On October 17, 2018, the Pennsylvania Supreme Court issued an Opinion, authored by Justice Baer, addressing the applicability of the discovery rule in Nicolaoui, et al. v. James J. Martin, M.D., et al., No. 44 MAP 2017. The issue was whether Plaintiff had satisfied the discovery rule in order to toll the running of the statute of limitations in a medical malpractice action filed against a number of healthcare providers for failing to diagnose and/or treat Lyme disease. The Trial Court granted summary judgment in favor of Defendants deeming the action as time-barred. The Superior Court affirmed and held that the discovery rule did not toll the statute of limitations because, as a matter of law, Plaintiff failed to demonstrate pursuing the action with reasonable diligence. The Supreme Court reversed and held that summary judgment was improper as the determination of whether a Plaintiff acted with due diligence under the circumstances is one of fact for a jury to decide.
In 2001, Plaintiff was bitten by a tick on her left ankle and developed a rash, numbness and tingling into the left foot, fatigue, and lower back pain. In August of 2001, Plaintiff reported her tick bite and symptoms to Dr. Stephen P. Falatyn who ordered a Lyme disease test which was negative. As the symptoms continued, Plaintiff sought treatment from Dr. James J. Martin from 2002 through 2005. Eventually, a 2nd Lyme disease test revealed an equivocal negative result. Due to continuing symptoms, Plaintiff sought medical care with a Certified Nurse Practitioner, Louise A. Dillonsynder, from 2005 through 2006. MRI revealed findings were consistent with infectious or inflammatory demyelinating process; such as, multiple sclerosis (MS) or Lyme disease. A 3rd Lyme disease test was negative. In 2007-2008, Plaintiff treated with Dr. Jeffrey D. Gould for the tick bite and resulting symptoms which had expanded to an inability to walk, fatigue, and incontinence. A 4th Lyme disease test was performed and, again, returned with negative results. However, the laboratory report cautioned that the test did not exclude B. Burgdorferi infection, the bacterium that causes Lyme disease. Nevertheless, Dr. Gould definitively told Plaintiff that she did not have Lyme disease. Rather, Plaintiff was told she was suffering from MS.
At some point in 2007, Plaintiff suspected that she may have Lyme disease and not MS. She sought a medical opinion from Nurse Practitioner Rita Rhoades who had experience with Lyme disease misdiagnoses. During her first visit on July 20, 2009, Nurse Rhoades informed Plaintiff that she probably did have Lyme disease. Nurse Rhoades opined that the false negative test results were due to a Lyme disease vaccine which had been taken off the market prior to these events. Despite no positive Lyme disease test result, Nurse Rhoades prescribed a course of antibiotics. After two months of taking the prescribed antibiotics, Plaintiff’s symptoms improved. At Nurse Rhoades’ recommendation, Plaintiff underwent another Lyme disease test, IGeneX. On February 11, 2010, Nurse Rhoades emailed Plaintiff that the test results were positive for Lyme disease. Within two years, on February 10, 2012, Plaintiff filed her Complaint against the Defendants.
Defendants’ Motion for Summary Judgment was based upon the contention that Plaintiff should have known that she had Lyme disease despite numerous or repeated medical opinions to the contrary. In its holding in support of summary judgment, the Superior Court relied upon Gleason v. Borough of Moosic, 15 A.3d 479, 484-85 (Pa. 2011), wherein the court confirmed that a greater burden is placed upon a plaintiff asserting the discovery rule because invocation of the doctrine was “tied to ‘actual or constructive knowledge of at least some form of significant harm and of a factual cause linked to another’s conduct, without the necessity of notice of the full extent of the injury, the fact of actual negligence, or precise cause.’” The Supreme Court held that whether Plaintiff knew or should have reasonably known that the injuries were caused by Defendants’ misdiagnosis is disputed and should be resolved at trial. Accordingly, the matter was reversed and remanded.
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