Nevada Rules Doctor-Patient Communications May Modify Inquiry Notice Date

Nevada's Court of Appeals has ruled that some types of communication between health care providers and patients can extend the inquiry notice date, even if patients have their medical records.

Background

In Boman v. Elkanich, 140 Nev. Adv. Op. 31 (App. Apr. 26, 2024), a patient underwent a laminectomy and awoke after surgery experiencing numbness and paralysis in his left leg. The surgeon told the patient that the spinal cord dura had been "nicked" during the surgery, but that it had been repaired. The surgeon told the patient that the symptoms in "his left leg can occur and should improve over time." Over time the pain lessened but feeling in the left leg did not return. The surgeon later referred the patient to another provider for a second opinion. That provider diagnosed "cauda equina syndrome with exacerbation from the post-operative hematoma."

The patient asserted that his one-year statute of limitations based on inquiry notice started the day he received the cauda equina syndrome diagnosis and his complaint was filed on the deadline. The surgeon argued the inquiry notice started earlier, when a post-surgery MRI requested by the patient identified the hematoma. The district court agreed with the surgeon and dismissed the complaint.

Court of Appeals Ruling

The Court of Appeals reversed. It concluded that the surgeon's reassurance that the patient's symptoms could happen and would resolve over time delayed the start of the inquiry notice period. The court stated that because the patient continued to treat with the surgeon and relied on the surgeon's skill, judgment and reassurances supported delaying the start of the inquiry notice period until the second provider gave the alternative diagnosis. The Court of Appeals did not rule that the complaint was timely as a matter of law, but noted it was at least possible and thus dismissal was not supported.

Clients evaluating when inquiry notice began should evaluate Boman in context with Igtiben v. Eighth Jud. Dist. Ct., 140 Nev. Adv. Rep. 9 (Feb. 22, 2024),. decided earlier this year and previously discussed in another Wilson Elser Insight . Igtiben also discussed inquiry notice and concluded it begins to run when the patient has "all relevant medical records." Boman adds another factor: Inquiry notice can begin to run when the patient has all relevant medical records, but if a provider informs a patient that his status is normal, expected or will resolve, inquiry notice is suspended until the patient learns otherwise, even if the patient has the necessary records.

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