Opinion
2950470.
November 22, 1996. Rehearing Denied January 10, 1997.
Appeal from the Houston Circuit Court, No. CV-95-354, Charles L. Little, J.
Lister H. Proctor and Wanda J. Batson of Proctor Vaughn, Sylacauga; and Sybil Shainwald, New York City, for appellants.
Fred W. Tyson and Patrick M. Shegon of Rushton, Stakely, Johnston Garrett, P.A., Montgomery, for appellees.
This is a medical malpractice case. Tammy Talley and her husband, Lawrence Talley, appeal from a summary judgment in favor of Dr. Marc Q. Sonnier, Dr. Robert van der Meer, and Flowers Hospital, Inc. (hereinafter "the defendants"). This case was transferred to this court by the supreme court, pursuant to § 12-2-7(6), Ala. Code 1975.
On April 5, 1995, the Talleys sued the defendants, alleging that the defendants had been negligent in rendering medical care and treatment to Mrs. Talley and that, as a proximate result, she had suffered pain, mental anguish, and permanent injury and that Mr. Talley had suffered a loss of consortium. The Talleys amended their complaint in September 1995, specifically alleging that on April 1, 1991, an unnecessary hysterectomy had been performed on Mrs. Talley and that false representations that she had cancer had been made to her both before and after the surgery. The defendants moved to dismiss, or, alternatively, for a summary judgment. The court, on November 2, 1995, entered a judgment in favor of the defendants; the Talleys appeal.
The Talleys contend that there was a material question of fact as to the date that their cause of action accrued. Mrs. Talley testified in her deposition that she had received care and treatment from June 1990 to October 1991. She stated that she was informed by Dr. Sonnier in March 1991 that she had cancer of the cervix, that it had spread to the lining of her uterus, and that a hysterectomy was the appropriate treatment. On April 1, 1991, Dr. Sonnier and Dr. van der Meer performed a hysterectomy. Mrs. Talley alleges that, post-operatively, she was informed that the original diagnosis was correct; that she was informed the cancer had been removed; and that in October 1991 when she was reexamined to see if the cancer had returned, she was told by Dr. Sonnier that she would need frequent check-ups because "someone who had cancer once was more likely to get it again." The Talleys argue that the court should have applied the "continuing treatment rule," which would have extended the limitations period until October 1995, or, in the alternative, that the court should have determined the limitations period to be six months from December 1994, when the Talleys discovered that the operation may have been unnecessary. The Talleys sued on April 5, 1995.
The defendants argue that the judgment was proper, citing Jones v. McDonald, 631 So.2d 869 (Ala. 1993). In Jones, a physician was sued for medical malpractice after he left a gauze in the patient's eye area following surgery and failed to discover the gauze during follow-up treatment. Our supreme court rejected the "continuing treatment rule" as inapplicable to medical malpractice actions brought pursuant to the Alabama Medical Liability Act of 1987 ("AMLA") and held that the patient's action was barred by the statute of limitations provided in the AMLA. Id., at 873.
The Talleys' claim is governed by the AMLA, because the alleged malpractice occurred in 1991. See §§ 6-5-480 and 6-5-540, Ala. Code 1975. Section 6-5-482(a) establishes the limitations period for the commencement of an action against a health care provider, as follows:
"All actions against physicians, surgeons, dentists, medical institutions, or other health care providers for liability, error, mistake, or failure to cure, whether based on contract or tort, must be commenced within two years next after the act, or omission, or failure giving rise to the claim, and not afterwards; provided, that if the cause of action is not discovered and could not reasonably have been discovered within such period, then the action may be commenced within six months from the date of such discovery or the date of discovery of facts which would reasonably lead to such discovery, whichever is earlier; provided further, that in no event may the action be commenced more than four years after such act. . . ."
We, therefore, apply both the AMLA statute and our usual standard for review of a summary judgment.
Alabama law regarding summary judgments is well settled. Rule 56, Ala. R. Civ. P., establishes a two-tiered standard for entering a summary judgment. Once the movant has made a prima facie showing that there is no genuine issue of material fact, and that the moving party is entitled to a judgment as a matter of law, the nonmovant must rebut this showing by presenting "substantial evidence." "Substantial evidence" has been defined as "evidence of such weight and quality that fair-minded persons in the exercise of impartial judgment can reasonably infer the existence of the fact sought to be proved." West v. Founders Life Assurance Co. of Florida, 547 So.2d 870, 871 (Ala. 1989); see Willard v. Perry, 611 So.2d 358 (Ala. 1992), Lacey v. American Shell Co., 628 So.2d 684 (Ala.Civ.App. 1993).
