Ruff v. York Hosp.

257 A.3d 43

Tammy M. RUFF, a/k/a Tammy Shifflett, Executrix of the Estate of Linda J. Shifflett

v.YORK HOSPITAL

No. 2015 MDA 2019

Superior Court of Pennsylvania.

Argued September 9, 2020

Filed March 12, 2021

Reargument Denied May 19, 2021

Donald L. Reihart, York, for appellant

Matthew Walker Rappleye, Lancaster, for appellee.

BEFORE: SHOGAN, J., STABILE, J., and MURRAY, J.

OPINION BY SHOGAN, J.:

Appellant, Tammy M. Ruff, also known as Tammy Shifflett, executrix of the estate of Linda J. Shifflett ("Shifflett"), appeals from the December 16, 2019, entry of judgment after a jury trial culminated in a defense verdict for York Hospital ("York"). In her appeal, Appellant challenges the trial court's December 9, 2019 order denying her post-verdict motions for judgment notwithstanding the verdict ("JNOV") and for a new trial, and the August 26, 2019 order resolving pretrial motions. After careful review, we affirm.

On May 24, 2014, Shifflett presented to the emergency room at Hanover Hospital ("Hanover") complaining of shortness of breath. Dr. Michael Denney, Hanover's emergency department physician, determined that Shifflett had an acute coronary syndrome that required further evaluation. Denney Deposition, 8/2/17, at 2–4.¹ Denney was concerned about Shifflett's cardiac condition and stability and requested that she be transferred to York for treatment. One reason for the transfer was that Shifflett might require a heart catheterization which Hanover was not equipped to perform. Id . at 4.

Dr. Lyle Siddoway, a physician employed by Cardiac Diagnostics Associates ("CDA"), was the cardiologist on call when Shifflett was transferred to York. Siddoway Deposition, 4/5/16, at 6. Siddoway recalled that Denney advised him that Shifflett "had a small heart attack and that she had some fluid apparent on her chest X-ray and it looked like she had congestive heart failure." Id. at 7. Upon examination, Siddoway determined that Shifflett's congestive heart failure and respiratory weakness contra-indicated that she was stable enough to undergo a catheterization procedure that day. Id. at 8.

During the following week, Siddoway and another CDA cardiologist, Dr. Gregory Fazio, monitored Shifflett and continued to conclude that the risks of catheterization outweighed the benefit of performing the procedure. Siddoway Deposition, 4/5/16, at 17: Fazio Deposition, 3/29/16, at 20. On June 1, 2014, Shifflett went into cardiogenic shock. Dr. Jay Nicholson Deposition, 4/5/16, at 36. A catheterization was performed revealing coronary artery blockage, and bypass surgery was performed. Id. at 56. Shifflett died on June 7, 2014.

Appellant filed a complaint on July 14, 2015, an amended complaint on August 31, 2015, and a second amended complaint on May 24, 2016, alleging wrongful death and survival claims. The second amended complaint included two counts of corporate liability against York; two counts of vicarious liability against York; two counts of vicarious liability against CDA; and two counts of negligence against Siddoway. Specifically, Appellant claimed that Siddoway and CDA were negligent for failing to perform a timely cardiac catheterization. Appellant's corporate negligence claim against York was based upon its purported failure to properly supervise the cardiologists, which contributed to a negligently-timed cardiac catheterization. Appellant further alleged that York was vicariously liable for the actions of its hospitalists, intensivists, and CDA cardiologists regarding the timing of the cardiac catheterization.

On June 6, 2017, Appellant's claim against Siddoway was dismissed with prejudice. On February 26, 2018, Appellant stipulated that she was discontinuing her outstanding claims against CDA. The trial court ordered the dismissal of CDA on February 28, 2018.

There were numerous pretrial motions including motions for summary judgment, motions for discovery, and motions in limine. Trial commenced on Monday, September 23, 2019, solely on the corporate negligence claim against York. On September 30, 2019, the jury returned a defense verdict in favor of York. Appellant filed post-trial motions requesting a new trial and JNOV. Appellant also challenged the trial court's pretrial decisions, its evidentiary rulings during trial, and alleged error in the jury instructions. The trial court denied the post-trial motions on December 9, 2019. Judgment was entered against Appellant on December 16, 2019, and this appeal followed.

Appellant raises three issues on appeal:

A. Did the Lower Court Commit a Reversible Error By Denying Appellant's Motion for A New Trial and Judgment NOV?

B. Did the Trial Court Commit Reversible Error Requiring A New Trial Because of An Incomplete Understanding of the Requirements of the Hospital's Direct Institutional Corporate Negligence By Refusing To Give Plaintiff's Instructions That Were Filed In the Prothonotary's Office On September 23 and September 27, 2019 That Contained Correct and Relevant Statements of Law That Were Not Covered By the Court's Charge As A Whole?

