This is one of two similar cases decided today seeking reconsideration of the holding in
Pasquale
v.
*612
Chandler,
It is the court’s present opinion that Pasquale placed undue emphasis on legislative history in its refusal to examine the injustice of a rule that can deprive an injured plaintiff of any remedy even before he knows he has suffered harm. We now overrule the decisions in Pasquale and Capucci and hold that a cause of action for medical malpractice does not “accrue” under G. L. c. 260, § 4, until a patient learns, or reasonably should have learned, that he has been harmed as a result of a defendant’s conduct.
The plaintiffs Peter Franklin and his wife brought an action against the defendants on July 27, 1978, claiming damages as a result of alleged medical malpractice. The plaintiffs’ complaint and affidavit allege the following facts. Peter Franklin had complained of intermittent chest pain upon his admission to Massachusetts General Hospital in January, 1974, for oral surgery. A chest X-ray was ordered. Two days later, Franklin was discharged from the hospital by an unknown resident doctor, later found to be Dr. Thomas W. Albert. In his discharge summary, Dr. Albert noted that the X-ray taken of Franklin’s chest was normal. In fact, the X-ray was not normal. The report prepared by the hospital’s X-ray department noted “apparent left superior mediastinal widening” and concluded that “[f]ur-ther evaluation of this is recommended.” Nonetheless, Franklin was discharged without any further examination *613 and without any knowledge on his part of the abnormal findings noted in the X-ray report.
In January of 1978, after experiencing flu-like symptoms, Franklin returned to Massachusetts General Hospital for a chest X-ray. That X-ray disclosed a malignancy, which was diagnosed as Hodgkin’s disease. The plaintiffs allege that the “apparent left superior mediastinal widening” noted on the 1974 X-ray was an early manifestation of Hodgkin’s disease and that the defendants’ failure to report correctly and to evaluate further this finding was medical malpractice.
The plaintiffs filed suit approximately six months after their discovery of the findings of the original X-ray and four and half years after the alleged act of malpractice. Both defendants in their answers pleaded the three-year statute of limitations, G. L. c. 260, § 4, 4 as an affirmative defense, and then moved for summary judgment on the same ground. On September 19, 1979, a medical malpractice tribunal, convened in accordance with G. L. c. 231, § 60B, unanimously found that the evidence submitted to it, if properly substantiated, was sufficient to raise a legitimate question of liability appropriate for judicial inquiry. On October 3, 1979, a judge of the Superior Court allowed the defendants’ motions for summary judgment on the basis of the statute of limitations. The plaintiffs appealed, and their application for direct appellate review was allowed by this court.
In its initial interpretation of the statute of limitations for malpractice, in a case involving a gauze sponge left in the plaintiff’s abdomen during an operation, this court held that the cause of action accrued on the date of the operation.
Capucci
v.
Barone,
The
Capucci
doctrine was reaffirmed in 1966 in
Pasquale
v.
Chandler,
The defendants’ principal contention is that Pasquale forecloses further judicial consideration of the proper time of accrual of a medical malpractice claim. We disagree.
It can be argued in support of the result in
Pasquale
that, at the time of the 1965 amendment increasing to three years the limitation period for medical malpractice cases only,
*615
“the Legislature put medical malpractice cases in a distinct category.”
Hendrickson
v.
Sears,
Even if we do not accept this line of reasoning, we would overrule
Pasquale.
The
Pasquale
holding was based primarily on an interpretation of the Legislature’s failure to enact a proposed discovery rule as constituting legislative disapproval of a discovery rule, sufficient to preclude any contrary judicial interpretation of the word “accrues” in G. L. c. 260, § 4. 350 Mass, at 456-458. We decline to place so much significance on this legislative history. In answering a similar contention that the legislative failure to pass a discovery bill showed the Legislature desired no change, the Supreme Court of Oregon remarked: “The fallacy in this argument is that no one knows why the legislature did not pass the proposed measures. . . . Did the legislature fail to pass the measures because it was satisfied with the [former Capucci-type case] interpretations of the statute or because it was not in favor of [the] overall limitation [placed in the proposed discovery rule], or because it disliked the length of the overall limitation? The practicalities of the legislative
*616
process furnish many reasons for the lack of success of a measure other than legislative dislike for the principle involved in the legislation.”
