The 90-Day Notice of Claim in NYC Public Hospitals

When a birth injury occurs at a New York City public hospital, families face unique legal deadlines that don’t apply to private hospitals. The most critical is the 90-day notice of claim requirement, a strict deadline that can determine whether a family can pursue compensation for their child’s injury.

This requirement catches many families off guard. Unlike private hospitals where families have two and a half years to file a lawsuit, NYC Health + Hospitals facilities operate under completely different rules. Missing the 90-day window doesn’t automatically end a case, but it makes everything significantly more complicated.

What Is the Notice of Claim Requirement

New York’s General Municipal Law § 50-e requires anyone with a potential claim against a public entity to file a formal written notice within 90 days of when the injury occurred. This applies to all NYC Health + Hospitals facilities, which include:

• Bellevue Hospital
• Elmhurst Hospital
• Harlem Hospital
• Kings County Hospital
• Lincoln Medical Center
• Metropolitan Hospital
• NYC Health + Hospitals/Queens
• Woodhull Medical Center

And all other facilities operated by NYC Health + Hospitals Corporation.

The notice of claim is not a lawsuit. It’s a mandatory first step that must happen before any lawsuit can be filed. Think of it as a formal notification system that gives the hospital early warning of a potential claim.

Why NYC Public Hospitals Have Different Rules Than Private Hospitals

This requirement exists specifically to protect public entities and taxpayer funds. The reasoning behind it includes:

Early investigation opportunity – The hospital can investigate while memories are fresh and evidence is readily available.

Settlement potential – Many claims get resolved before expensive litigation begins.

Protection of public resources – The requirement prevents old claims from surfacing years later when defending them becomes difficult.

Witness availability – Medical staff can be interviewed and their recollections documented while details are still clear.

From a practical standpoint, this means families dealing with injuries at public hospitals face a much shorter window than those at private facilities. A birth injury at Mount Sinai or NYU Langone gives families 30 months to file suit. The same injury at Bellevue or Kings County gives them 90 days to file a notice, then just over a year total to file the actual lawsuit.

When the 90 Day Clock Starts Ticking

Understanding exactly when your 90 days begins is crucial. In birth injury cases, the clock typically starts on the date the injury occurred, not when you discovered it.

For injuries during labor and delivery – The 90 days usually begins on the birth date itself. If shoulder dystocia caused a brachial plexus injury during delivery on June 1st, the notice deadline is August 30th (90 days later).

Under the continuous treatment doctrine – If the same medical team continues treating the same condition that caused the injury, the clock may not start until treatment ends. For example, if a baby suffers hypoxic-ischemic encephalopathy at birth and the NICU team provides ongoing treatment for weeks, the 90-day period might begin when the baby is discharged, not at birth.

For wrongful death cases – The 90 days doesn’t start until a representative of the deceased infant’s estate is officially appointed by the court. This appointment must happen through Surrogate’s Court, and the notice period begins from that appointment date, not from the date of death.

Under Lavern’s Law for failure to diagnose cancer – When a cancer diagnosis is missed or delayed, the 90-day period runs from either the date of discovery or the last date of continuous treatment, whichever comes later. This primarily applies to maternal injuries rather than newborn birth injuries.

What Information Must Be Included in a Notice of Claim

The notice must be in writing, sworn to under oath, and contain specific information. Vague notifications don’t satisfy the requirement.

Required contents include:

• Full name and address of the injured party (the baby, the mother, or both)
• Attorney information if you’ve already retained legal counsel
• Detailed description of what happened, including which medical providers were involved
• Date, time, and location where the injury occurred, as specifically as possible
• Description of injuries sustained, with as much medical detail as available at that time
• Amount of damages sought – For NYC hospitals specifically, you must state a dollar amount

The damages amount requirement presents a challenge for birth injury cases. Within 90 days of birth, the full extent of injuries like cerebral palsy or cognitive impairment may not be apparent. Developmental delays often take months or years to fully manifest. However, you still must include a damages figure, even if it’s an estimate that will likely be revised later.

The notice doesn’t need to identify the exact legal theory or pinpoint which specific medical provider was negligent. It needs to give the hospital enough information to understand what happened and begin investigating.

How to Properly Serve a Notice of Claim on NYC Health + Hospitals

Filing the notice correctly is just as important as filing it on time. Improper service can invalidate an otherwise timely notice.

For NYC Health + Hospitals specifically, the notice must be served on a director, officer, or regularly engaged attorney of the corporation. You cannot simply mail it to the hospital where the injury occurred.

