Category Archives: Medical Malpractice

How to Find a Lawyer When Your Baby Suffers a Birth Injury

Having a baby is a joyous and exciting experience for most families. Unfortunately, sometimes complications during childbirth can cause serious injuries to babies. When this happens, it can be a devastating experience for parents. To ensure that their rights are protected and that their baby receives the best possible care, it’s important for families to find a lawyer who specializes in birth injury cases. This article will provide information on how to find a lawyer when your baby suffers a birth injury.

Understand the Types of Birth Injuries

The first step to finding a lawyer when your baby suffers a birth injury is to understand the types of birth injuries that can occur. Birth injuries can be divided into two categories: those caused by medical negligence and those caused by natural causes. Medical negligence occurs when a medical professional fails to provide a standard of care that a reasonable person would expect. Natural causes, on the other hand, are caused by factors beyond the control of the medical professional, such as a baby’s size or a mother’s health.

Sometimes a birth injury can occur as a result of natural causes or medical malpractice. In these cases, you will likely need an experienced medical malpractice attorney to help identify the specific cause of a birth injury. For instance, cerebral palsy can and does occur without medical malpractice. However, sometimes cerebral palsy results from intraventricular hemorrhaging that could have been avoided had a baby been delivered sooner. Prenatal hypoxia is one cause of intraventricular hemorrhage. Causes of Intraventricular Hemorrhage

Research Local Lawyers

Once you have a better understanding of the types of birth injuries that can occur, the next step is to begin researching local lawyers who specialize in birth injury cases. Start by looking for lawyers who are members of relevant legal associations.  For instance, if you are looking for an experienced medical malpractice lawyer in Pennsylvania, you should search for a lawyer who is a member of the Pennsylvania Association of Justice. PAJ The PAJ provides resources to help families find experienced lawyers who specialize in birth injuries.

Check the Lawyer’s Credentials

Once you have identified a few potential lawyers, it’s important to research their credentials to ensure they are qualified to handle your case. Look for lawyers who have experience in handling birth injury cases, as well as those who have a proven record of success. You should also ask for references from former clients, or look for online reviews, to get an idea of the lawyer’s reputation.

Schedule a Consultation

Once you have narrowed down your list of potential lawyers, it’s time to schedule a consultation. During the consultation, ask questions about the lawyer’s experience with birth injury cases, the process for filing a claim, and the estimated cost of their services. You should also be prepared to discuss the details of your case and provide any relevant medical records.

Make Your Decision

After your consultation, it’s time to make a decision about which lawyer to hire. Consider factors such as the lawyer’s experience, the cost of their services, and the type of compensation you may be entitled to. It’s also important to trust your instincts and choose a lawyer who you feel comfortable working with.

Conclusion

When a baby suffers a birth injury, it’s important for families to find a lawyer who specializes in birth injury cases. The best way to find a lawyer is to understand the types of birth injuries that can occur, research local lawyers, check the lawyer’s credentials, schedule a consultation, and make an informed decision. With the right lawyer on your side, you can ensure that your rights are protected and that your baby receives the best possible care.

James Goslee is an experienced medical malpractice, personal injury and product liability trial lawyer in Philadelphia.  James Goslee is a Super Lawyer who is a shareholder at CPR Law.  James Goslee can be reached at or on linked in at LinkedIn or by phone at 215-567-3500.

Intrapartum Interventions for Preventing Shoulder Dystocia

We had previously written about shoulder dystocia injuries caused by medical malpractice (Medical Malpractice and Shoulder Dystocia). In this article, we will explore how following the standard of care and properly managing delivery can prevent permanent injuries associated with shoulder dystocia. 

Shoulder dystocia (SD) is a serious obstetric complication that occurs during delivery when the baby’s shoulder gets stuck behind the mother’s pubic bone. It is diagnosed when the baby’s head is delivered, but the shoulders remain stuck behind the mother’s pubic bone. This can lead to severe birth trauma, including neonatal asphyxia, brachial plexus injury, and even fetal death.

