PER CURIAM:
William and Beverly McCoy appeal from two orders entered by the Circuit Court of Kanawha County on June 25, 2001, dismissing a second medical malpractice action they filed against Appellee Doctors Jay Requarth and John Chapman
on grounds of both
res judicata
and statute of limitations and against Dr. Scott Miller solely on statute of limitations grounds. The McCoys also appeal from a January 30, 2002, order refusing to reinstate their legal malpractice action against Steven Miller.
In
McCoy v. CAMC, Inc., (McCoy I),
210 W.Va. 324, 557 S.E.2d 378 (2001), this Court affirmed both the lower court’s dismissal of the McCoys’ first medical malpractice cause of action on grounds of failure to prosecute
and the trial court’s
decision not to reinstate the action. Upon our full review of the orders at issue against the record in this case, we find no error and accordingly, affirm.
I. Factual and Procedural Background
Mr. McCoy underwent double coronary bypass surgery at Charleston Area Medial Center, Inc. (“CAMC”) on January 3, 1995. Although the surgery performed by Dr. Req-uarth, and assisted by Dr. Chapman, was performed without incident, Mr. McCoy’s sternum became separated during the recovery period and he alleged that he sustained a staph infection as a result of the surgery required to repair his separated sternum. Based on these alleged acts and the resulting injuries sustained, the McCoys filed their initial medical malpractice complaint against CAMC, Dr. Requarth, and Dr. Chapman on January 3, 1997. In them complaint, the McCoys alleged negligence, failure to warn, and loss of consortium.
The first civil action filed by the McCoys was dismissed by order of Judge Irene Berger on December 20, 2000, for failure to prosecute. In
McCoy 1,
this Court upheld both the dismissal order and the subsequent order of Judge Berger denying the McCoys’ motion to reinstate their cause of action and to amend them complaint.
See
210 W.Va. at 331, 557 S.E.2d at 385.
On February 27, 2001, the McCoys filed a second medical malpractice cause of action
based on the 1995 heart surgery. In addition to Doctors Requarth and Chapman, the McCoys named Dr. Miller as a defendant, based on his referral of Mr. McCoy for the bypass surgery. While the underlying allegations of malpractice stemming from the separated sternum incident are the same as those asserted in the first action, the McCoys included an additional allegation in the second malpractice action by averring that the bypass surgery was medically unnecessary. The McCoys contend that they first learned that the bypass surgery was unnecessary following an examination of Mr. McCoy by Dr. Joseph A. Chiota, Jr., on August 22, 2000.
By order entered on June 25, 2001, Judge Stucky dismissed Dr. Miller, who had not been named in the original medical malpractice cause of action filed by the McCoys, on statute of limitation grounds. By separate order on that same date, Judge Stucky dismissed Doctors Requarth and Chapman on grounds of statute of limitations and
res judi-cata.
Through an order entered on January 30, 2002, Judge Stucky refused to reinstate the McCoys’ legal malpractice cause of action filed against Mr. Miller.
II. Standard of Review
With regard to the two dismissal orders from which the McCoys appeal, this Court has recognized that “[ajppellate review of a circuit court’s order granting a motion to dismiss a complaint is
de novo.” State ex rel. McGraw v. Scott Runyan Pontiac-Buick, Inc.,
194 W.Va. 770, 775, 461 S.E.2d 516, 521 (1995). Accordingly, we proceed to review this matter to determine whether the dismissal orders were entered in error.
III. Discussion
A. Dismissal on Statute of Limitations Grounds
Appellants argue that the application of the discovery rule, as it relates to a medical malpractice case, requires reversal of the dismissal orders that were entered on statute of limitations grounds. As support for this contention, Appellants maintain that this Court’s decisions in
Gaither v. City Hospital, Inc.,
199 W.Va. 706, 487 S.E.2d 901 (1997), and
Bradshaw v. Soulsby,
210 W.Va. 682, 558 S.E.2d 681 (2001), have broadened the application of the “discovery rule.”
In syllabus point one of
Cart v. Marcum,
188 W.Va. 241, 423 S.E.2d 644 (1992), this Court held that “[generally, a cause of action accrues (i.e., the statute of limitations begins to run) when a tort occurs; under the ‘discovery rule,’ the statute of limitations is tolled until a claimant knows or by reasonable diligence should know of his claim.” With regard to when the “discovery rule” could be utilized, we stated in
Cart
that “the ‘discovery rule’ applie[d] only when there [wa]s a strong showing by the plaintiff that some action by the defendant prevented the plaintiff from knowing of the wrong at the time of the injury.”
