Nevada Rules Doctor-Patient Communications May Modify Inquiry Notice Date – Healthcare

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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