Rose v. Tievsky , 2021 Ohio 3051 ( 2021 )


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  • [Cite as Rose v. Tievsky, 
    2021-Ohio-3051
    .]
    IN THE COURT OF APPEALS OF OHIO
    SECOND APPELLATE DISTRICT
    MONTGOMERY COUNTY
    BERNARD JOSEPH ROSE, M.D.                        :
    :
    Plaintiff-Appellant                      :   Appellate Case No. 29024
    :
    v.                                               :   Trial Court Case No. 2020-CV-2018
    :
    ANDREW TIEVSKY, M.D., et al.                     :   (Civil Appeal from
    :   Common Pleas Court)
    Defendants-Appellees                     :
    :
    ...........
    OPINION
    Rendered on the 3rd day of September, 2021.
    ...........
    BERNARD JOSEPH ROSE, M.D., 1318 Laurelwood Road, Kettering, Ohio 45409
    Plaintiff-Appellant, Pro Se
    MATTHEW L. SCHRADER, Atty. Reg. No. 0074230, 200 Civic Center Drive, Suite 800,
    Columbus, Ohio 43215
    Attorney for Defendants-Appellees
    .............
    WELBAUM, J.
    -2-
    {¶ 1} This matter is before us on the pro se appeal of Plaintiff-Appellant, Bernard
    Rose, M.D., from an order granting a motion to dismiss and a motion for summary
    judgment filed by Defendants-Appellees, Andrew Tievsky, M.D., and Cleveland Clinic
    Foundation (CCF) (collectively “Appellees”). The trial court dismissed the case with
    prejudice because: (1) Dr. Rose failed to file an affidavit of merit as required by Civ.R.
    10(D)(2)(a) and did not move for an extension of time to do so; (2) Dr. Rose failed to
    comply with the statute of limitations in R.C. 2305.113(A) and the requirements of Ohio’s
    savings statute, R.C. 2305.19(A); (3) the statute of limitations was not tolled under R.C.
    R.C. 2305.113(C) and R.C.2305.16 for persons of “unsound mind”; and (4) Dr. Rose’s
    claims were barred because they were not brought within the four-year statute of repose
    in R.C. 2305.113(C).
    {¶ 2} According to Dr. Rose, he was not required to provide an affidavit of merit
    because his claims were based on negligence, and the matters in question were within
    the common knowledge of the trier of fact. Dr. Rose further contends that the statute of
    limitations for his claims should have been that set forth in R.C. 2305.10(B(1), which
    pertains to bodily injury caused by hazardous or toxic chemicals, rather than the statute
    of limitations for medical claims.
    {¶ 3} Dr. Rose also argues that he brought his claims within the proper time after
    he was informed by a “competent medical authority” that he had an injury related to
    carbon monoxide exposure, or within the time that, in the exercise of reasonable care and
    diligence, he should have discovered the resulting injury. In addition, Dr. Rose argues
    that the statute of limitations should have been tolled because he was of unsound mind.
    -3-
    Finally, Dr. Rose mentions certain procedural failings, like the fact that the trial court
    required him to offer proof when the allegations in the complaint should have been
    construed as true. Allegedly, the trial court also failed to consider an affidavit that Dr.
    Rose did file.
    {¶ 4} After reviewing the record, we conclude that Dr. Rose’s claims were “medical
    claims” under R.C. 2305.113(E)(3), and not claims for bodily injury due to exposure to
    hazardous or toxic chemicals or claims for negligence.          The one-year statute of
    limitations in R.C. 2305.113(A) therefore applied. Furthermore, the trial court did not err
    in fixing the date upon which Dr. Rose’s cause of action accrued, which was several years
    before Dr. Rose refiled his complaint. Dr. Rose also could not salvage his claims based
    on tolling under R.C. 2305.113(C) and R.C. 2305.16, because there were no genuine
    material issues of fact concerning whether Dr. Rose was of unsound mind when the cause
    of action accrued or thereafter.
    {¶ 5} The trial court did err in finding that Dr. Rose’s medical claims were barred
    because he failed to refile them until 21 months after his original claims were dismissed
    and that, as a result, the requirements of the savings statute in R.C. 2305.19(A) were not
    satisfied. Contrary to the court’s holding, R.C. 2305.19(A) did not apply. Any error was
    harmless, however, because Dr. Rose’s claims were barred by R.C. 2305.113(C).
    {¶ 6} R.C. 2305.113(C) is a statute of repose, which bars any medical claims that
    are not filed within four years after the acts or omissions causing an injury. A plaintiff,
    therefore, may not take advantage of the savings statute in R.C. 2305.19(A) to refile a
    medical claim after the applicable one-year statute of limitations in R.C. 2305.113(A) has
    expired if the four-year statute of repose for medical claims has also expired. Here, Dr.
    -4-
    Rose’s claims were barred because the one-year statute of limitations and the four-year
    repose period had both expired before Dr. Rose refiled his complaint. In fact, Dr. Rose
    refiled the complaint more than seven years after the occurrence of the act or omission
    constituting the alleged basis of his medical claims. Consequently, Dr. Rose could not
    take advantage of the savings provision in R.C. 2305.19(A).
    {¶ 7} We further conclude that the trial court correctly dismissed Dr. Rose’s claims
    because he failed either to file a proper affidavit of merit or to ask for an extension for
    filing one. Finally, the trial court did not commit any error in requiring proof beyond the
    complaint’s allegations or in considering such evidence. Accordingly, the judgment of
    the trial court will be affirmed.
    I. Facts and Course of Proceedings
    {¶ 8} This case began with an action that was filed and dismissed in 2018, and
    was then refiled. Concerning the first case, Dr. Rose filed a pro se medical malpractice
    action against Dr. Tievsky and CCF on June 15, 2018. That action was designated as
    Montgomery C.P. No. 2018-CV-2727.1
    {¶ 9} The 2018 complaint was presented in narrative form.         According to the
    complaint, Dr. Rose was hospitalized at Glenbeigh Rehabilitation Center in 2013. During
    the hospitalization, a doctor (Dr. Zinni) ordered an MRI because Dr. Rose was having
    1 Relevant pleadings from that case were attached to Appellees’ Summary Judgment
    Motion. Tievsky/CCF Motion for Summary Judgment (July 10, 2020). We can also take
    judicial notice of judicial opinions and public records accessible on the internet. E.g.,
    State v. Thompson, 2d Dist. Montgomery No. 28449, 
    2019-Ohio-5140
    , ¶ 4, fn. 1. The
    records of the Montgomery County Common Pleas Court are readily accessible on the
    Clerk of Courts’ website.
    -5-
    confusion issues and bizarre behavior. 2018 Complaint, p. 1.2 The MRI was done on
    May 3, 2013, and Dr. Tievsky, a neurologist with the Cleveland Health System, read the
    MRI as normal. 
    Id.
     See also Ashtabula County Medical Center MRI, “Final Report,” p.
    1.
    {¶ 10} In contrast, an August 2011 MRI of Dr. Rose, which was attached as part
    of the complaint, indicated some changes that might be seen with “hypoxic/anoxic brain
    injury.”     August 1, 2011 University Radiology Associates Diagnostic Radiology
    Interpretation of Films for: Linder Center of Hope, p. 1.
    {¶ 11} Dr. Rose also attached a Final Report of Cleveland Clinic Star Imaging to
    the 2018 Complaint. The exam date is listed as May 24, 2017, and the history given was
    of a “58 year old man with chronic heartburn, monoxide exposure, serum imbalance, and
    low sodium.” Id. at p. 1.      On that day, an MRI was done with and without contrast, and
    the stated impression was: “Abnormal signal intensity at the interior basil ganglia
    bilaterally with evidence for magnetic susceptibility artifact. The findings may be related
    to mineralization. * * * [A] previous insult such as from carbon monoxide exposure could
    also have this appearance.” Id. at p. 2.
