Rodriguez v. Manhattan Medical Group, P.C.

• Decision Date: 27 December 1990
• Citation: 77 N.Y.2d 217,567 N.E.2d 235,566 N.Y.S.2d 193
• Parties: , 567 N.E.2d 235 Evelyn RODRIGUEZ et al., Appellants, v. MANHATTAN MEDICAL GROUP, P.C., et al., Respondents.
• Court: New York Court of Appeals Court of Appeals

Page 193

566 N.Y.S.2d 193

77 N.Y.2d 217, 567 N.E.2d 235

Evelyn RODRIGUEZ et al., Appellants, v. MANHATTAN MEDICAL GROUP, P.C., et al., Respondents.

Court of Appeals of New York.

Dec. 27, 1990.

[77 N.Y.2d 218] [567 N.E.2d 236] William Kirchhofer, New York City, for appellants.

Thomas Samuel Nogaro, Rosedale, and Michael Saunders, New York City, for respondents.

OPINION OF THE COURT

TITONE, Judge.

Although a medical malpractice action must ordinarily be brought within 2 1/2 years after the act, omission or failure complained of, the time for commencing an action based on the discovery of a "foreign object" does not begin to run until the date the object was, or should have been, discovered (CPLR 214-a). This appeal requires us to consider whether a "fixation device" originally implanted in a patient's body for a specific treatment purpose is transformed into a "foreign object" within the meaning of this rule when a physician retained to remove it negligently fails to do so. We now hold that the "fixation device" does not become a "foreign object" in these circumstances and that, accordingly, plaintiffs' complaint was properly dismissed as time barred.

According to the complaint's allegations, plaintiff had an intrauterine device (I.U.D.) inserted into her uterus in 1980 as a birth control measure. Approximately two years later, when she and her husband decided to begin having a family, plaintiff made an appointment with defendant Manhattan Medical Group to have the I.U.D. removed. On November 5, 1982, plaintiff was examined by defendant Dr. Klein, an employee of the Group. Having failed to locate the I.U.D. during the examination, Klein ordered X rays to be taken of plaintiff's lower abdomen. When the X rays did not disclose the presence of an I.U.D., Klein met with plaintiff on December 17, 1982 and informed her that she could attempt to conceive without the need for any further medical procedures.

Plaintiff's efforts to become pregnant over the next 3 1/2 years were unsuccessful. By the spring of 1986, she was experiencing heavy vaginal bleeding, leading her to consult with a new physician, Dr. Radney. A sonogram ordered by Dr. Radney revealed the presence of an I.U.D. embedded in the uterus wall. Plaintiff ultimately had to be admitted to the hospital so that the I.U.D. could be surgically removed.

On February 19, 1987, more than four years after her last consultation with Klein, plaintiff and her husband commenced the present action against Klein and the Manhattan Medical Group, alleging that Klein had acted negligently in failing to discover the presence of the I.U.D. Defendants subsequently interposed CPLR 214-a's 2 1/2 year Statute of Limitations as an affirmative defense. In response, both plaintiffs invoked the special statutory rule for "foreign objects" and argued that the limitations period on their medical malpractice claim had not begun to run until the I.U.D.'s continued presence in plaintiff's uterus was discovered.

On cross motions to test the validity of this defense, Supreme Court rejected plaintiffs' efforts to bring their case within the special statutory provisions for actions "based upon the discovery of a foreign object." Holding that the I.U.D. was a "fixation device" and was therefore not a foreign object as that term is used in the statute, Supreme Court dismissed the complaint in an order that was affirmed by a closely divided Appellate Division panel. 155 A.D.2d 114, 552 N.Y.S.2d 947. Plaintiffs then appealed to this Court, as a matter of right (see, CPLR 5601[a], arguing that while the I.U.D. may have originally been a deliberately implanted "fixation device," it became a "foreign object" when defendants left it in place after having been retained for the specific purpose of removing it. We now reject plaintiffs' argument and affirm the lower courts' dismissal of their complaint.

Traditionally, the limitations period for bringing a medical malpractice action has been held to run from the date that the last act of alleged malpractice was performed rather than from the date that the resulting injury was discovered (see, e.g., Conklin v. Draper, 254 N.Y. 620, 173 N.E. 892 affg. 229 App.Div. 227, 241 N.Y.S. 529). Recognizing the harshness of this rule in cases where the harm could not have been discovered before the Statute of Limitations had expired (see, e.g., Schwartz v. Heyden Newport Chem. Corp., 12 N.Y.2d 212, 219, 237 N.Y.S.2d 714, 188 N.E.2d 142 [Desmond, Ch. J., dissenting], cert. denied 374 U.S. 808, 83 S.Ct. 1697, 10 L.Ed.2d 1032), this Court in Flanagan v. Mount Eden Gen. Hosp., 24 N.Y.2d 427, 301 N.Y.S.2d 23, 248 N.E.2d 871, recognized a narrow exception to this rule in cases where a "foreign object," such as surgical clamps, had accidentally been left inside the patient's body. In such cases, the Court held, the Statute of Limitations should begin to run not from the date of the negligent act, but rather from the date on which the malpractice was, or should reasonably have been, discovered.

