Peters v. United Community & Family Services, Inc. , 182 Conn. App. 688 ( 2018 )


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    STEVEN V. PETERS, JR. v. UNITED COMMUNITY
    AND FAMILY SERVICES, INC., ET AL.
    (AC 39559)
    DiPentima, C. J., and Prescott and Norcott, Js.
    Syllabus
    The plaintiff sought to recover damages from the defendant dental surgeon,
    R, arising out of the allegedly negligent performance of maxillofacial
    surgery. The plaintiff, pursuant to statute (§ 52-190a), appended to his
    complaint an opinion letter authored by a maxillofacial surgeon stating
    that there appeared to be evidence of medical negligence. The letter
    did not indicate whether the author was board certified. R filed a motion
    to dismiss the allegations directed toward him, claiming that the trial
    court lacked personal jurisdiction over him because the author was not
    a ‘‘similar health care provider’’ as defined by statute (§ 52-184c [c]).
    The plaintiff claimed that, although the letter was defective, he fully
    complied with § 52-190a because the author met all necessary qualifica-
    tions at the time he wrote the letter. The plaintiff filed with his opposition
    to the motion to dismiss an affidavit from the author attesting to his
    board certification. The trial court declined to consider the affidavit,
    which was filed outside the relevant statute of limitations period, granted
    the motion to dismiss and rendered judgment thereon, from which the
    plaintiff appealed to this court. Held that the trial court properly granted
    R’s motion to dismiss: although a plaintiff who files a legally insufficient
    opinion letter may, in certain instances, cure the defective opinion letter
    through amendment of the pleadings, thereby avoiding the need to file
    a new action, the plaintiff here did not attempt to cure the defective
    opinion letter by way of amendment of the pleadings and, instead,
    submitted the explanatory affidavit with his opposition to the motion
    to dismiss, after the expiration of the applicable statutes of limitations,
    because the opinion letter was defective in that it failed to indicate that
    the author was board certified in the same specialty as R, there was an
    adequate ground to dismiss the action pursuant to § 52-190a (c), and
    even if the affidavit submitted with the plaintiff’s opposition to the
    motion to dismiss was functionally equivalent to a request for leave to
    file an amended opinion letter, that effort to cure the defect was made
    well after the statute of limitations had run; moreover, although the
    plaintiff factually distinguished the affidavit procedure that he employed
    from the procedure of filing amended pleadings, he failed to provide
    any legal analysis as to why the procedures should be treated differently
    for statute of limitations purposes, and it would have been illogical to
    conclude that the plaintiff could avoid dismissal by submitting an affida-
    vit in lieu of an amendment, both of which would have been untimely.
    Argued January 11—officially released June 19, 2018
    Procedural History
    Action to recover damages for the defendants’ alleged
    medical malpractice, and for other relief, brought to the
    Superior Court in the judicial district of New London,
    where the court, Vacchelli, J., granted the motion to
    dismiss filed by the defendant Edward Reynolds, Jr.,
    and rendered judgment thereon, from which the plain-
    tiff appealed to this court. Affirmed.
    Cody A. Layton, for the appellant (plaintiff).
    Beverly Knapp Anderson, for the appellee (defendant
    Edward Reynolds, Jr.).
    Opinion
    PRESCOTT, J. With the intent to deter the filing of
    frivolous medical malpractice actions, our legislature in
    1986 adopted General Statutes § 52-190a, which makes
    malpractice actions subject to dismissal unless the
    plaintiff obtains and attaches to the complaint an opin-
    ion letter written and signed by a similar health care
    provider indicating that there appears to be evidence
    of medical negligence. The meaning and application of
    this requirement itself has spawned extensive litigation
    since its enactment.1 This appeal is the latest iteration
    of this judicial journey.
    The plaintiff, Steven V. Peters, Jr., commenced the
    underlying action for monetary damages arising out
    of the alleged negligent performance of maxillofacial
    surgery. He appeals from the judgment of the trial court
    dismissing, pursuant to § 52-190a (c),2 count three of
    his action directed against the defendant, Edward Rey-
    nolds, Jr., DDS, because the opinion letter that the plain-
    tiff attached to the complaint failed to provide that its
    author is board certified by the appropriate American
    board in the same specialty as the defendant.3 The plain-
    tiff claims on appeal that the trial court improperly
    relied on this court’s decision in Gonzales v. Langdon,
    
    161 Conn. App. 497
    , 
    128 A.3d 562
    (2015), as the basis
    for its decision to reject the affidavit that he attached
    to his response to the motion to dismiss, in which he
    sought to clarify the credentials of the opinion letter’s
    author. We conclude that, because the plaintiff’s
    attempt to cure the defect in the opinion letter came
    after the relevant statute of limitations had run, the trial
    court properly granted the motion to dismiss on the
    basis of an inadequate opinion letter. Accordingly, we
    affirm the judgment of the trial court.