It is estimated to occur in 0.3–3% of all vaginal deliveries, with higher rates in certain risk factors such as larger than average babies, diabetes, and macrosomia. As such, it is important to take precautionary measures to prevent shoulder dystocia from occurring in the first place. Intrapartum interventions, including fetal monitoring, external cephalic version, and the use of forceps and vacuum extraction, are used to reduce the risk of SD and its associated complications.

Ultrasound

Ultrasound is used to predict shoulder dystocia by measuring the size of the baby.  Babies that are bigger than normal (sometimes called macrosomia) often have a higher risk of shoulder dystocia. The doctor can also look for other signs of shoulder dystocia on the ultrasound, such as a larger than normal space between the baby’s shoulder blades. If these signs are present, there is an increased risk of shoulder dystocia and the doctor should discuss this with their patient and can take steps to reduce the risk.

Fetal Monitoring

Fetal monitoring is a non-invasive approach used to assess the baby’s well-being during labor. It can be done with either a fetal heart rate monitor or an ultrasound to detect any abnormalities in the fetal heart rate or in the presentation of the baby. Fetal monitoring can help detect signs of fetal distress that can be associated with a slow progression of labor and subsequent shoulder dystocia.

External Cephalic Version (ECV)

External cephalic version (ECV) is a procedure used to manually turn the baby in the uterus from a breech position to a cephalic (head-first) position. This can reduce the risk of SD since the baby’s head is larger than the shoulders, and the head-first presentation can make it easier for the baby to pass through the mother’s pelvis. ECV is generally only recommended for breech pregnancies, and it is not recommended for women with certain risk factors such as placenta previa or a history of uterine surgery.

Forceps and Vacuum

Extraction Forceps and vacuum extraction are two instruments used to assist in delivery. Forceps are curved blades that fit around the baby’s head, and they are used to guide the baby’s head out of the birth canal. Vacuum extraction is a procedure in which a plastic cup is attached to the baby’s head, and suction is used to help guide the baby’s head out of the birth canal. Both of these instruments can reduce the risk of SD by helping to guide the baby’s head out of the birth canal and reduce the risk of a prolonged second stage of labor.

Shoulder Dystocia and Medical Malpractice

Shoulder dystocia is a serious obstetric complication that can lead to severe birth trauma and even death if not managed properly. Intrapartum interventions, such as ultrasound, fetal monitoring, external cephalic version, and the use of forceps and vacuum extraction, are often used to reduce the risk of shoulder dystocia and its associated complications. It is important for healthcare providers to be aware of the risk factors for shoulder dystocia and to recommend the appropriate intrapartum interventions for women at risk.

Although shoulder dystocia can be difficult to predict, often serious injury can be prevented if medical providers properly manage the delivery and follow the standard of care. In some cases, injuries from shoulder dystocia are caused by medical malpractice. If a medical professional fails to provide the expected level of care, then the patient or their family may be eligible to file a medical malpractice lawsuit in Philadelphia.

James Goslee is an experienced medical malpractice, personal injury and product liability trial lawyer in Philadelphia.  James Goslee can be reached at CPR Law or on linked in at LinkedIn

References American College of Obstetricians and Gynecologists. (2018). Practice Bulletin No. 201: Shoulder dystocia. Obstetrics & Gynecology, 132(3), e112-e125 (Pub Med)

Hill M., R., Cohen, W. (2016). Shoulder Dystocia: Prediction and Management (Managing Shoulder Dystocia

Nelson K., Sartwelle, T, Electronic fetal monitoring, cerebral palsy, and caesarean section: assumptions versus evidence (Fetal Monitoring)

Cerebral Palsy and Medical Malpractice in Philadelphia

Cerebral palsy is a lifelong physical disability that affects movement, posture, and balance. It is caused by damage to the parts of the brain that control movement, usually occurring before, during, or shortly after birth. Unfortunately, some cases of cerebral palsy are caused by medical negligence or malpractice. If a medical professional fails to provide the expected level of care, then the patient or their family may be eligible to file a medical malpractice lawsuit in Philadelphia.

What Is Cerebral Palsy?

Cerebral palsy (CP) is a neurological disorder that primarily affects the ability to control movement. It is caused by damage to the parts of the brain that control movement, usually occurring before, during, or shortly after birth. The extent of the damage and the area of the brain affected will determine the type of CP and the severity of the symptoms.

