Opinion ID: 867605
Heading Depth: 3
Heading Rank: 2

Heading: Arizona case law

Text: ¶ 15 In Kowske, the court of appeals held that the cause of action in a wrongful death case accrued when the surviving husband obtained medical records concerning his deceased wife. The statute was triggered at that time even though the doctor who forwarded the records stated that he found no signs of misdiagnosis or mistreatment and said that the autopsy also revealed nothing significant. Id. at 536, 863 P.2d at 255. The court held that the statute was not tolled even though plaintiff was not aware that his wife's death was attributable to negligence until he later consulted an attorney. Id. at 537, 863 P.2d at 256. ¶ 16 Kowske certainly is factually relevant to the present case. Both Kowske and the present case are situations in which the fact of injury is known but the possibility of negligence is difficult to discern. There are instances, of course, in which an unfortunate result would immediately put the plaintiff on notice that the result is not only unfavorable but might be attributable to some fault and should be investigated. See, e.g., Trede v. Family Dental Ctr., 147 Ariz. 25, 27, 708 P.2d 116, 118 (App.1985) (injury to plaintiff's hand during tooth extraction); Speed v. DeLibero, 23 Conn.App. 437, 580 A.2d 1242 (1990) (patient underwent elective outpatient surgery and died from anesthesia-induced brain injury). In such cases, one may say as a matter of law that the patient is not only aware of the injury but also on notice to investigate whether the injury is likely attributable to the fault of someone responsible for her care. The bright-line rule drawn by Kowske and similar cases is properly applied to such cases and the action accrues even though the plaintiff has not sought an expert opinion on malpractice or a legal opinion that a cause of action exists. See Kowske, 176 Ariz. at 537-38, 863 P.2d at 256-57. ¶ 17 There are also cases, and this is one, in which factual context does not permit finding, as a matter of law, that a patient was promptly on sufficient notice of the confluence of what and who and that an unhappy result should be investigated to determine whether it is attributable to fault of those responsible for the patient's care. Contrary to Defendant's argument, we do not believe the statute is automatically triggered each time a professional's services have failed to produce the desired result or may even have brought about an adverse result. Indeed, it is often the rule that in such cases the question of accrual is for the jury. Gust, Rosenfeld & Henderson v. Prudential Ins. Co., 182 Ariz. 586, 591, 898 P.2d 964, 969 (1995). ¶ 18 Over the years, our courts have discussed accrual in a series of cases. From early days, we have treated the question of accrual as one of equitable tolling. Thus, when the defendant secretly removed ore from a mine, we held it was equitable to commence the limitations period on the plaintiff's discovery of the trespass and conversion. Tom Reed Gold Mines Co. v. United Eastern Mining Co., 39 Ariz. 533, 535, 8 P.2d 449, 450 (1932). In an early dental malpractice case that twice came to this court, we construed Tom Reed as having two distinct holdings: first, that limitation does not begin to run against a trespass until the plaintiff knows, or reasonably should know, of the trespass, and [second,] that if the wrong constituting the cause of action is concealed, limitation will not begin to run until such concealment is discovered, or reasonably should have been discovered. Acton v. Morrison, 62 Ariz. 139, 144, 155 P.2d 782, 784 (1945). ¶ 19 The second time that case came to this court, we held that a patient was not barred from bringing an action against his dentist because the patient should [not] be penalized for failing for even this long period of time to discover the true seat of his troubles. Morrison v. Acton, 68 Ariz. 27, 36, 198 P.2d 590, 596 (1948). The dentist in Morrison left a piece of metal in the patient's jaw after surgical removal of a wisdom tooth. As a result, the patient was left with serious pain in his mouth. The dentist was aware that his drill bit had broken and that this might be the cause of the plaintiff's post-surgical problems, but he failed to explain this to the plaintiff. We held the statute of limitations tolled until the plaintiff's discovery of the facts. In Morrison, as in the present case, the plaintiff knew his continuing pain and the failure of his jaw to heal were attributable to the dentist's procedure, but he was unaware of the dentist's negligence. A jury could find the same to be true in the present case. ¶ 20 The court of appeals adopted and applied the Morrison doctrine in Mayer v. Good Samaritan Hospital, 14 Ariz.App. 248, 482 P.2d 497 (1971). In Mayer, the plaintiff's injuries were caused by an episode of insulin shock sustained in 1964. Although the injuries became apparent that same year, the plaintiff did not file her action until four years later, approximately six months after discovering the physician's negligent conduct. Declining to interpret Morrison as resting only on the basis of fraudulent concealment, the court of appeals held that Mayer's action was not time barred. Our court of appeals concluded that the legislature intended to adopt a fair and just statute of limitations that would balance the ease or difficulty a plaintiff has in understanding the cause of an injury with a plaintiff's tardiness in allowing a claim to become stale after the first