Statute of Limitations

Radiologists Owe Patient Duty of Continuing Care for Statute of Limitations - Montgomery v. South County Radiologists, Inc., No. ED77285 (Mo.App. E.D. 12/19/2000)

One of the more controversial issues in statute of limitations cases is whether radiologists, pathologists, and other physicians whose only contact with patients is through interpreting diagnostic tests have a physician patient relationship and any duty of continuing care, including following up to assure that the treating physician acts on adverse findings.  This case which arose from a negligent failure of a group of radiologists to diagnose plaintiff's spinal tumor, which plaintiff only became aware of after the two year statute of limitations had passed.  Such cases pose a particular problem because the specific nature of the negligence - failure to diagnose a hidden condition - is the reason that the statute of limitations runs.  Most courts, irrespective of whether they allow the plaintiff to proceed, find this a terrible injustice.  Missouri has a very strict 2 year statute of limitations which only preserves the discovery rule for foreign body cases, and, after a very recent statutory modification, for negligent failure to appraise patients of adverse lab tests.  The only other exception is for continuing care, which tolls the statute until the patient is no longer under the care of the physicians or other health care entity.  While the facts of this case would fit the continuing care exception, Missouri had not previously addressed whether radiologists had a physician patient relationship and thus are subject to the continuing care exception.  After a useful review of the precedent in other states, the court made this state of public policy:

"With medical achievements, new and unique administrative demands are placed upon doctors. We live in a society of increasingly managed health care. Doctors must cope with competing pressures to provide total patient care and to maintain low overhead costs. Their expanding caseloads require assistance from other health care professionals for specialized care or treatment. Patients understand that doctors are no longer capable of providing every essential service or treatment, but believe they will be assisted and monitored by likewise professional health care providers--a team management approach to enhance medical care.  Yet, when medical specialists assisting the primary care provider make mistakes, there must be accountability for their actions. We do not wish to encourage primary care providers to attempt medical care outside their capabilities, and we do not want to immunize those providing specialist care from liability due to the fact they are providing a specialist treatment and/or diagnosis."

Based on this policy and precedent from other states, the court found that radiologists (and clearly pathologists as well) did have a physician-patient relationship, at least to the extent of being subject to the continuing care exception to the statute of limitations.