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Case Bulletin – Pennsylvania Supreme Court Publishes Opinion Regarding Discovery Rule and Statute of Limitations

On October 17, 2018, the Pennsylvania Supreme Court published an opinion that requires determinations regarding the applicability of the discovery rule to toll a statute of limitations to be put to a jury.  In Nicolaou v. Martin, et al., No. 44 MAP 2017, 2018 WL 5019804 (Pa. October 17, 2018), the Pennsylvania Supreme Court held that summary judgment was precluded in a medical malpractice case where a genuine issue of material fact existed as to whether the plaintiffs knew or should have known of the plaintiff-wife’s injury and that it was caused by the defendants’ negligence.

In Nicolaou, Nancy Nicolaou was bitten by a tick sometime in 2001.  Beginning in August 2001, Mrs. Nicolaou sought treatment for her symptoms, which initially included a rash at the site of the bite and worsened to include tingling and numbness in her left leg and fingers, decreasing sensation in her left foot, fatigue, lower back pain, incontinence, difficulty walking, leg pain and weakness, and joint stiffness.  Mrs. Nicolaou received an MRI and the results of the MRI indicated the presence of multiple sclerosis (MS) or Lyme disease.  Mrs. Nicolaou was never treated with the standard antibiotic treatment for Lyme disease, but the Defendants tested her for Lyme disease on four different occasions and all tests returned negative results.  Mrs. Nicolaou was diagnosed with MS and her treating physician began an aggressive MS treatment regimen.  Mrs. Nicolaou’s symptoms worsened dramatically and she was confined to a wheelchair.

In 2007, Mrs. Nicolaou stopped seeking treatment from the Defendants and sought treatment for Lyme disease from Nurse Practitioner Rita Rhoads, who prescribed a course of antibiotics as a way of determining whether Mrs. Nicolaou’s symptoms would respond.  She also suggested that Mrs. Nicolaou undergo a test by a company named IGeneX, Inc. at a cost of about $250 to confirm her Lyme disease diagnosis.  Mrs. Nicolaou declined the test for financial reasons and said that she wanted to wait and see how her symptoms would react to the antibiotic treatment.  After two months of treatment, Mrs. Nicolaou’s symptoms began to improve and, ultimately, she agreed to take the IGeneX test.

On February 13, 2010, Nurse Rhoads emailed Mrs. Nicolaou to inform her that the test was positive for Lyme disease.  Within two years of receiving the positive Lyme disease test, Mrs. Nicolaou and her husband initiated a lawsuit against the Defendants, alleging negligence for failing to diagnose and treat her Lyme disease, which resulted in the infection becoming chronic and permanent.  The Defendants raised the affirmative defense of statute of limitations because the lawsuit was initiated more than three years after Mrs. Nicolaou’s last contact with the Defendants.

Following the exchange of discovery, the Defendants filed a motion for summary judgment.  In opposition to the motion, the Plaintiffs invoked the discovery rule, arguing that the statute of limitations did not begin to run until the date Mrs. Nicolaou was informed of her positive Lyme disease test. The trial court granted the motion and concluded that the Plaintiffs were time barred from asserting their claims.  The trial court reasoned that though the determination of whether a plaintiff knew or should have known about her injury is generally an issue of fact to be determined by the jury, the facts of this case were so clear that reasonable minds could not differ that the statute of limitations began to run before the Plaintiffs were informed of the IGeneX results.  The Plaintiffs appealed to the Pennsylvania Superior Court and the Superior Court affirmed the trial court.

The Plaintiffs appealed to the Pennsylvania Supreme Court and the Court reversed and remanded the case.  It reasoned that Pennsylvania’s formulation of the discovery rule, which originated in cases where the plaintiff’s injury or its cause was neither known nor reasonably ascertainable, is more narrow than other jurisdictions and places a greater burden of proof on plaintiffs.  However, a lay person is only charged with the knowledge communicated to her by her treating medical professionals.  Moreover, although a plaintiff must act with reasonable diligence to discover her injury and the cause, a reasonable diligence determination is fact intensive and ordinarily a question for a jury.

In this case, the Plaintiffs were repeatedly told that Mrs. Nicolaou did not have Lyme disease and she was officially diagnosed with MS.  The Court determined that the lower courts had improperly undertaken fact-resolution and inference-drawing functions when finding, as a matter of law, that the discovery rule did not apply because the Plaintiffs knew or should have known sometime between July and September of 2009 of Mrs. Nicolaou’s injury and its possible causal link to Defendants’ failure to diagnose and treat Lyme disease.  Instead, the Court held that the factual issues pertaining to Plaintiffs’ notice and diligence are for a jury to decide.  In particular, the Court highlighted that it should be for a jury to determine whether a reasonable person in Mrs. Nicolaou’s position would have initially declined the $250 IGeneX test or whether this indicated a lack of reasonable diligence on the part of the Plaintiffs.