McClendon v. Beck, 96-164

• Decision Date: 17 September 1997
• Docket Number: No. 96-164,96-164
• Citation: 569 N.W.2d 382
• Parties: Betty J. McCLENDON, Appellant, v. David BECK, Edwin Crowell, and North Iowa Mercy Health Center, a Delaware Corporation, Appellees.
• Court: Iowa Supreme Court

Page 382

569 N.W.2d 382

Betty J. McCLENDON, Appellant, v. David BECK, Edwin Crowell, and North Iowa Mercy Health Center, a Delaware Corporation, Appellees.

No. 96-164.

Supreme Court of Iowa.

Sept. 17, 1997.

Rehearing Denied Oct. 23, 1997.

Michael A. Smith of Lundy, Butler & Smith, P.C., Eldora, and John P. Whitesell of Whitesell Law Office, Iowa Falls, for appellant.

Walter C. Schroeder and Roberta M. Anderson of Schroeder & Anderson, Mason City, for appellees David Beck and North Iowa Mercy Health Center.

Thomas A. Finley and Kerry A. Finley of Finley, Alt, Smith, Scharnberg, May & Craig, P.C., Des Moines, for appellee Edwin Crowell.

Considered by McGIVERIN, C.J., and LAVORATO, NEUMAN, ANDREASEN, and TERNUS, JJ.

NEUMAN, Justice.

This appeal reaches us on further review from a court of appeals decision that reversed the district court's summary judgment for defendants on statute of limitations grounds. The question is whether this medical malpractice action is barred by the two-year limit of Iowa Code section 614.1(9) (1995), or whether the record made on summary judgment reveals disputed material facts bearing on fraudulent concealment or the continuous treatment doctrine. Like the district court, we find no facts in the record that would support a tolling of the limitation period. We therefore vacate the court of appeals decision and affirm the district court.

Plaintiff Betty McClendon suffers from a congenital deformity of the spine known as spondylolisthesis. She consulted physicians Edwin Crowell and David Beck, who recommended surgery. In September 1988, the two surgeons operated on her lower back. Because the fusion they hoped for did not "take," the doctors performed another operation on October 19, 1989--this time inserting plates and screws onto McClendon's spine. Immediately following this surgery, McClendon complained of extreme leg pain. According to Beck's surgery notes, the right sacral screw appeared to impinge the sciatic nerve. So on October 27, 1989, further surgery was performed to reconfigure the offending screw. McClendon's pain continued following this corrective procedure. Three days later the doctors operated yet again, this time to repair a ruptured disk and remove one of the plates.

McClendon was discharged from the hospital on November 7, 1989. Beck furnished a written discharge summary to Thomas Graham, McClendon's family physician. Beck explained the problems encountered in the previous operations but concluded McClendon was "doing well" and predicted that "she will have a good outcome."

McClendon's back problems persisted. Some ten months later, on August 23, 1990, Beck and Crowell performed a fifth operation to remove scar tissue, the other plate, and a broken screw. McClendon, still suffering back and leg pain, had a postoperative visit with Beck in December 1990. Beck ruled out any more surgery and advised her "that the pain would get better as time went on." McClendon's family physician continued to prescribe medicine for pain.

McClendon did not consult either Beck or Crowell in 1991 or 1992. Not until May 3, 1993, upon her request for a referral from Graham, did McClendon pursue a "follow-up" visit with Beck concerning her ongoing back and leg pain. Beck reported the substance of this visit to Graham in the following letter:

Betty McClendon returned today for a follow-up. As you know, she has had chronic pain in the right leg and back. Betty continues to be miserable. She is taking Percocet every three hours. Again, I discussed things with Betty. I really think the only way to get Betty out of pain is something like a morphine installation pump. I don't think a dorsal column stimulator or any other pain procedure would help. I have given her a videotape on this. She is going to call me in a week. I have also started her on a Medrol Dose-Pak to see if an epidural steroid would help.

