J-A01030-17
NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37
SCOTT R. DEBONIS, ESQUIRE, AS IN THE SUPERIOR COURT OF
EXECUTOR OF THE ESTATE OF FAYE M. PENNSYLVANIA
DAVIS, DECEASED, AND MILDRED
HARRIS,
Appellants
v.
GREGORY A. GEORGE, M.D., GREGORY
A. GEORGE, M.D., INC., JAMES
EZI-ASHI, M.D. AND SAGAR V.
VALLABH, M.D., P.C.
Appellees No. 907 WDA 2016
Appeal from the Order Entered January 15, 2015
In the Court of Common Pleas of Mercer County
Civil Division at No(s): 2011-156
BEFORE: BOWES, OLSON and STRASSBURGER,* JJ.
MEMORANDUM BY OLSON, J.: FILED MAY 26, 2017
Appellants, Scott R. Debonis, Esq., executor of the estate of Faye M.
Davis (Decedent), and Mildred Harris, Decedent’s sister, appeal from the
order entered on January 15, 2015 that granted summary judgment in favor
of Appellees, Gregory A. George, M.D., Gregory A. George, M.D., Inc., James
Ezi-Ashi, M.D., and Sagar V. Vallabh, M.D., P.C. (collectively Appellees). We
affirm.
The trial court summarized the facts in this case as follows:
This case arises from [Decedent’s death, which occurred on]
January 2, 2007, as a result of a ruptured abdominal aortic
aneurysm. Decedent is survived by her sister, [] Mildred Harris.
*Retired Senior Judge assigned to the Superior Court.
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[]Scott R. Debonis[, Esq.] was appointed [e]xecutor of
Decedent's [e]state.
On December 12, 2003, Decedent visited Dr. Ezi-Ashi[, a
licensed physician who specializes in the field of
gastroenterology,] for abdominal complaints. Dr. Ezi-Ashi
performed a physical examination that revealed "a pulsating
mass about the region of the mid-abdomen, possibly
[Decedent’s] abdominal aorta, possibly an aneurysm." Dr.
Ezi-Ashi noted that he "would like to schedule patient for a
[computer tomography (CT)] scan of the abdomen to [rule out
or rule in] abdominal aneurysm[.]" A copy of this record was
sent to Decedent's primary care physician, Dr. George[, a
licensed physician specializing in family medicine,] on December
15, 2003.
On December 19, 2003, Decedent underwent the CT scan that
Dr. Ezi-Ashi ordered. The CT scan revealed a "5.1 cm abdominal
aneurysm." Dr. Ezi-Ashi then performed an upper endoscopy and
a colonoscopy on Decedent, and sent the biopsy results to Dr.
George. [Appellants] allege[d] that neither Dr. Ezi-Ashi nor Dr.
George informed Decedent of the biopsy results.
On June 14, 2005, Decedent visited Dr. George for a follow-up
appointment regarding her hypertension. Decedent saw Dr.
George several more times until July 7, 2006. In October 2006,
Decedent visited Dr. Ezi-Ashi twice for abdominal complaints.
After her visits, Dr. Ezi-Ashi sent to Dr. George a report wherein
he noted that a CT scan was "normal," despite the CT scan
actually showing the presence of an abdominal aortic aneurysm.
[Appellants] allege, again, that [Appellees never] advised
Decedent of her abdominal aortic aneurysm nor the need to
progressively manage her hypertension to prevent growth or
rupture of the aneurysm.
Decedent went to Sharon Regional Hospital on January 1, 2007
complaining of back pain on her right side that "radiate[d] to the
right side of her abdomen." The [h]ospital diagnosed Decedent
with a compression fracture and discharged her with instructions
to follow-up with Dr. George. The following morning, on January
2, 2007, Decedent met with Dr. George[,] who again failed to
advise her of the aneurysm or its possible association with back
pain.
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Later that afternoon, at 12:35 p.m., Decedent sought treatment
at Sharon Regional Hospital. After looking at the previous day's
imaging, a radiologist determined that "a large aortic aneurysm
is present." Shortly after the diagnosis, Decedent's aneurysm
ruptured in the presence of her sister. At 3:00 p.m. a code was
called, resuscitation efforts failed, and ended at 4:05 p.m.
Decedent passed away at 4:05 p.m. on January 2, 2007.
