Meekins v. St. John's Regional Health Center, Inc.

PHILLIP R. GARRISON, Presiding Judge,

concurs in part and dissents in part.

I concur in the result reached in the majority opinion with reference to Mee-kins’ first point on appeal. I respectfully dissent, however, with reference to the second.

The trial court, without specifying the grounds upon which it acted, dismissed the second count of Meekins’ petition. As pointed out by the majority opinion, we presume that the dismissal was based on one or more of the reasons stated in the motion to dismiss. Here, St. John’s filed two motions to dismiss. The first, as it related to the count for damages, was based on Meekins’ failure to file the affidavit required by § 538.225.1 in an action against a health care provider for damages for personal injury or death on account of the rendering of or failure to render health care services. The second was based on the two-year statute of limitations pursuant to § 516.105.

In holding that the trial court erroneously dismissed Count II of the petition, the majority opinion concludes that “we determine that a drug screen test performed by a hospital is not a health care service if such is not performed within the confines of a physician/patient relationship.” It thus seems to conclude that here the two-year statute of limitations and the *534requirement of an affidavit by a qualified health care provider do not apply because the drug screen test was not a health care service as a consequence of there being no physician/patient relationship between Meekins and St. John’s. I disagree with this conclusion for several reasons.

First, the basis for the majority’s conclusion is unclear, but appears to be related to Meekins’ statement in her point relied on that “[St. John’s] is not a health care provider when performing a drug screen at any employer’s discretion, not in the course of necessary treatment.” That statement, together with Meekins’ statements in the Statement of Facts portion of her brief concerning the background and circumstances surrounding the drug screening are completely foreign to the record on appeal. Meekins admits that in her Statement of Facts, and St. John’s, in its brief, argues that this appeal should be dismissed because of Meekins’ violation of Rule 84.04(c).1

We cannot consider matters that are not part of the record on appeal. Denny’s Inc. v. Avesta Enter. Ltd., 884 S.W.2d 281, 291 (Mo.App. W.D.1994); Miller v. River Hills Dev., 831 S.W.2d 756, 757 (Mo.App. E.D.1992). In particular we cannot accept statements in a party’s brief as a substitute for the record on appeal. Trout v. Gen. Sec. Serv. Corp., 8 S.W.3d 126, 130 (Mo.App. S.D.1999); Rice v. State, Dept. of Social Serv., 971 S.W.2d 840, 842 (Mo.App. E.D.1998).

Additionally, the majority cites Millard v. Corrado, 14 S.W.3d 42, 49 (Mo.App. E.D.1999) for the proposition that “absent [a] physician/patient relationship, a medical malpractice claim must fail.” That case was against an individual physician and the issue was the propriety of the entry of summary judgment. As stated in Richardson v. Rohrbaugh, 857 S.W.2d 415, 417-418 (Mo.App. E.D.1993), “[i]n order to maintain a cause of action in tort against a doctor, appellants must first establish a physician/patient relationship.” “A physician’s liability to a patient is predicated on the existence of a physician-patient relationship.” Corbet v. McKinney, 980 S.W.2d 166, 169 (Mo.App. E.D.1998). I am not aware of any Missouri cases holding that a “physician/patient” relationship must exist between a hospital and patient as a predicate for a medical malpractice claim to be viable. In construing § 538.225, courts have held that a health care affidavit is required if the relationship of the parties is that of health care provider and recipient, and if the true claim relates only to the provision of health care services. Vitale v. Sandow, 912 S.W.2d 121, 122 (Mo.App. W.D.1995).

Here, the partiefe admit that St. John’s is a hospital. Once a hospital accepts a patient, it owes that patient a specific duty of reasonable care proportionate to the patient’s needs as the patient’s known condition requires to safeguard and protect that patient from injury. Poluski v. Richardson Transp., 877 S.W.2d 709, 713 (Mo.App. E.D.1994). According to § 538.225.1, an affidavit from a qualified health care provider is required in “any action against a health care provider for damages for personal injury or death on account of the rendering of or failure to render health care services.” Section 516.105 applies the two-year statute of limitations to “[a]ll actions against physicians, hospitals, ... and any other entity providing health care services ... for damages for malpractice, negligence, error or mistake related to *535health care.” “Any act or omission related to the care, custody, or treatment of the patient, whether pled as ordinary negligence or negligence relating to malpractice is covered under section 516.105.” Robinson v. Health Midwest Dev. Group, 58 S.W.3d 519, 522 (Mo. banc 2001).

Second, the majority’s declaration, as a matter of law, “that a drug screen test performed by a hospital is not a health care service if such is not performed within the confines of a physician/patient relationship” seems to me to be contrary to the definition of health care services. Section 538.205(5) defines “health care services” as:

any services that a health care provider renders to a patient in the ordinary course of the health care provider’s profession or, if the health care provider is an institution, in the ordinary course of farthering the purposes for which the institution is organized. Professional services shall include, but are not limited to, transfer to a patient of goods or services incidental or pursuant to the practice of the health care provider’s profession or in furtherance of the purposes for which an institutional health care provider is organized.

Within the confines of the record before the trial court, I do not believe we can say as a matter of law that the drug screen test here was not a health care service thereby excluding the application of § 538.225.1, as well as § 516.105.

