By Damian D. Capozzola, Esq., and Jamie Terrence, RN
News
The Georgia Court of Appeals recently upheld the dismissal of a medical malpractice case, finding that the plaintiff’s claim was time-barred by Georgia’s statute of limitations. The plaintiff argued that a long-term steroid prescription to manage post-surgical swelling after brain surgery led to severe health complications. He claimed that the “continuous treatment doctrine” should extend the statute of limitations, starting it when his treatment ended in 2020.
However, the court disagreed, ruling that the statute began in 2018, when the plaintiff first displayed symptoms from long-term steroid use. Although he later developed serious conditions such as osteoporosis and deep vein thrombosis, the court found that these were not new injuries that reset the statute of limitations. Citing prior Georgia Supreme Court rulings, the appeals court reiterated that the two-year period begins at the initial injury — rather than at the end of treatment — reinforcing Georgia’s strict interpretation. This case is an important reminder for practitioners and medical malpractice plaintiffs that, regardless of how clearly they may be able to show liability on a medical malpractice claim, the first order of business is filing the claim in time.
Background
On Oct. 22, 2024, the Georgia Court of Appeals upheld the dismissal of a medical malpractice lawsuit against a physician and their employer, confirming that the plaintiff’s claims were time-barred under the statute of limitations. The plaintiff alleged that a long-term steroid prescription, initially intended to manage post-surgical swelling after brain surgery, resulted in severe health complications. The question before the court was whether the statute of limitations began with the first signs of steroid-related symptoms or if the timeline could be extended under the “continuous treatment doctrine.”
The plaintiff, diagnosed with a brain tumor in 2009, underwent surgery in November 2016. Following the operation, doctors prescribed steroids to reduce swelling, which he discontinued in December 2016 but resumed shortly after to address headaches. In early 2017, the plaintiff began consulting with the defendant physician for ongoing oncological care. Throughout the year, he made several attempts to get off steroids but experienced symptoms like swelling and headaches whenever he tried to reduce his dose. Over the following years, his symptoms worsened to include health conditions commonly linked to prolonged steroid use, such as abdominal stretch marks, weight gain, muscle aches, gastroesophageal reflux disease, and prediabetes.
In September 2020, imaging revealed epidural lipomatosis, a condition in which fat accumulates around the spinal cord — a known complication of long-term steroid use. Based on this finding, the plaintiff’s neurologist advised him to stop steroids permanently. Although he successfully discontinued the medication by November 2020, he subsequently faced other complications, including osteoporosis, deep vein thrombosis, and Cushing syndrome.
The plaintiff filed a lawsuit in September 2022, claiming the physician and medical group negligently failed to discontinue his steroid prescription, resulting in his various health issues. He argued that the continuous treatment doctrine should apply, delaying the start of the statute of limitations until his treatment with the physician ended in September 2020. The defendants moved for summary judgment, asserting that the statute of limitations had expired well before the plaintiff filed his complaint, as Georgia law allows only two years from the date of the injury for medical malpractice claims.
The trial court granted summary judgment to the defendants on the basis that the plaintiff’s claims were time-barred. On appeal, the Court of Appeals affirmed the trial court’s ruling, finding that the statute of limitations began running in February 2018, when the plaintiff first exhibited symptoms of steroid-related complications. Citing established Georgia law, the court emphasized that the limitations period begins when injury symptoms are first apparent, even if the patient is unaware of the cause.
The court also rejected the plaintiff’s argument to apply the continuous treatment doctrine, pointing to prior Georgia Supreme Court decisions that explicitly dismiss the doctrine in medical malpractice cases. By affirming that the two-year period starts at the first sign of injury rather than the end of treatment, the decision reinforces Georgia’s strict interpretation of statutes of limitations in medical malpractice cases.
What This Means for You
A statute of limitations is a legal time limit for filing a lawsuit, designed to ensure that claims are brought within a reasonable period after an injury or issue occurs. Although it differs by jurisdiction, in medical malpractice cases, the statute of limitations generally starts when the patient first experiences symptoms of harm related to the alleged negligence. Once this time frame has passed, the right to file a lawsuit usually is lost — unless an exception applies. Understanding how statutes of limitations apply is crucial to bringing any lawsuit.
