Court Opinion

ID: 9803300
Source: CourtListenerOpinion
Date Created: 2023-08-31 15:30:05.341645+00
Date Added: 2024-06-11T10:03:01.159179
License: Public Domain

Friedman, J.,
dissents in part in a memorandum as follows: The majority affirms the judgment for plaintiff Johnson Devadas in this medical malpractice action based on its holding that a factual question was presented at trial as to whether the “continuous treatment” doctrine tolled the running of the statute of limitations from May 19, 2004, the date of plaintiffs last immediate postoperative consultation with defendant Kevin Niksarli, M.D., until February 21, 2007, the date of plaintiffs last consultation with defendant before he commenced this ac*1011tion.1 The majority reaches this result even though it is undisputed that, following defendant’s performance of the allegedly contraindicated LASIK eye surgery in April 2004, there was no contact of any kind between plaintiff and defendant during the 33 months that passed between the May 2004 visit and the February 2007 visit — an interval three months longer than the 30-month limitation period (CPLR 214-a). The majority’s sustaining of a finding that a course of “continuous treatment” persisted over a period longer than the limitation period, in which no physician-patient contact whatsoever occurred, appears to be without precedent in this state (see Edward J. Guardaro, Jr. & Norman Bard, New York Medical Malpractice § 9:100 [2014]).
The majority purports to justify its apparently unprecedented holding by pointing to the “guarantee” that plaintiff claims to have received from defendant. According to plaintiff’s own testimony, however, this alleged “guarantee” was nothing more than a promise that plaintiff would not be charged for additional treatment or follow-up procedures relating to the LASIK surgery.2 By plaintiffs own account, although he believed that he could see defendant “at any time” for issues relating to the surgery, on an “as-needed basis,” he had no specific intention of returning to consult with defendant at any “definite time,” or within any particular time frame, after the May 2004 office visit. Notwithstanding the blurred vision that persisted after the operation, plaintiff testified that he did not return to defendant’s office for nearly three years after the May 2004 appointment because he “had adapted to [the] blurry vision” and had found defendant to be “dismissive” of his complaints at his postoperative visits in 2004. It was only when the blurred vision “got[ ] worse” in early 2007 that plaintiff returned to see defendant.
Even assuming in plaintiffs favor that his May 2004 and February 2007 consultations with defendant were “for the same illness, injury or condition” (CPLR 214-a), I cannot see how plaintiffs knowledge of the alleged “guarantee,” by itself, can be deemed to support a finding that “continuous treatment” *1012persisted over a 33-month period in which there was neither any actual physician-patient contact nor any definite plans or expectation for such contact to resume. That plaintiff believed he could return to defendant’s office at any point in the future to seek treatment relating to his LASIK surgery, on an “as-needed basis,” does not distinguish this case from any situation in which a course of treatment concludes without either a definite breach in the physician-patient relationship or the patient’s switching to a different doctor. Plaintiffs belief that defendant would not charge him for any future LASIK-related treatment is irrelevant to the question of whether a course of treatment continued over nearly three years during which the parties had no actual contact, whether in person or otherwise. Thus, plaintiff’s own testimony establishes, as a matter of law, that defendant’s continuous treatment of plaintiff relating to the allegedly negligent April 2004 LASIK surgery came to an end in May 2004. Plaintiff’s brief resumption of treatment with defendant in February 2007 (for only one visit), while perhaps for the same condition, was not part of the earlier course of treatment that had ended in May 2004 and could not revive claims arising from that course of treatment, for which the statute of limitations had expired in November 2006. A renewal or resumption of treatment after a lengthy break is not continuous with an earlier course of treatment that had reached its end (see Rizk v Cohen, 73 NY2d 98, 105 [1989] [the continuous treatment doctrine did not apply where the later contact between the parties “was a renewal, rather than a continuation, of the physician-patient relationship”]; Aulita v Chang, 44 AD3d 1206, 1210 [3d Dept 2007] [the patient’s “later treatment . . . could only be considered a resumption of treatment as opposed to a continuation of his prior care” (internal quotation marks omitted)]; Van Inwegen v Lucia, 222 AD2d 576, 577 [2d Dept 1995] [“the plaintiffs return to Dr. Lucia in August of 1982 for treatment of two teeth which he had not worked on since 1977 was a resumption of treatment rather than continuous treatment”]).
