A woman was in a car accident. She underwent an exploratory laparotomy. Nearly 14 years later, she underwent another exploratory laparotomy at a different hospital because she was having pain in her side. During the second laparotomy her doctors found for foreign objects that had been left inside her abdomen during the first surgery.
The woman and her husband sued the hospital where the first surgery was performed. The complaint alleged that the hospital committed medical malpractice in failing to account for and remove the four foreign objects during her first laparotomy.
The hospital moved to dismiss the claims on the ground that they were barred by the ten year statute of repose for claims of medical negligence involving the leaving of foreign objects in the body. The suit was filed within two years from the date the woman discovered that for foreign object been left in her body. But this was not within ten years after she alleged the foreign objects were left in her abdomen during her surgery. The Circuit Court of St. Louis County dismissed the claims with prejudice. The trial court held that Missouri’s ten year statute of repose for foreign object medical malpractice claims was not equitably tolled until the woman discovered the foreign objects. The trial court concluded that because the couple filed their action fourteen years after the date of the alleged negligence, the statute of repose applied, making their claims time-barred and subject to dismissal. The trial court also determined that the couples' constitutional claims—that the statute of repose violated due process, equal protection, and the Missouri Constitution's open courts and special legislation provisions—failed to present a real and substantial constitutional challenge and were not well taken.
The Supreme Court of Missouri affirmed. The court held that Missouri’s ten year statute of repose for foreign object medical malpractice claims was not subject to equitable tolling, the statute of repose did not violate the guarantee of open courts or the Equal Protection Clause, the statute of repose did not violate the prohibition against special laws, and the statute of repose did not violate due process.
Missouri’s ten year statute of repose for foreign object medical malpractice claims was not subject to equitable tolling. Equitable tolling is almost universally used in the context of statutes of limitations. Statutes of repose began to run on the date of the allegedly tortious act and provide an absolute deadline beyond which suit may not be brought. The legislature specifically provided that claims of foreign object medical malpractice were barred by the statute of repose once ten years had passed from the time of the negligent act, even if the plaintiff had not at that point discovered the wrong. The court reasoned that to toll them would disregard the basic purpose of statutes of repose, providing a final time limit beyond which suit is foreclosed.
The statute of repose did not violate the guarantee of open courts or the Equal Protection Clause. The open courts guarantee applied only to recognized causes of action; it did not guarantee access to the courts once the statute of repose extinguishes the cause of action. The open courts provision did not guarantee victims of medical malpractice an unlimited time to sue. The right to bring a medical malpractice action was not a fundamental right subject to the Equal Protection Clause. Fundamental rights included only basic liberties explicitly or implicitly guaranteed by the United States Constitution. Medical malpractice victims did not fall into a class of persons who command extraordinary protection from the majoritarian political process. Thus, medical malpractice claimants were not a suspect class entitled to strict scrutiny analysis. The court applied a rational basis test to determine whether the statute of repose violated the couples’ equal protection rights. The ten-year statute of repose was rationally related to a legitimate state interest because it reflected a reasonable balance struck by the legislature between the right of those injured by medical malpractice to discover their injuries and the concern that medical defendants should be free from worry about liability for past acts after a reasonable period of time.
The statute of repose did not violate the prohibition against special laws. Special laws were those that included less than all who are similarly situated. But a law was not special if it applied to all of a given class alike and the classification was made on a reasonable basis. The legislature had a reasonable basis to impose a ten-year statute of repose when they adopted a discovery rule for medical malpractice actions involving foreign objects. It was not irrational for the legislature to balance a victim's right to discover his or her injury with a defendant's right to closure and to determine that ten years was the outside limit for discovery of a cause of action for leaving a foreign object in a patient's body.
The statute of repose did not violate due process. The court reasoned that, because the plaintiff's claim was barred by the statute of repose before the claim accrued, the plaintiff never acquired a vested property right to which due process could apply.
The Supreme Court of Missouri affirmed the trial court’s dismissal of the couples’ foreign object medical malpractice claim.
See: Ambers-Phillips v. SSM DePaul Health Center, 2015 WL 1926012 (Mo., April 28, 2015) (not designated for publication).