*1 gued im- sufficiency reasons for sentence and, posed; clear, since the of the sentence is I legality would not consider this sponte. issue sua DOHAN,
Evelene Executrix of the Estate David
Dohan, Deceased, Appellant, Stephen Dr. C. STAHLNECKER and Riddle Hospital.
Superior Pennsylvania. Court of
Argued 8, March 1981. 25,
Filed March 1983.
Reargument Denied June 1983. Petition for Appeal Allowance of Granted Nov. Wickersham, J., and filed statement. dissented *2 II, Media, E. Lippincott, Edwin for appellant. Media, Riddle, C. Beatty, appellee. William CERCONE, Judge, Before President and WICKERSHAM BROSKY, JJ. CERCONE, President Judge: in appeal The sole issue raised lower in in setting court erred its to the forth parties proper light regarding contentions of the appellee hospital care dece- by appellant’s owed record, a of the hold Upon thorough dent. review we now concerning this matter the lower court’s instructions n were and order a unduly vague. Accordingly, reverse new trial. Dohan, appellant’s Mr. David September .
On decedent, his home was located awoke at 6:00 a.m. at which (here- Hospital from Riddle Memorial appellee, a miles few complained pain Mr. Dohan “Riddle”). Initially, inafter attack soon arms, of a heart symptoms but the other Stahlnecker, long time and Dr. a themselves manifested decedent, was physician personal friend and family he Dohan that would advised Mrs. The doctor summoned. However, Doctor when immediately. her residence come to hour, Mrs. Dohan half within one did not arrive Stahlnecker to Riddle. her husband transport an ambulance called him of this and advised Dr. Stahlnecker telephoned then She He, turn, course of action. alerting called Riddle room to the fact that a of his was on the to that way facility, suffering pains, chest that Dr. Stahlnecker would meet the at Riddle.
Dr. Stahlnecker at a arrived Riddle few minutes before the decedent who was taken immediately emergen- into room. cy The Riddle was staffed a emergency facility by nurse, nurse, technician, a registered practical EKG a resident physician sub-specialty with At cardiology. request of Dr. Stahlnecker an EKG was taken which was thereafter read Dr. then shown the resident physician, Kohutiak. The EKG confirmed had, indeed, decedent a myocardial suffered infarc- tion—a heart attack. trial,
At medical testimony was adduced to show that *3 there is a risk high of death the two hour period follow- ing the onset of a great heart attack. This risk is encoun- tered due to temporary heart rhythm alterations —a condi- tion arrhythmia. called Deaths occur during seldom this however, period, critical where life-sustaining facilities are is undisputed available. It that has Riddle such facilities and that it fully equipped to adequately staffed care Nevertheless, for victims of coronary attacks. Dr. Stahl- necker was unaware of this fact and testified trial a at had him nurse told that Riddle not coronary did have a care Thus, unit. the doctor announced that he was going to Mr. have Dohan taken to Hospital Lankenau where he was on the staff. When Mr. Dohan and his wife asked about change the reason for the of Dr. hospitals, Stahlnecker replied: “They don’t the have facilities here to care for this kind of a case.” Mrs. Dohan testified that this statement presence was made of the resident Dr. physician, Kohutiak, hearing but doctor denied the statement and Stahlnecker, Dr. family doctor, having did recall not spoken these exact words. Unfortunately, Mr. Dohan died on the way Hospital to Lankenau due a sudden onset of arrythmia. important
It is to note that at no time did any Riddle’s Emergency personnel Room inform Dr. Stahlnecker or the fact that Riddle adequate D.ohans had facilities to the patient, care for nor did inform them great a cardiac dangers transporting involved so soon fact, In after his attack. Dr. Stahlnecker testified that one nurses him hospital’s registered told had no supporting equipment life meet Mr. Dohan’s heart result, As problem. a the decedent was from the removed emergency placed room at Riddle and the same ambu- him to hospital. lance that had taken The Riddle trial, protest. this and did not At Dr. employees watched he did suggested Kohutiak not want interfere with doctor-patient relationship between the decedent and Dr. himself that he Dr. Stahlnecker.1 Stahlnecker testified ignored any suggestions made Dr. Kohutiak would have However, this regard transporting patient. with to not informed, understandable, since Dr. testified, sustaining not the life Riddle did problems. According heart facilities for Mr. Dohan’s information, try him not to no reason for there would be treat- proper life-supporting Lankenau for get ment. however, appeal, was the significant purposes of this More president Laughlin, the of Riddle testimony Mr. Donald elicited from Jocomo, registered nurse who Hospital, and Ms. Marion appellee’s room. upon his arrival at to Mr. Dohan attended physi- upon testimony imposed a resident