Castillo v. Emergency Medicine Associates, P.A.

• Decision Date: 17 June 2004
• Docket Number: No. 03-1564.,03-1564.
• Citation: 372 F.3d 643
• Parties: Latisha S. CASTILLO, Plaintiff-Appellant, v. EMERGENCY MEDICINE ASSOCIATES, P.A., Defendant-Appellee, and John/Jane Doe, MD; Prince William Hospital, Defendants.
• Court: U.S. Court of Appeals — Fourth Circuit

Page 643

372 F.3d 643

Latisha S. CASTILLO, Plaintiff-Appellant, v. EMERGENCY MEDICINE ASSOCIATES, P.A., Defendant-Appellee, and John/Jane Doe, MD; Prince William Hospital, Defendants.

No. 03-1564.

United States Court of Appeals, Fourth Circuit.

Argued: January 21, 2004.

Decided: June 17, 2004.

ARGUED:

Martin Trpis, Ashcraft & Gerel, Washington, D.C., for Appellant. Thomas M. Wochok, Hamilton Altman Canale & Dillon, L.L.C., Fairfax, Virginia, for Appellee. ON BRIEF:

ON BRIEF:

Wayne M. Mansulla, Ashcraft & Gerel, Washington, D.C., for Appellant. Stephen L. Altman, Hamilton Altman Canale & Dillon, L.L.C., Fairfax, Virginia, for Appellee.

Before MOTZ, GREGORY, and DUNCAN, Circuit Judges.

Affirmed by published opinion. Judge DUNCAN wrote the majority opinion, in which Judge MOTZ joined. Judge GREGORY wrote a dissenting opinion.

OPINION

DUNCAN, Circuit Judge:

Appellant Latisha S. Castillo ("Castillo") challenges the district court's granting Appellee Emergency Medicine Associates, P.A.'s ("EMA") motion for summary judgment, on the ground that her medical malpractice claim is barred by Virginia's statute of limitations. Castillo argues that the district court erred in failing to view the evidence in the light most favorable to her, and in finding that the continuing treatment doctrine did not apply to toll the statute of limitations. Because we conclude that the claim is indeed time-barred and that the district court did not err in granting the motion for summary judgment, we affirm.

I.

Castillo came to the emergency department of Prince William Hospital on October 10, 1999, complaining of lower abdominal pain and several months' history of severe nausea and abdominal pain with bloating. An unidentified emergency department physician ("Dr.Doe") diagnosed Castillo with a urinary tract infection. Dr. Doe prescribed antibiotics and discharged Castillo that same day. Upon discharge, Castillo was provided with the following Emergency Services Department Discharge Instructions:

The examination and treatment you received today in the Emergency Services Department has been rendered on an emergency basis. It is not intended to be a substitute for comprehensive medical attention. SHOULD YOUR CONDITION WORSEN, ANY NEW SYMPTOMS DEVELOP, OR YOU NOT RECOVER AS EXPECTED, PLEASE CONTACT THE DOCTOR YOU WERE GIVEN FOR

FOLLOW-UP CARE (listed below). If you cannot reach the doctor, return to the Emergency Services Department. You should return immediately to the nearest emergency room for any emergency.

J.A. 75 (emphasis added). The follow up care specifically refers Castillo first to her "own MD in North Carolina" or a follow-up with "Dr. Wall for recheck in 3-4 days if not better." Id. Dr. Wall is a gynecologist who works at Prince William Hospital, but is not employed by EMA. The Instructions go on to emphasize as follows: "It is important that you follow up with the doctor listed above [i.e., her own doctor or Dr. Wall] for a re-examination." Id. (emphasis in the original).

On October 14, 1999, Castillo called the emergency department because her condition had not improved. Initially, she asked to speak with Dr. Wall. When Dr. Wall could not be reached, Castillo spoke with an unidentified emergency department physician, who prescribed a new medication over the telephone. On October 19, 1999, Castillo returned to the emergency department, complaining of severe acute abdominal pain, fever, and chills. She was seen by Dr. James Eskew, who admitted her to the hospital. On that day, Castillo underwent surgery for treatment of abdominal adhesions and infected abscesses in the pelvic area, which had resulted from soilage due to a perforated intestine. All of the emergency department physicians who treated Castillo were employed by EMA.

Castillo filed the original complaint on October 19, 2001. That complaint was voluntarily dismissed, and Castillo filed an amended complaint on August 7, 2002. The amended complaint alleged that EMA is liable for the acts and omissions of its agents, including Dr. Doe, and that Dr. Doe was negligent in his treatment of Castillo on October 10, 1999. EMA moved for summary judgment on the ground that Castillo failed to bring her cause of action for medical malpractice within two years of the date it accrued. Castillo argued that there existed a genuine issue of material fact regarding the date of the onset of her injury, and therefore a grant of summary judgment was improper. Further, Castillo contended that the district court should apply the continuing treatment doctrine to toll the statute of limitations while she was under the care of physicians employed by EMA. For both these reasons, Castillo argued that her cause of action was not time-barred.

