James, F. v, Albert Einstein Medical Center
170 A.3d 1156
Pa. Super. Ct.2017Background
- Plaintiff Florence James, individually and as executrix of her brother Lafayette James's estate, sued multiple physicians and hospitals for medical malpractice alleging a delayed diagnosis of a neuroendocrine (carcinoid) tumor from 2004–2011; Lafayette died in 2014.
- Plaintiff claimed defendants failed to order proper follow-up tests or make specialist referrals, causing the tumor to metastasize and become incurable.
- Defendants argued they met the standard of care and that Lafayette was largely noncompliant with referrals and follow-up visits.
- At a ten-day trial the jury returned a verdict of no negligence for all defendants; plaintiff moved for JNOV which was denied by operation of law.
- On appeal plaintiff raised six principal claims: improper qualification of a defense expert in oncology, exclusion of the decedent’s mother’s testimony on emotional loss, alleged errors in jury instructions and supplemental charges, limiting plaintiff’s oncology expert to causation testimony, and a sufficiency argument supporting JNOV or a new trial.
- The Superior Court affirmed, finding no abuse of discretion or legal error in expert qualification, evidentiary rulings, jury instructions, or denial of JNOV.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| 1. Qualification of Dr. Peikin as oncology expert | Peikin (gastroenterologist) improperly allowed to testify on oncology/causation outside his specialty | Peikin has overlapping qualifications (GI, liver disease, tumor-board experience, fellowships) sufficient under liberal expert standard and MCARE | Court upheld qualification; no abuse of discretion |
| 2. Mother’s testimony on emotional loss | Mother should be allowed to testify about the impact of her son’s death | Mother is a wrongful-death beneficiary only for pecuniary losses; Pennsylvania does not recognize filial consortium | Court excluded testimony about mother’s pain/suffering (loss of consortium) and upheld the exclusion |
| 3. Jury instruction on “injuries” (and related jury question) | Court’s clarification during deliberations misstated injuries under Wrongful Death/Survival Acts and misled jury | Trial court’s charge, read as a whole, accurately stated law and clarifications were within discretion; plaintiff’s view is speculative about jury intent | Court found no reversible error in instructions or supplemental charge |
| 4. Re-reading negligence question to jury | Re-reading breached procedure and prejudged physician negligence; jury was focused on comparative negligence | Court acted reasonably to clarify jury’s question; no evidence jury had already decided negligence | Court affirmed re-reading; no abuse of discretion |
| 5. Repeated cautions limiting Dr. Schneider’s testimony | Cautionary instructions that Schneider testify only on causation improperly highlighted limits and prejudiced plaintiff | Plaintiff had agreed to limit Schneider to causation but repeatedly asked causation-adjacent standard-of-care questions; court’s reminders were appropriate | Court upheld cautionary instructions as justified and not reversible error |
| 6. Denial of JNOV / sufficiency of evidence | Evidence overwhelmingly supports plaintiff; no two reasonable minds could agree with defense verdict | Conflicts in evidence resolve for verdict winner; substantial competent evidence supports verdict | Court affirmed denial of JNOV; evidence sufficient to support jury verdict |
Key Cases Cited
- B.K. ex rel. S.K. v. Chambersburg Hosp., 834 A.2d 1178 (Pa. Super. 2003) (expert-qualification test is liberal; specialties can overlap)
- McDaniel v. Merck, Sharp & Dohme, 533 A.2d 436 (Pa. Super. 1987) (experts in one medical area may testify in related areas when specialties overlap)
- Tillery v. Children's Hosp. of Philadelphia, 156 A.3d 1233 (Pa. Super. 2017) (standard for reviewing denial of JNOV—view record in favor of verdict winner)
- Krepps v. Snyder, 112 A.3d 1246 (Pa. Super. 2015) (standards for reviewing jury instructions—charge must accurately reflect law and guide jury)
- Machado v. Kunkel, 804 A.2d 1238 (Pa. Super. 2002) (Pennsylvania does not recognize filial loss of consortium)
- Jackson v. Tastykake Inc., 648 A.2d 1214 (Pa. Super. 1994) (collecting cases on nonrecognition of filial consortium)
- Commonwealth v. Spuck, 86 A.3d 870 (Pa. Super. 2014) (procedural sanction authority for noncompliant appellate briefs)