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  "id": 8301130,
  "name": "LENA LOCKLEAR, Plaintiff v. STEPHEN L. LANUTI, M.D., STEPHEN L. LANUTI, M.D., P.A., AND SCOTLAND SURGICAL SERVICES, Defendants",
  "name_abbreviation": "Locklear v. Lanuti",
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      "Judges HUDSON and GEER concur."
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    "parties": [
      "LENA LOCKLEAR, Plaintiff v. STEPHEN L. LANUTI, M.D., STEPHEN L. LANUTI, M.D., P.A., AND SCOTLAND SURGICAL SERVICES, Defendants"
    ],
    "opinions": [
      {
        "text": "TYSON, Judge.\nLena Locklear (\u201cplaintiff\u2019) appeals from the trial court\u2019s order granting Stephen L. Lanuti, M.D. (\u201cDr. Lanuti\u201d), Stephen L. Lanuti, M.D., P.A., and Scotland Surgical services\u2019 (collectively, \u201cdefendants\u201d) motion to dismiss. We reverse and remand.\nI. Background\nA. History of Treatment\nOn 27 June 2002, plaintiff filed a complaint against defendants in the Robeson County Superior Court alleging medical malpractice by defendants. Plaintiff\u2019s complaint alleges the following sequence of events.\nOn or about 13 January 1997, plaintiff was seen by Dr. Lanuti for complaints of rectal bleeding, weakness, nausea, and vomiting coffee ground gastric contents. On 15 January, Dr. Lanuti performed an outpatient colonoscopy and esophagogastroduodenoscopy (EGD) procedure. Three biopsy specimens were sent to pathology for identification and description. A rectal polyp was identified as \u201chis-tologically unremarkable rectal mucosa.\u201d Plaintiff was instructed to follow up with Dr. Lanuti in one week. The following day, plaintiff telephoned Dr. Lanuti\u2019s office with complaints of bleeding and pain. Plaintiff was examined in the emergency room of Scotland Memorial Hospital and Plaintiff was released with instructions to follow up with Dr. Lanuti. On 27 January 1997, Dr. Lanuti diagnosed plaintiff with grade III hemorrhoids.\nOn 5 February 1997, plaintiff was again admitted to Scotland Memorial Hospital, diagnosed with grade IV hemorrhoids, and Dr. Lanuti performed a hemorrhoidectomy. On 8 February 1997, Dr. Timothy Moses (\u201cDr. Moses\u201d) provided a consultation for plaintiff for urinary retention, fever, and severe perineal pain. Dr. Moses suspected a perirectal abscess.\nDr. Moses performed a cystourethroscopy with bilateral urethral cath placement. On 9 February, Dr. Lanuti performed a diverting end colonoscopy with Hartman\u2019s Pouch on plaintiff. Plaintiff was discharged from Scotland Memorial Hospital by Dr. Lanuti on 18 February 1997 with final diagnoses of hemorrhoids, a presacral abscess, and insulin-dependent diabetes mellitus. Plaintiff returned for a follow-up with Dr. Lanuti where Dr. Lanuti made a diagnosis of \u201cstatus post rectal perforation.\u201d\nOn 21 May 1997, Dr. Lanuti performed a rigid proctoscopy and lateral sphincterotomy and diagnosed anal stenosis. Plaintiff was seen by Dr. Lanuti on 29 May 1997 and 26 June 1997 for anal stenosis. Dr. Lanuti admitted plaintiff to Scotland Memorial Hospital for a House Anal Advancement Flap operative procedure. On 27 August 1997, Dr. Lanuti performed another colon and rectum operative procedure on plaintiff. On 11 September 1997, plaintiff was seen in follow-up by Dr. Lanuti where Dr. Lanuti found a wound abscess at the surgical incision. Plaintiff was seen again by Dr. Lanuti on 23 September, 9 December, and 30 December 1997 for continued complaints related to her lower gastrointestinal tract.\nOn 3 May 1998, plaintiff was admitted to the emergency room where she was diagnosed with an ileus and an incarcerated ventral hernia. Dr. Lanuti performed a repair of plaintiffs hernia. On 22 December 1998, plaintiff was seen by Dr. Delia Chiaramonte (\u201cDr. Chiaramonte\u201d), who reduced a ventral hernia. Dr. Chiaramonte referred plaintiff back to Dr. Lanuti who performed a repair of multiple incarcerated ventral hernias on 30 December 1997.\nOn 14 May 1999, plaintiff was again admitted to the Scotland Memorial Hospital. Dr. Lanuti found \u201ca ventral abdominal wall hernia with numerous small bowel loops through the defect in the subcutaneous tissues about the umbilicus.\u201d Dr. Lanuti performed a repair of recurrent incarcerated ventral hernias with Gortex mesh. Plaintiff returned to Dr. Lanuti for an open wound which \u201ccommunicates with\u201d the Gortex mesh and which became infected. Plaintiff was admitted to Duke University Medical Center on 13 July 1999, and was seen by Dr. Salvatore Lettieri and Dr. John P. Grant, who made a diagnosis of infected Marlex mesh and performed a repair of a ventral hernia with persistent post-operative fistula. Plaintiff was discharged from Duke University Medical Center on 28 July 1999. Plaintiff has since undergone further surgery.