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NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37
JERALD L. DITLOW, INDIVIDUALLY AND : IN THE SUPERIOR COURT OF
ON BEHALF OF MARCY S. DITLOW, : PENNSYLVANIA
DECEDENT, :
APPELLANT :
v. :
:
CHELTENHAM YORK ROAD NURSING :
AND REHABILITATION CENTER AND :
ALBERT EINSTEIN MEDICAL CENTER :
: No. 905 EDA 2016
Appeal from the Order Entered February 22, 2016
In the Court of Common Pleas of Philadelphia County
Civil Division at No(s): 140201708
BEFORE: BOWES, J., DUBOW, J., and FORD ELLIOTT, P.J.E.
MEMORANDUM BY DUBOW, J.: FILED MARCH 29, 2017
Appellant, Jerald L. Ditlow, appeals from the Order granting summary
judgment in favor of Cheltenham York Road Nursing and Rehabilitation
Center (“Cheltenham”) and Albert Einstein Medical Center (“AEMC”)
(collectively, “Appellees”) in this medical negligence action. After careful
review, we affirm.
The trial court set forth the facts and procedural history as follows:
In 2008, [Decedent] Mrs. Ditlow, was admitted to
[Cheltenham] after having received a course of treatment
at Abington Hospital for bilateral lower extremity
contractions and recovery from hip surgery. [Appellant,
Decedent’s husband] alleges that after [Decedent’s]
admission to Cheltenham, Cheltenham’s negligence over
the next several years caused [Decedent] to suffer from
the following conditions, among others: “see through”
bones, anemia, diminished lung function, punctured lung
and persistent cough.
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On February 9, 2012, [Decedent] was transported from
Cheltenham to [AEMC], presenting with breathing
problems. [Appellant] alleges that while [Decedent] was
at Einstein, certain procedures should have been
performed, but were not; other procedures were
performed incompetently. On February 10, [Decedent]
was intubated; [Appellant] alleges that [ ] [D]ecedent was
intubated without her consent or that of her next of kin.
[Appellant] alleges further that [Decedent] suffered a
broken femur, that her esophagus and lung both were
punctured, and that she suffered severe [edema] while in
[AEMC’s] care. [Decedent] died minutes after the
ventilator was removed on February 16, 2012. [Decedent
was 64 years old.] Her death certificate states that the
cause of death was hypoxic respiratory failure due to, or as
a consequence of, septic shock related to pneumonia.
Trial Ct. Op., 5/24/16, at 2-3 (citations to Appellant’s Amended Complaint
omitted).
On February 18, 2014, Appellant commenced this matter by filing a
Writ of Summons, naming AEMC and Cheltenham as defendants. On April
17, 2014, Appellant filed a Motion for Leave to Conduct Pre-Complaint
Discovery in Lieu of Certificate of Merit, which the trial court denied on May
15, 2014.
On May 29, 2014, Appellant filed a Complaint and Certificates of Merit
against Appellees, raising the following claims: (i) Medical Negligence; (ii)
Corporate Liability; (iii) Lack of Informed Consent; (iv) Negligent Infliction of
Emotional Distress; (v) Fraudulent/Negligent Misrepresentation; (vi)
Wrongful Death Action; (vii) Survival Action; and (viii) Punitive Damages.
On June 19, 2014, both Appellees filed separate Preliminary Objections
to Appellant’s Complaint. On August 12, 2014, the trial court sustained in
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part and overruled in part Appellees’ Preliminary Objections, dismissing
Appellant’s claim of Negligent Infliction of Emotional Distress with prejudice,
and Fraudulent/Negligent Misrepresentation Claims without prejudice. The
court also granted Appellant leave to file an Amended Complaint addressing
Appellees’ objections to the Complaint’s lack of specificity.
On August 22, 2014, Appellant filed an Amended Complaint, advancing
claims of: (i) Medical Negligence; (ii) Corporate Liability; (iii) Lack of
Informed Consent; (iv) Fraudulent/Negligent Misrepresentation; (v) Punitive
Damages; (vi) Wrongful Death; and (vii) Survival Action against Appellees.
On September 10, 2014, AEMC filed an Answer and New Matter, to
which Appellant filed a Reply on October 1, 2014. On September 11, 2014,
Cheltenham filed Preliminary Objections to Appellant’s Amended Complaint.
On October 8, 2014, the court struck Appellant’s Fraudulent/Negligent
Misrepresentation Claim against Cheltenham for failure to state a cause of
action.
The parties concluded discovery on September 8, 2015, but Appellant
failed to file any expert reports.
On October 30, 2015, and November 2, 2015, AEMC and Cheltenham,
respectively, filed Motions for Summary Judgment. Appellant filed Answers
to both Motions.
Following a February 10, 2016 hearing, the trial court granted
Appellees’ Motions for Summary Judgment on February 22, 2016, and
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dismissed all claims against both Appellees. Appellant timely appealed.