    The following facts, as set forth in the complaint, and
    procedural history are relevant to our consideration
    of the plaintiff’s claim. Beginning in August, 2012, the
    plaintiff sought dental treatment from United Commu-
    nity and Family Services, Inc. (UCFS) for a ‘‘full maxil-
    lary denture over a partial mandibular denture.’’ The
    defendant was a ‘‘servant, agent, apparent agent . . .
    or employee’’ of UCFS, who ‘‘held himself out to the
    general public as a physician and surgeon duly licensed
    to practice medicine in the state of Connecticut, practic-
    ing in Norwich and specializing in oral and maxillo-
    facial surgery.’’ (Emphasis added.) On September 19,
    2012, the plaintiff underwent a procedure known as a
    decompression of a maxillary cyst. That procedure was
    performed by the defendant or by someone under his
    supervision. The plaintiff continued to receive treat-
    ment related to the cyst through October 11, 2013, at
    which time the plaintiff ‘‘became aware that there may
    have been a breach of the standard of care.’’
    The plaintiff commenced the underlying action
    against the defendant on January 7, 2016, within the
    applicable limitation period.4 The complaint had a
    return date of February 9, 2016. In his complaint, the
    plaintiff alleges that, while under the defendant’s treat-
    ment and care, he suffered serious, painful, and perma-
    nent injuries that required additional medical treatment,
    and that the defendant had failed ‘‘to exercise that
    degree of care and skill ordinarily and customarily used
    by physicians and surgeons specializing in oral and
    maxillofacial surgery . . . .’’
    Attached to the complaint was the requisite good
    faith certificate signed by the plaintiff’s attorney and
    an opinion letter from a physician who asserts that he
    had reviewed the plaintiff’s medical records and had
    conducted a clinical exam of the plaintiff. The opinion
    letter sets forth the author’s educational and profes-
    sional background, including that he graduated cum
    laude from the Harvard School of Dental Medicine in
    1988, and currently is a craniofacial trauma surgeon at
    Hartford Hospital and the oral and maxillofacial sur-
    geon for the Connecticut Children’s Medical Center Cra-
    niofacial Team. The letter contains the author’s opinion
    that the plaintiff’s diagnosis and overall treatment
    involved ‘‘an extreme departure from the standard of
    care’’ and sets forth in some detail the factual underpin-
    ning for that opinion. The letter does not provide, how-
    ever, whether the author is certified as a specialist by
    any American board.
    On March 8, 2016, the defendant filed a motion to
    dismiss all allegations in the complaint directed against
    him on the ground that the opinion letter attached to
    the complaint did not fully comply with § 52-190a. The
    defendant claimed that the opinion letter was defective
    in two ways.
    First, the defendant argued that the opinion letter
    failed to demonstrate that its author is a ‘‘similar health
    care provider’’ as that term is defined in General Stat-
    utes § 52-184c (c).5 Specifically, the defendant argued
    that because the plaintiff brought the action against
    the defendant as a specialist in oral and maxillofacial
    surgery, the opinion letter’s author needed to be
    ‘‘trained and experienced in the same [medical] spe-
    cialty’’ as the defendant and had to be ‘‘certified by the
    appropriate American [b]oard in the same specialty.’’
    General Statutes § 52-184c (c). Because the opinion let-
    ter attached to the plaintiff’s complaint did not provide
    whether the author was certified by the American board
    responsible for certifying oral and maxillofacial sur-
    geons, the defendant argued that it was insufficient to
    demonstrate that the opinion provided was by a similar
    health care provider.
    Second, the defendant argued that the letter con-
    tained no opinion of medical negligence with respect
    to the defendant because there was no express indica-
    tion by the author that the defendant had provided any
    treatment in violation of the standard of care. According
    to the defendant, the letter mentions him only in con-
    nection with his supervision of another physician, Jose
    Rivero; see footnote 3 of this opinion; but does not
    claim that the defendant’s supervision was negligent or
    breached the standard of care.
    On May 9, 2016, the plaintiff filed a memorandum of
    law in opposition to the defendant’s motion to dismiss.
    The plaintiff argued that the opinion letter he attached
    to his complaint complies with the requirements set
    forth in § 52-190a. The plaintiff acknowledged that, due
    to the allegations in his complaint, he was required
    to secure an opinion letter from a similar health care
    provider that was both trained and experienced in the
    same specialty as the defendant and certified by the
    appropriate American board in the same specialty. The
    plaintiff, however, asserted that he fully complied with
    those requirements because the author of his opinion
    letter, in fact, met all necessary qualifications at the
    time he wrote his letter. According to the plaintiff, the
    author, in setting forth his credentials, inadvertently
    left out the fact that he was board certified.
