ÿWPCU* =# fU:q %« 04±4åùw@ 0 ³P 0D 0JGb‘ 0T™ 0^í 0hK 0P³ 0r 0|u 0†ñ 0w 1u 0d| 0Dà AQ$ Æu 0D; 0@ B¿ D3Ü D/ B> 1m[ 0cÈ U*+úUB)ODCx AM» :(ýb~_ùÝ9Ö5'D™k v~#vÓ‚$˜HP LaserJet 4SiHPPCL5MS,ü,,,,,ü0nLhÎ,†r‰AZ‹"Arial RegularX( ¤U$¡¡Ó  Ózƒ=#tÔôÔô3|x» ©ª«D¬Se­D®D¯Ó€¹Dº»(DG2òv$¤¤Ý ƒ¤U!ÝÓ  ÓÝ  ÝÒ€°ÒÒÀ°Òà Ø àÔ€ôøÃôXXÔòòÚ  Ú0Ú  Úóó(#Ã$òòÚ  Ú0Ú  Úóó2 ÿÿ0Indent1Ô2ÔÔ3  Ô- ù-2" ÿÿ0Indent2à0 àÔ2ÔÔ3  Ô2, ÿÿ0Indent3à0 àà0 àÔ2ÔÔ3  Ô26 ÿÿ0Indent4à0 àà0 àà0 àÔ2ÔÔ3  Ô((3¾¸$§§Ý ƒ¤U!ÝÓ  ÓÝ  Ý2@ ÿÿ0Indent5à0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2J ÿÿ0Indent6à0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2T ÿÿ0Indent7à0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô2^ ÿÿ0Indent8à0 àà0 àà0 àà0 àà0 àà0 àà0 àÔ2ÔÔ3  Ô  ÿÿ?AGMSYaioIndent0I.A.1.a.(1)(a)i)a)P ÿÿ8Mac DefaultMac DefaultÓ ` °šXÓ($$””ò òÚ  Ú1Ú  Úó ó!"#&Cþÿ<< CÿÿƒLevel 1Level 2Level 3Level 4Level 5(3¯$¢¢Ý ƒ!ÝÝ  Ý("ÿÿ$££Ò  ÒÒ  Ò d$$$$'ÿÿdxd(('÷ÿ dxdüÿP Pd*#Je37=CIQYag­­1.a.i.(1)(a)(i)1)a)(;³É$´´Ô2JeÔÚ  Ú0Ú  Ú.Ô3  Ôà0  à< Œ 9p`(Arial ðÝ ƒ!ÝÑ  ÑÑ#€d#ÑÔ€-ÔÓ  ÓÝ  ÝÝ ƒ'ÝÝ  Ýà àà àà àà àà àà àà àà àà àà àà à% Line 7 d////7Border 1dd!#0Cþÿ << Gÿÿ Ý ƒ!ÝÑ  ÑÑ#€d#ÑÔ€-ÔÓ  ÓÝ  ÝÝ ƒ""ÝÝ  ÝÔ€-ÔÓ  Óò òÔ YYY ÔFILEDÔ€-XÔÌÌOctober€20,€1997ÌÌCecil€W.€CrowsonÌAppellate€Court€ClerkÔ  Ôó ó 0Ý ƒ!ÝÑ#€d#ÑÔ€-ÔÓ  ÓÝ  ÝÝ ƒ $ÝÒ € ÒÒ À Òà àÔ€-ôÔòòÚ  ÚÚ  ÚóóÝ  ÝòòTeeters€v.€Curreyóó,€518€S.W.2d€512,€517€(Tenn.€1974);€Tenn.€Code€Ann.€ðð€29„26„116(a)(2)(1980).Ì óÝ ƒ!ÝÑ#€d#ÑÔ€-ÔÓ  ÓÝ  ÝÝ ƒ $ÝÒ € ÒÒ À Òà àÔ€-ôÔòòÚ  ÚÚ  ÚóóÝ  ÝJohn€Stanbury€claimed€loss€of€consortium.Ì tÝ ƒ!ÝÑ#€d#ÑÔ€-ÔÓ  ÓÝ  ÝÝ ƒ $ÝÒ € ÒÒ À Òà àÔ€-ôÔòòÚ  ÚÚ  ÚóóÝ  ÝOn€June€9,€1993,€the€plaintiffs€voluntarily€dismissed€all€claims€against€Hospital€CorporationÏof€America,€d/b/a€Centennial€Hospital,€and€it€is€not€a€party€to€this€appeal.Ì ïÝ ƒ!ÝÑ#€d#ÑÔ€-ÔÓ  ÓÝ  ÝÝ ƒ $ÝÒ € ÒÒ À Òà àÔ€-ôÔòòÚ  ÚÚ  ÚóóÝ  ÝTenn.€Code€Ann.€ðð€29„26„116(1980).Ì /Ý ƒ!ÝÑ#€d#ÑÔ€-ÔÓ  ÓÝ  ÝÝ ƒ $ÝÒ € ÒÒ À Òà àÔ€-ôÔòòÚ  ÚÚ  ÚóóÝ  ÝòòTeeters€v.€Curreyóó,€518€S.W.2d€512,€517€(Tenn.€1974);€Tenn.€Code€Ann.€ðð29„26„116(a)(2)(1980).Ì +Ý ƒ!ÝÑ#€d#ÑÔ€-ÔÓ  ÓÝ  ÝÝ ƒ $ÝÒ € ÒÒ À Òà àÔ€-ôÔòòÚ  ÚÚ  ÚóóÝ  ÝAs€Judge€Koch€recognized,€the€facts€of€this€case€do€not€support€the€plaintiffððs€claim€of€Ïfraudulent€concealment.€€To€establish€fraudulent€concealment€a€plaintiff€must€prove€(1)€that€theÏdefendant€took€affirmative€action€to€conceal€the€cause€of€action€or€remained€silent€and€failed€toÏdisclose€essential€facts€despite€a€duty€to€do€soò ò€andó ó€(2)€the€plaintiff€could€not€have€discovered€theÏcause€of€action€despite€exercising€reasonable€diligence.€€òòBenton€v.€Snyderóó,€825€S.W.2d€409,€414Ï(Tenn.€1992).€€Because€Dr.€Bacardi€affirmatively€and€repeatedly€advised€the€plaintiff€to€wait€a€yearÏ(the€precise€statutory€time€period€within€which€she€had€to€file€a€malpractice€action)€for€her€feet€toÏcompletely€heal,€the€proof€in€this€record€supports€the€first€prong€of€the€fraudulent€concealmentÏexception.€€However,€the€defense€does€not€apply€because,€as€we€hold,€the€plaintiff€could€haveÏdiscovered€the€injury€through€the€exercise€of€reasonable€diligence.€€òòCompareóó€òòHall€v.€De€Saussureóó,Ï297€S.W.2d€81€(Tenn.€App.€1956)€(A€physician€performed€surgery€upon€the€spine€of€the€plaintiffÏwhich€had€not€been€authorized.€€The€physician€did€not€inform€the€plaintiff€about€the€unauthorizedÏprocedure.€€The€plaintiff€did€not€discover€the€injury€until€after€the€expiration€of€the€one€year€statuteÏof€limitations€when€another€physician€€made€an€x„ray€and€informed€the€plaintiff€of€the€true€characterÏof€the€surgery.€€The€plaintiff€brought€suit€and€the€defendant€alleged€that€the€suit€was€barred€by€theÏstatute€of€limitations.