Acceptable methods of service:

• Personal delivery to a designated officer of NYC Health + Hospitals Corporation
• Registered or certified mail (considered served when deposited in the post office, not when received)
• Electronic filing for NYC entities (served upon electronic receipt confirmation)
• Service on the Secretary of State as agent for the public corporation

Each method has specific requirements. Personal delivery requires handing the document to a specific authorized person. Certified mail provides a receipt but service is complete upon mailing, not delivery. Electronic filing is increasingly common but has technical requirements for confirmation.

What Happens If Service Is Done Incorrectly

If you serve the notice within 90 days but use the wrong method or serve the wrong person, the situation isn’t necessarily hopeless.

The notice may still be considered valid if:

The hospital demands a Section 50-h examination – By requesting this sworn deposition, the hospital effectively acknowledges receipt and waives any service defect.

The right person actually receives it within 90 days AND the hospital doesn’t return it within 30 days specifying the defect – If the hospital receives the notice but doesn’t promptly inform you of the service problem, they may waive the objection.

If the hospital does return your notice within 30 days identifying the service defect, you have 10 days from receiving that notice to serve a corrected version. If you do so, the corrected notice is treated as timely filed.

This cure provision provides some protection against technical mistakes, but it’s far better to serve correctly the first time. Working with an attorney familiar with these specific procedural requirements helps avoid these complications.

The Shortened Statute of Limitations for Filing the Actual Lawsuit

Filing the notice of claim doesn’t end the timeline pressure. After the notice is filed, you still have a limited window to file the actual lawsuit.

For NYC Health + Hospitals cases, you have until 1 year and 90 days from the date the injury occurred to file suit. This is dramatically shorter than the standard medical malpractice statute of limitations.

For private hospitals in New York, medical malpractice cases generally have a 2.5-year statute of limitations. For infant cases, this can be extended up to 10 years due to infant tolling provisions.

But for NYC public hospitals, the timeline is:

• Day 0: Birth injury occurs
• Day 90: Notice of claim deadline
• Day 455 (1 year + 90 days): Lawsuit filing deadline

This compressed timeline creates significant pressure on families. Within just over a year, they must:

• Recognize that an injury occurred
• Understand it may involve medical negligence
• Find and retain qualified legal counsel
• Gather medical records
• Have those records reviewed by medical experts
• File the notice of claim
• Participate in a Section 50-h examination if demanded
• Complete enough investigation to file a lawsuit with specific allegations

For families dealing with a critically ill or injured newborn, managing these legal deadlines while focusing on their child’s medical needs creates enormous stress.

Why Infant Tolling Does Not Apply to the 90 Day Notice Requirement

One of the most misunderstood aspects of birth injury claims against public hospitals is the relationship between infant tolling and the notice requirement.

Under New York’s CPLR § 208, the statute of limitations is “tolled” (paused) for minors. In medical malpractice cases involving infants, this typically extends the filing deadline until the child’s 10th birthday.

This tolling provision does NOT extend the 90-day notice of claim requirement.

The notice must be filed within 90 days of the birth injury, even though the injured party is a newborn. The fact that your child is an infant provides no automatic extension of this deadline.

However, infancy does become relevant in two ways:

As a factor in late filing petitions – If the 90-day deadline is missed, courts consider the infant status when deciding whether to allow a late notice.

For the lawsuit filing deadline – Some courts have held that infant tolling does extend the time to file the actual lawsuit after the notice of claim is filed, potentially giving more than the standard 1 year and 90 days in infant cases.

But there’s no ambiguity about the initial 90-day notice period. That clock starts ticking immediately, regardless of the injured party’s age.

What to Do If You Miss the 90 Day Deadline

Missing the deadline doesn’t automatically destroy a case, but it does require immediate legal action. You must petition the court under General Municipal Law § 50-e(5) for permission to file a late notice of claim.

Courts have “broad discretion” to grant extensions “in exceptional cases.” The law requires judges to consider all relevant circumstances, but focuses on three primary factors.

Actual knowledge by the hospital – This factor receives “great weight” in the court’s decision. Did NYC Health + Hospitals, its attorneys, or insurance carrier learn the essential facts of the claim within 90 days or a reasonable time afterward?

The mere fact that the hospital created or possesses medical records doesn’t automatically establish actual knowledge. The records must be detailed enough to show the hospital knew about the specific negligent acts being claimed.

