we do not apply a course-of-treatment limitations analysis. Similarly, the dissent mistakenly contends that Chambers supports the notion that, if the applicable standard of care requires follow-up treatment for a particular condition, a physician may breach an ongoing duty to monitor that condition without doing so on any single date. 67 S.W.3d at 850. But the dissent's conclusion disregards that we declined to apply a course-of-treatment analysis in Chambers because, based on the duty the plaintiff alleged, we could ascertain the tort date. Chambers, 883 S.W.2d at 159. Thus, even if the standard of care requires an ongoing duty to monitor, we do not apply the course-of-treatment limitations provision if we can ascertain the tort date. Accordingly, we conclude that the last date on which Dr. Shah could have breached his alleged duty to provide more frequent follow-up treatment was on October 23, 1993. Because Moss filed suit in June 1996, more than two years after Dr. Shah allegedly neglected to provide the proper follow-up care, limitations bars this claim. See Tex.Rev.Civ. Stat. art. 4590i, § 10.01.