the duties concerned This Kohutiak, case, cian, hospital’s by-laws to state in under the in this *4 together with the of a writing approval of the transfer Dr. Kohutiak admitted supporting a decision. precise such reason by employment Riddle as during period of his person- by hospital other informed physician, had never been he by-laws. testified Dr. Kohutiak responsibilities such under of his nel played he, hospital regulations, apparent violation of further transport Mr. Dohan in the decision virtually no whatsoever role facility. treatment another question of to the and relevant equal importance, Of patient, are Mr. as a regarded Mr. Dohan itself appellee patient”, "the at trial as Mr. Dohan persistent Laughlin’s references hospital for by was billed Mrs. Dohan the fact that performed. services prior
Just to the commencement of trial, the jury against claim Dr. Stahlnecker was settled and a joint tort- feasor’s release was executed.2 At the conclusion of the trial, the jury rendered a verdict in favor of both defend- ants, Dr. Stahlnecker and Riddle Hospital. Ap- motion for pellant’s a new trial was denied and this appeal followed.
In this appeal, Mrs. Dohan through asserts her counsel that the trial court erred refusing charge the jury as a matter of law that decedent herein was a emergen- cy to whom of reasonable care is owed. The trial court addressed this issue when responding to appellant’s motion for a new trial: opinion
It was the of the Trial Judge the issue of decedent, the status of the at the time was physically room, within the confines of the emergency was a ques- tion of fact that was to be subject jury determina- Taking tion. that issue of fact from the ambit of jury determination would be an invasion of the function of the jury as fact-finder.
Our judicial system is based upon the experience of ordinary law, individuals—the jury applying as stat- —in ed judge, to the facts of the case are presented court. A judge’s is, to the jury there- fore, part a crucial of our judicial system for without proper instruction, jurors would be left to surmise and conjecture in the adjudicative process. The late Justice Musmanno elaborated somewhat colorfully on precisely point:
Where the jury being law, instructed on the the lan- guage must imperative. be A has no latitude of interpretation It, in the realm course, of the law. has plenary authority weigh the value controverted (that facts indeed function) is its primary and to deter- mine on the scale of credibility what witnesses are to be believed and not believed. But legal principles where are knowledge 2. Because of Dr. Stahlnecker’s settlement would undoubt- edly prejudicial upon have had a effect jury, the trial commenced party as if Dr. Stahlnecker were still a to this action. *5 284
involved have no they discretion whatever. They must obey ship’s the as a judge obey crew must captain, their building as must workers the follow of the blueprints architect; nurses carry through as must told what is them by surgeon, the and must pupils faithfully as heark- en to their teacher. But in order demonstrate that receive, and loyalty put into effect the they instructions the subordinates must the are know what instructions A and what mean. ship’s captain who shrouds in ambiguity orders or indecisiveness chance of takes the having his run onto rocks of Instruc- ship the disaster. tions the which doubt the mind of the jury suggest as the the judge only to what law is can introduce into should be indef- jury certainty, box confusion where there sureness. at its best initeness where there must be Law Jurors, complexities average is a maze of layman. therefore, way through not asked find their own are be must a surefoot- They webwork. jurisprudential v. guide judge. must be Lobalzo guide, ed 15, (1962). Varoli, 409 Pa. charge a reviewing judge’s jury,
When in its in order charge entirety court will view appellate has misled. jury if the been to determine jury to the instructions determining In whether Court’s whole, as a erroneous, charge must consider are reverse, not even we will misleading, if it not or misstatements. some inaccuracies may there be though if, excerpts upon isolated predicated Error cannot be a true charge, the remainder read with when is revealed. charge correct Ct. Pa.Superior 245 Hospital, Mawr Bryn v. McAvenue 743, (1976), Sherman quoting 745-46 507, 513, 369 A.2d 67, 132 Co., 389 Pa. Heat Light Manufacturers cannot lower court (1957). Accordingly, A.2d when present error prejudicial unless reversed be as a whole. is viewed to the issue of owed a Germane decedent, judge appellant’s charged *6 follows:
Now, this case plaintiff hospital, in has sued the which is a and I Hospital, corporation Riddle determining corporation whether you negligent, you may corporation was consider whether the have taken steps emergency should to advise its standards, of those personnel bylaws, policies proce- operation dures which related to the of the emergency room.