Id.
at 242, 423 S.E.2d at 645, syl. pt. 3, in part.
In
Gaither,
this Court modified its former position that application of the “discovery rule” was triggered by the acts of a defendant to conceal the discovery of a medical wrong. Rejecting that narrow application of the “discovery rule,” we held that
In tort actions, unless there is a clear statutory prohibition to its application, under the discovery rule the statute of limitations begins to run when the plaintiff knows, or by the exercise of reasonable diligence, should know (1) that the plaintiff has been injured, (2) the identity of the entity who owed the plaintiff a duty to act with due care, and who may have engaged in conduct that breached that duty, and (3) that the conduct of that entity has a causal relation to the injury.
Syl. Pt. 4, 199 W.Va. at 708, 487 S.E.2d at 903. Recently, in
Bradshaw,
we overruled a prior ruling which held that the “discovery rule” was inapplicable in wrongful death actions, and adopted the same requirements we announced in
Gaither
for applying the rule, with certain additional factors relevant to wrongful death actions.
See
Syl. Pts. 7, 8, 210 W.Va. at 684, 558 S.E.2d at 683.
Based on the holdings in
Gaither
and
Bradshaw,
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PER CURIAM:
William and Beverly McCoy appeal from two orders entered by the Circuit Court of Kanawha County on June 25, 2001, dismissing a second medical malpractice action they filed against Appellee Doctors Jay Requarth and John Chapman
on grounds of both
res judicata
and statute of limitations and against Dr. Scott Miller solely on statute of limitations grounds. The McCoys also appeal from a January 30, 2002, order refusing to reinstate their legal malpractice action against Steven Miller.
In
McCoy v. CAMC, Inc., (McCoy I),
210 W.Va. 324, 557 S.E.2d 378 (2001), this Court affirmed both the lower court’s dismissal of the McCoys’ first medical malpractice cause of action on grounds of failure to prosecute
and the trial court’s
decision not to reinstate the action. Upon our full review of the orders at issue against the record in this case, we find no error and accordingly, affirm.
I. Factual and Procedural Background
Mr. McCoy underwent double coronary bypass surgery at Charleston Area Medial Center, Inc. (“CAMC”) on January 3, 1995. Although the surgery performed by Dr. Req-uarth, and assisted by Dr. Chapman, was performed without incident, Mr. McCoy’s sternum became separated during the recovery period and he alleged that he sustained a staph infection as a result of the surgery required to repair his separated sternum. Based on these alleged acts and the resulting injuries sustained, the McCoys filed their initial medical malpractice complaint against CAMC, Dr. Requarth, and Dr. Chapman on January 3, 1997. In them complaint, the McCoys alleged negligence, failure to warn, and loss of consortium.
The first civil action filed by the McCoys was dismissed by order of Judge Irene Berger on December 20, 2000, for failure to prosecute. In
McCoy 1,
this Court upheld both the dismissal order and the subsequent order of Judge Berger denying the McCoys’ motion to reinstate their cause of action and to amend them complaint.
See
210 W.Va. at 331, 557 S.E.2d at 385.
On February 27, 2001, the McCoys filed a second medical malpractice cause of action
based on the 1995 heart surgery. In addition to Doctors Requarth and Chapman, the McCoys named Dr. Miller as a defendant, based on his referral of Mr. McCoy for the bypass surgery. While the underlying allegations of malpractice stemming from the separated sternum incident are the same as those asserted in the first action, the McCoys included an additional allegation in the second malpractice action by averring that the bypass surgery was medically unnecessary. The McCoys contend that they first learned that the bypass surgery was unnecessary following an examination of Mr. McCoy by Dr. Joseph A. Chiota, Jr., on August 22, 2000.