    {¶ 12} According to the 2018 Complaint, Dr. Rose believed the pathologic changes
    shown by the 2011 MRI had caused the problems he had during the 2013 hospitalization
    at Glenbeigh. Dr. Rose alleged that Dr. Tievsky “misdiagnosed pathologic changes in
    the Globus Pallidus area” and “failed to perform acceptable medical practice by his failure
    to compare previously abnormal images.” 2018 Complaint at p. 1. Dr. Rose further
    alleged that CCF was “guilty of failure to follow acceptable care by not obtaining previous
    2   Dr. Zinni is not a defendant in this case.
    -6-
    medical images from the University of Cincinnati.” Id. The implication in the complaint
    was that Dr. Rose’s conduct while at Glenbeigh in 2013 actually resulted from carbon
    monoxide poisoning, rather than psychological problems and/or substance abuse, and
    that the failure to diagnose caused permanent damage. Id.
    {¶ 13} On July 17, 2018, Dr. Tievsky filed a motion to dismiss the complaint based
    on the fact that Dr. Rose had failed to file an affidavit of merit as required by
    Civ.R.10(D)(2). The trial court agreed, finding that the affidavit in question had been
    authored by Dr. Penny, a Ph.D., and not by a physician, as the rule required. The court
    therefore dismissed Dr. Rose’s claims without prejudice on August 22, 2018. Dr. Rose
    then appealed to our court.
    {¶ 14} We dismissed Dr. Rose’s appeal in January 2019, because the dismissal
    for lack of an appropriate affidavit of merit was without prejudice, did not prevent refiling,
    and was not a final appealable order. See Rose v. Tievsky, 2d Dist. Montgomery No.
    28184 (Decision and Final Judgment Entry, Jan. 16, 2019), p. 3. In a footnote, we also
    mentioned Appellees’ argument that, under R.C. 2305.19(A), Dr. Rose could refile his
    claims within one year after the trial court’s August 2018 decision and entry. Id. at p. 4,
    fn. 1.
    {¶ 15} Rather than refiling, Dr. Rose appealed our decision to the Supreme Court
    of Ohio, which declined jurisdiction over the appeal on May 15, 2019. Dr. Rose then
    refiled another pro se medical malpractice action (the current action), and again included
    Dr. Tievsky and CCF as defendants. See 2020 Complaint (May 14, 2020). Again, Dr.
    Rose failed to attach an affidavit of merit and did not ask for an extension of time to do
    so.      The 2020 Complaint also attached documents that were very similar to those
    -7-
    included with the 2018 Complaint.
    {¶ 16} On June 12, 2020, Appellees filed a motion to dismiss, contending the
    action should be dismissed because Dr. Rose failed to file an affidavit of merit and did not
    request an extension of time to do so. They also filed an answer and raised various
    affirmative defenses, including that the action was barred by the statute of limitations and
    by the statute of repose. Tievsky/CCF Answer (June 12, 2020), p. 2. On June 15, 2020,
    the court set a briefing schedule for the motion to dismiss.
    {¶ 17} Dr. Rose filed a response to the motion to dismiss. In his memorandum,
    Dr. Rose argued that he did not need an expert witness because Appellees’ failure to
    obtain and review the prior MRI report was “simple” negligence. Rose Reply (July 10,
    2020), p. 1-2. Dr. Rose also raised the issue that the legislation requiring an affidavit of
    merit prevented him from receiving a fair trial because it required him to spend significant
    sums of money on an expert. Id. at p. 3-4. Finally, Dr. Rose quoted from a report of an
    affidavit of merit from Dr. DiNella, who was apparently a board certified psychiatrist.
    {¶ 18} The quoted portion stated only as follows:
    The treating doctors’ failure to carry out their duty to accurately
    diagnose and treat Dr. Rose directly resulted in harm to him emotionally,
    medically and financially. Due to the damage to his reputation, his income
    as a physician dropped by $200,000 that year and took several years to
    recover. It also caused emotional damage to him due to the damage of his
    reputation.
    Rose Reply at p. 6.
    {¶ 19} On the same day that Dr. Rose responded to the motion to dismiss,
    -8-
    Appellees filed a motion for summary judgment, contending that the action was barred
    because it was not filed within one year after the original action was dismissed. As noted,
    Appellees also attached certified copies of the relevant pleadings in the 2018 case. The
    trial court then established deadlines for filing documents relevant to the summary
    judgment motion.
    {¶ 20} On July 24, 2020, Appellees filed a memorandum replying to Dr. Rose’s
    response to their motion to dismiss; they also included a motion to strike the “proffered”
    affidavit of Dr. DiNella because it failed to comply with Evid.R. 601(D) and Civ.R. 10(D)(2).
    After receiving an extension of time to file a surreply to the motion to dismiss and two
    extensions to reply to the summary judgment motion, Dr. Rose filed a memorandum on
    September 28, 2020. On the same day, he also filed a lengthy affidavit. Appellees filed
    a reply on October 13, 2020.
    {¶ 21} The trial court then issued an order granting Appellees’ motions and
    dismissing Dr. Rose’s action with prejudice. Order (December 29, 2020). The court
    concluded that Dr. Rose’s claims were medical claims governed by the statute of
    limitations in R.C. 2305.113(A) and that Dr. Rose was required to file an affidavit of merit
    under Civ.R. 10(D)(2) or to ask for an extension of time. Because he failed to do so, the
    trial court granted the motion to dismiss. Id. at p. 10-12.
    {¶ 22} Additionally, the court found that Dr. Rose failed to bring his medical claims
    within the one-year statute of limitations in R.C. 2305.113(A) and that the tolling provision
    in R.C. 2305.113(C) for persons of “unsound mind” did not apply. The court further held
    that the action was barred by the statute of repose in R.C. 2305.113(C), and that the
    savings statute in R.C. 2305.19(A) could not be used because Dr. Rose’s original
    -9-
    complaint was barred by the statute of limitations. In addition, the second complaint was
    not timely filed under R.C. 2305.19(A).    Based on these findings, the court granted
    summary judgment in Appellees’ favor and dismissed Dr. Rose’s claims with prejudice.
    On January 27, 2021, Dr. Rose appealed from the trial court’s decision.
    {¶ 23} With these facts in mind, we will consider the assignments of error that Dr.
    Rose has asserted.
    II. Status of Dr. Rose’s Claims and Appropriate Statute of Limitations
    {¶ 24} Dr. Rose is acting pro se on appeal, as he did in the trial court. Dr. Rose
    has asserted eight assignments of error, but he has failed to follow the proper format for
    briefs as outlined in App.R. 16(A)(1)-(8) and (D). Based on these omissions, we could
    “either strike the offending portions of the brief or sua sponte dismiss the appeal.”
    Brazelton v. Brazelton, 2d Dist. Montgomery No. 24837, 
    2012-Ohio-3593
    , ¶ 8. However,
    in the interests of justice, we will review the merits of Dr. Rose’s claims. 
    Id.
     This will
    involve addressing some assignments of error out of order. We will begin with the second
    assignment of error, which, quoted verbatim, states “Assignment of error No. 2 Denial
    of Negligence claim.” Appellant’s Brief at p. 6.
    {¶ 25} Under this assignment of error, Dr. Rose contends that the trial court erred
    in finding that his claims were “medical claims” rather than claims sounding in ordinary
    negligence or personal injury. Dr. Rose further argues that the matters at issue in this
    case (the failure to compare prior MRI films) fall within the common knowledge of jurors,
    which eliminates the need for expert testimony. As a result, Dr. Rose believes he did not
    need to furnish an affidavit of merit.
    -10-
    {¶ 26} We will also consider the interrelated fourth assignment of error, which
    states that:
    Assignment of error No. 4 Common Pleas Court (CPC) was wrong
    to grant summary judgment 56(c) based solely on Statute of Limitations
    2305.113.
    {¶ 27} Under this assignment of error, Dr. Rose contends that the trial court should
    have used the statute of limitations in R.C. 2305.10(B)(1), which covers exposure to toxic
    chemicals.