For example, if a baby suffered brain injury from delayed C-section, the hospital has actual knowledge if its records document the prolonged labor, fetal distress, and resulting brain damage. If those records exist and were reviewed by hospital staff, risk management, or attorneys within a reasonable time, courts often find actual knowledge.

Substantial prejudice to the hospital – Would the delay seriously harm the hospital’s ability to defend the case? Courts examine whether:

• Key witnesses are still available
• Medical records have been preserved
• Hospital staff members still work there and can recall the case
• An investigation is still feasible
• Physical evidence still exists

In birth injury cases, hospitals typically maintain comprehensive records and the cases involve enough medical providers that witness unavailability is less common. This often weighs in favor of granting late filing.

Reasonable excuse for the delay – Did the family have a legitimate reason for missing the deadline? Courts consider various circumstances:

• Caring for a critically ill newborn in the NICU
• The mother’s own medical complications from delivery
• Mental or physical incapacity during the 90-day period
• Justifiable reliance on settlement discussions with the hospital
• Reasonable confusion about whether to sue the hospital, individual doctors, or both
• Death of the parent or child before the period expired
• Excusable ignorance of the notice requirement

One factor alone won’t determine the outcome. Courts weigh all circumstances together, but when actual knowledge and lack of prejudice are clearly established, judges often grant relief even without a compelling excuse.

Time Limits for Requesting Permission to File a Late Notice

You cannot wait indefinitely to request permission for late filing. The petition for leave to file a late notice must be filed before the statute of limitations for the underlying lawsuit expires.

For NYC Health + Hospitals cases, this creates a complicated calculation:

• The standard deadline is 1 year and 90 days from the injury
• But infant tolling may extend this period
• Different courts have interpreted how infant tolling applies in this context

As a practical matter, if you discover you’ve missed the 90-day notice deadline, you should file a late notice petition immediately. The longer you wait, the harder it becomes to establish actual knowledge and lack of prejudice, and you risk running out the statute of limitations entirely.

Recent Birth Injury Cases Involving Late Notice of Claim

Court decisions provide insight into how judges actually apply these rules in birth injury cases.

Samedi v. NYC Health & Hospitals Corp. (2025) involved a birth injury on August 27, 2019, making the notice deadline November 25, 2019. The family didn’t file their notice until May 10, 2022, over two and a half years late.

Despite this lengthy delay, the court had discretion to consider granting the extension because the statute of limitations, with infant tolling, had not yet expired. The case illustrates that extremely late notices can still be entertained if filed before the tolled statute of limitations runs out.

Duenas v. NYC Health & Hospitals Corp. (2025) involved failure to diagnose cancer, not a birth injury, but demonstrates how courts apply the actual knowledge factor. The court applied Lavern’s Law, finding the 90-day period ran from January 2024 when the plaintiff discovered the missed diagnosis.

A late notice filed in January 2025 was deemed acceptable because the hospital had actual knowledge from its own records and couldn’t show substantial prejudice from the short delay.

Matter of Williams v. NYC Health & Hospitals Corp. (2025) involved wrongful death from failure to diagnose lung cancer. The court granted permission for late filing specifically because the hospital had actual knowledge from its own medical records documenting the missed diagnosis and treatment delays.

The lack of substantial prejudice weighed heavily in the plaintiff’s favor, as all relevant medical records existed and the hospital’s own documentation contained the evidence of negligence.

These cases demonstrate that courts genuinely evaluate each situation individually and often grant extensions when the hospital clearly knew what happened and hasn’t been harmed by the delay.

The Section 50 h Examination Process

After a notice of claim is filed, NYC Health + Hospitals typically demands a Section 50-h examination. This is a sworn deposition where hospital attorneys question the claimant about the claim.

For birth injury cases, this usually means the parents (or the parent serving as guardian for the infant) must appear and answer questions under oath about:

• The pregnancy and prenatal care
• Events during labor and delivery
• What they observed and were told by medical staff
• The infant’s condition after birth
• Medical treatment provided
• Current condition and ongoing needs
• How they learned about potential negligence
• Damages suffered by the family

The examination must be completed before the lawsuit can be filed. Hospital attorneys use it to investigate the claim, assess its merit, lock in testimony, and evaluate settlement potential.

While the examination is routine procedure, not an indication of how the hospital views the claim, it’s still a legal proceeding with consequences. Testimony given under oath can be used later in litigation. Having legal representation during this examination is essential.

Major Differences Between NYC Public Hospitals and Private Hospitals

The procedural differences between suing NYC Health + Hospitals and private hospitals are substantial and often misunderstood:

These differences create practical complications when injuries involve both public hospital staff and private physicians, or when families aren’t sure which entity employed which providers.

