In many respects, Virginia has been more conservative about modifying the common law than its sister states. To the extent modifications have been approved, many restrict rather than expand the rights of the victims of medical negligence. For example, Virginia has adopted three major modifications of medical malpractice law: a damage cap, screening of proposed lawsuits by a medical review panel, and a state fund to compensate victims of birth-related neurological injuries. Much of the legislation specific to medical malpractice can be found in the Medical Malpractice Act, Va. Code Ann. §§ 8.01-581.1 to 8.01-581.20.
Statutes of Limitations
All medical malpractice actions for injury (as opposed to death) must be brought within two years from the date the cause of action accrued. Va. Code Ann. § 8.01-243(A). In § 8.01-230, a cause of action “accrues” at the time of injury: “the cause of action shall be deemed to accrue and the prescribed limitation period shall begin to run from the date the injury is sustained in the case of injury to the person… and not when the resulting damage is discovered.”
This two-year limitation has long been applicable, and strictly enforced, in Virginia. Virginia is one of the minority states that use the “date-of-the-act” rule, which means that the plaintiff must file suit within two years of the date of the injury regardless of how obscure or undiscoverable the injury might have been. Exceptions to the two-year rule are (i) cases involving minors or mentally incompetent people who are in law regarded as unable to know their legal rights and (ii) cases where the injury was fraudulently concealed from the person.
The Virginia Supreme Court rejected the judicial adoption of a discovery rule, Nunnally v. Artis, 254 Va. 247, 492 S.E.2d 126, (1997), but held that “continuing treatment for the same conditions” tolls the statute of limitations until treatment ends. Grubbs v. Rawls, 235 Va. 607, 369 S.E.2d 683 (1988). The court defined “continuous treatment” as not “mere continuity of a general physician-patient relationship; we mean diagnosis and treatment for the same relating illness or injuries, continuing after the alleged act of malpractice.” The court acknowledged, however, the rule would not apply to a single, isolated act of malpractice. Farley v. Goode, 219 Va. 969, 252 S.E.2d 594 (1979). In other words, when an act of malpractice occurred and that physician continued to see the patient over a course of years for an unrelated condition, the rule would not apply.
In foreign object cases (surgical sponges, needles, etc.) and cases of fraud or concealment (i.e., alteration of medical records) the statute is extended to one year from the date the object or injury is discovered or reasonably should have been discovered. However, this extension is subject to a ten-year limit from the time the cause of action accrued. Va. Code Ann. § 8.01-243(C).
In cases in which the health care provider’s negligence caused the patient’s death (Wrongful Death Claims), suit must be filed within two years of death. Va. Code Ann. § 8.01-244(B).
If a person entitled to bring a personal action dies with no such action pending before the expiration of [the two-year] limitation period… then an action may be commenced by the decedent’s personal representative before the expiration of the limitation period… or within one year after his qualification as personal representative, whichever occurs later.
However, § 8.01-229(B)(6) states that:
[i]f there is an interval of more than two years between the death of any person in whose favor . . . a cause of action has accrued or shall subsequently accrue and the qualification of such person’s personal representative, such personal representative shall, for the purposes of [the statute], be deemed to have qualified on the last day of such two-year period.
A parent’s action for medical expenses caused by injury to a minor must be brought within five years. Va. Code Ann. § 8.01-243(B). A minor’s medical malpractice action for injury or death must be commenced within two years from the date of the last act of negligence, unless the child is less than eight years of age, in which case the action must be brought by the child’s tenth birthday. Va. Code Ann. § 8.01-243.1. The Virginia Supreme Court has upheld the constitutionality of this statute. Willis v. Mullett, 263 Va. 653, 561 S.E.2d 705 (2002). Incapacity (typically a substantial mental or physical handicap) also tolls the running of the statute of limitations during the period of incapacity. Va. Code Ann. § 8.01-229(A).
Contributory or Comparative Negligence
Virginia recognizes the doctrine of contributory negligence in medical malpractice cases. A plaintiff’s contributory negligence may bar her recovery entirely, but the patient’s negligence must be concurrent with the defendant’s negligence. Sawyer v. Comerci, 264 Va. 68, 563 S.E.2d 748 (2002); Ponirakis v. Choi, 262 Va. 119, 546 S.E.2d 707 (2001).
Joint and Several Liability
Virginia imposes joint and several liability on joint tortfeasors. Va. Code Ann. § 8.01-443. Thus, any joint tortfeasor against whom judgment is entered is liable to the plaintiff for the entire judgment, regardless of the tortfeasor’s degree or percentage of fault. For example, in a hospital setting, if the attending doctor and nurse are both negligent, then each one can be held responsible for the patient’s entire injury even if part of that injury was caused by the other’s negligence.
Under the doctrine of respondeat superior, hospitals in Virginia are vicariously liable for the negligence of their employees but not that of independent contractors. McDonald v. Hampton Training School for Nurses, 254 Va. 79, 486 S.E.2d 299 (1997). Whether a physician should be considered an employee is a question of fact not to be determined by whether the hospital calls him one, but by the factors of selection and engagement, payment of compensation, power of dismissal, and (most importantly) power to control the physician’s work. A physician’s exercise of professional judgment in the performance of professional duties is a factor, but not the only factor, in deciding whether the hospital has the power to control his work. There is also authority for holding a hospital liable for the act of a physician on the theory of negligent credentialing. Stottlemyer v. Ghramm, 2001 Va. Cir. LEXIS 501 (Va. Cir. Ct. July 13, 2001)(affirmed at 2004 Va. LEXIS 99 (2004). In other words, a hospital can be held legally responsible for granting hospital admission and treatment privileges to an unqualified physician.