Opinion issued February 11, 2016
In The
Court of Appeals
For The
First District of Texas
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NO. 01-14-00984-CV
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TIFFANY THOMAS, Appellant
V.
T. JAYAKUMAR, FIRST STREET HOSPITAL, AND FIRST SURGICAL
PARTNERS, LLC, Appellees
On Appeal from the 334th District Court
Harris County, Texas
Trial Court Case No. 2014-22071
MEMORANDUM OPINION
In this medical malpractice case, Tiffany Thomas appeals from the trial
court’s order granting summary judgment in favor of Dr. T. Jayakumar, First Street
Hospital, and First Surgical Partners, LLC. In her sole issue, Thomas contends that
the trial court erred in granting appellees’ motions for summary judgment because
it denied Thomas her rights under the open courts provision of the Texas
Constitution. We affirm.
Background
In 2001, Thomas underwent lap band surgery which was performed by
non-parties to this suit. During that surgery, silastic tubing was left in her
abdomen.1
On November 14, 2011, Thomas was admitted to First Street Hospital for
gastric bypass surgery. Dr. Jayakumar performed the surgery and Thomas was
released from the hospital the next day.
Following her surgery, Thomas returned for a follow-up visit in December
2011. When Thomas told Dr. Jayakumar that she was experiencing abdominal
pain, Dr. Jayakumar told her that it was normal and did not perform any additional
examination. Although Thomas continued to feel abdominal pain intermittently
throughout 2012, she believed that it was a normal lasting effect of gastric surgery
and did not seek any additional treatment.
On December 6, 2012, Thomas began to experience more severe abdominal
pain. She went to the emergency room at Houston Northwest Medical Center
where a CT scan revealed a foreign object in Thomas’s peritoneal cavity. The
1
Thomas does not allege any negligence on the part of appellees arising out of the
2001 surgery during which the tube was placed in her abdominal cavity.
2
doctors recommended that Thomas see a surgeon to have the object removed.
Thomas did not have the object removed at that time, giving as her reason that she
had no medical insurance and was financially unable to afford the cost of surgery.
Later that same month, Thomas retained attorneys.
In January 2013, after obtaining medical insurance, Thomas saw Dr.
Moparty, a gastroenterologist, at Spring Gastroenterology. Dr. Moparty told
Thomas that he thought her abdominal pain was caused by her gallbladder and
referred Thomas to Dr. Wadiwala, a bariatric surgeon, for evaluation. In March
and July 2013, Thomas saw Dr. Wadiwala who recommended that she return to
Dr. Jayakumar for the removal surgery.2 In July 2013, Thomas lost her job and her
medical insurance.
In November 2013, after obtaining financial assistance, Thomas saw Dr.
Daniel Albo who informed her that he believed there was a foreign object in her
peritoneal cavity.3 On February 20, 2014, Thomas’s attorney sent a Notice of
Claim letter to appellees pursuant to Texas Civil Practice and Remedies Code
section 74.051.4 On February 24, 2014, Dr. Albo performed the removal surgery
2
Dr. Moparty and Dr. Wadiwala are not parties to this suit.
3
In 2001, Thomas underwent a lap band surgery which required the insertion of
catheter tubing in her abdomen.
4
TEX. CIV. PRAC. & REM. CODE ANN. § 74.051(a) (West 2011).
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during which he determined that the foreign object was a piece of silastic-type
tubing that had been left in Thomas’s abdomen during her 2001 lap band surgery.
On April 21, 2014, Thomas filed this medical malpractice suit against
appellees alleging that they were negligent by (1) leaving a portion of a foreign
object in her abdomen and (2) failing to recognize the presence of the foreign
object in her abdomen during her follow-up visit in December 2011. Appellees
timely filed their answers in which they asserted, among other things, that
Thomas’s claims were barred by the applicable statute of limitations. Appellees
subsequently filed motions for summary judgment.
On October 29, 2014, the trial court granted appellees’ motions. In its order,
the trial court stated:
Thomas knew (or should/could have known) that the tubing was
placed in her abdomen in 2001 and, by December 2012 at the latest,
she knew Dr. Jayakumar had not removed it and that it might be
causing her medical complaints. The ensuing 11-12 months afforded
Thomas a reasonable opportunity to file suit, and requiring her to have
done so under these circumstances does not “impose an impossible
condition” of the type and nature that warrants the protection of the
Open Courts guarantee.
The court further noted that Thomas’s reasons for the delay in having removal
surgery and filing suit, i.e., her financial and work/insurance-related difficulties,
were legitimate concerns, but it concluded that “the cases applying the guarantee
do not appear to permit such real-world concerns to trump the objective inquiry
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into whether a plaintiff was afforded a reasonable time to sue.” This timely appeal
followed.