In support of this holding, the Court noted that the primary purpose of the Statute of Limitations, i.e., to weed out "belated, false or frivolous claims", was not undermined by the recognition of this exception, since suits based solely on the presence of negligently implanted "foreign objects" do not "raise questions as to credibility" and do not "rest on professional diagnostic judgment or discretion." (24 N.Y.2d, at 431, 301 N.Y.S.2d 23, 248 N.E.2d 871, supra). Further, because the unremoved object in Flanagan "retain[ed] its identity" despite the passage of time, the physician's ability to defend, which is often implicated in cases involving "stale" claims, was not "unduly impaired." Finally, the fact that there could be no possible break in the causal chain connecting the alleged negligence to the injury supported the adoption of a "foreign object" exception to the general accrual rule (id., at 430-431, 301 N.Y.S.2d 23, 248 N.E.2d 871).

Following the Court's ground-breaking decision in Flanagan, several lower courts attempted to extend its analysis to cases not involving tangible paraphernalia accidentally left inside the patient's body (see, e.g., Merced v. New York City Health & Hosps. Corp., 56 A.D.2d 553, 391 N.Y.S.2d 863, revd. 44 N.Y.2d 398, 406 N.Y.S.2d 9, 377 N.E.2d 453 [negligently performed tubal ligation discovered following emergency surgery for ectopic pregnancy]; Matter of Smalls v. New York City Health & Hosps. Corp., 55 A.D.2d 537, 389 N.Y.S.2d 372, revd. 44 N.Y.2d 398, 406 N.Y.S.2d 9, 377 N.E.2d 453 [lesion caused by negligently performed cervical myelogram]; Dobbins v. Clifford, 39 A.D.2d 1, 330 N.Y.S.2d 743 [damage to pancreas during course of operation to remove spleen]; Murphy v. St. Charles Hosp., 35 A.D.2d 64, 312 N.Y.S.2d 978 [malfunction in surgically implanted prosthetic device]; but see, Schiffman v. Hospital for Joint Diseases, 36 A.D.2d 31, 319 N.Y.S.2d 674 [declining to apply Flanagan rule to erroneous diagnosis of malignancy]. In several of these decisions, the courts relied on the factors mentioned in the Flanagan opinion, notably the supposed absence of professional judgment or discretion, the lack of a possible break in the causal chain and the small danger of a false claim, and concluded that the use of a discovery accrual date was warranted even though no specific "foreign object" was involved.

Further judicial extension of the doctrine was curtailed, however, when, in 1975, the Legislature enacted CPLR 214-a and incorporated in the new statute a narrow version of the "foreign object" exception to the traditional accrual rule (L.1975, ch. 109, § 6). Under the new statute, an action for medical malpractice "must be commenced within two years and six months of the act, omission or failure complained of * * * provided, however, that where the action is based upon the discovery of a foreign object in the body of the patient, the action may be commenced within one year of the date of such discovery or of the date of discovery of facts which would reasonably lead to such discovery, whichever is earlier " (emphasis supplied). The statute specifically excludes "chemical compound[s], fixation device[s] [and] prosthetic aid[s] or device[s]" from the definition of the term "foreign object." This exclusion was inserted specifically to overcome efforts by the intermediate appellate courts to expand Flanagan by applying it "to instances where fixation devices were inserted in a patient's body for the purpose of treatment" (Bill Jacket, Governor's Program Bill Mem., at 4 [hereinafter Governor's Mem.].

Any remaining uncertainty about the reach of the Flanagan discovery rule was eliminated when this Court stated in Beary v. City of Rye, 44 N.Y.2d 398, 415, 406 N.Y.S.2d 9, 377 N.E.2d 453, that the enactment of CPLR 214-a "left * * * no room but to conclude that [the Legislature] intended that Flanagan not be broadened beyond its existing confines." Our continuing commitment to that premise has been reiterated on many occasions, and in several different contexts (see, e.g., Goldsmith v. Howmedica, Inc., 67 N.Y.2d 120, 500 N.Y.S.2d 640, 491 N.E.2d 1097; Martin v. Edwards Labs., 60 N.Y.2d 417, 469 N.Y.S.2d 923, 457 N.E.2d 1150; Thornton v. Roosevelt Hosp., 47 N.Y.2d 780, 417 N.Y.S.2d 920, 391 N.E.2d 1002; see also, Matter of Steinhardt v. Johns-Manville Corp., 54 N.Y.2d 1008, 446 N.Y.S.2d 244, 430 N.E.2d 1297, appeal dismissed and cert. denied 456 U.S. 967, 102 S.Ct. 2226, 72 L.Ed.2d 840 Reis v. Pfizer, Inc., 48 N.Y.2d 664, 421 N.Y.S.2d 879, 397 N.E.2d 390).

In light of this history, it seems clear that plaintiffs cannot prevail in their present effort to broaden the definitions of the terms used in CPLR 214-a so as to extend the "foreign object" doctrine's applicability. The I.U.D. that prevented plaintiff from conceiving and ultimately became embedded in her uterus was originally placed in her body deliberately as a contraceptive...