Adams, T. v. Vaughn, D., M.D., Adams, T. v. Vaughn, D., M.D. No. 1383 MDA 2016

Theresa Adams underwent laparoscopic cholecystectomy (gallbladder removal) by Dr. David Vaughn on Feb. 14, 2012; post‑op CTs showed a pelvic abscess and a perforation (.2 cm) in the small bowel requiring repair.
Adams sued Dr. Vaughn and Surgical Specialists of Lancaster for medical negligence, claiming the bowel perforation occurred during the laparoscopic procedure due to negligent instrument placement.
At trial (Feb. 9–11, 2016) Adams presented one liability expert, Dr. I. Michael Leitman, who reviewed records and testified he formed opinions within a "reasonable degree of medical certainty."
Dr. Leitman repeatedly defined "reasonable medical certainty" as "more likely than not" and also conceded it was "possible, but less likely" the injury occurred at another time.
Defendants moved for a compulsory nonsuit at the close of Adams’s case; the trial court granted nonsuit, finding the expert’s testimony did not satisfy the requisite degree of medical certainty.
Adams’s post‑trial motions (to remove nonsuit and to admit her counsel’s affidavit recounting a chambers argument) were denied; the Superior Court affirmed on appeal.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Adams’s expert testified to a reasonable degree of medical certainty on breach and causation	Leitman testified he had opinions within a reasonable degree of medical certainty and that the perforation more likely than not occurred during the surgery	Leitman’s repeated definition of reasonable certainty as "more likely than not," plus concessions that injury possibly occurred at another time, fail the required certainty standard	Court held expert testimony was insufficient; nonsuit was proper
Whether a prima facie case was made against Surgical Specialists of Lancaster	Adams argued corporate/vicarious liability or that evidence supported submission against the practice	Defendants argued absence of admissible expert proof of breach/causation defeated liability	Court found no prima facie case without sufficient expert proof and affirmed nonsuit for the practice as well
Whether the trial court erred in striking plaintiff counsel’s affidavit recounting the chambers argument	Adams contended the affidavit was necessary to show what transpired in chambers regarding expert testimony and nonsuit argument	Defendants and court asserted the affidavit added nothing material, conflicted with memories, and counsel made no contemporaneous objections at trial	Court found exclusion within trial court’s discretion and did not abuse that discretion

Vicari v. Spiegel, 936 A.2d 503 (Pa. Super. 2007) (expert required to testify to reasonable degree of medical certainty for matters beyond lay knowledge)
McMahon v. Young, 276 A.2d 534 (Pa. 1971) (expert medical opinion must have sufficient certainty to permit a jury to find facts)
Winchel v. Jain, 925 A.2d 782 (Pa. Super. 2007) (expert need not be absolutely certain or rule out all alternatives, but testimony must show reasonable certainty)
Griffin v. Univ. of Pittsburgh Med. Ctr.-Braddock Hosp., 950 A.2d 996 (Pa. Super. 2008) (testimony framed as "possibly" or merely "more likely than not" may fail the required certainty)
Corrado v. Thomas Jefferson Univ. Hosp., 790 A.2d 1022 (Pa. Super. 2001) ("more likely than not" testimony, viewed in totality, can be insufficient)
Neidert v. Charlie, 143 A.3d 384 (Pa. Super. 2016) (standard of review for denial of motion to remove compulsory nonsuit)
Stumpf v. Nye, 950 A.2d 1032 (Pa. Super. 2008) (trial court has discretion to admit or exclude affidavits recounting off‑record proceedings)