    {¶ 28} And finally, we will discuss the sixth assignment of error, which is also
    interrelated. This assignment of error, quoted verbatim, states that:
    THE TRIAL COURT COMMITTED REVERSIBLE ERROR IN
    GRANTING       SUMMARY        JUDGMENT        TO    THE     DEFENDANTS/
    APPELLEES WHERE THERE IS A QUESTION OF FACT AS TO WHEN
    THE COGNIZABLE EVENT OCCURRED WHICH TOLLED THAT
    STATUTE OF LIMITATIONS IN MEDICAL MALPRACTICE CASE,
    SUMMARY JUDGMENT IS IMPROPER AS A MATTER OF LAW.
    {¶ 29} Under this assignment of error, Dr. Rose again argues that the appropriate
    statute of limitations should be R.C. 2305.10(B)(1). He also contends that even if the
    medical malpractice statute of limitations applied, the cognizable event for purposes of
    the statute was May 5, 2020. This is the date on which Dr. Rose was informed by a
    “competent medical specialist” that carbon monoxide had caused his problems and that
    his treating physicians provided negligent care.
    {¶ 30} Before we address these issues, we will briefly discuss the appropriate
    -11-
    standards of review that apply to the dismissal of claims under Civ.R. 12(B)(6) and to
    summary judgments.
    A. Dismissal Under Civ.R. 12(B)(6)
    {¶ 31} The law is well-established that orders granting Civ.R. 12(B)(6) motions to
    dismiss are subject to de novo review. Perrysburg Twp. v. Rossford, 
    103 Ohio St.3d 79
    ,
    
    2004-Ohio-4362
    , 
    814 N.E.2d 44
    , ¶ 5. De novo review “means that we apply the same
    standards as the trial court.” (Citations omitted.) GNFH, Inc. v. W. Am. Ins. Co., 
    172 Ohio App.3d 127
    , 
    2007-Ohio-2722
    , 
    873 N.E.2d 345
    , ¶ 16 (2d Dist.).
    {¶ 32} In the context of Civ.R. 12(B)(6) motions, this means that “[i]n construing a
    complaint upon a motion to dismiss for failure to state a claim, we must presume that all
    factual allegations of the complaint are true and make all reasonable inferences in favor
    of the non-moving party.” Mitchell v. Lawson Milk Co., 
    40 Ohio St.3d 190
    , 192, 
    532 N.E.2d 753
     (1998). Then, before a complaint may be dismissed, “it must appear beyond
    doubt that plaintiff can prove no set of facts warranting a recovery.” 
    Id.,
     citing O'Brien v.
    Univ. Community Tenants Union, 
    42 Ohio St.2d 242
    , 
    327 N.E.2d 753
     (1975), syllabus.
    Where, as here, documents are attached to or are incorporated into a complaint, we may
    also consider the documents. State ex rel. Washington v. D'Apolito, 
    156 Ohio St.3d 77
    ,
    
    2018-Ohio-5135
    , 
    123 N.E.3d 947
    , ¶ 10.
    {¶ 33} A motion to dismiss based on the statute of limitations may be granted
    where the defect is apparent on the face of the complaint, but such a motion “is
    erroneously granted where the complaint does not conclusively show on its face the
    action is barred by the statute of limitations.” Velotta v. Leo Petronzio Landscaping, Inc.,
    -12-
    
    69 Ohio St.2d 376
    , 379, 
    433 N.E.2d 147
     (1982), paragraph three of the syllabus. Accord
    LGR Realty, Inc. v. Frank & London Ins. Agency, 
    152 Ohio St.3d 517
    , 
    2018-Ohio-334
    , 
    98 N.E.3d 241
    , ¶ 10. In that situation, summary judgment would be the proper procedure.
    Here, however, we have both types of dismissals.
    B. Summary Judgment Decisions
    {¶ 34} “A trial court may grant a moving party summary judgment pursuant to
    Civ.R. 56 if there are no genuine issues of material fact remaining to be litigated, the
    moving party is entitled to judgment as a matter of law, and reasonable minds can come
    to only one conclusion, and that conclusion is adverse to the nonmoving party, who is
    entitled to have the evidence construed most strongly in his favor.” (Citation omitted.)
    Smith v. Five Rivers MetroParks, 
    134 Ohio App.3d 754
    , 760, 
    732 N.E.2d 422
     (2d
    Dist.1999).
    {¶ 35} “A party seeking summary judgment ‘bears the initial responsibility of
    informing the trial court of the basis for the motion, and identifying those portions of the
    record before the trial court which demonstrate the absence of a genuine issue of fact on
    a material element of the nonmoving party's claim.’ ” Griffith v. Aultman Hosp., 
    146 Ohio St.3d 196
    , 
    2016-Ohio-1138
    , 
    54 N.E.3d 1196
    , ¶ 26, quoting Dresher v. Burt, 
    75 Ohio St.3d 280
    , 292, 
    662 N.E.2d 264
     (1996). “If the moving party fails to satisfy its initial burden,
    the motion for summary judgment must be denied. However, if the moving party has
    satisfied its initial burden, the nonmoving party then has a reciprocal burden outlined in
    Civ.R. 56(E) to set forth specific facts showing that there is a genuine issue for trial and,
    if the nonmovant does not so respond, summary judgment, if appropriate, shall be entered
    -13-
    against the nonmoving party.” Dresher at 293.
    {¶ 36} As with decisions on motions to dismiss, we review trial court rulings on
    summary judgment decisions de novo. GNFH, Inc., 
    172 Ohio App.3d 127
    , 2007-Ohio-
    2722, 
    873 N.E.2d 345
    , at ¶ 16. With these standards in mind, we will consider Dr. Rose's
    arguments.
    C. Asserted Application of R.C. 2305.10(B)(1)
    {¶ 37} Dr. Rose suggests that the statute of limitations in R.C. 2305.10(B)(1),
    rather than the limitations period in R.C. 2305.113(A), should be applied to his claims.
    Appellant’s Brief at p. 14, 18, and 25.
    {¶ 38} R.C. 2305.10(A) generally provides a two-year statute of limitations for
    product liability claims and for certain actions for bodily injury and injury to property. The
    section to which Rose refers, R.C. 2305.10(B)(1), states that:
    For purposes of division (A) of this section, a cause of action for bodily
    injury that is not described in division (B)(2), (3), (4), or (5) of this section
    and that is caused by exposure to hazardous or toxic chemicals, ethical
    drugs, or ethical medical devices accrues upon the date on which the
    plaintiff is informed by competent medical authority that the plaintiff has an
    injury that is related to the exposure, or upon the date on which by the
    exercise of reasonable diligence the plaintiff should have known that the
    plaintiff has an injury that is related to the exposure, whichever date occurs
    first.
    {¶ 39} As far as we can tell, Dr. Rose is arguing that using this statute would toll
    -14-
    the limitations period for bringing his action until May 20, 2020, when Dr. Kenneth DiNella
    signed an affidavit indicating that Dr. Rose’s “psychiatric and physical problems were
    related to a ‘toxic gas[,]’ poisonous and lethal with latent manifestations.” Appellant’s
    Brief at p. 18 and 24. This is based on Dr. Rose’s apparent belief that Dr. DiNella was
    the first “competent medical authority” who informed him of his injury.
    {¶ 40} This argument is incorrect.      First of all, Dr. Rose did not allege that
    Appellees had anything to do with his exposure to toxic chemicals; he alleged that they
    failed to obtain prior MRI records and to correctly diagnose his condition. As a result,
    Dr. Rose’s claims are “medical claims,” which are defined in R.C. 2305.113(E)(3) as “any
    claim that is asserted in any civil action against a physician, podiatrist, hospital, home, or
    residential facility, against any employee or agent of a physician, podiatrist, hospital,
    home, or residential facility, * * * and that arises out of the medical diagnosis, care, or
    treatment of any person.” “Unquestionably, a claim for an injury that occurs during or in
    medical diagnosis, care, or treatment arises from medical diagnosis, care, or treatment.”
    Lerner v. Broadview NH, LLC, 
    2017-Ohio-8001
    , 
    98 N.E.3d 1014
    , ¶ 13 (10th Dist.).
