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  • RECENT DEVELOPMENTSIN PENNSYLVANIA

    MEDICAL MALPRACTICE LAW

    January 3, 2011

    James R. Kahn, EsquireMargolis Edelstein

    The Curtis Center170 S. Independence Mall West - Suite 400E

    Philadelphia, PA 19106-3337(215)931-5887

    Fax (215)922-1772jkahn@margolisedelstein.com

    HARRISBURG OFFICEP.O. Box 932Harrisburg, PA 17106-0932717-975-8114

    PITTSBURGH OFFICE525 William Penn PlaceSuite 3300Pittsburgh, PA 15219412-281-4256

    SCRANTON OFFICE220 Penn AvenueSuite 305Scranton, PA 18503570-342-4231

    WESTERN PA OFFICE983 Third StreetBeaver, PA 15009724-774-6000

    CENTRAL PA OFFICEP.O. Box 628

    Hollidaysburg, PA 16648814-224-2119

    MT. LAUREL OFFICE100 Century Parkway

    Suite 200Mt. Laurel, NJ 08054

    856-727-6000

    BERKELEY HEIGHTS OFFICE300 Connell Drive

    Suite 6200Berkeley Heights, NJ 07922

    908-790-1401

    WILMINGTON OFFICE750 South Madison Street

    Suite 102Wilmington, DE 19801

    302-888-1112

  • RECENT DEVELOPMENTS

    IN PENNSYLVANIA MEDICAL MALPRACTICE LAW

    January 3, 2011

    JAMES R. KAHNMargolis Edelstein

    jkahn@margolisedelstein.com

    TABLE OF CONTENTS

    A. ADDITIONS TO PENNSYLVANIA RULES OF CIVIL PROCEDURE . . . . . . . . . . . . . . 21. Certificate of Merit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22. Venue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53. Other procedural rules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

    B. MEDICAL CARE AVAILABILITY AND REDUCTION OF ERROR ACT (MCARE ACT) 61. Patient safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72. Informed consent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73. Punitive damages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84. Affidavit of non-involvement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85. Advance payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86. Collateral source rule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87. Calculation of damages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88. Preservation and accuracy of medical records . . . . . . . . . . . . . . . . . . . . . . . . . . 99. Expert qualifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 910. Statute of repose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1111. Venue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1112. Remittitur . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1113. Ostensible agency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1114. Insurance changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

    C. FAIR SHARE ACT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

    D. RECENT CASE DECISIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121. Duty of care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122. Expert witnesses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133. Scientific expert evidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154. Proof of causation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165. Informed consent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176. Corporate and vicarious liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177. Evidentiary matters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188. Various causes of action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199. Trial issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1910. Jury instruction issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2011. Jurors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2012. Statute of limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

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    13. Settlements and releases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2214. Mental Health Procedures Act . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2215. Section 1983 and EMTALA actions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2316. Bad faith cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2317. MCARE Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

    A. ADDITIONS TO PENNSYLVANIA RULES OF CIVIL PROCEDURE

    1. Certificate of Merit

    Pennsylvania Rules of Civil Procedure 1042.1 through 1042.8 are effective for actions filed on orafter January 27, 2003 notwithstanding that the alleged malpractice occurred prior to the enactment date.Three of the rules were slightly amended in February and December of 2005. The rules apply to all healthcare providers as defined in the MCARE Act, 40 P.S. 1303.503, which includes primaryhealthcare centers, personal care homes, nursing homes, birth centers, hospitals, physicians, nurse midwivesand podiatrists, and any corporation, university or educational institution licensed or approved by theCommonwealth to provide healthcare in those roles. The rules also apply to chiropractors, dentists, nurses,pharmacists, physical therapists, psychologists and veterinarians, as well as certain non-medicalprofessionals.

    On December 5, 2005, the Pennsylvania Supreme Court amended Rules 1042.3(b) and 1042.8 toclarify that where a plaintiff in a medical malpractice case is raising claims against a defendant for both thedefendant s own independent actions and for the actions of others for whom the defendant is responsible,the plaintiff must file certificates of merit for each claim or a single certificate of merit that references bothclaims.

    The original version of the rules allowed a certificate of merit to be filed within 60 days of the filingof a Complaint and a non pros default to be taken starting on the 61st day without any notice being required.On June 16, 2008, these rules were amended to require a defendant to file and serve a notice of intention totake a default at least 30 days before a non pros default is taken for failure of the plaintiff to file a certificate.The notice may not be filed until the 31st day after the complaint is filed. Once a notice is filed a plaintiffmay file a motion to determine whether a certificate is necessary and that motion tolls the time to file acertificate. A motion by plaintiff to extend the time to file a certificate must be filed by the 30th day after thenotice of intention is filed and such a motion also tolls the time to file a certificate. The rule change alsomakes clear that the certificate requirement applies to cross-claims. This rule went into effect immediatelyon June 16, 2008 and applies to pending cases as long as a non-pros had not already been entered as of theeffective date.

    The certificate of merit rules apply to any case where it is alleged that the professional deviated froma required professional standard of care. Such a certificate of merit must state wither one of three things,that an appropriate licensed professional provided a written statement that the treatment was below thestandard of care and caused harm to the plaintiff, or that a claim against a professional defendant is basedsolely on allegations that other professionals for whom the defendant is responsible were negligent (avicarious liability claim - there must be a certificate for the agent even if the agent is not a named defendant),or that expert testimony is unnecessary for prosecution of the claim. The certificate itself only need state thatthere has been a report by a licensed professional but it does not need to identify what the statement saysspecifically or the identity of the licensed professional. The Superior Court has affirmed that this rule can

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    be applied retroactively to a situation where the malpractice occurred before the enactment date. Warrenv. Folk, 886 A.2d 305 (Pa. Super. 2005).

    If no certificate is timely filed then a praecipe can be filed by the defendant which will result inautomatic dismissal of the claim for non pros (failure to prosecute). Under the holding in Moore v.Luchsinger, 862 A.2d 361 (Pa. Super. 2004), a praecipe to dismiss may be filed after the due date, but onlyif no certificate has been filed by the plaintiff. Accordingly, it is incumbent upon defense attorneys to fileon the due date to avoid a plaintiff from being able to file after the due date day simply because a praecipewas not filed. If both praecipe and certificate are filed the same say, the praecipe is valid if it is filed first.Shon v. Karason, 920 A.2d 1285 (Pa. Super. 2007).

    Under these rules, a plaintiff may ask for more time to file the praecipe, particularly if the plaintiffhas not been supplied the professional s medical records, and the filing of a motion tolls the ability of thedefendant to file a praecipe for non pro

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