Pennsylvania Supreme Court Addresses the Applicability of the Increased Risk of Harm Jury Instruction

In the case of Estate of Smith v. Kannarkatt, No. 17 MAP 2025 (Pa. Oct. 29, 2026) (Brobson, J.), the Pennsylvania Supreme Court addressed the applicability of the “increased risk of harm” jury instruction in medical malpractice cases.

According to the Opinion, this case arose out of a medical malpractice case involving a Plaintiff with cancer issues and an allegedly incorrect diagnosis regarding the same.

The Plaintiff’s estate sued the oncologist and other Defendants asserting a breach of the standard of care by the failure of the medical providers to properly diagnosis and consult, which allegedly resulted in a delayed proper treatment and increased harm to the Plaintiff’s decedent.

The essential issue in this case was whether there was sufficient expert evidence under Pennsylvania’s “increased risk of harm” standard to permit the case to go to the jury.

The case went up the appellate ladder and the Pennsylvania Supreme Court reviewed whether the Superior Court correctly applied the “increased risk of harm” standard under the case of Hamil v. Bashline.

Justice Brobson opened his Opinion with a succinct description of the question of law presented, as follows:

Oftentimes, as a part of establishing liability in a medical malpractice action, a plaintiff must present expert medical testimony that a defendant’s conduct fell below acceptable medical standards and that the conduct was the proximate cause of the plaintiff’s harm. There are instances, however, when a plaintiff cannot meet this standard because there exists a possibility that the plaintiff’s harm would have resulted irrespective of the quality of the medical treatment provided. Concluding that a defendant cannot escape liability simply based upon that statistical possibility, this Court, in Hamil v. Bashline, 392 A.2d 1280 (Pa. 1978), adopted a standard that relaxed a plaintiff’s burden of proving causation in those circumstances.

Specifically, the Hamil Court held that “causation may be founded upon expert opinion testimony to the effect that [the] defendant failed to exercise reasonable care in performing an undertaking to render services to a patient which the defendant should recognize as necessary for the other’s protection, that this failure increased the risk of physical harm to the patient, and that such harm did in fact result.” Hamil, 392 A.2d at 1283. In this discretionary appeal, we must determine whether the Superior Court

correctly applied this so-called “increased risk of harm” standard of causation in this case. For the reasons that follow, we hold that the Superior Court applied the standard correctly.  Accordingly, we affirm.

As noted, the Pennsylvania Supreme Court held that the Superior Court had indeed properly applied this relaxed causation standard after finding that the Plaintiffs’ expert testimony was sufficient to establish a prima facie case that the oncologist’s conduct allegedly increased the Plaintiff’s risk of harm.

As such, the Pennsylvania Supreme Court affirmed the Superior Court’s decision, which required the case to be submitted to the jury.

Anyone wishing to review a copy of this decision may click this LINK.


Source: Justia Daily Opinion Summaries: Supreme Court of Pennsylvania (Oct. 30, 2026).