## Facts

- Eugene R. Andreini underwent right-knee surgery at Holy Cross Hospital on May 5, 1987, performed by Dr. R. David Beck, with anesthesia administered by Dr. Bruce Hultgren.
- The next day Andreini experienced a “pins and needles” sensation in both hands, and by discharge on May 19, 1987, he had noticeable atrophy.
- The discharge summary noted “bilateral ulnar neuropathy” but did not identify a cause; Andreini asserted he was not told he had a nerve injury or what the diagnosis meant.
- A later physician diagnosed compression paralysis, and an independent nurse later suggested the condition might have resulted from improper hand strapping during the knee surgery.
- Dr. Beck advised Andreini that hand surgery was needed and would restore function.
- About 30 minutes before the hand surgery, after Andreini had been prepped for surgery, a hospital employee presented a release discharging Holy Cross from further liability; Andreini asserted Dr. Beck would not operate unless he signed.
- Andreini, upset and facing worsening hand function, signed the release; the hand surgery did not restore function and he lost most hand dexterity.
- Andreini sued for medical malpractice; the trial court granted summary judgment to (1) Dr. Hultgren as time-barred and alternatively for failure to timely request prelitigation panel review after notice of intent to sue, and (2) Dr. Beck and Holy Cross based on the release.

## Issues

1. Whether the malpractice claims against Dr. Hultgren were barred by the two-year limitations period as applied through the discovery rule.
2. Whether Andreini’s claims against Dr. Hultgren were barred for failing to timely request prelitigation panel review within sixty days after notice of intent to sue.
3. Whether the release signed immediately before hand surgery was enforceable as a matter of law, or whether fact issues of duress, voluntariness, and public policy precluded summary judgment for Dr. Beck and Holy Cross.

## Decision

- The Utah Supreme Court reversed the summary judgment for Dr. Hultgren and remanded.
- The court held that material fact disputes existed on when Andreini discovered, or reasonably should have discovered, both the injury and its negligent cause.
- The court rejected summary judgment based on the asserted sixty-day prelitigation-panel request defect because the record did not permit resolving compliance and related statutory questions as a matter of law.
- The Utah Supreme Court reversed the summary judgment for Dr. Beck and Holy Cross and remanded.
- The court held that the circumstances of execution of the release created triable issues regarding duress and voluntariness and implicated public-policy limits on exculpatory agreements in medical treatment.

## Legal Principles

- In Utah medical malpractice actions, the two-year limitations period runs from when the plaintiff discovered or, through reasonable diligence, should have discovered the injury and its negligent cause.
- When reasonable minds can differ about discovery of malpractice, the timing of discovery is generally a fact question inappropriate for summary judgment.
- Summary judgment must be reviewed with facts and reasonable inferences construed in favor of the nonmoving party.
- Statutory prelitigation screening requirements should not be enforced through summary judgment where the record leaves genuine disputes about compliance or statutory application.
- A liability release obtained in a medical setting may be unenforceable if procured under duress or without voluntary consent, especially where presented under time pressure as a condition of receiving needed treatment.
- Exculpatory clauses affecting professional medical services are subject to heightened scrutiny where unequal bargaining power and public-interest concerns are implicated.

## Conclusion

The Utah Supreme Court reversed summary judgments for the anesthesiologist, surgeon, and hospital because genuine disputes remained about when the patient reasonably discovered possible malpractice, whether prelitigation requirements were satisfied, and whether a last-minute pre-surgery release was voluntary and consistent with public policy.


Andreini v. Hultgren, 860 P.2d 916 (Utah 1993)