Court Opinion

ID: 9781551
Source: CourtListenerOpinion
Date Created: 2023-08-30 16:51:30.822845+00
Date Added: 2024-06-11T07:34:27.955005
License: Public Domain

*453DEITS, J. pro tempore
Plaintiffs appeal after the trial court granted summary judgment to defendants on plaintiffs’ claims for injuries related to plaintiff Lawrence Keller’s exposure to asbestos.1 The trial court held that the claims were barred by ORS 30.907, the applicable statute of limitations. We reverse.
Because we are reviewing summary judgment in defendants’ favor, we state the facts in the light most favorable to plaintiff and draw all reasonable inferences in his favor. ORCP 47 C; Jones v. General Motors Corp., 325 Or 404, 420, 939 P2d 608 (1997). Plaintiff worked as a automobile mechanic beginning the early 1960s. He specialized in muffler and exhaust work; part of the time he owned a small muffler business. Defendants Borg-Wamer Automotive, Inc., and Tenneco Automotive Operating Company, Inc., manufactured or supplied some of the mufflers on which plaintiff worked.2 During the time period when plaintiff worked on mufflers, it was common for mufflers to be wrapped in asbestos. As a result, plaintiff was exposed to asbestos when he replaced old, crumbling mufflers. He also worked for a company that made mufflers. Part of his job involved cutting sheets of asbestos and wrapping them around muffler cores, again exposing him to asbestos fibers. In addition, plaintiff was exposed to exhaust fumes on the job and was a smoker.
In the early 1980s, plaintiff began experiencing shortness of breath. In 1986, he saw Dr. Patterson, a pulmon-ologist, who diagnosed interstitial lung disease. Patterson asked plaintiff about his work environment and learned that he was exposed to asbestos, among other things. He performed a bronchoscopy that showed mild interstitial fibrosis and black lung but no asbestos bodies. Patterson told plaintiff that his exposure to asbestos and exhaust fumes was harmful and recommended that he sell his muffler business. *454He also suggested that plaintiff stop smoking, which plaintiff tried to do several times over the following years. Patterson did not tell plaintiff that asbestos exposure was the cause of his lung problems, but he did indicate that asbestos might be the cause. In 1987, plaintiff sold his muffler business. He thereafter purchased a building supplies store in Oakridge and moved there.
In 1991, plaintiff was referred to Dr. Kintz because of continuing lung problems. After conducting an examination and reviewing pulmonary function studies and a chest x-ray, Kintz had a “suspicion * * * that [plaintiff] has mild pulmonary fibrosis, possibly related to asbestos exposure. The records from Portland that I have certainly do not indicate any confirmed inflammatory interstitial disease.” Kintz ordered a bronchoscopic biopsy; at the time of the biopsy, Kintz described plaintiff as having a “ten year history of restrictive lung disease related to prior asbestos or muffler fume exposure.” At that time, Kintz noted that plaintiffs chest x-ray revealed “minor interstitial changes.” No records related to this biopsy or Kintz’s diagnosis after the biopsy are in the record.
In December 1991, plaintiff filed an application for social security disability benefits, stating that he had “lungs fibrous” and that the cause of his lung problems were exhaust fumes, dust, and asbestos.3 According to plaintiff, his lung capacity had been decreasing and an x-ray in 1992 showed “black spots” in his left lung. In November 1992, Kintz wrote a short statement supporting plaintiffs claim, stating that plaintiffs condition satisfied the criteria for disability for a patient with pulmonary fibrosis. Kintz did not, however, indicate a cause of that condition.
In 1993, plaintiff visited the emergency room at Providence Medical Center because of abdominal pain. The chart notes from that visit indicate that, in discussing his *455medical history with the examining physician, plaintiff reported that he was being treated for asbestosis.
In 1994, plaintiff had surgery for an aortic aneurysm. In preparation for that surgery, he saw Patterson again for a preoperative evaluation. In that evaluation, Patterson stated that plaintiff had “[interstitial lung disease, etiology uncertain[.]” He reviewed plaintiffs asbestos-related work history, noting that plaintiff s job that involved cutting sheets of asbestos “represent [s] a significant asbestos exposure.” Patterson noted that plaintiff s 1986 bronchoscopy had shown no asbestos bodies and, in connection with plaintiffs chest x-ray, “[n]o changes pathognomic of asbestos exposure are noted.” He further noted that, three weeks before the evaluation, plaintiff had again quit smoking. In the conclusion of his report, Patterson noted that “the importance of continuing without cigarettes was emphasized.”
Later in 1994, plaintiff submitted a “reconsideration disability report” in connection with his application for social security disability benefits. Plaintiff reported that his shortness of breath had worsened and that Kintz had advised him that, because of his “asbestos lungs” and. psychological problems related to his illness, he should not try to carry on his regular work duties.
