Hervey v. Northern Westchester Hospital: Clarifying the Limits of the “Continuous Course of Treatment” Doctrine and Psychiatric Malpractice Liability

Introduction

In Hervey v. Northern Westchester Hospital, 238 A.D.3d 1117 (2d Dep’t 2025), the Appellate Division, Second Department, confronted two recurring yet unsettled questions in New York medical-malpractice litigation:

1. When do multiple, temporally-separated hospitalizations constitute one “continuous course of treatment” sufficient to toll the statute of limitations under CPLR 214-a?
2. Under what circumstances can a psychiatrist’s medication and discharge decisions be deemed malpractice rather than protected professional judgment?

The estate of Justin Hervey alleged that Northern Westchester Hospital (“NWH”) misdiagnosed and improperly medicated Hervey during discrete admissions between 2008 and 2012, ultimately leading to his suicide in 2013. A jury found in favor of NWH, rejecting the estate’s “continuous treatment” theory and concluding the hospital’s care met accepted standards. The Supreme Court denied the estate’s post-trial motion under CPLR 4404(a), and the Appellate Division affirmed.

Summary of the Judgment

• Statute of Limitations: The court held there was no continuous course of treatment linking the 2008-2012 admissions, so all negligence alleged before the final 2012 admission was time-barred.
• Evidentiary Rulings: The Supreme Court’s evidentiary decisions—including exclusion of hearsay barred by the Dead Man’s Statute, permitting deposition testimony from an out-of-state nurse practitioner, and limiting potentially misleading demonstratives—were found to be sound exercises of discretion.
• Weight of the Evidence: The jury’s finding that NWH neither departed from accepted psychiatric practice nor provided sub-professional treatment enjoyed a “fair interpretation of the evidence,” precluding reversal.
• Result: Judgment for NWH, dismissal of the complaint, and affirmance on appeal.

Analysis

1. Precedents Cited and Their Influence

The court wove a dense tapestry of authority, mainly in three areas:

1. Trial-management and evidentiary discretion (Micallef v. Miehle, Bhim v. Platz, Molina v. Goldberg). These cases underscore the deference appellate courts accord trial judges on evidentiary rulings and set-aside motions. By invoking them, the panel signaled it would disturb the trial-court rulings only for clear abuse, which it did not find.
2. Dead Man’s Statute & Hearsay (Holcomb v. Holcomb, Grechko v. Maimonides). The estate attempted to introduce statements by both the deceased patient and a now-deceased psychiatrist. The court relied on these authorities to confirm that CPLR 4519 bars such testimony even if it fits a hearsay exception.
3. Continuous Course of Treatment & Psychiatric Liability (Lolik v. Big V Supermarkets; Thomas v. Reddy; Bell v. NYC H&H Corp.).
   • Continuous treatment: Dansby v. Trumpatori and others guide the fact-sensitive inquiry into whether treatment is truly “ongoing.”
   • Psychiatric judgment: The line of cases beginning with Bell shields psychiatrists from liability absent proof that decisions were “something less than a professional medical determination.” The panel found no such lapse here.

2. Legal Reasoning

a) Continuous Course of Treatment

CPLR 214-a ordinarily gives plaintiffs two years and six months from the alleged malpractice—or the patient’s last treatment for the same condition if the treatment is continuous. The estate argued that all hospitalizations comprised one uninterrupted continuum and that off-site facilities were “within NWH’s orbit.” The court disagreed, stressing:

• The admissions were separated by months with no evidence of a plan of ongoing care managed by the same practitioner or department.
• Intervening treatment at unaffiliated facilities broke any continuity.
• Absent a continuing physician-patient relationship or prospective monitoring, the statute was not tolled.

This aligns with, yet sharpens, prior doctrine by making clear that mere repeat admissions to the same hospital do not automatically create continuity—particularly when care is episodic and interspersed with outside providers.

b) Psychiatric Malpractice Standard

The panel reaffirmed that a psychiatrist’s medication or discharge decision is insulated unless the plaintiff demonstrates it was not the product of careful examination—i.e., something less than a professional medical determination. Competing expert testimony existed, but the jury was free to credit NWH’s experts who validated the medication regimen and discharge plan. Thus, even potentially debatable clinical choices are not actionable if grounded in reasonable professional judgment.

c) Evidentiary & Post-Trial Rulings

• Exclusion of hearsay statements under CPLR 4519 was mandatory.
• Use of demonstratives was curtailed to prevent juror confusion (a deferential standard).
• A minor error—disallowing a photograph—was harmless because the jury never reached damages.

3. Impact of the Decision

• Statute of Limitations Litigation: Hospitals facing serial but discrete admissions may raise the statute of limitations with increased confidence. Plaintiffs must now marshal concrete evidence of a single, uninterrupted therapeutic relationship to invoke the continuous-treatment toll.
• Psychiatric Malpractice Suits: The decision bolsters the “professional-judgment” defense, reminding litigants that second-guessing medication choices is insufficient; plaintiffs must prove a departure so egregious that it falls below professional standards.
• Trial Practice: The case affirms broad trial-court discretion over demonstratives and offers a cautionary tale on Dead-Man-Statute pitfalls for estates.

Complex Concepts Simplified

Continuous Course of Treatment (CPLR 214-a)

An exception that pauses (tolls) the statute of limitations while the patient remains under an ongoing regimen of care for the same complaint. The clock starts only when that course of treatment ends.

Professional Medical Judgment

Courts distinguish a negligent act (actionable) from a reasonable choice among medically acceptable alternatives (protected). For psychiatrists, liability arises only when decisions are baseless or made without adequate assessment.

Dead Man’s Statute (CPLR 4519)

Bars an interested party from testifying about communications with a deceased person when that testimony would be adverse to the decedent’s estate or representative. The rule is absolute even if the statement would otherwise be admissible hearsay.

CPLR 4404(a) Motion

Post-verdict request to set aside the verdict “in the interest of justice” or as “contrary to the weight of the evidence.” Judges apply their own sense of fairness, but reversal requires more than mere disagreement with the jury.

Conclusion

Hervey v. Northern Westchester Hospital reinforces two significant guardrails in New York medical-malpractice law. First, repeated hospital encounters do not elongate the statute of limitations unless plaintiff proves a truly continuous therapeutic relationship. Second, psychiatric malpractice remains tightly cabined: unless a treatment decision slips below the threshold of professional judgment, liability will not attach. Combined with a strong reaffirmation of trial-court discretion over evidence, the decision supplies defendants with potent defenses and signals to plaintiffs the evidentiary rigor required to overcome them.