We granted writ to determine whether survival actions and/or wrongful death actions are governed by the prescriptive period set forth in LSA-R.S. 9:5628.
Dr. William R. Giddens, an internist at The Diagnostic Clinic in Shreveport, was initially visited by Connolly Logan Taylor ("Mrs. Taylor") in June, 1982. She complained of dysphagia, a difficulty in swallowing solids. Dr. Giddens referred her to the radiologists at Schumpert Memorial Medical Center ("Schumpert") for upper GI x-rays. He allegedly gave her a note to give to the radiologist with "dysphagia, upper GI" written on it and instructed her to inform the radiologist about her dysphagia. While scheduling her x-ray examination, Dr. Giddens attempted to contact the radiologist who would have the x-ray assignment. Even though he did not speak with the radiologist, he expected Mrs. Taylor's esophagus to be x-rayed.
Dr. Jack E. Carlisle, a radiologist at Schumpert, x-rayed Mrs. Taylor. He allegedly did not receive Dr. Giddens' note and was not alerted by Mrs. Taylor to the dysphagia when he took her history.
After the x-rays were taken, Mrs. Taylor told her husband, Frank Taylor ("Mr. Taylor"), that the x-rays were "botched-up." The wife of the mayor of Shreveport had arrived for tests at Schumpert and was given VIP treatment, delaying Mrs. Taylor's appointment. She also told her husband Dr. Giddens' diagnosis was ridiculous. He said she did not believe the diagnosis.
Mrs. Taylor's symptoms abated and the family took a month vacation to the Bahamas. Upon their return to Shreveport, Mrs. Taylor's dysphagia worsened. While perusing a medical book at a bookstore, she diagnosed herself as having esophageal cancer. Rather than return to Dr. Giddens, she went to a gastroenterologist, Dr. Thomas V. Allen. Due to the persistence of the dysphagia and her previous negative x-rays, he performed two diagnostic tests, an esophageal motility, which showed esophageal spasms, and an esophagoscopy. The esophagoscopy showed a mass in the lining of the esophagus with a narrowing in the opening of the esophagus. Dr. Allen took two biopsies, the washing showed a class IV pap smear and the pinch showed a
Mr. Taylor, a businessman and a Tulane Law School graduate, had telephoned Dr. Giddens on September 23, 1982, and informed him that his wife had been reading medical books and, due to her research on the subject and the persistence of her symptoms, suspected that she might have cancer of the esophagus. Dr. Giddens indicated he would contact Drs. Wilder, Allen or McGinty to schedule an esophagoscopy. Consequently, Dr. Giddens was surprised to discover on September 27, 1982, that Mrs. Taylor had been esophagoscoped by Dr. Allen and the biopsy was positive. Dr. Giddens testified that,
Mr. Taylor admits that he knew in September 1982 that Dr. Giddens reported his wife's esophagus was normal and Dr. Allen diagnosed cancer of the esophagus. He testified that her primary treating physician was Dr. Frazier at St. Luke's in Houston, Texas, and her nutritionist was Dr. Dudrick, also at St. Luke's.
Mrs. Taylor died on January 9, 1985. In February, 1985, Mr. Taylor questioned the internist and radiologist for the first time concerning the basis for their failure to diagnose the cancer. He learned that Mrs. Taylor's esophagus had been examined, but it had not been x-rayed. Thereafter, Mr. Taylor and Mrs. Taylor's children filed a petition for the appointment of a medical review panel with the Commissioner of Insurance on January 8, 1986, pursuant to the Medical Malpractice Act, LSA-R.S. 40:1299.41 et seq, naming the internist and radiologists as defendants.
The defendants filed peremptory exceptions of prescription against the petition in district court, claiming the actions had prescribed under both the one and the three year time limitations set forth in LSA-R.S. 9:5628. The plaintiffs amended their petition, but the trial court sustained the exception. The plaintiffs filed a second amending petition alleging the defendants withheld information concerning the basis for the failure to diagnose. Defendants renewed their exceptions and they were sustained by the trial court. The appellate court affirmed, 607 So.2d 878 (La.App.2d Cir.1992), holding that the language of LSA-R.S. 9:5628 is unambiguous and provides no exception for wrongful death and/or survival actions brought beyond the statute's one year and three year prescriptive periods, and that the doctrine of contra non valentem is not factually supported in this case and, nevertheless, could not extend the malpractice action beyond the three year prescriptive period limit. We granted certiorari, 612 So.2d 43 (La. 1993), to determine whether the provisions of LSA-R.S. 9:5628 set forth the prescriptive period for survival and/or wrongful death actions having a genesis in medical malpractice.