indications of injury are present. The court said: [W]e specifically reject the defendants' alternate argument that the statute begins to run from the time the injuries manifest themselves. However, this point in time may be important in considering the issue as to whether the plaintiff by the exercise of reasonable diligence should have known of defendants' negligence. Id. at 252, 482 P.2d at 501. In Kenyon, this court adopted Mayer's formulation of the discovery rule. 142 Ariz. at 73 n. 1, 688 P.2d at 965 n. 1. ¶ 21 We approved that formulation again in a case involving application of the discovery rule to a breach of contract claim, holding that the important inquiry in applying the discovery rule is whether the plaintiff's injury or the conduct causing the injury is difficult for plaintiff to detect.... Gust, Rosenfeld, 182 Ariz. at 590, 898 P.2d at 968 (discovery rule applied seventeen years after landlord's breach of lease agreement containing most favored nations clause). The statute of limitations protects defendants from stale claims where plaintiffs have slept on their rights. Id. A blamelessly uninformed plaintiff cannot be said to have slept on his rights. Id. at 591, 898 P.2d at 969. [3] ¶ 22 We next addressed this problem in Doe v. Roe, 191 Ariz. 313, 955 P.2d 951 (1998). Reversing summary judgment, we held there was a genuine factual issue concerning application of the discovery rule, even though the plaintiff filed the action more than two years after she had her first memory that she had been sexually abused by her father. While an injured person need not know all the facts underlying a cause of action to trigger accrual ... [,] the plaintiff must at least possess a minimum requisite of knowledge sufficient to identify that a wrong occurred and caused injury.  Id. at 323 ¶ 32, 955 P.2d at 961 ¶ 32 (second emphasis added) (citations omitted). Doe makes clear it is not enough that a plaintiff comprehends a what; there must also be reason to connect the what to a particular who in such a way that a reasonable person would be on notice to investigate whether the injury might result from fault. ¶ 23 While it is ordinarily sufficient when the plaintiff is aware of the injury and its causative agent (the what and who elements), summary judgment is warranted only if the failure to go forward and investigate is not reasonably justified. The plaintiff could not be charged with a duty to file a complaint based on information she subjectively believed to be false or unbelievable at the time. Id. at 324 ¶ 35, 955 P.2d at 962 ¶ 35. Thus, the jury must determine at what point Plaintiff's knowledge, understanding, and acceptance in the aggregate provided sufficient facts to constitute a cause of action. Id. at ¶ 36. We pointed out that determinations of the time when discovery occurs and a cause of action accrues are usually and necessarily questions of fact for the jury. Id. at 323 ¶ 32, 955 P.2d at 961 ¶ 32 (citing Gust, Rosenfeld, 182 Ariz. at 591, 898 P.2d at 969). ¶ 24 In the present case, the court of appeals believed that Plaintiff had a reasonable opportunity to discover Defendant's negligence because she was placed under the care of other doctors. Mem. dec. at ¶ 11. No doubt Plaintiff did have an opportunity to discover Defendant's negligence, but the core question is whether a reasonable person would have been on notice to investigate. Plaintiff's doctor assured her he had done nothing wrong, and we do not believe that as a matter of law she was on notice to commence investigating whether negligence was involved. This is especially true when the doctors to whom Defendant later referred Plaintiff for treatment failed to disclose to her their belief that Defendant had been negligent. [4] While her failure to question the consulting doctors for such information could be taken as a lack of diligence, we do not believe it can be said as a matter of law that a reasonable person in this circumstance can be required to undertake such questioning or be held accountable for not doing so. This is the very sort of factual determination that must be left for the jury under Mayer, Kenyon, and other cases discussed above. ¶ 25 Given that Kowske was decided before Doe, it is understandable that the Kowske opinion focuses more on traditional conceptions of the what and who elements than on the plaintiff's knowledge or constructive knowledge that a wrong might have occurred. Today, we disapprove Kowske to the extent that it suggests accrual occurs in cases of this type before a plaintiff is put on reasonable notice to investigate whether the injury is attributable to negligence. [5] The existence of injury or untoward result is, of course, one of the factors to be considered on the question of reasonable notice, and our holding today is not meant to relieve a potential plaintiff of the reasonable duty to timely inquire whether any basis exists for legal action. ¶ 26 We believe that the analysis we have followed since Tom Reed in 1932 to date is applicable in the present case. The what is the fact of injury. With respect to those in a professional or fiduciary relationship with the tortfeasor, an adverse or untoward result, or a failure to achieve an expected result, is not, as a matter of law, always sufficient notice. To trigger the statute of limitations, something more is required than the mere knowledge that one has suffered an adverse result while under the care of a professional fiduciary. The history of the present statute supports that conclusion.