In January 1995, plaintiff filed a claim for workers’ compensation benefits, asserting that he had “asbestos lung” from exposure to asbestos from manufacturing and installing exhaust systems. As part of the evaluation of that claim, SAIF referred plaintiff to Dr. Smith for examination. Smith reviewed plaintiffs medical records and chest x-rays spanning a 20-year period and performed a number of additional tests. He concluded that plaintiffs condition was not asbestos related:
“This patient has a very unusual history and has been followed at the Thoracic Clinic since 1974. Serial chest x-rays were reviewed and there has been no evidence of significant progressive interstitial disease or an asbestos-related condition. The patient had definite exposure to asbestos most likely in the form of chrysotile blankets. The exposure would be characterized as relatively light in lifetime exposure and at best, moderate. It is unlikely that the exposure *456would be heavy enough to cause asbestosis. The clinical findings are consistent with the occupational exposure history. There is no evidence of asbestos-related pleural disease or pleural thickening or pleural fibrosis. There is no evidence of asbestos-related interstitial disease or asbestosis. * * *
“I believe his case can be closed in that he has no asbestos related condition.”
SAIF asked both Patterson and Kintz to review Smith’s report, and each signed a statement indicating that he agreed -with all of the report.4
In 2000, Dr. Schaumberg, a pulmonologist, reviewed CT scans of plaintiffs chest performed in August and November 1999, as well as the results of plaintiffs pulmonary function tests. In a letter to plaintiffs attorney, Schaumberg wrote that plaintiff “clearly has a[n] interstitial lung disease with a restrictive pulmonary defect. Given his history of asbestos exposure, the most likely etiology is because of asbestosis.”
Plaintiff filed his complaint in this case on October 23, 2000. Defendants moved for summary judgment, arguing that the action was barred by the applicable statute of limitations. As noted, the trial court granted the motions. We will affirm only if there are no genuine issues of material fact and the moving party is entitled to judgment as a matter of law. ORCP 47 C. As we explain below, a genuine issue of material fact exists in this case with respect to when plaintiff knew or should have known that he had an asbestos-related disease, and we accordingly reverse the grant of summary judgment.
*457The applicable statute of limitations, ORS 30.907, provides that a product liability action for asbestos-related disease must be commenced “not later than two years after the date on which the plaintiff first discovered, or in the exercise of reasonable care should have discovered, the disease and the cause thereof.” The parties do not dispute that plaintiff had symptoms before 1998. Accordingly, the sole issue is whether plaintiff discovered, or should have discovered, before October 23,1998, that those symptoms were related to asbestos. According to defendants, plaintiff discovered, or should have discovered, that his symptoms were related to asbestos before that date. Plaintiff argues the contrary. According to plaintiff, the most the medical evidence from before 1998 revealed was that he had lung disease. In plaintiffs view, the evidence demonstrates that the cause of that disease was uncertain. According to plaintiff, all that he and his treating physicians knew was that his symptoms might be caused by asbestos. It is plaintiffs position that his knowledge before 1998 that his disease might have been caused by asbestos is not sufficient knowledge to trigger the statute of limitations as a matter of law. Instead, according to plaintiff, a triable issue of fact exists as to whether, given the facts that defendant knew, a reasonable person should have known, or in the exercise of reasonable care should have discovered, that his disease was asbestos related.
This case requires us to construe ORS 30.907, and, consequently, we are guided by the interpretive principles set out in PGE v. Bureau of Labor and Industries, 317 Or 606, 610-11, 859 P2d 1143 (1993). ORS 30.907 provides:
“A product liability civil action for damages resulting from asbestos-related disease shall be commenced not later than two years after the date on which the plaintiff first discovered, or in the exercise of reasonable care should have discovered, the disease and the cause thereof.”
ORS 30.907 has not been construed by the Supreme Court or by this court. However, the Supreme Court has construed wording in ORS 12.110(4), the statute of limitations for medical malpractice actions, that, except for being in the passive *458voice, is identical to wording in ORS 30.907. ORS 12.110(4) provides, in part:
“An action to recover damages for injuries to the person arising from any medical, surgical or dental treatment, omission or operation shall be commenced within two years from the date when the injury is first discovered or in the exercise of reasonable care should have been discovered.”
