## Facts

- A laboring patient with two prior cesarean deliveries sought a vaginal birth for her third child at a hospital.
- During labor, the attending obstetrician concluded that continuing a trial of labor raised safety concerns and a cesarean delivery was ultimately performed.
- The patient alleged the cesarean was performed over her objection and asserted failures to respect her rights during decision-making.
- The surgery resulted in a bladder laceration requiring repair; the infant was born healthy.
- The patient sued the hospital, the hospital’s obstetrics director, the attending physician, and the physician’s practice, asserting medical malpractice, lack of informed consent, and statutory/regulatory patient-rights violations (including Public Health Law § 2803-c and 10 NYCRR 405.7).
- The hospital and director were also alleged to have failed to summon a patient-advocacy group and a bioethics panel during the dispute over delivery management.

## Issues

1. Whether malpractice and informed-consent theories premised on an alleged cesarean performed “despite her objection” were time-barred under CPLR 214-a, and whether the continuous-treatment doctrine saved any related theories.
2. Whether the patient was entitled to summary judgment on liability for lack of informed consent.
3. Whether a claim based on hospital patient-rights statutes/regulations stated a cause of action against the hospital and its obstetrics director at the pleading stage.
4. Whether the hospital and its director were entitled to summary judgment dismissing, as time-barred, the malpractice theory based on failing to summon a patient advocate group and bioethics panel.

## Decision

- The Appellate Division affirmed in part and modified in part the Supreme Court’s orders.
- It upheld dismissal, as time-barred, of the third cause of action and the portions of the first (malpractice) and second (lack of informed consent) causes of action that were based on the allegation that defendants performed a cesarean “despite her objection.”
- It affirmed denial of the patient’s summary-judgment motion on liability for lack of informed consent because factual disputes and competing expert opinions required trial resolution.
- It affirmed denial of the hospital’s and obstetrics director’s motion to dismiss the patient-rights cause of action for failure to state a claim, permitting it to proceed at the pleading stage.
- It affirmed denial of summary judgment to the hospital and obstetrics director on statute-of-limitations grounds as to the malpractice theory that they failed to summon a patient advocate group and bioethics panel, holding that continuous treatment could apply to that theory.

## Legal Principles

- Under CPLR 214-a, discrete alleged malpractice events may be time-barred even when other related treatment-based theories remain timely.
- The continuous-treatment doctrine may preserve claims tied to ongoing care and decision-making during a course of treatment, including alleged failures in hospital processes occurring during that course.
- Summary judgment on lack of informed consent is inappropriate where the record presents competing expert evidence and fact questions about what information was provided, what should have been provided, and whether a reasonably prudent patient would have declined the procedure if fully informed.
- Hospital regulations and patient-rights provisions (including 10 NYCRR 405.7) may support claims against hospital actors within existing liability frameworks, even where the regulation does not, by itself, create a standalone private right of action against non-hospital defendants.

## Conclusion

The court narrowed the case by dismissing as untimely theories premised on an alleged nonconsensual cesarean, but preserved (1) a malpractice theory against the hospital and its obstetrics director based on failure to engage patient-advocacy/bioethics mechanisms under continuous treatment and (2) a hospital-based patient-rights claim at the pleading stage, while leaving informed-consent liability for trial.


Dray v. Staten Island Univ. Hosp., 160 A.D.3d 614 (N.Y. App. Div. 2d Dep’t 2018)