The purpose of the continuous treatment toll, now codified by CPLR 214-a, is “to enforce the view that a patient should not be required to interrupt corrective medical treatment by a physician and undermine the continuing trust in the physician-patient relationship in order to ensure the timeliness of a medical malpractice action” (Young v New York City Health & Hosps. Corp., 91 NY2d 291, 296 [1998]). Here, during the 33-month interval between plaintiff’s May 2004 and February 2007 consultations with defendant, plaintiff was not undergoing any treatment of any kind by defendant; hence, commencing an action within that period would not have interrupted any ongoing *1013treatment. While it is possible for a course of continuous treatment to be extended beyond the patient’s last visit with the physician “when further treatment is explicitly anticipated by both physician and patient as manifested in the form of a regularly scheduled appointment for the near future” (Richardson v Orentreich, 64 NY2d 896, 898-899 [1985] [continuous treatment ended on the date of the patient’s last scheduled appointment, for which she failed to appear]), in this case — by plaintiffs own admission — the parties did not “explicitly anticipate[ ]” further treatment at any particular time or within any defined time frame. As plaintiff testified at trial: “There was no definite time I had to come back to him. It was an as-needed basis. He was my ophthalmologist for life. According to his guarantee I could come back any time.” Again, apart from plaintiffs alleged understanding that any future LASIK-related treatment would be free of charge, this is no different from the conclusion of any course of treatment in which neither the physician nor the patient affirmatively breaks off the relationship. Moreover, plaintiff admits that, in the time between his May 2004 and February 2007 consultations with defendant, he was not aware of any need for further treatment. “Given plaintiffs lack of awareness of a condition warranting further treatment, the purpose of the continuous treatment doctrine would not be served by its application here” (Young, 91 NY2d at 297; see also id. at 296 [“a patient who is not aware of the need for further treatment of a condition is not faced with the dilemma that the doctrine is designed to prevent”]; Rizk v Cohen, 73 NY2d at 104 [there was “no sound basis for applying the continuous treatment doctrine” where the plaintiff was “unaware of the need for further treatment”]).
Further, by extending the course of treatment in which the alleged malpractice occurred from May 2004, when the last regular postoperative examination occurred, to a single visit in February 2007, covering a period of 33 months in which the parties had no contact at all, the majority in effect applies an accrual-upon-discovery rule to a malpractice claim that is not based on the presence of a foreign object in the patient’s body.3 In so doing, the majority contravenes both the Legislature’s determination to limit the discovery rule to foreign-object claims (see CPLR 214-a) and the Court of Appeals’ admonition against *1014judicial extension of the discovery rule beyond the scope the Legislature prescribed for it in the statute (see Rizk v Cohen, 73 NY2d at 104 n 3).
The Court of Appeals’ statement, quoted by the majority, that a course of continuous treatment includes “a timely return visit instigated by the patient to complain about and seek treatment for a matter related to the initial treatment” (McDermott v Torre, 56 NY2d 399, 406 [1982]), does not support the majority’s result. As the Court of Appeals noted in Curcio v Ippolito (63 NY2d 967 [1984]), a unanimous decision rendered only two years later, the key word in the quoted passage from McDermott is “timely.” In Curcio, the Court of Appeals affirmed summary judgment dismissing as time-barred a malpractice claim against a surgeon who had operated on the plaintiffs nose. The Curcio plaintiff, who had been discharged from the defendant surgeon’s care in January 1976, went back to see the defendant on February 24, 1979, presenting with complaints about her breathing and nasal indentation, “without having seen defendant or any other physician in the meantime with respect to her nose” (id. at 