This appeal concerns the application of the statute of limitations to a complaint for medical malpractice involving newly added defendants. Plaintiff alleged that negligent treatment of low sodium levels in his blood serum caused him to develop a neurological disorder, central pontine myelinolysis (CPM). Invoking ORCP 21 A(9),
On appeal, the parties primarily dispute whether the operative complaint shows that plaintiff failed to commence the action within the time limited by statute after he discovered or reasonably should have discovered his claim. Plaintiff makes other assignments of error, but we do not reach them because they become moot or unnecessary after determination of the primary issue. On the primary issue, we conclude that the complaint does not show on its face that plaintiff commenced this action outside the limitations period. Because the trial court erred, we reverse and remand for further proceedings.
In reviewing an order granting dismissal under ORCP 21 A(9), our review is limited to the face of the operative complaint. Kelly v. Lessner,
The facts, as alleged, are as follows. Plaintiff experienced hyponatremia, a medical condition involving a low sodium level in his blood serum. On or about August 17, 2011, plaintiff sought diagnosis and treatment at the Salem Hospital’s urgent care clinic. That care included testing his serum sodium and potassium levels. On or about August 19, 2011, plaintiff returned to the hospital’s emergency room, reporting seizures and fainting episodes. The hospital tested plaintiffs blood again and found that his sodium and potassium measures had declined to life-threatening levels. An emergency room physician ordered intravenous sodium replacement therapy at a level below 10 millimoles per liter (mmol/L) in a twenty-four hour period. Serum sodium therapy should be kept below that amount in order to prevent the development of CPM. On the afternoon of August 19, plaintiff was transferred to the hospital’s intensive care unit, where Dr. Johnson ordered sodium replacement therapy that allegedly resulted in plaintiffs serum sodium level increasing more than 10 mmol/L in a twenty-four hour period.
On August 19 and 20, 2011, Dr. Ismail became responsible for plaintiffs care. Ismail allegedly failed to monitor so as to ensure that nurses did not administer too much intravenous saline to plaintiff. Although saline had been discontinued due to previously improper sodium replacement, Ismail allegedly was responsible for resumption of intravenous saline.
On November 19, 2012, plaintiff filed this action for medical malpractice against Salem Hospital and several individuals, who are now no longer material to the case. On October 30, 2014, plaintiff filed a third amended complaint so as to include as new defendants, Ismail and Salem Pulmonary Associates (SPA), alleging that Ismail was negligent in treating plaintiff and that SPA should be vicariously liable for that treatment.
“I do find that in the third amended complaint, that on its face it is time-barred, and that there was nothing alleged in the third amended complaint that would have tolled the time frame. There was nothing that would have indicated that there was something that did not or could not have been discovered or any mention of the insanity. Based on that, I am persuaded by counsel’s argument that it is outside the time frame and so dismissal is appropriate as to those defendants and that claim.”
The court dismissed the complaint with prejudice.
On appeal, plaintiff argues, in part, that the court erred because the complaint does not show on its face that plaintiff discovered Ismail and SPA’s role in his injury more than two years before he filed claims against them. He argues that, at the pleading stage in a complex claim like medical malpractice, a plaintiff cannot be assumed to have discovered his claim or the responsible defendants at a time outside the statute of limitations. Moreover, he argues, he should not be required in his complaint to plead delayed discovery because his task is only to state a claim, not to anticipate a motion to dismiss or an affirmative defense of limitations.
Taking just the reverse view, defendants argue that the complaint is “patently time-barred” because the complaint fails to allege facts from which it could be inferred that plaintiff discovered his claim against defendants less than two years before filing the amended complaint against them. In effect, defendants contend that plaintiff should have pleaded that he could not have reasonably discovered the claim until a date within the statute of limitations in order to avoid an implicit assumption that he should have discovered the claim much sooner. In other words, defendants contend that plaintiff should plead in anticipation of a limitations defense in order to avoid dismissal.
Further, defendants argue that a statement plaintiffs counsel made in opposition to dismissal permits an inference favoring defendants that, more than two years before the operative complaint, plaintiff should have discovered his injury, its cause, and the role of Ismail and SPA.
