LUZ Z. MORALES-MELECIO; MARÍA I. MARTÍNEZ-ORTIZ; EMILIO MATOS-PÉREZ; MARIELA MATOS-MARTÍNEZ, Plaintiffs, Appellants,
UNITED STATES (Department of Health and Human Services), Defendant/Third-Party Plaintiff, Appellee,
EMERGENCY PRACTICE MANAGEMENT, P.S.C.; HOSPITAL UNIVERSITARIO DR. RAMÓN RUIZ ARNAU; DR. LUIS E. MEJÍAS-BETANCOURT; DR. RICARDO ROSARIO-MENDOZA; DR. MINELY MARTÍNEZ-VELÁSQUEZ; DR. LUIS RODRÍGUEZ-ROSELLÓ, Third-Party Defendants.
FROM THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF
PUERTO RICO [Hon. Salvador E. Casellas, U.S. Senior District
José F. Velázquez-Ortiz and Velázquez
Law Offices, PSC on brief for appellants.
A. Mathews II, Assistant United States Attorney, Rosa Emilia
Rodríguez-Vélez, United States Attorney, and
Mariana E. Bauzá-Almonte, Assistant United States
Attorney, Chief, Appellate Division, on brief for appellee.
Torruella, Lipez, and Kayatta, Circuit Judges.
TORRUELLA, Circuit Judge.
case once again calls for this Court to determine the accrual
date of a claim arising under the Federal Tort Claims Act
("FTCA"), 28 U.S.C. §§ 1346(b),
2671-2680, and the potential application of the so-called
March 1, 2010, Emilio Matos-Martínez
("Matos") died at the Puerto Rico Medical Center
("PRMC") after having been diagnosed with septic
shock and multiple organ failure, and suffering two
cardiorespiratory attacks. Prior to his death at PRMC, Matos
was treated at two other medical facilities on February 27
and February 28, 2010. At some point after Matos's death,
Matos's parents, sister, and daughter (collectively,
"Appellants") became aware that the first medical
facility at which Matos was treated was a federally supported
entity. Appellants filed an administrative claim with the
United States Department of Health and Human Services
("USDHHS" or the "government") on April
16, 2012, followed by a medical malpractice complaint
pursuant to the FTCA against USDHHS in the district court on
April 22, 2013. The district court granted summary judgment
in favor of the government, holding that Appellants'
claims were time-barred for failing to file compulsory
administrative claims within the FTCA's two-year statute
of limitations. See 28 U.S.C. § 2401(b).
now appeal the dismissal of their complaint, arguing that
their FTCA claims did not begin to accrue until they received
Matos's autopsy report on July 28, 2010. After careful
review of the record, we agree with the district court that
Appellants' claims are time-barred. We therefore affirm.
facts are largely undisputed. On February 27, 2010, at 4:55
p.m., Matos, a thirty-six year old man weighing 370
poundswith a history of hypertension, arrived at
Salud Integral en la Montaña, Inc. ("SIM"),
a health center located in Naranjito, Puerto Rico,
complaining of abdominal pain that had persisted for five
days, constipation, and fever. SIM is a covered entity under
the Federally Supported Health Centers Assistance Act of
1995, Pub. L. 104-73, 109 Stat. 777 (codified at 42 U.S.C.
§ 233). After triaging Matos, a resident nurse at SIM
determined that his condition was such that he needed to be
promptly evaluated by a doctor. After the duty physician, Dr.
María Román-Bruno ("Dr.
