Opinion ID: 852412
Heading Depth: 3
Heading Rank: 4

Heading: Reasonable Diligence As a Question of Law or Fact

Text: Like many legal issues turning on reasonable conduct, the determination of the trigger date may raise issues of fact but often may be resolved as a matter of law. See Van Dusen, 712 N.E.2d at 499. The trigger date becomes a matter of law when it is clear that the plaintiff knew, or should have known, of the alleged symptom or condition, and facts that in the exercise of reasonable diligence would lead to discovery of the potential of malpractice. For example, the trigger date is established as a matter of law when a patient is told by a doctor of the reasonable possibility, if not a probability, that the specific injury was caused by a specific act at a specific time. Id. at 500; see, e.g., Moyer v. Three Unnamed Physicians from Marion County & Del. County, 845 N.E.2d 252, 259 (Ind.Ct.App.2006) (holding that trigger date when doctor told the plaintiff that there may be a link between prescribed medicine and heart disease). The date is also set as a matter of law when there is undisputed evidence that leads to the legal conclusion that the plaintiff should have learned of the alleged malpractice and there is no obstacle to initiating litigation. See Brinkman, 879 N.E.2d 549, 554-55. The trigger date will be tolled as a matter of law when the alleged malpractice was not reasonably discoverable within the limitations period. This may be the case if the disease or injury remains latent for an extended period after the alleged malpractice. So, in Martin, 711 N.E.2d 1273, the limitations period for failure to identify breast cancer noticeable in an x-ray was tolled until the cancer was revealed by a subsequent x-ray because the patient had no symptoms identifiable without that technology. Similarly, in Harris v. Raymond, 715 N.E.2d 388, 390-91 (Ind.1999), the limitations period for a defective jaw implant was tolled until a second doctor discovered the imploded implant in the course of treating the patient for an earache. There may, however, be factual issues that determine whether the claim is time-barred. Reliance on a medical professional's words or actions that deflect inquiry into potential malpractice can also constitute reasonable diligence such that the limitations period remains open. Where the plaintiff knows of an illness or injury, but is assured by professionals that it is due to some cause other than malpractice, this fact can extend the period for reasonable discovery. See Halbe v. Weinberg, 717 N.E.2d 876, 878-79 (Ind.1999) (holding that the limitations period was tolled for negligent insertion of silicone-based breast implants because the patient had been told that the implants were not silicone); Weinberg v. Bess, 717 N.E.2d 584, 586-88 (Ind.1999) (same). We have also found that an explicit or implicit denial of causation may prevent the plaintiff from discovering malpractice. In Booth, the plaintiff underwent LASIK surgery in November 1998. 839 N.E.2d at 1173. In October 1999, he learned that he had permanent eye damage, but his doctors continued to present other explanations for the vision difficulties, such as glaucoma and plaque associated with `mini strokes,' without ever mentioning the [LASIK] surgeries as the cause of the worsening condition. Id. at 1174. By attributing his failing vision to other causes, the plaintiff's doctors created a factual issue as to whether he should have discovered the alleged malpractice before December 2000, when a new physician told him that LASIK surgery should not have been performed. Id. at 1176. The physical incapacity of the plaintiff can in limited circumstances constitute yet a third ground for tolling the limitations period which ultimately turns on an issue of fact. In City of Fort Wayne v. Cameron, 267 Ind. 329, 370 N.E.2d 338 (1977), we recognized that under article I, section 12's guarantee of a remedy by due course of law, unusual circumstances of the plaintiff may prevent access to the courts and suspend the period in which reasonable diligence is required. In that case, a deputy sheriff shot the plaintiff, rendering him a quadriplegic confined to a hospital for over one year. Id. at 330, 370 N.E.2d at 339. Although the plaintiff, a minor at the time of the incident, filed a Tort Claims Act notice within three weeks after attaining majority, the notice was six months after the sixty-day period allowed at that time. Id. We held that the statute would be unconstitutional as applied to the plaintiff if he was mentally and physically incapacitated so that he could not give the notice as required by the statute. Id. at 333-34, 370 N.E.2d at 341. Enforcement of the time limit would deprive him of his constitutional right to a `remedy by due course of law.' Id. Although Cameron was not a medical malpractice case, the same principle applies to a medical malpractice claim that is alleged to have caused the plaintiff's inability to file. Cf. Martin, 711 N.E.2d at 1283 (citing Cameron with approval).