Standard of Review
We review a trial court’s decision to grant a motion for summary judgment
de novo. Valence Operating Co. v. Dorsett, 164 S.W.3d 656, 661 (Tex. 2005). A
defendant who moves for traditional summary judgment has the burden of (1)
showing that there is no genuine issue of material fact concerning one or more
essential elements of the plaintiff's claims or (2) pleading and conclusively
establishing each essential element of any affirmative defense, establishing that it
is entitled to judgment as a matter of law. TEX. R. CIV. P. 166a(c); Cathey v.
Booth, 900 S.W.2d 339, 341 (Tex. 1995).
A defendant moving for summary judgment on the affirmative defense of
limitations has the burden of conclusively establishing that defense. KPMG Peat
Marwick v. Harrison Cnty. Hous. Fin. Corp., 988 S.W.2d 746, 748 (Tex. 1999). If
the movant establishes that the statute of limitations bars the action, the nonmovant
must then adduce summary judgment proof raising a fact issue in avoidance of the
statute of limitations. Id.; see also Walters v. Cleveland Reg’l Med. Ctr., 307
S.W.3d 292, 295 (Tex. 2010) (“In the summary judgment context, the burden is on
the plaintiff asserting an Open Courts exception to the statute of limitations to raise
a fact issue demonstrating that she did not have a reasonable opportunity to
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discover the alleged wrong and bring suit before the limitations period expired.”).
In determining whether there are disputed issues of material fact, we take as true
all evidence favorable to the nonmovant and indulge every reasonable inference in
the nonmovant’s favor. Mann Frankfort Stein & Lipp Advisors, Inc. v. Fielding ,
289 S.W.3d 844, 848 (Tex. 2009).
Applicable Law
Health care liability claims are subject to a two-year statute of limitations:
Notwithstanding any other law . . . , no health care liability claim may
be commenced unless the action is filed within two years from the
occurrence of the breach or tort or from the date the medical or health
care treatment that is the subject of the claim or the hospitalization for
which the claim is made is completed . . . .
TEX. CIV. PRAC. & REM. CODE ANN. § 74.251(a) (West 2011). This statute adopted
an absolute two-year limitations period and abolished the “discovery rule” in
health care liability claims. Walters, 307 S.W.3d at 298 n.28 (noting that “the
Legislature abrogated the court-fashioned discovery rule” in 1975) (citation
omitted); see Chilkewitz v. Hyson, 22 S.W.3d 825, 829 (Tex. 1999) (holding that
“absent a violation of the open courts provision of the Texas Constitution,” the
legislature abolished discovery rule in cases governed by Medical Liability Act).
The Texas Constitution’s open courts guarantee provides that “[a]ll courts
shall be open, and every person for an injury done him, in his lands, goods, person
or reputation, shall have remedy by due course of law.” TEX. CONST. art. I, § 13.
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This provision assures that a person bringing a well-established common law cause
of action will not suffer unreasonable or arbitrary denial of access to the courts.
Yancy v. United Surgical Partners Int’l, Inc., 236 S.W.3d 778, 783 (Tex. 2007). A
statute that unreasonably or arbitrarily abridges a person’s right to obtain redress
for injuries another person’s harmful act causes is an unconstitutional due course
of law violation. Shah v. Moss, 67 S.W.3d 836, 842 (Tex. 2001).
Analysis
Thomas does not dispute that she filed her lawsuit against appellees outside
the two-year statute of limitations period.5 Rather, she argues that application of
section 74.251 to bar her claims violates the open courts guarantee of the Texas
Constitution.
The Texas Supreme Court has held that Chapter 74’s two-year limitations
period is not unconstitutional under the open courts provision of the Texas
Constitution “if the plaintiff had a reasonable opportunity to discover the alleged
wrong and bring suit before the limitations period expired.” Shah, 67 S.W.3d at
842 (analyzing whether plaintiff’s medical malpractice claims were barred under
5
In her petition, Thomas alleged that appellees were negligent (1) during her
November 14, 2011 gastric bypass surgery when they failed to remove the tubing
left in her abdomen during her 2001 lap band surgery and (2) during her December
2011 follow-up visit with Dr. Jayakumar when they failed to recognize the
presence of the tubing in her abdomen. Under these facts, the latest possible date
Thomas’s cause of action could have accrued was December 31, 2013. Thomas
did not file her suit until nearly four months later.
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two-year statute of limitations of statutory predecessor to section 74.251). Courts
analyzing whether the open courts doctrine invalidates a statute of limitations in a
particular case have focused on whether the nature of the claim made it impossible
or exceedingly difficult to discover the alleged wrong and bring suit within the
two-year period. See Walters, 307 S.W.3d at 296–97 (analyzing plaintiff’s claim
that she could not have discovered surgical sponge left inside her abdomen within
limitations period and holding that claims were protected by open courts
guarantee); Nelson v. Krusen, 678 S.W.2d 918, 920–24 (Tex. 1984) (holding, in
claim for wrongful birth, that parents could not reasonably have discovered their
claim within two-year limitations period because child was not diagnosed with
genetic disease until he was more than three years old, and thus that limitations
period would operate to bar parents’ suit before they knew it existed).
