Washington's medical malpractice statute of limitations, defined under RCW 4.16.350, establishes a dual-deadline framework requiring claims to be filed within three years of the alleged negligent act or within one year of discovery, whichever expires later. Unlike many jurisdictions, this plaintiff-favorable structure provides the benefit of a longer available period rather than a shorter one.
This article examines Washington's dual-deadline structure, discovery rule requirements, the six recognized tolling exceptions affecting medical malpractice claims, and recent judicial developments addressing constitutional challenges to the statute of repose.
Core Rules for Medical Malpractice Statute of Limitations in Washington
This section addresses the dual-deadline structure, the modified statute of repose, discovery rule requirements, the scope of professional negligence claims, and circumstances where alternative limitations periods apply.
Dual-Deadline Structure
Medical malpractice actions must be filed within:
- Three years from the date of the act, error, or omission alleged to have caused the injury or death.
- One year from the date the patient or representative discovered or reasonably should have discovered that the injury was caused by the act, error, or omission.
Washington applies the whichever period expires later rule, providing plaintiffs the benefit of the longer available period. This plaintiff-favorable approach means that even when the three-year period from the negligent act has expired, a claim remains viable if discovered within the prior year, provided the discovery period has not yet run. Conversely, when an injury is immediately apparent, the three-year period controls even if discovery occurs earlier, giving plaintiffs the full three years to file.
Eight-Year Statute of Repose
RCW 4.16.350 imposed an eight-year statute of repose, though the Washington Supreme Court declared this provision unconstitutional in 2023 when applied to bar claims for injuries not diagnosable within the repose period.
Three statutory exceptions allow claims beyond eight years:
- Fraud.
- Intentional concealment.
- Foreign bodies not intended for therapeutic or diagnostic purposes.
Whether the repose limitation applies now depends on whether the plaintiffs had a meaningful opportunity to discover injuries through available diagnostic methods.
Discovery Rule Requirements
Under Washington's discovery rule, the one-year limitations period does not begin until the patient:
- Knows or reasonably should know that an injury or condition exists.
- Knows or reasonably should know that the injury was caused by the healthcare provider's act or omission.
Both elements must be satisfied before the period begins. For minors, the knowledge of a custodial parent or guardian is imputed to the minor.
Washington courts apply an objective, reasonable person standard, examining whether the plaintiff had access to information that would prompt a reasonable person to investigate further. Patients are not required to second-guess their physicians' explanations absent red flags suggesting negligence. Once an inquiry notice exists—sufficient facts to prompt investigation—the limitations period begins running regardless of whether the plaintiff actually undertook such investigation.
Scope of Professional Negligence
Chapter 7.70 RCW, titled "Health Care Providers—Actions for Injuries Resulting From," governs the substantive requirements for medical malpractice actions. Claims arising from healthcare provider actions include:
- Diagnostic errors or failures
- Treatment decisions below the standard of care
- Surgical errors and complications
- Informed consent failures
- Medication errors and adverse reactions
Plaintiffs must establish that the healthcare provider failed to exercise the degree of care, skill, and learning expected of a reasonably prudent provider in the same or similar circumstances, typically through expert testimony. The breach must be a proximate cause of the plaintiff's injury, meaning the negligence was a substantial factor in bringing about the harm.
When RCW 4.16.350 Does Not Apply
The medical malpractice statute of limitations does not govern all claims involving healthcare settings. Standard personal injury statutes under RCW 4.16.080 apply to claims against non-healthcare providers or claims that do not involve professional medical judgment.
Slip-and-fall injuries in hospital common areas or claims against administrative staff for non-medical conduct fall outside RCW 4.16.350's scope.
Tolling Exceptions That Affect Medical Malpractice Statute of Limitations in Washington
Washington law provides six distinct tolling mechanisms that can pause or extend filing deadlines under specific circumstances.
1. Minority Tolling
The Washington Supreme Court held that eliminating minority tolling in medical malpractice cases violated the Washington Constitution. Under current law:
- The statute of limitations is tolled during minority and does not begin until the plaintiff reaches age 18.
- Minors receive the full three-year period after reaching majority (extending to their 21st birthday).
- The eight-year statute of repose does not apply to minors' claims.
This constitutional protection ensures that minors are not deprived of claims before they can personally exercise their legal rights, with minority tolling receiving protection under the Washington State Constitution's Privileges and Immunities Clause.
2. Incapacity Tolling
RCW 4.16.190 provides tolling when a person cannot understand the nature of legal proceedings. The incapacity must exist when the cause of action accrues, and tolling continues until incapacity is removed or a legal representative is appointed.
The functional impairment must be severe enough to prevent the plaintiff from managing legal affairs or protecting rights, requiring more than a psychiatric diagnosis alone.
3. Fraudulent Concealment
RCW 4.16.350 provides tolling for fraudulent concealment. The plaintiff must demonstrate affirmative acts by the healthcare provider to conceal material facts through intentional conduct preventing discovery despite reasonable diligence.