Both ORS 12.110(4) and ORS 30.907 define the beginning of the limitations period as when a plaintiff “first discovered or in the exercise of reasonable care should have discovered” the pertinent elements. It is that wording that indicates when the legislature intended that the periods of limitation begin to run. Because the wording that indicates when the periods of limitation begin to run is identical, cases construing the meaning of the phrase “first discovered or in the exercise of reasonable care should have discovered” in ORS 12.110(4) are helpful in determining the meaning of that phrase in ORS 30.907. See, e.g., Robinson v. Nabisco, Inc., 331 Or 178, 184, 11 P3d 1286 (2000) (prior case law interpreting the same statutory wording considered at first level of statutory interpretation); State v. Ford, 188 Or App 424, 428, 72 P3d 93 (2003) (same).
 The two statutes differ notably in one respect: ORS 12.110(4) pertains to when an “injury” is or should have been discovered, while ORS 30.907 pertains to when a disease and its cause is or should have been discovered. “Injury,” as used in ORS 12.110(4), means “legally cognizable harm” and is comprised of three elements: harm, causation, and tortious conduct. Gaston v. Parsons, 318 Or 247, 255, 864 P2d 1319 (1994). Because the legislature specifically referred only to harm and causation in ORS 30.907, and did not use the term of art “injury,” the issue of when a plaintiff knew or should have known about a defendant’s tortious conduct will not arise in assessing when the period of limitations began to run in an asbestos-related disease claim. Tortious conduct is not something of which a plaintiff must have knowledge in order for the period of limitations to commence. We accordingly observe that cases addressing issues of what a plaintiff must *459know to be aware of tortious conduct under ORS 12.110(4) may be of limited help in construing ORS 30.907.
In light of that difference between the two statutes, the dissent takes us to task for relying on constructions of ORS 12.110(4) in determining the meaning of ORS 30.907. 197 Or App at 473, 483-87 (Edmonds, J., dissenting). According to the dissent, “[cjontrary to the majority’s assertion, the legislature did not use ‘identical wording5 in the statutes to trigger the beginning of the limitations period." 197 Or App at 483 (Edmonds, J., dissenting). With respect, that is simply incorrect. The words that describe when the periods of limitation begin to run are the same; what differs is what a plaintiff must have discovered for the periods to commence. What the dissent ignores is that the legislature used identical wording in the two statutes to set the bar for when the limitations period begins to run. In both statutes, that happens when the plaintiff “discovers or should have discovered" certain things, namely particular elements of his or her claim. The only difference between the statutes is the elements that must be discovered to start the hmitations period.5
In both statutes, the legislature has indicated that a plaintiff must have the same level of certainty of the required elements in order to trigger the limitations period. Specifically, the statute of hmitations begins to run for either type of claim when the plaintiff “first discovered or in the exercise of reasonable care should have discovered” the pertinent elements. ORS 30.907; ORS 12.110(4). It is such wording that has been construed as creating a “discovery rule” in statutes *460of limitation. See Gladhart v. Oregon Vineyard Supply Co., 332 Or 226, 231, 26 P3d 817 (2001).6 In light of the similarities between the statutes, and in the absence of any legislative indication that the identical wording be construed differently, we rely on constructions of the identically phrased discovery rule in ORS 12.110(4) to discern the meaning of the discovery rule in ORS 30.907.
In its most recent case construing ORS 12.110(4), the Supreme Court observed:
“The period oflimitations in [ORS 12.110(4)] commences from the earlier of two possible events: (1) the date of the plaintiffs actual discovery of injury; or (2) the date when a person exercising reasonable care should have discovered the injury, including learning facts that an inquiry would have disclosed.”
Greene v. Legacy Emanuel Hospital, 335 Or 115, 123, 60 P3d 535 (2002) (emphasis in original). Applying the Greene formulation of the issue to this case, we must determine whether it is possible to say, as a matter of law, that plaintiff actually discovered the cause of his disease before October 23,1998, or that a person exercising reasonable care should have discovered the cause of his disease before that date. See also Schiele v. Hobart Corporation, 284 Or 483, 489, 587 P2d 1010 (1978) (applying general personal injury statute oflimitations to occupational disease claim; observing that “the statute oflimitations on claims involving negligent infliction of an occupational disease does not begin to ran until the plaintiff knows, or as a reasonably prudent person should know, that he has the condition for which his action is brought and that defendant has caused it”).
In Gaston, the Supreme Court concluded that a plaintiff “first discovered or in the exercise of reasonable care should have discovered” the elements of a statute of limitations when the plaintiff had knowledge of “facts [that] would make a reasonable person aware of a substantial possibility that each of the * * * elements * * * exists.” 318 Or at 256 (emphasis added). The court noted that a plaintiff need not *461know each element with certainty, but a plaintiff must have more than a “mere suspicion” in order to have “discovered” the element. Id. at 255-56. The requisite level of certainty, the court concluded, is awareness of a “substantial possibility” of the existence of the relevant elements.7
The exact contours of a “substantial possibility” are difficult to articulate in the abstract. As we explain below, *462determining whether that standard has been met in a particular case requires careful consideration of all the facts available to a plaintiff and all the surrounding circumstances. Having considered the meaning of the phrase “substantial possibility” as used by the Supreme Court, the meaning of the statutory term “discover,” and the purpose behind the discovery rule, we conclude that a “substantial possibility” connotes something less than a preponderance, but still a fairly high level of certainty, and certainly more than a suspicion.
