Opinion ID: 1850917
Heading Depth: 1
Heading Rank: 3

Heading: continuous treatment doctrine

Text: Prior to Carter, this court had declined to address directly the continuous treatment doctrine in medical malpractice cases or to recognize the possibility that a doctor's continuing professional relationship with a patient might, under some circumstances, operate to suspend prescription in a medical malpractice claim. Id. at 12-13, 892 So.2d at 1269. This court noted in Carter that one reason prescription is suspended under the continuous treatment doctrine is the fact that, so long as the plaintiff remains in the care of the defendant physician, she could reasonably expect [or hope for] a correction of the diagnosis or tortious treatment. Id. at 13, 892 So.2d at 1269. The court went on in Carter to find, based on the circumstances of that case, that prescription was suspended by virtue of the continuous treatment doctrine because the plaintiff had reasonably relied on the repeated assurances and . . . continuous efforts of the defendant dentist to correct the extensive dental problems caused by the alleged malpractice, which served to effectively prevent the plaintiffs from pursuing their claims against him. Id. at 19, 892 So.2d at 1273. Prescription was suspended, the court found, until the doctor-patient relationship terminated upon the defendant's refusal to continue treating the plaintiff. Id. Thus, the plaintiff's suit, filed within one year of that date, was timely. Id. at 19, 892 So.2d at 1273. The Carter case analogized the continuous treatment doctrine to the continuous representation doctrine that was once applied by Louisiana courts in legal malpractice cases where the professional's involvement after the alleged malpractice is for the performance of the same or related services and is not merely continuity of a general professional relationship. Id. at 16, 892 So.2d at 1271, quoting Lima v. Schmidt, 595 So.2d 624, 630 (La.1992). [4] This court adopted the continuous representation doctrine in legal malpractice cases in Braud v. New England Ins. Co., 576 So.2d 466, 468 (La.1991), in which it cited with approval a number of Louisiana court of appeal cases that had applied the doctrine, including Newsom v. Boothe, 524 So.2d 923 (La. Ap. 2 Cir.), writ denied, 531 So.2d 479 (La.1988); Malone v. Wright, 525 So.2d 13 (La.App. 3 Cir.1988); and Olivier v. National Union Fire Ins. Co., 499 So.2d 1330 (La.App. 3 Cir.1986). In Braud, this court characterized the continuous representation doctrine as follows: [D]uring the attorney's continuous representation of the client regarding the specific subject matter in which the alleged wrongful act or omission occurred, prescription will be suspended. 576 So.2d at 468. See Carter, 04-0646 at 15, quoting Lima, 595 So.2d at 630, quoting Braud. The continuous representation doctrine in legal malpractice cases was grounded on the premise that an attorney's decision to continue to represent a client induces the client to continue to depend on the attorney's expertise to resolve the pending legal issue. In Carter, this court noted the analogous principle that in a medical malpractice case, [i]t is the continuation of the special relationship that offers the possibility of correction of the injury and thus may postpone the running of prescription. 04-0646 at 13, 892 So.2d at 1269. Like the continuing representation doctrine in legal malpractice cases, the continuing treatment doctrine in medical malpractice cases applies where the professional's involvement after the alleged malpractice is for the performance of the same or related services and is not merely continuity of a general professional relationship. Id. at 16, 892 So.2d at 1271, quoting Lima, 595 So.2d at 630. I agree with the court of appeal that Ms. Noe has carried her burden in this case of proving that prescription was suspended by virtue of the continuous treatment doctrine adopted by this court in Carter. This court adopted two elements in Carter that must be established by a plaintiff in a medical malpractice action seeking to avail herself of the benefits of the continuous treatment doctrine to suspend prescription: (1) a continuing treatment relationship that is more than perfunctory, during which (2) the physician engaged in conduct which served to prevent the patient from availing herself of her cause of action, such as attempting to rectify an alleged act of malpractice. 04-0646 at 16, 892 So.2d at 1271. Ms. Noe established the first of those two elements through her testimony that she had selected Dr. Hill as her personal care physician in 1998 and that he had continued in that capacity between 1998 and 2002. Further, the IMG Healthcare records establish that Ms. Noe sought treatment from Dr. Hill on at least four occasions during the nine-month period following the injection. Obviously, their physician-patient relationship was more than perfunctory. Defendants' primary argument is that Ms. Noe failed to establish the second of the two elements  i.e., that Dr. Hill did not engage in conduct that discouraged Ms. Noe from filing suit, such as attempting to rectify an alleged act of malpractice. Defendants claim that the continuous treatment doctrine