By order entered on June 25, 2001, Judge Stucky dismissed Dr. Miller, who had not been named in the original medical malpractice cause of action filed by the McCoys, on statute of limitation grounds. By separate order on that same date, Judge Stucky dismissed Doctors Requarth and Chapman on grounds of statute of limitations and
res judi-cata.
Through an order entered on January 30, 2002, Judge Stucky refused to reinstate the McCoys’ legal malpractice cause of action filed against Mr. Miller.
II. Standard of Review
With regard to the two dismissal orders from which the McCoys appeal, this Court has recognized that “[ajppellate review of a circuit court’s order granting a motion to dismiss a complaint is
de novo.” State ex rel. McGraw v. Scott Runyan Pontiac-Buick, Inc.,
194 W.Va. 770, 775, 461 S.E.2d 516, 521 (1995). Accordingly, we proceed to review this matter to determine whether the dismissal orders were entered in error.
III. Discussion
A. Dismissal on Statute of Limitations Grounds
Appellants argue that the application of the discovery rule, as it relates to a medical malpractice case, requires reversal of the dismissal orders that were entered on statute of limitations grounds. As support for this contention, Appellants maintain that this Court’s decisions in
Gaither v. City Hospital, Inc.,
199 W.Va. 706, 487 S.E.2d 901 (1997), and
Bradshaw v. Soulsby,
210 W.Va. 682, 558 S.E.2d 681 (2001), have broadened the application of the “discovery rule.”
In syllabus point one of
Cart v. Marcum,
188 W.Va. 241, 423 S.E.2d 644 (1992), this Court held that “[generally, a cause of action accrues (i.e., the statute of limitations begins to run) when a tort occurs; under the ‘discovery rule,’ the statute of limitations is tolled until a claimant knows or by reasonable diligence should know of his claim.” With regard to when the “discovery rule” could be utilized, we stated in
Cart
that “the ‘discovery rule’ applie[d] only when there [wa]s a strong showing by the plaintiff that some action by the defendant prevented the plaintiff from knowing of the wrong at the time of the injury.”
Id.
at 242, 423 S.E.2d at 645, syl. pt. 3, in part.
In
Gaither,
this Court modified its former position that application of the “discovery rule” was triggered by the acts of a defendant to conceal the discovery of a medical wrong. Rejecting that narrow application of the “discovery rule,” we held that
In tort actions, unless there is a clear statutory prohibition to its application, under the discovery rule the statute of limitations begins to run when the plaintiff knows, or by the exercise of reasonable diligence, should know (1) that the plaintiff has been injured, (2) the identity of the entity who owed the plaintiff a duty to act with due care, and who may have engaged in conduct that breached that duty, and (3) that the conduct of that entity has a causal relation to the injury.
Syl. Pt. 4, 199 W.Va. at 708, 487 S.E.2d at 903. Recently, in
Bradshaw,
we overruled a prior ruling which held that the “discovery rule” was inapplicable in wrongful death actions, and adopted the same requirements we announced in
Gaither
for applying the rule, with certain additional factors relevant to wrongful death actions.
See
Syl. Pts. 7, 8, 210 W.Va. at 684, 558 S.E.2d at 683.
Based on the holdings in
Gaither
and
Bradshaw,
Appellants contend that the “discovery rule” is triggered by a prospective plaintiffs “recognition that the treatment received by the patient caused his injury.” They suggest that because Mr. McCoy had no way of knowing “until it was told to him” that his bypass surgery was unnecessary, the two-year statute of limitations
did not start running until Dr. Chiota informed him in August 2001 that the cardiac surgery was not medically necessary.
In making these arguments, Appellants seek to further extend the “discovery rule” beyond the parameters of the previously broadened reach of that rule. In
Gaither,
we expanded the “discovery rule” by linking the running of the limitations period with the prospective plaintiffs knowledge, or duty to gain such knowledge, of “the identity of the entity who owed the plaintiff a duty to act
with due care” and the fact that such entity may have breached that duty of care, which in turn caused the plaintiffs injury. 199 W.Va. at 708, 487 S.E.2d at 903, syl. pt. 4, in part. Critically, however, we did not eliminate the affirmative duty the law imposes on a plaintiff to discover or make inquiry to discern additional facts about his injury when placed on notice of the possibility of wrongdoing. The crux of the “discovery rule” has always been to benefit those individuals who were either unaware of their injuries or prevented from discovering them.