As noted, the court did not address in Gaston or in subsequent cases, nor have we, the meaning of the phrase “substantial possibility.” A “possibility” is “[something that is possible.” The American Heritage Dictionary of the English Language 1414 (3d ed 1996). “Possible,” in turn, means “[c]apable of* * * existing[ ] or being true without contradicting proven facts” or “[o]f uncertain likelihood.” Id. Standing alone, use of the term “possibility” would suggest that knowledge of any plausible set of facts, however uncertain, would trigger the statute of limitations. But “possibility” does not stand alone; the court modified “possibility” with the word “substantial,” which means “[t]rue or real; not imaginary,” “[a]mple,” or “[c]onsiderable in importance, value, degree, amount, or extent.” Id. at 1791. Accordingly, the court indicated that the level of possibility required here is fairly high. The plain meaning of the term “substantial possibility” indicates that a plaintiff must have an awareness of facts that indicate the existence of his or her disease and its cause with a considerable degree of likelihood in order for the statute of limitations to be triggered.
That view is consistent with the plain meaning of the statutory term “discover” that the court was construing when it adopted the “substantial possibility” test. “Discover” means, as relevant here, “to make known (something secret, hidden, unknown or previously unnoticed)” or “to come to know something not previously known.” Webster’s Third New Int’l Dictionary 647 (unabridged ed 2002). To “know” means “to apprehend with certitude as true, factual, sure, or valid.” Id. at 1252. The term “discover” used by the legislature thus carries a connotation of a high degree of certainty, indicating that the legislature intended that the period of limitations *463not begin to run until a plaintiff has a high degree of certainty about the facts that would support the elements of his or her claim identified in the statute of limitations.
That conclusion is bolstered by the court’s reiteration in Gaston of the familiar principle that “ [t]he discovery rule is designed to give plaintiffs a reasonable opportunity to become aware of their claim.” 318 Or at 255-56 (citing Frohs v. Greene, 253 Or 1, 4, 452 P2d 564 (1969); emphasis added). Similarly, both this court and the Supreme Court have indicated that statutes of limitations begin to ran only when a plaintiff knows the facts necessary “to support his right to judgment.” Stevens v. Bispham, 316 Or 221, 227, 851 P2d 556 (1993) (internal quotation marks omitted); Hoeck v. Schwabe, Williamson & Wyatt, 149 Or App 607, 612, 945 P2d 534 (1997). That requirement supports the view that, to trigger the statute of limitations, a plaintiff must have a high degree of certainty about the elements of the statute.
 “Ordinarily, the question of whether and when an employee knew or should have known that he had an occupational disease is one of fact for the jury.” McCoy v. Union Pacific Railroad Co., 102 Or App 620, 624, 796 P2d 646 (1990) (applying similar standard for statute of limitations under the Federal Employers’ Liability Act); see also Gaston, 318 Or at 256; Hoeck, 149 Or App at 612 (“Precisely when a person reasonably should have known that the harm suffered was caused by another’s negligence generally presents a question of fact.”). Thus, if a factual dispute exists about whether plaintiff actually discovered the cause of his disease before 1998 and about whether a person exercising reasonable care should have discovered that cause before 1998, summary judgment was inappropriate. See Greene, 335 Or at 120. In assessing whether such a factual dispute exists, we impute to plaintiff knowledge of all facts that he had a reasonable opportunity to discover, which includes all facts in the summary judgment record in this case.
We agree with the dissent to the extent that it asserts that a plaintiff can be held to have discovered the pertinent elements of his or her claim if he or she had a reasonable opportunity to become aware of facts that would support them. Actual knowledge is not required; a plaintiff may not *464avoid the bar of the statute of limitations by failing to make a further inquiry that would have revealed facts that would have supported the pertinent elements of his or her claim. That is why we impute to plaintiff knowledge of all facts reasonably available to him, which in this case includes all of the evidence in the summary judgment record. To the extent, however, that the dissent suggests that we should speculate about what else plaintiff might have learned had he inquired, 197 Or App at 481 (Edmonds, J., dissenting), as we explain below, 197 Or App at 468-70, that approach has been squarely rejected by the Supreme Court. To the extent that the dissent argues that the facts in this record establish causation to a sufficient level of certainty as a matter of law, we disagree.