Now, will have various you regulations those as to you will consider this particular instance they obligation were—had a or duty these regulations. follow
Now, Mr. Cherry, plaintiff’s attorney, contends regulations. had these They duty were bound to follow them. David Dohan did come under the control of emergency room as such and that the personnel there duty step had a in our say we are in control here and this man doesn’t leave. recall,
He’s also if contending you that if didn’t at that, least do there duty part was a on the of the hospital personnel look, tell Dr. Stahlnecker have every- we thing you need here for to care this man. He’d contend- ing there was this obligation. They perform failed to is negligence and that negligence and that is because the personnel directives, did not follow the up standards set here. But that’s all for you consider.
Now, hand, on other the hospital especially contending yes, we regulations, have rules and but they didn’t control such situation as this. man This never patient. became our All we did under these circum- stances let treat there and him the furnish machine to take the—the operator EKG machine. When given, he wanted this injection let our nurse do it. But we never in control. were We any didn’t have anything to do other than what we did and even if regulations our should otherwise, indicate these regulations were not up set every particu- cover lar case that may up come and certainly the situation such as here where the patient’s own physician was present and acting.
In determining whether Riddle Hospital through its employees were negligent in its treatment of David Do- han, you are instructed that a hospital may be held liable for permitting its facilities to be used by a physician under circumstances where it knew or should have known of such act of malpractice you will recall the testimo- isny they didn’t know they part. took no Dr. Kohutiak left there and so forth. You will have to determine from *7 what the hospital had here. I have out- .facts lined to you principles of law that you are to follow.
In determining the relative roles or relationships be- tween the emergency physician room you may consider the Mr. testimony Laughlin, president of Riddle. And his testimony, recollection, my —you will have to determine what it was.—is' that under bylaws standards and the primary responsibility in room is on emergency room emergency physician supplied by hospital. appellant subsequently requested
Counsel for that the fol- lowing points for read to the jury: be if you
7. Even find that re- attending physician Dohan, in charge mained of David Riddle neverthe- responsible less remained for those services or acts which, according good practice, medical it should Providence, performed. Aldan v. 382 F.2d [sic] (D.C.Cir.1967). 163 person brought hospital emergency is to a Once
room, is for care and treat- person accepted and that ment, unreasonably must not act allow- hospital from the The law ing premises. him to be removed patient kept that such at the requires be that or removed if it is not transferred foreseeable aggravated danger condition will be or his increased by such removal or transfer. Hospi- LeJeune Road Watson, 1965). 202 (Fla.App. tal So.2d Judge The granted this these request points read verbatim. He then appellee went on to reiterate the hospi- tal’s in response contention to these points: course, here, course,
Of the contention physi- room, he cally emergency was our but was not an emergency room ours. He was Dr. Stahlneck- er’s But will patient. you have to determine this from the facts.
