Hughes v. US, 00-3606

• Decision Date: 19 July 2001
• Docket Number: No. 00-3606,00-3606
• Citation: 263 F.3d 272
• Parties: (3rd Cir. 2001) RAYMOND HUGHES, APPELLANT v. UNITED STATES OF AMERICA Argued:
• Court: U.S. Court of Appeals — Third Circuit

Page 272

263 F.3d 272 (3rd Cir. 2001)

RAYMOND HUGHES, APPELLANT v. UNITED STATES OF AMERICA

No. 00-3606

U.S. Court of Appeals, Third Circuit

Argued: July 19, 2001

Filed: August 29, 2001

As amended August 31, 2001.

On Appeal From the United States District Court for the Eastern District of Pennsylvania (C.A. No. 00-CV-3605) District Judge: Honorable Edmund V. Ludwig

Gustine J. Pelagatti (Argued) Gustine J. Pelagatti & Associates 1845 Walnut Street, Suite 600 Philadelphia, PA 19103 Counsel for Appellant

Nuriye C. Uygur (Argued) Office of United States Attorney 615 Chestnut Street Philadelphia, PA 19106 Counsel for Appellee

Before: Scirica, Rendell and Rosenn, Circuit Judges.

OPINION ANNOUNCING THE JUDGMENT OF THE COURT

Rosenn, Circuit Judge.

Determining when the statute of limitations begins to run in a case is sometimes difficult, especially in cases claiming medical malpractice. The plaintiff, Raymond Hughes, was admitted to the Veterans Administration Medical Center (VAMC) in Charleston, South Carolina, on April 15, 1997, for a cardiac catheterization and a subsequent coronary bypass. In preparation for the surgery, physicians administered heparin, a blood thinner. The administration of heparin was almost continuous from April 16 to April 23, 1997. After the operation, gangrene developed in Hughes's extremities and, as a result, his doctors amputated them to prevent the gangrene from spreading. Hughes filed an administrative tort claim with the Veterans Administration. On December 16, 1999, the VA denied the claim and Hughes sued the United States on June 16, 2000 under the Federal Tort Claims Act, 38 U.S.C. S 1346.

The Government moved to dismiss the suit for lack of subject matter jurisdiction. The District Court granted the Government's motion and dismissed the action. The plaintiff timely appealed. We vacate and remand.

I.

On April 15, 1997, Hughes, a veteran, appeared at the Department of Veterans Affairs Medical Center in Charleston, South Carolina for treatment of neck pain. While at the hospital, the pain spread to his chest. Hughes then underwent cardiac catheterization, which revealed coronary artery disease. On the same day, VAMC personnel administered heparin to Hughes in preparation for coronary artery bypass surgery. The hospital performed the surgery on April 18, 1997. Hughes was hooked up to a heparin drip almost continuously for a week. During that time, his limbs grew cold and black with gangrene.

Hughes was heavily sedated and unconscious from April 17 to June 4, 1997. On May 13, 1997, VAMC personnel amputated his right leg above the knee because it had filled with gangrene. On May 20, both of Hughes's hands were amputated due to gangrene. Two days later, surgeons amputated his left leg below the knee.

On June 4, 1997, Hughes regained consciousness and discovered that he was a quadruple amputee. The doctors at the VAMC informed him that he had had a heparin-induced allergic reaction which caused the gangrene, leaving them no choice but to amputate. His reaction to heparin is known as heparin-induced thrombocytopenia with thrombosis ("HITT"). Hughes was not informed that, had the HITT been timely diagnosed, it could have been treated and arrested with anticoagulants.

The hospital released Hughes on July 23, 1997. In February 1999, he filed a claim for benefits available under 38 U.S.C. S 1151 ¹ to veterans disabled by medical treatment. When a social worker from the Veterans Administration questioned him, Hughes allegedly said that he did not wish to sue the Government.

On April 12, 1999, Hughes consulted attorney Robert D. Fogel of Charleston, South Carolina. Fogel requested Hughes's medical records from the VAMC on May 24, 1999. In the letter requesting such records, Fogel advised the VAMC that time was of the essence because Hughes's "potential claim against the government would expire on or about June 25 [1999]." On June 10, 1999, Fogel received Hughes's records, but declined to accept his case. Fogel never filed an administrative tort claim on Hughes's behalf to protect his claim.