    Because the alleged actions here involved injuries that arose from medical diagnosis (or
    failure to properly diagnose), the proper statute of limitations was R.C. 2305.113(A).
    D. Affidavit of Merit
    {¶ 41} Because this case involves medical claims under R.C. 2305.113(E), Dr.
    Rose needed to comply with the requirements for bringing these claims. One such
    requirement is filing an affidavit of merit under Civ.R. 10(D)(2), which states that:
    (a) Except as provided in division (D)(2)(b) of this rule, a complaint
    -15-
    that contains a medical claim, dental claim, optometric claim, or chiropractic
    claim, as defined in R.C. 2305.113, shall be accompanied by one or more
    affidavits of merit relative to each defendant named in the complaint for
    whom expert testimony is necessary to establish liability. Affidavits of merit
    shall be provided by an expert witness meeting the requirements of Evid.R.
    702 and, if applicable, also meeting the requirements of Evid.R. 601(D).
    Affidavits of merit shall include all of the following:
    (i) A statement that the affiant has reviewed all medical records
    reasonably available to the plaintiff concerning the allegations contained in
    the complaint;
    (ii) A statement that the affiant is familiar with the applicable standard
    of care;
    (iii) The opinion of the affiant that the standard of care was breached
    by one or more of the defendants to the action and that the breach caused
    injury to the plaintiff.
    {¶ 42} The exception in Civ.R. 10(D)(2)(b) pertains to filing a request for an
    extension of time to file the affidavit, which the court may grant for a reasonable time,
    upon a showing of good cause.
    {¶ 43} “Clearly, the purpose behind the rule is to deter the filing of frivolous
    medical-malpractice claims. The rule is designed to ease the burden on the dockets of
    Ohio's courts and to ensure that only those plaintiffs truly aggrieved at the hands of the
    medical profession have their day in court.” Fletcher v. Univ. Hosps. of Cleveland, 
    120 Ohio St.3d 167
    , 
    2008-Ohio-5379
    , 
    897 N.E.2d 147
    , ¶ 10.
    -16-
    {¶ 44} Here, Dr. Rose failed to either submit an affidavit of merit or ask the court
    for an extension of time. Consequently, he did not comply with the Civ.R. 10(D)(2)
    requirements. Dr. Rose argues, however, that he was not required to submit an affidavit
    because the importance of comparing previous abnormal films is within a trier of fact’s
    knowledge. The trial court rejected Dr. Rose’s “common knowledge” exception because
    it is rarely used and is limited in scope. Order at p. 11. The court also held that the
    allegations against Dr. Rose and CCF were not matters of common knowledge and expert
    testimony would be needed. 
    Id.
    {¶ 45} In Bruni v. Tatsumi, 
    46 Ohio St.2d 127
    , 
    346 N.E.2d 673
     (1976), the
    Supreme Court of Ohio stated that:
    “The issue as to whether the physician and surgeon has proceeded
    in the treatment of a patient with the requisite standard of care and skill must
    ordinarily be determined from the testimony of medical experts. * * * It
    should be noted that there is an exception to that rule in cases where the
    nature of the case is such that the lack of skill or care of the physician and
    surgeon is so apparent as to be within the comprehension of laymen and
    requires only common knowledge and experience to understand and judge
    it, and in such case expert testimony is not necessary.”
    Id. at 130.
    {¶ 46} As an example of “common knowledge,” cases involving matters like an
    unattended patient falling from a bed are “claims of ordinary negligence.” However,
    matters that involve "professional skill and judgment” are “not within the common
    knowledge and experience of the jurors.” Ramage v. Cent. Ohio Emergency Serv., Inc.,
    -17-
    
    64 Ohio St.3d 97
    , 103, 
    592 N.E.2d 828
     (1992). Notably, “ ‘[r]elatively few courts in Ohio
    have found the common knowledge exception applicable so as to obviate the need for
    expert witness testimony on the malpractice issue.’ ” Cunningham v. Children's Hosp.,
    10th Dist. Franklin No. 05AP-69, 
    2005-Ohio-4284
    , ¶ 20, quoting Buerger v. Ohio Dept. of
    Rehab. & Corr., 
    64 Ohio App.3d 394
    , 399, 
    581 N.E.2d 1114
     (10th Dist.1989).                In
    Cunningham, the court also stressed that “[t]he common knowledge exception has a
    limited scope in a world of increasing medical complexity.” 
    Id.
     Accord Culp v. Olukoga,
    
    2013-Ohio-5211
    , 
    3 N.E.3d 724
    , ¶ 74 (4th Dist.).
    {¶ 47} “Expert-opinion evidence * * * is required where the inquiry pertains to a
    highly technical question of science or art or to a particular professional or mechanical
    skill.” Jones v. Hawkes Hosp. of Mt. Carmel, 
    175 Ohio St. 503
    , 
    196 N.E.2d 592
     (1964),
    paragraph one of the syllabus. The field of radiology involves professional skill and
    highly technical scientific questions, and, therefore, is not within the common knowledge
    of jurors. Accordingly, the trial court did not err in rejecting Dr. Rose's assertion of the
    common knowledge exception, and it did not err in dismissing Dr. Rose’s action based
    on his failure to include an affidavit of merit or to ask for an extension.
    {¶ 48} Typically, a dismissal for failure to file an affidavit of merit is a dismissal
    without prejudice. Fletcher, 
    120 Ohio St.3d 167
    , 
    2008-Ohio-5379
    , 
    897 N.E.2d 147
    , at
    ¶ 20. Here, however, the court dismissed Dr. Rose’s claims with prejudice because the
    action was otherwise precluded by the statute of limitations. Order at p. 12. This leads
    us to the next issue, which concerns when the cognizable event occurred for purposes of
    the statute of limitations in R.C. 2305.113(A).
    -18-
    E. Cognizable Event for Purposes of R.C. 2305.113(A)
    {¶ 49} In connection with the sixth assignment of error, Dr. Rose again argues that
    the proper statute of limitations is found in R.C. 2305.10(B)(1). Dr. Rose further admits
    that he learned on June 15, 2017, that “a fellow CCF doctor had reviewed the MRI of
    2013 and found possible pathology suggesting carbon monoxide damage.” Appellant's
    Brief at p. 19-20. However, Dr. Rose contends that the opinion of the doctor in question
    did not qualify as a “competent medical authority” because that doctor was “not a
    neurologist or psychiatrist.” Id. at p. 20. Based on this theory, Dr. Rose argues that
    June 15, 2017, was not a “cognizable event” for applying the statute of limitations and
    that the trial court erred in using that date as the beginning point for applying R.C.
    2305.19(A).
    {¶ 50} Under R.C. 2305.113(A), “an action upon a medical, dental, optometric, or
    chiropractic claim shall be commenced within one year after the cause of action accrued.”
    For purposes of this statute, “a cause of action for medical malpractice accrues and the
    one-year statute of limitations commences to run (a) when the patient discovers or, in the
    exercise of reasonable care and diligence should have discovered, the resulting injury, or
    (b) when the physician-patient relationship for that condition terminates, whichever occurs
    later.” Frysinger v. Leech, 
    32 Ohio St.3d 38
    , 
    512 N.E.2d 337
     (1987), paragraph one of
    the syllabus (interpreting predecessor statute, R.C. 2305.11(A), which is similar to R.C.
    2305.113(A) in pertinent part).
    {¶ 51} There is no dispute here that Dr. Rose's relationship with Appellees ended,
    -19-
    at the latest, on May 3, 2013, when the 2013 MRI was read and reported.3 Given this
    date, the original complaint, filed on June 15, 2018, was clearly more than one year after
    the medical relationships ended. However, as noted, Dr. Rose argues that the current
    lawsuit is timely because he did not discover the resulting injury from the alleged
    malpractice until May 5, 2020, when he read Dr. DiNella's Civ.R. 10(D)(2) affidavit. See
    Appellant's Brief at p. 17-18. This argument is plainly incorrect, since Dr. Rose’s June
    2018 action raised the same allegations about carbon dioxide and medical malpractice
    that he asserts here.