Third, it is significant that Meekins’ counsel conceded to the trial court that St. John’s motion to dismiss for failure to file the affidavit required by § 538.225.1 was well taken. In particular, he filed a response to St. John’s first motion to dismiss in which he specifically admitted the accuracy of St. John’s analysis that the claim for damages should be dismissed because “(a) [St. John’s] is a health care provider as defined by [§ ] 538.205(4) RSMo, (b) a drug screen test falls within the broad definition of ‘health care service’ as defined in [§ ] 538.225(5) RSMo, and, therefore, a health care affidavit should have been filed within ninety (90) days of filing [Meekins’] Petition.” Meekins’ counsel also stated: “[t]herefore, [St. John’s] is correct that a health care affidavit is required. Count II is, in essence, a medical malpractice cause of action. As pleaded, it is a viable cause of action, but cannot be litigated without the requisite health care affidavit.” That response was filed on August 25, 2003. The next day, August 26, 2003, St. John’s filed a second motion to dismiss based on the two-year statute of limitations. That was the status of the record when the trial court entered its judgment dismissing the petition seven and one-half months later.

The majority opinion holds that the statements by Meekins’ counsel were not judicial admissions, citing Owens v. Dougherty, 84 S.W.3d 542, 547 (Mo.App. S.D.2002). The language from Owens cited by the majority, however, would seem to indicate that Meekins’ admissions in the written response to St. John’s first motion to dismiss were in fact judicial admissions. See also Francis v. Richardson, 978 S.W.2d 70, 73 (Mo.App. S.D.1998) (“[a] judicial admission is ‘a more or less formal act done in the course of judicial proceedings which waives or dispenses with the production of evidence and concedes for the purpose of the litigation that a certain proposition is true.’ ... ‘It removes the proposition in question from the field of disputed issues in the particular case wherein it is made.’ ”).

Some courts, in deciding whether a matter has been judicially admitted, have considered whether the opposing party relied on statements as admissions. Piel v. Piel, 918 S.W.2d 373, 375-76 (Mo.App. E.D.1996). Here, St. John’s specifically relied *536on the admissions of Meekins’ counsel in its second motion to dismiss, based on the statute of limitations, filed the next day.

Even if the statements of Meekins’ counsel were not judicial admissions, they were before the trial court when it ruled on the motions to dismiss. At that time, the status of the record was that the petition alleged that St. John’s was a non-profit hospital incorporated under Chapter 355 RSMo; it performed a drug screen on Meekins which showed positive for methamphetamine; that the drug screen was not correct; that St. John’s had a duty to properly perform and/or use a drug screen test process that was accurate and reliable; and that St. John’s breached its duty by either improperly performing the test and/or using an unreliable testing procedure with resulting damage to Meekins. It was in the face of those allegations of the petition that Meekins’ counsel informed the trial court that St. John’s was correct that this is a medical malpractice suit for which there must be an affidavit pursuant to § 538.225.1.

The majority also acknowledges the premise that a party may not present a new or different theory on appeal than was before the trial court, citing In re Marriage of Parmenter, 81 S.W.3d 234, 240 (Mo.App. S.D.2002). This court said in Parmenter that “[ajppellate courts are merely courts of review for trial court errors, and there can be no review of a legal proposition which was not presented to or expressly decided by the trial court.” Id. The majority avoids these principles by noting that Meekins later argued in a motion for reconsideration that her petition should not have been dismissed because her “causes of action do not sound in medical malpractice and the two[-]year statute of limitation and affidavit do not apply.” That motion was filed on April 28, 2004, after the final judgment had been entered on April 8, 2004. In my view the fallacy of the majority’s reasoning is that this is not an appeal from a denial of the motion for reconsideration. It is an appeal from the granting of the motions to dismiss. The trial court, when it ruled the motions to dismiss, did not have before it any contention other than the allegations in Meekins’ petition and her acknowledgment that this was a medical malpractice suit subject to the required filing of a § 538.225.1 affidavit. Based on the record here, the contrary contention was not placed before the trial court until after the petition was dismissed. The notice of appeal filed by Meekins specifically identifies the judgment appealed from as that of April 8, 2004, dismissing the petition. No appeal was taken, and no issue is raised on this appeal, concerning the overruling of Mee-kins’ motion for reconsideration in which she sought to take a different position on the nature of the action, the applicability of § 538.225.1, and the applicable statute of limitations.

As indicated, the second motion to dismiss filed by St. John’s was based on the two-year statute of limitation provided by § 516.105. Although not mentioned by the parties to this appeal, I note that the limitations period under that statute was not raised as an affirmative defense in the answer filed by St. John’s. A statute of limitations is an affirmative defense that is waived if not raised; a party raising the statute of limitations carries the burden of both pleading and proving the defense; and limitations is not one of the enumerated defenses under Rule 55.27 that may be raised by a motion rather than in an answer. Yahne v. Pettis County Sheriff Dept., 73 S.W.3d 717, 719 (Mo.App. W.D.2002). Where a statute of limitations is asserted in support of a motion to dismiss, the petition should not be dismissed unless the petition clearly establishes on its face and without exception that it is time *537barred. Id. Here, the petition, together with the admissions of Meekins established that the suit is one for medical malpractice governed by the two-year statute of limitations provided in § 516.105. The petition clearly alleged that the act complained of occurred on November 1, 2000, and that the suit was filed on March 19, 2003. Under § 516.105 the action must be brought within two years from the date of occurrence of the act of neglect complained of. Weiss v. Rojanasathit, 975 S.W.2d 113, 119 (Mo. banc 1998). Here, the fact that the statute of limitations was raised in the motion did not prevent the trial court from dismissing Count II of the petition on that basis.

I would also affirm the dismissal of Count II.

. I would deny the request to dismiss the appeal, and would decide the case on the merits.