In her summary judgment response and on appeal, Thomas alleges that she
did not have a reasonable opportunity to learn of the facts that comprised her claim
within two years from the date of her 2011 gastric bypass surgery. 6 Specifically,
she argues that she did not know, and could not have known until after her
procedure on February 24, 2014, that tubing left in her abdomen during her 2001
lap band surgery was the cause of her injury and that Dr. Jayakumar should have
6
In her summary judgment response, Thomas refers to her November 14, 2011
surgery as the event from which the statute of limitations began to run.
8
removed it during her gastric bypass surgery. Therefore, she contends the open
courts provision should preclude application of section 74.251 to her suit.
As the nonmovant, Thomas bore the burden of showing that the nature of
her claim made it impossible or exceedingly difficult to discover the alleged wrong
and bring suit within the two-year period. See Walters, 307 S.W.3d at 296–97;
Gale v. Lucio, 445 S.W.3d 849, 855 (Tex. App.—Houston [1st Dist.] 2014, pet.
denied). The discovery of a “fact of injury” is the triggering event for limitations.
See Moreno v. Sterling Drug, Inc., 787 S.W.2d 348, 357 (Tex. 1990); O’Reilly v.
Wiseman, 107 S.W.3d 699, 707 (Tex. App.—Austin 2003, pet. denied); see also
Borderlon v. Peck, 661 S.W.2d 907, 909 (Tex. 1983) (holding that knowledge of
“facts, conditions, or circumstances which would cause a reasonably prudent
person to make inquiry . . . is in law equivalent to knowledge of the cause of
action”).
Thomas alleges that Dr. Jayakumar committed malpractice when he failed to
remove the previously implanted tubing during her gastric bypass surgery on
November 14, 2011. On December 6, 2012, Thomas experienced severe
abdominal pain and went to the emergency room at Houston Northwest Medical
Center. In her affidavit, Thomas states that “[a]t the hospital, the doctors found
that there was a foreign object in my abdominal cavity. I was informed by the
doctors that I should seek a surgeon to remove the foreign object.” It is at this
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point that Thomas had knowledge of her injury. She had more than eleven months
to file suit before the statute ran as to appellees. See Wiseman, 107 S.W.3d at 708
(concluding that date on which plaintiff was diagnosed with breast cancer is date
on which she was deemed to have knowledge of fact of injury); see also Adkins v.
Tafel, 871 S.W.2d 289, 294 (Tex. App.—Fort Worth 1994, no writ) (stating
plaintiffs could not avoid summary judgment merely by alleging they did not know
they had claim against defendant until their lawyer’s expert informed them
defendant had committed malpractice).
In further support of her open courts challenge, Thomas also argues that she
did not have a reasonable opportunity to learn of her injury and file suit within the
limitations period because she did not have medical insurance and otherwise
lacked the financial resources for further testing or treatment. As the trial court
noted, “[t]hese are legitimate—and undisputed—concerns,” with which this Court
sympathizes. However, as of December 6, 2012, more than eleven months
remained to sue appellees within two years of the date of Thomas’s gastric bypass
surgery on November 14, 2011. The Texas Supreme Court has held that the open
courts provision allows a patient to avoid the absolute two-year limitations only if
it would be impossible or exceedingly difficult to discover the injury and sue
within that period. See Nelson, 678 S.W.2d 921–22. Because Thomas had more
than eleven months after discovering her injury in which to file her claim, we
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cannot say that conditions made it impossible for her to do so. See Wiseman, 107
S.W.3d at 708–09 (“It is quite understandable that [the plaintiff] would concentrate
on fighting her disease before pursuing her medical negligence claims, but because
she had four months after discovering her injury in which to file such a claim
against [the defendant], we cannot say that conditions made it impossible for her to
do so.”); Adkins, 871 S.W.2d at 295 (concluding mere fact that plaintiffs could not
find lawyer to file their suit until after it was time-barred did not affect
constitutionality of statute).
Thomas failed to raise a fact issue establishing that she did not have a
reasonable opportunity to discover the alleged wrong and bring suit within the
limitations period. Therefore, the open courts provision does not apply to save her
time-barred negligence claim.
The trial court did not err in granting appellees’ motions for summary
judgment. We overrule Thomas’s issue.
Conclusion
We affirm the trial court’s judgment.
Russell Lloyd
Justice
Panel consists of Justices Keyes, Massengale, and Lloyd.
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