In its written opinion released in advance on April 3, 2017, the Connecticut Supreme Court clarified the contours of the relation back doctrine as applied to medical malpractice claims, holding that the Connecticut Appellate Court properly held that the plaintiff’s amended medical malpractice complaint related back to the original complaint and that the trial court’s denial of the plaintiff’s request to amend and its subsequent granting of the defendants’ motion for summary judgment should be reversed.
The Relation Back Doctrine
The relation back doctrine provides that an amendment relates back when the original complaint has given the party fair notice that a claim is being asserted stemming from a particular transaction or occurrence, thereby serving the objectives of Connecticut’s statute of limitations, namely, to protect parties from having to defend against stale claims.
Where the proposed allegations promote a change in or an addition to a ground of negligence arising out of a single group of facts, the Connecticut Supreme Court has allowed use of the relation back doctrine. In the cases in which the Connecticut Supreme Court has determined that an amendment does not relate back to an earlier pleading, the amendment presented different issues or depended on different factual circumstances rather than merely amplifying or expanding upon previous allegations (where new allegations directly contradict those in the operative complaint, they do not relate back to those in the operative complaint).
In the case it was deciding, the Connecticut medical malpractice plaintiff filed a medical malpractice case against an orthopedic surgeon and the orthopedic surgeon’s medical practice, alleging medical malpractice during a spinal surgery resulting in the plaintiff suffering quadriparesis. After the expiration of the relevant statute of limitations (Connecticut General Statutes § 52-584), the plaintiff sought to amend his medical malpractice complaint: both the original complaint and amended complaint included claims that the defendant orthopedic surgeon failed to properly plan and to perform the surgery through the use of an instrumentality in his control.
The plaintiff’s original medical malpractice complaint, however, included detailed allegations of the improper usage of a skull clamp. In his proposed amended complaint, the plaintiff replaced those detailed allegations with allegations of the improper use of a retractor blade.
The trial court denied the request to amend, narrowly construing the original complaint as limited to a claim of the negligent usage of the skull clamp and subsequently granted the defendants’ motion for summary judgment because the plaintiff had abandoned the theory that negligent use of the skull clamp had caused his injury.
The Appellate Court reversed the trial court’s denial of the plaintiff’s request to amend, broadly construing the original complaint as a claim of negligence in performing the surgery, which could be supported by either set of factual allegations. The defendants appealed, requesting that the Connecticut Supreme Court adopt the narrower approach used by the trial court and to reverse the judgment of the Appellate Court.
The Connecticut Supreme Court Decision
The Connecticut Supreme Court stated that the modern trend, which is followed in Connecticut, is to construe pleadings broadly and realistically, rather than narrowly and technically. The complaint must be read in its entirety in such a way as to give effect to the pleading with reference to the general theory upon which it proceeded, and do substantial justice between the parties. The reading of pleadings in a manner that advances substantial justice means that a pleading must be construed reasonably, to contain all that it fairly means, but carries with it the related proposition that it must not be contorted in such a way so as to strain the bounds of rational comprehension.
The Connecticut Supreme Court stated that in order to provide fair notice to the opposing party, the proposed new or changed allegation of negligence must fall within the scope of the original cause of action, which is the transaction or occurrence underpinning the plaintiff’s legal claim against the defendant. Determination of what the original cause of action is requires a case-by-case inquiry by the trial court. In making such a determination, the trial court must not view the allegations so narrowly that any amendment changing or enhancing the original allegations would be deemed to constitute a different cause of action. But the trial court also must not generalize so far from the specific allegations that the cause of action ceases to pertain to a specific transaction or occurrence between the parties that was identified in the original complaint.
The Connecticut Supreme Court stated that if new allegations state a set of facts that contradict the original cause of action, which is the transaction or occurrence underpinning the plaintiff’s legal claim against the defendant, then it is clear that the new allegations do not fall within the scope of the original cause of action and, therefore, do not relate back to the original pleading. But an absence of a direct contradiction must not end the trial court’s inquiry. The trial court must still determine whether the new allegations support and amplify the original cause of action or state a new cause of action entirely. Relevant factors for this inquiry include, but are not limited to, whether the original and the new allegations involve the same actor or actors, allege events that occurred during the same period of time, occurred at the same location, resulted in the same injury, allege substantially similar types of behavior, and require the same types of evidence and experts.
In the case it was deciding, the Connecticut Supreme Court held that the plaintiff’s cause of action is that the defendant orthopedic surgeon negligently performed spinal surgery on the plaintiff, resulting in the plaintiff’s injuries. While count one of the original complaint does focus on improper use of the skull clamp, read as a whole it includes more general allegations that the defendant orthopedic surgeon failed to properly perform the surgery. Reading the two counts of the plaintiff’s original medical malpractice complaint together, the transaction or occurrence that formed the basis of the plaintiff’s claim was that the defendant orthopedic surgeon improperly used medical instruments during the plaintiff’s spinal surgery, resulting in his injury. Therefore, the plaintiff adequately put the defendants on notice that his claim related to the defendant orthopedic surgeon’s conduct during the surgery and, more specifically, his use of medical instruments during the surgery.
The Connecticut Supreme Court noted that the plaintiff’s amended medical malpractice complaint added new allegations that the defendant orthopedic surgeon improperly used the retractor blade during surgery and removed the allegations related to the skull clamp. The retractor blade allegations do not contradict the theory that the defendant orthopedic surgeon improperly used medical instruments during surgery. Instead, they constitute a change in and addition to an act of negligence, which is permitted under the relation back doctrine. Specifically, the single transaction or occurrence that constituted the cause of action was the negligent use of medical instruments during the plaintiff’s spinal surgery in the operating room by the defendant orthopedic surgeon, and this negligence caused the plaintiff to suffer quadriparesis.
The Connecticut Supreme Court held that the plaintiff’s amended medical malpractice complaint related back to the original complaint and that the trial court’s denial of the plaintiff’s request to amend and its subsequent granting of the defendants’ motion for summary judgment should be reversed, and the Connecticut Supreme Court therefore affirmed the judgment of the Appellate Court.
Source Briere v. Greater Hartford Orthopedic Group, P.C., SC 19576.
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