Seels v. Tenet Helath Sys., Hahnemann, LLC, 2017 Pa Super 227, 167 A.3d 190 (Pa. Super. 2017)

Plaintiff's refusal of blood transfusion leads to precedent for the admission of a consent form even when there is no informed consent claim in the case, post Brady.

The plaintiff, Estate of Terri Seels-Davila, claimed the defendants, Hahnemann University Hospital and Drexel University College of Medicine, negligently managed the decedent’s labor and delivery, resulting in her death. The plaintiff, a Jehovah’s Witness, explicitly disclaimed the use of any blood products during the course of her labor or thereafter. Following a C-section delivery, her blood pressure dropped. Despite the advice from her doctors, she was persistent that she did not want to receive any blood products. Ultimately, it was determined the patient’s blood would simply not clot unless blood transfusions were administered. Despite repeated efforts, the patient’s family would not override her directive, and she died in the hospital. A medical malpractice suit followed. After a six-day trial, the jury returned a verdict in favor of the defendants, and the plaintiff appealed.

The plaintiff raised the following issues in its appeal: (1) whether the trial court erred in excluding the plaintiff’s claims for corporate negligence; and (2) whether it was error to permit admission of the decedent’s consent forms into evidence at the time of trial.

Concerning the claims for corporate negligence, the Superior Court made it clear that, in order to proceed with a corporate negligence claim, the plaintiff must have an appropriately qualified expert establish that: (a) the hospital deviated form the standard of care; and (b) the deviation was a substantial factor in bringing about the harm. However, the plaintiff failed to produce an expert who was competent regarding bloodless medicine-related administrative programs. The plaintiff’s expert, a critical care and emergency medicine doctor, did not provide any basis for the court to conclude that he had any specialized knowledge in bloodless medicine policies or the applicable standard of care for the hospital. As such, the Superior Court agreed that he was properly precluded.

Concerning the admission of the informed consent forms, the Superior Court seized on language from Brady v. Urbas, 111 A.3d 1155 (Pa. 2016), which states that risks of surgical procedures, in the form of either testimony or risks that appear on an informed consent sheet, may be relevant in establishing the standard of care or if, for example, the standard requires that a doctor discuss certain risks with a patient. Ultimately, the Superior Court agreed with the trial court’s decision to admit the informed consent form because it was “absolutely relevant and essential to the truth seeking function of a trial jury.” Specifically, the Superior Court found that the consent forms were admissible because they prove the decedent refused treatments that would have saved her life.

This opinion demonstrates that: (1) to submit a corporate negligence claim to a jury, a plaintiff must produce a competent expert witness to testify as to the appropriateness of the administrative policies at issue, not necessarily the specific area of medicine; and (2) when trying to admit an informed consent form into evidence, the Seels opinion is precedent even when there is no informed consent claim in the case, post Brady.

 

Case Law Alerts, 1st Quarter, January 2019

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