Patient's treatment was continuous, Va. SC rules in statute of limitations case

By Jessica M. Karmasek | May 3, 2011

RICHMOND, Va. (Legal Newsline) - The Virginia Supreme Court has reversed the judgment of a circuit court in favor of a radiology group, saying the court erred in sustaining the group's plea of the statute of limitations.

In December 2002, Alyssa Chalifoux saw her family physician, Dr. David Stein, after experiencing headaches and other symptoms on the right side of her face.

Stein referred Chalifoux for a brain magnetic resonance imaging, or MRI, with Radiology Associates of Richmond Inc. at Henrico Doctors' Hospital. The requested brain MRI was performed on Dec. 23, 2002. Dr. Robert Y. Fidler Jr., a radiologist at Radiology Associates, interpreted the MRI and found no abnormalities. On Dec. 24, 2002, Fidler electronically signed a report of his findings and issued the results to Stein.

Stein then referred Chalifoux to Dr. John D. Blevins, a neurologist. Chalifoux saw Blevins on March 4, 2003 after experiencing severe pain on the right side of her face. Blevins referred Chalifoux to Radiology Associates for another brain MRI and a magnetic resonance angiography, or MRA, of the head.

The requested brain MRI and head MRA were performed on March 9, 2003. Dr. A. John Kuta, a neuroradiologist at Radiology Associates, read the images and reported no abnormalities. Kuta electronically signed his reports and issued the results to Blevins on March 10, 2003.

According to Blevins' records, Chalifoux also experienced numbness on the right side of her face on April 11, 2003 and July 21, 2003. After the July visit, Blevins recommended another brain MRI to evaluate Chalifoux's symptoms. Blevins added that if the tests were negative, Chalifoux could follow up in six months.

On Aug. 2, 2003, Chalifoux received another brain MRI and an imaging of the skull. Dr. J. Keith Thompson, a radiologist at Radiology Associates, read the images and reported no abnormalities. Thompson electronically signed his reports and issued the results to Blevins on Aug. 2, 2003.

About six months later, Chalifoux received another brain MRI. Thompson issued another brain MRI report to Blevins on Feb. 16, 2004. Again, he found no abnormalities.

Chalifoux saw Blevins again on Oct. 17, 2005 for her ongoing pain and numbness on the right side of her face. Blevins ordered another brain MRI.

On Oct. 22, 2005, Chalifoux received an MRI of the internal auditory canal. This time, Kuta detected an "abnormality in the region of the right cavernous sinus." In his report, Kuta noted that the abnormality "probably has been the cause of the patient's clinical symptoms and in retrospect is visible on the previous exams dating to 12-23-02." Kuta electronically signed his report and issued the results to Blevins on Oct. 24, 2005.

On Oct. 12, 2007, Chalifoux filed a lawsuit against Radiology Associates in the Circuit Court of the City of Richmond. Chalifoux later filed an amended complaint increasing the ad damnum. In her amended complaint, Chalifoux alleged she "exhibited symptoms on the right side of her face consistent with a tumor in the trigemenial region of her brain" from December 2002 through October 2005, and that Radiology Associates negligently read and interpreted various radiological studies that would have shown this tumor as early as December 2002.

Radiology Associates filed a plea of the statute of limitations and requested an evidentiary hearing. The group asserted that Chalifoux's suit was time-barred by the two-year statute of limitations for personal injuries, and that the so-called "continuing treatment rule" does not apply in this instance because the care she received from the radiologists was episodic.

The circuit court sustained Radiology Associates' plea of the statute of limitations. According to its Oct. 1, 2009 opinion, the court said Chalifoux's treatments were "single, isolated acts which do not toll the statute of limitations under the continuous treatment rule." The court found that the comparison of test results by Radiology Associates suggests adherence to appropriate diagnostic procedure, rather than an assumption of ongoing treatment. The court further found that the treatment rendered by the radiologists was terminated after Radiology Associates produced their reports and sent them to Chalifoux's clinical physicians.

The circuit court denied a motion for reconsideration by Chalifoux and dismissed the case. The state's high court took up Chalifoux's appeal.

At issue, the Court said, is whether services rendered by the radiology group were single, isolated acts or a part of the patient's continuing treatment. This would determine when the statute of limitations began to run, it said.

The Court, in its majority ruling filed April 21, said "a continuous and substantially uninterrupted course of examination and treatment" existed between Chalifoux and Radiology Associates. Senior Justice Lawrence L. Koontz Jr. wrote the Court's 16-page opinion.

"There is evidence that Radiology Associates was aware of Chalifoux's ongoing symptoms because all the studies were kept in one file under Chalifoux's name, and both experts in this case testified that radiologists frequently review previous examinations, especially when they relate to the same symptoms," it wrote.

Therefore, the Court said, the circuit court erred in not applying the continuing treatment rule to the facts of the case.

The statute of limitations began to run on Oct. 24, 2005, the day the physician-patient relationship between Radiology Associates and Chalifoux ended, the Court noted. Thus, Chalifoux's suit brought on Oct. 12, 2007 was within the applicable two-year statute of limitations, it said.

In addition to reversing the circuit court's judgment, the Court remanded the case.

From Legal Newsline: Reach Jessica Karmasek by e-mail at

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