\nB. Procedural History\nPlaintiff filed suit against Dr. Lanuti in Robeson County Superior Court on 27 June 2002 alleging Dr. Lanuti was negligent in: (1) removing viable mucosa tissue on 15 January 1997, which he mistakenly identified as a polyp, causing plaintiff to suffer a rectal perforation which Dr. Lanuti failed to timely diagnose; (2) misdiagnosing the presence of hemorrhoids when plaintiff had a perirectal abscess; (3) failing to possess the requisite knowledge, training, and skill necessary to perform the procedures that were performed upon plaintiff, and failing to adequately diagnose plaintiff\u2019s condition; (4) failing to make a timely referral for plaintiff to a tertiary care center when he knew or should have known that plaintiff\u2019s condition was deteriorating; and (5) using a Gortex mesh in plaintiff\u2019s ventral hernia repairs when Dr. Lanuti knew or should have known the use of such mesh was not indicated for plaintiff\u2019s condition.\nDefendants moved to dismiss all of plaintiff\u2019s claims pursuant to Rule 12(b)(6) of the North Carolina Rules of Civil Procedure. N.C. Gen. Stat. \u00a7 1A-1, Rule 12(b)(6) (2005). The trial court granted defendants\u2019 motion to dismiss by order dated 4 April 2005. Plaintiff appeals.\nII. Issues\nPlaintiff argues the trial court erred in: (1) allowing defendants\u2019 motion to dismiss; (2) considering matters outside the pleadings over plaintiff\u2019s objection when considering defendants\u2019 motion to dismiss; and (3) failing to make specific findings of fact and conclusions of law, and refusing to consider plaintiff\u2019s timely request for findings and conclusions under Rule 52 of the North Carolina Rules of Civil Procedure with respect to its order allowing defendants\u2019 motion to dismiss.\nIII. Motion to Dismiss\nA. Standard of Review\nOur standard of review of an order allowing a motion to dismiss is \u201cwhether, as a matter of law, the allegations of the complaint, treated as true, are sufficient to state a claim upon which relief may be granted under some legal theory, whether properly labeled or not.\u201d Harris v. NCNB Nat\u2019l Bank of N.C., 85 N.C. App. 669, 670, 355 S.E.2d 838, 840 (1987). In ruling upon such a motion, the complaint is to be liberally construed, and the court should not dismiss the complaint \u201cunless it appears beyond doubt that [the] plaintiff could prove no set of facts in support of his claim which would entitle him to relief.\u201d Dixon v. Stuart, 85 N.C. App. 338, 340, 354 S.E.2d 757, 758 (1987).\nHolloman v. Harrelson, 149 N.C. App. 861, 864, 561 S.E.2d 351, 353 (2002). A complaint may be properly dismissed for absence of law to support a claim, absence of facts sufficient to make a good claim, or the disclosure of some fact that necessarily defeats the claim. Sutton v. Duke, 277 N.C. 94, 102-03, 176 S.E.2d 161, 166 (1970). \u201cIf the complaint discloses an unconditional affirmative defense which defeats the claim asserted or pleads facts which deny the right to any relief on the alleged claim it will be dismissed.\u201d Id. at 102, 161 S.E.2d at 166.\nWe review the trial court\u2019s grant of a motion to dismiss de novo. Leary v. N.C. Forest Prods., Inc., 157 N.C. App. 396, 400, 580 S.E.2d 1, 4 (2003), aff'd, 357 N.C. 567, 597 S.E.2d 673 (2003).\nB. Statute of Limitations\nDefendants contend plaintiff\u2019s claims are barred by the statute of limitations. N.C. Gen. Stat. \u00a7 l-15(c) (2005) provides the statute of limitations for medical malpractice claims:\nExcept where otherwise provided by statute, a cause of action for malpractice arising out of the performance of or failure to perform professional services shall be deemed to accrue at the time of the occurrence of the last act of the defendant giving rise to the cause of action: Provided that whenever there is bodily injury to the person . . . which originates under circumstances making the injury . . . not readily apparent to the claimant at the time of its origin, and the injury ... is discovered or should reasonably be discovered by the claimant two or more years after the occurrence of the last act of the defendant giving rise to the cause of action, suit must be commenced within one year from the date discovery is made: Provided nothing herein shall be construed to reduce the statute of limitation in any such case below three years.\n(Emphasis supplied). Plaintiff filed her complaint against defendants on 27 June 2002. Absent an exception to the three-year statute of limitations, all of defendants\u2019 alleged negligent acts occurred prior to 27 June 1999 and are barred. Defendants asserted an affirmative defense of statute of limitations in their answer.