District of Columbia v. DunmoreDistrict of Columbia v. Dunmore
We are called upon in this case to decide whether the discovery rule adopted in
Burns v. Bell,
I
On June 6, 1987, appellee Reginald Dun-more, a diabetic, went to the Howard University Hospital emergency room complaining of pain in his left groin. Upon examining Mr. Dunmore, a doctor prescribed some pain pills and insulin and released him.
Mr. Dunmore’s discomfort worsened over the next two weeks, and on June 22 he was admitted to District of Columbia General Hospital (“D.C. General”) through its emergency room. A physician at D.C. General examined Mr. Dunmore and discovered that
The next day, Dr. Cuthbert Simpkins, the supervising physician in charge of Mr. Dun-more’s treatment, ordered various tests, including an arteriogram and a sonogram. The sonogram was inconclusive, but the ar-teriogram revealed a blockage in Mr. Dun-more’s left femoral artery, a major supplier of blood to the leg. The blockage was not complete, however; some blood was still flowing to Mr. Dunmore’s left leg and foot. In light of these tests and examinations, Dr. Simpkins concluded that Mr. Dunmore had a mycotic aneurysm in his left femoral artery, 3 and that as a result his artery had become weakened, infected, and enlarged. Dr. Simp-kins prescribed intravenous treatment with a series of more potent antibiotics, Vancomy-cin, Gentamyein, and Flagyl. 4 The first antibiotic treatment was given at approximately 9:00 p.m. on June 23, roughly thirty hours after Mr. Dunmore first came to the D.C. General emergency room. 5
At approximately 1:00 a.m. on June 24, Dr. Simpkins and another surgeon operated on Mr. Dunmore to remove the infected portion of his femoral artery and the surrounding tissue. Dr. Simpkins testified that he had intended to perform a bypass procedure that would re-establish the circulation of blood to the leg. However, he did not attempt this procedure because the infection had not abated, and because the region of the artery where the bypass was to be performed was covered with pus. According to Dr. Simp-kins’ testimony, at this stage “[t]he leg was doomed.”
Dr. Luis Queral, a vascular surgeon and one of Mr. Dunmore’s expert witnesses, testified that the bypass procedure could have been performed by removing a saphenous vein from Mr. Dunmore’s other leg and then grafting it in such a manner as to avoid the infected region altogether, thereby restoring the flow of blood to the infected leg. According to Dr. Queral, the failure of Mr. Dun-more’s physicians to perform this procedure at some point, either before or soon after the resection of the aneurysm, was a breach of the applicable standard of care. 6
After the operation, Mr. Dunmore began to have serious circulatory difficulties in his left leg. The pulse in the leg was greatly diminished. The leg itself became pale and caused him serious pain, and eventually he developed paralysis of the foot. After some time he noticed large black marks on his shin, and later on his toes and heel, which were not present before the surgery. His leg then began to turn purple and was cool to the touch, symptoms indicating a severe lack of oxygen to the leg. His groin infection also persisted. Finally, as a result of the circulatory failure, some of the tissues in Mr. Dun-more’s left leg died and became gangrenous. As a consequence of the gangrene, a separate infection developed in his lower leg.
Through his sister, Mildred Dunmore, Mr. Dunmore first sought legal representation on November 19, 1987, in contemplation of bringing a lawsuit. On that day Mildred Dunmore met with an attorney, Charles Smith, and asked him to “investigate the possibility of legal action against Howard University Hospital.” Ms. Dunmore made no suggestion during this meeting that D.C. General had improperly treated her brother. 7 On January 12, 1988, Mr. Smith requested Mr. Dunmore’s medical records from Howard University Hospital, which he received on March 15. These records shed little light on the case, however, prompting Mr. Smith to request Mr. Dunmore’s medical records from D.C. General on March 22. 8
D.C. General mailed the records to Mr. Smith on or about April 8. After receiving the records on April 14, Mr. Smith reviewed them and “saw some things that indicated that [Mr. Dunmore] had not received the propez- attention that he should have.” The vei’y next day, Api'il 15, 1988, pursuant to
Before the first of two jury trials, the District filed a motion for summaiy judgment, arguing that Mr. Dunmore’s case was time-barred under
After the second trial,
10
the jury found the District liable for medical malpractice because of the doctors’ failure to administer the antibiotics in a timely fashion and their failure to perform the bypass operation. The jury awarded Mr. Dunmore $850,000 in damages. The District filed a motion for judgment n.o.v. or a new trial in which it reasserted,
inter alia,
its contention that Dun-more’s action was time-barred under
In
Burns v. Bell, supra,
this court held that in medical malpractice cases, a cause of action “accrues” for purposes of compliance with the statute of limitations “when the plaintiff knows or through the exercise of due diligence should have known of the injury.”
Our case law has firmly established that, because it is in derogation of the common law principle of sovereign immunity,
The rationale underlying the Section 309 notice requirement is (1) to protect the District of Columbia against unreasonable claims and (2) to give reasonable notice to the District of Columbia so that the facts may be ascertained and, if possible, deserving claims adjusted and meritless claims resisted.
The statutory predecessor of
It is therefore not surprising that the language Congress chose to remedy this problem is clear and unequivocal.
11
The same analysis simply does not apply to
Moreover, as we made clear long ago in
Givinn,
To permit the notice period to be tolled, as appellant advocates, would create a situation where prospective litigants could delay in excess of seventeen years before notifying the District of their claim. Such an interpretation would totally frustrate the legislative intent.