    The plaintiff argued that the Superior Court has, in
    other cases, allowed parties to cure similar defects by
    submitting an affidavit from the letter’s author to sup-
    plement or clarify the original letter. The plaintiff
    attached to his opposition memorandum an affidavit
    executed on May 4, 2016, by the author of the opinion
    letter. In that affidavit, the author avers as follows:
    ‘‘I am certified by the American Board of Oral and
    Maxillofacial Surgery and have been continuously since
    October 1, 2008, through the present date, including
    November 25, 2015, the date I authored said opinion
    letter.’’ A photocopy of his board certificate is attached
    to the affidavit. At no time, however, did the plaintiff
    seek permission to amend the complaint or to file an
    amended opinion letter.
    The court heard argument on the motion to dismiss
    on July 25, 2016. The defendant argued, in relevant part,
    that in deciding whether the plaintiff had complied with
    § 52-190a, the court lacked the discretion to consider
    the affidavit that the plaintiff submitted with his opposi-
    tion to the motion to dismiss because the plaintiff’s
    attempt to cure the defect in the opinion letter came
    more than thirty days after the return date of the original
    complaint and, more importantly, after the statute of
    limitations had expired. The defendant cited this court’s
    decision in Gonzales v. 
    Langdon, supra
    , 
    161 Conn. App. 497
    , as supporting that proposition, relying on the fol-
    lowing language: ‘‘[I]f a plaintiff alleging medical mal-
    practice seeks to amend his or her complaint in order
    to amend the original opinion letter, or to substitute a
    new opinion letter for the original opinion letter, the
    trial court (1) must permit such an amendment if the
    plaintiff seeks to amend as of right within thirty days
    of the return day and the action was brought within
    the statute of limitations, and (2) has discretion to per-
    mit such an amendment if the plaintiff seeks to amend
    within the applicable statute of limitations but more
    than thirty days after the return day. The court may
    abuse its discretion if it denies the plaintiff’s request
    to amend despite the fact that the amendment would
    cure any and all defects in the original opinion letter
    and there is an absence of other independent reasons
    to deny permission for leave to amend.’’ 
    Id., 510. The
    plaintiff responded that, at the time this action
    was commenced, the author of the opinion letter
    attached to the complaint met all of the statutory qualifi-
    cations necessary to render an opinion as a similar
    health care provider. He admitted that the author inad-
    vertently had failed to include in the letter that he was
    certified by the appropriate American board, but never-
    theless took the position that this was not a fatal defect.
    The plaintiff argued that, pursuant to Practice Book
    § 10-31, which governs the filing of oppositions to
    motions to dismiss, courts may consider affidavits sub-
    mitted with an opposition to resolve factual ambiguities
    in the record.6 Thus, according to the plaintiff, the court
    properly could consider the affidavit that the plaintiff
    submitted to resolve in his favor the issue raised in the
    motion to dismiss with respect to the opinion letter.
    Moreover, the plaintiff argued that the Superior Court
    had, in other cases, permitted plaintiffs in medical mal-
    practice actions to cure defects in an opinion letter by
    way of an affidavit rather than by formal amendment
    of the pleadings. The plaintiff attempted to distinguish
    our decision in Gonzales, arguing that its application
    was limited to if and when the court may allow amend-
    ments to the complaint or accept the submission of
    an entirely new opinion letter, and did not address or
    resolve whether, even after the statute of limitations
    had run, an affidavit might be sufficient to rectify a
    deficient opinion letter.
    The trial court issued a decision on August 8, 2016,
    granting the defendant’s motion and dismissing the
    third count of the complaint, without prejudice, on the
    ground that the required opinion letter was deficient
    because, as admitted by the plaintiff, it failed to state
    whether the author was board certified in the same
    specialty as the defendant.7 The court first rejected the
    plaintiff’s attempt to ‘‘stave off dismissal by arguing
    that it is questionable whether [§ 52-190a] requires that
    the author [of an opinion letter] describe how he pur-
    ports to be a similar health care provider in the letter.’’
    The court concluded that that issue had been resolved
    by the Appellate Court in Lucisano v. Bisson, 132 Conn.
