Landmark Cases

Christiansen v. Rathgeber, D.O. et. al., 895 A.2d 644 (Pa. Super. 2006)

In Christiansen v. Rathgeber, Paul E. Peel, Esquire successfully argued that plaintiffs’ chosen venue was improper. The plaintiffs filed a complaint in the Court of Common Pleas of Philadelphia County alleging medical malpractice against several physicians and hospitals. The cause of action stemmed from medical treatment that the husband plaintiff received following his admission to the emergency department of a Bucks County hospital with complaints of right-sided facial weakness, right-sided extremity weakness, and slurred speech. In their Complaint, the plaintiffs alleged that the physicians at the Bucks County hospital were negligent in failing to timely and accurately diagnose and treat the husband plaintiff and failing to promptly and properly transfer the husband to a facility that was equipped to treat his condition. The plaintiffs further alleged that medical personnel from a Philadelphia County hospital, who were consulted over the phone while the husband was a patient at the Bucks County hospital, gave negligent medical advice regarding the husband's treatment to the physicians at the Bucks County hospital. According to the plaintiffs, the defendants’ negligence caused the husband to suffer severe and permanent injuries.

After the plaintiffs commenced their cause of action in Philadelphia County, the defendants filed preliminary objections to the plaintiffs’ Complaint, arguing that the plaintiffs’ choice of venue was improper because the plaintiffs’ cause of action arose solely in Bucks County. The trial court agreed with the defendants and transferred the case to Bucks County. The plaintiffs then appealed the trial court’s ruling to the Superior Court of Pennsylvania.

On appeal, the plaintiffs argued that their claims against the Philadelphia hospital located in arose in Philadelphia County because the hospital’s physicians who were consulted regarding the husband's treatment were physically located in Philadelphia when they allegedly breached the standard of care. Specifically, the plaintiffs asserted that the physicians from the Philadelphia County hospital gave negligent medical advice concerning the husband plaintiff’s treatment over the phone and that these physicians were physically located in Philadelphia when these consultations occurred. However, the Superior Court rejected this argument and held that the trial court correctly determined that the plaintiffs’ cause of action arose solely in Bucks County. In reaching this decision, the Superior Court noted that, even though the physicians from the Philadelphia County hospital located gave medical advice over the phone from Philadelphia County, all of the husband's medical treatment based on that advice was provided in Bucks County. The Superior Court then held that a cause of action in a medical malpractice case does not arise in the county where an allegedly negligent physician is physically located when he renders treatment advice over the phone; rather, the cause of action arises in the county where the treatment advice is utilized. Therefore, because Bucks County is where the husband was physically located when the defendants’ alleged negligence occurred and when the Philadelphia County physicians’ medical advice was followed, the Superior Court concluded that Philadelphia was an improper forum for the plaintiffs’ case and affirmed the trial court’s transfer of venue to the Court of Common Pleas of Bucks County.

Toledo v. Mitra, M.D., 832 A.2d 552 (Pa. Super. 2003)

After a long stay of all silicone breast implant litigation, due in large part to the Dow Corning Bankruptcy, the Coordinating Court released a handful of cases in 1998 to proceed to trial. The first case, Toledo v. Mitra, M.D., proceeded to trial on July 16, 2001 against the implanting plastic surgeon in which the plaintiff claimed that the doctor failed to obtain the patient’s informed consent prior to inserting silicone gel implants. Prior to trial, The Honorable Stanton Wettick issued an opinion precluding plaintiffs’ experts from testifying that silicone gel caused injury and/or persistent, chronic pain after removal of the implant. The issues were therefore limited to whether the doctor informed the patient of the risks of surgery. Plaintiffs took the position that the risks of the procedure included risks associated with the implants themselves and that the plaintiff should have been told about the alternative of saline implants. Damages were sought for pain, capsular contracture, lymphadenopathy, silicone granulomas, chest wall deformity, gel bleed/migration, hematoma, scarring and disfigurement. The trial, tried by our own Daniel F. Ryan, III, Esquire, resulted in a defense verdict.

On appeal, the Superior Court affirmed the trial court’s judgment in favor of the defendant physician, Dr. Mitra. The sole issue raised on appeal was whether the trial court committed reversible error by precluding plaintiffs’ expert witness, Frederick W. Hetzel, Ph.D., from testifying about what type of silicone breast implant Dr. Mitra purportedly used during Mrs. Toledo’s breast implant surgery. Plaintiffs maintained that Dr. Hetzel would have testified that Dr. Mitra implanted a “high-bleed” implant during Mrs. Toledo’s operation even though Dr. Mitra testified at his deposition that he thought he implanted a “low-bleed” device during the procedure. The Superior Court agreed that the trial court did not abuse its discretion by limiting Dr. Hetzel’s testimony during trial. The Superior Court specifically noted that the trial court’s preclusion order expressly barred Dr. Hetzel from testifying about anything that was contained in his 1999 report, which included Dr. Hetzel’s only reference to the type of implants that Dr. Mitra used during surgery. The Superior Court also observed that the trial court later clarified its order in response to a Motion for Reconsideration of the preclusion order which plaintiffs filed several months before trial began. Therefore, the Superior Court concluded that plaintiffs failed to demonstrate that the trial court abused its discretion in applying its pre-trial orders which precluded Dr. Hetzel from testifying about the type of breast implants that Dr. Mitra used during Mrs. Toledo’s operation. Consequently, the Superior Court affirmed the trial court’s judgment in Dr. Mitra’s favor.

