Adam L. Walton v. Strong Memorial Hospital
35 N.E.3d 827, 25 N.Y.3d 554, 14 N.Y.S.3d 757 (2015)
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Rule of Law:
An object intentionally placed in a patient's body for a post-operative purpose is a 'foreign object' under CPLR 214-a if its function is for monitoring or another temporary instrumental purpose and not for fixation (securing or supporting tissue), and it was intended to be completely removed.
Facts:
- In May 1986, three-year-old Adam Walton underwent heart surgery at Strong Memorial Hospital.
- During the operation, a polyvinyl catheter was placed in Walton's left atrium to monitor atrial pressure.
- On May 30, 1986, three days after the surgery, medical personnel attempted to remove the catheter while Walton was in the surgical intensive care unit.
- A nursing progress note from that day stated that the left atrial line "possibly broke off with a portion remaining in pt [patient], as it was being removed."
- Over the subsequent years, Walton experienced numerous cardiac issues, including a stroke and transient ischemic attacks.
- In December 2008, an echocardiogram revealed a foreign body in Walton's left atrium.
- On December 18, 2008, Walton underwent exploratory surgery, during which a 10.2 cm fragment of plastic tubing was discovered in and removed from his heart.
Procedural Posture:
- Adam Walton sued Strong Memorial Hospital and several physicians in the New York Supreme Court, Erie County (a state trial court), for medical malpractice.
- Defendants moved to dismiss the complaint as time-barred under CPLR 3211(a)(5), arguing the foreign object discovery rule did not apply.
- The trial court granted defendants' motion and dismissed the complaint.
- Walton, as appellant, appealed the dismissal to the New York Supreme Court, Appellate Division, Fourth Department (an intermediate appellate court).
- The Appellate Division unanimously affirmed the trial court's dismissal of the complaint.
- The Court of Appeals of New York (the state's highest court) granted Walton leave to appeal.
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Issue:
Is a fragment of a catheter, intentionally placed in a patient's heart for post-operative monitoring and intended for subsequent removal, a 'foreign object' for purposes of the discovery rule in CPLR 214-a, thereby tolling the statute of limitations for a medical malpractice action?
Opinions:
Majority - Judge Read
Yes, a catheter fragment left in a patient's heart under these circumstances is a foreign object. The determination of whether an object is a 'foreign object' versus an excluded 'fixation device' requires consideration of both the nature of the materials and their intended function. While every fixation device is intentionally placed for a continuing treatment purpose, not every object intentionally placed for a continuing purpose is a fixation device. A fixation device must serve a securing or supporting function. Here, the catheter's purpose was solely for monitoring; it was a 'conduit for information' and performed no securing or supporting role. Since it was not a fixation device, chemical compound, or prosthetic aid, and was intended for complete removal, the piece negligently left behind qualifies as a foreign object under the discovery rule, akin to the surgical clamps in Flanagan v. Mount Eden Gen. Hosp.
Analysis:
This decision clarifies the scope of the 'fixation device' exception under CPLR 214-a, preventing an overly broad interpretation that would encompass any item left for a post-operative purpose. The court established that the object's specific function—whether for fixation/support versus monitoring/facilitation—is a critical part of the analysis. This ruling preserves the core purpose of the foreign object discovery rule for patients who are victims of quintessential medical oversights, such as leaving behind temporary, non-structural medical paraphernalia. It will guide future cases involving items like drains, wires, or monitors that are intended for temporary use and complete removal.
