EMAIL TO A FRIEND COMMENT

 

Limitations Not Tolled for Insanity When No Total Inability to Function


A student considering attending medical school in Grenada attended an information session where the school staff told attendees that there would be medical facilities and treatment available for students on the Grenada Campus, including medical evacuation if needed. A publication provided by the medical school stated:

 

University Health Services (UHS) maintains modern clinic facilities with scheduled and walk-in hours from 9:00AM to 4:30PM, Monday through Friday. Additionally, there is daily 24–hour coverage by well-credentialed physicians and physician assistants to provide students with emergency care when the clinic is closed. Medical emergencies in Grenada are referred to Grenada General Hospital or St. Augustine Clinic.... University Health Services facilitates with air evacuation, if indicated, on both campuses.

 

Upon admission to the medical school, the student received a handbook from the Dean of Students which stated, “The Office of the Dean of Students advocates on behalf of students to help you make the best use of the services available both on and off campus. Any student with mental or physical disabilities is provided a wide range of support services.”

 

In his second spring of attendance at the medical school, the student consulted his faculty advisor. He arrived appearing disheveled and wearing inappropriately warm clothing given the climate. The advisor suggested he take a vacation. The student went on a sailing trip. When he returned he was suffering from mental illness. He wandered aimlessly on and off the school's campus. Other students alerted school officials to the student’s condition. In response, school security officers picked him up and escorted him to a Grenada hospital that was not one of the two referred to in the school’s publication.

 

Fellow students notified the parents about the student’s admission to the hospital. The student’s father traveled to the hospital where he found his son in an outdoor cell lying on a concrete floor without a mattress, naked except for boxer shorts that were hanging down. He was incoherent due to overdosing on Haldol and other drugs and was experiencing muscle weakness, muscle tremors, dilated eyes, drowsiness, and dry mouth and lips due to his overmedication and a lack of adequate hydration. His body was covered with insect bites and his own excrement. His parents obtained his release from the hospital and he returned to the United States.

 

The student returned to the school twice in attempts to complete his medical education. On both occasions, however, he became ill and returned to the United States. Since his return to the United States, the student required medical treatment to ameliorate conditions that were non-existent prior to his admission to the hospital in Grenada.

 

The student sued the medical school in New York Supreme Court. The complaint claimed that the school committed psychiatric malpractice, breached its contract, and was negligent based on its failure to appropriately treat the student's mental illness. The school had the case removed to the United States District Court for the Southern District of New York. The student objected to the removal. The school moved to dismiss because the medical malpractice claim was time-barred and the contract and negligence claims were duplicative of the malpractice claim. The District Court rejected the student’s challenge to removal jurisdiction and dismissed as time-barred the student’s complaint because the two and one-half year limitations period for the medical malpractice claim expired one day before the summons was filed.

 

The Second Circuit United States Court of Appeals affirmed. The court concluded that the case was properly removed and that the complaint was properly dismissed as time-barred. Specifically, the court noted that the statute of limitations was not tolled by the student's alleged insanity during the first two days of the statutory period. The statute of limitations on breach of contract and negligence claims in New York is three years. The complaint was filed within three years of the accrual of the claims. However, the school’s promotional and informational materials did not furnish the basis of a breach of contract claim and the student’s negligence claim was duplicative of the medical malpractice claim.

 

The case was properly removed from state court to federal court. The court found that the real party defendant in interest was entitled to remove the action. Additionally, the inclusion of a non-diverse unincorporated association did not destroy diversity jurisdiction.

 

The statute of limitations was not tolled by the student's alleged insanity during the first two days of the statutory period. The limitations period started when the student's malpractice claim accrued, which was the day he was brought to the hospital in Grenada. The student argued that the statute of limitations should be tolled because of his insanity for at least two days, referring to the day he was brought to the hospital and the next day when his father observed his condition at the hospital. The court reasoned that, under New York law, a plaintiff must be totally unable to function as the result of severe and incapacitating disability to establish insanity for the purposes of tolling the statute of limitations. Difficulty in functioning is not sufficient. The statute of limitations for filing a medical malpractice action was not tolled by the student's alleged insanity during the first two days of the statutory period, despite the student's incoherence during that period due to excessive medication. The student’s allegations about the two days in question indicated deficient hospital conditions, not his own insanity. Additionally, the court noted that the complaint was filed one day after the statute of limitations had run, suggesting mere oversight or mistake, rather than inability to function.

 

The school's promotional and information materials did not furnish a basis for a breach of contract claim. Under New York law, a breach of contract claim arising out of the rendition of medical services by a doctor is legally sufficient only where it is based upon an express special promise to cure or to accomplish some definite result. The medical school's promotional and information materials regarding its medical facilities and treatment available for students did not constitute an express promise or special agreement with the student so as to furnish the basis for a breach of contract claim based on the school's allegedly inadequate response to the student's mental health difficulties.

 

The student's negligence claim was duplicative of his medical malpractice claims. Under New York law, when a duty arises from the physician-patient relationship or is substantially related to medical treatment, a breach gives rise to an action sounding in medical malpractice, not simple negligence. The student's claim that the medical school's agents negligently failed to use due care in performance of their duties by failing to refer him to counseling or medical treatment and failing to provide him with proper psychiatric care and medical treatment was substantially related to medical treatment. Thus, this claim was duplicative of his medical malpractice claims.

 

The Second Circuit United States Court of Appeals affirmed the trial court’s dismissal of the complaint.

 

See: La Russo v. St. George's University School of Medicine, 2014 WL 814919 (C.A.2 (N.Y.), March 4, 2014) (not designated for publication).

 

See also Medical Law Perspectives, January 2014 Report: Prescription Painkillers: Risks for Patients, Pharmacists, and Physicians

 

See also Medical Law Perspectives, May 2013 Report: Drugs, Dosage, and Damage: Physician Liability for Prescribing or Administering Medication

 

 

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