Estrella v Montefiore[1]: New York Appeals Court Dismissed Continuous Treatment Doctrine


On January 28, 2021, the Appellate Division of the Supreme Court of the State of New York discussed application of the continuous treatment doctrine. In its decision, the ourt dismissed plaintiff’s plea for application of continuous treatment doctrine.

As per the doctrine, the limitation period for bringing a medical-malpractice action is tolled while the patient continues to avail treatment which is related to the negligent act or omission. The Supreme Court of New York, Appellate Division, explained the concept of continuous treatment doctrine in Clifford v. Kates, 169 A.D.3d 1375 (N.Y. App. Div. 2019). It observed that “the continuous treatment doctrine provides that the statute of limitations does not begin to run until after the plaintiff’s treatment with the defendant provider ends. A plaintiff’s treatment for purposes of the doctrine including care begins at the initial visit and runs continuously until the last visit when the treatment is related to the same injury or illness. In assessing whether the continuous treatment doctrine applies, a court is to accept the plaintiff’s version of facts as true.”

The rationale behind the continuous treatment was also reiterated in Moses v. Moubarek, TDC-15-3875, (D. Md., 2020). The United States District Court, District of Maryland held that, under the continuous treatment doctrine, “the statute of limitations does not begin to run on a medical malpractice claim upon a claimant’s initial discovery of an injury and its cause so long as the claimant remains under the ‘continuous treatment’ of a physician whose negligence is alleged to have caused the injury.”[1] The doctrine of continuous treatment seeks to give protection to an ill or injured patient who does not question the conduct or actions of the physician and is suffering from a chronic condition which has either been untreated or treated inadequately.

In the case in discussion, the plaintiff was suffering from liver cancer and visited Montefiore for her treatment in the year 2012. She visited the emergency room, whereby a CT scan of her liver was performed. As per the CT scan results, a lesion on her liver was detected. Thereafter, she did not make any visit to Montefiore till 2015. On February 24, 2015, she made her second visit to the emergency room of Montefiore, and was diagnosed with hepatocellular carcinoma.  Therefore, she only made two ER visits which were more than 2.5 years apart. As per the court, the visits “did not constitute a course of treatment”, which is required as per the doctrine. It further elaborated that plaintiff’s return to Montefiore in 2015 did not constitute continuation of treatment, and instead was a resumption of treatment. The court thereby dismissed the complaint of the plaintiff and affirmed the March 2020 decision given by Bronx County Supreme Court, Justice George Silver, whereby plaintiff’s lawsuit alleging medical malpractice, was dismissed on the grounds of two-and-a-half-year applicable statute of limitations. Also, the court noted that the plaintiff failed to establish a nexus between Dr. Garan and Montefiore “to impute his (Dr. Garan’s) treatment of plaintiff for the purpose of extending the statute of limitation against Montefiore”.


[1] Citing Miller v. United States, 932 F.2d 301, 304 (4th Cir. 1991)



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