The appellate courts of this state are in conflict as to whether LSA-R.S. 9:5628 applies to actions for survival and/or wrongful death. The Second and Fourth Circuits hold that the broad language of LSA-R.S. 9:5628 applies to those actions, while the First and Third Circuits hold the statute is a general law that does not specifically provide for the two actions and therefore must yield to the specific provisions of LSA-C.C. art. 2315, now arts. 2315.1 (survival) and 2315.2 (wrongful death). See Dunn v. North Community Hosp., 545 So.2d 1267 (La.App. 2d Cir.1989), writ den., 550 So.2d 633 (La.1989) [both actions]; Minor v. Casten, 521 So.2d 465 (La.App. 4th Cir.1988) [both actions]; Gover v. Bridges, 486 So.2d 1117 (La.App. 2d Cir.1986), aff'd on other grounds, 497 So.2d 1364 (La.1986)
The polemic statute provides in pertinent part as follows:
The statute's language directs that its provisions contain the prescriptive period for all of the victim's medical malpractice claims and for existing correlative actions, such as the victim's spouse and child[ren]'s action for loss of consortium. The reference in the statute to actions for death seems to encompass all death actions, survival and wrongful death, having a genesis in medical malpractice.
Although both actions arise from a common tort, survival and wrongful death actions are separate and distinct. Guidry v. Theriot, 377 So.2d 319 (La.1979). Each right arises at a different time and addresses itself to the recovery of damages for totally different injuries and losses. Id. The survival action comes into existence simultaneously with the existence of the tort and is transmitted to beneficiaries upon the victim's death and permits recovery only for the damages suffered by the victim from the time of injury to the moment of death. Id. It is in the nature of a succession right. Comment, Wrongful Death: Prescription? Peremption? Confusion! 39 La.L.Rev. 1239, 1249 (1979). On the other hand, the wrongful death action does not arise until the victim dies and it compensates the beneficiaries for their own injuries which they suffer from the moment of the victim's death and thereafter. Guidry v. Theriot, supra. Wrongful death damages compensate beneficiaries for their own injuries. 39 La. L.Rev. 1239, supra at 1249.
Even though the malpractice is not discovered, the victim's medical malpractice claims and the victim's family's claims, such as for loss of consortium, exist from the inception of the tortious act, omission or neglect. Likewise, the survival action, which is a derivative of the malpractice victim's action, is linked to the inception of the tortious act, omission or neglect. The action is based upon the victim's right to recovery being transferred by operation of law to the beneficiary. See Comment, Prescription—What You Don't Know Can Hurt You—Louisiana Adheres To A Three Year Limit On The Discovery Rule 58 Tul.L.Rev. 1547, 1249 (1984). The action is dependent upon the victim having a viable malpractice action on the date of death and must be filed within one year of the malpractice victim's death but, nevertheless, within the three year outward limit of LSA-R.S. 9:5628.
In contrast, the wrongful death action does not necessarily come into existence simultaneously with the malpractice action or even come into existence while the victim's
Though it may have its genesis in an act of malpractice, a wrongful death action is not a malpractice action. From its inception, the action exists only in favor of the victim's beneficiaries. Guidry v. Theriot, supra. Therefore, it is not controlled by the prescriptive period for medical malpractice actions. The reference to actions for death in LSA-R.S. 9:5628 applies solely to survival actions as they are derivative of the malpractice victim's action. Further, wrongful death actions are not dependent upon the victim having a viable malpractice action. The date of the malpractice victim's death determines when the prescriptive period commences running, as that is the date the claimants are injured. The date of the discovery of the malpractice by the victim or the claimants prior to the victim's death, is not consequential.
The determination that the prescriptive period for wrongful death actions arising from acts of medical malpractice are not within the scope of LSA-R.S. 9:5628, does not alter the affect that the Medical Malpractice Act, LSA-R.S. 40:1299.41 et seq, has on wrongful death actions. The actions continue to be governed and procedurally controlled by the provisions of the Act. Rather, because LSA-R.S. 9:5628 does not provide the prescriptive period for wrongful death actions, the commencement and running of its prescriptive period is controlled by the one year liberative period applicable to delictual actions, LSA-C.C. art. 3492, and the action is available to the certain beneficiaries named in LSA-C.C. art. 2315.2 (formerly named in LSA-C.C. art. 2315).