Based on the record in this case, we conclude that a factual dispute exists about whether plaintiff actually discovered the cause of his disease before 1998 and about whether a person exercising reasonable care would have discovered that cause before 1998. We agree with plaintiff that the facts available to him simply do not establish, as a matter of law, that he discovered, or reasonably should have discovered, before 1998 that there was a considerable degree of certainty that his symptoms were caused by asbestos. On the contrary, his treating doctors consistently expressed uncertainty about the nature of his condition and identified several possible causes.
To review the evidence, in 1986, Patterson told-plaintiff that asbestos “might” be the cause of his symptoms, but he also told plaintiff that exhaust fumes were harmful and that he should stop smoking. In 1991, Kintz had a “suspicion” that plaintiff had mild pulmonary fibrosis, “possibly” related to his exposure to asbestos; Kintz also described plaintiffs symptoms as being related to asbestos or muffler fume exposure. In 1992, when Kintz stated that plaintiffhad pulmonary fibrosis, he did not indicate a cause. In 1994, Patterson stated that the “etiology [of plaintiffs condition was] uncertain.” In 1995, Smith concluded that plaintiffs condition was not related to asbestos, and both Patterson and Kintz concurred. Finally, in 2000, Schaumberg stated that the “most likely etiology” of plaintiffs condition was asbestosis.
*465Given that factual record, a factfinder could reason as follows: Before Schaumberg’s opinion in 2000, the record shows only that plaintiffs physicians were uncertain about the nature and cause of plaintiffs disease. Although they thought that plaintiffs symptoms might be related to asbestos, they also told him that the exhaust fumes that he had been exposed to were harmful and that he should quit smoking. Before he received Schaumberg’s opinion in 2000, plaintiff did not have available sufficiently certain information about the cause of his symptoms to conclude that he knew, or should have known, with a considerable level of certainty that his disease was caused by asbestos. Based on that view of the record, a factfinder could conclude that plaintiff had not discovered, nor should a reasonable person have discovered, the cause of plaintiffs disease before October 23,1998.
In addition, as the court noted in Gaston, whether a reasonable person would be aware of a substantial possibility of one of the elements of the statute of limitations depends on all the relevant circumstances. 318 Or at 256. In cases involving medical conditions, the existence of alternative possible causes and the plaintiffs awareness of such possible causes are relevant circumstances. See McCoy, 102 Or App at 624 C‘[W]hether off-the-job exposures could have contributed to the condition [is] relevant to the question of whether the plaintiff had knowledge of the condition and its cause.”).8
In this case, plaintiffs doctors consistently expressed uncertainty about the cause of his disease and gave him several alternative explanations for his symptoms. In that respect, this case is similar to those malpractice and products liability cases in which courts have held that statutes of limitation did not begin to run where plaintiffs *466received reassurances from defendants that prevented plaintiffs from having sufficient certainty about the existence of facts pertaining to the elements of the statutes of limitation. See Gaston, 318 Or at 260-61; Forest Grove Brick v. Strickland, 277 Or 81, 559 P2d 502 (1977); Hoeck, 149 Or App at 613-14; Penuel v. Titan/Value Equities Group, Inc., 127 Or App 195, 200-01, 872 P2d 28, rev den, 319 Or 150 (1994); Hoffman v. Rockey, 55 Or App 658, 662-63, 639 P2d 1284, rev den, 292 Or 722 (1982). In those cases, a manufacturer’s assurance that a product could be fixed or a doctor’s assurance that an untoward effect was normal and not the result of negligence presented each plaintiff with several alternative explanations for the injury, only one of which supported the plaintiff’s tort claim. In this case, similarly, plaintiff was presented with several alternative explanations, only one of which supports his asbestos-related disease claim.
Of course, in this case, the alternative explanations were not presented with the intent of hiding a tortfeasor’s wrongdoing or liability. That intent is not important, however; the effect of an awareness of the existence of alternative explanations on a reasonable person is. Where, as here, a plaintiff’s doctors consistently express uncertainty about the cause of disease and present him or her with a number of equally plausible factual explanations for his or her disease, that may preclude the conclusion that he or she knew, or should have known, as a matter of law, that one of those explanations was sufficiently correct to trigger the statute of limitations. See Lundy v. Union Carbide, 695 F2d 394, 397 (9th Cir 1982) (where the plaintiffs doctor indicated that the plaintiffs symptoms could have “numerous causes,” including exposure to asbestos, smoking, and exposure to formaldehyde fumes, grant of summary judgment on statute of limitations ground was improper); Hutchison v. Semler et al, 227 Or 437, 361 P2d 803 (1961) (exposure to silica dust on the job was the only identified explanation for the plaintiff s silicosis; jury instruction on statute of limitations upheld).