    App. 459, 466, 
    34 A.3d 983
    (2011) (‘‘[t]he only plausible
    application of the plain language of §§ 52-190a and 52-
    184c requires the disclosure of qualifications in the opin-
    ion letter’’). The court then turned to whether it had
    authority to rely on the affidavit that the plaintiff had
    attached to his opposition to the motion to dismiss as
    a means of curing a defect in the opinion letter. The
    court acknowledged the plaintiff’s argument that ‘‘a
    long line of Superior Court decisions’’ have sanctioned
    the use of an explanatory affidavit under similar circum-
    stances, ‘‘favorably comparing the affidavit procedure
    to Appellate Court language sanctioning the curing of
    such defects by amendment practice, available under
    Practice Book § 10-60.’’8
    The court concluded, however, that it was unneces-
    sary for it to resolve whether the defective opinion
    letter was amenable to correction through the filing of
    an affidavit as opposed to the filing of an amended
    pleading. The court determined that, because the stat-
    ute of limitations had run, neither procedure was a
    viable option. It reasoned as follows: ‘‘The court is not
    persuaded that the plaintiff’s affidavit should be exempt
    from the Gonzales v. Langdon rule. The reason why
    affidavits have been allowed is because they are com-
    pared favorably to Appellate Court authority allowing
    amendments. [Because] any amendment that sought to
    supply this missing necessary information would be
    too late, so too would be an affidavit that sought to
    accomplish the same thing.’’
    The court also rejected the plaintiff’s argument that
    the defect in his opinion letter was merely circumstan-
    tial in nature and, thus, excusable. See General Statutes
    § 52-123 (‘‘[n]o writ, pleading, judgment or any kind of
    proceeding in court or course of justice shall be abated,
    suspended, set aside or reversed for any kind of circum-
    stantial errors, mistakes or defects, if the person and
    the cause may be rightly understood and intended by
    the court’’). The court explained that ‘‘[t]he designation
    of circumstantial defect is reserved for defects that are
    not substantive or jurisdiction[al] in nature,’’ and that
    the failure to provide an opinion letter that complies
    with statutory requirements constitutes insufficient
    process, thus implicating the court’s personal jurisdic-
    tion. See Morgan v. Hartford Hospital, 
    301 Conn. 388
    ,
    402, 
    21 A.3d 451
    (2011). The court concluded that,
    because the defect at issue was jurisdictional in nature,
    it was not circumstantial. Accordingly, the court
    granted the defendant’s motion to dismiss. This
    appeal followed.
    The sole issue raised by the plaintiff on appeal is
    whether the trial court, in ruling on the motion to dis-
    miss, correctly determined that our decision in Gonza-
    les v. 
    Langdon, supra
    , 
    161 Conn. App. 497
    , barred it
    from considering the affidavit that he had attached to
    his opposition to the motion to dismiss in an effort to
    cure the defect in the opinion letter attached to his
    complaint. The plaintiff concedes, as he did before the
    trial court, that, on the basis of the allegations alleged
    in his complaint, he was required by statute to provide
    an opinion letter from a doctor who not only is trained
    in oral and maxillofacial surgery, but also is board certi-
    fied in that specialty. He further concedes that, although
    the author of the opinion letter had all the necessary
    bona fides, they were not set forth in the opinion letter
    attached to his complaint. Nevertheless, the plaintiff
    argues that the court should have permitted him to
    avoid dismissal of his action by accepting an affidavit
    from the author clarifying his credentials. We are not
    persuaded and agree with the trial court that, regardless
    of the procedure the plaintiff elected to employ to cor-
    rect the admittedly defective opinion letter, the plain-
    tiff’s efforts came after the statute of limitations had
    expired. Accordingly, the court was obligated to grant
    the defendant’s motion and dismiss the action.
    Our standard of review in an appeal challenging the
    granting of a motion to dismiss is well settled. ‘‘A motion
    to dismiss tests, inter alia, whether, on the face of the
    record, the court is without jurisdiction. . . . [O]ur
    review of the court’s ultimate legal conclusion and
    resulting [determination] of the motion to dismiss will
    be de novo. . . . When a . . . court decides a . . .
    question raised by a pretrial motion to dismiss, it must
    consider the allegations of the complaint in their most
    favorable light. . . . In this regard, a court must take
    the facts to be those alleged in the complaint, including
    those facts necessarily implied from the allegations,
    construing them in a manner most favorable to the
    pleader. . . . The motion to dismiss . . . admits all
    facts which are well pleaded, invokes the existing
    record and must be decided upon that alone.’’ (Internal
    quotation marks omitted.) Bennett v. New Milford Hos-
    pital, Inc., 
    300 Conn. 1
    , 10–11, 
    12 A.3d 865
    (2011).
