The opinion
NOTICE: Summary decisions issued by the Appeals Court pursuant to M.A.C. Rule
23.0, as appearing in 97 Mass. App. Ct. 1017 (2020) (formerly known as rule 1:28,
as amended by 73 Mass. App. Ct. 1001 [2009]), are primarily directed to the parties
and, therefore, may not fully address the facts of the case or the panel's
decisional rationale. Moreover, such decisions are not circulated to the entire
court and, therefore, represent only the views of the panel that decided the case.
A summary decision pursuant to rule 23.0 or rule 1:28 issued after February 25,
2008, may be cited for its persuasive value but, because of the limitations noted
above, not as binding precedent. See Chace v. Curran, 71 Mass. App. Ct. 258, 260
n. 4 (2008).
COMMONWEALTH OF MASSACHUSETTS
APPEALS COURT
23-P-14 8
LORRAINE BELLMAR, personal representative,1
vs.
ROBERT MOORE & another.2
MEMORANDUM AND ORDER PURSUANT TO RULE 23.0
On June 12, 2016, Harry Bellmar died from ventricular
arrhythmia at the age of sixty-two and the plaintiff, as
personal representative of Mr. Bellmar's estate, filed suit
against the defendants, alleging negligent medical treatment and
wrongful death. The sole issue on appeal is whether summary
judgment was appropriate under G. L. c. 260, § 4. We hold that
it was.
Background. Because this appeal relates to the grant of
summary judgment, we discuss the facts necessary to decide this
issue in the light most favorable to the nonmoving party, the
1 Of the estate of Harry Bellmar.
2 Robert R. Moore, M.D., Ph.D., P.C., doing business as Moore
Family Practice.
plaintiff. See Bulwer v. Mount Auburn Hosp., 473 Mass. 672, 680
(2016).
Dr. Robert Moore was Mr. Bellmar's primary care physician.
At all relevant times, Mr. Bellmar suffered from morbid obesity
and osteoarthritis of the knees and was suspected to suffer from
sleep apnea. In 2006, when Mr. Bellmar was fifty-three years
old, in preparation for lumbar disc surgery, an
electrocardiogram (EKG) was performed. Dr. Moore wrote in his
medical notes that Mr. Bellmar had an abnormal EKG and noted
there was "possible ectopic atrial rhythm." A nurse
practitioner working under Dr. Moore's supervision diagnosed
Mr. Bellmar with hypertension and prescribed antihypertensive
medication, and Dr. Moore cleared Mr. Bellmar for surgery.
Dr. Moore did not order or recommend additional cardiac testing
or a cardiology consultation based on the abnormal EKG report
during Mr. Bellmar's 2006 office visit or anytime thereafter.
After that visit. Dr. Moore saw Mr. Bellmar on thirteen other
occasions between 2006 and 2015.3 Mr. Bellmar died from
ventricular arrhythmia in 2016.
3 The plaintiff's complaint provides the dates of these visits:
December 13, 2006; December 17, 2010; May 23, 2011; January 5,
2012; April 23, 2012; May 14, 2012; July 10, 2013; May 27, 2014;
June 16, 2014; September 26, 2014; June 2, 2015; November 6,
2015; and November 24, 2015.
2
Mr. Bellmar's widow, as personal representative of his
estate, filed the instant suit in 2017, alleging that the
defendants were negligent in their medical treatment of
Mr. Bellmar. During discovery, the plaintiff provided reports
written by her expert witness. Dr. Richard Pels, regarding
Mr. Bellmar's health conditions, the treatment provided to him
by the defendants, and the reasonable standard of care.
Dr. Pels stated that based on Mr. Bellmar's 2006 EKG report.
Dr. Moore had deviated from the standard of medical care by
failing to follow up on the 2006 EKG results, especially given
Mr. Bellmar's risk factors. After a request by the defendants,
the court held an evidentiary hearing pursuant to Daubert v.
