The Second Appellate District of Ohio has reversed the Montgomery County Court of Common Pleas’ decision in a medical malpractice case, sending the matter back for further proceedings. The ruling, issued on November 14, 2025, centers on the timeliness of the lawsuit filed by Isidora Tsonis and her family against Anesthesiology Services Network Ltd. (“ASN”), Dr. Bradley Besson, Edward Jones, and Miami Valley Hospital (“MVH”). The appellate court found the trial court erred in its interpretation of the statute of limitations and its denial of discovery crucial to resolving the case.
Background of the Case
The case stems from a medical procedure Tsonis underwent at MVH on July 20, 2021. She was scheduled for an electrophysiology study, a cardiology procedure that required general anesthesia. During the procedure, the complaint alleges that Jones, a certified registered nurse anesthetist employed by ASN, negligently inserted the endotracheal tube into the esophagus instead of the trachea. This error, which allegedly went unnoticed for a significant period, resulted in a brain injury to Tsonis. Dr. Besson, an anesthesiologist also employed by ASN, was accused of failing to properly supervise Jones.
Following the complication, Tsonis became comatose and required intensive care. While she regained consciousness the next day, she exhibited signs of encephalopathy and memory loss. Tsonis has no memory of her hospitalization.
On January 10, 2023, Tsonis initially filed a medical negligence lawsuit (Case No. 2023 CV 00143) against the involved parties. This action was voluntarily dismissed on February 16, 2023. Subsequently, with new legal representation, Tsonis refiled the action on February 14, 2024 (Case No. 2024 CV 00907).
The Trial Court’s Decision
The Anesthesia Defendants (ASN, Besson, and Jones) filed a motion for summary judgment, arguing that Tsonis’s claims were time-barred because they were not filed within the one-year statute of limitations for medical malpractice claims. They argued that the 180-day letters, required by Ohio law to extend the statute of limitations, were not properly received. MVH also filed a separate motion for summary judgment, raising similar arguments.
The trial court sided with the defendants, granting both motions for summary judgment. It determined that the statute of limitations began running on July 23, 2021, the date Tsonis was discharged from the hospital. The court also held that the 180-day letters were not timely served, even if the defendants did not receive actual notice of the letters. The court did not address tolling arguments, which would have extended the statute of limitations if the defendants were out of state.
Appellate Court’s Findings
The appellate court disagreed with the trial court’s conclusions, reversing the summary judgment decisions and remanding the case. The court’s analysis focused on three key areas:
1. Notice under R.C. 2305.113(B): The court clarified that, due to a 2019 amendment to the law, actual notice of the 180-day letters is no longer required. The law now specifies how these letters must be sent (certified mail, return receipt requested), and compliance with this method is sufficient. The trial court’s reliance on the older standard of “actual notice” was incorrect.
2. Effective Date of the 180-Day Letters: The court determined that the 180-day letters to Besson and Jones were effective on July 28, 2022, based on the return receipts. While the defendants claimed the letters weren’t properly received by their agents, the court found their affidavits insufficient to demonstrate the letters were not delivered to the correct address.
3. Accrual of Medical Claim and Tolling: The appellate court found that a genuine issue of material fact existed as to whether Tsonis’s mental impairment, caused by the brain injury, delayed the start of the statute of limitations. The court also ruled that the trial court erred in not allowing discovery regarding whether Besson or Jones were out of state, which could toll (extend) the statute of limitations. The court emphasized that the defendants’ absence from Ohio for vacation or other personal reasons, even for a short period, could potentially extend the deadline.
Implications of the Ruling
The appellate court’s decision means the case will now proceed with further legal action. The trial court must reconsider the statute of limitations and allow Tsonis to conduct discovery to determine whether the defendants were out of state for any period during the relevant time frame. This information is crucial for determining the timeliness of the lawsuit.
The ruling underscores the importance of correctly interpreting statutory requirements, particularly those related to statutes of limitations and the service of legal notices.