    As previously indicated, § 52-190a was enacted by
    the legislature as part of tort reform efforts in 1986 and
    was intended to help screen out frivolous malpractice
    actions. See Plante v. Charlotte Hungerford Hospital,
    
    300 Conn. 33
    , 53, 
    12 A.3d 885
    (2011). Subsection (a) of
    § 52-190a provides in relevant part: ‘‘No civil action
    or apportionment complaint shall be filed to recover
    damages resulting from personal injury or wrongful
    death occurring on or after October 1, 1987, whether
    in tort or in contract, in which it is alleged that such
    injury or death resulted from the negligence of a health
    care provider, unless the attorney or party filing the
    action or apportionment complaint has made a reason-
    able inquiry as permitted by the circumstances to deter-
    mine that there are grounds for a good faith belief that
    there has been negligence in the care or treatment of
    the claimant. . . . [T]he claimant or the claimant’s
    attorney . . . shall obtain a written and signed opinion
    of a similar health care provider, as defined in section
    52-184c, which similar health care provider shall be
    selected pursuant to the provisions of said section, that
    there appears to be evidence of medical negligence
    and includes a detailed basis for the formation of such
    opinion. . . .’’
    Furthermore, ‘‘§ 52-190a (c) requires the dismissal of
    medical malpractice complaints that are not supported
    by opinion letters authored by similar health care pro-
    viders.’’ Bennett v. New Milford Hospital, 
    Inc., supra
    ,
    
    300 Conn. 25
    ; see also Morgan v. Hartford 
    Hospital, supra
    , 
    301 Conn. 401
    –402 (‘‘[T]he attachment of a writ-
    ten opinion letter that does not comply with § 52-190a
    constitutes insufficient process and, thus, service of
    that insufficient process does not subject the defendant
    to the jurisdiction of the court. . . . The jurisdiction
    that is found lacking, however, is jurisdiction over the
    person, not the subject matter.’’ [Citation omitted; inter-
    nal quotation marks omitted.]).
    In Bennett v. New Milford Hospital, 
    Inc., supra
    , 
    300 Conn. 21
    , our Supreme Court indicated that in any case
    in which the plaintiff alleges in his complaint that a
    defendant is board certified in a particular specialty or
    holds himself out as a specialist, ‘‘the author of an
    opinion letter pursuant to § 52-190a (a) must be a similar
    health care provider as that term is defined by § 52-
    184c (c), regardless of his or her potential qualifications
    to testify at trial pursuant to § 52-184c (d).’’ It also
    indicated that, although dismissal of an action for rela-
    tively insignificant defects in an opinion letter might,
    at first blush, appear to be a harsh result for plaintiffs;
    
    id., 30–31; ‘‘plaintiffs
    are not without recourse when
    facing dismissal occasioned by an otherwise minor pro-
    cedural lapse’’ because ‘‘the legislature envisioned the
    dismissal as being without prejudice . . . and even if
    the statute of limitations has run, relief may well be
    available under the accidental failure of suit statute,
    General Statutes § 52-592.’’ (Citation omitted.) 
    Id., 31. In
    Gonzales v. 
    Langdon, supra
    , 
    161 Conn. App. 510
    ,
    this court recognized an additional avenue of recourse
    available to plaintiffs to correct defects in an existing
    opinion letter. We held, as a matter of first impression,
    that a plaintiff who files a legally insufficient opinion
    letter may, in certain instances, cure the defective opin-
    ion letter through amendment of the pleadings, thereby
    avoiding the need to file a new action. Specifically, we
    stated that ‘‘if a plaintiff alleging medical malpractice
    seeks to amend his or her complaint in order to amend
    the original opinion letter, or to substitute a new opinion
    letter for the original opinion letter, the trial court (1)
    must permit such an amendment if the plaintiff seeks
    to amend as of right within thirty days of the return
    day and the action was brought within the statute of
    limitations, and (2) has discretion to permit such an
    amendment if the plaintiff seeks to amend within the
    applicable statute of limitations but more than thirty
    days after the return day. The court may abuse its dis-
    cretion if it denies the plaintiff’s request to amend
    despite the fact that the amendment would cure any
    and all defects in the original opinion letter and there
    is an absence of other independent reasons to deny
    permission for leave to amend.’’ (Emphasis added.) 
    Id. In Gonzales,
    this court reasoned that ‘‘[t]he legislative
    purpose of § 52-190a (a) is not undermined by allowing
    a plaintiff leave to amend his or her opinion letter or
    to substitute in a new opinion letter if the plaintiff did
    file, in good faith, an opinion letter with the original
    complaint, and later seeks to cure a defect in that letter
    within the statute of limitations. Amending within this
    time frame typically will not prejudice the defendant
    or unduly delay the action.’’ (Emphasis added.) 
    Id., 519. Furthermore,
    the court explained that allowing the cor-
    rection of a defective opinion letter under the circum-
    stances prescribed favors judicial economy. 