In reviewing the statute and case law, we find support for the Talleys' argument that they produced substantial evidence to create a material issue of fact regarding the dates for their cause of action. Therefore, the summary judgment could not be based on the statute of limitations. While we agree that the hysterectomy and the initial diagnosis of cancer occurred more than four years before the Talleys sued, Mrs. Talley made follow-up visits, in which she says she was told that she had had cancer, that the cancer had been removed, and that she needed regular check-ups to guard against recurrence. We conclude that the evidence of these misrepresentations created a genuine issue of fact as to the date on which the claims would have been barred and that a jury could determine that on each visit a separate act of malpractice occurred.
We reject the application of the continuing treatment rule and find that Jones is distinguishable from this case. There was no evidence in Jones that the physician had made subsequent false representations. See Hood v. Slappey, 601 So.2d 981 (Ala. 1992) (supreme court considered cause of action for medical malpractice and fraud to accrue in 1989, although initial surgery was performed in 1985, based on physician's false statements and breach of the standard of care).
We further determine that there was no need for the Talleys to present additional expert testimony regarding the appropriate standard of care. Although the general rule requires expert testimony to support a medical malpractice claim, our law allows an exception when the breach of the standard of care is obvious to the average layperson. See Ellingwood v. Stevens, 564 So.2d 932 (Ala. 1990); see also Rudolph v. Lindsay, 626 So.2d 1278 (Ala. 1993). Viewing the record in the light most favorable to the Talleys, we conclude that this case falls within that exception. Therefore, based on the foregoing, we reverse the judgment and remand the case for further proceedings.
REVERSED AND REMANDED FOR FURTHER PROCEEDINGS.
ROBERTSON, P.J., and MONROE, J., concur.
THIGPEN and CRAWLEY, JJ., dissent.
I conclude that the Talleys did not file their lawsuit, alleging medical malpractice, within the statute of limitations provided by the AMLA, Ala. Code 1975, § 6-5-482(a). Therefore, I would affirm the trial court's entry of summary judgment for the defendants, and I must respectfully dissent.
Mrs. Talley's alleged unnecessary hysterectomy occurred on April 1, 1991. The Talleys filed their lawsuit on April 5, 1995. Section 6-5-482(a) clearly provides "that in no event may the action be commenced more than four years after [the occurrence of the alleged malpractice]." The Talleys filed their action more than four years after the date of the alleged malpractice.
In their brief, the Talleys argue that the "continuing treatment rule" should be applied to this case, which would extend the date of the alleged malpractice to October 1991, the date of Mrs. Talley's last doctor's visit. The majority correctly states that our supreme court has held that the "continuing treatment rule" is not applied to actions brought pursuant to the AMLA. Jones, supra. This court is bound by the precedents of our supreme court. Ala. Code 1975, § 12-3-16.
The majority nevertheless reverses the trial court's entry of summary judgment for the defendants and holds that the alleged misrepresentations during each follow-up doctor's visit constitutes a separate AMLA cause of action, which accrues at the date of the respective doctor's visit. Although the majority states that it is not applying the "continuing treatment rule" and states that it is merely distinguishing Jones, I cannot distinguish Jones from this case. Our supreme court has held:
"The limitations period of § 6-5-482 commences with the accrual of a cause of action. Street v. City of Anniston, 381 So.2d 26 (Ala. 1980); Bowlin Horn v. Citizens Hosp., 425 So.2d 1065 (Ala. 1983); Ramey v. Guyton, 394 So.2d 2 (Ala. 1981). A cause of action 'accrues' under § 6-5-482 when the action complained of results in legal injury to the plaintiff. Grabert v. Lightfoot, 571 So.2d 293, 294 (Ala. 1990); Colburn v. Wilson, 570 So.2d 652, 654 (Ala. 1990). The statutory limitations period begins to run whether or not the full amount of damages is apparent at the time of the first legal injury. Garrett v. Raytheon Co., 368 So.2d 516, 518 (Ala. 1979). When the wrongful act or omission and the resulting legal injury do not occur simultaneously, the cause of action accrues and the limitations period of § 6-5-482 commences when the legal injury occurs. Moon v. Harco Drugs, Inc., 435 So.2d 218, 219 (Ala. 1983); Ramey v. Guyton, 394 So.2d 2, 4-5 (Ala. 1981)."
The Talleys' legal injury occurred on April 1, 1991, and the statutory period of limitations began to run from that date, and no cause of action would accrue on a later date just because of later doctor's visits.
As I find the dispositive issue to be the statute of limitations in § 6-5-482(a), I do not address the issue of the sufficiency of the affidavits the Talleys presented in opposition to the summary judgment motion.
THIGPEN, J., concurs.