    {¶ 52} Based on Dr. Rose's own allegations in the complaint filed in the present
    case on May 14, 2020, the trial court found that “the cognizable event occurred on June
    15, 2017, when Dr. Rose discovered the resulting injury.” Order at p. 13. The court's
    finding was due to the complaint's allegation that on June 15, 2017, “a repeat MRI * * *
    was read * * * by another radiologist, * * * who reviewed this MRI and felt pathological
    changes existed,” which Dr. Rose described as a “ ‘revelation.’ ” (Emphasis sic.) Id.
    at p. 12, quoting Complaint at p. 1. We agree with the trial court this was the date the
    cause of action accrued. There is simply no evidence otherwise.
    {¶ 53} In this context, we stress Dr. Rose's admission that he learned about the
    pathology suggesting carbon monoxide on June 15, 2017. Complaint at p. 1; Appellant’s
    Brief at p. 19-20. As indicated, Dr. Rose discounts this fact because the doctor who
    provided the information was not a neurologist or psychiatrist as required by Civ.R.
    3 Based on the allegations in the complaint, the trial court used June 2, 2013, as the date
    that Dr. Tievsky read and reported on the MRI. Order at p. 12 and 13. However, the
    relevant MRI report that Dr. Rose attached to his affidavit was dated May 3, 2013. Rose
    Aff. at p. 208. As a result, we will use that date rather than June 2, 2013. For purposes
    of analysis, the difference in the two dates is not material.
    -20-
    10(D)(2).   However, there is no requirement that discovery of an injury must be
    occasioned by a doctor providing a Civ.R. 10(D)(2) affidavit. To the contrary, the law
    requires only that the “patient discovers or, in the exercise of reasonable care and
    diligence should have discovered, the resulting injury.” Frysinger, 
    32 Ohio St.3d 38
    , 
    512 N.E.2d 337
    , at paragraph one of the syllabus. “The standard of reasonable care and
    diligence required by this test is that which is employed by an ordinary reasonably prudent
    person in like circumstances.” Clark v. Hawkes Hosp. of Mt. Carmel, 
    9 Ohio St.3d 182
    ,
    183, 
    459 N.E.2d 559
     (1984).
    {¶ 54} Furthermore, courts must look to a particular case's facts and decide “when
    the injured party became aware, or should have become aware, of the extent and
    seriousness of his condition, which, of course, may occur without the necessity of further
    medical consultation; whether the injured party was aware, or should have been aware,
    that such condition was related to a specific professional medical service previously
    rendered him; and whether such condition would put a reasonable person on notice of
    need for further inquiry as to the cause of such condition.” Hershberger v. Akron City
    Hosp., 
    34 Ohio St.3d 1
    , 5-6, 
    516 N.E.2d 204
     (1987), paragraph one of the syllabus.
    {¶ 55} “The ‘extent and seriousness of his condition’ language of the test set forth
    in Hershberger * * * requires that there be an occurrence of a ‘cognizable event’ which
    does or should lead the patient to believe that the condition of which the patient complains
    is related to a medical procedure, treatment or diagnosis previously rendered to the
    patient and where the cognizable event does or should place the patient on notice of the
    need to pursue his possible remedies.” Allenius v. Thomas, 
    42 Ohio St.3d 131
    , 
    538 N.E.2d 93
     (1989), syllabus. “If a patient believes, based on a known injury, that her
    -21-
    treating medical professional has done something wrong, that belief is sufficient to alert
    the patient to the need to investigate and pursue a remedy.” Schmitz v. Natl. Collegiate
    Athletic Assn., 
    155 Ohio St.3d 389
    , 
    2018-Ohio-4391
    , 
    122 N.E.3d 80
    , ¶ 22, citing Allenius
    at 133.
    {¶ 56} The affidavit that Dr. Rose signed on September 15, 2020, indicated that he
    graduated from The Ohio State University Medical School in 1984 and had been a primary
    care physician for 33 years. Rose Affidavit (Sep. 28, 2020), p. 1. Dr. Rose further
    stated that “[o]ver the last 9 years,” he had “been very interested in the effects of Carbon
    Monoxide on human mental and physical problems,” had “read over 700 peer-reviewed
    articles,” and had “reviewed over 100 books dealing with carbon monoxide pathology.”
    Id. at p. 2. In addition, Dr. Rose's affidavit stated that since 2016, he had been aware
    that his automobile “was causing toxic carbon monoxide levels in the driver's
    compartment.” Id. at p. 4, referencing Ex. G attached to the Rose Affidavit.4
    {¶ 57} In light of these facts, including Dr. Rose's knowledge of carbon monoxide
    effects and pathology dating back to around 2011, his suspicion since at least 2016 that
    he had been exposed to inappropriate carbon monoxide, and the MRI abnormalities
    related to potential carbon monoxide exposure to which he was alerted in June 2017, a
    reasonably prudent person in Dr. Rose's circumstances would have been put on notice
    of the need for further inquiry as to the cause of his condition and the need to pursue
    4 Exhibit G attached to Dr. Rose’s affidavit was a July 13, 2016 Inspection Report of Dr.
    Rose’s automobile. The report stated that the vehicle “is suspected of exposing the
    occupant(s) to Carbon Monoxide poisoning.” Id. at p. 68 of the documents attached to
    the Rose Affidavit. Further, the report concludes that “Tailpipe emissions of CO and HC
    are extremely high, due to a malfunction in the fuel injection system,” and that “[u]nder
    some conditions, tailpipe emissions enter the passenger compartment, creating a
    hazardous environment.” Id. at p. 71.
    -22-
    remedies, at the latest, on June 15, 2017 (and probably earlier). Therefore, the trial court
    correctly concluded that the “cognizable event” occurred on June 15, 2017. Accordingly,
    the trial court did not err in applying the statute of limitations found in R.C. 2305.113(A)
    and in assigning a date on which the cognizable event occurred for purposes of applying
    the statute.
    {¶ 58} Based on the preceding discussion, the second, fourth, and sixth
    assignments of error are overruled.
    IV. Tolling of the Statute of Limitations
    {¶ 59} Concerning tolling, Dr. Rose presents the following three assignments of
    error (all recited verbatim):
    Assignment of error No. 3 Common Court stated pg 13 para 18 “Dr.
    Rose does not provide evidence of unsound mind. . . Furthermore, Dr. Rose
    does not assert he was of unsound mind at the time the cause of action
    accrued.......The Court therefore finds the tolling provision of R.C. 2305.16
    to be inapplicable.”
    Assignment of error 7    Defendant's contention “not of unsound
    mind.”
    Assignment of error 8     Failure, by plaintiff to provide proof of
    allegation in memorandum against Summary Judgment.
    {¶ 60} Under these assignments of error, Dr. Rose essentially contends that there
    were genuine issues of material fact concerning whether he was of “unsound mind” at the
    time his cause of action accrued, and that the trial court, therefore, should have found the
    -23-
    statute of limitations tolled. The court rejected Dr. Rose's claim that his action was timely
    filed due to R.C. 2305.113(C) and/or R.C. 2305.113(D)(1). Order at p. 13-14. We will
    only consider R.C. 2305.113(C), as Dr. Rose did not mention R.C. 2305.113(D)(1) in his
    brief.
    {¶ 61} Regarding R.C. 2305.113(C), the court held that tolling did not apply
    because Dr. Rose failed to provide any evidence that he was of unsound mind when the
    cause of action accrued on June 15, 2017, or at any time thereafter. Id. at p. 13. Again,
    we review the court's decision on a de novo basis.