Berry
v.
Branner,
Similarly, we think the consideration and rejection of various proposed measures since
Pasquale
should not control our decision today. We recognize that the Legislature, in 1967,
8
91975,
9
and 1979
10
has rejected bills that would have amended G. L. c. 260, § 4, to include some form of
*617
discovery rule for medical malpractice cases.
11
The defendants urge us to construe these rejected bills as constituting such definite proof of legislative disapproval of a discovery rule as to be binding in this court. However, we do not read the failure to enact these bills as necessarily disapproving, in principle, a discovery rule. Further, we reject the suggestion that defeated legislative proposals have the power to disable us, in a proper case, from considering the questions presented by such proposals and from abandoning prior conclusions that now seem inappropriate. See e.g.,
Girouard
v.
United States,
The
Pasquale
and
Capucci
opinions nowhere elucidated or sought to balance the harm of being deprived of a remedy versus the harm of being sued. Both decisions implicitly placed the policy of promoting repose above all other considerations, without, however, analyzing the purposes of statutes of limitations. Historically, common law tort actions could be brought as long as either party lived. See
*618
Developments in the Law — Statutes of Limitations, 63 Harv. L. Rev. 1177, 1177-1178 (1950). The primary purpose of the first statute of limitations, 21 Jac. 1, c. 16 (1623) (the 1623 Limitation Act), was to keep out inconsequential claims.
Id.
at 1178. The United States Supreme Court has long recognized the broader social importance of statutes of limitations, deeming them “vital to the welfare of society. . . . They promote repose by giving security and stability to human affairs.”
Wood
v.
Carpenter,
The manifest injustice of the
Capucci
doctrine is that, rather than punishing negligent delay by the plaintiff, it punishes “blameless ignorance” by holding a medical malpractice action time-barred before the plaintiff reasonably could know of the harm he has suffered. Cf.
Urie v. Thompson,
The defendants contend that sound policy dictates rejection of a discovery rule. A discovery rule, they claim, will fan the medical malpractice crisis by resulting in more claims that will in turn contribute to higher insurance premiums and, finally, to curtailment of health care services. Although these are relevant considerations, they are better addressed to the Legislature, which is, of course, free to make a contrary reconciliation of the conflicting policies involved or to place an outside limit on the time for bringing a malpractice action.
12
As far as increased claims are concerned, however, we note that the Legislature has provided a rational means of weeding out frivolous claims through the medical malpractice screening procedure established by St. 1975, c. 362. Moreover, even with the adoption of a discovery rule, the plaintiff bears the burden of proving facts taking his case outside the impact of the three-year statute of limitations.
Friedman
v.
Jablonski,
*620
The defendants argue further that a discovery rule should be limited to malpractice claims based on the presence of a foreign object in the patient’s body, such as the clamp in
Pasquale
and the sponge in
Capucci.
As no foreign object is involved here, this case is inappropriate for constructing such a rule. We observe, however, the theoretical difficulty of justifying the applicability of the discovery rule to one kind of malpractice and not to another, as the principle underlying the discovery rule applies whether the malpractice consists of leaving a foreign object in the patient’s body or of other negligence in diagnosis or treatment of the patient. See
Lipsky
v.