The district court found that no genuine issue of material fact existed as to the timing of the injury, and that the continuing treatment doctrine did not apply. Specifically, with respect to the continuing treatment theory, the court found that the physician-patient relationship between Castillo and Dr. Doe terminated upon her discharge from the Emergency Department on October 10, 1999, and so, necessarily, did her physician-patient relationship with EMA. Thus, the district court found that the statute of limitations barred Castillo's cause of action and granted EMA's motion for summary judgment.

II.

We review a district court's grant of a motion for summary judgment de novo. See Stone v. Liberty Mut. Ins. Co., 105 F.3d 188, 191 (4th Cir.1997). To prevail on a motion for summary judgment, a party must show (1) there is no genuine issue of material fact; and (2) it is entitled to judgment as a matter of law. Id. at 190. In reviewing the evidence, we draw all reasonable inferences in favor of Castillo, the non-moving party. Thompson v. Aluminum Co. of Am., 276 F.3d 651, 656 (4th Cir.2002).

As a federal court sitting in diversity, we interpret and apply the substantive law of the state in which the action arose. Erie R.R. Co. v. Tompkins, 304 U.S. 64, 78, 58 S.Ct. 817, 82 L.Ed. 1188 (1938). In this case, the Virginia statute of limitations applies. See Rowland v. Patterson, 852 F.2d 108, 110 (4th Cir.1988) ("Federal courts sitting in diversity generally apply state statutes of limitations.").

The applicable Virginia statute of limitations states that "every action for personal injuries, whatever the theory of recovery... shall be brought within two years after the cause of action accrues." Va.Code Ann. § 8.01-243(A) (Michie 2003). Under Virginia law, the statute of limitations for personal injury begins to run when the wrong is committed, rather than on the date the injury is discovered. See Va.Code Ann. § 8.01-230 (Michie 2003) ([T]he right of action shall be deemed to accrue and the prescribed limitation period shall begin to run from the date the injury is sustained in the case of injury to the person...."); Caudill v. Wise Rambler, Inc., 210 Va. 11, 168 S.E.2d 257, 259-60 (1969) (finding that the right to recover damages for personal injuries accrues at the time a person is injured).

In this case, the original complaint was filed on October 19, 2001. Therefore, in order for the cause of action to fall within the two-year statute of limitations, the injury must have been sustained on or after October 19, 1999, or the limitations period must have been tolled.

A.

Castillo contends that an issue of material fact existed regarding the date of injury, and that a reasonable jury could find that the injury began on or after October 19, 1999. She argues that a grant of summary judgment was therefore improper.

In making her argument, Castillo contends that the actionable injury resulted from the adhesions and fistulas caused by the intra-abdominal scarring that happened when an intestinal perforation was allowed to seal on its own instead of being treated. Since the scarring occurred after the sealing of the perforation, and the sealing was complete by the time corrective surgery was performed on October 19, 1999, Castillo argues that the scarring could have started after that date.

To support this contention, Castillo offered the opinion of Dr. Eric Munoz, her expert on causation and damages. During his deposition, Dr. Munoz opined that the intestinal perforation sealed "[s]ome time before [October] 20 but no one could say." J.A. 103-04. Castillo contends that based on this testimony, a reasonable juror could find that the scarring process occurred on or after October 19, 1999.

However, the following colloquy also occurred during Dr. Munoz's deposition:

Q: [Castillo] presents on October 10 and you are saying that between the tenth and the twelfth is basically the time frame within which to meet the standard of care?

A: Correct.

Q: And after the twelfth she begins to receive some physical damage from the lack of intervention?

A: Yes.

Q: Let me put it this way: On October 13, 1999 to a reasonable degree of medical certainty, in your opinion, because interventions weren't performed she has suffered physical damage?

A: Yes.

Q: And that the physical damage became exacerbated day by day until she actually received the care?

A: Correct.

J.A. 105-06. Additionally, during the depositions of Castillo's other expert witnesses, Drs. Soloman Shah and David Munter, each opined that the damage from the perforated intestine began before October 19, 1999.¹ Further, in her memorandum to the district court in opposition to EMA's motion for summary judgment, Castillo states that "[o]n October 10, 1999, [she] had either a perforation of her intestine or she had and [sic] acute appendicitis." J.A. 112.

Each of Castillo's three witnesses agrees that medical intervention should have begun on October 10, 1999, on her first visit to the emergency department.² Further they agree that the onset of the injury occurred sometime before October 19, 1999.

Thus, even under Castillo's version of the sequence of events, her focus on when the scarring process might...