C. Did the Trial Court Commit Reversible Error Requiring A New Trial Because of An Incomplete Understanding of the Requirements of the Hospital's Direct Institutional Corporate Negligence By Granting York Hospital's Pre-Trial Motions In Limine ?

Appellant's Brief at 6 (verbatim ).

Our standard of review of an order denying JNOV is whether, viewing the record in the light most favorable to the verdict winner and granting the benefit of every favorable inference, "there is sufficient competent evidence to support the verdict." Tillery v. Children's Hosp. of Philadelphia , 156 A.3d 1233, 1240 (Pa. Super. 2017) (citation omitted). Any conflict in the evidence is resolved in the verdict winner's favor. Id. JNOV may be granted only in clear cases where the facts are such that no two reasonable minds could fail to agree that the verdict was improper. We will disturb a trial court's grant or denial of JNOV "only for an abuse of discretion or an error of law." Quinby v. Plumsteadville Family Practice, Inc. , 589 Pa. 183, 907 A.2d 1061, 1074 (2006) (citation omitted). Additionally,

A motion for a new trial based on a claim that the verdict is against the weight of the evidence is addressed to the discretion of the trial court. A new trial should not be granted because of a mere conflict in the testimony or because the judge on the same facts would have arrived at a different conclusion. Rather, the role of the trial judge is to determine that notwithstanding all the facts, certain facts are so clearly of greater weight that to ignore them or to give them equal weight with all the facts is to deny justice. It has often been stated that a new trial should be awarded when the [factfinder's] verdict is so contrary to the evidence as to shock one's sense of justice and the award of a new trial is imperative so that right may be given another opportunity to prevail.

An appellate court's standard of review when presented with a weight of the evidence claim is distinct from the standard of review applied by the trial court:

Appellate review of a weight claim is a review of the exercise of discretion, not of the underlying question of whether the verdict is against the weight of the evidence. Because the trial judge has had the opportunity to hear and see the evidence presented, an appellate court will give the gravest consideration to the findings and reasons advanced by the trial judge when reviewing a trial court's determination that the verdict is against the weight of the evidence. One of the least assailable reasons for granting or denying a new trial is the lower court's conviction that the verdict was or was not against the weight of the evidence and that a new trial should be granted in the interest of justice.

In re M.B. , 228 A.3d 555, 566 (Pa. Super. 2020) (quoting Commonwealth v. Clay , 619 Pa. 423, 64 A.3d 1049, 1055 (2013) (internal citations, quotations, and emphasis omitted)).

Corporate negligence is a doctrine under which a hospital owes a direct duty to its patients to ensure their safety and well-being while in the hospital. Thompson v. Nason Hospital , 527 Pa. 330, 591 A.2d 703, 708 (1991) (adopting the corporate negligence doctrine in Pennsylvania jurisprudence). Under a corporate negligence theory, four general, non-delegable duties are imposed on the hospital:

(1) a duty to use reasonable care in the maintenance of safe and adequate facilities and equipment;

(2) a duty to select and retain only competent physicians;

(3) a duty to oversee all persons who practice medicine within its walls as to patient care; and

(4) a duty to formulate, adopt and enforce adequate rules and policies to ensure quality care for the patients.

Id. at 707 (citations omitted).

In Welsh v. Bulger , 548 Pa. 504, 698 A.2d 581 (1997), the Pennsylvania Supreme Court held that:

corporate negligence is based on the negligent acts of the institution. A cause of action for corporate negligence arises from the policies, actions or inaction of the institution itself rather than the specific acts of individual hospital employees. Thus, under this theory, a corporation is held directly liable, as opposed to vicariously liable, for its own negligent acts.

Welsh , 698 A.2d at 585. (citations omitted). The Welsh Court further explained: "To establish a claim for corporate negligence against a hospital, a plaintiff must show that the hospital had actual or constructive knowledge of the defect or procedures that created the harm." Id. (citation omitted). Moreover, "to make out a viable Thompson claim, a plaintiff must prove that [the] hospital knew or should have known of the mistake or deficiency." Whittington v. Episcopal Hospital , 768 A.2d 1144, 1154 (Pa. Super. 2001) (citing Edwards v. Brandywine Hospital , 438 Pa.Super. 673, 652 A.2d 1382, 1387 (1995) ). In a corporate negligence action against a hospital, the element of actual or constructive notice is critical because "the corporate negligence...