Common symptoms of Cerebral Palsy include:

  •   Muscle stiffness
  • Stiff or weak muscles
  • Poor coordination and balance
  • Abnormal gait
  • Difficulty speaking
  • Difficulty eating
  • Seizures
  • Visual impairments

What Causes Cerebral Palsy?

The epidemiology of cerebral palsy has been studied closely for years. Cerebral palsy can be caused by a variety of factors before, during, or after birth, including:

  • Lack of oxygen to the brain (anoxia or hypoxia)
  • Infections, such as meningitis or encephalitis
  •  Genetic disorders
  • Intracranial hemorrhage
  • Traumatic brain injury
  • Physical trauma during childbirth
  • Prolonged labor
  • Maternal health conditions, such as diabetes or hypertension
  • Exposure to toxins, such as lead or mercury
  • Medical negligence or malpractice

Medical Malpractice and Cerebral Palsy

When a medical professional fails to provide the expected level of care, the patient or their family may be eligible to file a medical malpractice lawsuit. In the case of cerebral palsy, medical negligence or malpractice can include:

  • Failing to recognize symptoms of fetal distress
  • Failing to order a C-section in a timely manner
  • Failing to properly monitor the mother or baby during labor and delivery
  • Failing to diagnose or treat an infection
  • Failing to diagnose or treat a genetic disorder
  • Failing to diagnose or treat an intracranial hemorrhage
  •  Failing to treat a traumatic brain injury
  • Failing to recognize or treat a mother’s health condition
  • Failing to recognize or treat an exposure to toxins

Filing a Medical Malpractice Lawsuit in Philadelphia

If you or your loved one has been diagnosed with cerebral palsy due to medical negligence or malpractice, you may be eligible to file a medical malpractice lawsuit in Philadelphia. Before filing a claim, you should consult a law firm with experience handling medical malpractice cases in Philadelphia. An experienced medical malpractice lawyer can help you determine if you have a valid claim.

Experienced medical malpractice lawyers will investigate your case and determine whether the medical professional failed to provide the expected level of care. If the medical professional did not provide the expected level of care and you suffered an injury, then you may be eligible to receive financial compensation for medical bills, lost wages, and pain and suffering.

Conclusion

Cerebral palsy is a lifelong physical disability that affects movement, posture, and balance. It is caused by damage to the parts of the brain that control movement, usually occurring before, during, or shortly after birth. Unfortunately, some cases of cerebral palsy are caused by medical negligence or malpractice. If a medical professional fails to provide the expected level of care, then the patient or their family may be eligible to file a medical malpractice lawsuit in Philadelphia.

James Goslee is an experienced medical malpractice, personal injury and product liability trial lawyer in Philadelphia.  James Goslee can be reached at CPR Law or LinkedIn

Shoulder Dystocia Injuries and Medical Malpractice Claims in Philadelphia

Shoulder dystocia is a serious medical condition that can occur during childbirth when the baby’s shoulder becomes stuck behind the mother’s pelvis during delivery. This can be a life-threatening situation for both the mother and the baby, and if the medical team does not take the appropriate steps to prevent or treat the shoulder dystocia, the baby can suffer serious injuries. In this article, we will explore shoulder dystocia injuries, how they can be prevented, and how to bring a lawsuit when an injury occurs.

What Is Shoulder Dystocia?

Shoulder dystocia is a medical complication that can occur during labor and delivery when the baby’s shoulder becomes stuck behind the mother’s pubic bone. This can cause the baby to become stuck in the birth canal and can be a potentially life-threatening situation. Shoulder dystocia is a relatively rare condition, occurring in approximately only one to two percent of all births.

What Are the Symptoms of Shoulder Dystocia?

The primary symptom of shoulder dystocia is the baby’s shoulder becoming stuck behind the mother’s pelvis.

Other symptoms may include:

• Prolonged labor

• Excessive bleeding

• Decreased fetal heart rate

• Weak maternal pulse

• Fetal distress

• Abnormal fetal positioning

What Are the Risks of Shoulder Dystocia?

Shoulder dystocia is a serious medical condition that can have serious consequences, including:

• Fetal hypoxia – This occurs when the baby is deprived of oxygen due to the shoulder dystocia.

