In Gaither v. City Hospital, Inc., 199 W. Va. 706, 487 S.E.2d 901 (1997), the Court discussed when the statute of limitations period began to run on actions such as those involved in the present appeal. In Syllabus Point 4 of Gaither v. City Hospital, Inc., id., the Court concluded: 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; (3) that the conduct of that entity has a causal relation to the injury. The 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," the Court 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.) In Gaither, the Court expanded the "discovery rule" by linking the running of the limitations period with the prospective plaintiff's 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 plaintiff's injury. 199 W.Va. at 708, 487 S.E.2d at 903, syl. pt. 4, in part. The Court held that a question of fact exists as to when Mr. Gaither first "became aware" that the hospital's negligence, as opposed to his own negligence, may have resulted in the amputation of his leg. "We find nothing in the record to indicate that the appellant had any reason to know before January 1993 that City Hospital may have breached its duty and failed to exercise proper care, or that City Hospital's conduct may have contributed to the loss of his leg." 199 W.Va. 706, 715, 487 S.E.2d 901, 910. The second situation may occur when an individual "does or should reasonably know of the existence of an injury and its cause." Gaither, 199 W.Va. at 713, 487 S.E.2d at 908. In footnote 6 of Gaither, the Court lists instances where "causal relationships are so well-established between the injury and its cause that we cannot excuse a plaintiff who pleads ignorance." These instances include a patient who, after having a sinus operation, lost sight in his left eye, and a patient who, after undergoing a simple surgery for the removal of a cyst, was paralyzed in both legs. Gaither, 199 W.Va. at 712, 487 S.E.2d at 907.