Court Opinion

ID: 9497088
Source: CourtListenerOpinion
Date Created: 2023-08-05 16:43:05.244919+00
Date Added: 2024-06-11T17:57:59.830651
License: Public Domain

GREGORY, Circuit Judge,
dissenting:
The majority holds that Castillo was not entitled, as a matter of law, to invoke the continuous treatment doctrine to toll Virginia’s two year statute of limitations for medical malpractice causes of action. I respectfully dissent from this holding for two reasons. First, I believe that Merritt v. Clark, 40 Va. Cir. 13 (1995), 1995 WL 17015552, at *1, the case upon which the majority relies to reach this holding, is factually distinguishable and thus inapplicable. Second, I believe, as will be discussed below, that Castillo did in fact receive continuous treatment from EMA and was thus entitled to toll Virginia’s statute of limitations for medical malpractice suits.
In Merritt, Florence Stansel, the decedent, went to Mount Vernon Hospital on November 30, 1992 complaining of chest pains. Dr. Ford, a doctor who was employed by Capital Emergency Associates, examined and admitted Stansel into the hospital, where she remained until December 1, 1992. On that same day, Stansel was discharged from the hospital “by order of her regular doctor, Dr. Clark.” Id. at *1. Stansel, however, returned to the hospital on December 4, 1992, again complaining of chest pains, and was examined by Dr. Palace, another Capital Emergency Associates physician. Later that day, Stansel suffered a heart attack and died.
The administratrix of Stansel’s estate, Merritt, filed a wrongful death and medical malpractice claim against Capital Emergency Associates and Dr. Ford on December 2, 1994. A Virginia trial court, however, held that this claim was barred by Virginia’s two year statute of limitations. In so holding, the court concluded that Merritt was not entitled to toll the statute of limitations because she failed to establish continuous treatment. The court reached this conclusion because “there [were] two isolated incidents, involving two different doctors in emergency situations.... Neither [of whom were] the patient’s regular practitioner, nor were the visits continuous.” Id. at *2 (emphasis added).
Stansel’s visits to the emergency room on November 30 and December 4, 1992 were not continuous, because in the interim Stansel was treated, and in fact, discharged from the hospital by her regular physician. The intervention of Stansel’s emergency treatment by her regular physician transformed her return trip to the emergency room on December 4th into a discrete emergency visit. On December 4th, Stansel was seeking emergency services for acute chest pains. And, as the majority recognizes in its opinion, “[w]here the patient is not completely recovered on discharge, the patient’s continuing care obligations are assumed by the patient’s treating physician.... ” Ante, at 651 (quoting Pidgeon v. Wake, 34 Va. Cir. 336, 341 (1994)).
The facts of the instant case are quite different from those in Merritt. Upon being released-from Prince William Hospital’s emergency services department, Castillo was presented with three options in her discharge instructions: “(1) Should your condition worsen, any new symptoms *653develop, or you not recover as expected, please contact the doctor you were given for follow up care; (2) If you cannot reach the doctor, return to the Emergency Services Department; (3) You should return immediately to the nearest emergency room for any emergency.” Ante, at 645. For follow up care, Castillo was referred to her “own MD in North Carolina” * or to a Prince William Hospital gynecologist, Dr. Wall, for “recheck in 3-4 days if not better.” Ibid.
The majority concedes that Castillo called the Prince William Hospital emergency department on October 14, 1999, not for emergency care, but “because her condition had not improved.” Ibid. During that phone call, Castillo attempted to reach Dr. Wall, as instructed by her October 10, 1999 discharge sheet. Dr. Wall, however, was unavailable at that time, and thus another EMA physician provided Castillo with follow up treatment and prescribed her a different type of medication. In doing so, this EMA physician instructed Castillo “to follow up with Dr. Wall or return to the emergency services department if [she] didn’t [feel] better.” J.A. 72. Accordingly, when her condition did not improve, Castillo returned to Prince William Hospital’s emergency department on October 19, 1999 for additional follow up treatment. Despite these facts, the majority erroneously concludes that the treatment rendered by the Prince William Hospital’s emergency services department consisted of “discrete and isolated” contacts. Ante, at 650.
In my view, rather than being “discrete and isolated” contacts, Castillo’s visit on October 10th, phone call on October 14th, and follow up visit on October 19th, were all part of EMA’s continuous treatment of Castillo’s original illness. Unlike in Merritt, Castillo was not treated by her regular physician, or any physician other than an EMA physician, during the period that she was treated by EMA. Moreover, EMA’s instructions to Castillo clearly indicated that its treatment of Castillo’s illness would be continuous. The fact that Castillo was not required to follow up with the same physician or with EMA does not, as the majority concludes, alter the continuous nature of this treatment. The fact remains that EMA instructed Castillo to return for follow up care, Castillo sought and received this follow up care for the same illness and Castillo never was treated by an independent physician. Under these circumstances, I believe that there is little doubt that Castillo received continuous treatment from EMA and was thus entitled to toll Virginia’s two year statute of limitations.
For the foregoing reasons, I respectfully dissent from the majority’s holding.

 The EMA physicians at the Prince William Hospital were made aware upon Castillo’s first visit to the emergency department that she was a North Carolina resident who was visiting Virginia at the time of her illness.