Shiflett v. Lehigh Valley Health Network, Inc.

174 A.3d 1066

Betty L. SHIFLETT and Curtis Shiflett, Husband and Wife, Appellees

v.LEHIGH VALLEY HEALTH NETWORK, INC. ; and Lehigh Valley Hospital, Appellants

No. 2293 EDA 2016

Superior Court of Pennsylvania.

Argued February 14, 2017

Filed November 9, 2017

Reargument Denied January 12, 2018

Kimberly G. Krupka, Allentown, for appellants.

James P. Goslee, Philadelphia, for appellees.

BEFORE: SHOGAN, J., SOLANO, J., and PLATT, J.^*

OPINION BY SOLANO, J.:

Appellants, Lehigh Valley Health Network, Inc., and Lehigh Valley Hospital (together, "Lehigh Valley"), appeal from the judgment entered following a jury trial and verdict in favor of Appellees Betty L. Shiflett and Curtis Shiflett. We conclude that the Shifletts' second amended complaint pleaded a new cause of action—for vicarious liability against Lehigh Valley for the negligent actions of Nurse Kristina Michels Mahler in Lehigh Valley's Transitional Skills Unit—that did not appear in the Shifletts' first amended complaint, and that this new cause of action was barred by the applicable statute of limitations. Accordingly, we vacate the judgment and reverse with respect to the verdict against Lehigh Valley for vicarious liability regarding Nurse Michels Mahler's actions. We reject Lehigh Valley's contentions of error with respect to the verdict of corporate negligence related to the Shifletts' claim of improper care in Lehigh Valley's Post–Surgical Unit. We remand for a new trial on the question of damages.

On April 12, 2012, Ms. Shiflett underwent left knee surgery at Lehigh Valley Hospital. On April 14, 2012, Ms. Shiflett fell out of her hospital bed in Lehigh Valley's Post–Surgical Unit ("PSU") and suffered an avulsion fracture of her left tibial tubercle, which was not diagnosed until April 19, 2012. N.T., 2/5/16, at 31, 39.¹

On April 15, 2012, Ms. Shiflett was transferred to Lehigh Valley's Transitional Skills Unit ("TSU"), where she received physical and occupational therapy. N.T., 2/3/16, Tr. of Cynthia Balkstra, at 61–64, 68–69; N.T., 2/5/16, at 39, 64, 66–69; Trial Ct. Op. at 2.² Ms. Shiflett claims that soon after her arrival at the TSU, she repeatedly reported "sharp pain" and a "clicking" in her knee to Kristina Michels Mahler, a nurse working in the TSU, but Nurse Michels Mahler did not notify a physician about those complaints. As a result, there was a delay in diagnosing Ms. Shiflett's avulsion fracture. After Ms. Shiflett's physical therapist reported Ms. Shiflett's concerns on April 19, 2012, she had two additional surgeries to repair her avulsion fracture, but those surgeries were unsuccessful. Ms. Shiflett was left with no extensor mechanism in her leg and was no longer a candidate for further surgery due to past infection.³

On February 7, 2014, the Shifletts filed a complaint against Lehigh Valley ("Original Complaint") that made the following factual allegations:

10. On April 12, 2012 , plaintiff Betty Shiflett underwent left knee revision surgery at Lehigh Hospital.

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12. In the early morning of April 14, 2012 , as a direct and proximate result of the negligence of the defendants, including inadequate fall protection provided by defendants, an unattended Betty Shiflett fell and suffered a left tibia avulsion fracture .

13. A nursing note in the chart of Lehigh Hospital dated April 14, 2012 at 4:45 A.M. records that immediately after Betty Shiflett was found on the floor of her hospital room, a bed check was initiated and yellow socks were put on her feet.

14. The left tibia avulsion fracture suffered as a result of Betty Shiflett's fall would not have occurred in the absence of the negligence of the defendants including their failing to provide adequate and sufficient fall protection and monitoring.

15. On April 24, 2012, Dr. Ververeli performed open reduction surgery to repair Betty Shiflett's left tibia avulsion.

16. Post-surgical care of Betty Shiflett's left tibia reduction surgery was complicated by a staph infection. As a result, on May 22, 2012, Dr. Ververeli performed another surgery on her left knee, irrigating and debriding the left knee and inserting screws and antibiotic beads in an effort to treat the infection.

17. As a result of plaintiff Betty Shiflett's avulsion fracture and resulting tibial reduction surgery and infection, she continued to, and is likely to continue to stiffer pain, reduced range of motion, weakness and left knee instability and disability.

