283 A.3d 885
Pa. Super. Ct.2022Background
- Patient Glen Cauffman (POA: Judith Shoemaker) was admitted to UPMC Harrisburg ICU with severe COVID-19; hospital followed institutional COVID-19 protocol and declined to use ivermectin.
- Shoemaker (as POA) obtained a prescription for ivermectin from a Pennsylvania primary care physician who lacked hospital ICU credentials, and sought to have two outside physicians administer it; she offered to sign a liability waiver.
- The trial court initially granted an ex parte injunction and, after a hearing, entered a mandatory preliminary injunction ordering UPMC to permit the outside physicians to administer ivermectin and to consult with hospital staff.
- UPMC appealed and this Court stayed the injunction; Cauffman later died, rendering the appeal technically moot, but the Court proceeded under the capable-of-repetition/evading-review exception.
- The Superior Court reversed, holding the POA failed to show a clear legal right to compel treatment outside hospital protocol or to force credentialing of unvetted physicians; courts may not override hospital medical judgment or credentialing processes.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether a court may compel a hospital to administer ivermectin or allow uncredentialed physicians to give it | Shoemaker: prescription from PC physician + POA authority + lack of other options justified injunction to preserve life | UPMC: ivermectin is outside standard of care, contraindicated by major health authorities; credentialing and patient safety are hospital prerogatives | Reversed — no legal right to force treatment outside hospital protocol or to require credentialing; mandatory injunction improper |
| Whether testimony that ivermectin improved the patient establishes likelihood of success for a mandatory injunction | Shoemaker: expert testimony showed post‑treatment improvement, supporting likelihood of success on merits | UPMC: efficacy disputed; mandatory injunction requires a clear legal right, not merely contested medical testimony | Reversed — trial court erred by resolving competing medical opinions instead of finding a clear legal right to relief |
| Whether the appeal is reviewable after the patient’s death | Shoemaker: (implicit) relief still matters for rights of patients/POAs | UPMC: appeal technically moot but involves recurring public‑importance issues | Court exercised mootness exception (capable of repetition/evading review) and reached merits |
Key Cases Cited
- Mazzie v. Commonwealth, 432 A.2d 985 (Pa. 1981) (mandatory injunctions command positive acts and require a clear right to relief)
- Summit Towne Centre, Inc. v. Shoe Show of Rocky Mount, 828 A.2d 995 (Pa. 2003) (preliminary‑injunction standards and prerequisites)
- Thompson v. Nason Hosp., 591 A.2d 703 (Pa. 1991) (hospital corporate‑negligence duties)
- Cooper v. Delaware Valley Med. Ctr., 654 A.2d 547 (Pa. 1995) (role of peer review and credentialing in hospitals)
- Whittington v. Episcopal Hosp., 768 A.2d 1144 (Pa.Super. 2001) (corporate negligence elements and hospital duties)
- In re Duran, 769 A.2d 497 (Pa.Super. 2001) (mootness exception where issue is capable of repetition and evades review)