Rathje v. Mercy Hosp.

• Decision Date: 22 February 2008
• Docket Number: No. 04-2081.,04-2081.
• Parties: Georgia M. RATHJE, Kelly Rathje and Richard Rathje, Appellants, v. MERCY HOSPITAL, Cedar Rapids, Iowa, and Dwight J. Schroeder, Appellees.
• Court: Iowa Supreme Court

745 N.W.2d 443

Georgia M. RATHJE, Kelly Rathje and Richard Rathje, Appellants, v. MERCY HOSPITAL, Cedar Rapids, Iowa, and Dwight J. Schroeder, Appellees.

No. 04-2081.

Supreme Court of Iowa.

February 22, 2008.

James. P. Hayes and Karen A. Lorenzen of Hayes Lorenzen Lawyers PLC, Iowa City, and Richard H. Doyle of Galligan, Doyle & Reid, PC, Des Moines, for appellants.

David A. Elderkin and Robert M. Hogg of Elderkin & Pirnie, P.L.C., Cedar Rapids, for appellees.

CADY, Justice.

In this appeal, we must decide if the district court correctly granted summary judgment in a medical malpractice action based on a claim that the plaintiffs failed to file their petition within the statute of limitations. Although the district court relied on our line of prior cases in reaching its decision, we now conclude the statute of limitations for medical malpractice actions does not begin to run until discovery of both the injury and its factual cause. On our review, we reverse the decision of the district court and remand for further proceedings.

I. Background Facts and Proceedings.

On March 19, 1999, Kelly and Richard Rathje admitted their sixteen-year-old daughter, Georgia, to an outpatient alcohol abuse treatment center at Mercy Hospital in Cedar Rapids. Part of the treatment plan developed for Georgia called for the administration of a drug called Antabuse. This drug causes the body to produce an alcohol sensitivity that results in a highly unpleasant reaction to the ingestion of beverages containing alcohol. The treatment plan called for. Georgia to receive a liquid dose of Antabuse, administered by a nurse at the treatment center, twice each week.

Around a week later, Georgia began to feel sick and nauseated. She also began to experience cramps and was constipated. Georgia reported these symptoms to the nurse who administered the Antabuse at the treatment center, and the nurse suggested she consume food prior to taking Antabuse in the future.

On April 5, Kelly contacted the family's physician, Dr. Jerome Janda, to report Georgia was nauseated and frequently expelled an acid-like fluid from her stomach. Dr. Janda subsequently examined Georgia, and ordered an upper gastrointestinal test. The results of the test were consistent with peptic disease and duodenitis, but revealed no definite ulcer or reflux disease. Dr. Janda prescribed medication for Georgia's stomach pain.

On April 20, Georgia would not eat or drink. She was suffering from abdominal pain and was vomiting a green substance. She was also fatigued. Kelly reported these symptoms to a nurse in Dr. Janda's office.

On April 23, Georgia was seen by Dr. Janda with continued complaints of nausea and constipation. Dr. Janda ordered x-rays, together with a liver function test, a blood test, and a test used to diagnose various intestinal diseases and problems. The x-rays were taken, but the other tests were not performed due to a mix up.

On April 26, Georgia returned to Dr. Janda's office. She had been bedridden for most of the time since the previous office visit on April 23. She was nauseated, vomiting, and constipated. At this visit, Dr. Janda noticed Georgia's skin color was "mildly yellow or jaundiced and the whites of her eyes were yellowish or icteric." He again ordered the prior tests and added a test to determine the presence of any inflammation.

Georgia had blood drawn for testing at Mercy Hospital. The blood tests were performed by the hospital lab, with abnormal results. Dr. Janda informed Kelly of the test results, and Georgia was admitted to St. Luke's Hospital on April 27.

Dr. Janda consulted with a surgeon about his concern that Georgia could have gallbladder stones. A CAT scan revealed some enhancement of the gallbladder wall and some fluid around the gallbladder, but no other abnormalities. The surgeon then consulted with a gastroenterologist.

The gastroenterologist determined the jaundice and elevated liver enzymes experienced by Georgia were secondary to hepatitis. He believed Georgia's condition might be a "drug-induced hepatitis secondary to Antabuse." He recommended Georgia stop taking all prior medications.

Georgia was discharged from St. Luke's Hospital, but promptly readmitted on April 29. She still appeared jaundiced, and her condition continued to deteriorate over the passing days. On May 5, she was transferred to the University of Iowa Hospitals and Clinics Pediatric Intensive Care Unit. She later received a liver transplant as a result of end-stage liver disease secondary to Antabuse.