On June 27, 1994, McClendon filed a medical malpractice action against physicians Crowell and Beck, and North Iowa Mercy Health Center. She alleged negligent performance of the surgeries, and negligent preoperative and postoperative treatment. McClendon sought punitive as well as compensatory damages, alleging the defendants willfully and wantonly disregarded her rights and safety by intentionally withholding information about the use of plates and screws in the operation.

Defendants filed general denials and asserted the affirmative defense that Iowa Code section 614.1(9) bars her cause of action. They moved for summary judgment, asserting that because McClendon's surgeries and follow-up care occurred in 1988, 1989, and 1990, her claim filed in June 1994 was time barred.

McClendon resisted the motion on two grounds. She claimed the suit was not time barred because (1) the defendants fraudulently concealed her true condition, and (2) she remained in defendants' continuous care and was unaware until consulting with Beck in May 1993 that her condition would not improve.

The district court found no support for McClendon's arguments in the record made in response to defendants' motion. Given the series of problematic surgeries and McClendon's acute awareness that neither her discomfort nor the limitation in her mobility had abated, the court concluded a reasonable person would have known by late 1990, if not before, that a problem existed. Nor was the court persuaded that the optimism revealed by Beck's 1989 letter constituted fraudulent concealment. In the court's words, "[t]here was nothing in the letter that would cause Ms. McClendon in the exercise of reasonable diligence to ignore the observations of her own physical senses ... [or] dissuade her from obtaining other opinions...." It is from this ruling that McClendon appeals.

I. Scope of Review.

Defendants contend the record establishes their statute of limitations defense as a matter of law. They carry the burden and are entitled to prevail only if the pleadings, depositions, answers to interrogatories, affidavits, and admissions on file demonstrate that "there is no genuine issue as to any material fact" that would prevent summary judgment in their favor. Iowa R. Civ. P. 237(c). We afford the plaintiff, who opposes the motion, every reasonable inference the facts will bear. Langner v. Simpson, 533 N.W.2d 511, 516 (Iowa 1995). But summary judgment is properly granted if the only controversy concerns the legal consequences flowing from undisputed facts. Teleconnect Co. v. U.S. West Communications, Inc., 508 N.W.2d 644, 646 (Iowa 1993).

II. Analysis.

McClendon relies heavily on two factual claims to overcome the two-year time bar of Iowa Code section 614.1(9). ¹ First, she asserts "Dr. Beck and Dr. Crowell set the course of treatment during the period of 1988 through and including May of 1993. It was at the May 1993 meeting with Dr. Beck that [she] was informed of her true condition." Proof of this ongoing relationship, she claims, supports her reliance on the continuous treatment doctrine to toll the statute of limitations. Second, she contrasts Beck's 1989 letter (stating the surgeries "went well" and predicting "a good outcome") with his May 1993 assessment (her condition would not improve) as proof the doctors "fraudulently concealed the true nature of her condition and injuries until after the statute of limitations ran." We address the arguments in turn.

A. Continuous treatment doctrine. Several courts have held that when a plaintiff receives continuing care for the same injury from a negligent actor whose malpractice is at issue, the statute of limitations may be tolled until the treatment ceases. Langner, 533 N.W.2d at 519. Two common-sense reasons underlie the doctrine: (1) it is unreasonable to expect a patient to discover that her doctor's ongoing care is, in fact, the cause of her injury; and (2) the patient should not be expected to interrupt corrective medical treatment with a lawsuit. Id. at 519-20.

We declined to adopt the continuous treatment doctrine in Langner because the undisputed facts revealed the patient's knowledge of her injury and immediate termination of the doctor-patient relationship when the allegedly tortious conduct occurred. Id. at 520. Similar shortcomings prevent application of the doctrine here. Even assuming McClendon was not aware that a problem existed until May 1993, she points to no evidence of an ongoing treatment...