Merrell Dow Pharms., Inc., 509 U.S. 579, 597 (1993), and
Commonwealth v. Lanigan, 419 Mass. 15, 26 (1994), at which
Dr. Pels testified.4 Dr. Pels testified that had Mr. Bellmar
been prescribed different medications or treatments, his death
would have been preventable. Dr. Pels was also asked, "And even
if [Mr. Bellmar] had a normal EKG in 2006, would his underlying
risk factors warrant the performance of a follow-up EKG?"
Dr. Pels responded, "Yes, it would have."
The defendants filed a motion for summary judgment, arguing
that G. L. c. 260, § 4, the statute of repose, bars the
4 The court's ruling on the defendant's Daubert-Lanigan motion is
not at issue on this appeal.
3
plaintiff's claims as a matter of law.5 After the Superior Court
judge heard arguments from the parties, the judge ruled in favor
of the defendants. This appeal followed.
Discussion. The plaintiff argues that summary judgment was
not appropriate and that we should overrule Moran v. Benson, 100
Mass. App. Ct. 744 (2022),6 because it inappropriately expands
the scope of G. L. c. 260, § 4. We first state the applicable
standard of review before examining the holding in Moran and
whether summary judgment was appropriate in this case.
1. Standard of review. A motion for summary judgment
under Mass. R. Civ. P. 56 (c), as amended, 436 Mass. 1404
(2002), is appropriate where "the moving party . . . 'show[s]
that there is no genuine issue as to any material fact and that
the moving party is entitled to a judgment as a matter of law'
based on the undisputed facts." Premier Capital, LLC v. KMZ,
Inc., 464 Mass. 467, 474 (2013), quoting Mass. R. Civ.
P. 56 (c). "In deciding a motion for summary judgment the court
may consider the pleadings, depositions, answers to
interrogatories, admissions on file, and affidavits" (citation
5 The defendants also argued that the plaintiff failed to show
exactly when the interstitial scarring that led to Mr. Bellmar's
death occurred. The Superior Court allowed summary judgment on
the grounds that the statute of repose bars recovery and,
because we affirm on those grounds, we need not address the
defendants' other argument.
6 The Supreme Judicial Court denied further appellate review.
See 498 Mass. 1108 (2022).
4
omitted). Bank of N.Y. Mellon v. Morin, 96 Mass. App. Ct. 503,
506 (2019). We review the allowance of a motion for summary
judgment de novo. Bulwer, 473 Mass, at 680.
2. Revisiting Moran. General Laws c. 260, § 4, second
par., provides as follows:
"Actions of contract or tort for malpractice, error or
mistake against physicians, surgeons, dentists,
optometrists, hospitals and sanitoria shall be commenced
only within three years after the cause of action accrues,
but in no event shall any such action be commenced more
than seven years after occurrence of the act or omission
which is the alleged cause of the Injury upon which such
action is based except where the action is based upon the
leaving of a foreign object in the body" (emphasis added).
This period of repose creates an "absolute time limit" on
medical malpractice claims, even when "the plaintiff's injury
does not occur, or is not discovered, until after the statute's
time limit has expired." Moran, 100 Mass. App. Ct. at 746,
quoting Parr v. Rosenthal, 475 Mass. 368, 382 (2016). "A repose
period begins to run from some 'definitely established event,'
abolishing a plaintiff's cause of action thereafter, even if the
injury does not occur, or is not discovered, until after the
statute's time limit has expired" (citation omitted). Rudenauer
v. Zafiropoulos, 445 Mass. 353, 358 (2005). Although this can
lead to harsh results, see Moran, supra at 748, the
Legislature's intent was that tolling under the statute not be
allowed in an effort to create "systemwide certainty."
Rudenauer, supra at 359.
5
In Moran, the patient underwent a magnetic resonance
imaging (MRI) scan and the results indicated that she was
suffering from multiple sclerosis. See 100 Mass. App. Ct. at
744-745. The doctor failed to inform her of these results,
instead treating her for migraine headaches. See id. This
court ruled that there was only one "definitely established
event" from which the period of repose could be considered to
have begun: the initial failure to act after the MRI. Id. at
747. This court affirmed the judgment in favor of the medical
provider defendants because the only "definitely established
event" occurred more than seven years prior to the filing of the
complaint and the continuing medical treatment, which was within
seven years of the filing of the complaint, could not stand
alone. _Id. ("Moran labors hard to claim the defendants' actions
within the repose period are separate acts or omissions
constituting negligence; however, such acts are nothing more
than the defendants' acts of continuing treatment").