If you deliver at a NYC public hospital but your obstetrician is in private practice with admitting privileges, you may need to file a notice of claim against the hospital within 90 days while having two and a half years to sue the private doctor. Missing this distinction can leave part of your case time-barred while other parts proceed.

What Families Should Do Immediately After a Birth Injury at a NYC Public Hospital

The compressed timeline requires immediate action, even while families are focused on their child’s medical needs.

Preserve all documentation from the delivery and any subsequent treatment. This includes hospital bracelets, discharge papers, billing statements, prescription information, and any written instructions or educational materials provided by hospital staff.

Document your own memories of what happened during labor and delivery. Details fade quickly, especially during traumatic experiences. Write down what you remember about:

• When you arrived at the hospital and why
• How long labor lasted
• What concerns you raised with staff
• What you were told by doctors and nurses
• Changes in your baby’s condition
• When interventions occurred
• How providers responded to complications

Request complete copies of all medical records for both mother and baby. Under New York law, you’re entitled to these records. The hospital must provide them, though they may charge reasonable copying fees. Don’t wait for an attorney to request records. Start this process immediately.

Seek legal consultation as quickly as possible, even if you’re not certain negligence occurred. The 90-day deadline is not forgiving. An experienced birth injury attorney can quickly evaluate whether the timeline of events suggests possible negligence and ensure the notice deadline is met while investigation continues.

Don’t wait for medical certainty about the full extent of injuries. Many birth injuries aren’t fully apparent in the first weeks. Cerebral palsy may not be diagnosed until months later. Developmental delays may not become clear until missed milestones accumulate. Cognitive impacts may not be assessable for years.

The 90-day clock doesn’t pause while you wait for diagnoses. If something went wrong during delivery, and your baby is showing any concerning symptoms (seizures, feeding difficulties, abnormal muscle tone, breathing problems, unusual lethargy or irritability), seek legal advice immediately.

Continue all recommended medical treatment and therapy regardless of legal considerations. Your child’s health and development come first. Comprehensive medical records documenting injuries and required treatment also become important evidence if you do pursue a claim.

Why These Deadlines Matter for Birth Injury Cases

Birth injuries often involve complex medical questions. Determining whether shoulder dystocia was managed appropriately, whether fetal monitoring strips were correctly interpreted, whether a C-section should have been performed sooner, or whether neonatal resuscitation met standards of care requires detailed record review and expert analysis.

This type of case investigation typically takes months. Medical records must be obtained, reviewed by qualified experts, and evaluated against applicable standards of care. Expert physicians must be retained to provide opinions about what should have been done differently.

The 90-day notice requirement compresses this entire process into an impossibly short window. Realistically, most families can’t complete a full investigation in 90 days. They can, however, ensure the notice deadline is met to preserve their legal rights while the investigation continues.

This is why early legal consultation is so critical in public hospital cases. Attorneys experienced with these claims maintain relationships with medical experts who can provide preliminary case reviews quickly, allowing the notice to be filed with sufficient detail to meet legal requirements, even while detailed investigation continues.

The Intersection of Medical Crisis and Legal Deadlines

The 90-day requirement creates a painful collision between medical crisis and legal deadlines. Families with babies in the NICU are focused on survival and stabilization. Parents may be shuttling between hospital and home, managing their own recovery from delivery complications, caring for other children, and simply trying to get through each day.

Learning complex legal requirements, finding appropriate attorneys, gathering documents, and making litigation decisions feels overwhelming and inappropriate when your child is fighting for life or recovering from serious injury.

Courts recognize this reality, which is why infancy and medical crisis during the 90-day period are considered relevant factors in late filing petitions. Judges understand that families caring for critically ill newborns may not focus on legal deadlines.

However, courts also apply the law as written. Sympathetic circumstances don’t guarantee late filing approval, particularly if the hospital can show substantial prejudice or the family waited well beyond any reasonable crisis period.

The unfortunate reality is that these legal deadlines don’t pause for medical emergencies. Families must somehow manage both simultaneously, often with help from attorneys who understand the medical context and can handle legal requirements while families focus on their children.

Finding Legal Help for NYC Public Hospital Birth Injury Cases

Not all medical malpractice attorneys handle birth injury cases. Even among those who do, not all are familiar with the specific procedural requirements for claims against NYC Health + Hospitals.