968). In affirming the dismissal of the claim, the Court of Appeals explained: “[I]t is enough to bar plaintiffs claim that no contact between plaintiff and defendant after her discharge and before the February 24, 1979 visit has been shown. Under such circumstances the required continuity has not been established through ‘a timely return visit instigated by the patient to complain about and seek treatment for a matter related to the initial treatment’ (McDermott v Torre, 56 NY2d 399, 406 [emphasis supplied]), or otherwise” (63 NY2d at 969). Since, by the majority’s reckoning, a return visit may serve to extend the toll of the statute of limitations even where further treatment is not specifically contemplated, a return visit occurring any length of time after the initial course of treatment — perhaps for the rest of the patient’s life or for the rest of the physician’s career— could be deemed “timely” under the majority’s holding. I do not believe that this approach is consistent with the continuous treatment doctrine as formulated by the Court of Appeals and enacted by the Legislature.
The instant plaintiff, like the plaintiff in Curcio, had no contact with the defendant physician after the alleged malpractice for a period of time longer than the limitation period applicable to his claim. During that hiatus, moreover, neither party anticipated that contact would be resumed within any particular time frame. Accordingly, the claim here, like the claim in Curcio, should be dismissed as time-barred (see also Spear v Rish, 161 AD2d 197, 198 [1st Dept 1990] [the plaintiff, who *1015completed the course of allegedly negligent treatment in 1967 and did not see the defendant physician again until 1975, failed to establish “a ‘timely’ return visit so as to be able to invoke the continuous treatment doctrine,” where, “(d)uring the long periods between treatments, (she) was not under any form of medical care, nor was there any existing ongoing physician-patient relationship”]).
I note that the result reached by the majority is anomalous and will create perverse incentives for physicians. Had plaintiff instituted this suit in February 2007, without visiting defendant’s office again for the first time in nearly three years, the action plainly would have been dismissed pursuant to the statute of limitations upon defendant’s motion. By deeming plaintiffs one-time office visit in February 2007 to extend a course of treatment that otherwise plainly ended in May 2004, the majority sends physicians the unfortunate message that they should think twice before seeing patients with whom they have not had contact for longer than 2½ years — especially in the cases of patients with whom the physicians have had difficulties. Under the majority’s holding, by seeing such a patient, the physician may be reviving an otherwise time-barred claim. Thus, as applied by the majority, a doctrine that was instituted for the purpose of avoiding the “interrupt[ion] [of] corrective medical treatment” (Young, 91 NY2d at 296) could have the effect of deterring physicians from resuming treatment of former patients.
For the reasons discussed above, I believe that the record does not support the jury’s finding' that February 21, 2007 was the last date of a “continuous course of treatment” that included defendant’s alleged malpractice in April 2004, and that defendant’s posttrial motion for judgment notwithstanding the verdict should have been granted and the complaint dismissed. I therefore respectfully dissent to the extent the majority’s affirms the judgment for plaintiff. Given my view that the statute of limitations issue is dispositive of this appeal, I need not reach the remaining issues defendant raises.

. I concur with the majority’s dismissal of the derivative claim of plaintiff Saramma Devadas. In the remainder of this writing, the term “plaintiff refers to plaintiff Johnson Devadas. References to “defendant” include Dr. Niksarli’s professional limited liability company, which is also named as a defendant in this action.

. According to defendant, he had told plaintiff that he could receive any follow-up treatment free of charge for the first year after the surgery and, thereafter, he would be billed for further treatment relating to LASIK surgery at a reduced rate.

. In the February 2007 examination, defendant diagnosed plaintiff as having a congenital eye condition that, had it been diagnosed in 2004, would have contraindicated LASIK surgery. The majority’s ruling effectively tolls the running of the statute of limitations on plaintiffs claim until his discovery, in 2007, of defendant’s failure to diagnose the condition in 2004.