In Cenni v. Laboratory Corp., a New Jersey appellate decision that came down yesterday takes an interesting look at a lab error lawsuit against Quest and Lab Corp and how the discovery rule and the fictitious party rule work in New Jersey.
Facts of Cenni v. Lab Corp
The plaintiff filed a misdiagnosis against LabCorp, alleging it inaccurately interpreted the plaintiff’s annual Pap smear slides, a critical component of cervical cytology exams. The plaintiff argued that due to this error, her cervical cancer diagnosis for years, by which time the cancer had already progressed to stage four.
The plaintiff’s expert reviewed the 2013 and 2014 slides from her annual exam, and asserted that LabCorp’s reading of the slides as “‘negative for intraepithelial lesion or malignancy’ fell significantly short of acceptable standards of care in the reading of Pap smears, and were thus negligently diagnosed.”
Despite not having seen the 2012 slide before the 2013 and 2014 slides, the pathologist offered the opinion that considering the advanced stage of cancer cells visible on the 2013 slide, it was probable that the plaintiff’s 2012 Pap smear slide would also reveal malignant cells.
It turns out that the 2012 slides were not submitted to LabCorp but rather to Quest Diagnostics. After examining the 2012 slides, the plaintiff’s expert pathologist issued a supplemental report. In it, he posited that Quest’s findings also fell outside of, and below, acceptable professional or occupation standards or treatment practices. So plaintiff’s second amended complaint included Quest and its cytotechnologist employees as defendants, alleging they had misread her 2012 Pap smear slides. This misreading, she claimed, contributed to the delay in diagnosing her cervical cancer.
Motion to Dismiss on Statute of Limitations
Quest moved to dismiss the complaint, citing that it was filed beyond the applicable two-year statute of limitations. They also claimed that the plaintiff had not acted diligently, which would disqualify her from benefitting from the fictitious party rule.
Lab Error Lawsuits in New Jersey
Laboratory errors can take many forms, including incorrect test results, lost specimens, test contamination, and misinterpretation of results. These errors can lead to devastating consequences, such as unnecessary treatments, delayed care (which is what we have in this case), missed diagnoses, or even death.
In New Jersey, as in most states, lab error lawsuits fall under the umbrella of medical malpractice law. This is based on the premise that laboratories and their staff must provide accurate and reliable test results. When they fail to meet this standard, and a patient is harmed as a result, it constitutes a breach of this duty, potentially making them liable for damages.
Filing a lab error lawsuit in New Jersey requires a plaintiff to prove four key elements:
- Duty: The plaintiff must establish that the lab owed them a duty of care. This is generally straightforward since labs inherently owe a duty to provide accurate and reliable test results.
- Breach of Duty: The plaintiff must demonstrate that the lab breached this duty. This could involve showing that the lab failed to follow appropriate testing procedures, made errors in handling or analyzing samples, or failed to interpret the results correctly.
- Causation: The plaintiff must prove that the lab’s breach directly resulted in their injury. This often requires expert testimony to link the error in the lab results to the harm suffered by the patient.
- Damages: The plaintiff must demonstrate that they suffered damages due to the lab error. These damages can include costs related to additional medical treatment, lost wages, pain and suffering, and other related expenses.
Under New Jersey law, plaintiffs have two years from the date they became aware (or reasonably should have become aware) of their injury to file a medical malpractice lawsuit, including those related to lab errors. This is known as the statute of limitations. The plaintiff in this case missed this deadline but seeks refuge in the discovery rule. The defendant says the plaintiff or her New Jersey medical malpractice lawyers should have used the fictitious party rule.
What Is the Fictious Party Rule?
The fictitious-party rule, often called the “John Doe” rule, is a procedural rule significant in civil litigation in many but not all states. The rule enables a plaintiff to initiate a lawsuit even when they do not know the identity of all responsible parties, often to protect the statute of limitations. So it is a legal strategy used to preserve a plaintiff’s rights when the statute of limitations is about to run out, but the plaintiff has not yet identified all potential defendants.