€€€Finding€that€the€physician€had€a€duty€to€disclose€the€nature€of€the€surgeryÏbecause€of€the€confidential€physician„patient€relationship€òòandóó€concluding€that€the€plaintiff€could€notÏhave€discovered€the€cause€of€action€by€reasonable€diligence,€the€intermediate€court€applied€theÏfraudulent€concealment€exception€and€held€that€the€suit€had€been€timely€filed.)Ì Ý ƒ!ÝÑ#€d#ÑÔ€-ÔÓ  ÓÝ  ÝÝ ƒ $ÝÒ € ÒÒ À Òà àÔ€-ôÔòòÚ  ÚÚ  ÚóóÝ  ÝòòSeeóó€òòalsoóó€òòHoush€v.€Morrisóó,€818€S.W.2d€39,€43„44€(Tenn.€App.€1991).Ì Ý ƒ!ÝÑ#€d#ÑÔ€-ÔÓ  ÓÝ  ÝÝ ƒ $ÝÒ € ÒÒ À Òà àÔ€-ôÔòòÚ  ÚÚ  ÚóóÝ  ÝComment,€òòWhen€Your€Doctor€Says,€ð ðYou€Have€Nothing€to€Worry€Aboutðð€Donððt€Be€SoÏSure:€The€Effect€of€Fabio€v.€Bellomo€on€Medical€Malpractice€Actions€in€Minnesotaóó,€78€Minn.€L.€Rev.Ï943,€n.53€(April,€1994).€€Several€of€the€jurisdictions€which€continue€to€apply€the€doctrine€have€notÏadopted€the€discovery€rule.€òòSeeóó€òòe.g.óó€òòHealy€v.€Langdonóó,€511€S.W.2d€498€(Neb.€1994);€òòAubin€v.ÏBurkeóó,€434€N.W.2d€282€(Minn.€Ct.€App.€1989).ÌPtPtHHÚ(ÿáÿâùFG(üHHØ(d'`Styl{WP}01•ÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃÃà Ãà Ãà Ãà Ãà ÃÃÃÃÃÃÃÃÃÃÃÐ ÐÐHHÐÐ  ÐÐ2ÐÐÿÿ¸æ$ÿÐÐHHÐÐÐÐÐÐÐÐ  ÐÐ ÐÐ ÐÑÑÑGenevaÑÑ ÑÑ € ÑÑ<Px–ÈÑÒÒÒ443!#4ÒÒ$ *$ÒÒ$*$ÒÒ ÿKK ÒÒ  Geneva ÒÒ  Geneva ÒÓ.,ÓÓÓÓ6ÓÓ ÓßßßßßßßßßßßßßßßßßßÑGenevaÑÑ ÑÒ  ion-F Geneva ÒÒ  ion-F Geneva ÒÝ ƒ!ÝÔ . ÔÔ€-ÔÓ  ÓÝ  Ý›Ñ , ÑÑ ` ÑÒ € ÒÒ ° ÒÒ € ÒÒ À ÒÑ7€GæXXdædÈ7ÑÑ  ÑÑ\R AØ'\ÑÑ  ÑÔ  ÔÑ€ÑÖ€.ÖØ ØÓ&€X°d&Óœ›Þ ÞÌà@ àIN€THE€SUPREME€COURT€OF€TENNESSEEÌÌà@ àAT€NASHVILLE€ÌÌÌÌÌTHERESA€STANBURY€and€spouse,à à)à àà àòòò òFOR€PUBLICATIONóóó óÌJOHN€STANBURY,à àà àœ›à à)à àà àà àà àà àÌà àà àà àà àà àà à)à àà àò òFiled:€October€20,€1997ó óÌà àPlaintiffs„Appellants,à àà à)à àà àÌà àà àà àà àà àà à)à àà àDAVIDSON€COUNTYà àÌv.à àà àà àà àà àà à)à àà àÌà àà àà àà àà àà à)à àà àHon.€Hamilton€V.€Gayden,ÏJr.,ÌBRIAN€E.€BACARDI,à àà àà à)à àà àJudgeÌà àà àà àà àà àà à)à à€€€à à̜ـ!ÙßR€120A1-j|1ö` ç `€€@ÿRß›à àDefendant„Appellee.à àà à)à àà àAppeal€No.à àÌà àà àà àà àà àà à)à àà à01S01„9609„CV„00178Ìà àÌÌÌÌÌÌÌÌòòFor€Plaintiffs„Appellantsóó:à àà àà àòòFor€Defendant„Appelleeóó:ÌHelen€Sfikas€Rogersà àà àà àLela€M.€HollabaughÌJONES,€ROGERS€&€FITZPATRICKà àMANIER,€HEROD,€HOLLABAUGH€&ÏSMITHÌNashville,€Tennesseeà àà àà àNashville,€TennesseeÌÌÌÌÔ€-„ÔÌÌÌÌÌà@ àO€P€I€N€I€O€NÔ€-XÔÌÌÌÌÖ€ÖÖ€ÖCOURT€OF€APPEALS€AFFIRMED.à àà àà àà àDROWOTA,€J.ÇÓÓà àIn€this€appeal€we€must€determine€whether€the€common€law€ð ðcontinuingÏmedical€treatment€doctrineðð€remains€viable€in€Tennessee€and€operates€to€toll€theÏstatute€of€limitations€in€medical€malpractice€cases€until€the€termination€ofÏtreatment€or€the€physician/patient€relationship.€€Relying€upon€that€doctrine,€theÏplaintiffs,€Theresa€and€John€Stanbury,€argue€that€the€Court€of€Appeals€erred€byÏdismissing€this€medical€malpractice€action€which€was€filed€within€one€year€ofÏTheresa€Stanburyððs€last€office€visit€with€the€defendant€Dr.€Brian€E.€Bacardi,€aÏpodiatrist.€€The€Court€of€Appeals€found€the€doctrine€inapplicable€under€the€factsÏof€this€case,€and,€in€addition€observed€that€its€applicability€has€been€eroded€orÏeliminated€in€this€State€by€judicial€and€legislative€adoption€of€the€discovery€rule.× ƒ3 ××  ×€ÏIn€a€separate€opinion,€Judge€Koch€concluded€that€the€doctrine€has€beenÏcompletely€subsumed€into€the€discovery€rule,€and€he€urged€that€its€abolition€beÏexpressly€recognized.ÌÌà àWe€conclude€that€the€common€law€doctrine€of€continuing€medicalÏtreatment€has€been€completely€abrogated€by€adoption€of€the€discovery€rule€inÏTennessee.€€Accordingly,€for€the€reasons€explained€hereafter,€we€affirm€theÏdecision€of€the€Court€of€Appeals€dismissing€the€plaintiffsðð€complaint.ÌÌÌà@ àòòò òBACKGROUNDÌóóó óà àIn€1991,€Theresa€Stanbury€worked€on€the€assembly€line€at€the€SaturnÏCorporation€in€Spring€Hill,€Tennessee.€€She€developed€a€corn€on€the€fifth€toe€ofÏher€right€foot€which€caused€discomfort€while€she€stood€during€her€ten€hour€shift.