Michael Reese Hosp.,
In the case before us, the plaintiff Peter Franklin’s allegations that when he left the hospital he was unaware of the X-ray findings indicating his potentially serious condition, and that he remained unaware of those findings until four arid one-half years later, are sufficient to withstand summary judgment on the question of the statute of limitations. The plaintiff filed his complaint approximately six months after his discovery of the X-ray findings. We cannot say, as a matter of law, that the plaintiff reasonably should have learned any earlier of the harm to him which presumably occurred as soon as he was left unnecessarily in ignorance as a result of the defendants’ conduct. Cf. Friedman v. Jablonski, supra at 487 (reversing allowance of defendants ’ motion to dismiss action for deceit in sale of real estate, because complaint did not show, as a matter of law, that plaintiffs reasonably could have known of misrepresentation at time of sale). Although the trial judge here correctly granted summary judgment, confronted as he was by our rigid application of the statute of limitations in Pasquale, we reverse and remand the case for further proceedings consistent with this opinion. Our rulings here do not, of course, preclude reliance by the defendants upon the statute of limitations as appropriate in further proceedings, including presentation of evidence as to the facts relevant to that defense.
So ordered.
Notes
General Laws c. 260, § 4, as amended through St. 1973, c. 777, § 3, reads in relevant part: “Actions of contract or tort for malpractice, error or mistake against physicians, surgeons, . . . hospitals . . . shall be commenced only within three years next after the cause of action accrues.” A related statute of limitations, G. L. c. 231, § 60D, applying exclusively to claims of minors, similarly uses the word “accrues.” A constitutional challenge to the latter statute was rejected in
Cioffi
v.
Guenther,
See note 3, supra.
General Laws c. 260, § 4, then provided that actions of medical malpractice must be “commenced only within two years next after the cause of action accrues.”
In Pasquale, a Kelly clamp, a scissors-like instrument about eight inches long, had been left in the plaintiff’s abdomen during an operation and was not discovered until almost six years later. 350 Mass, at 452-454.
House Doc. No. 530 (1965) would have provided that malpractice actions “be commenced only within two years next after the injured party has knowledge of the facts which give rise to a cause of action but only within five years after the cause of action accrues.” See Pasquale v. Chandler, 350 Mass, at 456-457.
On May 3, 1967, the Senate refused to advance House Doc. No. 952, providing for an open-ended discovery rule, to a third reading, which action is equivalent to a rejection of the bill. 1967 Senate Journal 1049.
On April 14, 1975, House Doc. No. 2120 was introduced, providing that an action for medical malpractice “must be brought within two years from the date of the incident giving rise to the action or within one year of the date of discovery, whichever occurs last, but in no event later than four years from the date of the incident.” The House accepted a report by the Judiciary Committee that this bill ought not to pass. 1975 House Journal 1419-1420.
1979 Senate Doc. No. 1832 would have provided for an open-ended three-year period within which an action for medical malpractice could be commenced “after the malpractice, error or mistake has been discovered or reasonably should have been discovered.” The Committee on the Judiciary reported to the Senate that this bill ought not to pass. 1979 Senate Journal 714. The Senate accepted the report. Id. at 733. A second 1979 bill, House Doc. No. 5134, was reported favorably to the Senate by the Committee on the Judiciary together with Senate Doc. No. 894, and the combined bill was designated Senate Doc. No. 894. 1979 Senate Journal 674. House Doc. No. 5134 would have amended G. L. c. 260, § 4, to permit medical malpractice actions to be commenced “within three years next after the cause of action accrues, or within three years next after the cause of action reasonably should have been discovered, whichever is later.”
Additional similar bills introduced in 1968 and 1980 failed to receive more than preliminary attention. See House Doc. Nos. 2366 and 2008; 1968 House Journal 1160; House Doc. No. 2455; 1980 House Journal 328.
For example, in some States whose Supreme Courts have overruled their prior cases and favored a discovery rule, the Legislatures have recognized the justice of such a rule and have incorporated it into their statutes of limitation, but with the addition of an outer limit in which the action must be brought. See, e.g., Tenn. Code. Ann. §§ 28-304, 23-3415, as amended by 1975 Tenn. Pub. Acts, c. 299, § 15; Wash. Rev. Code Ann. § 4.16.350; amended by 1975-1976 Wash. Laws. 2d Exec. Session, c. 56, § 1.