Southard v. Temple University Hospital, 566 Pa. 335, 781 A.2d 101 (2001)

The Supreme Court held that a patient could not bring an informed consent action against his treating physicians based on the physicians’ failure to disclose the FDA status of a medical device surgically implanted in his spine. The court acknowledged that the FDA does not regulate the practice of medicine and recognized that physicians are permitted to use medical devices in an "off-label" manner. The court therefore determined that a particular label had nothing to do with any medical issues surrounding a particular surgery and that once a device had been approved by the FDA, it was a matter for the physician’s medical judgment to determine how to use it. According to the court, regulatory classifications of medical devices were irrelevant to obtaining a patient’s informed consent to surgery.

Goldberg v. Isdaner, M.D., 780 A.2d 654 (Pa. Super. 2001)

The Superior Court concluded that parent-plaintiffs suing on behalf of their injured children were not entitled to recover Rule 238 delay damages in association with their claim for reimbursement for medical expenses. The court reasoned that, as in the case of loss of consortium claims, the parent’s claim for reimbursement for medical expenses clearly was not a claim seeking monetary relief for bodily injury, death or property damage. Rather, similar to a claim for loss of consortium, the parent’s claim for reimbursement for medical expenses was a separate and distinct claim, seeking separate and distinct damages, from the claim brought on behalf of the physically injured persons. Thus, the Superior Court held that the trial court correctly refused to award the parents any delay damages.

Panea v. Isdaner, M.D., 773 A.2d 782 (Pa. Super. 2001) (en banc)

An en banc panel of the Superior Court considered whether the exhaustion provision of the Pennsylvania Property and Casualty Insurance Guaranty Association (PP&CIGA) Act, 40 P.S. § 991.1817(a), barred a claimant from recovering damages against PP&CIGA or the policyholder of an insolvent insurer to the extent that the claimant received compensation from other sources of insurance. The court concluded that this provision allowed PP&CIGA to offset its payment obligations on behalf of the policyholder with any compensation the plaintiff received from other insurance sources that was reasonably related to the policyholder’s culpable conduct. The court also held that this provision barred claimants from recovering any amount taken by PP&CIGA as an offset by looking directly to the personal assets of the policyholder. According to the court, "[t]o find the doctors personally liable for the offset amount would contravene one of the stated purposes of the [PP&CIGA] Act, which is ‘to avoid financial loss to . . . policyholders as a result of the insolvency of an insurer.’"

Harman v. Borah, M.D., 562 Pa. 455, 756 A.2d 1116 (2000)

The Supreme Court held that the Superior Court applied an erroneous standard of review when determining whether the trial court erred in denying the plaintiffs’ motion for a new trial as a result of the trial court’s off-the-record discussion with a witness in the jury’s presence. The Supreme Court unanimously concluded that the proper standard of review was whether the trial court abused its discretion in denying the plaintiffs’ motion for a new trial. The Supreme Court held that, because the trial court gave a detailed cautionary instruction emphasizing the court’s impartiality and repeatedly advised the jury that they were the sole fact finders and determiners of the credibility of witnesses, the plaintiffs did not suffer any prejudice from the trial court’s improper conduct and the trial court did not abuse its discretion in denying the plaintiffs’ motion for a new trial. In addition, at least four members of the court concluded that the trial court’s decision to deny the plaintiffs’ motion for a new trial was appropriate because the plaintiffs failed to raise a timely objection to the trial court’s improper conduct. Therefore, the Supreme Court reversed the Superior Court’s order which granted the plaintiffs a new trial and remanded this matter to the Superior Court.

Edwards v. Germantown Hospital, 736 A.2d 612 (Pa. Super. 1999)

The Superior Court held that the Health Care Services Malpractice Act (HCSMA) precluded a patient from maintaining an action for breach of an express oral contract to produce a specific result after the patient became pregnant and delivered a healthy child following defendants’ performance of a tubal ligation procedure on her. The patient claimed that, before she underwent the operation, the defendants made an oral promise to her that the operation would prevent her from ever becoming pregnant. However, the Superior Court held that the HCSMA bars patients from maintaining actions against physicians based on a physician’s oral promise that treatment will produce a particular result. Therefore, the Superior Court held that the trial court properly granted judgment on the pleadings in the defendants’ favor.

Velazquez v. Gupta, M.D., 443 Pa. Super. 18, 660 A.2d 645 (1995)

The Superior Court held that the father and natural guardian of a minor child was not entitled to immediate disbursement of wrongful death settlement proceeds that had been placed in escrow for the minor child’s benefit until she reached the age of majority. The court noted that the father failed to establish that his daughter needed the money and that the trial court was not certain that the father would continue to support his daughter. Therefore, the Superior Court concluded that, in light of the it’s strong public policy requiring fathers to support their children, the trial court did not abuse its discretion by denying the father’s request to release his daughter’s escrow funds.

Hoffman v. Brandywine Hospital, 443 Pa. Super. 245, 661 A.2d 397 (1995)

The Superior Court held that the plaintiffs could not maintain an action for lack of informed consent based on a physician’s alleged failure to advise a patient of the attendant risks and alternatives to a blood transfusion. The Court noted that, because the doctrine of informed consent in Pennsylvania is premised on the law of battery, the requirements of informed consent attach only in the surgical context. Therefore, the Court concluded that, because the blood transfusion did not occur during surgery, the physician who performed the transfusion was not required to disclose the material risks and alternatives to the procedure.