• Brachial plexus injury – This is an injury to the network of nerves that connect the shoulder, arm, and hand.

• Bone fractures – The baby may suffer broken clavicles, humerus, or other bones due to the shoulder dystocia.

• Neonatal death – In some cases, shoulder dystocia can result in the death of the baby.

How Can Shoulder Dystocia Be Prevented?

Shoulder dystocia can be difficult to predict in advanced. However, the risks of injury can be reduced by taking certain steps before, during, and after labor and delivery. These steps include:

• Educating the mother about the risk factors for shoulder dystocia.

• Monitoring the baby’s heart rate during labor to detect any signs of distress.

Performing an ultrasound to detect any potential problems before labor begins.

 • Using specialized techniques to help reduce the risk of shoulder dystocia.

• Scheduling a cesarean section if the baby is in the breech position or if the physician believes there is an elevated risk of a dystocia occuring.

What Should You Do If Your Baby Suffers an Injury Due to Shoulder Dystocia?

If your baby has suffered an injury due to shoulder dystocia, you may be able to file a medical malpractice lawsuit. In order to do so, you will need to prove that the medical team failed to take the appropriate steps to prevent or treat the shoulder dystocia. You will also need to prove that the injury was a direct result of their negligence. In order to prove your case, you will need to gather evidence such as medical records, expert witness testimony, and other evidence that supports your claim. You will also need to hire a medical malpractice attorney who can help you navigate the legal system and ensure that your rights are protected.

Conclusion

Shoulder dystocia is a serious medical condition that can have serious consequences, including fetal hypoxia, bone fractures, and even death. It is important for medical teams to take the appropriate steps to prevent shoulder dystocia and to treat it quickly and effectively if it does occur. If your baby has suffered an injury due to shoulder dystocia, you may be able to file a medical malpractice lawsuit. In order to do so, you will need to hire an experienced medical malpractice attorney who can guide you through the legal process and ensure that your rights are protected.

James Goslee is an experienced medical malpractice, personal injury and product liability trial lawyer in Philadelphia.  James Goslee can be reached at https://cprlaw.com/attorneys/james-p-goslee/ or on linked in at https://www.linkedin.com/in/james-goslee-8214415/

Bringing a Birth Injury Lawsuit in Pennsylvania

Introduction

If your child has suffered a birth injury in Pennsylvania, you may be considering filing a lawsuit against the hospital or doctor responsible for the injury. Birth injuries can range from minor to severe, and they can have long-term physical, psychological, and financial consequences for your family. Knowing what to expect when bringing a birth injury lawsuit in Pennsylvania can help you prepare for the legal process and manage the emotional toll. This guide will provide an overview of the steps to filing a birth injury lawsuit in Pennsylvania.

Step 1: Review the Statute of Limitations

The statute of limitations determines the amount of time you have to file a lawsuit in Pennsylvania. Generally, the statute of limitations for medical malpractice cases in Pennsylvania is two years. However, if your child was under the age of 18 when the injury occurred, the statute of limitations will not begin to run until they reach the age of 18. It is important to be aware of the statute of limitations to ensure that you do not miss the deadline to file your lawsuit.

Step 2: Collect Evidence

To build a strong case, you will need to collect evidence to prove your claim. This can include medical records, witness statements, and other forms of evidence that can prove that the hospital or doctor was negligent and caused your child’s injury.

Step 3: Set Up a Consultation with a Birth Injury Attorney

Once you have collected the necessary evidence, it is time to set up a consultation with a birth injury attorney. During the consultation, the attorney will review your evidence and discuss the potential for a successful lawsuit. It is important to choose an attorney that has experience handling birth injury cases in Pennsylvania.

Step 4: Determine Which Parties to Name in Your Lawsuit

It is important to determine which parties you will name in your lawsuit. Depending on the circumstances and the evidence, you may be able to name the hospital, doctor, or both in your lawsuit.

Step 5: File the Lawsuit

Once you have determined the parties to name in your lawsuit, you can file your lawsuit. This involves filing a complaint with the court and serving the defendants with the complaint. The defendants will then have a certain amount of time to respond to the complaint.

