dissenting:
The majority concludes that in order for a claim to accrue under the “discovery rule,” the claimant must know or by exercise of reasonable diligence should know of the injury, its cause in fact and have some knowledge of the wrongful conduct involved. Applying the foregoing test, the majority holds that appellant’s claim is not time-barred by the statute of limitations and, therefore, the trial court’s order granting summary judgment for appellee was erroneous. I view the majority opinion as an unfounded extension of this court’s decision in Burns v. Bell, 409 A.2d 614 (D.C.1979). I therefore dissent.
In Bums, the decision upon which the majority relies to support its broadening of the discovery rule, this court spoke strictly in terms of “knowledge of injury” as being the essential discovery required in order for a claim to accrue and, consequently, for the statute of limitations to run. We specifically stated: “[I]n all medical malpractice actions, the cause of action accrues when the plaintiff knows or through the exercise of due diligence should have known of the injury.” Id. at 617 (emphasis added). In my view, the majority has disregarded the plain meaning of the Bums language by inferring that more than mere knowledge of the injury is necessary before a claim can accrue. In Bums, this court did not set out implicitly to make accrual contingent upon the plaintiff’s knowledge of actionable harm. Rather, Bums modified the “time of injury rule,” see Shehyn v. District of Columbia, 392 A.2d 1008, 1013 (D.C.1978), by holding that the point at'which an injury should reasonably have been discovered is largely a function of the circumstances of the particular case. Specifically, we held that in a medical malpractice case the tort-feasor’s statements and actions, or lack thereof, may be considered when determining the point of time at which the plaintiff gained knowledge of the injury. Burns, supra, 409 A.2d at 617. Thus, if a patient were to receive repeated, uncontradicted assurances from his physician that a particular physical manifestation is characteristic during the post-surgery healing period and that this condition would improve, that patient may not reasonably be expected to know, while receiving those assurances, that the condition was, in fact, an injury. Similarly, if a person were to undergo continued treatment following surgery for a condition that developed as a result of the surgery, that individual may not reasonably be expected to have known that the post-surgical condition was actually an injury until after the follow-up treatment had run its course.
*437I believe that Bums reflected this court’s understanding that the question of whether a plaintiff had knowledge of his injury may depend upon the defendant’s conduct even after manifestations of the injury were present. In other words, a defendant’s conduct after the tortious act occurs may prevent the plaintiff from gaining knowledge of the injury and, thus, preclude the claim from accruing. Bums did not state, explicitly nor implicitly, that a plaintiff must be aware that the conduct causing the harm was wrongful or actionable in order for the claim to accrue.
The majority’s effort to broaden the meaning of Bums beyond that which was intended is illustrated by this court’s more recent decision in Kelton v. District of Columbia, 413 A.2d 919 (D.C.1980). In Kelton, we restated the discovery rule as announced in Bums and noted this court’s unwillingness to expand it any further. 413 A.2d at 921 n. 4. More pointedly, in the same footnote, we quoted with approval United States v. Kubrick, 444 U.S. 111, 123, 100 S.Ct. 352, 360, 62 L.Ed.2d 259 (1979), noting the Supreme Court’s adoption of “a Bums -type standard” and rejection of the “conclusion ‘that Congress intended that ‘accrual’ of a claim must await awareness by the plaintiff that his injury was negligently inflicted....’” Kelton, supra, 413 A.2d at 921 n. 4.
In Kubrick, the Supreme Court modified the discovery rule by holding that a claim does not accrue until the plaintiff has discovered both his injury and its cause in fact. 444 U.S. at 122-24, 100 S.Ct. at 359-60. Because Kubrick was a medical malpractice case which arose under the Federal Tort Claims Act, 28 U.S.C. §§ 2674 et seq. (1982), the determination of when a claim accrues under the Act involved considerations of sovereign immunity — a factor obviously not of concern to this court. However, I believe the standards set forth in Kubrick are relevant ones for our consideration here, and I urge that accrual under the discovery rule occur at that point in time when the claimant has discovered both his injury and its cause in fact.
With knowledge of the fact of injury and its cause, the claimant of malpractice is on the same footing as any other person claiming negligence. I do not perceive an undue burden in putting the plaintiff on notice that diligence from that point is required in determining whether there has been, in addition, a legal wrong. Once a plaintiff discovers, or should have discovered through due diligence, his injury and who caused the injury, he must “determine within the period of limitations whether to sue or not_” Kubrick, supra, 444 U.S. at 124, 100 S.Ct. at 360. Thus, the previously expressed policy of this court, see Bums v. Bell, supra, that the discovery rule be utilized to alleviate the inequities of the time of the injury rule, is accomplished by putting the medical malpractice plaintiff on an equal footing with any other plaintiff claiming negligence.