This is not a case of competing medical opinions. It is a case in which plaintiff’s treating physicians consistently expressed uncertainty about the cause of his symptoms. As late as 1994, one of those doctors indicated that the etiology of his symptoms was uncertain. Two other possible causes for *467his symptoms — exhaust fumes and smoking — were identified. When confronted in 1995 with a report that stated repeatedly that asbestos was not the cause of plaintiffs symptoms, his treating physicians concurred, which was consistent with their earlier and ongoing expressions of uncertainty about the cause of his disease. Given that record, we cannot say as a matter of law that plaintiff knew, or reasonably should have known, that there was a considerable likelihood that the cause of his disease was asbestos.
It appears that at some times plaintiff held a subjective belief that his symptoms were caused, at least in part, by asbestos. However, plaintiffs subjective belief is not determinative of the question of what a reasonable person should have known about the elements of a statute of limitations, because that issue is determined using an objective standard. Doe v. American Red Cross, 322 Or 502, 512, 910 P2d 364 (1996); Gaston, 318 Or at 256. Considering the question of what plaintiff knew, we note that belief and knowledge are not synonymous. At best, plaintiffs subjective belief could support an inference that he had discovered that asbestos caused his condition. However, drawing that inference would favor defendants. Because plaintiff is the nonmoving party, we must draw all reasonable inferences in his favor, not in defendants’ favor. An equally reasonable inference in light of this record is that plaintiff, a layman, knowing that he had lung problems and knowing that asbestos was dangerous, formed his own belief about the cause of his condition, despite having been told by his physicians that asbestos was only one of several possible causes.9
Moreover, there is evidence from which a reasonable juror could conclude that, had plaintiff directly inquired of the physicians he saw before 2000, he would have been told that his disease was not caused by asbestos, contradicting his apparent assumption that asbestos was its cause. In 1995, Smith definitively stated that plaintiffs condition was not related to asbestos, and both of plaintiffs treating physicians *468stated that they agreed with that conclusion. That evidence supports an inference that, had plaintiff asked Patterson and Kintz directly in 1995 whether his condition was caused by asbestos, they would have said, “No.”10
A plaintiffs subjective belief that asbestos caused his symptoms must be supported by some objective evidence, and that evidence must be sufficiently certain to satisfy the “substantial possibility” standard. Although a positive diagnosis is not always required, Schiele, 284 Or at 490, neither can a plaintiffs unsupported belief that one of several causes of a disease identified by his physicians is the cause be sufficient. To hold otherwise would be to conclude, as a matter of law, that the period of limitations begins to run on an asbestos-related disease claim when a plaintiffs doctors are uncertain about the cause of his or her disease and indicate to the plaintiff that there are several possible causes of his or her disease, only one of which is asbestos, and the plaintiff subjectively believes that asbestos is the cause.
Finally, we note that defendants have not argued that plaintiff could have received, before October 23, 1998, a different medical opinion that would have established more definitively that his symptoms were caused by asbestos. Presumably defendants did not raise that argument because there is no evidence in the summary judgment record to support it. See Doe, 322 Or at 514-15 (because no evidence was submitted that addressed what the plaintiffs would have learned had they inquired, record did not permit summary judgment for defendants).
Moreover, we observe that, to the extent that it could be argued that plaintiff had discovered facts that triggered a “duty to inquire” further about the cause of his symptoms, a “duty to inquire” standing alone is not sufficient to cause the period of limitations to begin to run; a factual question will *469persist until the facts learned as a result of the inquiry would cause a reasonable person to discover that his or her symptoms are asbestos related. See Greene, 335 Or at 123. The dissent’s assertion that “the issue in this case turns on whether plaintiffs failure before 1998 to make a further inquiry about the cause of his disease constitutes the lack of diligence expected of a reasonable person,” 197 Or App at 475 (Edmonds, J., dissenting) (emphasis in original), is accordingly misleading. As the court made clear in Doe and Greene, the existence of a duty to inquire and failure to do so are not, standing alone, sufficient to support a conclusion that the period of limitations began to run as a matter of law. There must also be evidence that, had a plaintiff inquired, he or she would have learned facts sufficient to support the pertinent elements of his or her claim. We have imputed to plaintiff knowledge of all facts in the summary judgment record. Defendants introduced no evidence on summary judgment about what plaintiff would have learned, had he inquired further.