Look for attorneys with specific experience in:

• Birth injury and obstetric malpractice cases
• Claims against New York public entities
• The notice of claim process and Section 50-h examinations
• The shortened timelines applicable to NYC Health + Hospitals cases

Many birth injury attorneys offer free initial consultations. Given the 90-day deadline, seeking multiple consultations quickly is appropriate. Ask about:

• The attorney’s specific experience with NYC public hospital cases
• How many birth injury cases they’ve handled
• Whether they’ve successfully obtained late filing permission when deadlines were missed
• How they work with medical experts for case evaluation
• Their approach to managing the compressed timeline
• What they need from you immediately to evaluate the case

Most birth injury cases are handled on contingency, meaning attorneys are paid a percentage of any recovery rather than charging hourly fees. This makes legal representation accessible even when families are facing overwhelming medical expenses.

Understanding That Not Every Bad Outcome Involves Negligence

The 90-day deadline creates pressure to make quick decisions about potential claims, but it’s important to understand that birth injuries don’t always involve medical negligence.

Even with excellent prenatal care and skilled delivery management, complications can occur. Some babies experience distress during labor for reasons unrelated to medical care. Some injuries happen despite appropriate monitoring and timely intervention. Some conditions are related to genetic factors, developmental issues, or unavoidable complications rather than provider error.

Medical malpractice requires proving that care fell below accepted standards and that this substandard care caused injury. Not every injury meets this legal definition.

The purpose of early legal consultation isn’t to encourage frivolous claims. It’s to ensure that when negligence did occur, families preserve their rights to pursue compensation that helps provide for their child’s lifetime needs.

An experienced attorney can quickly evaluate whether the timeline of events and resulting injuries suggest possible negligence worth investigating. If not, they’ll tell you. If potentially yes, they’ll ensure the notice deadline is met while thorough investigation proceeds.

Long Term Implications of Public Hospital Birth Injuries

Birth injuries at NYC public hospitals often affect families who already face economic challenges. NYC Health + Hospitals facilities serve diverse communities, many with limited resources and complex health needs.

When birth injuries occur in this context, the financial impact is devastating. Children with cerebral palsy, hypoxic-ischemic encephalopathy, brachial plexus injuries, or other significant birth trauma require:

• Ongoing medical care from multiple specialists
• Physical, occupational, and speech therapy
• Mobility equipment and assistive devices
• Home modifications for accessibility
• Special education services and supports
• Potential lifetime care needs

The costs accumulate to millions of dollars over a lifetime. For families who were already economically vulnerable, these expenses are impossible to manage without compensation.

The shortened timeline for public hospital claims creates a barrier to accessing this compensation. Families in crisis may not learn about the 90-day requirement until it’s too late. Language barriers, lack of access to legal information, and focus on immediate medical needs all contribute to missed deadlines.

This makes community education about these requirements essential, along with systems that connect families with legal resources quickly after concerning births at public facilities.

The Practical Reality of the 90 Day Requirement

The 90-day notice requirement is harsh, particularly in birth injury cases. Ninety days is barely enough time to recognize that an injury occurred, let alone understand its cause and identify it as potential negligence.

Many developmental impacts of birth injuries don’t become apparent until weeks or months after delivery. A baby who seems to recover from initial complications may later show signs of cerebral palsy, cognitive delays, or other lasting effects. By the time these become clear, the notice deadline has often passed.

The requirement also creates inequity. Families who deliver at private hospitals have two and a half years (or up to ten years for infant cases) to recognize injuries, understand their causes, and pursue legal action. Families at public hospitals have 90 days to do the same thing.

Legislative reform of this requirement has been discussed but not enacted. Until the law changes, families must navigate the requirement as it exists.

The practical approach is protective filing. When there’s any question about whether something went wrong during delivery at a NYC public hospital, consulting an attorney quickly allows a notice to be filed preserving legal rights while investigation continues. If investigation later reveals no negligence, the case simply doesn’t proceed. But if negligence is discovered, the notice deadline has been met.

This Is Not Legal Advice

This article provides general information about the 90-day notice of claim requirement for NYC public hospitals. It is not legal advice for any specific situation.

Birth injury cases involve complex medical and legal questions that depend on specific facts and circumstances. The only way to get advice about your particular situation is to consult directly with an attorney who can review your medical records and case details.

If you believe your child may have suffered a birth injury at a NYC Health + Hospitals facility, contact a qualified birth injury attorney immediately. The deadlines discussed in this article are real and strictly enforced. Don’t risk losing legal rights by waiting to seek guidance.