Step 6: Prepare for Mediation

Mediation is a process where the parties come together to try to resolve the dispute without going to trial. A mediator, who is usually a lawyer, will facilitate the mediation. The goal is to resolve the dispute as quickly and as amicably as possible.

Step 7: Prepare for Trial

If mediation is not successful, the case will go to trial. During the trial, both sides will present evidence and witnesses to prove their case. The judge or jury will then decide who is responsible for the birth injury.

Conclusion

Bringing a birth injury lawsuit in Pennsylvania can be a challenging and emotional process. Knowing the steps to filing a birth injury lawsuit in Pennsylvania can help you prepare for the legal process and manage the emotional toll. It is important to consider the statute of limitations and to collect evidence, set up a consultation with a birth injury attorney, determine the parties to name in your lawsuit, file the lawsuit, prepare for mediation, and prepare for trial.

James Goslee is an experienced medical malpractice, personal injury and product liability trial lawyer in Philadelphia.  James Goslee can be reached at https://cprlaw.com/attorneys/james-p-goslee/ or on linked in at https://www.linkedin.com/in/james-goslee-8214415/

Amending a Civil Complaint in Pennsylvania After the Statute of Limitations? Beware of the “New Theory of Liability” Myth

For trial lawyers, drafting and filing a Civil Action Complaint is an obvious and important step in litigation. The Complaint is the document that literally starts a lawsuit. But it is more than that. Much more. Although it is filed at the very beginning of a case, the Complaint, and specifically the allegations and causes of action set out in the Complaint, is the foundational document that controls the scope of the litigation and the availability of remedies. So you better get it right.

A plaintiff can only purse the specific claims (causes of action) against a defendant that are “pled” (i.e “alleged”) in the Complaint. If you don’t plead a cause of action, you cannot pursue it and you cannot recover for it. So needless to say, it is important to understand what causes of action you have before filing a Complaint.

Unfortunately, what constitutes a “cause of action” is not always clear and a number of sloppy Superior Court opinions in recent years have made it even more challenging.

“Causes of Action”

But lets start with the basics. What is a cause of action and why does it matter? Say, for example, you undergo surgery and things go badly. Sadly, you are permanently injured. Assume also that you believe your surgeon did two things wrong that caused your injury. First, he made a mistake during surgery and that mistake contributed to your injury. Second, the surgery he performed was different from the surgery you agreed on. In this scenario, you have at least two different causes of action. One cause of action is medical negligence (the doctor made a mistake). The second cause of action is one for lack of informed consent (the doctor did not have permission to perform the surgery). In this scenario, you need to include both causes of action in your Complaint. If you forget to plead one of the causes of action and the statute of limitations expires, you are out of luck.

“The Myth”

But in recent years, lawyers and courts have blurred the line between a cause of action (which needs to be pled), and a theory of liability, which does not. What do I mean? Well lets go back to our previous example. Say you file a Complaint after your surgery alleging both medical negligence and lack of informed consent. Assume further that your claim for medical negligence is that the doctor accidentally cut a specific nerve in your knee during surgery leaving you with limited function in your leg. When you file your Complaint you include an allegation that the doctor accidentally cut nerve A. Turns out though, that the doctor did not accidentally cut nerve A. He used the wrong medical equipment which led to your nerve injury. In either case nerve A is injured and you still can’t use your leg. If you wanted to amend your Complaint after the statute of limitations, under Pennsylvania law you absolutely should be permitted to do so. Why? Because you are not alleging a new cause of action (your claim is still that the surgeon committed medical negligence that caused nerve damage), you are only revising your theory of liability (wrong equipment instead of accidentally cutting a nerve).

Over the years, both trial courts and even the Superior Court have begun to blur the distinction between a “cause of action” and a “theory of liability.” The result is that courts have disallowed amendments after the statute of limitations, even when those amendments do not change the cause of action, but merely seek to alter or expound upon the theory liability. For instance, the Superior Courts decision in Reynolds v. Thomas Jefferson Hospital flat out ignores the distinction between a cause of action and a theory of liability. That decision is wrong, but still has not been corrected.
The upshot is that it is now common practice for defense attorneys to object to motions to amend a complaint, claiming that a plaintiff should not be permitted to allege a “new theory of liability” after the running of the statute of limitations. This is completely wrong. It is a modern legal myth in desperate need of correction.