See Cart,
188 W.Va. at 244-45, 423 S.E.2d at 647-48;
Gaither,
199 W.Va. at 713, 487 S.E.2d at 908 (recognizing that “discovery rule has its origins in the fact that many times an injured party is unable to know of the existence of any injury or its cause”). When this Court augmented the application of the “discovery rule” to cases beyond those where the defendant actively sought to prevent the discovery of the malfeasance, we did not eradicate the rule’s additional objective of benefitting those individuals who were unaware of their injuries due to no fault of their own.
The counter-vailing consideration of whether the prospective plaintiff “knew or should have known” through the exercise of reasonable diligence of his injury has always been closely intertwined with the “discovery rule.”
See Harrison v. Seltzer,
165 W.Va. 366, 371, 268 S.E.2d 312, 314 (1980) (stating that inquiry is “whether the injured plaintiff was aware of the malpractice or, by the exercise of reasonable care, should have discovered it”); Syl. Pt. 2,
Hill v. Clarke,
161 W.Va. 258, 241 S.E.2d 572 (1978) (holding that “statute of limitations for malpractice begins to run when plaintiff knows or has reason to know of the alleged malpractice”). This critical element of the “discovery rule” has not been vitiated with the Court’s modification of the rule’s application. Where a plaintiff knows of his injury, and the facts surrounding that injury place him on notice of the possible breach of a duty of care, that plaintiff has an affirmative duty to further and fully investigate the facts surrounding that potential breach.
See Harrison v. Davis,
197 W.Va. 651, 478 S.E.2d 104 (1996) (holding that plaintiff mother’s failure to exercise reasonable diligence in discovering injuries associated with the birth and wrongful death of her daughter precluded tolling of statute of limitations by “discovery rule”).
In this case, had the most basic and routine of inquiries been made during the discovery phase of the first action, it is likely that Dr. Chiota’s “eleventh hour” opinion of unnecessary surgery could have surfaced at a much earlier point in the litigation’s protracted history.
Because Appellants timely retained counsel and timely brought suit in connection with the sternum separation incident, this Court cannot turn a blind eye to the fact that additional inquiry on the part of their trial counsel
could have easily uncovered the “unnecessary surgery” allegation at an earlier date, thereby allowing Appellants the opportunity to seek amendment of their complaint to add such an allegation in a timely fashion.
The facts underlying the malpractice at the center of this case were straightforward. There were no concealed or hidden injuries. As Judge Stueky opined in his order of June 25, 2001, “[tjhere is no allegation in this case of fraudulent concealment or any action by Dr. Miller to prevent plaintiff from knowing the cause of his injury or bringing this action.” Similarly, in a second order of that same date, Judge Stueky found that “[tjhere is no act on the part of either Dr. Chapman or Dr. Requarth which concealed any of their actions relative to plaintiffs nor is there any act by either Dr. Chapman or Dr. Requarth
which prevented plaintiffs from knowing of their injuries and damages[.]”
This case falls into that category of eases we discussed in
Gaither
where “an injury or wrong occurs of such a character that a plaintiff cannot reasonably claim ignorance of the existence of a cause of action.” 199 W.Va. at 712, 487 S.E.2d at 907. In such cases, as we explained in
Gaither,
“the burden shifts to the plaintiff to prove entitlement to the benefit of the discovery rule.”
Id.
at 712, 487 S.E.2d at 907. The McCoys knew as soon as they were informed following bypass surgery of the need to reattach the sternum that Mr. McCoy had suffered injury from certain acts of improper handling. They promptly sought counsel and brought suit within the two-year filing period.
See supra
note 8. Appellants have failed to provide this Court with any explanation as to why they could not have discovered at an earlier point in time the facts underlying their allegation that the bypass surgery was medically unnecessary.
