In an opinion authored by Justice David N. Wecht, the Supreme Court of Pennsylvania recently addressed whether certain jurors should have been presumed prejudiced and dismissed based on their indirect relationship with the defendant’s employer, who was not a party to the case at the time of trial.

In Shinal v. Toms,[1] Megan L. Shinal had treated with Steven A. Toms, M.D. for a recurring, non-malignant tumor in the pituitary region of her brain. She had had surgery years earlier to extract the tumor through her nose, but the surgeon was unable to remove the entire tumor. At the time she saw Dr. Toms, the tumor had grown and extended into vital structures of the brain, threatening her eyesight, carotid artery, and her pituitary and hormone function.

Mrs. Shinal underwent an open craniotomy total resection of the brain tumor at Geisinger Medical Center in January 2008. During the surgery, Dr. Toms perforated her carotid artery, resulting in hemorrhage, stroke, brain injury, and partial blindness.

Mr. and Mrs. Shinal initiated a medical malpractice action in the Court of Common Pleas of Montour County against Dr. Toms, Geisinger Medical Center, and Geisinger Clinic, alleging that Dr. Toms failed to obtain Mrs. Shinal’s informed consent for the surgery.

Prior to jury selection, the Shinals moved to strike all potential jurors who were either employed or insured by, or had family members employed or insured by, any Geisinger entity. The trial court granted the motion in part, directing that any prospective jurors who were employed by Geisinger Medical Center or Geisinger Clinic, or who had family members residing in the same house who were so employed, would be stricken for cause. After numerous prospective jurors were disqualified, however, the court aborted the selection process and postponed trial. The Shinals’ motion for a change of venue was denied.

The hospital entities then were dismissed on a motion for summary judgment, since the duty to obtain informed consent does not belong to a physician’s employer or the employer’s agents.[2] The trial court also amended its order regarding juror disqualification. Relying on Cordes v. Assoc. of Internal Medicine,[3] the trial court held that per se disqualification of prospective jurors was not required based on an employment relationship with a non-party Geisinger entity. Rather, the inquiry would focus on whether the financial or situational relationship of the prospective juror or their close family member would give rise to an appearance of partiality or bias.

During jury selection, the Shinals moved to strike four jurors for cause based on their or their immediate family member’s employment with a Geisinger entity.[4] The trial court denied the motion since all four jurors indicated that they believed they could be fair and impartial, that they did not know Dr. Toms personally or as patients, and that they did not believe a negative verdict against Dr. Toms would negatively impact their or their family member’s employer. The Shinals exhausted their four peremptory strikes on these jurors.

At the conclusion of trial, the jury returned a verdict in favor of Dr. Toms.

The Shinals appealed, asserting that the trial court failed to strike for cause the four jurors with personal or familial employment relationships with Geisinger entities. The Superior Court affirmed, and the Shinals appealed to the Supreme Court.

With regard to jury selection, the Court began by noting that a trial court is required to strike a juror “when the prospective juror has such a close relationship, familial, financial, or situational, with the parties, counsel, victims, or witnesses or alternatively, when the juror demonstrates a likelihood of prejudice by his or her conduct and answers to questions.”[5] Such strikes are a question of law, subject to de novo review. On the other hand, if a juror’s conduct or answers to questions reveal a likelihood of prejudice, the trial court’s discretion is given much weight and reversed only in the case of palpable error.

The Court first considered whether the jurors in this matter should have been presumed prejudiced and stricken, a question of law. It noted that the mere existence of some familial, financial, or situational relationship does not require dismissal in every case. “[R]emote relationships should be scrutinized by the trial court in order to elucidate the particulars and address the potential appearance of partiality.” The Court also noted, however, that Pennsylvania law holds that “where there is a direct employment relationship between a juror and a party or participant, the courts must presume prejudice and the juror must be stricken for cause.”

Discussing McHugh v. Proctor & Gamble Paper Products Co.[6] and the plurality opinion in Cordes, the Court held that “[a]n indirect employment relationship with an employer that has an ownership interest in a party defendant, standing alone, does not warrant a presumption of prejudice. However, a juror may reveal a likelihood of prejudice resulting from such an indirect employment relationship through his or her conduct or answers to questions.” The Court continued,

An indirect employment relationship will require removing a potential juror for cause if the juror believes that the outcome of the case could have a financial impact upon his or her employer. When it is apparent both that there is a common employer between a juror or a juror’s close family member and a party defendant, and that the juror believes that the employer would be affected by the outcome of the case, the trial court must remove the juror for cause.

The Court thus affirmed the trial court in not striking the jurors for cause. Neither Geisinger Health System nor Geisinger Clinic were trial defendants. None of the jurors knew Dr. Toms. None of the jurors worked directly for Geisinger Clinic (Dr. Toms’ employer) or Geisinger Medical Center (the site of the surgery). There was no indication that the non-party Geisinger employers had a financial stake in the outcome of the litigation. The indirect relationships did not require a presumption of prejudice as a matter of law. Additionally, there was no evidence of an abuse of discretion after the trial court further scrutinized the jurors’ relationships with Geisinger. Accordingly, it affirmed the trial court on this issue.

The Court also addressed a physician’s duty to provide information necessary to obtain informed consent. For a discussion of its holding on that issue, please click here.

[1] No. 31 MAP 2016 (June 20, 2017).

[2] Citing Valles v. Albert Einstein Med. Ctr., 805 A.2d 1232, 2139 (Pa. 2002).

[3] 87 A.3d 829, 843-45 (Pa. Super. 2014).

[4] One juror was an administrative secretary at the Geisinger sleep labs. Another juror’s wife worked as an administrative assistant in a pediatrics department for a Geisinger entity for thirty-five years. A third juror was a customer service representative for Geisinger Health Plan. An alternate juror was a retired physician assistant who had previously worked at a Geisinger entity, but never in Dr. Toms’ department. Also, his son worked as a night security officer for a Geisinger entity.

[5] Citing Commonwealth v. Bridges, 757 A.2d 859, 873 (Pa. 2001).

[6] 776 A.2d 266, 270 (Pa. Super. 2001).