Opinion ID: 2318666
Heading Depth: 3
Heading Rank: 2

Heading: Action for Professional Negligence

Text: [¶ 21] We review the court's interpretation of section 2902 de novo by first examining the plain meaning of the statute within the context of the whole statutory scheme to give effect to the Legislature's intent. [5] HL 1, LLC v. Riverwalk, LLC, 2011 ME 29, ¶ 17, 15 A.3d 725, 731; Dickey, 2008 ME 179, ¶ 5, 960 A.2d at 1180. [¶ 22] In relevant part, section 2902 of the Health Security Act provides: Actions for professional negligence shall be commenced within 3 years after the cause of action accrues. For the purposes of this section, a cause of action accrues on the date of the act or omission giving rise to the injury.... This section does not apply where the cause of action is based upon the leaving of a foreign object in the body, in which case the cause of action shall accrue when the plaintiff discovers or reasonably should have discovered the harm. 24 M.R.S. § 2902. Although section 2902 directs that, a cause of action accrues on the date of the act or omission giving rise to the injury, it does not define act or omission. Elsewhere in the statutory scheme, however, the Act defines action for professional negligence and professional negligence, and those terms offer insight into the plain meaning of act or omission. Section 2502(6) defines an action for professional negligence as: any action for damages for injury or death against any health care provider, its agents or employees, or health care practitioner, his agents or employees, whether based upon tort or breach of contract or otherwise, arising out of the provision or failure to provide health care services. 24 M.R.S. § 2502(6) (2010). Section 2502(7) defines professional negligence as meaning: A. There is a reasonable medical or professional probability that the acts or omissions complained of constitute a deviation from the applicable standard of care by the health care practitioner or health care provider charged with that care; and B. There is a reasonable medical or professional probability that the acts or omissions complained of proximately caused the injury complained of. 24 M.R.S. § 2502(7) (2010). [¶ 23] The Act's definition of professional negligence accounts for each of the four elements in every claim of negligenceduty, breach, proximate causation, and harm. See 24 M.R.S. § 2502(7); Dickey, 2008 ME 179, ¶ 9 n. 2, 960 A.2d at 1180. This definition recognizes that a cause of action for professional negligence is stated when either a single act or omission or two or more acts or omissions complained of constitute a deviation from the applicable standard of care ... and ... [t]here is a reasonable medical or professional probability that the acts or omissions ... proximately caused the injury complained of. 24 M.R.S. § 2502(7). [¶ 24] Accordingly, a single cause of action may arise from multiple acts or omissions even if each independent act or omission, viewed in isolation from the other acts or omissions, constitutes an independent deviation from the applicable standard of care. In such cases, the key question is whether, in combination, the acts or omissions complained of proximately caused the injury complained of. Id. (emphasis added). If so, the single cause of action must accrue from the date of the last act or omission that contributed to the alleged injury because only then was the alleged negligence complete. By contrast, if it were reasonably probable that one act or omission in a series of acts or omissions was the sole proximate cause of the injury complained of, a cause of action would accrue from the date of that act or omission, and not from the dates of any subsequent acts or omissions. [¶ 25] Thus, in cases involving a continuing course of negligent treatment, the Act allows for the possibility that two or more negligent acts or omissions might combine to proximately cause a patient's injury. See 24 M.R.S. § 2502(7). In such cases, the cause of action accrues for purposes of the three-year limitations period on the date of the last act or omission by the health care provider or practitioner that contributed to the proximate causation of the patient's harm. There is no sound reason to require a plaintiff to split his or her claims and assert a separate cause of action for each individual negligent act or omission when the acts or omissions combine to proximately cause a discrete harm. Judicial economy, fairness to litigants, and the strong public interest favoring finality in judicial proceedings demand that a plaintiff present all relevant aspects of his cause of action in a single lawsuit. Camps Newfound/Owatonna Corp. v. Town of Harrison, 1998 ME 20, ¶ 12, 705 A.2d 1109, 1113-14 (quotation marks omitted). This view is in harmony with the plain meaning of section 2902 when it is read in conjunction with section 2502(6) and (7). [¶ 26] In contrast, when section 2902 is read in isolation from section 2502(6) and (7), the term act or omission naturally refers to a single, specific occurrence. This literal construction, adopted by the Superior Court and urged by Farrand, supports a conclusion that the plain meaning of act or omission, as used in section 2902, does not mean the last in a series of acts or omissions. So read, a cause of action accrues for purposes of section 2902 upon the occurrence of each negligent act or occurrence that proximately caused an injury. [¶ 27] To determine a statute's meaning, however, our reading of the statute must be squared with all applicable rules of statutory construction. Here, we must account for the rule: Words of the singular number may include the plural; and words of the plural number may include the singular. 1 M.R.S. § 71(9) (2010). We apply this rule unless the resulting construction is inconsistent with the plain meaning of the enactment. 1 M.R.S. § 71 (2010); Adoption of M.A., 2007 ME 123, ¶ 12, 930 A.2d 1088, 1092. [¶ 28] There is a circular quality to the logic of using a rule of statutory construction to interpret the plain meaning of a statute when that rule only applies if it does not conflict with the plain meaning of the statute. But the application works here because there are no other words or phrases in section 2902 suggesting that act or omission should be read to express only the singular. It is not inconsistent with the plain meaning of the words employed in section 2902, or the Health Security Act as a whole, to treat a cause of action for professional negligence as accruing on the most recent date of the act(s) or omission(s) giving rise to the harm because elsewhere the Act defines professional negligence using the plural acts or omissions. 24 M.R.S. § 2502(7). Thus, it is consistent with the Act's definition of a cause of action for professional negligence to define the term act or omission as used in section 2902 as referring to either a single act or omission, or a series of related acts or omissions that proximately cause a harm. [¶ 29] We therefore hold that, pursuant to section 2902, a plaintiff may bring a single action alleging continuing negligent treatment that arises from two or more related acts or omissions by a single health care provider or practitioner where each act or omission deviated from the applicable standard of care and, to at least some demonstrable degree, proximately caused the harm complained of, as long as at least one of the alleged negligent acts or omissions occurred within three years of the notice of claim. This construction is consonant with the plain meaning of section 2902, the Legislature's definitions of action for professional negligence and professional negligence in sections 2502(6) and 2502(7), and the legislatively adopted rule of construction provided in 1 M.R.S. § 71(9). [¶ 30] The question on report asks whether we will recognize the continuing negligent treatment doctrine and allow Baker to assert a claim based on acts or omissions that occurred more than three years prior to the filing of his notice of claim. Subject to the requirements for a claim involving continuing negligent treatment as we have discussed, we answer this question in the affirmative based on the language and authority of the Health Security Act and not the common law.