Mere failure to disclose does not suffice. The concealment must involve active misrepresentation or deliberate obstruction of information that would have allowed the plaintiff to discover the injury or its causal connection to medical care.
4. Foreign Object Discovery
RCW 4.16.350 provides tolling for foreign objects unintentionally left in a patient's body. Washington applies a strict actual knowledge standard: the statute does not begin running until the plaintiff has actual knowledge of the foreign object's presence.
Foreign object cases are exempt from the eight-year statute of repose. This exception encompasses surgical instruments, sponges, or other materials left during procedures, but does not extend to implanted devices intended for therapeutic purposes, even if subsequently determined to be inappropriate for the patient's condition.
5. Continuous Treatment
The Washington Supreme Court adopted the continuous treatment doctrine. Tolling applies when the patient receives ongoing treatment from the same provider addressing the same condition related to the alleged malpractice.
The doctrine does not apply to routine follow-up visits unrelated to the underlying injury.
6. Mediation Tolling
RCW 7.70.110 provides that a written, good-faith request for mediation of a health care injury dispute made prior to filing an action tolls the statute of limitations for one year from the date of the request. Washington courts have clarified that mediation letters sent in good faith can invoke tolling protections even with minor addressing errors, reflecting judicial preference for substantial compliance.
How Washington Courts Interpret Medical Malpractice Statute of Limitations Rules
Washington appellate courts have fundamentally reshaped the statute of limitations framework through constitutional interpretation, establishing protections for minors and latent injury cases while clarifying mediation tolling requirements.
Bennett v. United States — Constitutional Challenge to Statute of Repose
The Washington Supreme Court in Bennett v. United States (2023) held that the eight-year statute of repose violates the privileges and immunities clause when applied to bar claims before injuries are medically diagnosable. The plaintiff underwent nasal surgery in 2009 and suffered a traumatic brain injury undiagnosed until 2017, after the eight-year repose period expired. The Court found that barring Bennett's claim before her injury effectively denied any meaningful opportunity to bring the claim.
The Court's constitutional analysis focused on whether the plaintiff had a reasonable opportunity to discover and pursue her claim within the repose period. Finding that medical technology could not have identified Bennett's brain injury earlier, the Court concluded that the repose provision operated as an unconstitutional barrier to her remedy. This holding transformed Washington's statute of repose from an absolute barrier into a contextual limitation dependent on when injuries become diagnosable through available medical science.
Schroeder v. Weighall — Constitutional Protection for Minority Tolling
The Washington Supreme Court in Schroeder v. Weighall (2014) invalidated RCW 4.16.190(2), which had eliminated tolling for minors in medical malpractice claims, holding it violated the privileges and immunities clause. The decision restored full tolling benefits for injured minors and exempted their claims from the eight-year statute of repose.
The Court reasoned that minors lack the legal capacity to protect their own interests and cannot be held responsible for failing to timely file claims during their minority. This constitutional foundation prevents legislative elimination of these protections through statutory amendment.
Fraley v. CommonSpirit Health — Mediation Tolling and Substantial Compliance
The Washington Court of Appeals in Fraley v. CommonSpirit Health (2023) held that mediation letters sent to incorrect addresses can still toll the statute when the plaintiff acts in good faith. The plaintiff sent mediation letters to entities other than the direct healthcare provider defendants, but the Court found substantial compliance satisfied the statute when the core purpose of providing notice and opportunity for mediation was achieved.
The decision emphasized that RCW 7.70.110's purpose is to encourage pre-litigation resolution, and technical addressing errors should not defeat tolling when the plaintiff demonstrates good faith efforts, and defendants receive actual notice with sufficient time to engage in meaningful mediation discussions.
Recent Updates to Medical Malpractice Statute of Limitations in Washington
No legislative amendments to RCW 4.16.350 were enacted between 2023 and 2025. The statute has remained unchanged since 2006, though its practical application has been fundamentally transformed through judicial constitutional interpretation.
The 2023 invalidation of the eight-year absolute deadline for latent injuries represents the most significant change to Washington's medical malpractice limitations landscape in nearly two decades. The legislature has not responded with new legislation, suggesting acceptance of the judicial framework. The decision's emphasis on constitutional privileges and immunities protections signals potential vulnerability of other repose provisions that bar claims before injuries become discoverable.
What This Means for Medical Malpractice Filing Deadlines in Washington
Washington's medical malpractice framework provides plaintiff-favorable timing rules through the "whichever expires later" structure of RCW 4.16.350, constitutional protections for minors and latent injury cases, and extensive tolling exceptions. Compliance requires accurate calculation of both the three-year and one-year discovery deadlines, identification of applicable tolling provisions, and assessment of constitutional protections limiting the statute of repose.
Accurate case evaluation depends on establishing treatment timelines, injury discovery points, and supporting medical records documenting when plaintiffs knew or should have known of both injury and causation. Legal technology supports this work by organizing records, building defensible chronologies, and helping firms track statutory deadlines—particularly the dual-deadline framework where claims must be filed within the later of three years from the negligent act or one year from discovery.
Explore Tavrn’s legal technology solutions.
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