should not apply because the relationship between Ms. Noe and Dr. Hill was merely continuity of a general professional relationship, rather than involvement after the alleged malpractice . . . for the performance of the same or related services. Id. In support of this argument, they point to the fact that the IMG Healthcare record includes only two notations by Dr. Hill indicating that Ms. Noe sought treatment for continuing problems related to the injection site. The first of those two notations appears in Dr. Hill's note concerning Ms. Noe's August 6, 2001, visit that occurred approximately six weeks after the injection. The second of those notations appears in Dr. Hill's note concerning Ms. Noe's visit on April 3, 2002, ten months after the injection, when he referred her to a neurologist. Because Dr. Hill's notes concerning Ms. Noe's December 17, 2001, and her January 25, 2002, visits include no notation that Ms. Noe complained about the injection site, defendants argue that, beyond August 6, 2001, Dr. Hill provided no treatment for that problem. To the contrary, Ms. Noe directs this court's attention to her deposition and affidavit, in which she stated that she consulted Dr. Hill with complaints about the injection site on at least four occasions, including the December 17, 2001, visit, when, according to Ms. Noe, Dr. Hill in fact checked the injection site. Furthermore, Ms. Noe stated in her affidavit that she spoke to Dr. Hill by telephone between the August and December visits regarding the injection site, and that Dr. Hill consistently told her that he was confident about his diagnosis that she was suffering from an allergic reaction to the Celestone. Moreover, according to Ms. Noe, Dr. Hill placed her on a one-year exercise program to strengthen her buttock muscles and encouraged her on several occasions to continue with the program when she questioned his diagnosis. In Blanchard v. Reeves, 469 So.2d 1165 (La.App. 5 Cir.), writ denied, 476 So.2d 347 (La.1985), a case that applied the analogous continuous representation doctrine in a legal malpractice case, the court noted that either the defendant attorney did not know that continuing to represent the plaintiff after the cause had prescribed was a conflict of interest, or the defendant attorney had failed to disclose a conflict of interest that he knew existed. 469 So.2d at 1168. Either way, the court implied, the continuous representation doctrine suspended prescription. If the attorney was unaware of the conflict, he would have us impose on his client a greater burden of legal knowledge than he possessed, the court stated Id. An analogous rule applies here. The defendants would have us find that, because Ms. Noe expressed a suspicion that she might have suffered nerve damage as a result of the injection, her medical malpractice claim prescribed because she did not file her medical malpractice complaint within one year of the date the injection was administered. However, if it were to find that Ms. Noe's medical malpractice complaint is prescribed, this court would be imposing on Ms. Noe a greater burden of medical knowledge than Dr. Hill possessed. Otherwise, Dr. Hill intentionally misled Ms. Noe concerning the nature of her injury, which itself would be sufficient to suspend prescription in this case. Further, in Braud, 576 So.2d 466, in which this court first adopted the continuing representation doctrine for legal malpractice cases, the court noted that a finding that prescription ran during the existence of an on-going attorney-client relationship would create a situation where an attorney could effectively defeat a malpractice claim against himself by utilizing the appeals process to continue the attorney-client relationship until such time as prescription has run. Again, that reasoning applies to this case. A finding that Ms. Noe's medical malpractice claim prescribed one year from the date of the injection would create a situation where Dr. Hill could have defeated her medical malpractice claim simply by misdiagnosing her problem, then prescribing a one-year course of treatment during which prescription would run. Such a result would be untenable. Accordingly, the majority has correctly found that prescription in Ms. Noe's medical malpractice claim was suspended pursuant to the continuous treatment doctrine until the professional relationship between Ms. Noe and Dr. Hill was terminated. That conclusion leads me to the question of whether Ms. Noe's claim was timely filed on March 12, 2003. When, as in this case, prescription has been suspended by virtue of the third category of contra non valentum, prescription does not run until the reason for the suspension is removed. The injection that allegedly caused Ms. Noe's damage was administered on June 11, 2001, but Ms. Noe's physician-patient relationship with Dr. Hill continued until at least April 3, 2002, the last time she saw Dr. Hill, when he referred her to a neurologist. Because Ms. Noe's relationship with Dr. Noe did not terminate until April 3, 2002, at the earliest, prescription did not begin to run until that date. Accordingly, her Medical Malpractice Complaint filed on March 12, 2003, within one year of April 3, 2002, was timely.