Opinion
No. 1-293 / 00-1324.
Filed January 28, 2002.
Appeal from the Iowa District Court for Story County, CARL D. BAKER, Judge.
On appeal from the district court's order granting summary judgment against them on their medial malpractice action, plaintiffs contend the court erred in concluding the action was barred by the statute of limitations. AFFIRMED.
Max E. Kirk and Jen Bries of Ball, Kirk Holm, P.C., Waterloo, for appellants.
Robert C. Rouwenhorst of Rouwenhorst Brown, P.C., West Des Moines, for appellees.
Heard by HUITINK, P.J., and ZIMMER and VAITHESWARAN, JJ.
Laura L. and Douglas J. Clark appeal from the district court's entry of summary judgment dismissing their medical malpractice claim. We affirm.
Laura L. Clark died during the pendency of this appeal. Her interests are represented by her husband, Douglas L. Clark, who is the executor of her estate.
I. Background Facts and Proceedings .
On August 3, 1999, Laura Clark and her husband, Douglas, sued Dr. David C. Larson and his employer, McFarland Clinic, for medical malpractice. The Clarks' petition included the following allegations:
4. On December 12, 1996 Plaintiff Laura L. Clark was evaluated at Defendant McFarland Clinic, P.C. for persistent hoarseness and left vocal chord paralysis. On January 30, 1997 Plaintiff Laura L. Clark was again evaluated at Defendant McFarland Clinic, P.C., for a continuation of symptoms leading to a diagnosis of bilateral vocal chord paralysis.
5. On February 3, 1997 a CT scan was performed on Plaintiff Laura L. Clark, covering the base of the skull, neck and mediastinum. The CT scan was interpreted by Defendant David C. Larson, M.D. as presenting a negative examination.
6. On or about August 6, 1997 Plaintiff Laura L. Clark was diagnosed with a posterior pharyngeal mass. Upon biopsy examination this mass was determined to present an undifferentiated carcinoma.
7. The Defendant David C. Larson, M.D. and Defendant McFarland Clinic, P.C., through its agents or employees were negligent in failing to properly interpret the CT scan of February 3, 1997, in failing to make an appropriate medical diagnosis of the condition of Plaintiff Laura L. Clark and in failing to provide medical evaluation, recommendation, care and treatment to Plaintiff Laura L. Clark.
Larson and McFarland denied liability for any of the damages claimed. In their motion for summary judgment, Larson and McFarland claimed the Clarks' lawsuit was time barred because it was filed more than two years after the Clarks knew or should have known of the injury for which they sought damages. In their resistance the Clarks argued that the statute of limitations was not triggered until at least August 7, 1997, the date on which they were informed that a mass noted on an August 2, 1997 CT scan was malignant. The trial court's ruling on this motion states:
The record supports the contention that the plaintiffs were made aware on approximately February 27 [1997] that the Mayo clinic physicians did not perceive the McFarland Clinic CT scan as normal or negative. This should have alerted the plaintiffs that there was a possibility that Dr. Larson had improperly interpreted the scan. Mrs. Clark testified in her deposition that on approximately February 25 [1997], either Dr. Boeve or Dr. Midthun [Mayo physicians] showed her and Mr. Clark the CT scan and pointed out where the abnormality was. Dr. Boeve's report dated February 25, states that a formal review of the outside CT scan showed "a slight tissue prominence," "some deformity of the right posterolateral wall of the trachea," and "some increased soft tissue." The report refers to "lesions on the CT scan" and "the CT abnormality." (Exhibit 8) Dr. Midthun's report on February 27 likewise stated that a review of the outside CT scan showed asymmetry close to the vocal cords, deformity, and increased soft tissue. (Exhibit 9) When these reports were read during deposition, Mrs. Clark testified that the reports were not different from her recollection of her visits with the doctors. It is sufficient that the plaintiffs became aware that there was a problem with Dr. Larson's care; it was not required that they knew the cause of Mrs. Clark's ailment was cancer. . . .
The defendants additionally contend that on August 2 the plaintiffs knew about the mass in Mrs. Clark's neck, which should have caused them to question whether Dr. Larson's interpretation of the CT scan was correct. The plaintiffs acknowledge that Dr. Bell informed them of the mass on August 2, and that a biopsy should be done. Mrs. Clark indicated in her deposition that on August 2 she thought the mass was related to her vocal cord problems. Even if the plaintiffs' view is used, that the injury was Dr. Larson's failure to detect the early stages of a cancerous mass, rather than failure to detect abnormalities, the plaintiffs would be charged with knowledge of the injury on August 2 when they were informed Mrs. Clark had a mass which needed a biopsy. . . .