Id.
at 1378. Likewise, application of the discovery rule to
We note, moreover, that in the great majority of cases, including the case at bar, compliance with
In light of the relative ease with which potential plaintiffs can preserve their claims against the District, there is nothing unreasonable in requiring an individual like Mr. Dunmore, who has incurred a very serious and obvious injury while under the care of a District employee in a medical facility owned and operated by the District, to file a
Finally, we reject Mr. Dunmore’s assertion that
Kelton v. District of Columbia,
413 A.2d
The Keltons then filed suit against the District and the doctor who had performed the tubal ligation, but the trial court granted summary judgment for the District based on Mrs. Kelton’s failure to give timely notice under
Mrs. Kelton argues that her action against the District of Columbia is not barred by the six-month notice requirement ofD.C.Code § 12-309 , contending that the period does not begin to run until “the complainant’s cause of action has accrued.” The language of the statute, however, starts the clock at the moment “the injury or damage ivas sustained.”
Id.
at 921 (emphasis added). We went on to say that, even if the discovery rule did apply to
Basing his argument on
Kelton
and on the court’s subsequent discussion of that decision in
Bussineau v. President & Directors of Georgetown College,
Second, although
Bussineau
discusses
Kelton
in a manner consistent with Mr. Dun-more’s interpretation, we emphasize that
Bussineau
was a case involving the statute of limitations and not
It is undisputed that Mr. Dunmore, through counsel, sent his
Reversed and remanded.
Notes
.
An action may not be maintained against the District of Columbia for unliquidated damages to person or property unless, within six months after the injury or damage was sustained, the claimant, his agent, or attorney has given notice in writing to the Mayor of the District of Columbia of the approximate time, place, cause, and circumstances of the injury or damage. A report in writing by the Metropolitan Police Department, in regular course of duty, is a sufficient notice under this section.
. The District raises three additional issues on appeal, all of which relate to various trial court rulings during the second of the two trials in this case. In light of our holding that the complaint should have been dismissed even before the first trial because of appellee's failure to give timely notice under
. The doctor defined a mycotic aneurysm in this instance as “an area of infection around a blood vessel caused from injury due to [a] needle.” The record indicates that Mr. Dunmore was a user of illegal drugs as well as an insulin-dependent diabetic.
. Dr. Simpkins testified that because Dunmore was allergic to penicillin, the treatment of his infection was more complicated and risky than normal, in that the three antibiotics prescribed had serious potential side effects. He also said that the Erythromycin which had been prescribed the previous day, but never administered, would have been too weak to treat the infection.
. Dr. Neal Crane, one of Mr. Dunmore's expert witnesses, testified that, by 8:00 p.m. on June 22, Dr. Simpkins and his subordinates had sufficient information available to them from hospital records to prescribe the antibiotics which were ultimately administered twenty-five hours later. Dr. Crane also stated that infections as severe as the one discovered in Mr. Dunmore often double in size every twenty-four hours.
.Dr. Simpkins testified that he had considered performing the graft procedure but found Mr. Dunmore's saphenous vein to be unsuitable for that purpose. Moreover, Dr. Simpkins was reluctant to attempt such a graft because of Dun-more's high temperature and malnourished condition. He said that a rupture of the bypass vessel would very likely have resulted in Mr. Dunmore's death.
. Ms. Dunmore testified that neither she nor her brother had any reason to believe that he had received negligent treatment at D.C. General until Mr. Smith reviewed the medical records from D.C. General in April 1988.
. Mr. Smith testified that he sought the records from D.C. General "in order to have a complete medical picture of Mr. Dunmore’s case.”
. On motion by the District, the trial court dismissed the claim against D.C. General because it is not sui juris and cannot be sued in its own name.
. The first trial ended with a jury verdict in the District's favor. The jury' found that Mr. Dun-more had not demonstrated that the doctors were negligent either in failing to administer the stronger antibiotics sooner or in electing not to perform the bypass operation. Mr. Dunmore then moved for a judgment n.o.v., or in the alternative a new trial, asserting that the District had violated an in limine order concerning the exclusion of evidence of his drug use. The court granted the motion for a new trial, ordering that ”[a]t the new trial, absolutely no mention of needle or puncture marks or drug use will be made either directly or indirectly." In addition, the District was ordered to pay all of Mr. Dun-more's attorney's fees and costs from the first trial.
. The 1933 statute is "nearly identical” to the present
. Under the discovery rule, a cause of action accrues when the plaintiff knows, or through the exercise of reasonable diligence should know, of "(1) the existence of the injury, (2) its cause in fact, and (3) some evidence of wrongdoing.”
Knight v. Furlow,
. We leave for another day the more difficult issue of whether
. The claim against the doctor was dismissed as barred by the statute of limitations.
.
Bussineau
involved only the statute of limitations,
Since Burns [v. Bell], this court has acknowledged that the discovery rule requires knowledge of some wrongdoing in several cases. In Kelton v. District of Columbia, supra, we interpreted a notice statute which required parties intending to sue the District of Columbia for negligence to notify the District of such intent within six months after the injury was sustained.... We applied the discovery rule of Burns v. Bell ... to determine when the cause of action accrued; we concluded that the suit was barred because, for a time longer than the statutory period, she was on "inquiry notice that she might have suffered an actionable injury.” ... Thus, in Kelton, we reiterated our interpretation of the discovery rule, noting that the statute of limitation for negligence begins to run at such time a prospective plaintiff gains inquiry notice that wrongdoing may be involved.