[Appellants initiated legal action by filing a complaint on
December 3, 2008 alleging professional negligence against
Sharon Regional Health System, Emergency Care Consultants,
Regional Imaging Associates, Kathy McNutt, and Steven
Muehlenbein. After discovery commenced, Appellants served
various records requests upon] Dr. George and Dr. Ezi-Ashi, with
which both physicians complied. [Appellants] made two records
requests of Dr. George prior to the expiration of the statute of
limitations. On September 11, 2008, [Appellants] requested
medical records "from 01/01/06 through 02/01/07," which Dr.
George sent within the month. On November 11, 2008,
[Appellants] requested an itemized billing statement for services
rendered on January 2, 2007, which Dr. George sent on
November 12, 2008.
All other records requests of Dr. George and Dr. Ezi-Ashi were
made after the expiration of the statute of limitations. On
September 28, 2010, [Appellants] requested from Dr. George
medical records for a CT scan performed sometime before
October 2006. Dr. George made it known to [Appellants] that
he had no such records on or around October 1, 2010.
[Appellants] finally requested Decedent's full medical records
from Dr. George on October 19, 2010. Originally, Dr. George's
office manager mistakenly informed [Appellants] that the
records had been destroyed. At Dr. George's deposition, it was
discovered that the records were in the possession of his
attorney, that the office manager was unaware of this and
mistakenly assumed, and communicated to [Appellants], that
the records were destroyed[. T]he records were later given to
[Appellants] on February 5, 2013, pursuant to a [r]equest for
[a]dmission.
When [Appellants] learned that Dr. George did not have
possession of Decedent's medical records, they requested
Decedent's full medical records from Dr. Ezi-Ashi on October 19,
2010. Dr. Ezi-Ashi failed to reply until [Appellants] made a
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second request for Decedent's full medical records on November
9, 2010. On January 12, 2011, Dr. Ezi-Ashi [produced
Decedent's full medical records to Appellants].
[Appellants commenced a separate action against Appellees by
filing a praecipe for writ of summons on January 28, 2011.
Thereafter, Appellants] filed their complaint on February 18,
2011 alleging, inter alia, medical negligence survival action,
medical negligence wrongful death action, and negligent
infliction of emotional distress claims against [] Dr. George and
Dr. Ezi-Ashi. [Appellants claimed that Dr. George and Dr.
Ezi-Ashi failed to properly notify, follow, and treat Decedent for
an abdominal aortic aneurysm from December 12, 2003 until her
death on January 2, 2007.] Dr. George filed a [m]otion for
[j]udgment on the [p]leadings on June 22, 2011 [and] Dr.
Ezi-Ashi filed a [m]otion for [j]udgment on the [p]leadings on
July 13, 2011. Both motions asserted that [Appellants’] claims
were barred by the statute of limitations. [The trial court denied
both motions] on September 30, 2011. On September 11,
2014[] Dr. George filed a [m]otion for [s]ummary [j]udgment,
and on October 17, 2014 [] Dr. Ezi-Ashi filed a [m]otion for
[s]ummary [j]udgment. Both motions argued, again, that
[Appellants’] claims [were] barred by the statute of limitations.
[On December 17, 2014, the trial court entered its order
granting summary judgment in favor of Dr. George and Dr.
Ezi-Ashi and against Appellants.]
Trial Court Opinion, 12/17/14, at 2-5 (footnotes omitted).1
Appellant’s raise the following issues on appeal:
____________________________________________
1
Although the trial court partially consolidated Appellants’ complaint against
Dr. George and Dr. Ezi-Ashi with Appellants’ complaint against Sharon
Regional Health System, Emergency Care Consultants, Regional Imaging
Associates, Kathy McNutt, and Steven Muehlenbein, the subsequent order
granting summary judgment in favor of Dr. George and Dr. Ezi-Ashi
constituted a final, appealable order. See Malanchuk v. Tsimura, 137
A.3d 1283 (Pa. 2016) (order granting summary judgment in one of two
cases consolidated for purposes of discovery and trial is appealable
immediately as a matter of right where complete consolidation had not
occurred). The trial court and the parties have complied with Pa.R.A.P.
1925(b) and the matter is now ripe for consideration on appeal.
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Whether the [t]rial [c]ourt erred in concluding, as a matter of
law, that [Appellants’] cause of action was barred by the
applicable statute of limitations/statute of repose[?]