So lets work on that correction!

The “Real” Law

The Pennsylvania Supreme Court has long held that the “right to amend should be liberally granted at any stage of the proceeding  unless there is an error of law or resulting prejudice to an adverse party.” Werner v. Zazyczny, 681 A.2d 1331, 1338 (Pa. 1996). The reason for freely allowing amendments is to “secure a determination of the case on the merits whenever possible, and not enforce technical rules of pleading.” In re Francis Edward McGillick Foundation, 594 A.2d 322, 329 (Pa. Super. 1991), aff’d in part, rev’d in part on other grounds, 642 A.2d 467 (Pa. 1994).

Not only should amendments be liberally permitted, but trial courts have broad discretion to allow amendments that include more specific factual pleadings. See, e.g., Pike Cnty. Hotels Corp. v. Keifer, 396 A.2d 677, 681 (Pa. Super. 1978). The Pennsylvania Superior Court has observed that “the lower court has broad discretion in determining the amount of detail that must be averred since the standard of pleading set forth in Rule 1019(a) is incapable of precise detail.” Id. at 681.

Contrary to the defense counsel “new theory of liability” myth, it is blackletter law that a Complaint does not limit plaintiff to a specific theory of liability. Indeed, as explained by the Pennsylvania Supreme Court in Kusis v. Baldwin-Lima-Hamilton Corp., 319 A.2d 914 (Pa. 1974):

The notion that a complaint weds a plaintiff to a particular theory of liability is foreign to Pennsylvania pleading. Ours is a system of fact pleading, not “theory” pleading; a plaintiff is free to proceed on any theory of liability which the facts alleged in his complaint will support. Id. at 918, n.8; see also Zitney v. Appalachian Timber Prods., 72 A.3d 281 (Pa. Super. 2013).

Although a plaintiff may not assert a new “cause of action” after the statute of limitations has run, if an amendment “merely amplifies that which has already been averred, it should be allowed even though the Statute of Limitations has already run.” Connor v. Allegheny General Hospital, 461 A.2d 600, 602 (Pa. 1983). The Pennsylvania Superior Court addressed the issue of a “new cause of action” in Junk v. East End Fire Dep’t, 396 A.2d 1269 (Pa. Super. 1978), explaining:

A new cause of action does not exist if plaintiff’s amendment merely adds to or amplifies the original complaint or if the original complaint states a cause of action showing that the plaintiff has a legal right to recover what is claimed in the subsequent complaint. Id., at 1277.

I cite this case law because it is an accurate reflection of Pennsylvania law governing pleadings. It also obliterates the growing myth that a theory of liability is the same thing as a cause of action.

James Goslee is a trial attorney in Philadelphia and can be reached at https://jamiegoslee.com/about/

 

Medical Negligence, MCARE Act and Future Medical Expenses in Pennsylvania

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Credit: Darastar, Everystockphoto.com

