- Court
- Court of Appeals of Georgia
- Year
- 2026
- Case
- Paul v. Urban Family Practice Assocs., P.C.
- Citation
- Case No. A25A2019, 378 Ga. App. 400
- Decided
- January 30, 2026
Where a medical-malpractice complaint alleging failure to diagnose prostate cancer did not affirmatively show when the localized cancer first could have been diagnosed, when it metastasized, or when symptoms attributable to the metastatic cancer first manifested, the complaint did not affirmatively prove the limitations defense, and 12(b)(6) dismissal under OCGA § 9-3-71(a) was improper. Reversed.
The opinion is a clean application of an old rule. On a motion to dismiss for failure to state a claim, the statute of limitations is an affirmative defense, and the complaint either proves the defense out of its own four corners or it does not. If it does not, the case proceeds. There is no new doctrine here. There is a trial court that lost track of which side carried the burden, and a Court of Appeals that put it back where it belongs.
The procedural posture is short. The plaintiffs filed a medical-malpractice complaint against Urban Family Practice Associates, P.C. (“UFPA”) and one of its primary care physicians, Dr. Godfrey J. Mark, alleging that the failure to monitor PSA levels and perform prostate examinations over an eight-year stretch led to an undiagnosed prostate cancer that, by the time it was found, was already advanced. The complaint was filed eleven days after the two-year anniversary of the last UFPA visit. The Cobb State Court treated the case as a misdiagnosis case, applied the general rule that limitations runs from the misdiagnosis date, and dismissed under OCGA § 9-3-71(a). The Court of Appeals reversed.
The factual setup matters because the new-injury exception lives in the facts. A PSA test was performed in 2011 (2.5 ng/ml); another in 2014 (2.52 ng/ml); the contemporaneous digital prostate exam was unremarkable. The patient complained of urologic symptoms at later visits, and Dr. Mark diagnosed benign prostatic hypertrophy in 2019. No PSA test or prostate examination was performed between November 2014 and August 2022 — roughly eight years. The August 2022 PSA was 18.05 ng/ml. A November 2022 Mayo Clinic biopsy revealed advanced prostate cancer. The expert affidavit alleged that the failure to monitor “caused a critical delay in the identification of malignant prostate cells … eliminated … [the] potential for local cancer control/cure, facilitated metastasis, and increased [the] morbidity and mortality.”
The doctrinal architecture is well-settled and the opinion walks it cleanly. Under Kaminer v. Canas, 282 Ga. 830 (2007), and Adams v. McDonald, 346 Ga. App. 464 (2018), limitations in a failure-to-diagnose case ordinarily runs from the misdiagnosis date. Under Cleaveland v. Gannon, 284 Ga. 376 (2008), and Amu v. Barnes, 283 Ga. 549 (2008), a localized cancer that goes undiagnosed and then metastasizes can produce a “new injury,” with limitations running from the date symptoms attributable to the new injury first manifest. And under Roberts v. DuPont Pine Products, 352 Ga. App. 659 (2019), and Perry v. Emory Healthcare Servs. Mgmt., 374 Ga. App. 41 (2025), the limitations defense on a motion to dismiss must be proved out of the complaint itself: “if the facts alleged in the complaint affirmatively prove a defense, a court may dismiss the complaint based upon the defense, but if the facts alleged in the complaint merely fail to affirmatively disprove a defense, no dismissal is warranted.”
That last sentence is the case. The complaint did not affirmatively show when the localized cancer first could have been diagnosed, when it metastasized, or when symptoms attributable to the metastatic cancer first manifested. Construed in the plaintiffs’ favor, the allegations were consistent with a metastasis-as-new-injury theory. The limitations question therefore could not be resolved on the pleadings.
The takeaway is procedural rather than doctrinal. Footnote 5 makes the point explicit: “the discovery process bears the burden of filling in details, and a motion for summary judgment is the ‘appropriate vehicle’ for determining whether there is an evidentiary basis for the ‘new injury’ exception.” The trial court’s mistake was choosing the wrong vehicle, not misreading the substantive law. The rule the Court of Appeals applied is the same rule it has been applying for twenty years; the only thing the case adds is one more reminder that on a 12(b)(6) the burden runs the way the burden has always run.