Unlike
Gaither
where the plaintiff reasonably believed his leg amputation resulted from his own negligent acts in riding a motorcycle, Appellants knew immediately that the sternum separation Mr. McCoy sustained was caused by actions of parties other than Mr. McCoy.
Gaither
does not go so far as to suggest that until a prospective plaintiff is informed of every possible act of malpractice and the identity of every potential wrongdoer, the statute of limitations is tolled. To the contrary,
Gaither
only tolls the limitations period until the plaintiff in factually specific situations, such as where the plaintiff has no reason to know or learn of an act of malpractice, is placed on notice of a possible wrongdoing. This Court has always been clear, as we restated in
Gaither,
that “[m]ere ignorance of the existence of a cause of action or of the identity of the wrongdoer does not prevent the running of the statute of limitations^]” 199 W.Va. at 712, 487 S.E.2d at 907 (quoting Syl. Pt. 3, in part,
Cart,
188 W.Va. at 242, 423 S.E.2d at 645). As we explained in
Gaither,
“[t]his rule was crafted because in some circumstances causal relationships are so well established that we cannot excuse a plaintiff who pleads ignorance.” 199 W.Va. at 712, 487 S.E.2d at 907.
In those instances where the “ ‘patient is immediately aware that something went wrong,’ ” the statute of limitations begins to run upon the plaintiffs awareness of “ ‘adverse results of medical treatment.’ ”
Gaither,
199 W.Va. at 712, 487 S.E.2d at 907 (quoting
Seltzer,
165 W.Va. at 371, 268 S.E.2d at 315). In such cases, as we observed in
Gaither,
the statute of limitations starts running with the plaintiffs knowledge of the fact that something went wrong and
not
his awareness of “ ‘the precise act of malpractice.’ ” 199 W.Va. at 712, 487 S.E.2d at 907 (quoting
Seltzer,
165 W.Va. at 371, 268 S.E.2d at 315). The facts of the instant case paradigmatically fall into the category of cases discussed in
Seltzer
where the plaintiff knows instantly that something went wrong.
See
165 W.Va. at 371-72, 268 S.E.2d at 315.
Armed with information about the wrongdoing stemming
from Mr.
McCoy’s bypass surgery, Appellants were then required to make reasonable and diligent inquiry into all relevant issues related to the malpractice.
Whether or
not the
original bypass surgery should have been performed was clearly an issue related to the resulting malpractice claim.
Any physician with training in car
diology could have reviewed Mr. McCoy’s records to ascertain whether the bypass surgery was required. In failing to make such inquiries within a reasonable period of time sufficient to have permitted a timely amendment of Appellants’ complaint, we are forced to conclude that the McCoys did not meet their burden of proving entitlement to the “discovery rule.”
See Gaither,
199 W.Va. at 712, 487 S.E.2d at 907. The facts of this case simply do not permit this Court to rule otherwise.
In
Gaither,
this Court noted that “[i]n the great majority of cases, the issue of whether a claim is barred by the statute of limitations is a question of fact for the jury.” 199 W.Va. at 714-15, 487 S.E.2d at 909-10. While many cases will require a jury to resolve the issue of when a plaintiff discovered his or her injury, including the related issue of whether the plaintiff was reasonably diligent in discovery his or her injury, the issue can also be resolved by the court where the relevant facts are undisputed and only one conclusion may be drawn from those facts.
See Harrison,
197 W.Va. at 660, 478 S.E.2d at 113 (upholding trial court’s decision that plaintiff failed to exercise reasonable diligence in discovering injuries);
Cathedral of Joy Baptist Church v. Village of Hazel Crest,
22 F.3d 713, 719 (7th Cir.1994);
Witherell v. Weimer,
85 Ill.2d 146, 52 Ill.Dec. 6, 421 N.E.2d 869, 874 (1981). Because Mr. McCoy was immediately aware of his sternum injury and resulting infection, the question of whether Appellants acted with reasonable diligence to discover the related allegation that the bypass surgery was unnecessary, under the facts of this case, was properly a legal question for the trial court to resolve.
III. Conclusion
Having found no error with regal’d to the dismissal orders at issue, the decision of the Circuit Court of Kanawha County is hereby affirmed.
Affirmed.