The plaintiff argues that Moran inappropriately expands the
scope of G. L. c. 260, § 4, by preventing claims arising from
negligence that occurred inside the period of repose. We
disagree. In Moran, the court held that the initial failure to
act on the MRI scan eclipsed any other claims of negligence and
was thus the only "definitely established event." Id. at 747.
Our holding in Moran thus does not eliminate the possibility of
6
a complaint surviving summary judgment where the plaintiff has
sufficiently established that subsequent medical appointments
inside the period of repose are not simply continuing medical
treatment but are rather the basis of a negligence claim on
their own. See id. To simplify, Moran does not address the
outcome under G. L. c. 260, § 4, where the plaintiff has
successfully pleaded multiple "definitely established events,"
some of which are within seven years of the filing of the
complaint and some of which are not. As a result, we see no
need to revisit Moran because its holding does not, as the
plaintiff argues, improperly provide immunity from suit for
negligent acts that occur within the period of repose.
3. Summary judgment. Turning to the facts of this case,
the motion judge, following this court's holding in Moran,
ordered entry of summary judgment because "[t]he allegations in
the instant complaint clearly center on Dr. Moore's failure to
order subsequent testing after the abnormal EKG in December
2006," which is outside the period of repose. The plaintiff
claims that despite the fact that the 2006 EKG was outside the
period of repose, summary judgment should not have been granted
since eleven of the thirteen subsequent medical appointments
mentioned in the complaint were within seven years of the filing
of the complaint. We disagree.
7
The plaintiff has not pleaded or demonstrated any acts of
negligence that could be considered "definitely established
events" which occurred within seven years of the filing of the
complaint. The subsequent medical appointments which occurred
within seven years of the filing of the complaint cannot stand
alone because the plaintiff has not established what the
standard of care required in the absence of the alleged
negligence that occurred more than seven years before the
complaint was filed. "The proper standard is whether the
physician, if a general practitioner, has exercised the degree
of care and skill of the average qualified practitioner, taking
into account the advances in the profession." Palandjian v.
Foster, 446 Mass. 100, 104 (2006), quoting Brune v. Belinkoff,
354 Mass. 102, 109 (1968). The plaintiff's complaint does not
allege independent negligence by Dr. Moore after his 2006 EKG
other than his inaction in failing to order further tests.
Although the testimony of Dr. Pels makes this case closer than
Moran, it does not eliminate this fundamental deficiency.
Dr. Pels confirmed that even if Mr. Bellmar had a normal EKG in
2006, his underlying risk factors would warrant the performance
of a follow-up EKG.7 In this context, "warrant" means "to serve
7 Although this testimony is not the type of evidence
specifically listed under Mass. R. Civ. P. 56 (c), its inclusion
in the summary judgment exhibits was appropriate and we consider
as or give adequate ground or reason for." See Merriam-
Webster's Collegiate Dictionary 1410 (11th ed. 2005). This
testimony thus means that even without the abnormal EKG in 2006,
testing would have been appropriate during the medical
appointments, including those that occurred within seven years
of the filing of the complaint. The testimony does not
establish either what the standard of care was during these
subsequent medical appointments, or that said standard of care
was breached.
Fundamentally, we hold that the plaintiff did not present
any evidence to the motion judge that would distinguish this
case from Moran: evidence that the defendants, even without the
abnormal EKG in 2006, were negligent during the subsequent
medical appointments. Accordingly, we conclude that the
subsequent medical appointments in this case are the type of
it when deciding this issue on appeal. See Cornelias v.
Viveiros, 410 Mass. 314, 316-318 (1991).
9
continuing treatment described in Moran and that summary
judgment was appropriate.
Judgment affirmed.
By the Court (Ditkoff,
Englander & Walsh, JJ.8),
Assistant Clerk
Entered: December 29, 2023.
The panelists are listed in order of seniority.
10