€ÏA€physician€removed€the€corn€and€recommended€that€Stanbury€consult€aÏpodiatrist.€€On€November€22,€1991,€Stanbury€met€with€Dr.€Brian€Bacardi.€€After€aÏcursory€examination,€Dr.€Bacardi€recommended€a€minor€surgical€procedure€toÏprevent€the€fifth€toe€on€Stanburyððs€right€foot€from€lying€on€top€of€her€fourth€toe.€€Dr.ÏBacardi€assured€Stanbury€that€recovery€time€following€the€surgery€would€beÏshort€and€her€work€schedule€would€not€be€interrupted.ÌÌà àStanbury€signed€two€consent€forms€prior€to€the€December€11,€1991Ïsurgery.€€One€document€on€Dr.€Bacardiððs€stationery€entitled€ð ðSurgery€InformerððÏcontained€a€brief€discussion€of€the€general€risks€and€complications€of€surgery,Ïbut€did€not€identify€the€type€of€surgery€Dr.€Bacardi€planned€to€perform.€€TheÏsecond€document€was€a€Centennial€Medical€Center€form€entitled€ð ðConsent€forÏOperation,€Administration€of€Anesthesia€and€Other€Procedures.ðð€€In€the€spaceÏprovided€for€describing€the€operation€to€be€performed,€someone€hand€wrote:ÏððBilateral€Osteotomy,€Bilateral€Repair€Tailor€Bunion,€Bilateral€Arthroplasty,ÏBilateral€Realignment€Digit€4€and€5,€Bilateral€Removal€5th€Toenail.ðð€€StanburyÏasserts€that€she€was€not€informed€about€the€nature€of€these€procedures€and€thatÏshe€did€not€know€that€she€had€consented€to€surgical€procedures€on€both€her€feet.€ÏStanbury€said€that€she€did€not€knowingly€€consent€to€anything€other€than€theÏminor€procedure€Dr.€Bacardi€had€described€in€his€office€on€November€22.ÌÌà àOn€December€11,€1991,€Dr.€Bacardi€performed€extensive€surgery€on€bothÏof€Stanburyððs€feet€while€she€was€under€a€general€anesthetic.€€During€the€mid„afternoon,€Stanbury€was€released€from€the€hospital,€and€exited€in€a€wheelchairÍwith€both€feet€heavily€bandaged.€€Although€she€could€remember€very€little€aboutÏthe€afternoon€following€surgery,€Stanbury€said€that€over€the€following€days€sheÏrealized€that€surgery€had€been€performed€on€both€her€feet,€and€she€describedÏher€feet€as€ð ð[t]wo€big€white€blobs.ðð€€When€Dr.€Bacardi€removed€the€surgicalÏdressing€during€her€first€office€visit€on€December€20,€1991,€nine€days€afterÏsurgery,€Stanbury€said€she€was€in€ð ðcomplete€and€utter€shockðð€and€that€sheÏð ðcouldnððt€believe€all€that€had€been€done.€€There€were€so€many€stitches€and€soÏmany€things,€it€was€just€unbelievable.ðð€€Stanbury€also€noticed€that€the€fifth€toe€ofÏher€right€foot€was€not€touching€the€floor€but€rather€was€pointing€straight€up€in€theÏair.€€Stanbury€said€she€did€not€specifically€ask€Dr.€Bacardi€why€he€had€performedÏsurgery€on€her€left€foot;€however,€she€asked€him€generally€what€he€had€done€toÏher€feet.€€According€to€Stanbury,€Dr.€Bacardi€was€very€vague€and€told€her€theÏsurgery€was€necessary€to€correct€hereditary€problems.€ÌÌà àStanbury€had€four€more€office€visits€with€Dr.€Bacardi€between€January€10Ïand€March€17,€1992.€€On€April€3,€1992,€Dr.€Bacardi€performed€additional€surgeryÏto€correct€the€misalignment€of€the€fifth€toe€on€Stanburyððs€right€foot.€€During€a€post„operative€visit€on€May€5,€1992,€Dr.€Bacardi€told€Stanbury€that€there€was€nothingÏmore€he€could€do€for€her€and€that€it€would€take€approximately€one€year€for€herÏfeet€to€fully€heal.€€ÌÌà àTheresa€Stanbury× ƒ4 ××  ×€filed€a€malpractice€action€against€Dr.€Bacardi€andÏHospital€Corporation€of€America× ƒ5 ××  ×€on€April€30,€1993.€€€She€alleged€that€Dr.ÏBacardi€had€been€negligent€in€advising€her€to€have€surgery,€in€performing€theÏsurgery,€and€in€providing€her€post„operative€care.€€Stanbury€also€alleged€that€Dr.ÏBacardi€had€performed€unnecessary€surgery,€that€he€had€failed€to€obtain€herÏconsent€to€the€surgery€performed€on€December€11,€1991,€that€he€had€ignoredÏher€complaints€of€pain€and€infection,€and€€that€he€had€falsified€office€notes€toÏconceal€her€actual€condition.€€Dr.