    {¶ 62} As relevant here, R.C. 2305.113(C)(1) states that “No action upon a medical
    * * * claim shall be commenced more than four years after the occurrence of the act or
    omission constituting the alleged basis of the medical * * * claim.” In a very recent
    decision, the Supreme Court of Ohio distinguished as follows between statutes of
    limitations and statutes of repose:
    A statute of limitations establishes “a time limit for suing in a civil
    case, based on the date when the claim accrued (as when the injury
    occurred or was discovered).”         Black's Law Dictionary 1707 (11th
    Ed.2019).   A statute of limitations operates on the remedy, not on the
    existence of the cause of action itself. Mominee v. Scherbarth, 
    28 Ohio St.3d 270
    , 290, 
    503 N.E.2d 717
    , fn. 17 (Douglas, J., concurring). A statute
    of repose, on the other hand, bars “any suit that is brought after a specified
    time since the defendant acted * * * even if this period ends before the
    plaintiff has suffered a resulting injury.” Black's Law Dictionary at 1707. A
    statute of repose bars the claim – the right of action – itself. Treese v.
    -24-
    Delaware, 
    95 Ohio App.3d 536
    , 545, 
    642 N.E.2d 1147
     (10th Dist. 1994).
    ***
    Wilson v. Durrani, Ohio Slip Opinion No. 
    2020-Ohio-6827
    , ___ N.E.3d ___, ¶ 9.
    {¶ 63} The Supreme Court of Ohio further remarked that “[s]tatutes of limitations
    and statutes of repose target different actors.”         Id. at ¶ 10, citing CTS Corp. v.
    Waldburger, 
    573 U.S. 1
    , 8, 
    134 S.Ct. 2175
    , 
    189 L.Ed.2d 62
     (2014). In this vein, the court
    explained that:
    Statutes of limitations emphasize plaintiffs’ duty to diligently prosecute
    known claims. [CTS Corp. at 8], citing Black's Law Dictionary 1546 (9th
    Ed.2009). Statutes of repose, on the other hand, emphasize defendants’
    entitlement to be free from liability after a legislatively determined time. Id.
    at 9, 
    134 S.Ct. 2175
    .         In light of those differences, statutory schemes
    commonly pair a shorter statute of limitations with a longer statute of repose.
    California Pub. Emps.’ Retirement Sys. v. ANZ Securities, Inc., --- U.S. ---,
    
    137 S.Ct. 2042
    , 2049, 
    198 L.Ed.2d 584
     (2017). When the discovery rule –
    that is, the rule that the statute of limitations runs from the discovery of injury
    – governs the running of a statute of limitations, the “discovery rule gives
    leeway to a plaintiff who has not yet learned of a violation, while the rule of
    repose protects the defendant from an interminable threat of liability.” 
    Id.
    at ----, 137 S.Ct. at 2050.
    Wilson at ¶ 10.
    {¶ 64} In Wilson, the court stressed that “R.C. 2305.113(C) ‘exists to give medical
    providers certainty with respect to the time within which a claim can be brought and a time
    -25-
    after which they may be free from the fear of litigation.’ ” Id. at ¶ 16, quoting Ruther v.
    Kaiser, 
    134 Ohio St.3d 408
    , 
    2012-Ohio-5686
    , 
    983 N.E.2d 291
    , ¶ 19. “It is a ‘true statute
    of repose that applies to both vested and nonvested claims. Therefore, any medical-
    malpractice action must be filed within four years of the occurrence of the act or omission
    alleged to have caused a plaintiff's injury.’ ” 
    Id.,
     quoting Antoon v. Cleveland Clinic
    Found., 
    148 Ohio St.3d 483
    , 
    2016-Ohio-7432
    , 
    71 N.E.3d 974
    , ¶ 1.
    {¶ 65} As applied to the current case, whether or not a prior action was filed and
    dismissed, this action would be barred, absent tolling, because it was filed on May 14,
    2020, more than seven years after the alleged “acts or omissions constituting the alleged
    basis of the medical * * * claim.” R.C. 2305.113(C)(1). Notably, this subsection of the
    statute does not refer to when a claim accrues; it refers to when the acts or omissions
    occurred.
    {¶ 66} R.C. 2305.113(C) contains a few exceptions to the four-year barrier. The
    first, in subsection (C)(1), is for “persons within the age of minority or of unsound mind as
    provided by section 2305.16 of the Ohio Revised Code.”            R.C. 2305.16 states, in
    pertinent part, that:
    Unless otherwise provided in sections 1302.98, 1304.35, and
    2305.04 to 2305.14 of the Revised Code, if a person entitled to bring any
    action mentioned in those sections * * * is, at the time the cause of action
    accrues, within the age of minority or of unsound mind, the person may
    bring it within the respective times limited by those sections, after the
    disability is removed. * * *
    {¶ 67} A second exception in R.C. 2305.113(C)(2) allows tolling after a cause of
    -26-
    action accrues “if the person entitled to bring the action becomes of unsound mind and is
    adjudicated as such by a court of competent jurisdiction or is confined in an institution or
    hospital under a diagnosed condition or disease which renders the person of unsound
    mind.”
    {¶ 68} “ ‘Of unsound mind’ includes all forms of derangement or intellectual
    disability.” R.C. 1.02 (C). “ ‘[D]erangement’ has been equated with insanity.” Fisher
    v. Ohio Univ., 
    63 Ohio St.3d 484
    , 488, 
    589 N.E.2d 13
     (1992), citing Webster's Third New
    International Dictionary 607 (1986).     A plaintiff has the burden of showing that “the
    condition from which he or she suffered was ‘some species of mental deficiency or
    derangement [that caused him] to be unable to look into his affairs, properly consult with
    counsel, prepare and present his case and assert and protect his rights in a court of
    justice.’ ” Thomas v. Progressive Cas. Ins. Co., 
    2011-Ohio-6712
    , 
    969 N.E.2d 1284
    , ¶ 29
    (2d Dist.), quoting Bowman v. Lemon, 
    115 Ohio St. 326
    , 329, 
    154 N.E. 317
     (1926),
    paragraph three of the syllabus.
    {¶ 69} Dr. Rose argues on appeal that there are factual issues concerning whether
    he was of unsound mind because he suffered several periods between 2013 and 2017
    where he was hospitalized for mental changes that forced him to be off work. Appellant’s
    Brief at p. 10. He further argues that while hospitalized at Glenbeigh (a rehabilitation
    center) in June 2013, his mind was described as “hazy,” or “not in touch with reality.”
    Appellant's Brief at p. 11. In addition, Dr. Rose claims that he “has obtained proof of 52
    days of unsound mind since [his] memorandum,” and asks that this data be entered into
    the record. Id. at p. 12.
    {¶ 70} To the extent this latter statement refers to matters outside the record, we
    -27-
    will not consider it. E.g., State v. Ishmail, 
    54 Ohio St.2d 402
    , 
    377 N.E.2d 500
     (1978),
    paragraph one of the syllabus (stressing “[a] reviewing court cannot add matter to the
    record before it, which was not a part of the trial court’s proceedings, and then decide the
    appeal on the basis of the new matter”).
    {¶ 71} The trial court rejected tolling for two reasons. First, Dr. Rose failed to
    submit any evidence that he was of unsound mind on June 15, 2017, or at any time
    thereafter. Order at p. 13. The court also stressed that Dr. Rose did not claim that he
    was unsound at these times; rather, he asserted “without proof that he was of ‘unsound
    mind’ for several periods between 2013 and 2017 and that he was on a 72-hour hold in
    May of 2017, all of which occurred prior to his discovery of the underlying medical
    malpractice case.” 
    Id.,
     quoting Complaint at p. 1.
    {¶ 72} We agree with the trial court. The only items Dr. Rose submitted in the trial
    court were: “Plaintiff’s Memorandum Against Motion to Dismiss” (July 10, 2020),
    containing only argument and unverified allegations; “Plaintiff’s Motion Against Summary
    Judgement [sic] and Request for Jury trial” (Sep. 28, 2020), containing only argument and
    unverified allegations; and Dr. Rose’s own affidavit with various unauthenticated materials
    attached. Rose Aff. (Sep. 28, 2020).
    {¶ 73} Dr. Rose's affidavit sets forth his qualifications and background as a primary
    care physician. Rose Aff. at p. 1. He then stated that he experienced “substandard
    treatment” while a patient at Glenbeigh in May and June 2013. Id. at p. 2. The rest of
    the affidavit detailed incidents and medical evaluations that occurred between 2011 and
    April 2017 which indicated, in Dr. Rose's opinion, that the prior diagnoses of his medical
    problems (“schizo-affective, biopolar, obsessive compulsive, alcohol dependent,
    -28-
    benzodiazepine dependence”) were “wrong and were arrived at by substandard review
    of all medical records available to the Glenbeigh personnel and Dr. Primc.” Id. at p. 6.