Both Appellant and the trial court complied with Pa.R.A.P. 1925.
On appeal, Appellant raises one issue for our review:
Was an error of law committed when the [t]rial [c]ourt
granted [Appellees’] Summary Judgment Motions
preempting [Appellant] from proceeding to trial of the
instant matter via application of res ipsa loquitur in
conjunction with 231 Pa.C.S. § 1042(a)(3) [sic][.]
Appellant’s Brief at 15.
Appellant argues that, because Decedent’s “deplorable condition is the
kind of condition [that] does not occur in the absence of negligence[,]” the
trial court erred in failing to apply the doctrine of res ipsa loquitur, which
would have relieved Appellant of the obligation to provide testimony of an
expert in order to make out a prima facie negligence claim.1 Id. at 20.
Our Supreme Court has clarified our role in reviewing summary
judgment determinations as follows:
. . . [A]n appellate court may reverse a grant of summary
judgment if there has been an error of law or an abuse of
discretion. But the issue as to whether there are no
genuine issues as to any material fact presents a question
of law, and therefore, on that question our standard of
review is de novo. This means we need not defer to the
determinations made by the lower tribunals. To the extent
that this Court must resolve a question of law, we shall
review the grant of summary judgment in the context of
the entire record.
1
Appellant does not challenge the portions of the trial court’s Orders
dismissing Appellant’s Fraudulent/Negligent Misrepresentation or Wrongful
Death claims, claim for Punitive Damages, or claim under the Survival Act.
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Summers v. Certainteed Corp., 997 A.2d 1152, 1159 (Pa. 2010)
(citations and quotation omitted).
A trial court may grant summary judgment “only in those cases where
the record clearly demonstrates that there is no genuine issue of material
fact and that the moving party is entitled to judgment as a matter of law.”
Id. (citation and quotation omitted); see also Pa.R.C.P. No. 1035.2(1).
“When considering a motion for summary judgment, the trial court must
take all facts of record and reasonable inferences therefrom in a light most
favorable to the non-moving party.” Summers, supra at 1159 (citation
omitted). “In so doing, the trial court must resolve all doubts as to the
existence of a genuine issue of material fact against the moving party, and,
thus, may only grant summary judgment where the right to such judgment
is clear and free from all doubt.” Id. (citation and internal quotation marks
omitted).
For purposes of deciding a Motion for Summary Judgment, the record
includes the pleadings, depositions, answers to interrogatories, admissions,
and affidavits. Bailets v. Pennsylvania Tpk. Comm’n, 123 A.3d 300,
3014 (Pa. 2015) (citing Pa.R.C.P. 1035.1(1), (2)). “Where the non-moving
party bears the burden of proof on an issue, he may not merely rely on his
pleadings or answers in order to survive summary judgment.” Truax v.
Roulhac, 126 A.3d 991, 997 (Pa. Super. 2015), appeal denied, 129 A.3d
1244 (Pa. 2015) (citation and quotation omitted). “Further, failure of a non-
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moving party to adduce sufficient evidence on an issue essential to his case
and on which he bears the burden of proof establishes the entitlement of the
moving party to judgment as a matter of law.” Id. (citation and internal
quotation marks omitted). “If there is evidence that would allow a fact-
finder to render a verdict in favor of the non-moving party, then summary
judgment should be denied.” Id. (citation and quotation omitted).
Where a plaintiff has raised claims of Medical Negligence, Corporate
Negligence, and Informed Consent, in order to make out a prima facie case,
he is required to present expert testimony. See Quinby v. Plumsteadville
Family Practice, 907 A.2d 1061, 1070-71 Pa. (2006). (explaining that, in a
medical malpractice action, a plaintiff must present a medical expert to
establish the applicable standard of care, the deviation from that standard,
causation, and the extent of the injury); Welsh v. Bulger, 698 A.2d 581,
585-86 (Pa. 1997) (noting that a corporate negligence claim requires an
expert to identify a defendant medical institution’s standard of care, and the
ways in which the defendant’s departure from those standards led to the
plaintiff’s injuries); Moure v. Raeuchle, 604 A.2d 1003, 1008 (Pa. 1992)
(holding that a lack of informed consent claim requires “expert information
as to the nature of the harm attendant to the procedure, and the probability
of that harm occurring.”).
A medical malpractice plaintiff is relieved of his burden to provide a
medical expert who will testify only if he can prove “that he has been injured
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by a casualty of a sort that normally would not have occurred in the absence
of the defendant's negligence.” Quinby, 907 A.2d at 1071. The application
of this doctrine—res ipsa loquitur—is appropriate when
(a) the event is of a kind which ordinarily does not occur in
the absence of negligence;
(b) other responsible causes, including the conduct of the
plaintiff and third persons, are sufficiently eliminated by
the evidence; and
(c) the indicated negligence is within the scope of the
defendant's duty to the plaintiff.
Id. (quoting Rest. (2d) Torts § 328(D)(1)).