€Bacardi€responded,€denying€all€wrongdoingÏand€asserting€that€the€claims€were€barred€by€the€statute€of€limitations.ÌÌà àAt€the€close€of€the€plaintiffsðð€proof€in€the€jury€trial,€the€trial€court€directed€aÏverdict€in€favor€of€Dr.€Bacardi€on€the€theories€of€negligent€post„operative€care,Ïignoring€Stanburyððs€complaints€of€pain€and€infection,€and€intentionally€falsifyingÏoffice€notes€to€conceal€her€true€condition.€€The€defendant€moved€for€a€directedÏverdict€on€the€basis€that€all€claims€were€barred€by€the€one€year€statute€ofÏlimitations€of€the€Tennessee€Medical€Malpractice€Act,× ƒ6 ××  ×€but€the€trial€court€deniedÏthat€motion€finding€that€Dr.€Bacardi€had€provided€continuing€care€to€StanburyÏthrough€the€final€office€visit€on€May€5,€1992,€which€was€within€one€year€of€theÏdate€she€filed€suit.€€The€trial€court€submitted€to€the€jury€the€plaintiffððs€claimsÏconcerning€lack€of€informed€consent,€advising€and€performing€unnecessaryÏsurgery,€and€negligently€performing€the€surgeries.€€In€response€to€a€questionÏwhich€arose€during€jury€deliberations,€however,€the€trial€court€withdrew€the€claimÏfor€negligently€performing€the€surgeries.€€The€jury€returned€a€general€verdict€inÏfavor€of€the€plaintiffs€awarding€Theresa€Stanbury€$211,000€and€John€StanburyÏ$10,000.ÌÌà àThe€defendant€appealed,€and€the€Court€of€Appeals€reversed€the€judgmentÏin€favor€of€the€plaintiffs€and€dismissed€the€complaint,€finding€that€the€claims€wereÏbarred€by€the€one€year€statute€of€limitations.€€The€intermediate€court€found€theÏcontinuing€medical€treatment€doctrine€inapplicable€under€the€facts€of€this€case,Ïand,€in€addition,€observed€that€its€applicability€has€been€eroded€or€eliminated€inÏthis€State€by€judicial€and€legislative€adoption€of€the€discovery€rule.€€Judge€Koch,Ïin€a€separate€opinion,€agreed€with€the€majority€that€the€informed€consent€claimsÏwere€barred€by€the€statute€of€limitations.€€Finding€that€the€continuing€medicalÏtreatment€doctrine€has€been€completely€subsumed€into€the€discovery€rule,€JudgeÏKoch€urged€that€its€abolition€be€expressly€recognized.€€However,€he€dissentedÏfrom€dismissal€of€the€entire€case.€€Since€Stanburyððs€unnecessary€surgery€claimÏwas€filed€within€one€year€of€the€time€she€was€informed€by€another€health€careÏprofessional€that€the€initial€surgery€was€unnecessary,€Judge€Koch€opined€that€itÏhad€been€timely€filed€within€one€year€of€its€discovery.€ÌÌà àThereafter,€we€granted€the€plaintiffs€permission€to€appeal€to€determineÏwhether€the€common€law€ð ðcontinuing€medical€treatment€doctrineðð€remains€viableÍin€Tennessee.€€For€the€reasons€that€follow,€we€conclude€that€the€common€lawÏdoctrine€has€been€subsumed€by€the€discovery€rule€and€therefore€affirm€theÏjudgment€of€the€Court€of€Appeals€dismissing€the€complaint.̛̜à@ àòòò òCONTINUING€MEDICAL€TREATMENT€DOCTRINEóóó óÌà àUntil€December€1974,× ƒ7 ××  ×€negligence€actions€against€health€care€providers,Ïlike€all€other€actions€for€injuries€to€the€person€in€Tennessee,€were€required€to€beÏfiled€within€one€year€after€the€date€of€the€wrongful€act€that€caused€the€plaintiffððsÏinjury.€€òòAlbert€v.€Shermanóó,€167€Tenn.€133,€135,€67€S.W.2d€140,€141€(1934);ÏòòBodne€v.€Austinóó,€156€Tenn.€353,€364„65,€2€S.W.2d€100,€103€(1928);€Tenn.€CodeÏAnn.€ðð€28„304.€€The€two€most€common€exceptions€to€this€rule€involved€continuingÍtorts€and€fraudulent€concealment€of€the€injury.× ƒ8 ××  ×ÌÌà àIn€1938,€the€intermediate€appellate€court€adopted€the€continuing€tortÏprinciple€in€a€case€involving€an€employee€who€had€become€disabled€byÏbreathing€chemical€particles€in€his€employerððs€plant€over€an€extended€period€ofÏtime.€€Noting€that€the€employer€had€a€duty€to€protect€its€employees€from€breathingÏthese€particles,€the€court€held€that€the€employer€had€committed€ð ðone€continuousÏtort,€beginning€with€the€employment€and€ending€only€at€the€time€of€total€disabilityÍof€the€employee€and€the€termination€of€his€employment.