    At the end of this discussion, Dr. Rose stated briefly that “Dr. Tievsky’s MRI misread has
    been paramount in damages to Dr. Rose. Failure to compare previous films absolute
    negligence.” Id.
    {¶ 74} None of this, however, had anything to do with whether Dr. Rose was of
    unsound mind on June 15, 2017, when the cause of action accrued, or on April 19, 2017,
    which Dr. Rose suggests in his affidavit was the date he was given an opinion of possible
    carbon monoxide involvement. Id. at p. 5. This information also had nothing to do with
    whether Dr. Rose was of unsound mind any time after June 15, 2017.
    {¶ 75} The materials attached to Dr. Rose's affidavit (208 pages of documents)
    consisted of various medical records and other records, which were not properly
    authenticated. Nonetheless, even if these materials were considered, a consultation
    with Dr. Goldstick dated May 26, 2017, stated that after being admitted to Kettering
    Hospital on May 20, 2017, for a “brief period of psychological decompensation,” Dr. Rose
    “returned to his normal mentation * * *.” Rose Aff., Ex. A, May 26, 2017 Report of Dr.
    Goldstick p. 2. At that time, according to the patient history, Dr. Rose noted that “in 2010,
    he bought a used car and was driving this for quite some time. He feels there may have
    been exposure of carbon monoxide at the time and when the car was tested at one point
    it registered 300 ppm of carbon monoxide.” Id.
    {¶ 76} In Dr. Goldstick's examination of Dr. Rose on May 26, 2017, Goldstick
    stated that Dr. Rose's attention and concentration were “normal,” his speech was
    “normal,” his level of consciousness was “alert,” his knowledge was “good,” and his
    -29-
    comprehension was “normal.” Ex. A at p. 2-3. Another examination by Dr. Goldstick on
    September 27, 2017, indicated that Dr. Rose “remains stable at this time and is operating
    a [sic] normal activities at this time [and] apparently is also active professionally.” Ex. A,
    September 27, 2017 Report of Dr. Goldstick, p. 13. Dr. Rose did not provide any other
    materials relating to the “unsoundness” of his mind after September 2017.
    {¶ 77} Accordingly, even if we considered Dr. Rose's affidavit and the attached
    materials, they would only disprove any contention that he was of unsound mind as of
    June 15, 2017, or any time thereafter.
    {¶ 78} In connection with the eighth assignment of error, Dr. Rose questions why
    the trial court required him to show proof of his “unsound mind,” when Civ.R. 12(B)(6)
    requires that the court construe all the allegations in the complaint as true. Appellant's
    Brief at p. 21-22. Dr. Rose then offers to submit records from his current psychiatrist,
    which he obtained after the trial court issued its decision, and states that he wants us to
    allow these records to be “admitted to [the] record.” Id. at p. 22. As we stressed earlier,
    we cannot add matters to the record that the trial court did not consider. Ishmail, 
    54 Ohio St.2d 402
    , 
    377 N.E.2d 500
    , at paragraph one of the syllabus.
    {¶ 79} Next, regarding the “proof” requirement, the trial court was entitled to
    consider what the evidence established, because two motions were pending: a motion to
    dismiss and a motion for summary judgment. As we mentioned, a court does construe
    a complaint’s allegations as true for purposes of motions to dismiss. However, when Dr.
    Tievsky and CCF submitted materials to satisfy their burden on summary judgment, Dr.
    Rose had the reciprocal burden of showing there were genuine issues of material fact
    precluding summary judgment. Dresher, 75 Ohio St.3d at 293, 
    662 N.E.2d 264
    . This,
    -30-
    he failed to do. Consequently, the trial court did not err in this regard.
    {¶ 80} As a pro se litigant, Dr. Rose clearly does not understand legal procedure,
    and, like most such litigants, finds the law difficult.     However, we have repeatedly
    emphasized that “[i]n Ohio, a pro se litigant ‘is presumed to have knowledge of the law
    and of correct legal procedure and is held to the same standard as all other litigants.’ ”
    Citibank S. Dakota, N.A. v. Wood, 
    169 Ohio App.3d 269
    , 
    2006-Ohio-5755
    , 
    862 N.E.2d 576
    , ¶ 57 (2d Dist.), quoting Kilroy v. B.H. Lakeshore Co., 
    111 Ohio App.3d 357
    , 363, 
    676 N.E.2d 171
     (8th Dist.1996).      See also Williams v. PNC Bank, Natl. Assn., 2d Dist.
    Montgomery No. 28933, 
    2021-Ohio-977
    , ¶ 2; State ex rel. Fuller v. Mengel, 
    100 Ohio St.3d 352
    , 
    2003-Ohio-6448
    , 
    800 N.E.2d 25
    , ¶ 10.
    {¶ 81} Having agreed with the trial court that tolling does not apply, a few additional
    points about R.C. 2305.19 are in order. Normally, when a complaint is dismissed without
    prejudice, the plaintiff “may commence a new action within one year after the date of * * *
    the plaintiff's failure otherwise than on the merits.” R.C. 2305.19(A) (the savings statute).
    Here, the trial court held that even if the original complaint had been timely filed, Dr. Rose
    could not take advantage of the savings statute. Order at p. 14-16. In this regard, the
    court noted that the 2020 action was filed about 21 months after the first action was
    dismissed on August 22, 2018. Because this was more than a year after the dismissal,
    R.C. 2305.19(A) did not apply and provided an additional reason for dismissing Dr. Rose's
    claims. Id. at p.15.
    {¶ 82} We agree that this would normally be the case, and further observe that Dr.
    Rose has not assigned error specifically on this issue. However, the Supreme Court of
    Ohio recently issued a decision that impacts what previously would have been true in
    -31-
    situations like the present. Specifically, in Wilson, the Supreme Court of Ohio held that:
    R.C. 2305.113(C) is a true statute of repose that, except as expressly
    stated in R.C. 2305.113(C) and (D), clearly and unambiguously precludes
    the commencement of a medical claim more than four years after the
    occurrence of the alleged act or omission that forms the basis of the claim.
    Expiration of the statute of repose precludes the commencement, pursuant
    to the saving statute, of a claim that has previously failed otherwise than on
    the merits in a prior action.
    Wilson, Ohio Slip Opinion No. 
    2020-Ohio-6827
    , __ N.E.3d __, at ¶ 38. Therefore, a
    plaintiff may not “take advantage of Ohio's saving statute to refile a medical claim after
    the applicable one-year statute of limitations has expired if the four-year statute of repose
    for medical claims has also expired.” Id. at ¶ 1.
    {¶ 83} The trial court was likely unaware of the Wilson decision, as it was issued
    on December 23, 2020, only a few days before the court dismissed Dr. Rose's case with
    prejudice on December 29, 2020. The effect of Wilson is that Dr. Rose could not have
    used the savings statute in R.C. 2305.19(A) to refile because both the one-year statute
    of limitations in R.C. 2305.113(A) and the four-year statute of repose in R.C. 2305.113(C)
    had already expired before Dr. Rose filed the current action.
    {¶ 84} Specifically, Dr. Rose's latest contact with Dr. Tievsky and CCF ended at
    the latest on May 3, 2013. Four years from that date would have been May 4, 2017.
    Thus, by the time Dr. Rose filed his initial action in this matter on June 15, 2018, the four-
    year statute of repose in R.C. 2305.113(C) had already expired. Based on the June 15,
    2017 accrual date of Dr. Rose’s medical claims, the one-year statute of limitations in R.C.
    -32-
    2305.113(C) also expired the day after Dr. Rose filed the initial action.