    Id. In light
    of the numerous references in Gonzales to
    the statute of limitations, we conclude that the court
    intended to limit the scope of its newly recognized
    remedy to those curative efforts initiated prior to the
    running of the statute of limitations. Logically, it follows
    that a plaintiff who fails to seek to correct a defective
    opinion letter within the statute of limitations period
    will be limited to the remedy previously identified by
    our Supreme Court in Bennett, namely, seeking to file
    a new action pursuant to § 52-592, the accidental failure
    of suit statute.
    In Ugalde v. Saint Mary’s Hospital, Inc., 182 Conn.
    App. 1,       A.3d     (2018), this court recently had an
    opportunity to discuss the scope of the remedy recog-
    nized in Gonzales, stating that ‘‘[t]he holding in Gonza-
    les permits amendments to legally insufficient opinion
    letters only if they are sought prior to the expiration
    of the statute of limitations.’’ (Emphasis added.) 
    Id., 12. This
    court, in Ugalde, determined that an amend-
    ment filed after the limitations period had run did not
    comply with the Gonzales rule and could not be saved
    by invoking the relation back doctrine. 
    Id., 9–12. ‘‘To
    hold that an amendment can be permitted after the
    expiration of the statute of limitations on the theory
    that the amended pleading relates back to the date of
    the filing of the improperly pleaded action would render
    all references to the statute of limitations and the acci-
    dental failure of suit statute in Gonzales irrelevant, for
    under that analysis, every amendment, however unsea-
    sonable, would relate back to the date of the original
    complaint without need for invoking, or thus complying
    with, the requirements of the accidental failure of suit
    statute.’’ 
    Id., 12. The
    plaintiff in the present case takes the position
    that Gonzales applies only in those cases in which a
    plaintiff has sought to cure a defective opinion letter
    by way of an amendment of the pleadings, and suggests
    that a plaintiff can evade the clear limits set forth in
    Gonzales by submitting an explanatory or clarifying
    affidavit in lieu of amendment, even after the limitations
    period has expired. Just as this court rejected the plain-
    tiff’s attempt in Ugalde to evade the statute of limita-
    tions problem that existed in that case by invoking the
    relation back doctrine, we reject the plaintiff’s attempt
    to limit or distinguish Gonzales in the present case.
    As an initial matter, we recognize that certain Supe-
    rior Court decisions provide some authority for permit-
    ting a plaintiff to cure a defective opinion letter by
    supplemental affidavit rather than by following the
    amendment procedures set forth in Practice Book
    §§ 10-59 and 10-60.9 See footnote 8 of this opinion. The
    Superior Court decisions that have permitted affidavits,
    however, have done so largely upon a theory that if a
    plaintiff is permitted to correct a defective opinion letter
    by amending the pleadings, it would be equally reason-
    able for a court to permit and consider an affidavit
    that clarifies a defect in an existing opinion letter. No
    appellate court to date has sanctioned the use of an
    affidavit to cure a defective opinion letter. The plaintiff,
    in his brief to this court, seeks to establish that the use
    of an explanatory or supplemental affidavit to cure a
    defect in an opinion letter in response to a motion to
    dismiss comports with language in Practice Book § 10-
    31 (a) permitting supporting affidavits to establish facts
    necessary for the adjudication of the motion to dismiss.
    Because our resolution of the present appeal does not
    turn on whether we agree with that analysis, we leave
    that issue for another day.10
    On the basis of our plenary review, we agree with
    the trial court’s decision to grant the defendant’s motion
    to dismiss. There is no question that the opinion letter
    attached to the plaintiff’s complaint was defective. The
    letter did not establish on its face that its author was
    a similar health care provider as that term is defined
    in § 52-184c (c) because the author never indicated that
    he was board certified in the same specialty as the
    defendant. Because the opinion letter was defective,
    this provided an adequate ground to dismiss the action
    pursuant to § 52-190a (c). Furthermore, the statute of
    limitations for bringing a medical malpractice action
    against the defendant expired, at the latest, on January
    9, 2016. See footnote 4 of this opinion. The plaintiff
    took no action to cure the defect in the opinion letter
    until May 9, 2016, when, in response to a motion to
    dismiss filed by the defendant, he offered a supplemen-
    tal affidavit from the letter’s author. Even if we assume,
    for the sake of argument, that the affidavit submitted
    by the plaintiff was functionally equivalent to a request
    for leave to file an amended opinion letter, this effort
    to cure the defect was made well after the statute of
    limitations had run. Although the plaintiff factually dis-
    tinguishes the affidavit procedure that he employed
    from the amendment procedure discussed in Gonzales,
    he has failed to provide any legal analysis why the two
    procedures should be treated differently for statute of
    limitations purposes. It simply would be illogical and
    an unwarranted circumvention of our decision in Gon-
    zales to conclude that a plaintiff could avoid dismissal
    by submitting an affidavit in lieu of an amendment. As
    the trial court aptly indicated, because ‘‘any amendment
    that sought to supply [the] missing necessary informa-
    tion would be too late, so too would be an affidavit
    that sought to accomplish the same thing.’’