ðð€€òòTennessee€EastmanÏCorp.€v.€Newmanóó,€22€Tenn.€App.€270,€279,€121€S.W.2d€130,€135€(1938).€ÏAccordingly,€the€employeeððs€action€filed€within€one€year€of€the€onset€of€hisÏdisability€and€the€termination€of€his€employment€was€held€to€be€timely€filed.€€òòIdóó.;Ïòòseeóó€òòalsoóó€òòSteiner€v.€Spenceróó,€24€Tenn.App.€389,€145€S.W.2d€547€(1940).ÌÌà àSeveral€years€later,€the€intermediate€appellate€court€extended€theÏcontinuing€tort€principle€to€medical€malpractice€actions.€In€òòFrazor€v.€Osborneóó,€57ÏTenn.App.€10,€414€S.W.2d€118€(1966),€the€plaintiff€brought€a€medical€malpracticeÏaction€against€her€physician€and€the€hospital€in€which€she€had€undergoneÏsurgery€over€ten€years€earlier.€During€the€operation,€in€1952,€a€surgical€spongeÏwas€placed€in€her€body€and€negligently€left€there€upon€the€operationððsÏcompletion.€€Over€the€next€ten€years,€the€plaintiff€was€under€the€defendantÏdoctorððs€care€and€throughout€that€time,€the€incision€from€plaintiffððs€operationÏremained€open€and€infected,€and€as€a€result,€she€suffered€severe€pain€and€wasÏeventually€totally€disabled.€€On€May€2,€1961,€some€members€of€the€plaintiffððsÏfamily€noticed€that€threads€were€beginning€to€work€out€of€the€incision.€€WhenÍFrazorððs€family€was€unable€to€locate€Dr.€Osborne,€one€of€his€associates€made€aÏhouse€call,€probed€the€incision,€and€removed€portions€of€the€embedded€sponge.€ÏThe€remainder€of€the€embedded€sponge€was€removed€shortly€thereafter,€andÏwithin€a€few€days,€the€incision€completely€healed€and€never€caused€the€plaintiffÏfurther€problems.ÌÌà àThe€plaintiff€brought€suit€in€1962,€within€one€year€of€the€date€the€spongeÏwas€discovered€and€removed.€€The€trial€court€directed€a€verdict€for€the€defendantÏdoctor€Ñ < Ñand€hospital€finding€the€action€barred€by€the€one€year€statute€of€limitations.€ÏThe€Court€of€Appeals€affirmed€the€trial€courtððs€judgment€as€to€the€hospital,€butÏreversed€as€to€the€doctor,€finding€that€the€plaintiffððs€cause€of€action€did€not€accrueÏuntil€the€physician/patient€€relationship€terminated.€€Accordingly,€in€the€context€ofÏmedical€malpractice€cases,€the€continuing€tort€principle€became€known€as€theÏcontinuing€medical€treatment€doctrine.ÌÌà àSix€years€after€òòFrazoróó€was€decided,€this€Court,€in€òòTeeters€v.€Curreyóó,€518ÏS.W.2d€512€(Tenn.€1974),€adopted€the€discovery€rule€for€determining€when€theÏstatute€of€limitations€begins€to€run€in€medical€malpractice€actions.€€In€that€case,Íthe€continuing€treatment€doctrine€was€unavailable€because€the€doctor„patientÏrelationship€had€terminated€approximately€three€years€before€the€suit€was€filed.€ÏTeeters,€following€the€birth€of€a€normal€child,€developed€medical€complicationsÏwhich€led€Dr.€Currey,€her€attending€physician,€to€recommend€a€tubal€ligation€toÏprevent€future€pregnancies.€€Teeters€followed€his€advice€and€Dr.€CurreyÏperformed€the€procedure€on€June€6,€1970.€€On€December€6,€1972,€Teeters€wasÏinformed€that€she€was€pregnant,€and€on€March€9,€1973,€Teeters€gave€birth€to€aÏpremature€child€with€severe€complications.€€Following€a€second€bilateral€tubalÏligation,€Teeters€brought€suit€against€Dr.€Currey€on€November€15,€1973,€almostÏthree€and€one„half€years€after€the€initial€surgery,€but€only€eleven€months€afterÏdiscovering€her€pregnancy.ÌÌà àIn€concluding€that€the€plaintiffððs€claim€was€timely€filed,€this€Court€held€thatÏð ðthe€cause€of€action€accrues€and€the€statute€of€limitations€commences€to€runÏwhen€the€patient€discovers,€or€in€the€exercise€of€reasonable€care€and€diligenceÏfor€his€own€health€and€welfare,€should€have€discovered€the€resulting€injury.ðð€ÏòòTeetersóó,€518€S.W.2d€at€515.