The Parkway Extended Care Ctr. v. Elias

1

THE PARKWAY EXTENDED CARE CENTER, INC. D/B/A PARKWAY MEDICAL CENTER A/K/A PARKWAY REHABILITATION AND NURSING CENTER; ALTON CREEK, LLC; JOE OHKRULICA IN HIS CAPACITY AS ADMINISTRATOR OF THE PARKWAY EXTENDED CARE CENTER INC. D/B/A PARKWAY MEDICAL CENTER A/K/A PARKWAYREHABILITATION AND NURSING CENTER; AND PARKWAY ACQUISITION, LLC APPELLANTS v. LEO J. ELIAS, AS EXECUTOR OF THE ESTATE OF LINDA S. ELIAS, DECEASED AND LEO J. ELIAS, ON BEHALF OF THE WRONGFUL DEATH BENEFICIARIES OF LINDA S. ELIAS, DECEASED APPELLEES

No. 2022-CA-0390-MR

Court of Appeals of Kentucky

September 1, 2023

NOT TO BE PUBLISHED

APPEAL FROM JEFFERSON CIRCUIT COURT HONORABLE ERIC JOSEPH HANER JUDGE ACTION NO. 15-CI-004690

BRIEFS FOR APPELLANTS:

John L. Tate

Bethany A. Breetz

Neil E. Barton

Louisville, Kentucky

BRIEF FOR APPELLEES:

Stephen M. Garcia

Louisville, Kentucky

BEFORE: CALDWELL, COMBS, AND LAMBERT, JUDGES.

OPINION

CALDWELL, JUDGE

The Appellants challenge, inter alia, the trial court's applying the continuous treatment doctrine to find a nursing home negligence claim based on a pressure injury not time-barred. As the pressure injury claim was time-barred under the facts here, we reverse and remand for a new trial in conformity with this Opinion.

FACTS

Linda Elias was admitted into the Parkway Extended Care Center ("Parkway") - a skilled nursing facility - in November 2010. Ms. Elias was ninety years old and had many serious health problems including heart problems and dementia. She had recently been hospitalized for a broken hip, but she had not undergone surgery for the broken hip due to her age and health issues. She was unable to walk and her right leg was contracted and tight when she was admitted to Parkway.

In March 2011, a pressure ulcer on Ms. Elias's right heel was noted. Parkway claims its skin management team monitored the ulcer for the next several weeks and that it took other steps such as placing special booties on her feet and turning her once or twice an hour according to doctor's orders. But there was a lack of documentation of such steps in Parkway's records about Ms. Elias between the March 2011 notation of the heel pressure injury and May 2011. By May 2011, the heel pressure ulcer had worsened and was described as a deep tissue injury.

From May 2011 to February 2012, Ms. Elias received treatment from a wound care specialty medical practice for the heel pressure ulcer including debridement. In February 2012, the specialty practice ceased treating or monitoring Ms. Elias because the heel pressure wound had essentially healed - having been reduced to the size of a pinprick. There is no evidence of any other pressure injuries occurring before Ms. Elias passed away in early 2015.

In late 2015, the executor of Ms. Elias's estate filed suit against Appellants Parkway, its administrator, and related corporate entities. (Henceforth, we refer to Appellees as "Elias" and the Appellants collectively as "Parkway".) The suit did not name as defendants any of Ms. Elias's treating doctors, who were not Parkway employees. The case proceeded to trial on negligence claims against Parkway, its corporate entities, and administrator.

Prior to trial, Parkway filed a motion for partial summary judgment on all claims relating to injuries suffered more than a year prior to Ms. Elias's death. Parkway asserted such claims were barred by the one-year statute of limitations in KRS^[1] 413.140.

Elias argued the continuous treatment doctrine applied so the statute of limitations was tolled during the time Ms. Elias received treatment from Parkway - i.e., until her death in early 2015. Parkway responded by asserting the continuous treatment doctrine applied only to medical malpractice claims against doctors and not to negligence claims against nursing homes.

The trial court agreed with Elias that the continuous treatment doctrine could apply to skilled nursing facilities. It reasoned the aim of the continuous treatment doctrine - to further the relationship of trust between patients and physicians - should also apply to a skilled nursing facility providing treatment. So, it denied the motion for partial summary judgment.

The case proceeded to trial. At trial, Ms. Elias's daughter and attorney-in-fact testified to being aware of the heel pressure ulcer in 2011 and suspecting substandard care by Parkway to be the cause.

The medical evidence included the testimony of a treating wound care specialist physician, who stated Ms. Elias received treatment for the heel pressure ulcer from his clinic from May 2011 through February 2012 - with clinic treatment ceasing upon the wound resolving to a mere pinprick size. The wound care specialist further stated that the course of healing indicated Parkway's staff was following the practice's orders. Elias's experts criticized Parkway but admitted the heel pressure ulcer had ultimately been fully resolved - without explicitly disputing that this occurred by the early months of 2012.

Parkway moved the trial court to enter a directed verdict on statute of limitations grounds, which the trial court denied. The trial court and the parties again discussed whether the continuous treatment doctrine applied. But the trial court did not change its prior ruling that the continuous treatment doctrine applied.

The jury rendered a verdict in favor of Elias. Parkway argues it is entitled to a new trial since, in its view, the trial court erroneously applied the continuous treatment doctrine.

ANALYSIS

Most of Parkway's arguments on appeal challenge the trial court's application of legal authority including statutes of limitation and court precedent. We review the trial court's interpretation and application of such legal authority de novo. See, e.g., Adamson v. Adamson, 635 S.W.3d 72, 77 (Ky. 2021); Commonwealth v. Reed, 647 S.W.3d 237, 243 (Ky. 2022).

The trial court's denial of a motion for new trial is entitled to some deference on appeal, however, and cannot be reversed except for clear error or an abuse of discretion. See, e.g., Jefferson v. Eggemeyer, 516 S.W.3d 325, 337 (Ky. 2017); Banker v. University of Louisville Athletic Association, Inc., 466 S.W.3d 456 460 (Ky. 2015).

Trial Court Erred in Applying the Continuous Treatment Doctrine to Toll the Statute of Limitations to Claims Based on Heel Wound Under These Facts

The continuous treatment doctrine was first recognized by our Supreme Court in Harrison v. Valentini, 184 S.W.3d 521, 524 (Ky. 2005).^[2] Our Supreme Court stated: "Under this doctrine, the statute of limitations is tolled as long as the patient is under the continuing care of the physician for the injury caused by the negligent act or omission." Id. (Emphasis added.)

Assuming arguendo that this doctrine could apply to injuries allegedly caused by the negligence of a skilled nursing facility, under the...