Román"), conducted a cursory examination of Matos
that did not involve x-rays, laboratory tests, or other
imaging, she diagnosed Matos with "abdominal pain"
and prescribed him Maalox and Enulose for his constipation,
Bentyl for his abdominal pain. Dr. Román then discharged
Matos and instructed him to see his primary doctor in two
next day, Matos's sister, Mariela Matos, took Matos to
the Hospital Universitario Ramón Ruiz-Arnau
("HURRA"), a regional hospital in Bayamón,
because his symptoms had worsened overnight. Upon arrival,
Matos was diagnosed with abdominal pain, dehydration, and
hematuria. Medical tests revealed that Matos had a
bowel obstruction, which prompted the emergency room
physician to request a surgical evaluation. However, the head
of HURRA's surgery department, Dr. Ricardo Rosario
("Dr. Rosario"), refused to evaluate Matos because
he believed that the surgical tables at the hospital would
not support Matos's weight. Due to HURRA's inability to
properly evaluate Matos, the staff at HURRA attempted to
transfer Matos to another medical facility but was unable to
do so until the next day.
March 1, 2010, Matos was transferred to the PRMC where he was
diagnosed with septic shock and multiple organ failure.
Shortly thereafter, Matos suffered two consecutive cardiac
arrests and, at 4:15 p.m., was declared dead. Immediately
after Matos's death, a PRMC physician appears to have
informed his father, Emilio Matos-Pérez, that Matos
died of a heart attack. That same day, Matos's mother,
("Martínez"), authorized PRMC to perform an
autopsy of Matos's body. The autopsy was performed on
March 2, 2010.
March 6, 2010, Matos's body was cremated. Two days later,
Martínez was given Matos's ashes along with a copy
of his death certificate. The death certificate listed
Matos's immediate cause of death as "septic shock,
secondary to peritonitis, secondary to intestinal
perforation." On May 26, 2010, Martínez requested
a certified copy of Matos's complete PRMC medical file.
She received the file, along with the final autopsy report,
on July 28, 2010. The autopsy report matched the death
certificate findings as to the septic shock and the
peritonitis. However, rather than listing
"intestinal perforation, " the autopsy report went
into further detail about Matos's torn intestine, listing
"diverticulitis, perforated with peritonitis with
abscess formation." The narrative section of the autopsy
report labeled "Laboratory Findings" reads that
"[a]n intestinal perforation in the Colon at 192 cm from
the ileo-cecal valve (distal portion) measuring 0.5 cm
corresponded to a diverticuli (Sigmoid Colon)." At an
unidentified time after obtaining possession of the medical
file, Appellants hired an attorney to explore their legal
March 16, 2011, Appellants filed a medical malpractice suit
in the Puerto Rico Court of First Instance against SIM,
HURRA, and several physicians, alleging the wrongful death of
Matos. On June 30, 2011, Appellants voluntarily dismissed
their state court lawsuit. At some point thereafter,
Appellants became aware that SIM was a federally covered
entity and, on April 16, 2012, they filed an administrative
claim with the USDHHS. While that administrative claim was still
pending, on April 22, 2013, Appellants filed this FTCA
medical malpractice claim against the USDHHS, as the
representative of SIM and Dr. Román (as SIM's
agent), seeking compensatory damages for their own suffering
as a result of Matos's death. In the same complaint,
Matos's minor daughter, Z.M.M., as heir of her deceased
father, also asserted an inherited action for Matos's
pain and suffering before his death as a result of the
alleged medical malpractice. The government brought a
third-party complaint against HURRA and several physicians
that cared for or evaluated Matos in the events leading up to
his death, seeking to add them as additional parties to the
lawsuit. On May 3, 2013, the USDHHS denied the administrative
claims against SIM.
discovery was complete in the district court, Appellants
filed a motion for partial summary judgment on November 27,
2015, claiming there was no factual dispute as to the
negligence of the government's agent. On November 30,
2015, the government filed its own motion for summary
judgment, positing that the Appellants' claims were
barred by their failure to file an administrative claim
within two years after their causes of action accrued, as
mandated by 28 U.S.C. § 2401(b). Appellants countered
that there was undisputed evidence that Matos's
diverticulitis triggered his death, and that they could not
have known of that evidence and possibly connected
Matos's death to any governmental malfeasance until they
received the autopsy report on July 28, 2010. ...