Accordingly, the dissent’s statement that “[t]he majority and I * * * appear to agree that the limitations period begins to rim * * * when the obligation to undertake reasonable efforts to discover a claim occurs” is not entirely accurate. 197 Or App at 483 (Edmonds, J., dissenting). We agree that actual knowledge is not required, but we dispute that the obligation to undertake reasonable discovery efforts, standing alone, triggers the statute of limitations as a matter of law. As the court made clear in Doe and Greene, that obligation must be accompanied by evidence of what the plaintiff would have learned had he or she undertaken the discovery efforts. Such evidence is necessary to establish what a plaintiff “should have known”; we cannot create such evidence if it is not in the record. In this case, defendants put no evidence into the record about what plaintiff would have learned had he inquired further. As explained above, 197 Or App at 482, we impute to plaintiff all the evidence in the record. In our view, the crux of our disagreement with the dissent is whether that evidence is sufficient to establish as a matter of law that plaintiff knew or should have known by 1998 that his disease was related to asbestos. We hold that it is not.
*470The dissent takes issue with our conclusion that there is a genuine issue of material fact as to whether plaintiff knew, or should have known, that his disease was asbestos related before 1998. Under the dissent’s analysis, there is only one conclusion that a reasonable juror could reach on that issue.11 We do not disagree that a reasonable juror could conclude that plaintiff had access to sufficiently certain facts to make him aware of a substantial possibility that his disease was caused by asbestos. However, for the reasons explained above, we do not agree that a reasonable juror would be compelled to reach that conclusion. Given the state of the record in this case, and drawing reasonable inferences in plaintiffs favor, the question of whether the information available to plaintiff was sufficient to trigger the statute of limitations in this case should go to a jury.
We hold that, in the light of the conflicting evidence, there is a genuine issue of material fact as to when plaintiff knew or should have known, in the exercise of reasonable care, that he had an asbestos-related disease. Because there is a genuine issue of material fact, the trial court erred in granting summary judgment in favor of defendants.
Reversed and remanded.

 Plaintiff Patricia Keller is Lawrence Keller’s wife and brings a claim for loss of consortium. References to “plaintiff” in this opinion are to Lawrence Keller.

 Plaintiffs brought claims against other defendants, but those claims are not before us on appeal. The judgments from which plaintiffs appeal comply with the version of ORCP 67 B that was in effect when the judgments were entered. We understand that the provisions of House Bill 2646 (2003) do not affect our analysis. See Or Laws 2003, ch 576.

 The record does not indicate what action was taken on plaintiffs claims for social security disability benefits or on his claims — mentioned in the text below— for workers’ compensation benefits. Defendants, during oral argument before the trial court in support of their motion for summary judgment, assumed that the claims had been denied.

 Defendants argue that there is no evidence that plaintiff knew about Smith’s report or Patterson’s and Kintz’s concurring statements, and therefore plaintiff cannot rely on them to establish a genuine issue of material fact. We reject that argument because, even if it is not reasonable to infer that plaintiff knew about the report and the statements, the question presented here is not only what plaintiff knew, but also what he would have known had he inquired. The dissent observes that defendants argue that the fact that there is no evidence that plaintiff knew about the report and the statements should undercut plaintiffs ability to rely on them here. 197 Or App at 476-77 (Edmonds, J., dissenting). However, as the dissent elsewhere correctly observes, we should impute to plaintiff knowledge that he had a reasonable opportunity to learn. Id. at 476 n 1, 481. Smith’s report and Patterson’s and Kintz’s concurring statements may well have become part of plaintiff s treating doctors’ files, and, moreover, it is not clear why we should not consider all sources of information available to a plaintiff in order to determine what he or she had a reasonable opportunity to learn.

 The dissent points to ORS 30.905 to support its argument that the legislature could have used “injury” in ORS 30.907 if it had wanted to. ORS 30.905 is the statute of hmitations generally applicable to product liability claims. The dissent notes that, in ORS 30.905(2)(a), the legislature indicated that the statute begins to run when the plaintiff" ‘discovers, or reasonably should have discovered, the personal injury and its causal relationship to the defendant’s product.” 197 Or App at 483 (Edmonds, J., dissenting) (quoting ORS 30.905(2)(a); emphasis added). “Injury’in ORS 30.905(2)(a) is not used in the same sense as in ORS 12.110(4)). For one thing, “injury’ in ORS 12.110(4) includes causation within it, Gaston, 318 Or at 255, so if the legislature had intended “injury’ in ORS 30.905(2) to have the same meaning as in ORS 12.110(4), the wording emphasized above would be mere surplusage. Moreover, the modifier “personal” and the alternative element “property damage” in ORS 30.905 indicate that, as a whole, the phrase “personal injury or property damage” refer to the “harm” element of a plaintiffs product liability claim. The analogue of that phrase in ORS 30.907 would thus be “disease.”

 In Gladhart, the Supreme Court pointed to ORS 30.907 (then numbered ORS 30.905(3) (1983)) as a statute that expressly contains a discovery rule. 332 Or at 232-33.

