In an opinion filed April 10, 2013, the Honorable Rosalyn K. Robinson of the Philadelphia County Court of Common Pleas held that a pediatric cardiologist in New Jersey could be sued in Philadelphia, Pennsylvania, given that 1) the defendant physician had sufficient minimum contacts with Pennsylvania, and 2) the statutory basis for venue in Philadelphia was constitutional. 

The underlying case of Nees v. Anderson, M.D., et al. involved a claim for medical negligence against a defendant physician who treated a child for a heart murmur over the course of almost a decade.  When the child was thirteen years old, an exercise stress test was ordered by the physician due to complaints of shortness of breath.  While the test allegedly revealed cardiac abnormalities, plaintiff claimed that the physician failed to place any restrictions on the child’s athletic activities.  Soon thereafter, the child collapsed and died while playing roller hockey. 

Suit was filed in the Philadelphia County Court of Common Pleas.  The named defendants included the defendant physician along with his employer, the Children’s Hospital of Philadelphia (CHOP).  Preliminary objections were subsequently filed on behalf of the defendant physician.  The objections stated that the physician defendant was not subject to jurisdiction in Pennsylvania because his office, patient population, and residence were confined to New Jersey.  The defendant further alleged that venue in Philadelphia was improper as the statutory basis for this location was unconstitutional. 

To address the issue of jurisdiction, the court turned to the Pennsylvania Long Arm Statute, which provides jurisdiction over a defendant if he or she has the sufficient “minimum contacts” with the forum state (in this case, Pennsylvania).  Pursuant to the statute, the defendant’s contacts with the forum state must be 1) related to plaintiff’s claim, and 2) derived from significant and purposeful activities by the defendant within the forum state.  Under this framework, the court held that the physician defendant had the necessary contacts with Pennsylvania to bring him under the jurisdiction of the courts in Pennsylvania.  Notwithstanding the physician’s obvious connections to New Jersey, the court noted that the physician purposely designated his office as a “CHOP Specialty Care Center.”  As a result, there was a significant likelihood that patients, including the decedent child, would seek out the physician’s services due to his affiliation with CHOP and its reputation as a well-regarded Pennsylvania institution.  The court also considered other factors such as the physician’s practice of referring the decedent child to affiliated sites in Pennsylvania when additional testing was required, as well as his practice of sending bills and health insurance payments from a Pennsylvania address.         

Once the necessary minimum contacts were established, the court held that the exercise of jurisdiction in Pennsylvania was consistent with notions of fair play and substantial justice.  In this regard, trial in Philadelphia placed no undue burden on the defendant physician, as he already traveled to the city to teach at the University of Pennsylvania’s medical school.  Additionally, because the question of his liability was closely tied to the liability of a Pennsylvania hospital, the court recognized that Pennsylvania had a clear interest in adjudicating the case. 

With regard to the physician’s second argument regarding venue in Philadelphia, the court looked to Pennsylvania Rule of Civil Procedure 1006(a.1), enacted in 2002, which requires a medical malpractice case in Pennsylvania to be brought within the county in which the treatment at issue took place.  According to the court, this Rule had created problems for litigants attempting to sue a physician in Pennsylvania for a cause of action that arose out-of-state, in effect leaving them without a proper venue in which to bring their claim.  Given the restriction this placed upon these litigants’ substantive rights, the court noted that a provision was added to the rule in 2011 which barred its application to such out-of-state claims. 

Examining the constitutionality of Rule 1006(a)(1) under the “rational basis test,” the court held that the rule furthered a legitimate state goal by closing a loophole where a lack of proper venue stripped injured parties of their right to bring suit in Pennsylvania.  As such, Judge Robinson deemed the rule constitutional and the physician’s preliminary objections were overruled in their entirety.