€€In€choosing€to€adopt€the€discovery€rule,€this€CourtÏrefused€to€embrace€a€rule€of€law€which€would€require€a€plaintiff€to€sue€toÍvindicate€a€non„existing€wrong€at€a€time€when€the€injury€is€ð ðunknown€andÏunknowable.ðð€€òòIdóó.€€This€Court€did€not€address€the€relationship€between€the€newlyÏadopted€discovery€rule€and€the€continuing€medical€treatment€doctrine.€€€ÌÌà àApproximately€six€months€later,€the€General€Assembly€included€theÏdiscovery€rule€as€part€of€the€Medical€Malpractice€Claims€Act€of€1975.€€NowÏcodified€at€Tenn.€Code€Ann.€ðð€29„26„116,€the€legislative€statute€of€limitationsÏprovides,€in€pertinent€part,€as€follows:ÌÓÓà8 à(a)(1)€The€statute€of€limitations€in€malpractice€actions€shall€be€oneÏ(1)€year€as€set€forth€in€ðð€28„3„104.Ìà8 à(2)€In€the€event€the€alleged€injury€is€not€discovered€within€the€saidÏone€(1)€year€period,€the€period€of€limitation€shall€be€one€(1)€yearÏfrom€the€date€of€such€discovery.Ìà8 à(3)€In€no€event€shall€any€such€action€be€brought€more€than€three€(3)Ïyears€after€the€date€on€which€the€negligent€act€or€omission€occurredÏexcept€where€there€is€fraudulent€concealment€on€the€part€of€theÏdefendant€in€which€case€the€action€shall€be€commenced€within€oneÏ(1)€year€after€discovery€that€the€cause€of€action€exists.Ìà8 à(4)€The€time€limitation€herein€set€forth€shall€not€apply€in€casesÏwhere€a€foreign€object€has€been€negligently€left€in€a€patientððs€bodyÏin€which€case€the€action€shall€be€commenced€within€one€(1)€yearÏafter€the€alleged€injury€or€wrongful€act€is€discovered€or€should€haveÏbeen€discovered.€€€€ÌÓÓTenn.€Code€Ann.€ðð€29„26„116€(1980).€€The€statute€of€limitations€has€several€keyÏelements.€€Section€1€grants€an€injured€party€one€year€within€which€to€bring€suitÍafter€the€cause€of€action€has€accrued.€€If€an€injury€is€not€discovered€within€the€oneÏyear€time€period,€Section€2€allows€the€injured€party€one€year€within€which€toÏbring€suit€from€the€date€of€discovery,€but€Section€3€(a€statute€of€repose)€imposesÏa€three„year€ceiling€upon€that€right.€€If€there€is€fraudulent€concealment€on€the€partÏof€the€physician€or€if€a€foreign€object€has€been€negligently€left€in€a€patientððs€bodyÏby€the€physician,€as€was€the€case€in€òòFrazoróó,€òòsupraóó,€the€injured€party€is€entitled€toÏcommence€a€lawsuit€within€one€year€after€discovery€of€the€fraudulentÏconcealment€or€foreign€object.€€òòHoffman€v.€Hospital€Affiliates,€Incóó,€652€S.W.2dÏ341€(Tenn.€1983).€ÌÌà àNeither€this€Court€in€òòTeetersóó,€nor€the€General€Assembly€in€the€statute,Ïexplicitly€addressed€the€viability€of€the€continuing€medical€treatment€doctrine.€ÏTherefore,€the€dispositive€inquiry€in€this€appeal€is€whether€the€common€lawÏcontinuing€medical€treatment€doctrine€has€been€abrogated€by€judicial€andÏlegislative€adoption€of€the€discovery€rule€in€this€State.€€We€join€the€intermediateÏappellate€court€and€conclude€that€the€doctrine€has€been€abrogated.× ƒ9 ××  ×ÌÌà àThe€common€law€doctrine€has€been€described€as€follows:ÌÓÓà8 à[I]f€the€facts€show€continuing€medical€or€surgical€treatment€for€aÏparticular€illness€or€condition€in€the€course€of€which€there€isÏmalpractice€producing€or€aggravating€harm,€the€cause€of€action€ofÏthe€patient€accrues€at€the€end€of€the€treatment€for€that€particularÏillness,€injury€or€condition,€unless€the€patient€sooner€knew€orÏreasonably€should€have€known€of€the€injury€or€harm.€.€.€.ðð€ÌÓÓÌòòHecht€v.€Resolution€Trust€Corp.óó,€635€A.2d€394,€401€(Md.€1994);€òòRobinson€v.ÏMount€Sinai€Medical€Centeróó,€402€N.W.2d€711,€716€(Wis.€1987).€€The€rationaleÏunderlying€the€rule€is€that€a€patient€must€trust€a€physician€to€remain€in€his€careÏand€during€that€care,€the€patient€is€not€likely€to€suspect€negligent€treatment.€€ð ðIt€isÏthe€trust€relationship€that€may€make€discovery€of€a€claim€difficult.ðð€€òòWheeler€v.ÏSchmid€Laboratories,€Inc.óó,€451€N.W.2d€133,€138€(N.D.