Finally, defendants have particular criticism for the amendment that made SPA a new defendant, alleged to be vicariously liable for Johnson and Ismail. Defendants argue that the amendment was untimely because Johnson was already named a defendant in the original complaint and the employee relationship between SPA and Johnson was “inherently discoverable.” Defendants contend that SPA should have been discovered as related and liable for Johnson earlier.
We start where everyone agrees. A medical malpractice action must be filed within two years of the date on which the claim accrues. ORS 12.010; ORS 12.110(4). By statute, a medical malpractice action accrues “when the injury is first discovered or in the exercise of reasonable care should have been discovered.” ORS 12.110(4); Gaston v. Parsons,
To defeat a motion to dismiss under ORCP 21 A(9), “a complaint does not have to show that the action is timely; it suffices if the complaint does not reveal on its face that the action is not timely.” Munsey v. Plumbers’ Local No. 51,
“Every defense, in law or fact, to a claim for relief in any pleading, whether a complaint, counterclaim, cross-claim or third party claim, shall be asserted in the responsive pleading thereto, except that the following defenses may at the option of the pleader be made by motion to dismiss: * * * (9) that the pleading shows that the action has not been commenced within the time limited by statute.”
The rule permits a defendant to file a motion raising a limitations defense only when a plaintiff’s “pleading shows” that the action is untimely. At this early stage in a case, the sole reference by which a limitations defense is evaluated is the plaintiffs complaint. In that way, the limitations defense in ORCP 21 A(9) differs from other defenses listed in ORCP 21 A(l) through (7), because, as to those defenses, the court may entertain “affidavits, declarations and other evidence” when “the facts constituting such defenses do not appear on the face of’ the plaintiffs complaint. ORCP 21 A. In that way, a motion to dismiss also differs from a motion for summary judgment, because, on summary judgment, a defendant may offer evidence outside the complaint to show that there is no genuine dispute of material fact about when the plaintiff reasonably should have discovered a claim and when the limitations period lapsed. ORCP 47 C.
This understanding of ORCP 21 A(9) is illustrated by a case decided under the rule’s precursor, ORS 16.260(7), which likewise made the complaint the sole frame of reference. In Hewitt v. Thomas,
We have followed the same principle in applying ORCP 21 A(9). In Munsey, plaintiff filed an action in 1985 alleging, among other
We followed the same principle once again in Bodunov v. Kutsev,
We adhere to the
“At the outset, we note that, under [the] standard of review, the question is not whether the facts alleged in [the] plaintiff’s complaint established, as a matter of law, that the complaint was timely filed. Rather, it is whether those facts established, as a matter of law, that it was not timely filed.
Id. at 785 (emphasis in original). We determined that nothing in the complaint compelled the conclusion that the grandmother immediately knew or should have known that her lawyer’s advice or steps undertaken were faulty even when challenged. Id. at 786-87. The debate about when the grandmother should reasonably have discovered the claim represented a fact question that could not be resolved as a matter of law on a motion to dismiss under ORCP 21 A(9). Id. at 787-88.
More commonly, disputes about time limitations under ORCP 21 A(9) are arguments about whether the complaint shows that a plaintiff should have reasonably discovered the claim at an earlier date, given the allegations of wrongdoing and allegations of delayed discovery. In Doe v. Lake Oswego School District,
In light of these cases, plaintiff is correct that it is his responsibility to state facts sufficient to constitute a claim, ORCP 18 A, that it is defendants’ responsibility to plead or assert an affirmative defense of limitations, ORCP 19 B or ORCP 21 A(9), and that, ordinarily when stating a claim, his “complaint does not have to show that the action is timely.” Munsey,
First, the allegations do not establish when plaintiff discovered, or should have discovered, that he suffered CPM, the cause of that harm, or that negligence was involved. Although the complaint provides the dates when plaintiffs blood was tested and when he received serum sodium infusions, the complaint does not indicate that the harm necessarily occurred or its cause was reasonably known, immediately on the dates of treatment. As the Supreme Court has observed, “A reasonable person that experiences symptoms that are incidental to a particular medical procedure may not be aware that he or she has been a victim of tortious conduct.” Gaston,
“We do not believe the legislature intended to limit patients asserting malpractice claims, who by the very nature of the treatment had no way of immediately ascertaining their injury, to the same overall period of time that is allowed for bringing other tort claims that are normally immediately ascertainable upon commission of the wrong. The protection of the medical profession from stale claims does not require such a harsh rule.”