This statutory construction and interpretation satisfies the State's interest in protecting the family unit which is at the core of the wrongful death statute. Comment, Wrongful Death in Louisiana: Too Often A "Cause" Without A "Right" 41 La. L.Rev. 954 (1981). It also prevents the loss of the wrongful death action to a certain class of victims (claimants), an action which was given to all wrongful death victims (claimants) by Acts of 1884, No. 71, and which have been considered since 1884 as a compensable injury and a vested property right. See LSA-C.C. arts. 2315, 2315.2; Guidry v. Theriot, supra; 39 La.L.Rev. 1239, supra at 1241; 58 Tul.L.Rev. 1547, supra 1248. Cf. Crier v. Whitecloud, on reh'g, supra, [when an injury occurs which gives the injured party a cause of action, that cause of action becomes a vested property right which is protected by the guarantee of the due process clause; when a person does not file suit within the prescriptive period, the person has no cause of action and no vested property right]. Additionally, this construction prevents the aura of unconstitutional restriction of access to the courts to a certain class of wrongful death claimants and equally protects the claimant's property interest by insuring they have a period in which to bring their cause of action after it accrues. LSA-Const. Art. I, § 3, Art. I, § 22
The interpretation that wrongful death actions are not within the ambit of LSA-R.S. 9:5628 also balances the interest of society, by allowing that class of tort claimants an opportunity to recover damages from the tortfeasor, against the interest of the public in controlling medical costs, since wrongful death actions have limited types of damages and, generally, the causal connection declines as the period between the alleged act of malpractice and the date of death lengthens.
Therefore, the plaintiffs' wrongful death action, filed within the one year period set forth in LSA-C.C. art. 3492, was timely filed. However, the plaintiffs' survival action, controlled by the prescriptive periods set forth in LSA-R.S. 9:5628 and filed three and one-half years after the tortious act, has prescribed on its face.
Prescription runs against all persons unless exception is established by legislation. LSA-C.C. art. 3467. Nevertheless, plaintiffs claim that prescription was suspended and did not run on their survival action because defendants withheld information concerning the basis of their failure to diagnose, i.e., plaintiffs claim they were not informed that Mrs. Taylor's esophagus was not x-rayed in June, 1982.
Despite the express statutory provision that prescription runs against all persons unless exception is established by legislation, the doctrine of contra non valentem was juridically created as an exception to the general rule, suspending the running of prescription in four general categories. Plaquemines Parish Com'n Council v. Delta Development Co., Inc., 502 So.2d 1034, 1054 (La.1987); Crier v. Whitecloud, on orig hrn'g, 486 So.2d 713 (La.1986), aff'd on rhn'g, 496 So.2d 305 (La.1986). Only the third and fourth categories are relevant to this case. The fourth category, known as the "discovery rule," was expressly made inapplicable to medical malpractice actions filed more than three years after the date of the act, omission or neglect. Rajnowski v. St. Patrick's Hospital, 564 So.2d 671 (La.1990); Hebert v. Doctors Memorial Hospital, 486 So.2d 717 (La. 1986); Crier v. Whitecloud, on rehn'g, supra; Chaney v. State Through the Dept. of Health and Human Resources, 432 So.2d 256 (La.1983); 58 Tul.L.Rev. 1547, supra at 1248. Therefore, as this suit was filed more than three years after the act of malpractice, it is unnecessary to determine the date prescription commenced running on Mrs. Taylor's malpractice action because the discovery rule can not be used to save plaintiffs' survival action.
The applicability of the third category of contra non valentem, where the health care provider himself has done some act effectually to prevent the victim from availing himself of his cause of action for medical malpractice, has been confronted by this court in three cases in recent years. See Rajnowski v. St. Patrick's Hospital, supra; Whitnell v. Menville, 540 So.2d 304 (La.1989); and Gover v. Bridges, 497 So.2d 1364 (La.1986). However, those cases do not expressly declare that the third category of contra non valentem applies to medical malpractice cases to suspend or interrupt prescription. See Rajnowski v. St. Patrick's Hospital, supra (Dennis, J., concurring).
Nevertheless, as in Rajnowski, Drs. Giddens and Carlisle did not prevent Mrs. Taylor or plaintiffs from learning of or availing themselves to her medical malpractice cause of action or their survival action. Since the cancer was diagnosed in September, 1982, the facts were apparent and discoverable. Possession of the x-rays was
The allegations of fraud against the physicians set forth in the second amending petition and supporting affidavit, and the factual support on record, do not rise to the level necessary to trigger the application of the third category of contra non valentem. Therefore, without expanding on jurisprudence of this court on the third category, we find neither the discovery rule nor the ill practices contra non valentem theories can be used to save plaintiffs' survival action from the prescriptive limitations of LSA-R.S. 9:5628.