The two-year statute of limitations began to run when Mrs. Clark knew, or through the use of reasonable diligence should have known, that she had sustained an injury because of Dr. Larson's alleged negligent interpretation of the CT scan. It is the point in time when she gained knowledge of her injury sufficient to put her on inquiry notice to investigate further. This point occurred on February 27, 1997, which was more than two years before the petition was filed. The action is therefore barred by Iowa Code section 614.1(9). The defendants have shown that there are no genuine issues of material fact and they are entitled to judgment as a matter of law.
(Citations omitted.) The Clarks' lawsuit was accordingly dismissed.
On appeal the Clarks contend the trial court erred in finding the statute of limitations on their claim began to run either on February 27, 1997 or August 2, 1997. They also argue summary judgment was inappropriate because the date on which they knew or had reason to know of Laura's injury presents a genuine issue of material fact for a jury to decide.
II. Scope of Review .
We review a summary judgment ruling for corrections of errors of law. Howell v. Merritt Co., 585 N.W.2d 278, 280 (Iowa 1998). Under Iowa Rule of Civil Procedure 237(c), summary judgment is appropriate when no genuine issue of material fact exists and the moving party is entitled to judgment as a matter of law. Id. The facts are reviewed in the light most favorable to the nonmoving party. Shriver v. City of Okoboji, 567 N.W.2d 397, 400 (Iowa 1997).
III. The Merits .
Iowa Code section 614.1(9) (1999) provides that medical malpractice actions must be brought:
within two years after the date on which the claimant knew, or through the use of reasonable diligence should have known, [of] . . . the injury or death for which damages are sought in the action. . . .
The relevant fact is knowledge of an injury rather than knowledge of physician negligence. Langner v. Simpson, 533 N.W.2d 511, 517 (Iowa 1995). Knowledge of an injury is imputed when there are sufficient facts to alert a reasonable person of the need to investigate. Id. at 518. Resolution of this issue by summary judgment is appropriate if the only controversy concerns the legal consequences flowing from undisputed facts. See McClendon v. Beck, 569 N.W.2d 382, 384 (Iowa 1997).
The Clarks contend the trial court's determination that the statute of limitations began to run on February 27, 1997 is based on an incomplete consideration of the Mayo Clinic reports cited in the court's ruling. They note the following portion of the same reports:
IMPRESSION/REPORT/PLAN:
#1 Soft tissue asymmetry, likely insignificant.
I took the CT scan of the neck and chest as well as the MRI of the neck and reviewed it with Dr. Aughenbaugh. There is some asymmetry of the trachea just below the vocal cords on the MRI. The asymmetry is also present, but there is no clear soft tissue mass in this region to explain the finding. I do not think that endoscopic inspection of this area would be at all informative. He thought the soft tissue lateral to the left carotid artery was insignificant, and the soft tissue in the anterior mediastinum was the innominate vein as well as a normal-appearing thymus. There is no clear cause identified for the vocal cord paralysis on these images, nor is there anything that is suspicious and warrants further imaging at this time . Apparently the plan for her is to simply observe and hope that the idiopathic vocal cord paralysis resolves on its own.
(Emphasis added.) When this report is considered in its entirety, it defeats rather than supports the trial court's conclusion. Even if the report suggests that Dr. Larson misread the CT scan, that fact is not sufficient to trigger the statute because the report clearly indicates Laura sustained no resulting harm. The legal consequence of the undisputed fact emphasized is that the Clarks did not know nor could they have known through the exercise of reasonable diligence that Laura was injured as of February 27, 1997.
The remaining question is whether the summary judgment record supports the trial court's conclusion that the statute of limitations began to run on or before August 2, 1997. Our review of the record indicates Laura's symptoms, including hoarseness and dramatic weight loss, persisted even after receipt of the Mayo reports on February 25 and 27, 1997. When these facts are considered together with the results of the August 2, 1997 CT scan, we conclude they were sufficient to put the Clarks on notice of Laura's February 3, 1997 injury. The legal consequence of these undisputed facts is that the statute of limitations on the Clarks' medical malpractice claim expired before their lawsuit was filed on August 3, 1999. The district court ruling dismissing the Clarks' petition is therefore affirmed.
AFFIRMED.