Berry v. Branner,
Second, the complaint does not allege facts regarding when plaintiff discovered, or should have discovered, Ismail’s and SPA’s role in causing his harm. The complaint only alleges that Dr. Ismail’s negligent actions occurred on August 19 and 20, 2011. The complaint does not allege that plaintiff discovered defendants’ causal role at that time or at any other time more than two years before filing the third amended complaint. See T. R. v. Boy Scouts of America,
Third, the complaint does not show, as defendants argue, that SPA should sooner have been discovered as a defendant, inasmuch as Johnson was a defendant in the original complaint. We cannot accept defendants’ argument that the relationship between SPA and Johnson was “inherently discoverable”
This case is distinguishable from Gehrke v. CrafCo, Inc.,
In sum, the complaint does not establish, on its face, that plaintiff discovered or reasonably should have discovered his injury, its tortious cause, and those persons who may be responsible, more than two years before commencing this action. Because the complaint does not show that the statute of limitations had run, plaintiff was not required to have pleaded delayed discovery to avoid an assumption that it had run. We conclude that the trial court erred in granting defendants’ motion to dismiss. Accordingly, we reverse and remand for further proceedings.
Reversed and remanded.
Notes
In relevant part, ORCP 21 A(9) provides that a defendant may move to dismiss on the ground “that the pleading shows that the action has not been commenced within the time limited by statute.”
In relevant part, ORS 12.110(4) provides:
“An action to recover damages for injuries to the person arising from any medical, surgical or dental treatment, omission or operation shall be commenced within two years from the date when the injury is first discovered or in the exercise of reasonable care should have been discovered.”
See ORS 12.160(3) (tolling the commencement of time limitations for a disabling mental condition that prevents a person from comprehending rights); see also ORS 12.160(4) (tolling time for five years or one year after disabling mental condition ends, whichever occurs first).
Defendants refer to documents with facts outside the complaint. Our account, however, omits such materials because they are not properly considered when reviewing a motion to dismiss under ORCP 21 A(9). See Roberts v. Drew,
The third amended complaint also alleged that Johnson, an original defendant, was an employee of SPA, for whom SPA should also be vicariously liable. After that complaint, plaintiff settled with original defendants Salem Hospital, Buchanan, and Kruse. The court entered a limited judgment approving settlement and granted plaintiff’s motion to abate the case against remaining defendant Johnson, pending this appeal involving defendants Ismail and SPA.
Defendants rely on a statement in plaintiffs response to defendants’ motion that, on April 30, 2012, plaintiff obtained a professional medical review concerning the care of the earlier, original defendants. From that statement, defendants infer that plaintiff must have known his injury and its cause and should have uncovered the role of Ismail and SPA.
In that case, former ORS 16.260(7) provided the same framework for our decision as does today’s ORCP 21 A(9). In relevant part, that statute provided that a “defendant may demur to the complaint * ⅜ * when it appears upon the face thereof. * * ⅜ [t]hat the action has not been commenced within the time limited by statute.” Former ORS 16.260 (1955), repealed by Or Laws 1979, ch 284, § 199 (emphasis added).
For a contrary proposition, defendants quote Eldridge v. Eastmoreland General Hospital,
We recognize that some early fraud cases declare facts sufficient to have put plaintiffs on notice to inquire about the falsity of the representations, and, in turn, those facts obligated plaintiffs to plead so as to avoid an assumption that plaintiffs reasonably should have discovered their claims near the time of a transaction or representation—a time outside the statute of limitations. See, e.g., Heard v. Coffey,
We concede that, at points in Guirma and in other cases, we have slipped into referring to whether the allegations established that the action was timely, as opposed to not untimely. Id. at 780-81 (asking whether complaint affirmatively alleges facts to permit a fact finding that the complaint was filed timely); see also Sternberg v. Lechman-Su,
