Missouri

All actions against physicians, hospitals, dentists, registered or licensed practical nurses, optometrists, podiatrists, pharmacists, chiropractors, professional physical therapists, and any other entity providing health care services and all employees of any of the foregoing acting in the course and scope of their employment, for damages for malpractice, negligence, error or mistake related to health care shall be brought within two years from the date of occurrence of the act of neglect complained of, except that a minor under the full age of ten years shall have until his twelfth birthday to bring an action, and except that in cases in which the act of neglect complained of its introducing and negligently permitting any foreign object to remain within the body of a living person, the action shall be brought within two years from the date of the discovery of such alleged negligence, or from the date on which the patient in the exercise of ordinary care should have discovered such alleged negligence, whichever date first occurs, but in no event shall any action for damages for malpractice, error, or mistake be commenced after the expiration of ten years from the date of the act of neglect complained of.

Time of Accrual of Action

a. Date of Last Treatment

Shaw v. Clough, 597 S.W.2d 212 (Mo. Ct. App. 1980). (Statute is tolled where the defendant physician continues to treat the patient after the allegedly negligent act occurred. The case involved a nerve injury which occurred in a procedure to take bone plugs for the purpose of a cervical fusion.)

b. Date of Discovery

Snyder v. United States, 717 F.2d 1193 (8th Cir. 1983) , applying federal law. (Malpractice cases are an exception to the rule that a tort claim accrues at the time of the plaintiff's injury. Malpractice claims accrue when the plaintiff has discovered his injury and its probable cause, even though he may be ignorant of his legal rights. Statute bars an action for an unnecessary cordotomy following the erroneous diagnosis of cancer where the action was begun more than two years after the plaintiff learned these facts. The additional claim that the cordotomy resulted in permanent pain was not barred since the failure of the procedure to stop pain does not constitute notice of possible negligence.)

c. Foreign Object Exception

Hershley v. Brown, 655 S.W.2d 671 (Mo. Ct. App. 1983). (To come within the tolling exception for foreign objects, the plaintiff must allege that the doctor negligently permitted the foreign object to remain within her body. The negligent implanting of a contraceptive device does not fall within the foreign object exception.)

d. Continuous Treatment Rule

Weiss v. Rojanasathit, 975 S.W.2d 113, 117 (Mo. banc 1998). (The defendant's failure to inform the plaintiff of abnormal Pap smear results did not invoke continuous treatment rule where plaintiff had failed to return as ordered for follow-up visit and another Pap smear by defendant later revealed cancer. Under the malpractice statute, limitations commenced to run upon occurrence of the act or neglect, not upon ascertainment of damage resulting from the wrong. Because continuing or subsequently developing injuries did not start the running of the statute anew, the continuing tort theory did not apply to malpractice cases even though the court had adopted the rule in other tort cases).

Statute Tolled For Fraudulent Concealment

If any person, by absconding or concealing himself, or by any other improper act, prevent the commencement of an action, such action may be commenced within the time herein limited, after the commencement of such action shall have ceased to be so prevented.

Wilson v. Jackson, 823 S.W.2d 512 (Mo. Ct. App. 1992). (In a wrongful death action brought against a physician based on alleged medical malpractice, the court held that comments made by the physician to the family after the child's death, that everything that could be done had been done and that the death of the child was an act of God, did not rise to the level of fraudulent concealment of his malpractice.)