In State ex rel. Charleston Area Medical Center v. Kaufman, 197 W.Va. 282, 475 S.E.2d 374 (1996), the plaintiff filed an action in the Circuit Court of Kanawha County against Charleston Area Medical Center for medical malpractice. Service of the summons and complaint, however, was not made within the time required under Rule 4(l), and, 337 days after the filing of the complaint, the Circuit Court dismissed the action. The day following the dismissal, the plaintiff moved to have the action reinstated pursuant to Rule 41(b) upon the assertion that service was delayed by ongoing settlement negotiations. The Circuit Court reinstated the action. Concluding that the action had been improperly reinstated, the Court, in Kaufman, granted relief in prohibition to Charleston Area Medical Center. As syllabus point 2 holds: "A circuit court exceeds its jurisdiction if it purports to reinstate a civil action, which was dismissed under the provisions of Rule 4(l) of the West Virginia Rules of Civil Procedure, under the authority of Rule 41(b), and prohibition will lie with respect to such an order." In so holding, the Court acknowledged that Rule 4(l), itself, contemplates relief in limited circumstances from a failure to timely serve the summons and complaint. In that regard, syllabus point 3 of Kaufman states: "Dismissal under Rule 4(l) of the West Virginia Rules of Civil Procedure is mandatory in a case in which good cause for the lack of service is not shown, and a plaintiff whose case is subject to dismissal for noncompliance with Rule 4(l) has two options to avoid the consequence of the dismissal: (1) To timely show good cause for not having effected service of the summons and complaint, or (2) to refile the action before any time defenses arise and timely effect service under the new complaint." In addition, the Court noted, in Kaufman, that relief from a Rule 4(l) dismissal may be sought under Rule 59(e), concerning motions to alter or amend a judgment, or under Rule 60(b), discussed above, subject to the respective requirements of those Rules and subject to the showing of good cause prescribed under Rule 4(l). 197 W.Va. at 289, 475 S.E.2d at 381. Syllabus point 5 of Kaufman holds: "Under the West Virginia Rules of Civil Procedure, relief from dismissal under Rule 4(l) may be sought under Rule 59(e) and under Rule 60(b), subject to the respective requirements of the applicable rule and subject in all events to the showing of good cause required by Rule 4(l)." The Court observed, in Kaufman, that the plaintiff, seeking to maintain the action on the docket, had raised the issue of relief under Rule 60(b) and at the same time, had not had an opportunity to show good cause under Rule 4(l) for the delay in service. Accordingly, the relief in prohibition awarded to Charleston Area Medical Center precluding reinstatement of the action was made subject to a hearing to be subsequently conducted by the Circuit Court to determine whether the plaintiff could show good cause under Rule 4(l) for the delay in service and whether the plaintiff could show entitlement to relief under Rule 60(b). 197 W.Va. at 290, 475 S.E.2d at 382.The Court held that a dismissal under the Rules of Civil Procedure is ordinarily mandatory where a plaintiff fails to perfect service of process within the time provided by the rules. However, the Court also recognized that dismissal is not mandatory where the plaintiff shows good cause for not having effected service of the summons and complaint in a timely manner. In short, the Court considered the dismissal of an action after a 370-day delay in service. In that case, the circuit court reinstated the action, but we prohibited further proceedings unless the plaintiff was able to demonstrate good cause why the action should not be dismissed pursuant to Rule 4(k). The Court stated that "good cause must be substantial and not just a ruse." 197 W. Va. at 287, 475 S.E.2d at 379. To ascertain if good cause existed for failure to timely serve the complaint, we established several factors to be examined: (1) length of time to obtain service; (2) activity of plaintiff; (3) plaintiff's knowledge of defendant's location; (4) ease with which location could have been known; (5) actual knowledge by defendant of the action; (6) special circumstances. 197 W. Va. at 288, 475 S.E.2d at 380.