167 A.3d 190
Pa. Super. Ct.2017Background
- Terri Seels-Davila, a Jehovah’s Witness, declined blood transfusions and signed multiple hospital forms refusing blood and hemodilution; she authorized use of nonblood volume expanders and a cell saver.
- She underwent a cesarean at Hahnemann; post-op hypotension and falling hemoglobin led to exploratory laparotomy where massive intra-abdominal bleeding from an anomalous uterine horn was found.
- Because she (and family) refused allogeneic blood, clinicians used a cell saver and performed additional surgeries (including supracervical hysterectomy); she received salvaged autologous blood but died several days later.
- Plaintiff (her father/estate administrator) sued Hahnemann/Drexel alleging medical malpractice, vicarious liability, corporate negligence, negligent infliction of emotional distress, wrongful death, and survival; trial resulted in a defense verdict.
- Key contested legal rulings on appeal: exclusion of plaintiff’s proposed administrative expert, grant of nonsuit on corporate negligence theory, admission of Seels-Davila’s refusal/consent forms into evidence, and the form of the jury verdict slip.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Expert qualification — Dr. Paynter (administrative expert on “bloodless medicine”) | Paynter was qualified to testify about hospital administrative standards and the adequacy of Hahnemann’s Bloodless Medicine Program. | Paynter lacked specialized, practical experience in bloodless-medicine programs and mischaracterized the program as a medical specialty; testimony would confuse jury. | Trial court did not abuse discretion in excluding Paynter; no specialized expertise shown and testimony would confuse jury. |
| Corporate negligence — nonsuit on hospital liability for administrative failures | Hospital failed to maintain proper bloodless program, training, policies and oversight causing harm. | Plaintiff presented no competent expert establishing deviation from standards or causation for the corporate-negligence claim. | Nonsuit properly entered: plaintiff failed to present requisite expert proof on deviation and causation for corporate negligence. |
| Admissibility of consent/refusal forms | Consent forms are irrelevant to negligence and should be excluded under Brady v. Urbas where informed-consent evidence is not probative of ordinary negligence. | Forms were highly relevant to show Seels-Davila knowingly refused life-saving transfusions and to prevent misleading inference that she consented to standard treatment. | Admission of consent/refusal forms was within trial court’s discretion; forms were relevant to show patient’s refusal of transfusion that directly affected causation. |
| Verdict slip — omission of unnamed staff/agents | Verdict slip should allow jury to consider negligence by other unnamed hospital staff and agents. | Plaintiff previously had broad allegations against unnamed agents struck without prejudice and never amended complaint; evidence focused on Drs. Green and Daniels. | No reversible error: verdict form asked about Drs. Green and Daniels as agents of defendants; plaintiff failed to preserve or plead specific unnamed-agent claims. |
Key Cases Cited
- Kovalev v. Sowell, 839 A.2d 359 (Pa. Super. 2003) (expert qualification standard is liberal but requires some reasonable pretension to specialized knowledge)
- Reading Radio, Inc. v. Fink, 833 A.2d 199 (Pa. Super. 2003) (standard of review and purpose of compulsory nonsuit; plaintiff entitled to all reasonable inferences)
- Rauch v. Mike-Mayer, 783 A.2d 815 (Pa. Super. 2001) (doctrine of corporate negligence and the four duties of a hospital)
- Thompson v. Nason Hospital, 591 A.2d 703 (Pa. 1991) (formulation of hospital duties under corporate negligence doctrine)
- Brady v. Urbas, 111 A.3d 1155 (Pa. 2015) (limits on using informed-consent evidence in ordinary negligence cases but recognizes circumstances where consent evidence is relevant to standard of care)