Plaintiffs also argue that Dr. Giddens continually treated Mrs. Taylor through the duration of her illness and on the basis of his continual treatment and their continued professional relationship, prescription was suspended until her death, citing Trainor v. Young, 561 So.2d 722 (La.App. 2d Cir.1990), writ. den., 567 So.2d 1124, 1125 (La.1990), and Abrams v. Herbert, 590 So.2d 1291 (La.App. 1st Cir.1991) [the basis for interrupting prescription is the premise that the professional relationship is likely to hinder the patient's inclination to sue]. The record, however, including the depositions of Dr. Giddens and Mr. Taylor, belies the plaintiffs' representations of the extent of Mrs. Taylor's professional relationship with Dr. Giddens. The deposition of the physician indicates that, although he attended Mrs. Taylor during her terminal illness, "[he thought] it was common knowledge that Mrs. Taylor and Mr. Taylor's doctors were actually the Houston doctors, and [he] was trying to do what they said, and they wanted us to give her iron and so forth, and we did it." The deposition of Mr. Taylor, taken before the case emphasized the issue of the continuing nature of the patient/physician relationship, accords this view. See note 7, supra.
Since the record fails to evince that the malpractice victim had more than a perfunctory patient-physician relationship with Dr. Giddens, we decline to address the issue of suspension of prescription based upon the patient's continual treatment by the physician tortfeasor.
Plaintiffs' final argument is the unconstitutionality of the statute of limitation in medical malpractice cases. We decline to consider this argument also because plaintiffs have not complied with the prerequisites that the constitutionality of a statute must first be questioned in the trial court and the Attorney General must be served as he is an indispensable party, LSA-C.C.P. art. 1880. Lemire v. New Orleans Public Service, Inc., 458 So.2d 1308 (La.1984).
For the reasons assigned, the judgment sustaining the peremptory exceptions is affirmed as to the survival action and reversed as to the wrongful death action. The case is remanded for further proceedings. The parties are to bear their own costs.
AFFIRMED IN PART, REVERSED IN PART AND REMANDED.
LEMMON, J., concurs and assigns reasons.
DENNIS, J., concurs for the reasons assigned by LEMMON, J.
MARCUS, J., concurs in part, dissents in part and assigns reasons.
LEMMON, Justice, concurring in part.
La.Rev.Stat. 9:5628 provides two prescriptive periods and one peremptive period. The normal period of prescription is one year from the act, omission or neglect constituting the malpractice. The second period of prescription, which is one year from discovery of the act, omission or neglect, incorporates the discovery rule of the fourth category of the doctrine of contra non valentem enunciated in Corsey v. State of La., Department of Corrections, 375 So.2d 1319 (La.1979). The three-year
Since the period of peremption in La.Rev. Stat. 9:5628 was adopted as a limitation on the discovery rule contained in the statute, the limitation must be construed to ban after three years any suit on a cause of action that arose at the time of the act, omission or neglect. A cause of action for wrongful death damages does not arise at the time of the act, omission or neglect. The cause of action in favor of the tort victim's survivors to recover their own damages does not come into existence until the tort victim's death. If plaintiffs had asserted this wrongful death action prior to the tort victim's death, they would have been met with an exception of prematurity.
While La.Rev.Stat. 9:5628 bars any "action for damages for injury or death " (emphasis added) after three years from the act, omission or neglect, the operation of the statute must be limited to causes of action for the tort victim's damages which arose at the time of the act, omission or neglect, and not to causes of action for the tort victim's survivors' own damages which arose after that time.
MARCUS, Justice (concurring in part and dissenting in part).
I concur with the majority opinion insofar as it sustains the exception of prescription as to the survival action; however, I dissent from the holding that the wrongful death action is not prescribed. La.R.S. 9:5628 clearly provides "no action for damages for injury or death" shall be brought unless filed within one year of discovery of the alleged act or at the latest within three years from the alleged act. (emphasis added). By using the word "death," the legislature must have intended to include the wrongful death action, since it is axiomatic that the alleged victim of malpractice could not bring an action for his own death. Accordingly, I am unable to say a suit for wrongful death arising from medical malpractice is not an action for death as contemplated by La.R.S. 9:5628. Rather, I would view La.R.S. 9:5628 as the specific statute to be controlling over the general pronouncement of La.Civ.Code art. 2315.2. For these reasons, I would affirm the decision of the court of appeal's holding that La.R.S. 9:5628 is unambiguous and provides no exception for wrongful death and/or survival actions brought beyond the statute's three year prescriptive period.