Appellant’s took exception Judge’s counsel addi- tional hospital’s reference to the requested contention and Judge that the eliminate that contention as a matter of law and thereby remove the issue from the jury: If the please, Court I’m
[PLAINTIFF’S ATTORNEY]: asking your Honor to rule in this case a matter of law that David Dohan an emergency patient. room I’m asking your Honor to eliminate from the Jury’s considera- tion the defense that the has injected into this case and that can find or they liberty are at find he was not an I patient. do not believe the law will permit finding from this evidence and I ask your Honor rule as a matter of law that he was an emergency Jury direct the their deliberations to find that evidence.
THE COURT: Refused. *8 I move for the with-
[PLAINTIFF’S ATTORNEY]: of drawal a Juror.
THE COURT: Refused. this
Viewing charge entirety, its we conclude that the was not jury given the of benefit clear sufficiently the instructions on matter of the duty of care by owed appellee to hospital appellant’s decedent as a matter of law under the of Appellee facts correctly instructs case. its brief that the lower appellant’s points court read for # # charge 7 8 in However, verbatim fashion. arewe compelled to agree appellant with # although points 7
288 # legal 8 constitute accurate statements of the of to by hospitals persons
care owed receiving emergency treatment,3 room the court’s subsequent regard- statement ing appellee’s response points inescapable to these had the eradicating imperative effect of the force with which instructions on the applicable court’s law should be invari- context, gratuitous cloaked. Read the court’s refer- ably appellee’s argument regarding ence to Mr. Dohan’s status to the permitted jury the draw inference that it could disregard entirely the court’s to respect instructions with Mr. Dohan the affirmative duties owed the to under facts of this case. The instructions the the enabled find as contended that Mr. Dohan never jury appellee hospital’s emergency the control of the came under authority to actually enjoyed The issue of who the staff. of Mr. as a properly control the treatment Dohan viewed wholly independent itself of the matter of law and was according opinion, hospital, of to its question whether clearly duties Mr. Dohan or not breach its as did did The requested charge. for appellant’s points outlined court’s defect the lower crucial allegations hospital’s plaintiff’s evidence with equated the difference. The jury not and did make clear leaving jury charge was tantamount effect of the said, if didn’t “we impression with patient”, consider hospital despite in favor a verdict could render equita- more for that cried out plaintiff presented by facts its staff defense that appellee’s In view ble treatment. (1975), Matzko, Pa.Superior Ct. See Fabian (Second) § adopted Tort specifically Restatement wherein entirety: its (1965) reads in which consideration, undertakes, to render gratuitously or who One recognize necessary for the he should another which services to liability things, subject person or protection of the other's resulting to exercise from his failure physical harm the other for undertaking, if perform his care to reasonable risk of such (a) care increases exercise such his failure to harm, or upon the reliance the other's (b) because of suffered the harm is undertaking. *9 left the responsibility care solely Stahlnecker while inactive, they sat mute and the court failed to take into consideration, in its that the charge, “captain of the ship doctrine”, upon hospital apparently predicated which the its opinion Dohan, no responsibility had to Mr. is not 246, viable Pennsylvania. Wagner, Tonsic v. 458 Pa. (1974). A.2d 497
Accordingly, since the lower court’s failed to distinguish allegations, between evidence and did not have the benefit of proper guidelines to decide this case. aAs result the court erred denying appellant’s motion for a new trial. Reversed and remanded for a new trial.
Jurisdiction is relinquished. J.,
WICKERSHAM, files a dissenting statement. WICKERSHAM, Judge, dissenting: I DISSENT. I would affirm on the opinion of the trial judge, the Wright. Honorable Robert A. KNAUER, Appellant,
David W. Edward SALTER. Superior Pennsylvania. Court of
Argued 13, Dec. 1982. 25,
Filed March 1983.
Reargument Denied June 1983.
Petition for Appeal Allowance of Denied Oct.