 Some opinions construing ORS 12.110(4) discuss only the plaintiffs awareness of tortious conduct. See 197 Or App at 473 (Edmonds, J., dissenting). However, that is because the plaintiffs’ awareness of the other elements was undisputed. In Greene, 335 Or at 119, 121, for example, the plaintiff was aware immediately after surgery that there had been a complication and that it was the result of the defendant’s conduct. In Doe v. American Red Cross, 322 Or 502, 508-09, 512-13, 910 P2d 364 (1996), the plaintiffs conceded on summary judgment that they knew that plaintiff John Doe had become HIV-positive as a result of a transfusion of blood collected by the defendant. In Gaston, the plaintiff did not dispute that he knew with certainty that his left arm was numb and did not function as a result of the surgery performed by the defendant soon after the surgery. Accordingly, the sole issue in those cases was whether the plaintiffs had sufficient certainty about the third element — tortious conduct — to trigger the statute of limitations. Under Gaston and its progeny, substantial possibility is required as to harm and causation — elements that also appear in ORS 30.907 — as well as to tortious conduct.
Although we have not found a case in which we or the Supreme Court has expressly applied the “substantial possibility’ standard to an element of a statute of limitations other than tortious conduct, Berry v. Branner, 245 Or 307, 421 P2d 996 (1966), illustrates why applying that standard to all elements of a statute of limitations is appropriate. In Berry, the defendant performed a hysterectomy on the plaintiff in 1956. The plaintiff began to suffer pain in her lower back and upper leg within several months after the surgery. The cause of her pain — a surgical needle left in her abdomen during the hysterectomy — was not discovered until 1965. Given the difficulty of establishing the connection between the needle and its effects, it would seem appropriate that a plaintiff have a quantum of awareness between mere suspicion and actual knowledge — i.e., awareness of facts supporting a substantial possibility — before she is deemed to have “discovered” causation in such a case. Berry was decided long before Gaston, but, as the Supreme Court noted in Gaston, ORS 12.110(4) was intended to codify the discovery rule announced in that case. 318 Or at 254.
The Supreme Court has consistently indicated that a plaintiff must have the same level of certainty about each pertinent element to begin the period of limitations. E.g., Gaston, 318 Or at 256 (“[T]he statute of limitations begins to run when the plaintiff knows or in the exercise of reasonable care should have known facts [that] would make a reasonable person aware of a substantial possibility that each of the three elements (harm, causation, and tortious conduct) exists.” (Emphasis added; citation omitted.)); Doe, 322 Or at 514 (“Gaston holds that a defendant in a summary judgment motion must establish that the plaintiff knew or in the exercise of reasonable care should have known facts [that] would have made a reasonable person aware of a substantial possibility that each of the three elements (harm, causation, and tortious conduct) existed.” (Emphasis added; citation omitted.).

 The dissent would, in effect, limit the relevant circumstances that might affect the beginning of the limitations period to a single circumstance: the existence of a doctor-patient relationship between a potential defendant and the plaintiff. 197 Or App at 483-86 (Edmonds, J., dissenting). A number of other circumstances, however, may prevent a plaintiff from discovering the pertinent elements of a statute of limitations. An example of such other circumstances — i.e., a causal relationship that was medically difficult to detect — existed with respect to causation in Berry. 245 Or at 308. Similarly, in this case, equivocal medical advice about causation and the offering of alternative possible causes could allow a reasonable juror to conclude that plaintiff did not have a factual basis for sufficient certainty about the cause of his disease to trigger the statute of limitations.

 It is also possible that plaintiff had other lung problems early on, but only later developed an asbestos-related disease. If that were the case, then plaintiff could not have discovered a disease that he did not have at the time. The parties do not frame their arguments in that manner, however, and, accordingly, we do not address that possibility.

 We agree with the dissent that, had the period of limitations already begun to run before that report, the report would not have unrung the bell. See 197 Or App at 477-78 (Edmonds, J., dissenting). However, from the beginning, plaintiff’s physicians had consistently expressed 'uncertainty about the cause of his condition. Their concurrence in Smith’s conclusion that plaintiff “ha[d] no asbestos related condition” supports a reasonable inference that plaintiffs doctors never had sufficient certainty about causation to have communicated an opinion about causation to plaintiff.

 In reaching that conclusion, the dissent relies on inferences that favor defendants, e.g., an inference that plaintiffs conduct in selling his muffler business, filing disability claims, and making certain statements to other medical providers establishes that he had actual knowledge of the cause of his disease and an inference that an attorney who represented plaintiff before 1998 could have advised him about the viability of a product liability claim. 197 Or App at 476 (Edmonds, J., dissenting). Because the trial court granted defendants’ motion for summary judgment, however, it is inappropriate for us to draw those inferences in their favor.