Whether the [t]rial [c]ourt erred in interpreting the term “cause
of death” as used in 40 P.S. § 1303.513 to mean “immediate
cause of death” and not also “underlying cause of death” and
therefore finding Appellees did not fraudulently conceal
[Decedent’s] cause of death so as to toll the statute of
limitations[?]
Whether there are genuine issues of material fact regarding
Appellants’ “reasonable diligence” in uncovering [Decedent’s]
cause of death[?]
Appellants’ Brief at 9.
Appellants challenge an order that entered summary judgment in favor
of Dr. George and Dr. Ezi-Ashi. The principles we apply in reviewing such an
order are well established:
Our scope of review of a trial court's order granting or denying
summary judgment is plenary, and our standard of review is
clear: the trial court's order will be reversed only where it is
established that the court committed an error of law or abused
its discretion.
The entry of summary judgment is proper whenever no genuine
issue of any material fact exists as to a necessary element of the
cause of action. The moving party's right to summary judgment
must be clear and free from doubt. We examine the record,
which consists of all pleadings, as well as any depositions,
answers to interrogatories, admissions, affidavits, and expert
reports, in a light most favorable to the non-moving party, and
we resolve all doubts as to the existence of a genuine issue of
material fact against the moving party.
Krapf v. St. Luke’s Hosp., 4 A.3d 642, 649 (Pa. Super. 2010) (internal
citations omitted), appeal denied, 34 A.3d 831 (Pa. 2011).
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Under the Medical Care Availability and Reduction of Error Act (MCARE
Act), “wrongful death claims under 42 Pa.C.S.A. § 8301 and survival claims
under 42 Pa.C.S.A. § 8302 must be commenced within two years after the
death, unless there is fraudulent misrepresentation or concealment as to the
cause of death.” Matharu v. Muir, 86 A.3d 250, 263 (Pa. Super. 2014) (en
banc); see also 40 P.S. § 1303.513(d).2 In Matharu, this Court said that
the period within which a claim must be filed under § 1303.513(d) begins to
run when the cause of action accrues, which is the date of death. See
Matharu, 86 A.3d at 263 (“In other words, the two-year time period under
[§ 1303.513(d)] does not begin to run until the injury (death) occurs, unless
there is fraud relating to the cause of death, in which case the two-year
period is tolled until the plaintiff knows or reasonably should have known of
the cause of death.”), citing Krapf 4 A.3d at 649. In the present case,
Decedent died on January 2, 2007 but Appellants did not commence their
action against Appellees until January 28, 2011. Hence, the trial court
____________________________________________
2
Section 1303.513(d) provides a two-year limitations period for medical
professional liability claims asserted in the context of a wrongful death or
survival action. It states:
(d) Death or survival actions.--If the claim is brought under
42 Pa.C.S. § 8301 (relating to death action) or 8302 (relating to
survival action), the action must be commenced within two years
after the death in the absence of affirmative misrepresentation
or fraudulent concealment of the cause of death.
40 P.S. § 1303.513(d).
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determined that the limitations period expired before Appellants initiated
suit.
Appellants’ position is that the trial court erred in concluding that the
statute of limitations barred their wrongful death and survival claims.3
Specifically, Appellants assert that the term “cause of death,” as used in
§ 1303.513(d), embraces the concept of an “underlying cause of death”
which includes not just the disease, injury, or complication that directly
precedes death but also a disease or injury that ignites a sequence of events
that produces death. See Appellants’ Brief at 27. Relying on this expanded
conception of the term “cause of death,” Appellants argue that the failures of
Dr. Ezi-Ashi and Dr. George to inform, follow, and refer Decedent for
treatment of her abdominal aortic aneurism from December 2003 until
January 2, 2007 constituted fraudulent concealment of Decedent’s cause of
death which tolled the two-year limitations period in this case. Appellants
add that Appellees’ production and dissemination of documents that
characterized Decedent’s 2003 test results as “normal” served as “continued
misrepresentation” of Decedent’s condition, which further tolled the statute
of limitations. Appellants’ contentions are inconsistent with relevant
Pennsylvania case law.
____________________________________________
3
The issues raised in Appellants’ claims are interrelated and we shall
address them in a single discussion.
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In Krapf, this Court considered the applicability of the fraudulent
concealment doctrine in the context of wrongful death and survival actions.
