Opinion ID: 2094758
Heading Depth: 2
Heading Rank: 2

Heading: Medical Negligence

Text: ¶ 11 The estate's survival action is a claim for medical negligence asserted on Robert's behalf. The parties do not dispute, and we agree, that Wis. Stat. § 893.55(1m)(a) is the applicable statute of limitations for this claim, and that the claim accrued on the date that Robert sustained an injury as that term is used in the statute. Where the parties differ is with respect to the meaning of the term injury. ¶ 12 The statute does not define injury. However, the parties point to decisions by Wisconsin courts that purportedly support their proposed interpretations of the term. The estate and Kathy cite to our decision in Paul to argue that an injury does not occur under Wis. Stat. § 893.55(1m)(a) until the underlying condition is no longer treatable. That is, only after a medical condition has become irreversible does a claim accrue. Because Robert's condition did not become irreversible until on or after August 9, 2003, the estate argues that its claim was timely filed. ¶ 13 In Paul, we determined when an actionable injury based on medical negligence for misdiagnosis occurred, thereby causing the claim to accrue. Paul, 242 Wis.2d 507, ¶¶ 12-13, 625 N.W.2d 860. We concluded that the estate's claim accrued, at the latest, on the date that the decedent's undiagnosed arteriovenous malformation ruptured. Id., ¶ 45. The estate and Kathy cite the following language in Paul in support of their argument that an injury triggering the limitations period does not occur until the patient's condition becomes untreatable or irreversible: That actionable injury which resulted from the alleged misdiagnosis occurred either at the time that [the arteriovenous malformation] AVM ruptured, or at the time that [the] AVM could no longer be treated. . . . . . . . . . . [B]ased on the information presented, the injury that resulted from the alleged misdiagnosis occurred when the rupture of the AVM in [decedent]'s brain happened . . ., or it occurred at that point . . . when, more likely than not, [decedent]'s AVM could not have been successfully treated. Id. at ¶¶ 45, 53. In this case, the estate and Kathy contend that Robert's condition did not become untreatable until on or after August 9, 2003, resulting in the estate's medical negligence claim being timely-filed on August 9, 2006. ¶ 14 OHIC, on the other hand, asserts that Robert sustained an injury on the date he first suffered a physical injurious change, as that term was used by the court of appeals in Fojut. In Fojut, the court of appeals determined the date of injury for a woman who had undergone tubal ligation surgery. Fojut, 212 Wis.2d at 830-31, 569 N.W.2d 737. The surgery was unsuccessful, and the woman subsequently became pregnant. Id. at 829, 569 N.W.2d 737. The court decided that the date of the plaintiff's unwanted conception, rather than the date of the surgery, was the injury that triggered Wis. Stat. § 893.55(1m)(a). The court explained: There is no evidence that on the date the tubal ligation was performed that [the plaintiff] suffered any physical injury. The purpose of the surgery was to render [the plaintiff] infertile  to avoid pregnancy. There was no physical injurious change to [the plaintiff]'s body until she became pregnant. . . . Using this date as the date of injury, [the plaintiff]'s claim was untimely because the complaint was not filed within three years. Id. at 831, 569 N.W.2d 737. ¶ 15 OHIC contends that Robert suffered an injury on July 24, 2003, when the sponge was left in his abdominal cavity and he developed an infection. This was a physical injurious change to Robert's body, as that term was used in Fojut. In the alternative, OHIC asserts that any physical injurious change could have occurred no later than August 8, 2003, when Robert underwent the second surgery to remove the sponge. As a result, because the claims were filed on August 9, 2006, and more than three years had passed, the estate's and Kathy's claims are time-barred by Wis. Stat. § 893.55(1m)(a). ¶ 16 In response, the estate and Kathy assert that Paul and Fojut are inconsistent, and that their interpretation of Paul should control the questions presented here. We disagree. Although the estate and Kathy have selected the language from Paul most favorable to their interpretation, Paul and Fojut are entirely consistent with one another. Neither of them concludes that an injury must be untreatable or irreversible to trigger the limitations period imposed by Wis. Stat. § 893.55(1m)(a). As we noted in Paul, a condition need not be untreatable before an injury occurs; rather, an actionable injury arises when the [negligent act or omission] causes a greater harm