    {¶ 85} As a result, even if the first action had been timely filed, Dr. Rose could not
    have used R.C. 2305.19(A) to refile the action on May 14, 2020, since the four-year period
    of repose expired by May 4, 2017. And, on May 14, 2020, the one-year statute of
    limitations in R.C. 2305.113(A) had also already expired. In fact, Dr. Rose refiled the
    present case more than seven years after May 3, 2013. Accordingly, Dr. Rose's claims
    were barred under the statute of repose in R.C. 2305.113(C).
    {¶ 86} Any error by the trial court, however, was harmless, because the end result
    was the same. See Civ.R. 61 (instructing courts to disregard errors that do “not affect
    the substantial rights of the parties”). We note that the trial court did also make a finding,
    while discussing tolling, that the statute of repose in R.C. 2305.113(C) barred Dr. Rose’s
    claims because they were not commenced until more than four years after the occurrence
    of the acts on which his claims were based. Order at p. 13.
    {¶ 87} Based on the preceding discussion, the third, seventh, and eighth
    assignments of error are without merit and are overruled.
    V. Failure to Consider Dr. Rose’s Affidavit
    {¶ 88} Dr. Rose's first assignment of error states as follows:
    Assignment of error No. 1. Failure to Recognize Civ.R. 56 Qualified
    Affidavit by Dr. Rose.
    {¶ 89} Under this assignment of error, Dr. Rose appears to be arguing that the trial
    court erred by failing to admit his affidavit into the record or to consider it. Dr. Rose
    contends that he was qualified to give an opinion under Civ.R. 56(E), as he had been a
    -33-
    practicing physician for many years.
    {¶ 90} The trial court did not err in this regard. While the court did not specifically
    mention Dr. Rose’s affidavit and the attached documents during its discussion, we have
    already said that even if the content of Dr. Rose's affidavit and the attached documents
    were considered, they indicated that a reasonably prudent person in his circumstances
    would have been put on notice of the need for further inquiry as to the cause of his
    condition and the need to pursue remedies, at the latest, on June 15, 2017. These
    materials also established that Dr. Rose was of sound mind at the relevant time and
    thereafter.
    {¶ 91} In addition, Dr. Rose admitted in his brief that he was not certified as a
    neuro-radiologist. Appellant’s Brief at p. 5. Dr. Rose did not specifically argue that his
    affidavit could substitute for an affidavit of merit in the trial court, although that is, perhaps,
    implied. However, that argument would fail for two reasons. First, Dr. Rose did not
    make this argument in the trial court.
    {¶ 92} A fundamental rule of appellate procedure is that appellate courts “will not
    consider any error which could have been brought to the trial court's attention, and hence
    avoided or otherwise corrected.” Schade v. Carnegie Body Co., 
    70 Ohio St.2d 207
    , 210,
    
    436 N.E.2d 1001
     (1982). Accord Jackson v. Internatl. Fiber, 
    169 Ohio App.3d 395
    , 2006-
    Ohio-5799, 
    863 N.E.2d 189
    , ¶ 11 (2d Dist.).           We can recognize plain error in such
    situations, but it is disfavored in civil cases “and may be applied only in the extremely rare
    case involving exceptional circumstances where error, to which no objection was made
    at the trial court, seriously affects the basic fairness, integrity, or public reputation of the
    judicial process, thereby challenging the legitimacy of the underlying judicial process
    -34-
    itself.” Goldfuss v. Davidson, 
    79 Ohio St.3d 116
    , 
    679 N.E.2d 1099
     (1997), syllabus. No
    exceptional circumstances exist here.
    {¶ 93} Even if we did consider “plain error,” any such notion would be squelched
    by our second reason for rejecting Dr. Rose’s argument. Specifically, Dr. Rose’s affidavit
    could not be substituted for a proper Civ.R. 10(D)(2) affidavit of merit because it failed to
    comply with the requirements of Civ.R. 10(D)(2). One defect was that the affidavit did
    not state that Dr. Rose was familiar with the standard of care for radio-neurologists or
    radiologists. This is a requirement under Civ.R. 10(D)(2)(a)(ii).
    {¶ 94} Furthermore, Civ.R. 10(D)(2)(a) mandates that expert witnesses must meet
    “the requirements of Evid.R. 702 and, if applicable, also * * * the requirements of Evid.R.
    601(D).”5 Among other things, Evid.R. 601(D) [now Evid.R. 601(B)(5)(a)-(c)] disqualifies
    persons from giving expert testimony about medical claims unless “[t]he person practices
    in the same or a substantially similar specialty as the defendant.” Evid.R. 601(B)(5)(c).
    In Dr. Rose’s affidavit, he identified himself as a person certified in “Family Practice,” and
    he did not provide any evidence indicating that this was the same or a substantially similar
    specialty as the one Dr. Tievsky practiced (radiology).
    {¶ 95} As a result, the trial court did not err in any manner relating to Dr. Rose's
    affidavit. The first assignment of error, therefore, is overruled.
    5 Evid.R.601 has been amended a number of times since Civ.R. 10 was amended to add
    provisions pertaining to medical actions. Subsection (D) became subsection (E) on July 1, 2020,
    and under an amendment effective on July 21, 2021, is now Evid.R. 601(B)(5)(a)-(c). See
    https://www.supremecourt.ohio.gov/ruleamendments/documents/4.22.20%20Posting.pdf, and
    https://www.supremecourt.ohio.gov/ruleamendments/documents/Online%20Posting%20-
    %20Final%20Rules%20(7.1.21).pdf (both accessed on August 16, 2021). Civ.R. 10 has not
    been updated to address the change in Evid.R. 601.
    -35-
    VI. Fraudulent Concealment
    {¶ 96} Dr. Rose's fifth assignment of error, again quoted verbatim, states as
    follows:
    Fraudulent Concealment, Fraudulent Conveyance, by Dr. Spreitzer,
    Employee of CCF.
    {¶ 97} Under this assignment of error, Dr. Rose alleges that Dr. Spreitzer
    purposely failed to compare Dr. Tievsky’s 2013 MRI reading because Dr. Spreitzer
    realized an error had been made previously. This is apparently based on a comment in
    Dr. Spreitzer's notes that “[a] previous study 5/03/2013 is not available for comparison.”
    Appellant's Brief at p. 14-15. During the rest of his argument, Dr. Rose refers to facts he
    allegedly learned after he filed his summary judgment motion, by apparently looking up
    the phone number for “CCF's Star Imagining” in Kettering, Ohio, by reviewing a CCF
    advertisement, and by making a telephone call to the Ashtabula Radiology Department.
    Id. at p. 15-16. Somehow, according to Dr. Rose, this adds up to some sort of claim for
    fraudulent concealment.
    {¶ 98} Dr. Rose did not sue Dr. Spreitzer. Based on documents attached to the
    complaint, Dr. Spreitzer apparently reviewed an MRI done on Dr. Rose on May 24, 2017,
    based on a history of “chronic heartburn, monoxide exposure, imbalance, and low serum
    sodium.” The original report indicated that a prior study done on May 3. 2013, was not
    available for comparison. However, a June 15, 2017 update (less than a month later)
    added that the previous study of May 3, 2013, was now available for comparison. There
    was no difference between the original and updated reports with respect to the findings
    made about the May 24, 2017 MRI.
    -36-
    {¶ 99} The complaint, Dr. Rose's memoranda, and his affidavit did not mention
    claims against Dr. Spreitzer based on this MRI report. Even if they had, we see no
    relevance of this matter.         And, as we have already mentioned, we cannot consider
    evidence that was not presented to the trial court.
    {¶ 100} Based on the preceding discussion, the matters discussed in connection
    with this assignment of error either are completely irrelevant or relate to information that
    Dr. Rose learned after his case was dismissed. Consequently, the fifth assignment of
    error is without merit and is overruled.
    VII. Conclusion
    {¶ 101} All of Dr. Rose's assignments of error having been overruled, the judgment
    of the trial court is affirmed.
    .............
    DONOVAN, J. and EPLEY, J., concur.
    Copies sent to:
    Bernard Joseph Rose, M.D.
    Matthew L. Schrader
    David Valent
    Hon. Mary Lynn Wiseman