In that case, the estates of five patients filed wrongful death and survival
actions against a hospital after a former nurse confessed to killing the
patients. The hospital previously issued death certificates to the estates
indicating causes of death consistent with the progression of the respective
diseases for which the patients had received treatment. Thereafter, the
nurse confessed to killing the patients. By the time the estates instituted
claims against the hospital, however, the two-year limitations period had
expired. On appeal, we affirmed the trial court’s refusal to enter summary
judgment in the hospital’s favor.4 We observed that the doctrine of
fraudulent concealment applied when a defendant, who owes a duty to
speak, commits an affirmative, independent act of concealment upon which
a plaintiff justifiably relies. Krapf, 4 A.3d at 650, citing Lange v. Burd, 800
A.2d 336, 339 (Pa. Super. 2002). Applying these principles, we concluded
that the trial court correctly determined that the hospital fraudulently
concealed the patients’ causes of death by issuing death certificates
indicating natural progression of underlying diseases, which induced the
detrimental reliance of the estates. Id. at 650.
____________________________________________
4
The appeal in Krapf came before us by way of the hospital’s petition for
review under Pa.R.A.P. 1501 et seq.
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We agree with the trial court’s determination that the actions of Dr.
Ezi-Ashi and Dr. George before January 2, 2007 did not constitute fraudulent
concealment of Decedent’s cause of death. Under settled case law,
Appellants’ wrongful death and survival causes of action accrued on January
2, 2007, the date on which Decedent died, and only fraudulent concealment
of her cause of her death tolls the limitations period. See Matharu, 86 A.3d
at 263. Since Appellees could not conceal the cause of a death that had not
yet occurred, the trial court did not err in concluding that their actions prior
to January 2, 2007 were irrelevant to application of the doctrine of
fraudulent concealment.
We also reject Appellants’ claim that alleged misstatements included
within Decedent’s medical records prepared and produced by Appellees are
akin to the inaccurate death certificates issued by the hospital in Krapf and,
therefore, constitute fraudulent misrepresentation of the cause of Decedent’s
death. In disposing of this contention, the trial court reasoned as follows:
[Appellants] further contend that [Decedent’s medical] records
contained a false statement similar to the incorrect statements
at issue in Krapf. In Krapf, the decedent-victims were killed by
a nurse administering harmful doses of certain medications.
Krapf, supra, at 645-658. Prior to the nurse’s confession that
he killed the patients, the hospital issued death certificates to
the decedent-victims’ estates “indicating causes of death
consistent with the progression of the respective diseases for
which the patients had been receiving treatment.” Id. at 648.
[This Court] relied on the trial court’s reasoning that the
incorrect statement, albeit unintentional, prevented the plaintiffs
from knowing the decedent-victims’ true cause of death. Id. at
651.
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The statement at issue here is that a CT scan was noted as being
“normal” when it actually showed the presence of an abdominal
aortic aneurysm. Unlike the plaintiffs in Krapf, however,
[Appellants] here knew the cause of death – a ruptured
abdominal aortic aneurysm – on the date on which Decedent
died. This cause of death has not changed since January 2,
2007; nor have any of the records recovered during discovery
indicated a different cause of death. Additionally, since
[Appellants] instituted this suit, on December 3, 2008, they have
[confirmed] that the cause of death was a ruptured aortic
aneurysm. Because [Appellants] knew the cause of death on
January 2, 2007, the misstatement in [Decedent’s medical
records] does not toll the statute of limitations. Rather, it put
[Appellants] on inquiry notice to determine what the CT scan
showed and why there was a misstatement.
Trial Court Opinion, 12/17/14, at 12. Our review of the certified record and
pertinent case law leads us to conclude that the trial court adequately and
accurately addressed this issue. Hence, we reject Appellants’ claim for the
reasons set forth by the trial court.
In sum, we conclude that Appellees did not fraudulently conceal or
misrepresent the cause of Decedent’s death and that the two-year
limitations period barred Appellants’ wrongful death and survival claims
against Appellees. In light of these determinations, we need not pass upon
Appellants’ third issue, which asks whether Appellants exercised reasonable
diligence in discovering Appellees’ possible role in bringing about Decedent’s
death. Accordingly, we affirm the entry of summary judgment in favor of
Appellees.
Order affirmed.
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Judgment Entered.
Joseph D. Seletyn, Esq.
Prothonotary
Date: 5/26/2017
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