$8.6 million verdict for decedent's estate affirmed.

CASE ON POINT: Hyrcza v. W. Penn Allegheny Hlth. Sys, Inc., 2009-PA-0702.458 (7/1/2009)-PA

ISSUE : Time and again we have stressed that the amount of a jury verdict is often directly related to the extent and degree of medical malpractice. If the amount awarded by the jury to the decedent's estate in this extraordinary Pennsylvania case is any measure, this case must be among the mothers of all cases of the most egregious forms of medical malpractice.

CASE FACTS: Margaret Mahunick, was a 60 Year-old woman, who died at Suburban General Hospital (Suburban) on July 10, 2001, after undergoing hip surgery at Allegheny General Hospital (Allegheny) on June 22, 2001. The decedent was admitted to the rehabilitation unit at Suburban on June 27, 2001. Suburban had an agreement with CoiceCare to provide rehabilitation services to patients admitted to its Rehabilitation Unit. ChoiceCare assigned Dr. Yvette C. Ross Hebron, Board-Certified psychiatrist as the decedent's attending physician. On admission, Dr. Hebron issued an order to continue the decedent on Ectocrin, a form of aspirin and Sulumedrol, a form of steroid. She consulted with Dr. Jonathan Artz and Dr. Morris, an internist with the decedent's general family group. Drs. Artz and Morris each saw the decedent one time, on June 28, 2001. Dr. Hebron was the only physician who saw the decedent after June 28, 2001. The decedent showed signs of gastrointestinal bleeding on July 4, 2001, which went unnoticed by Dr. Hebron. Dr. Hebron's last day of employment by Choice Care Was July 6, 2001. ChoiceCare did not assign another physician to see the patient. On July 8, 2001, the decedent experienced shortness of breath and was transferred to the hospital's Intensive Care Unit where she died two days later from massive gastrointestinal bleeding. Suit was filed by the Administratrix of the decedent's estate against numerous defendants, including, without limitation thereto, Drs. Hebron, Artz, Stroud, Conaway, Hassan, their respective practice groups as well as against Allegheny and Suburban Hospitals. Shortly before trial, the Administratrix settled with Suburban and Drs. Stroud, Conaway and Artz and their respective practice groups. The trial court denied a motion by the remaining defendants to amend their answers and file cross-claims. These defendants, included Dr. Hebron and ChoiceCare. After a jury trial, the jury returned a verdict against the defendants in the amount of $8.6 Million. All of the defendants post trial motions were denied. They appealed.

COURT'S OPINION: The Superior Court of Pennsylvania affirmed the judgment entered on the jury verdict by the lower court in the amount of $8.6 Million. Further, the court affirmed the trial courts denial of the defendants' motions to amend their pleadings to permit the to file cross-claims. In addition, the court affirmed the trial court's denial of the defendants' motions for post-trial relief. The court held, inter alia, that after reviewing all of the evidence adduced at trial, it was sufficient established that ChoiceCare was responsible for the coordination and management of all patients in the Suburban hospital's rehabilitation unit, which ChoiceCare independently operated.

LEGAL COMMENTARY: The court rejected the defendants' contention that the trial court erred in failing to give the standard negligence charge to the jury, which is routinely given in such cases. To the credit of both the trial court and the appellate court, both recognized that this was a case that not only permitted the trial judge to give something other than a so-called routine charge to the jury on negligence, but a case that required a custom tailored charge, which the court on appeal found had been in total compliance with the law. Further, the appellate court was convinced that ChoiceCare failed to deliver the comprehensive care which it had contracted obligated to provide to the decedent. Of this there was no doubt! Editor's Note: From time to time we have written articles in our sister publication. Nursing Law's Began Report, about cases in which we find deplorable nursing care. We point it out and characterize it as such. This case exemplifies what we will characterize as deplorable care! However, it did not involve nurses, but physicians who were either unconscious or oblivious, not only as to the condition of their patient, but perhaps not even attending their patient. How could Dr: Hebron not see her patient for the two day period, coincidentally (or perhaps not so coincidentally) the two days before termination of her employment by ChoiceCare? What, if anything, did ChoiceCare know about Dr: Hebron that may, or may not have led to her termination? Did she voluntarily terminate her employment with ChoiceCare? Or, did ChoiceCare terminate her? And if so, why? Apparently, neither the trial judge nor jury hesitated in imposing and upholding the jury verdict. Neither did the appellate court!

Meet the Editor & Publisher: A. David Tammelleo, JD, is a nationally recognized authority on health care law. Practicing law for over 40 years, he concentrates in health care law with the Rhode Island firm of A. David Tammelleo & Associates. He has presented seminars on medical, nursing and hospital law throughout the United States. In addition to his writings as Editor of Medical Law's, Nursing Law's & Hospital Law's Regan Reports, his legal articles have been published in the most prestigious health law journals. A prolific writer, his thousands of articles, as well as his achievements as an attorney and lecturer, have won him recognition in Martindale-Hubbell's Bar Register of Preeminent Lawyers, Marquis Who Who in American Law, Who's Who in America and Who's Who in the World.