On April 26, 2001, Georgia and her parents filed a petition against numerous health care providers, including Mercy and Dr. Dwight Schroeder, the medical director at the Alcohol Treatment Center at Mercy. The lawsuit claimed Dr. Schroeder and the hospital were negligent in prescribing Antabuse and in their treatment of Georgia for alcohol abuse, and this negligence was the cause of her irreversible liver damage and transplant. The Rathjes eventually dismissed all defendants from the lawsuit except Mercy Hospital and Dr. Schroeder.

Mercy Hospital and Dr. Schroeder filed answers to the petition and later were permitted to amend their answers to claim the statute-of-limitations defense. They both then subsequently moved for summary judgment based on the two-year statute of limitations.

Mercy Hospital and Dr. Schroeder claimed the statute of limitations began to run when Georgia began to experience symptoms of her injury prior to April 26, 1999. Georgia and her parents claimed the statute of limitations began to run when Georgia learned after April 26, 1999, her liver was irreversibly damaged, or, at the earliest, when her condition worsened on April 26, 1999, to include symptoms of jaundice.

The district court granted summary judgment for Mercy Hospital and Dr. Schroeder. It found the facts were undisputed that Georgia's injury had physically manifested itself well prior to April 26, 1999, more than two years before the Rathjes filed suit. Consequently, it concluded the lawsuit filed by the Rathjes was barred by the statute of limitations contained in Iowa Code section 614.1(9)(a) (2001).

The Rathjes appealed. They argue the district court erred in allowing Mercy to amend its answer to include a statute-oflimitations defense and further argue the district court erred in granting summary judgment for Mercy Hospital and Dr. Schroeder.¹

II. Standard of Review.

We review a district court ruling granting a motion for summary judgment for correction of errors at law. Kragnes v. City of Des Moines, 714 N.W.2d 632, 637 (Iowa 2006).

III. Statute of Limitations for Medical Malpractice Actions.

This case requires us once again to visit the medical malpractice statute of limitations and apply it to the facts of a particular case. We have done this on a number of occasions since the special statute was enacted in 1975, and have developed a body of interpretative law in the process. Yet, this law has raised some questions about the fairness of the outcome of a number of these cases. This perception has not gone unnoticed by us, for we have freely acknowledged the statute can "severely restrict[] the rights of unsuspecting patients." Schlote v. Dawson, 676 N.W.2d 187, 194 (Iowa 2004). Nevertheless, we have declined to change course, recognizing it is the role of the legislature to "address this problem." Id.

It is, of course, the role of the legislature to write statutes, and it is our role to interpret them based on their application in the course of litigation. Moreover, the legislature can rewrite a statute to reflect its intent when it does not believe our interpretation in a particular case has accomplished this goal. Yet, these general principles of separation of powers and fundamental duties do riot totally absolve us from our continued responsibility to interpret applicable statutes in each case and, more importantly, to revisit our past interpretations if we are convinced they have not clearly captured the intent of our legislature. We adhere to precedent, but also remain committed to clarifying the law as we work with our precedent. When our interpretation of a statute has created problems in the application of the statute to subsequent cases, we should be willing to reexamine our precedent to see if our understanding of the legislative intent can be better articulated. See Ruth v. Dight, 75 Wash.2d 660, 453 P.2d 631, 634 (1969) (reexamining past interpretation of statute of limitations in light of "constant intellectual bombardment").

We begin the task of revisiting our interpretation of section 614.1(9) by returning to the original statute of limitations for personal injury actions enacted by our legislature in the Nineteenth Century. This journey is necessary to put the issue we face today in perspective and to help understand the intent of our legislature in choosing the language it used to write the statute of limitations for medical malpractice actions. As originally enacted, the statute of limitations provided:

"The following actions may be brought within the times herein limited, respectively, after their causes accrue, and not afterwards, except when otherwise specially limited: (1) Actions founded on injuries to the person . . ., whether based on contract or tort, . . . within two years."

Fadden v. Satterlee, 43 F. 568, 568-69 (S.D.Iowa 1890) (quoting Iowa Code § 2529). Thus, our legislature selected the prescriptive period of time to bring a personal injury action based on tort and used the accrual of the claim as a starting point for the limitation period. In doing so, the legislature determined a two-year period was sufficient for a reasonably diligent person to file a claim with the judicial system.² See Estate of Kuhns v. Marco, 620 N.W.2d 488, 490 (Iowa 2000) ("Statutes of limitations establish a reasonable period of time for plaintiffs to file their claims."). The statute was designed primarily to protect the courts and ...