Appellate Court Reinstates Claims of Negligent Treatment Causing Permanent Disability
News: A three-judge appeals panel in Illinois reinstated claims by a patient with multiple sclerosis for her neurologist’s negligence in treating her disorder. The treatment caused the patient’s permanent disability. The trial court originally rejected the patient’s amended complaint.
The patient and her mother claimed the neurologist and the clinic are responsible for the patient’s progressive multifocal leukoencephalopathy (PML), a brain infection the patient alleged she contracted while undergoing treatment for multiple sclerosis. The patient alleged the doctor failed to follow a warning the medication could cause PML as a side effect if the medication is used improperly.
Because of the infection, the patient cannot function or communicate properly. A probate court found the patient legally disabled, making her mother the legal guardian of her estate. Following this ruling, the patient, through her attorneys, asked the trial court to file an amended complaint to name the patient’s mother as co-plaintiff.
Defendants moved to dismiss the case on a statute of limitations defense. They also argued the case is not subject to tolling, as the patient was not legally disabled before filing suit. The trial court sustained defendant’s motion for summary judgment. The appellate court later reversed the ruling, stating there is a genuine factual dispute as to when the patient became disabled and if tolling would be applicable. The appellate court urged the patient’s mother to submit an amended complaint for the lower court to consider.
But when the case went back to the trial court, the neurologist took issue with what they believed was a new allegation in the patient’s amended complaint, which contended the patient was disabled in November 2012 when she was diagnosed with PML. The defendants also asked the trial court to eject the patient’s expert witness, who testified the patient was disabled by the time she was diagnosed with PML. They argued the patient’s mother used it to contradict a “judicial admission” the patient made in her earlier complaints, which said she discovered the neurologist’s mistake in June 2015.
The trial court agreed with the defendants, dismissing the witness’s statements and the amended complaint. The lower court judge awarded summary judgment to the neurologist and clinic based on the facts in the previous complaint.
Background: From March 2008 to October 2012, a patient with multiple sclerosis was prescribed natalizumab to slow the progression of the disease. The patient claimed the doctor knew treating patients with natalizumab for longer than two years placed them at an increased risk for developing PML, a rare brain infection that causes severe disability.
In April 2018, a probate court found the patient was legally disabled and appointed her mother as guardian of her estate and person. The patient’s mother moved to file an amended complaint and to substitute the patient’s mother as plaintiff. The defendants objected, and filed a combined motion to dismiss and for summary judgment due to the statute of limitations. Defendants moved for summary judgment, arguing the patient knew her cause of action when she was first diagnosed with PML on Nov. 15, 2012, and was required to file suit no later than Nov. 15, 2014.
The plaintiffs argued a genuine issue of material fact as to when the patient discovered the injury based on the defendants’ wrongful conduct. They attached a doctor’s affidavit, stating the patient was under a legal disability as of November 2012, contending the limitations period was tolled by either the patient’s legal disability or the discovery rule. The discovery rule stops the clock for statute of limitations defenses to when the plaintiff reasonably could discover his or her damages.
Despite the proof of a triable issue of fact, the trial court granted defendants’ motions, to which the plaintiffs appealed. The appellate court reversed the trial court’s ruling, holding there was a genuine issue of material fact regarding when the patient became legally disabled. The panel ruled the lower court’s ruling “directly contradicts” the previous appeals opinion.
What this case means to you: At issue in this appeal is whether the trial court erroneously vacated its order granting plaintiff leave to file the amended complaint and denied plaintiff’s motion for leave to file her amended complaint based on the law-of-the-case doctrine.
The law-of-the-case doctrine is the concept that a decision by an appellate court on a legal issue is binding on both the trial court on remand and an appellate court on a subsequent appeal in the same case with the substantially same facts. Under this doctrine, legal issues decided on appeal to a court of last resort usually govern the case throughout its subsequent stages. The case law is intended to ensure lower courts follow the rulings of higher courts and to prevent relitigation of previously resolved issues, as seen here. The doctrine applies to questions of law and fact, encompassing both explicit and necessary implication decisions made by a court.
The purpose of the law-of-the-case doctrine is to protect the parties’ settled expectations, ensure consistency in decisions, maintain consistency throughout the course of a single case, effect proper administration of justice, and close litigation.
In this case, the defendants argued the law-of-the-case doctrine does not apply because the trial court was trying to remedy its mistake. However, the court addressed this issue in the initial case and determined the law-of-the-case doctrine applied.
The facts indicated the trial court knew the amended complaint contained a new allegation the patient was disabled in November 2012, when she was originally diagnosed with PML. The appellate court concluded the trial court, by allowing the new amended complaint to be filed, was aware of its contents and was compelled to accept the allegations in the amended complaint. Therefore, the appellate court concluded there was no mistake to be remedied on remand, and the trial court was required to accept the amended complaint as the operative pleading.
The key takeaway is that courts do not want to relitigate an already-litigated issue. The law-of-the-case doctrine requires both trial and appellate courts to follow the rules set forth by a former appeal regardless of whether the initial court was right or wrong. In this case, the appeals court determined the trial court’s ruling directly contradicted its prior holding allowing the amended complaint to be filed without limitation. The trial court was erroneous in not accepting the allegations of the amended complaint as they were pled. They disregarded the court’s previous ruling and did not correctly apply the law-of-case doctrine. Because of this, the patient tolled the statute of limitations that allowed for her to try her case.
Tolling and when a patient discovers his or her injury are crucial components of any medical malpractice claim. The discovery rule allows the statute of limitations clock to run upon reasonable discovery by the patient of his or her injury. Timing of when a patient becomes disabled is a genuine issue of material fact and should be permitted.
- Decided Nov. 16, 2021, in the Appellate Court of Illinois, Second District, Case No. 2-20-0735.
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