BISHOP v. WEXFORD HEALTH SOURCES, INC., 1:17-cv-00060

Background

Michael Bishop, an inmate at SCI‑Albion, was hospitalized at UPMC Hamot in August 2014 for small‑bowel obstruction; CT showed a 10 × 6.3 cm cecal mass. He underwent surgery and a retroperitoneal lymph‑node biopsy that reported findings interpreted as Castleman’s disease.
After discharge, Bishop continued to receive care from prison medical staff and outside oncologists; by October–November 2014 biopsies revealed adenocarcinoma of colonic origin with bladder invasion and later liver metastases. He died in May 2015.
Plaintiff Iris Bishop (administratrix) sued Hamot for medical malpractice alleging a delayed diagnosis of colon cancer caused additional pain and complications; her case against Wexford and Correct Care had already been dismissed on other grounds.
Plaintiff’s sole medical expert, Dr. Edward Gelmann, submitted a short report: he summarized the records, opined the cecal mass was likely colon cancer in August 2014, and stated that the delay "more likely than not" increased the risk of bladder invasion and that earlier treatment would have been initiated.
Hamot moved for summary judgment arguing Dr. Gelmann’s report fails to (1) identify the applicable standard of care or any deviation by Hamot, and (2) state causation (increased risk) with the required medical certainty.
The court granted Hamot’s summary‑judgment motion, holding the expert report legally insufficient because it omitted opinions on standard of care and breach and did not state causation (increased risk) to a reasonable degree of medical certainty.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether plaintiff’s expert satisfies the required proof of applicable standard of care and breach	Gelmann implies the cancer diagnosis was delayed and that earlier pursuit would have led to treatment; this supports malpractice imputable to Hamot	Gelmann’s report does not state the standard of care or identify any act/omission by Hamot that deviated from it; it largely uses passive language and omits criticism of specific conduct	Held for Hamot — expert failed to articulate standard of care or breach; summary judgment proper
Whether expert established causation via the "increased risk" standard for delayed cancer diagnosis	Gelmann opined the delay "more likely than not" increased risk of bladder invasion and that earlier treatment would likely have prevented that outcome	Gelmann did not tie any increased risk specifically to a deviation by Hamot and did not express the increased‑risk opinion with the reasonable degree of medical certainty required	Held for Hamot — causation not proved with requisite medical certainty and not attributable to Hamot
Whether summary judgment is appropriate when sole expert report is deficient under Rule 26 and Pennsylvania malpractice law	Plaintiff relies solely on Dr. Gelmann’s report to raise triable issues	With no expert opinion on standard, breach, or sufficiently certain causation, plaintiff cannot meet essential elements at trial	Held for Hamot — Celotex standard satisfied; judgment entered for defendant

Key Cases Cited

Mitzelfelt v. Kamrin, 584 A.2d 888 (Pa. 1990) (adopts "increased risk" causation standard for delayed cancer diagnosis)
Hamil v. Bashline, 392 A.2d 1280 (Pa. 1978) (explains increased‑risk rule and jury role once increased risk shown)
Corrado v. Thomas Jefferson Univ. Hosp., 790 A.2d 1022 (Pa. Super. Ct. 2001) (expert opinions must be to a reasonable degree of medical certainty)
Toogood v. Rogal, 824 A.2d 1140 (Pa. 2003) (narrow exception to expert requirement where negligence is obvious)
Maurer v. Trustees of the Univ. of Pa., 614 A.2d 754 (Pa. Super. Ct. 1992) (expert must address deviation from standard, not just supply "magic words")
In re Paoli R.R. Yard PCB Litig., 35 F.3d 717 (3d Cir. 1994) (expert testimony required to show medical causation)
Celotex Corp. v. Catrett, 477 U.S. 317 (U.S. 1986) (summary judgment framework)