    In sum, we conclude that the court properly applied
    our decision in Gonzales in granting the motion to dis-
    miss. Regardless of the type of procedure a plaintiff
    elects to employ to cure a defect in an opinion letter
    filed in accordance with § 52-190a, that procedure must
    be initiated prior to the running of the statute of limita-
    tions. Otherwise the sole remedy available will be to
    initiate a new action, if possible, pursuant to § 52-592.
    The judgment is affirmed.
    In this opinion the other judges concurred.
    1
    A computer search for Connecticut cases citing § 52-190a yields almost
    a thousand results.
    2
    General Statutes § 52-190a (c) provides: ‘‘The failure to obtain and file
    the written opinion required by subsection (a) of this section shall be grounds
    for the dismissal of the action.’’
    3
    In addition to count three, which alleges negligence against Reynolds,
    the operative complaint contained four additional counts alleging negligence
    by United Community and Family Services, Inc. (UCFS); and other physi-
    cians, namely, Jose Rivero; Graham Garber, and John Doe. Because UCFS,
    Rivero, Garber and Doe have not participated in the present appeal, all
    references to the defendant in this opinion are to Reynolds, Jr., only. We
    note that the partial judgment on the complaint was final for purposes of
    appellate jurisdiction because it disposed of all causes of action brought
    against the defendant. See Practice Book § 63-1. Both Rivero and Garber
    also filed motions to dismiss the counts of the complaint directed at them,
    citing defects in the qualifications set forth in the opinion letter. Garber’s
    motion, like Reynold’s, was granted by the court, Vacchelli, J., and the
    plaintiff filed a separate appeal from the judgment in favor of Garber (AC
    40645). Rivero’s motion to dismiss, however, was heard by the court, Cole-
    Chu, J., who declined to follow the reasoning of Judge Vacchelli and denied
    the motion. Accordingly, the present action remains pending before the
    Superior Court with respect to the counts against UCFS and Rivero.
    4
    General Statutes § 52-584 provides that the statute of limitations for a
    medical malpractice action is ‘‘two years from the date when the injury is
    first sustained or discovered or in the exercise of reasonable care should
    have been discovered, and except that no such action may be brought more
    than three years from the date of the act or omission complained of . . . .’’
    Here, the two year limitation period began to run on October 11, 2013, the
    date the plaintiff alleges he first became aware of the defendant’s negligence.
    The plaintiff petitioned the clerk of the court pursuant to § 52-190a (b) for an
    automatic ninety day extension of the limitation period, which was granted.
    Accordingly, the two year limitation period expired on January 9, 2016. The
    defendant was served process on January 7, 2016. Even if we assume,
    however, that the act or omission complained of was the decompression
    procedure that occurred on September 19, 2012, the action also needed to
    be brought within three year from that date. Accounting for the ninety day
    extension, the three year limitation period expired on December 18, 2015.
    Although the defendant was not served process until January 7, 2016, the
    affidavit attached to the marshal’s return indicates that the marshal person-
    ally received the writ, summons and complaint on December 18, 2015.
    General Statutes § 52-593a provides that a cause of action will not be lost
    on statute of limitations ground if ‘‘the process to be served is personally
    delivered to a state marshal . . . within [the limitation period] and the
    process is served, as provided by law, within thirty days of the delivery.’’
    The defendant was served twenty days after the marshal took delivery.
    Thus, using either calculation of the limitation period, the present action
    was commenced within the applicable period, which expired, at the latest,
    on January 9, 2016.
    5
    Section 52-190a (a) provides that the term, ‘‘similar health care provider,’’
    is defined in § 52-184c. Section 52-184c contains the following definitions:
    ‘‘(b) If the defendant health care provider is not certified by the appropriate
    American board as being a specialist, is not trained and experienced in a
    medical specialty, or does not hold himself out as a specialist, a ‘similar
    health care provider’ is one who: (1) Is licensed by the appropriate regulatory
    agency of this state or another state requiring the same or greater qualifica-
    tions; and (2) is trained and experienced in the same discipline or school
    of practice and such training and experience shall be as a result of the
    active involvement in the practice or teaching of medicine within the five-
    year period before the incident giving rise to the claim.