than [that which] existed at the time of the [negligent act or omission]. Paul, 242 Wis.2d 507, ¶ 25, 625 N.W.2d 860. This language articulates the same concept set forth by the court of appeals' decision in Fojut, i.e., that an injury does not occur until there is a physical injurious change. ¶ 17 Furthermore, our conclusion, that the determination of a physical injurious change is the appropriate benchmark for establishing the date of injury under Wis. Stat. § 893.55(1m)(a), is consistent with the facts set forth in Paul. In Paul, the rupturing of the plaintiff's arteriovenous malformation was the first physical injurious change experienced by the plaintiff following the doctor's negligent misdiagnosis. There was no point prior to that rupture where a greater harm than existed at the time of the misdiagnosis occurred. Id. Even though plaintiff's condition was irreversible once the arteriovenous malformation ruptured, that was not the reason that the rupture was the injury. Rather, it was the injury because there was no point prior to that rupture in which the plaintiff experienced a physical injurious change. Therefore, we reject plaintiffs' contention that Paul and Fojut are in conflict. ¶ 18 Applying Paul and Fojut to this case, we conclude that Robert's injury that triggered the three-year limitations period in Wis. Stat. § 893.55(1m)(a) occurred on July 24, 2003. It was on that date that an infection-producing sponge was left in Robert's abdomen, which eventually caused his death. [6] The second surgery performed on August 8, 2003, while it may have inflicted an additional injury on Robert because he was subjected to more surgery, mainly confirmed Robert's injury from the first surgery. ¶ 19 It was the negligence during the first surgery that resulted in an infection-producing sponge being present in Robert's abdomen. Stated otherwise, by leaving the sponge inside of Robert, the doctors cause[d] a greater harm than existed at the time of the [negligent act]. Paul, 242 Wis.2d 507, ¶ 25, 625 N.W.2d 860. Robert suffered an injury when the doctors left an infection-producing sponge in his abdominal cavity, and the sponge was not there prior to the doctors' negligent conduct. ¶ 20 Accordingly, the presence of an infection-producing sponge in Robert's abdominal cavity is the type of physical injurious change discussed in Fojut, and our conclusion that it constitutes an injury is consistent with Paul. When the doctors negligently left a sponge inside of Robert, which caused the sepsis that resulted in his death, he sustained an injury that triggered Wis. Stat. § 893.55(1m)(a)'s three-year limitations period. [7] Because this injury occurred more than three years prior to August 9, 2006, when the claim was filed, we conclude that the estate's claim is time-barred by § 893.55(1m)(a). ¶ 21 Furthermore, accepting the estate's and Kathy's definition of injury would contradict the maxim that `[a] later injury from the same tortious act does not restart the running of the statute' of limitations. Fojut, 212 Wis.2d at 832, 569 N.W.2d 737 (quoting Segall v. Hurwitz, 114 Wis.2d 471, 482, 339 N.W.2d 333 (Ct. App.1983)). That is, even though an infection-producing sponge was present inside of Robert's abdomen as a result of the first surgery, the estate and Kathy urge us to restart the statute of limitations by concluding that Robert sustained an injury only when his condition became irreversible. We decline to do so. ¶ 22 Were we to conclude as the estate and Kathy suggest, it would logically follow that Robert could not have filed a medical negligence action once the infection-producing sponge was present inside of his abdomen, even if that injury led only to a protracted recovery course, rather than to death. However, many claims of medical negligence are not grounded in untreatable injuries. For example, in Fojut, a tubal ligation was negligently performed; however, the ligation was re-done subsequently. Fojut, 212 Wis.2d at 832, 569 N.W.2d 737. Because all injuries that result from medical negligence do not lead to death or to an irreversible medical course, it is not reasonable to interpret the word injury as the estate and Kathy suggest. As we also have explained, once a claimant has sustained an injury and has an enforceable claim, that claimant cannot sit on that claim until all consequential damages have come to fruition. Paul, 242 Wis.2d 507, ¶ 39, 625 N.W.2d 860 (citing Nierengarten v. Lutheran Soc. Servs. of Wis. & Upper Mich., Inc., 219 Wis.2d 686, 701, 580 N.W.2d 320 (1998)). Accordingly, we conclude that the estate's claim for medical negligence accrued more than three years before the estate filed suit. Therefore, it is untimely under Wis. Stat. § 893.55(1m)(a).