\nC. Continuous Course of Treatment Doctrine\nPlaintiff argues she alleges facts in her complaint to show a \u201ccontinuous course of treatment,\u201d which is an exception to the rule that \u201c \u2018the action accrues at the time of the defendant\u2019s negligence.\u2019 \u201d Stallings v. Gunter, 99 N.C. App. 710, 714, 394 S.E.2d 212, 215 (1990) (quoting Ballenger v. Crowell, 38 N.C. App. 50, 58, 247 S.E.2d 287, 293 (1978)).\nAccording to this doctrine, the actiop accrues at the conclusion of the physician\u2019s treatment of the patient, so long as the patient has remained under the continuous treatment of the physician for the injuries which gave rise to the cause of action. It is not necessary under this doctrine that the treatment rendered subsequent to the negligent act itself be negligent, if the physician continued to treat the patient for the particular disease or condition created by the original act of negligence.\nTo take advantage of the \u2018continuing course of treatment\u2019 doctrine, plaintiff must show the existence of a continuing relationship with [her] physician, and . . . that [she] received subsequent treatment from that physician. Mere continuity of the general physician-patient relationship is insufficient to permit one to take advantage of the continuing course of treatment doctrine. Subsequent treatment must consist of either an affirmative act or an omission, [which] must be related to the original act, omission, or failure which gave rise to the cause of action. However, plaintiff is not entitled to the benefits of the \u2018continuing course of treatment\u2019 doctrine if during the course of the treatment plaintiff knew or should have known of his or her injuries.\nId. at 714-15, 394 S.E.2d at 215-16 (internal citations and quotation marks omitted).\n\u201c[T]he doctrine tolls the running of the statute for the period between the original negligent act and the ensuing discovery and correction of its consequences; the claim still accrues at the time of the original negligent act or omission.\u201d Horton v. Carolina Medicorp, Inc. 344 N.C. 133, 137, 472 S.E.2d 778, 780-81 (1996). Our Supreme Court stated the reason for the rule as follows: \u201c[T]he doctrine rests on the theory that \u2018so long as the relationship of [physician] and patient continued, the [physician] was guilty of malpractice during that entire relationship for not repairing the damage he had done.\u2019 \u201d Id. (quoting Ballenger, 38 N.C. App. at 58, 247 S.E.2d at 293).\nD. Plaintiff Knew or Should Have Known\nDefendants argue plaintiff should lose the benefit of the continuous course of treatment doctrine because \u201cplaintiff knew or should have known of . . . her injuries\u201d during the course of Dr. Lanuti\u2019s treatment. Stallings, 99 N.C. App. at 715, 394 S.E.2d at 216. We disagree.\n\u201cAn injury may be readily apparent but the fact of wrong may lay hidden. It is only when the plaintiff knew or should have known that this wrongful act caused his injury that the plaintiff loses the benefit of the continuing course of treatment doctrine.\u201d Whitaker v. Akers, 137 N.C. App. 274, 280-81, 527 S.E.2d 721, 726 (2000). In Akers, this Court held, \u201cwhile there is no question that the plaintiff knew he was incontinent and impotent, there is some question whether he knew or should have known that the defendant\u2019s conduct was wrongful and whether that conduct caused his incontinence and impotence, prior to the running of the statute of limitations.\u201d Id. at 281, 527 S.E.2d at 726. On its face, the complaint does not establish that plaintiff knew or should have known that Dr. Lanuti\u2019s conduct was allegedly wrongful during Dr. Lanuti\u2019s course of treatment and whether that conduct allegedly caused plaintiff\u2019s injuries. Id.\nE. Plaintiff\u2019s Allegations\nPlaintiff\u2019s complaint alleges Dr. Lanuti treated plaintiff for several different ailments. Plaintiff was first seen by Dr. Lanuti for complaints of rectal bleeding, weakness, nausea, and vomiting. Dr. Lanuti performed a colonoscopy and EGD procedure on 15 January 1997. Plaintiff alleges Dr. Lanuti was negligent in removing viable mucosa tissue, causing plaintiff to suffer a rectal perforation which Dr. Lanuti failed to timely diagnose. The question remains whether Dr. Lanuti\u2019s continuing course of treatment was related to Dr. Lanuti\u2019s initial alleged negligence. Stallings, 99 N.C. App. at 714-15, 394 S.E.2d at 215-16.\nAlso, the question remains whether plaintiff\u2019s abscess, which was allegedly undiagnosed by Dr. Lanuti, was related to Dr. Lanuti\u2019s further and continuous treatment of plaintiff. Id.