In Georgia, the statute of limitations in medical malpractice cases starts when symptoms first become apparent, not when the patient receives a diagnosis or understands the cause of those symptoms. In this case, there was no dispute that the plaintiff’s symptoms of abdominal stretch marks and weight gain were first observed in early 2018 and were attributed to long-term steroid use. Although the plaintiff’s conditions worsened and changed over the following years — leading to serious health issues, such as osteoporosis, deep vein thrombosis, and Cushing syndrome — the court ruled that these later complications did not reset the statute of limitations. For patients, this means that, if symptoms arise that could be linked to a treatment complication, the clock on filing a malpractice claim likely is ticking, regardless of when the underlying cause is fully understood.
The continuous treatment doctrine, adopted in some states, allows the statute of limitations to begin only after treatment for the condition in question has ended. The plaintiff argued that because he continued treatment with the defendant until September 2020, the statute of limitations should begin at that point. However, the court rejected this argument, citing previous Georgia Supreme Court rulings that explicitly dismiss the continuous treatment doctrine. For patients, this serves as a reminder that continuing treatment does not mean there is additional time to file a claim. For healthcare providers, it underscores the importance of discussing symptoms and potential side effects early, since continued care will not delay the statute of limitation’s countdown.
In Georgia, new or worsening symptoms related to an initial injury do not restart the statute of limitations, either. Here, the plaintiff developed multiple serious health conditions over several years because of prolonged steroid use, with a key diagnosis of epidural lipomatosis made in September 2020. However, the court ruled that each additional complication was tied to the plaintiff’s initial symptoms from 2018 and did not qualify as a new injury for statute of limitations purposes. The court viewed all related conditions as stemming from the same root cause — extended steroid use. This means that, for patients experiencing worsening or additional symptoms, waiting for the progression of symptoms to reach a critical stage could risk their legal window for filing.
The plaintiff in this case also tried to argue for the “new injury” exception to the statute of limitations in Georgia. Although Georgia law recognizes a “new injury” exception in medical malpractice cases, it is reserved for very specific, extreme circumstances. This exception applies where an initially benign condition, because of misdiagnosis, worsens and develops into a more serious injury. In this case, the plaintiff argued that his progressively worsening symptoms from steroid use constituted a “new injury.” However, the court rejected this argument and found that each symptom was traceable back to his initial steroid use. None of his later diagnoses called for an application of this “new injury” exception. This strict interpretation means that patients should take prompt action upon experiencing any symptoms that may be linked to a prior treatment to avoid missing the filing window. Because the “new injury” exception is only applied in rare, “extreme circumstances” in Georgia, relying on it carries substantial risk for plaintiffs.
In cases involving long-term or evolving health issues, this ruling shows the importance of early legal consultation. The plaintiff in this case suffered serious complications, some of which were only diagnosed after years of symptom progression. However, by the time he filed his lawsuit, the statute of limitations had expired because of the court’s view that his cause of action began in 2018 with his initial symptoms. Consulting with legal professionals at the onset of symptoms can help clarify the timeline and ensure that patients have a clear understanding of their legal options.
For healthcare providers, this case shows the value of clear documentation, particularly when managing long-term treatments. Because long-term use of steroids puts patients at risk for multiple complications, it also is important that the physician obtain informed consent from the patient as soon as that treatment decision is made. That consent should contain the possible risks, the alternative treatments available, and the possible risks of those. Documentation of the patient’s understanding of the potential risks and obtaining the patient’s signature of understanding also can help support the physician’s efforts to make certain that the patient has the opportunity to make an informed decision. The plaintiff’s long-term steroid use was repeatedly documented and advised on by multiple healthcare providers, and although the plaintiff argued he was unaware of the long-term risks, the court did not extend the statute based on his understanding. This reinforces the importance for providers to clearly communicate the risks of ongoing treatments to patients, document these conversations, and advise on any symptoms that might indicate complications. This approach helps patients make informed decisions about their health and reduces the potential for delayed legal claims based on patient misunderstandings.
Reference
- Decided on Oct. 22, 2024, in the Court of Appeals of Georgia, Case No. A24A1135.
Damian D. Capozzola, Esq., The Law Offices of Damian D. Capozzola, Los Angeles Jamie Terrence, RN, President and Founder, Healthcare Risk Services, Former Director of Risk Management Services (2004-2013), California Hospital Medical Center, Los Angeles
The Georgia Court of Appeals recently upheld the dismissal of a medical malpractice case, finding that the plaintiff’s claim was time-barred by Georgia’s statute of limitations.
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