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20. The injuries and permanent disabilities suffered by plaintiff Betty Shiflett were the direct result of the defendants' negligence, by and through their agents, servants and/or employees and/or their ostensible agents following her April 12, 2012 left knee revision surgery at Lehigh Hospital which negligence includes:

a.) Failing to use due care or employ reasonable skill in the treatment administered to plaintiff Betty Shiflett.

b.) Employing inappropriate or inadequate methods, techniques and procedures in the care and treatment of plaintiff Betty Shiflett;

c.) Failing to timely and properly recognize that plaintiff Betty Shiflett was at significant risk for a post-operative fall;

d.) Failing to timely and properly prepare and/or otherwise have in place a patient care plan for plaintiff Betty Shiflett that would include appropriate monitoring and safeguards to reduce and/or eliminate her risk of post-operative fall;e.) Failing to utilize and/or have in place reasonable and appropriate measures to prevent plaintiff Betty Shiflett from falling after her April 12, 2012 knee revision surgery, including but not limited to, full bed side rails, properly monitor the Plaintiff in her bed, a bed alarm and/or institute a bed check; provide non-skid socks;

f.) Failing to adopt and enforce adequate policies and procedures to plan for and to ensure the proper and safe use of reasonable fall protection methods;

g.) Failing to select and retain competent physicians and staff;

h.) Failing to properly oversee the professional staff working in Lehigh Hospital;

i.) Failing to properly train and educate professional staff to identify fall risks and use appropriate methods to reduce the risk of a fall; and

j.) Failing to adhere to the standard of medical care in the community.

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23. But for the negligence of the defendants described above, Plaintiff Betty Shiflett would have fully recovered from her knee revision surgery on April 12, 2012.

Original Compl., 2/7/14, at ¶¶ 10, 12–17, 20, 23 (emphases added). Of significance here, these allegations all pertained to alleged negligence leading to Ms. Shiflett's fall from the bed in her hospital room; they did not allege subsequent negligence in the TSU.

Lehigh Valley filed preliminary objections. Among other things, it argued that the allegations in Paragraph 20(a), (b), (d), (h), and (j) were too "general, vague and overbroad" to state a valid claim and to permit formulation of defenses. Prelim. Objs. of Lehigh Valley, 3/11/14, at 9–11 ¶¶ 30–37; Br. in Supp. of the Prelim. Objs. of Lehigh Valley, 3/11/14, at 8–10.

In response, the Shifletts filed an amended complaint ("First Amended Complaint") on March 27, 2014. This First Amended Complaint repeated the allegations in Paragraphs 10, 12–17, and 23 from the Original Complaint⁴ and added the following new paragraphs:

23. In addition to the allegations of negligence described in paragraphs 1 through 21 above, the injuries and permanent disabilities suffered by plaintiff Betty Shiflett were the direct result of the defendants' negligence, by and through their agents, servants and/or employees and/or their ostensible agents following her April 12, 2012 left knee revision surgery at Lehigh Hospital which negligence includes: [eight subparagraphs that are identical to subparagraphs 20(a)-(d), (g)-(h), and (j) in the Original Complaint].

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31. In addition to the allegations of negligence described in paragraphs 1 through 29 above, the injuries and permanent disabilities suffered by plaintiff Betty Shiflett were the direct result of the defendants' negligence following her April 12, 2012 left knee revision surgery at Lehigh Hospital which negligence includes:

a.) Failing to timely and properly prepare and/or otherwise have in place patient care plans that would include appropriate monitoring and safeguards to reduce and/or eliminate risk of post-operative fall;

b.) Failing to utilize and/or have in place reasonable and appropriate fall protection measures, including but not limited to, full bed side rails, proper bed monitoring, a bed alarm and/or institute a bed check, provide non-skid socks;

c.) Failing to adopt and enforce adequate policies and procedures to plan for and to ensure the proper and safe use of reasonable fall protection methods;

d.) Failing to select and retain competent physicians and staff;

e.) Failing to properly oversee the professional staff working in Lehigh Hospital;

f.) Failing to properly train and, educate professional staff to identify fall risks and use appropriate methods to reduce the risk of a fall; and

g.). Failing to adhere to the standard of medical care in the community.

First Amended Compl., 3/27/14, at ¶¶ 23, 31. The amendment added no paragraphs referencing Ms. Shiflett's care in the TSU.

Once again, Lehigh Valley filed preliminary objections that argued, among other things, that the negligence allegations were too vague and general to state a claim and permit framing of defenses. Prelim. Objs. of Lehigh Valley, 4/10/14, at 7–9 ¶¶ 24–31. It also argued that, if not stricken, the broad averments of negligence might improperly be used to permit some "future, unexpected amendment to the complaint based upon new facts after the statute of limitations has run." Id. at 9 ¶ 30 (citation omitted); Br. in Supp. of the Prelim. Objs. of Lehigh Valley, 4/10/14, at 8.

This time, the Shifletts responded by detailing why their allegations were sufficient:

Here, the Amended Complaint, read as a whole and in context, contains detailed and specific allegations that are more than sufficient to allow

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