    ‘‘(c) If the defendant health care provider is certified by the appropriate
    American board as a specialist, is trained and experienced in a medical
    specialty, or holds himself out as a specialist, a ‘similar health care provider’
    is one who: (1) Is trained and experienced in the same specialty; and (2) is
    certified by the appropriate American board in the same specialty; provided
    if the defendant health care provider is providing treatment or diagnosis
    for a condition which is not within his specialty, a specialist trained in the
    treatment or diagnosis for that condition shall be considered a ‘similar health
    care provider’.’’
    6
    Practice Book § 10-31 (a) provides: ‘‘Any adverse party shall have thirty
    days from the filing of the motion to dismiss to respond to the motion to
    dismiss by filing and serving in accordance with [§§] 10-12 through 10-17
    a memorandum of law in opposition and, where appropriate, supporting
    affidavits as to facts not apparent on the record.’’
    7
    At the start of its decision, the court indicated that it had not based its
    decision to grant the motion to dismiss on the defendant’s claim that the
    letter failed adequately to allege medical negligence by the defendant. The
    court nevertheless later analyzed this claim and rejected it, concluding
    that the information provided in the letter was sufficient to satisfy the
    requirement that the opinion letter set forth a ‘‘detailed basis’’ for the opinion
    that there appears to be evidence of medical negligence attributable to the
    defendant. On appeal, the defendant argues that the lack of a proper opinion
    of medical negligence as to him provides an alternative ground on which
    to affirm the court’s decision to grant the motion to dismiss. Because we
    affirm the court’s judgment on the basis that the letter failed to demonstrate
    that the author was a similar health care provider, we do not address whether
    the letter was deficient in other ways or whether the alternative ground
    actually was decided and, thus, preserved for appellate review. See Perez-
    Dickson v. Bridgeport, 
    304 Conn. 483
    , 498–99, 
    43 A.3d 69
    (2012) (rule that
    appellate courts generally will not consider claims not actually raised to and
    decided by trial court applies equally to alternative grounds for affirmance).
    8
    By way of example, the court cited to Field v. Lawrence & Memorial
    Hospital, Superior Court, judicial district of New London, Docket No. CV-
    14-6019542-S (June 10, 2014, Devine, J.) (
    58 Conn. L. Rptr. 308
    ), and Jaboin
    v. Bridgeport Hospital, Superior Court, judicial district of Fairfield, Docket
    No. CV-09-5023443-S (September 11, 2009, Bellis, J.) (
    48 Conn. L. Rptr. 469
    ).
    In Jaboin, the court reasoned that ‘‘[i]f the Appellate Court has given a trial
    court the authority to allow a plaintiff to amend the complaint to add an
    opinion letter, it seems reasonable that the court could consider [an] affidavit
    that explains [a]n existing opinion letter.’’ Jaboin v. Bridgeport 
    Hospital, supra
    , 473 n.3.
    9
    Practice Book § 10-59 provides in relevant part: ‘‘The plaintiff may amend
    any defect, mistake or informality in the writ, complaint or petition and
    insert new counts in the complaint, which might have been originally inserted
    therein, without costs, during the first thirty days after the return day. . . .’’
    Practice Book § 10-60 (a) provides in relevant part: ‘‘[A] party may amend
    his or her pleadings or other parts of the record or proceedings at any time
    subsequent to that stated in [Practice Book § 10-59] in the following manner:
    ‘‘(1) By order of judicial authority; or
    ‘‘(2) By written consent of the adverse party; or
    ‘‘(3) By filing a request for leave to file an amendment together with: (A)
    the amended pleading or other parts of the record or proceedings, and (B)
    an additional document showing the portion or portions of the original
    pleading or other parts of the record or proceedings with the added language
    underlined and the deleted language stricken through or bracketed. . . .’’
    10
    In Gonzales v. 
    Langdon, supra
    , 
    161 Conn. App. 510
    , this court sanctioned
    the use of amended pleadings to correct a defect in an existing opinion
    letter, largely resolving a split in the Superior Court arising from dicta in
    Votre v. Country Obstetrics & Gynecology Group P.C., 
    113 Conn. App. 569
    ,
    585, 
    966 A.2d 813
    , cert. denied, 
    292 Conn. 911
    , 
    973 A.2d 661
    (2009). See
    Bennett v. New Milford Hospital, 
    Inc., supra
    , 
    300 Conn. 30
    –31 n.17; see
    also Liu v. Yale Medical Group, Superior Court, judicial district of New
    Haven, Docket No. CV-14-6050183-S (February 18, 2015), and cases cited
    therein. Although at this juncture it would seem prudent for a plaintiff to
    follow the corrective measures approved in Gonzales, we do not decide
    at this time whether a trial court has the authority to permit alternative
    procedures, such as the use of a clarifying affidavit, to remedy a defective
    opinion letter.