Court Opinion

ID: 9521338
Source: CourtListenerOpinion
Date Created: 2023-08-07 02:02:56.191533+00
Date Added: 2024-06-11T12:49:40.878570
License: Public Domain

GILBERT, Justice
(dissenting).
This case is before us on summary judgment. Therefore, we must view the evidence in a light most favorable to the party against whom the motion was granted. Grondahl v. Bulluck, 318 N.W.2d 240, 242 (Minn.1982) (citing Vieths v. Thorp Fin. Co., 305 Minn. 522, 525, 232 N.W.2d 776, 778 (1975)). “Where there are disputed questions of material fact as to whether a plaintiff is barred by the statute of limitations, these questions are to be decided by a jury.” Id. at 243 (citing Schmit v. Esser, 183 Minn. 354, 357, 236 N.W. 622, 624 (1931)). I agree that the single act exception does not apply in this case. However, I respectfully dissent from the majority’s holding that as a matter of law Rindal’s course of treatment of Ciardelli’s TMJD did not continue until Rindal specifically authorized the prescription level pain medication Motrin by phone. We have stated that a jury may reasonably conclude that a course of treatment may continue by virtue of a telephone conversation between a doctor and a patient even after office visits have stopped. Id. at 243. Likewise, I would hold that a reasonable jury could find that Rin-dal’s authorization of a refill of medication that he initially prescribed years prior as part of a course of treatment was a continuing part of that treatment.
We consider the following three factors to determine whether a continuing course of treatment has ceased: “(1) whether there is a relationship between physician and patient with regard to the illness; (2) whether the physician is attending and examining the patient; and (3) whether there is something more to be done.” Id. at 243. Here, beginning with the third factor, there was clearly something more to be done, which the majority acknowledges. Rindal indicated to Ciar-delli at her December 1992 appointment that surgery may be the next step in her treatment. The first and second factors are closely related. Both factors existed at least through December 1992 when Ciardelli last went to see Rindal in his office. At that time Rindal had been treating Ciardelli for her TMJD for more than 6 years. The issue then is whether, when Rindal renewed Ciar-delli’s prescription, they had a doctor-patient relationship and Rindal was attending to Ciardelli.
Ciardelli first went to see Rindal about trouble with her jaw in May 1986. Rindal diagnosed her with TMJD and began treating her for the disorder. Rindal prescribed Motrin for Ciardelli in April 1992 during an office visit. Ciardelli last went to see Rindal in December 1992 at which time Rindal recommended that she continue to take the Motrin as needed and indicated that surgery might be a possibility if her symptoms did not improve. Rindal asked Ciardelli to return to see him in 6 to 8 weeks, which Ciardelli did not do. If all contact with Rindal’s office had ended at this point, then I would agree that the doctor-patient relationship would have been terminated. However, Ciardelli’s December 1992 office visit was not the last time that Rindal prescribed medication for Ciardelli for her TMJD.
When Ciardelli went to have her prescription filled on December 8, 1993, she had already used all of the refills that Rindal had previously authorized. Pharmacies are prohibited from refilling prescriptions without written or verbal consent from the preseri-ber. Minn.Stat. § 151.211 (1996). In fact, it is a misdemeanor to do so. Minn.Stat. § 151.29 (1996). Consequently, the pharmacist telephoned Rindal who specifically authorized another refill of the Motrin prescription for Ciardelli. Rindal gave authorization for a *915refill for Motrin to alleviate Ciardelli-’s symptoms from TMJD. Rindal noted the new prescription authorization in Ciardelli’s medical records, which he maintained in his office. The refill was for medication that Ciardelli had been taking as part of Rindal’s treatment plan for her. Under these circumstances, a reasonable jury could conclude that the doctor-patient relationship between Ciardelli and Rindal existed when Rindal authorized the refill and that Rindal was attending to Ciar-delli.
The majority cites Rowntree v. Himsucker for the proposition that someone “who takes medication significantly beyond the period contemplated by the physician’s prescription, without further attentions from thé physician, is not being treated by that physician, but is engaging in self-treatment.” 838 S.W.2d 103, 107 (Tex.1992). However, the “self-treatment” to which Rowntree refers is absent in this case. In Rowntree, the plaintiff, who suffered from hypertension, went to see Dr. Rowntree for treatment on October 4, 1985. Id. at 103. Rowntree prescribed the medication Sectral. The plaintiff returned to see Rowntree several additional times through September 15, 1986 which was the date of her last office visit to Rowntree. Id. at 103-04. At that time Rowntree continued the plaintiffs prescription. Id. at 104.
On May 22,1987, the plaintiff called Rown-tree requesting a refill for the medication, and Rowntree authorized five refills. Id. On January 5,1988, the plaintiff suffered a debilitating stroke as a result of an occluded carotid artery. Id. More than a year later, the plaintiff brought suit against Rowntree for failure to diagnose the occluded carotid artery. Id. The family did not allege that the Sectral was in any way the cause of the patient’s injury. The Rowntree court determined that in order to come within the statute of limitations for the malpractice claim, Rowntree’s treatment of the plaintiff had to have lasted until at after August 15, 1987. Id.
The plaintiffs argued that treatment continued as long as the plaintiff was taking the medication, or at least when she filled the last previously authorized prescription of Sectral, which was 7 months after Rowntree was called about the refill. Id. at 106. In rejecting this argument, the Rowntree court cited cases that involved patients who obtained a refill from a pharmacy without the participation of the physician. Id. at 106-07 (citing Bernardo v. Ayerest Lab., 99 A.D.2d 430, 470 N.Y.S.2d 395 (1984); Fleishman v. Richardson-Merrell, Inc., 94 N.J.Super. 90, 226 A.2d 843 (1967)). The Rowntree court explained that:
[cjommon to all of these cases is a recognition that a plaintiff who takes medication significantly beyond the period contemplated by the physician’s prescription, without further attentions from the physician, is not being treated by the physician, but is engaging in self-treatment. The cases stand for the proposition that a physician may establish a course of treatment by enlisting the aid of the patient to self-administer a medication, but only if the physician controls the treatment and continues to render medical services.
Id. at 107. What Rowntree explicitly rejected was either a rule that would extend the statute of limitations by a patient’s taking of medication or a rule that would extend the statute of limitations until all authorized prescription refills had been obtained. Id.
In contrast, Ciardelli argues that the last date that Rindal took an active role in treating her TMJD, by prescribing a refill of medication for her, was the last day of treatment. See, e.g., Bikowicz v. Nedco Pharmacy, Inc., 114 A.D.2d 708, 494 N.Y.S.2d 541, 542 (1985) (concluding that the doctor’s treatment' of the plaintiff terminated either when the direct consultations ended, or when the doctor last consulted the pharmacist about the refills regarding dosage). This action by Rindal establishes that he maintained control of and attended to Ciardelli’s treatment through December 8, 1993, when he authorized the prescription. Without Rindal’s authorization, the prescription would not have been filled. A physician’s specific authorization of a refill prescription to treat an ongoing ailment for which the physician had previously treated the patient for more than 7 year’s and had last seen the patient within the past year, arguably constitutes a continuing course of treatment. At a minimum, the facts of this case raise a question for a jury. A jury may reasonably conclude that Rindal’s *916treatment of Ciardelli’s TMJD continued through his specific authorization of the Motrin refill in December 1993. Accordingly, I would reverse the trial court’s grant of summary judgment and affirm the court of appeals and remand for trial.