€1990).ÌÌà àConsidering€the€formulation€of€the€doctrine,€and€the€rationale€upon€whichÏit€is€based,€it€is€clear€that€the€continuing€medical€treatment€doctrine€is€merely€aÏparticularized€application€of€the€discovery€rule.€€The€rule€presumes,€for€policyÏreasons,€that€a€patient€has€not€discovered€an€injury€during€the€time€medicalÍtreatment€continues.€€If€there€is€actual€proof€that€the€patient€òòknows€or€reasonablyÏshould€know€of€the€injury€or€harm€before€termination€of€medical€treatmentóó,€theÏstatute€of€limitations€is€not€tolled.€€The€rule€has€outlived€its€necessity€in€light€of€theÏcomprehensive€medical€malpractice€statute€of€limitations€which€requires€that€suitÏbe€brought€within€one€year€of€the€negligent€act€or€within€one€year€of€discovery.€ÏThe€statute€contains€explicit€exceptions€for€fraudulent€concealment€and€foreignÏobjects€which€more€often€result€in€lengthy€delays.€€Although€the€common€lawÏdoctrine€still€is€recognized€in€some€jurisdictions,× ƒ: ××  ×€it€has€been€judicially€orÏlegislatively€abrogated€in€many€states€following€adoption€of€the€discovery€rule.€ÏòòSeeóó€òòe.g.óó€òòJones€v.€McDonaldóó,€631€So.2d€869,€873€(Ala.€1993);€€òòEwing€v.€Beckóó,Ï520€A.2d€653€(Del.€1987);€òòCunningham€v.€Huffmanóó,€609€N.E.2d€321€(Ill.€1993);ÏòòHecht€v.€First€National€Bank€&€Trust€Co.óó,€490€P.2d€649€(Kan€1971);€òòHill€v.ÏFitzgeraldóó,€501€A.2d€27€(Md.€1985);€òòCrumpton€v.€Humana,€Inc.óó,€661€P.2d€54€(N.M.Í1983);€òòRusso€v.€Diethrickóó,€617€P.2d€30,€35€(Ariz.€Ct.€App.€1980).€€The€time€for€itsÏexpress€abolition€has€arrived€in€Tennessee€as€well.Ìà àÌ€à àHaving€decided€that€the€continuing€medical€treatment€doctrine€has€beenÏabrogated€by€adoption€of€the€discovery€rule,€we€must€next€determine€whether€the€ÏCourt€of€Appeals€erred€in€concluding€that€the€plaintiffððs€claims€are€time„barred.€ÏWithout€question,€the€plaintiffððs€lawsuit€was€not€filed€within€one€year€of€theÏalleged€negligent€act,€the€surgery€on€December€11,€1991.€€We€must€thereforeÏdetermine€whether€suit€was€filed€within€one€year€of€discovery€of€an€injury.ÌÌà àWe€begin€our€analysis€of€this€issue€with€the€principle€that€the€statute€ofÏlimitations€commences€to€run€when€the€patient€knows€or€in€the€exercise€ofÏreasonable€care€and€diligence€should€know,€that€an€injury€has€been€sustained.€ÏòòTeetersóó,€518€S.W.2d€at€515;€òòseeóó€òòalsoóó€òòWyatt€v.€A„Best,€Co.,€Inc.óó,€910€S.W.2d€851,Ï854€(Tenn.€1995).€€In€other€words,€the€statute€of€limitations€in€a€medicalÏmalpractice€case€is€tolled€until€the€plaintiff€ð ðdiscovered,€or€reasonably€shouldÏhave€discovered,€(1)€the€occasion,€the€manner,€and€the€means€by€which€aÏbreach€of€duty€occurred€that€produced€his€injuries;€and€(2)€the€identity€of€theÍdefendant€who€breached€the€duty.ðð€€òòFoster€v.€Harrisóó,€633€S.W.2d€304€(Tenn.Ï1982).€€However,€it€is€not€necessary€that€the€plaintiffÌÓÓà8 àactually€know€that€the€injury€constitutes€a€breach€of€the€appropriateÏlegal€standard€in€order€to€discover€that€he€has€a€ððright€of€action;ðð€theÏplaintiff€is€deemed€to€have€discovered€the€right€of€action€if€he€isÏaware€of€facts€sufficient€to€put€a€reasonable€person€on€notice€thatÏhe€has€suffered€an€injury€as€a€result€of€wrongful€conduct.ÌÌÓÓòòRoe€v.€Jeffersonóó,€875€S.W.2d€653,€657€(Tenn.€1994);€òòseeóó€òòalsoóó€òòCarvell€v.€Bottomsóó,Ï900€S.W.2d€23,€29€(Tenn.€1995).ÌÌà àApplying€that€standard€to€the€facts€in€this€case,€it€is€clear€that€the€plaintiffððsÏmedical€malpractice€lawsuit€is€time„barred.€€Dr.€Bacardi€performed€surgery€onÏTheresa€Stanburyððs€feet€on€December€11,€1991.€€A€few€days€after€surgery,ÏStanbury€realized€that€both€feet€were€bandaged€and€she€described€them€asÏð ð[t]wo€big€white€blobs.ðð€€Stanbury€maintains€that€she€knowingly€consented€toÏsurgery€on€her€right€foot€only.