Pennsylvania Superior Court Addresses Claims of Corporate Negligence in a Medical Malpractice Case

 

In the case Ruff v. York Hospital, 2021 Pa. Super. 39 (Pa. Super. March 11, 2021 Shogan, J., Stabile, J., and Murray, J.) (Op. by. Shogan, J.), the court affirmed the lower court's denial of a Plaintiff’s post-trial motions in a medical malpractice case in which a defense verdict was entered. In so ruling, the Pennsylvania Superior Court touched upon a number of different issues pertinent to medical malpractice cases.

The Superior Court emphasized that, in the context of a medical malpractice case, corporate negligence is a doctrine under which a hospital owes a direct duty to its patients to ensure their safety and well-being while the patients are in the hospital.

The Court noted that, in order to establish a claim of corporate negligence, the Plaintiff must show that the hospital had actual or constructive knowledge of the alleged defect or procedures that allegedly created the harm. The court noted that corporate negligence typically involves claims of systemic negligence in the actions and procedures of the hospital itself, rather than any individual acts of its employees.

The Court otherwise ruled that a hospital’s oversight duty does not require that the hospital direct or override a physician’s clinical judgment in any given case.

The Superior Court also found that the jury instructions utilized the trial court on corporate negligence, which conformed to the Suggested Standard Jury Instruction, were adequate.

On an evidentiary issue, the Superior Court ruled that the Plaintiff’s expert was properly allowed to reference a learned treatise as support for the expert’s opinions, but that the Plaintiff was properly precluded by the trial court from placing the learned treatise itself into evidence.

The Superior Court also found that the Plaintiff’s expert was properly precluded by the trial court from offering any opinion that the Defendant’s conduct was reckless. The Superior Court noted that, whether conduct was reckless was to be determined by the jury and was not a proper subject of expert testimony. In this regard, the court noted that expert witnesses are not permitted to render legal opinions and may not offer opinions on whether conduct complied with the law.

As stated, overall, the appellate court affirmed the trial court’s denial of the Plaintiff’s post-trial motions.

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


I send thanks to Attorney James M. Beck of the Philadelphia office of the Reed Smith law firm for bringing this case to my attention.

Propriety of Utilizing a Learned Treatise At Trial Reviewed By Pennsylvania Superior Court

In the case of Charlton v. Troy, No. 2020 Pa. Super 170 (Pa. Super. July 16, 2020 Bowes, J., Olson, J., and Ford Elliott, P.J.E.) (Op. by Bowes, J.), the Pennsylvania Superior Court addressed the propriety of using a learned treatise to cross-examine a witness at a medical malpractice trial.

In the end, the Superior Court found that the trial court erred in allowing a Plaintiffs’ attorney to cross-examine the Defendant physician, who testified as a fact witness at trial, about the contents of a medical textbook that the witness did not recognize as authoritative. The court ruled that this error caused extreme prejudice to the Defendants. As such, the substantial jury verdict was vacated and the case was remanded for a new trial.

The Superior Court found that there was no foundation laid that would establish that the textbook was a learned treatise for the limited purpose of impeaching the Defendant. The court noted that the Pennsylvania Rules of Evidence did not recognize a hearsay exception for a learned treatise, i.e., any textbook or published work or periodical that has been accepted as authoritative or as reliable authority by members of a specific professional community. Rather, the court noted that the contents of a learned treatise offered at trial to establish principles or theories is inadmissible hearsay as extra-judicial declarations offer to prove the truth of the matter asserted within the treatise.

However, such materials may be utilized to impeach an expert with statements contained in such a text or publication if those statements are deemed authoritative or reliable by that witness or other experts in the relevant field.

The court noted that the Defendant doctor could have been questioned about the contents of the textbook if he was an expert. However, as he was only testifying as a fact witness, the Defendant doctor could only be cross-examined with a publication that he agreed was authoritative or reliable. No such foundation was laid in this regard in this case as the witness did not recognize the work as authoritative.

The appellate court found that this error was exacerbated at trial by the fact that the Plaintiff was allowed to argue the substance of the inadmissible excerpts in the closing argument.

In colorful language, the Superior Court noted that, because the error at trial in the admission of the evidence was "of such a consequence that, like a dash of ink in a can of milk, it cannot be strained out, the only remedy, so that justice may not ingest a tainted fare, is a new trial."  See Op. at p. 37 [citation omitted].

In the end, the appellate court vacated a $40+ million dollar verdict and remanded the case for further proceedings.

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


Source: “Digest of Recent Opinions” Pennsylvania Law Weekly (July 28, 2020).

Several Notable Civil Litigation Decisions Pertaining to Expert Testimony

Judge Terrence R. Nealon of the Lackawanna County Court of Common Pleas recently issued several decisions of note heading into a medical malpractice trial in the case of The Pennsylvania Trust Co. v. Wilkes-Barre Hosp. Co., LLC, et al., No. 17 - CV - 4655 (C.P. Lacka. Co. April 12, 2019 Nealon, J.).

The case arose out of claims of alleged negligent neonatal care.  Plaintiff's counsel in the case was Attorney Matthew A. Casey of Ross Feller Casey, LLP out of Philadelphia.

Reduction of future medical costs to present value prohibited

In a decision found at this LINK, Judge Nealon addressed issues pertaining to the reduction of future medical expenses to present value.  In this matter, the Plaintiff asserted a pre-trial objection to the defense economists expert from repeatedly referencing the amounts of future medical and/or life care costs in terms of the present value of the costs.

Judge Terrence R. Nealon
Lackawanna County

After pointing to 80 years of Pennsylvania precedent, as well as MCARE precedent, confirming that future medical cost claims are not to be reduced to present value in (non-automobile accident) civil litigation matters, the court granted the Plaintiff's motion in limine in this regard and held that the defense economist expert was precluded from referencing the reduction of the Plaintiff's future medical and/or life care costs to present value.

Expert testimony on need for future medical care allowed

Under a separate detailed Order found at this LINK, Judge Nealon addressed the issue of the presentation of expert testimony on likelihood of future medical care.  The defense objected to the Plaintiff's expert's proposed testimony in this regard as speculative and inappropriate.  Citing to a number of cases, the court overruled the defense's objection and allowed the opinion on the basis that experts are permitted to offer their opinions as to the future treatment required by a Plaintiff's injury or condition based upon facts in evidence that the jury would be warranted in relying upon.

References to learned treatises is hearsay in Pennsylvania state court (but allowed in a limited fashion)

In yet another pre-trial detailed Order found at this LINK, the court addressed objections by the Plaintiff to the defense expert's plan to reference medical publications in his opinion.

The court pointed out that, unlike the Federal Rules of Evidence, the Pennsylvania Rules of Evidence do not recognize an exception to the hearsay rule permitting the admission of a learned treatise as substantive evidence on a limited basis.  Judge Nealon even pointed to a Superior Court decision from a week ago in which that Court held that reading a passage from a treatise into evidence in an effort to prove the truth of the matter asserted therein amounts to inadmissible hearsay which is not changed by the fact that the passage is read by an expert.  See Order at p. 2 citing Hassel v. Franzi, 2019 WL 1512346 at *5 (Pa.Super. 2019).

Yet, the court also noted that experts may refer to treatises to explain the reasoning behind the expert's opinion as long as limiting instructions are provided by the court to ensure that the reference to the treatise does not come in as substantive evidence on the point made.

As such, Judge Nealon crafted a result in this matter by granting part, and denying in part, the Plaintiff's motion.  Under the Order, the defense expert would be permitted to reference certain treatises or publications but the court would issue limiting instructions to confirm that the referenced passages were not coming into the case before the jury as substantive evidence.