Back in March 2002, Pennsylvania joined a host of other states in passing legislation aimed at insulating medical providers from liability for their negligence. Rather than accepting accountability for needless injuries caused by carelessness, physicians and large medical providers successfully lobbied to have special laws passed. Laws intended to make it more difficult for injured patients to receive compensation. Or stated another way, special laws that would make it easier for medical providers to get off the hook for their misconduct.
Citing dubious studies suggesting trial lawyers were responsible for escalating medical insurance premiums in the State (as opposed to formation and consolidation of giant health networks that placed patient care a distant second to growth and profitability), Pennsylvania passed the Medical Care Availability and Reduction of Error Act (“MCARE”). MCARE, despite its pretentious title, was a clumsily drafted tort reform act.
Among the various roadblocks to seeking justice erected by the MCARE Act was a provision that arguably makes it less profitable for trial lawyers to represent people injured by medical negligence.
Virtually all lawyers representing injured clients do so on a contingency basis. Most injured clients are unable to pay a lawyer on an hourly basis, or front the costs of litigation, which can easily run into the hundreds of thousands of dollars. Contingency fee agreements provide a solution. Clients pay nothing, no fees, no costs unless there is a recovery. If litigation does result in a successful recovery, the attorney gets an agreed upon percentage of the net recovery, normally one-third.
In medical malpractice cases, as in most personal injury cases, plaintiffs can recover (among other things) the cost of future medical expenses. Historically, juries would award future medical expenses in a lump sum amount. In other words, if a jury found a defendant negligent, it would be instructed to: (1) determine how long they thought a plaintiff would live; (2) the amount of medical expenses the injured plaintiff would incur per year; and (3) multiply those two numbers and award that amount to the plaintiff in a lump sum.
Defendants often objected to this method of calculation with a credible argument. If a jury awarded a plaintiff a specific sum of money for yearly medical expenses assuming the plaintiff would live another 10 years, but the plaintiff only ended up living 2 more years, why should they have to pay the entire amount?
The MCARE Act changed this paradigm by prohibiting juries from awarding future medical costs in a lump sum. Instead, each verdict sheet should contain a specific amount of future medical expenses, itemized per year (i.e., 2018: $100,000; 2019: $102,000). The MCARE Act also specifies that a plaintiff is only entitled to future medical awards if they are alive. So if a jury awarded a plaintiff future medical awards from 2017 to 2021, and the plaintiff died in 2018, he would not be permitted to receive the amounts awarded for 2019-2021.
But the MCARE Act threw in one more twist. Instead of a plaintiff lawyer receiving a previously agreed percentage fee for the future medical component of an award, the ACT operated to reduce the fee of the lawyer. Under the MCARE Act, future medical expenses awarded by the jury need to be reduced to present value for purposes of calculating attorney fees. So, using our previous example, if a jury awarded $102,000 for future medical expenses in 2019, that amount needs to be reduced to 2017 dollars (which will be something less than $102,000), and the lawyer will receive only a percentage of that lesser amount.
But the language of the MCARE Act is so unclear, for years defense lawyers have been arguing (frivolously) that the entire award should be reduced to present value (not just the amount awarded in attorneys fees). The upshot of this argument is that a medical defendant found liable for future medical expenses years into the future should only have to pay the present value of that award.
With respect to future medical costs, the MCARE Act states:
(b) Future Damages
(1) Except as set forth in paragraph (8), future damages for medical and other related expenses shall be paid as periodic payments after the proportionate share of counsel fees and costs based upon the present value of future damages awarded pursuant to this subsection. 40 P.S. §1303.509.
Now admittedly, this provision is very poorly written. And defense counsel have seized upon this poor draftsmanship to argue that juries need to reduce the amount of future medical awards to present value. The problem with this argument is that it is inconsistent with the purpose of the MCARE Act and really doesn’t make any sense.
Contrary to the defense bar’s arguments, the MCARE Act does not require reducing the future medical costs to present value before submitting them to a jury. In fact it requires just the opposite. Future medical costs are only reduced to present value after a verdict in order to award attorney’s fees. See Pa. SSJI (Civ.) § 14.150 (commentary).
This result is also compelled by logic. One of the benefits conferred by the MCARE Act to medical providers is that an award of future medical damages is paid out in yearly increments and only if the plaintiff is still living. Thus, considering the yearly amounts awarded by the jury are only paid in the future and only if the plaintiff is living, it would make no sense for the jury to reduce its award to present value before entering the verdict.
Judge Rambo reached this exact conclusion in a case of first impression in the Middle District of Pennsylvania in 2014. See Late v. U.S., No. 13-0756, 2014 U.S. Dist. LEXIS 112999, at *5 (M.D. Pa. Aug. 14, 2014). Two years later in Shiflett v. Lehigh Valley Hospital, Judge Carol McGinely reached the same conclusion.
But it was not until last month that the issue was finally (I think) put to rest. In Tillery v. CHOP, the Superior Court finally had an opportunity to address the issue. Following the logic of Judges Rambo and McGinley, the Superior Court rejected any argument that the MCARE Act required future medical costs to be reduced to present value by the jury. To the contrary, the Superior Court held that future medical costs are only reduced to present value for purposes of calculating attorneys’ fees.
James Goslee is a trial attorney in Philadelphia and can be reached at https://jamiegoslee.com/about/