Two-Year Statute of Limitations for Filing Wrongful-Death Claim Tolled Due to Patient's “Mental Disorder” Before Death
In Maycock v. Hoody, 799 N.W.2d 322 (Neb. 2011), the Supreme Court of Nebraska dismissed a medical malpractice and wrongful-death suit on the basis that the appellant failed to rebut the prima facie case, but held that the two-year statute of limitations for the case should be tolled as previously established by the Nebraska Court of Appeals. The court held that a comatose medical patient has a de facto medical condition that should be extended to the person representing the patient after his death as justifying a delay in filing the paperwork for the lawsuit.
Facts of the Case
Marty A. Maycock (age 21), was a patient at Bergan Mercy Medical Center, an Alegent Health hospital, from November 17, 2005, until his death on November 22, 2005. Dr. James Frock, a board-certified nephrologist, was called in for consultation by Dr. Steve Hoody, a family medicine doctor (a defendant who was dismissed from this case, although the case bears his name). Dr. Frock's report indicated that he suspected an antifreeze overdose based on the observed severe health consequences (oliguria, acute renal failure, severe increase in anion gap metabolic acidosis, and hyperkalemia). When asked by Dr. Frock, Mr. Maycock acknowledged that he had drunk a large amount of antifreeze. Mr. Maycock was hospitalized; his condition deteriorated throughout the day of November 17, and he ceased to give coherent verbal responses and became more restless. On the morning of November 18, he was described as resting quietly in bed, eyes closed, and responding by opening his eyes to sound, but not giving responses to orientation questions and not following commands. He was intubated and placed on a ventilator that afternoon. His care was overseen by several physicians. On November 22, Mr. Maycock was diagnosed with septic shock and was comatose; he died later that day. Mr. Maycock, Sr, as special administrator of the estate of his deceased son, filed suit on Monday, November 26, 2007, but, because of the Thanksgiving holiday, it was considered to be effectively brought on November 22. The suit listed several doctors and Alegent Health. Three of the treating and consulting physicians established in their affidavits that they had met the requisite standard of care. The district court granted summary judgment for these defendants as the estate failed to rebut their prima facie case. The district court also dismissed the case against Alegent Health.
Four other doctors who cared for Mr. Maycock filed affidavits in support of their motions for summary judgment on the sole basis that the estate claims against them were barred by the statute of limitations; that is, the treatment they provided occurred before the two-year deadline for the date of filing on November 22, 2007. The district court granted summary judgment, dismissing claims against the doctors as time barred, on the basis of the two-year statute of limitations on professional negligence applicable under the Nebraska Hospital-Medical Liability Act (NHMLA) (Neb. Rev. Stat. §§ 44-2801–44-2855 (2007)).
The estate appealed. The court of appeals ruled that Nebraska law allows for the tolling of the statute of limitations on condition of the existence of a mental disorder and reversed the district court's ruling. The doctors petitioned the Supreme Court of Nebraska for review of the appellate court's decision.
Ruling and Reasoning
The supreme court held that the appellate court had correctly reversed the district court's summary judgment in favor of the doctors on the basis of accurate application of Nebraska law, which allows for tolling the two-year statute of limitations in the presence of mental disorder (Neb. Rev. Stat. § 25-213 (2007)). The court of appeals has defined mental disorder for the purposes of this statute as “a condition of mental derangement which actually prevents the sufferer from understanding his or her legal rights or from instituting legal action” (Maycock, p 329).
The court disagreed with the doctors' argument that, because the case had been brought by the estate of Mr. Maycock, and the law applied only to the person with the mental disorder, tolling was not applicable. The court cited Neb. Rev. Stat. § 25-213 (2007), according to which tolling may be invoked by “a person entitled to bring any action mentioned in … the NHMLA” [Nebraska Hospital-Medical Liability Act]. Such a person includes a representative of a patient: the “personal representative inherits the benefits and burdens connected with running of any applicable statute of limitations applicable to decedent” (Maycock, p 328). The court further concluded that the state of being unconscious and unresponsive constitutes a mental disorder and remanded the case for further proceedings.
In its reasoning, the supreme court cited cases in other states in which courts had ruled similarly. The court also held that if an issue is not raised at the appropriate stage of the proceedings in a lower court, it cannot be raised sua sponte on appeal, thereby dismissing the doctors' argument on appeal that they had met requirements of standard of care and should prevail in the case.
Discussion
At the time of this commentary, the case was back in the district court. Although the case raises questions of legal strategy, the relevant concern for forensic psychiatrists and psychologists is the court's view of what constitutes mental impairment. Many physical illnesses and severe traumas result in coma and altered consciousness; under those circumstances, a diagnosis of mental disorder is rarely applied. Yet under Nebraska law, the tolling could hold a medical team liable for months and potentially years in cases of prolonged coma or consequences of severe brain damage. The court applied a common sense view that Mr. Maycock was not able to make decisions for himself because of an altered mental state. Notably, however, the facts of the case suggest that, in early interviews with the doctors, he was able to respond to questions. His condition deteriorated over time, but not before doctors determined that he had ingested antifreeze, the poison that resulted in his physical deterioration, coma, and death.
This case has several other interesting dimensions. First, a presumably competent representative was given the tolling right, even though no type of incapacitation prevented him from pursuing the legal claims in a timely manner. Second, the apparently simpler defense based on the formalities of the statute of limitations proved to be far less prudent than the more complex defense invoking affidavits regarding standards of care. Finally, although the Nebraska Court of Appeals determined that Mr. Maycock was “undisputedly … suffering from a mental disorder, i.e., incapacitated” (Maycock, p 329) on November 22, 2005, when he became comatose, questions of material fact remained as to whether he was incapacitated before November 22. Since the suit was filed on November 22, 2007, this determination is critical to the two-year statute of limitations. For example, Mr. Maycock appeared to be largely unresponsive to efforts at communication on November 18, as described earlier. If he were found to be incapacitated on that date, the two-year statute of limitations would presumably have expired on November 18, 2007. The final determination of these findings is still being litigated at the time of this review.
Footnotes
Disclosures of financial or other potential conflicts of interest: None.
- © 2014 American Academy of Psychiatry and the Law