“It is the function of the court to determine whether the inference [of a
defendant’s negligence] may reasonably be drawn by the jury, or whether it
must necessarily be drawn.” Id. (quoting Rest. (2d) Torts § 328(D)(2)).
In concluding that Appellant failed to make out a prima facie case, the
trial court noted the following:
The record in this case is sparse. The court has before it
the docket, prior orders, the amended complaint,
[Appellees’] respective answers thereto, [Appellant’s]
response to [AEMC’s] malpractice interrogatories, four
defense expert reports and excerpts from the defense
deposition taken of Leslie Ditlow, Esq., counsel for
[Appellant] and daughter of [Appellant] and [D]ecedent.
There are no admissions and there are no affidavits. There
is no deposition testimony from any defense witness. The
record contains no evidence that [Appellant]
conducted any discovery. Most important, the
record contains no expert evidence in support of
[Appellant’s] claims, and at oral argument,
[Appellant’s] counsel made clear that one was not
forthcoming.
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***
As far as can be gleaned from [Appellant’s] own
[A]mended [C]omplaint and his [A]nswers to [AEMC’s
I]nterrogatories, [Decedent] presented a complex
constellation of medical challenges. They included bi-
lateral lower extremity contractures and surgically repaired
hip fracture, proper medications and/or physical therapy,
depression, cardiac and blood pressure history, anemia,
bone disease, scoliosis, a bone fracture with indications for
amputation, respiratory ailments, pneumothorax, edema,
esophageal and lung injuries and medical procedures such
as defibrillation and intubation.
[Appellees’] experts reported that upon [D]ecedent’s
admission to Cheltenham in 2008, she was already
suffering “depression, anxiety, hypercholesterolemia,
hypertension, bilateral knee contractures, diffuse
myopathy” and had been “non-ambulatory for greater than
one year.” She had “restrictive lung disease, fractured
femur, contractures, depressive disorder, hypertension,
gastroesophageal reflux, scoliosis, and was not
ambulatory. Upon her admission to [AEMC] she was
diagnosed with “a past history of severe kyphoscoliosis,
chronic obstructive lung disease and depression” and
“hypercapnic respiratory failure,” tachycardia and atrial
fibrillation. Her pulmonary problems upon admission to
[AEMC] included “atrial fibrillation and atelectasis of her
left bronchial tree.” As far as can be discerned from the
record, the procedures that were performed on [Decedent]
included a thoracentesis, blood transfusion and
intubation.”
Trial Ct. Op., 5/24/16, at 4-7 (footnotes and citations omitted) (emphasis
added).
The trial court considered Appellees’ Motions for Summary Judgment
on Appellant’s Medical Negligence, Corporate Negligence, and Informed
Consent claims with Decedent’s complicated and extensive medical history.
It concluded as follows:
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The record, then, shows that [D]ecedent suffered from an
array of pulmonary, cardiac, and bone diseases when she
came into [Appellees’] care. Against this picture,
[Appellant] failed to present any expert testimony of the
respective standards of care [] in treating these
aggregated conditions or any evidence showing how
[Appellees’] conduct deviated from those standards.
[Appellant’s] record, such as it is, consists of conclusory
allegations of neglect, starvation and dehydration that are
unsupported by evidence and are merely lay opinions;
they are insufficient to sustain any prima facie case on
medical negligence, corporate negligence, or informed
consent that can be given to a jury.
Id. at 7 (citations omitted).
With respect to Appellant’s claim that the doctrine of res ipsa loquitur
is applicable in this case, and that Appellant could proceed without an
expert, the trial court noted:
it is plain from the complicated medical history and status
of the decedent that res ipsa loquitur is an unavailable
theory in this case. Toogood v. Rogal, 824 A.2d 1140,
1150 (Pa. 2003) [(plurality)] (stating “[w]e reiterate that
the degree of care and skill [of a medical professional] can
only be proven by the testimony of experts” and that res
ipsa loquitur is inapplicable where such care and skill is
challenged).
Id. at 7-8.
We agree with the trial court that, in light of the complex and
numerous medical problems Decedent presented to Appellees, the doctrine
of res ipsa loquitur is not applicable to this matter. The court correctly
concluded that Appellant failed to satisfy the first and second prongs of the
test to determine the applicability of the doctrine i.e. that Appellant did not
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establish that Decedent could not have died absent any negligence on the
part of Appellees, and that Appellant did not sufficiently eliminate by the
evidence other responsible causes of Decedent’s death.
Because the facts rendered the doctrine of res ipsa loquitur
inapplicable, Appellant was required to provide expert testimony to establish
a prima facie case of Medical Negligence, Corporate Negligence, and lack of
Informed Consent. Appellant did not provide such testimony. Accordingly,
the trial court properly granted summary judgment in Appellees’ favor.
Order affirmed.
Judgment Entered.
Joseph D. Seletyn, Esq.
Prothonotary
Date: 3/29/2017
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