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Szczuvelek v. Harborside Healthcare Woods Edge1/24/2005
vere pseudomembraneous colitis complicated by fecal impaction and massive cecal distention with probable syndrome of toxic megacolon." The plaintiff's expert asserted that "the combined respiratory arrest with hypoxia and later development of coma and respiratory acidosis... cause the untimely death of" Burns.
II.
Under the equitable doctrine of the discovery rule, "a cause of action will be held not to accrue until the injured party discovers, or by an exercise of reasonable diligence and intelligence should have discovered[,] that he may have a basis for an actionable claim." Lopez v. Swyer, 62 N.J. 267, 272 (1973). This equitable doctrine tempers the harshness of statutes of limitations, which are "designed to stimulate litigants to pursue their actions diligently." Mancuso v. Neckles, 163 N.J. 26, 29 (2000). The discovery rule requires that a plaintiff have "knowledge not only of the injury but also that another is at fault" to start the statutory period. Guichardo v. DeLisi, 177 N.J. 45, 51 (2003) (internal quotation marks and citation omitted).
However, in cases of complex medical causation, such as the present matter, "it is not at all self-evident that the cause of the injury ... the fault of... a third party." Mancuso, supra, 163 N.J. at 34 (internal quotation marks and citation omitted). Because fault is not readily ascertainable in such situations, we apply a specialized formulation of the discovery rule and "require [more] than mere speculation or an uninformed guess" to start the statutory period. Ibid. A plaintiff must have "some reasonable medical support that there was a causal connection between [the plaintiff's] condition and [the defendant's] conduct" before we will deem him or her to have the requisite knowledge of the facts that trigger the statutory period. Ibid. (emphasis added) (internal quotation marks omitted); see also Guichardo, supra, 177 N.J. at 51; cf. Vispisiano v. Ashland Chem. Co., 107 N.J. 416, 437 (1987) (recognizing toxic tort plaintiffs must have some reasonable medical support to trigger statute of limitations in discovery rule context).
III.
Because the concurrence deems plaintiff to have had sufficient knowledge of Harborside's fault based solely on his personal observations, rather than reasonable medical support, I dissent on that issue.
A.
As Burns's medical history demonstrates, this appeal presents a case of complex medical causation. The cause of Burns's death is so unclear that the medical experts did not articulate the same cause of death. The defense expert stated that the theory that the allegedly inadequate suctioning at Harborside led to Burns's death "is a totally unsubstantiated conclusion and ignorant of the obvious cause of death in this case," i.e., septic shock. Plaintiff's expert stated the opposite. Additionally, in the two and one-half months preceding his death, Burns did not suffer from just one ailment. Rather, he endured a series of medical conditions including an aortic aneurysm, an inability to breathe on his own, pneumonia, and colitis. Moreover, the Harborside nurse's statement that the doctor's orders prohibited her from suctioning Burns, other than at specified intervals, further masked the cause of Burns's death because a layperson would not be able to determine if such an order was medically inappropriate. Finally, at oral argument defense counsel agreed with the principle "that without the medical records there is no conceivable way that anyone would have a reasonable basis on which to conclude that there was an actionable claim." It is for this type of malpractice case that we have developed the complex medical causation formulation of the discover
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