€€According€to€Stanbury,€she€had€no€medicalÏproblems€with€her€left€foot€prior€to€the€surgery€performed€by€Dr.€Bacardi.€€WhenÏshe€questioned€Dr.€Bacardi€about€the€reason€for€the€surgery,€Stanbury€said€sheÏreceived€a€very€vague€response.€Based€on€the€record,€it€appears€that€shortly€afterÍthe€surgery,€Stanbury€was€aware€of€facts€sufficient€to€put€a€reasonable€person€onÏnotice€that€she€had€suffered€an€injury€as€a€result€of€wrongful€conduct.€€€Not€onlyÏwas€she€aware€of€the€occasion,€manner,€and€€means€by€which€the€breach€of€dutyÏproducing€her€injuries€occurred,€she€also€knew€the€identity€of€the€person€whoÏbreached€the€duty.€ÌÌà àEven€assuming€that€her€claim€for€lack€of€informed€consent€is€barred€by€theÏstatute€of€limitations,€the€plaintiff€maintains€that€she€had€not€discovered€her€claimÏof€unnecessary€surgery€until€she€was€informed€by€another€health€careÏprofessional€that€Dr.€Bacardi€deviated€from€the€standard€of€care€for€podiatrists€byÏfailing€to€follow€a€conservative€treatment€regime€before€recommending€surgery.€ÏSince€she€filed€suit€within€one€year€of€receiving€that€information,€Stanbury€arguesÏthat€her€claim€was€timely€filed.€€We€disagree.ÌÌà àWe€emphasize€that€under€the€discovery€rule,€the€statute€begins€to€runÏwhen€the€plaintiff€knows€or€in€the€exercise€of€reasonable€care€and€diligenceÏshould€know,€that€an€injury€has€been€sustained.€It€is€knowledge€of€facts€sufficientÏto€put€a€plaintiff€on€notice€that€òòanóó€injury€has€been€sustained€which€is€crucial.€ÍAgain,€a€plaintiff€need€not€ð ðactually€know€that€the€injury€constitutes€a€breach€ofÏthe€appropriate€legal€standard€in€order€to€discover€that€he€has€a€ððright€of€action.ðððð€ÏòòRoeóó,€875€S.W.2d€at€657;€òòseeóó€òòalsoóó€òòCarvell€v.€Bottomsóó,€900€S.W.2d€at€29.€In€otherÏwords,€a€plaintiff€need€not€actually€know€the€specific€type€of€legal€claim€he€or€sheÏhas€so€long€as€the€plaintiff€is€ð ðaware€of€facts€sufficient€to€put€a€reasonable€personÏon€notice€that€he€has€suffered€an€injury€as€a€result€of€wrongful€conduct.ðð€€òòIdóó.€€InÏthis€case,€the€plaintiff€was€aware€of€facts€sufficient€to€put€a€reasonable€person€onÏnotice€that€she€had€suffered€an€injury€as€a€result€of€the€surgery.€€Advice€fromÏanother€health€care€professional€that€a€claim€exists€is€not€a€prerequisite€toÏaccrual€of€a€medical€malpractice€cause€of€action.€€In€fact,€we€have€specificallyÏrejected€such€a€requirement€in€the€context€of€medical€and€legal€malpracticeÏactions.€€òòRoeóó,€857€S.W.2d€at€658;€òòCarvellóó,€900€S.W.2d€at€29.€€Even€assumingÏTennessee€applied€such€a€rule,€which€it€does€not,€in€this€case€the€plaintiffððsÏassertion€that€she€was€unaware€of€her€claim€for€unnecessary€surgery€untilÏadvised€by€another€health€care€professional€is€unpersuasive€because€she€wasÏnot€so€advised€until€òòafteróó€she€filed€the€complaint€in€this€case€allegingÏunnecessary€surgery.€€€€Stanbury€knew€or€reasonably€should€have€known€thatÏshe€had€a€right€of€action€against€the€defendant,€at€the€latest,€by€the€time€of€theÍFebruary,€1992€office€visit,€when€she€realized€that€the€fifth€toe€on€her€foot€was€notÏin€a€normal€position.€However,€more€than€fourteen€months€had€passed€beforeÏsuit€was€filed€on€April€30,€1993.€€Accordingly,€the€plaintiffððs€lawsuit€is€time„barred.ÌÌà@ àòòò òCONCLUSIONóóó óÌà àBecause€we€conclude€that€the€continuing€medical€treatment€doctrine€wasÏabrogated€by€adoption€of€the€discovery€rule,€and€the€plaintiffððs€action€was€notÏinstituted€within€one€year€of€discovery,€the€lawsuit€is€time„barred€by€the€statute€ofÏlimitations.€€Accordingly,€we€affirm€the€judgment€of€the€Court€of€AppealsÏdismissing€the€complaint.ÌÓÓÌÌÌÌà àà àà àà àà à_______________________________________Ìà àà àà àà àà àFRANK€F.€DROWOTA€IIIÌà àà àà àà àà àJUSTICEÌÌÌò òConcur:ó óÌAnderson,€C.€J.ÌReid,€Birch,€Holder,€JJ.ÌÌ