Walters v. UPMC Presbyterian Shadyside
187 A.3d 214
Pa.2018Background
- David Kwiatkowski, a radiology tech placed at UPMC by staffing agency Maxim, was observed diverting injectable fentanyl at UPMC in May 2008; UPMC terminated him but did not report the diversion to the DEA as required by federal regulation.
- After leaving UPMC, Kwiatkowski worked at multiple hospitals and later reused/refilled syringes; plaintiffs allege they contracted hepatitis C from syringes he contaminated while working at a Kansas hospital.
- Kwiatkowski was later criminally prosecuted and convicted for extensive diversion and tampering; he pleaded guilty to federal charges.
- Plaintiffs sued UPMC and Maxim for negligence (and other claims), alleging a duty to report Kwiatkowski to DEA or law enforcement; trial court dismissed for lack of duty; the Superior Court reversed as to both defendants.
- The Pennsylvania Supreme Court affirmed that UPMC (a CSA registrant) has a common-law duty to report the diversion to appropriate authorities (informed by the federal reporting requirement), but reversed as to Maxim (a non-registrant staffing agency), finding no sufficiently defined duty for Maxim.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether hospital (UPMC) owed common-law duty to report employee diversion to DEA or law enforcement | UPMC had actual knowledge of diversion; federal CSA/regulations require registrants to report thefts/losses to the DEA; failure to report foreseeably allowed continued diversion and patient harm | Imposing a judicially-created tort duty would expand liability beyond regulatory scope and create indeterminate obligations; concerns about limitless liability | Court held UPMC does owe a duty to report, grounded in federal policy; scope limited — compliance with the DEA duty (or equivalent reporting to appropriate authorities) may discharge the common-law duty but facts on breach remain for trial |
| Whether staffing agency (Maxim) owed same duty to report employee diversion | Plaintiffs: Maxim knew or should have known of diversion risk and could have reported; special-relationship/master-servant principles support duty | Maxim: no regulatory reporting obligation, duty would be amorphous and impose indeterminate exposure on non-registrants | Court reversed Superior Court and held Maxim has no such common-law duty here — federal silence re: non-registrants and vagueness of a generalized reporting duty weigh against imposing it |
| Whether federal CSA/regulations can inform a state common-law duty | Plaintiffs: federal reporting rule evidences public policy and foreseeability supporting a common-law duty | Defendants: federal rule protects the public generally and does not create a private cause of action; adopting it as common law improperly expands liability | Court used federal statutes/regulatory policy as a primary guide for imposing a duty on UPMC, but declined to treat federal compliance as automatically dispositive of breach; emphasized caution and case-specific limitation |
| Scope and consequences of imposing duty (foreseeability and liability breadth) | Plaintiffs: reporting burden is modest and justified by grave foreseeable risk of disease transmission | Defendants: duty could create open-ended liability across time/geography, uncertain recipients and content of reports | Court acknowledged significant consequences but limited duty for UPMC to a defined, practicable obligation tied to federal reporting policy; declined to impose broad, undefined duty on Maxim |
Key Cases Cited
- Althaus v. Cohen, 562 Pa. 547, 756 A.2d 1166 (Pa. 2000) (sets five-factor public-policy rubric for recognizing new common-law duties)
- Seebold v. Prison Health Servs., Inc., 618 Pa. 632, 57 A.3d 1232 (Pa. 2012) (court warns against creating new affirmative duties absent clear policy predominance)
- DiMarco v. Lynch Homes–Chester County, 525 Pa. 558, 583 A.2d 422 (Pa. 1990) (physician’s duty extends to foreseeable third parties re: communicable disease advice)
- Emerich v. Philadelphia Ctr. for Human Dev., Inc., 554 Pa. 209, 720 A.2d 1032 (Pa. 1998) (mental-health professional’s limited duty to warn/protect third parties)
- Witthoeft v. Kiskaddon, 557 Pa. 340, 733 A.2d 623 (Pa. 1999) (refuses to extend physician duty when risk not analogous to communicable disease/public-health concerns)
- Phillips v. Cricket Lighters, 576 Pa. 644, 841 A.2d 1000 (Pa. 2003) (imposes duty based on foreseeability, social utility, and manageable cost of preventive design)
- R.W. v. Manzek, 585 Pa. 335, 888 A.2d 740 (Pa. 2005) (recognizes duty where defendant’s activity foreseeably created particular risks to identifiable class)