Here, using both knowledge of injury and its cause as the sole determinants for ascertaining when a claim has accrued, it is apparent that appellant’s claim accrued more than three years prior to the date the suit was filed. Viewing, as this court must, the record in the light most favorable to appellant, it clearly demonstrates knowledge of an injury as early as March 7,1980. In appellant’s letter of that date to the Dean of the Georgetown Dental School, she states that as a result of the student-dentist’s “forceful” efforts to seat a number of crowns her gums had receded and were “irritated and inflamed.” In addition, she stated that “all of the trauma” associated with the student-dentist’s efforts had affected her nervous system. Further, she subsequently wrote on March 11 that she suffered from “irritation to the tissues surrounding the teeth, muscular nervous spasms of the body ... disruption of sleeping habits and recurrent headaches.” These statements demonstrate knowledge of an injury. Furthermore, the statements indicate that appellant had made the connection between her injury and its cause. *438Specifically, in the March 11 letter she complains that her symptoms are “directly related” to the treatment she received at Georgetown.
The fact that appellant did not then comprehend the full extent, exact nature or medical description of her injury does not matter, for the law of limitations requires only that she have “inquiry notice of the existence of a cause of action for personal injury.” Baker v. A.H. Robins Co., 613 F.Supp. 994, 996 (D.D.C.1985); Caldwell v. A.H. Robins Co., 577 F.Supp. 796, 797-98 (D.C.Pa.), aff'd, 735 F.2d 1347 (3d Cir.1984), cert. denied, 469 U.S. 862, 105 S.Ct. 197, 83 L.Ed.2d 129 (1984). Once the putative plaintiff is on notice of some physically ascertainable harm, as appellant was here, she is in no different a position than the victim of more commonplace negligence. Both plaintiffs are similarly on notice that they must investigate and ascertain the nature and extent of their injury and resulting damages. More importantly, each must get to the court within the statutory period. To hold otherwise would have the effect of allowing the statute to start anew with the onset of each successive complication or development.
Appellant contends that throughout her treatment, she was consistently advised by Georgetown that her discomfort was the result of a 1977 injury and not the result of any dental work done at Georgetown. Therefore, the question arises whether appellant reasonably relied upon the representations of her treating physician, and if so, whether such reliance creates an issue of material fact as to when she discovered who caused her injury.
Similar to the inquiry as to when an injury was discovered, the determination as to when the cause of the injury was discovered may also take into account actions or statements of the defendant. Representations made by a defendant may prevent a plaintiff from learning of either the existence of an injury or its cause in fact. See Burns v. Bell, supra, 409 A.2d at 617 (statements by physician create question of fact as to when plaintiff should have discovered her injury).
Unlike the claimant in Bums, appellant was not satisfied with the representations made to her by the treating physician. On several occasions following the crowning of her teeth, she visited private dentists who advised her to return to Georgetown for corrective treatment. Specifically, in appellant’s “Chronology of Injury,” which was attached to her March 11 letter to Georgetown University, appellant wrote that on December 28, 1979, she visited one Dr. Yuhaniak, who advised her to bring to Georgetown’s attention the “unprofessional conduct” of the student-dentist. Yuhan-iak further informed appellant that the crowns had been improperly placed. On May 5, 1980, appellant went to another private dentist because the gum area surrounding the crowned teeth was “still puffy.” Further, appellant was advised sometime prior to May 8,1980, that if there was a problem with the position of the number eight tooth, that it should not have been crowned.
It is true that, like the plaintiff in Bums, appellant has no medical expertise. However, appellant had the benefit of the considered opinions of no less than three private practitioners. The opinions expressed by these dentists gave appellant “an accurate way of knowing whether the assurances given her [by Georgetown] were reasonable.” Burns, supra, 409 A.2d at 617.
It is clear from appellant’s correspondence that she believed she had suffered an injury caused by Georgetown and that she sought out independent advice to confirm her opinion. Her opinion having been confirmed no later than May of 1980, she cannot now claim that she, like Burns, relied upon the assurances of the defendant. When appellant discovered her injury and its cause, the limitations period began to run. To hold otherwise would, I believe, allow a putative plaintiff in possession of all of the critical facts of injury and causation to toll the running of the statute by repeatedly returning to the source of the *439treatment or advice for “assurances” that no injury has been caused.
The majority has chosen to broaden the rule of Burns v. Bell. I would agree with their adoption of knowledge of cause in fact as a finding required before a malpractice claim may accrue. I dissent from adopting the majority’s additional requirement that a plaintiff have knowledge of the defendant’s wrongful conduct in order for a claim to accrue. This latter requirement is neither implicit in the Burns holding, as the majority states, nor is it a prudent extension of our current test for determining when accrual occurs. Because, in my. view, appellant had both knowledge of her injury and its cause more than three years before her claim was filed, I would affirm the trial court’s finding that the statute of limitations had expired and that appellee was entitled to summary judgment.
My colleagues’ expansion of Bums v. Bell is, in my view, an unwise step in the many steps state courts have taken to expand tort liability to a point of systemic injury to the national economy. I believe it a step inconsistent with M.A.P. v. Ryan, 285 A.2d 310 (D.C.1971), requiring us to adhere to Bums. It is also a decision of exceptional importance.