Hughes retained his current attorney in December 1999. His attorney promptly filed a Notice of Claim with the VA. The VA rejected Hughes's claim on July 6, 2000. Ten days later, Hughes's attorney filed a complaint against the United States pursuant to the Federal Tort Claims Act ("FTCA"). Hughes sought damages for the failure of VAMC personnel to diagnose and treat his heparin-induced allergic reaction, which resulted in the amputation of his legs and hands. (Complt. at Para. 27(c) - (e)). The United States filed a motion to dismiss the complaint for lack of subject matter jurisdiction. The District Court granted the motion and dismissed the action pursuant to Fed. R. Civ. P. 12(b)(1).

II.

Statutes of limitations "are found and approved in all systems of enlightened jurisprudence." Wood v. Carpenter, 101 U.S. 135, 139 (1879). Although they provide what legislatures consider a reasonable period for plaintiffs to present their claims, "they protect defendants and the courts from having to deal with cases in which the search for truth may be seriously impaired by the loss of evidence." United States v. Kubrick, 444 U.S. 111, 117 (1979).

In enacting the Tort Claims Act, Congress generously waived the immunity of the United States. A condition of that waiver is that suits be filed within the statutory time limitation. 28 U.S.C. S 2401(b), enacted by Congress, specifically requires that tort claims be brought against the Government within two years of the accrual of the cause of action. Its obvious purpose is to encourage the prompt presentation of all claims. See id. "[W]e should not take it upon ourselves to extend the waiver beyond that which the Congress intended. Neither, however, should we assume the authority to narrow the waiver that Congress intended." Kubrick, 444 U.S. at 117-118 (citations omitted).

On appeal, Hughes contends that the statute of limitations was not activated by his awareness of his injury, but was tolled until he became aware of the act or omission which caused the injury. He further asserts that he relied on the VA physicians' explanation of the cause of his injuries and therefore had no reason to know of their failure to treat his reaction. In effect, his argument is that giving him the heparin did not cause his injury; rather, it was caused by the failure of the treating physicians timely to apply anticoagulants and other appropriate treatment to combat the HITT. He asserts that he was not made aware of this cause of his injury until Attorney Robert Fogel had obtained and reviewed his medical records on June 10, 1999. Prior to that date, Hughes claims to have accepted the doctors' explanation that his injuries were the direct result of his unforeseeable allergic reaction. Thus, Hughes argues that the statute of limitations was equitably tolled until he received his hospital records, and that he had two years thereafter to file his claim. On the other hand, the Government argues that Hughes had all relevant information about his injury and its cause when he was discharged on July 23, 1997, the date it claims the statute of limitations began to run.

In a medical malpractice action under the FTCA, the statute of limitations is tolled until the putative plaintiff possesses facts which would enable "a reasonable person to discover the alleged malpractice." Barren by Barren v. United States, 839 F.2d 987, 991 (3d Cir. 1988). The District Court dismissed this action for lack of subject matter jurisdiction, holding that, in June 1997, when Hughes awoke from his coma in the hospital and realized he was an amputee, he possessed sufficient facts to place a reasonable person on notice of medical malpractice. The District Court concluded that the plaintiff not only knew of his injury, but also knew of its cause, the unknown allergy, in June-July 1997. The court held that Kubrick "places an affirmative burden on a plaintiff armed with the predicate facts to obtain medical advice and pursue the claim." (D.C. op. at 10-11).

In Kubrick, the Supreme Court held that the statute of limitations barred the action because the plaintiff was aware of both his injury and the facts surrounding its causation. See Kubrick, 444 U.S. at 122. The Court reasoned that, once the plaintiff knows "the critical facts that he has been hurt and who has inflicted the injury," he can seek medical and legal advice to determine whether the medical care he received was substandard and whether he has a viable cause of action for negligence. Id.

Applying Kubrick to the facts before it, the District Court found that Hughes became aware of his injury (the amputations) when he awoke from his coma. It also found that Hughes learned the cause of his injury while still in the hospital, when his physician informed him that he had had an allergic reaction to the heparin which ultimately necessitated his amputations. Concluding that this information would have led a reasonable person to suspect malpractice, the District Court held that, once he was in possession of these facts, Kubrick charged Hughes with a duty to promptly investigate his claim or risk losing it.

The case before us differs from Kubrick in a crucial respect. In Kubrick, the plaintiff alleged that the administration of a particular drug, which caused him to lose his hearing, was negligent. Id. at 114. Hughes, by contrast, does not claim that his injury resulted from the administering of the heparin by the VA doctors. Rather, he alleges that the loss of his limbs was caused by the VA doctors' failure to monitor and treat his reaction to the heparin. Hughes was not informed, when he regained consciousness in the hospital, that his reaction could have been treated. Therefore, as a reasonable lay person, he did not know the facts surrounding the causation of his injuries until a considerable time after his hospital discharge, when he learned that...