A plaintiff using the fictitious-party rule can file a lawsuit against a “John Doe” defendant, essentially an unknown party, by describing the party’s role in causing the alleged harm. When the identity of the “John Doe” is later discovered, the plaintiff can amend the complaint to include the defendant’s true name. The crux of the fictitious party rule is that the substitution of the actual defendant’s name relates back to the original filing date. This allows the plaintiff to bypass the expiration of the statute of limitations, which would otherwise bar the claim. Lawyers rely on the fictitious party rule in cases involving complex circumstances where the identification of all responsible parties is not immediately apparent.
While the fictitious-party rule is widely recognized, the specifics of its application can vary by jurisdiction. Some jurisdictions require that the plaintiff show that they made a reasonable effort to ascertain the defendant’s identity before filing suit. Other jurisdictions allow the filing against a fictitious party without much effort, provided that the plaintiff acted diligently in discovering the defendant’s identity once the suit was initiated.
Despite its apparent advantage, the fictitious-party rule is not without limitations or potential complications. One such limitation is that it applies only when the plaintiff is genuinely ignorant of the identity of a defendant. How could the plaintiff or her lawyers have known about Quest in this case?
The Discovery Rule in New Jersey
The discovery rule in New Jersey delays the accrual of a cause of action until the injury is discovered, or by the exercise of reasonable diligence and intelligence, should have been discovered. This rule is particularly relevant in personal injury cases where the injury is not immediately evident. It serves to mitigate the potentially harsh impact of the statute of limitations. The discovery rule has long been a big issue in New Jersey sex abuse lawsuits (although less so since the new law expanding the statute of limitations in New Jersey in 2019).
New Jersey has had a discovery rule for over 60 years. There is no discovery rule statute in New Jersey. But the New Jersey Supreme Court has consistently held that where a party reasonably is unaware that he has been injured, or, although aware of an injury, does not know that it is attributable to the fault of another, the cause of action should be considered as not accruing until discovery is made.
The critical issue in every discovery rule case – in New Jersey or anywhere – is determining whether the facts would alert a reasonable person, exercising ordinary diligence, that they were injured due to another’s fault. In many instances, knowledge of the fault is gained simultaneously with knowledge of the injury, but when the connection between a plaintiff’s injury and a defendant’s fault is not evident, a reasonable person in the plaintiff’s circumstances must be aware of such fault to be prevented from invoking the discovery rule.
The discovery rule involves two types of plaintiffs: those who don’t know they’ve been injured, and those who know they have suffered an injury but are unaware it’s due to someone else’s fault. There’s a sub-category of the ‘knowledge of fault’ cases where a plaintiff knows they’ve been injured and that it was someone’s fault, but is unaware a third party was also responsible. That is the scenario we have her in Cenni v. Lab Corp.
A panel of three judges reversed the Middlesex County trial judge’s summary judgment ruling for Quest. The panel ruled that the trial court judge did not correctly implement the discovery rule, which stipulates that a plaintiff’s claim does not accrue until the injury is discovered.
The court found that the judge never determined when the plaintiff’s claims against Quest were first realized. If the judge had concluded that the plaintiff became aware of her claim against Quest in September 2015, then she was also aware of her claim against LabCorp at the same time, since its 2013 and 2014 reports were undoubtedly in the materials initially provided and supposedly in the documents he supplied by September 2015. This is the fatal flaw, the court found, in the trial court’s ruling.
So, in reaching its conclusion, the panel identified that the trial court’s error by determining that the plaintiff’s claims were expired due to the statute of limitations. They found she first “knew or should have known” of her claim her expert pathologist assessed the pap smear samples from 2013 and 2014. It was at that point that the pathologist concluded that these were inaccurately read by Quest’s competitor, LabCorp, and posited that it was plausible that slides from 2012, interpreted by Quest, were similarly misread. Because how could she have known before that? “Only at this juncture was Quest a potential party to be held accountable,” the panel concluded. Therefore, the court was willing to push past the usual deferential standard of review applied to the motion court’s decision on these issues and remand the case back to the trial court.