\nPlaintiff also alleges Dr. Lanuti was negligent in failing to refer her to a tertiary care center when he knew or should have known her condition was deteriorating. A question remains whether plaintiff remained under the continuous care of Dr. Lanuti, and Dr. Lanuti failed to refer plaintiff to a tertiary care center throughout that time period. Id.\nPlaintiff also alleges Dr. Lanuti was negligent in repairing her hernias with a Gortex mesh that was not indicated for plaintiff\u2019s condition. Plaintiff was subsequently seen by Dr. Lanuti for a \u201cone (1) cm open wound that communicates with the gortex and was infected.\u201d Whether plaintiff was under the continuous care of Dr. Lanuti for the injuries which gave rise to the cause of action also cannot be resolved as a matter of law from the face of plaintiffs complaint. Id.\nIn ruling on a motion to dismiss, the trial court must take all allegations in plaintiff\u2019s complaint as true, and every reasonable inference must be drawn in favor of plaintiff. Grindstaff v. Byers, 152 N.C. App. 288, 293, 567 S.E.2d 429, 432 (2002). \u201cIn general, a complaint should not be dismissed for insufficiency unless it appears to a certainty that plaintiff is entitled to no relief under any state of facts which could be proved in support of the claim.\" Harris v. NCNB, 85 N.C. App. 669, 671, 355 S.E.2d 838, 840 (1987) (citation omitted).\nHere, taking plaintiffs allegations as true and reviewing them in the light most favorable to plaintiff, it does not appear \u201cto a certainty\u201d that plaintiff is not entitled to the benefit of the continuing course of treatment doctrine to overcome defendants\u2019 statute of limitations defense. Id. The trial court erred in granting defendants\u2019 motion to dismiss.\nIV. Conclusion\nThe trial court erred in granting defendants\u2019 motion to dismiss. Viewed in the light most favorable to plaintiff, the allegations of the complaint are sufficient to raise an issue of whether plaintiff is entitled to the benefit of the continuing course of treatment doctrine to toll the expiration of the statute of limitations. In so ruling, we express no opinion on the ultimate merits, if any, of plaintiffs allegations and claims.\nIn light of our decision, it is unnecessary to address plaintiff\u2019s remaining assignments of error. The trial court\u2019s order.is reversed and this case is remanded for further proceedings.\nReversed and remanded.\nJudges HUDSON and GEER concur.",
        "type": "majority",
        "author": "TYSON, Judge."
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    "attorneys": [
      "Mitchell Brewer Richardson, by Ronnie M. Mitchell and Coy E. Brewer, Jr., for plaintiff-appellant.",
      "Patterson, Dilthey, Clay, Bryson & Anderson, L.L.P., by Mark E. Anderson, Tobias S. Hampson, and Edward K. Brooks, for defendants-appellees."
    ],
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    "head_matter": "LENA LOCKLEAR, Plaintiff v. STEPHEN L. LANUTI, M.D., STEPHEN L. LANUTI, M.D., P.A., AND SCOTLAND SURGICAL SERVICES, Defendants\nNo. COA05-900\n(Filed 7 March 2006)\nMedical Malpractice\u2014 statute of limitations \u2014 continuous course of treatment doctrine\nA de novo review revealed that the trial court erred in a medical malpractice case by granting defendants\u2019 motion to dismiss under N.C.G.S. \u00a7 1A-1, Rule 12(b)(6) based on the expiration of the statute of limitations, because: (1) continuous course of treatment is an exception to the rule that the action accrues at the time of defendant\u2019s negligence; (2) on its face, the complaint does not establish that plaintiff knew or should have known that the doctor\u2019s conduct was allegedly wrongful during the course of treatment and whether that conduct allegedly caused plaintiff\u2019s injuries; (3) whether plaintiff was under the continuous care of the doctor for the injuries which gave rise to the cause of action cannot be resolved as a matter of law from the face of plaintiff\u2019s complaint; and (4) taking plaintiff\u2019s allegations as true and reviewing them in the light most favorable to plaintiff, it does not appear to a certainty that plaintiff is not entitled to the benefit of the continuing course of treatment doctrine to overcome defendants\u2019 statute of limitations defense.\nAppeal by plaintiff from order entered 9 May 2005 by Judge Ola M. Lewis in Robeson County Superior Court. Heard in the Court of Appeals 9 February 2006.\nMitchell Brewer Richardson, by Ronnie M. Mitchell and Coy E. Brewer, Jr., for plaintiff-appellant.\nPatterson, Dilthey, Clay, Bryson & Anderson, L.L.P., by Mark E. Anderson, Tobias S. Hampson, and Edward K. Brooks, for defendants-appellees."
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