MCARE also changes the manner in which judgments, including future medicalexpenses, are paid. Under the statute, future medical expenses will be paid quarterly based uponthe present value of the expenses awarded with adjustments for inflation and the life expectancyof the plaintiff. 40 P.S. § 1303.509(b)(1)-(2). These periodic payments will terminate upon thedeath of the plaintiff. 40 P.S. § 1303.509(b)(5). Each party liable for all or a portion of the futuredamages shall contribute funding to the awarded periodic payments by means of an annuitycontract, trust, or other court-approved funding plan. 40 P.S. § 1303.509(b)(6). An award forfuture medical expenses is paid in a lump sum where the plaintiff stipulates that the expenses,without present value reduction, do not exceed $100,000. 40 P.S. § 1303.505(b)(8).(e)Preservation and Accuracy of Medical RecordsIn another effort to protect the safety of patients, MCARE requires that all entries into apatient’s chart must be made simultaneously with the rendering of the treatment to bedocumented, or as soon after as practically possible. 40 P.S. § 1303.511(a). Subsequent,additional, and/or reversionary entries into the patient’s chart must be clearly identified with thedate and time of their entry. 40 P.S. § 1303.511(b)(2)(i)-(ii).Additionally, MCARE addresses the consequence of an intentional alteration ordestruction of a patient’s medical records. 40 P.S. § 1303.511(c). The license of a medicalprofessional who engages is such prohibited activity is subject to suspension or revocation. 40P.S. § 1303.511(d). Furthermore, if a plaintiff can prove an intentional alteration or destructionof a medical record or entry, a jury may be instructed that such alteration and/or destructionconstitutes a negative inference. 40 P.S. § 1303.505(c).This issue was also addressed by the Philadelphia County Court of Common Pleas inBugieda v. Hosp. of the Univ. of Pennsylvania, 2007 Phila. Ct. Com. Pl. LEXIS 36 (C.P. Phila.Feb. 6, 2007). In this case, the defendant hospital argued that, pursuant to the MCARE Act, 40Pa. Cons. Stat. § 1303.511(c), a claimant must prove by a preponderance of the evidence thatthere was an intentional alteration or destruction of medical records before the jury is instructedon adverse inference due to lack of medical records produced. The Court rejected this argumentand held that there was no indication that the MCARE charge was intended to replace the chargegiven in medical malpractice actions as noted by the Superior Court in Magette v. Goodman, 771A.2d 775 (Pa. Super. Ct. 2001), appeal denied, 790 A.2d 1017 (Pa. 2001). The Court reasonedthat the general rule regarding adverse inference in medical malpractice actions applies when aparty fails to produce the records that would be in its interest to produce and does not necessarilydepend on the destruction or alteration of medical records.(f)Expert QualificationsIn order to be qualified to give expert medical testimony at a medical malpractice trial,the proposed expert must possess sufficient education, training, knowledge and experience toprovide credible, competent testimony. 40 P.S. § 1303.512 (a); see, e.g., Wexler v. Hecht, 928A.2d 973 (Pa. 2007). Additionally, MCARE establishes additional standards for qualification ofan expert in a medical liability case. 40 P.S. § 1303.512. Under the Act, in order to qualify as anexpert, a physician must possess an unrestricted medical license in any state (including theDistrict of Columbia), and have been engaged in active clinical practice or teaching within the100
previous five years. 40 P.S. § 1303.512(b)(1)-(2). The expert must also be familiar with theapplicable standards for the care at issue, and the expert must have practical experience in thesame subspecialty as the defendant physician, or be board-certified by the same or similarapproved board as the defendant doctor. 40 P.S. § 1303.512(c).The court may waive the subspecialty requirement for an expert if the defendantphysician provided care for a condition not within the defendant physician’s specialty. Undersuch circumstances, the court will certify a proposed expert where that proposed expert is trainedin the treatment of the condition for which the defendant physician actually treated (where suchcondition is outside of the specialty of the defendant doctor). 40 P.S. § 1303.512(d)However, many of these qualifications may be waived if the Court finds that the expertotherwise “possesses sufficient training, experience and knowledge to provide the testimony as aresult of active involvement in or full time teaching of medicine in the applicable subspecialty,”thus leaving the competency of the witness largely within the discretion of the trial judge. 40P.S. § 1303.512.(g)Statute of ReposeFor causes of action arising on or after March 20, 2002, a seven-year statute of reposewill apply. 40 P.S. § 1303.513. This provision will bar the commencement of a lawsuitasserting medical malpractice more than seven years from the date of the alleged tort or breachof contract. 40 P.S. § 1303.513(a). The Statute of Repose affects the influence of the “discoveryrule.” The “discovery rule” tolls the two-year statute of limitations for personal injuries until thepatient becomes aware of the alleged tort, or reasonably should have become aware of thealleged tort. Prior to the enactment of MCARE, the discovery rule was available to delay theexpiration of the statute of limitations for many years under certain circumstances. However,MCARE now limits the amount of time that the discovery rule can toll the statute of limitationsby requiring that suits be brought with seven years despite a possibly later deadline previouslyavailable under the discovery rule.It is worth noting that MCARE’s Statute of Repose does not apply to situations whereforeign objects are unintentionally left in the patient’s body, or for affirmative misrepresentationor fraudulent concealment of the cause of death in wrongful death or survival actions. 40 P.S. §1303.513 (c). Furthermore, minors may commence a lawsuit alleging a tort or breach of contractwithin the seven years under the Statute of Repose, or until their 20th birthday, whichever islater. 40 P.S. § 1303.513(c).Wrongful death and survival actions 10 must be commenced within two years afterthe death in the absence of affirmative misrepresentation or fraudulent concealment of thecause of death. 40 P.S. § 1303.513(d). In a recent case, Matharu v. Muir, 29 A.3d 375 (Pa.Super. June 28, 2011), the court found that the statutes of limitations delineated by 40 P.S.§ 1303.513(d) trumped more general statutes of limitations that preceded MCARE. InMatharu, defendants brought wrongful death and survival claims on behalf of their son,10 I.e., claims brought under under 42 Pa.C.S. § 8301 (relating to death action) or 8302 (relating tosurvival action).101
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EMTALA CASES ......................
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Filing an Affidavit of Non-Involvem
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II.PROFESSIONAL LIABILITY - AN OVER
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The Superior Court reversed the tri
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to a third party pursuant to the st
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After approximately five months, De
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learned the day after the surgery t
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conduct to the delay in colon cance
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court admitted the expert’s testi
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(b)(c)other reasonable causes, incl
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corroborated his testimony. The cou
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husband’s estate. Plaintiff alleg
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Other notable federal cases arising
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The Superior Court found that in re
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§ 1303.512(b). The court, however,
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In Neidig v. United States, No. 07-
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Additionally, the Supreme Court not
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were not indicated for her conditio
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surgeon is the same as it would be
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It should be noted that the Superio
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Finally, the court held that the tr
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The Supreme Court of Pennsylvania r
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nurses deviating from applicable st
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certainty, the court reviews expert
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Under Pennsylvania law, the Court n
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testimony, Defendant presented his
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- Page 58 and 59: Plaintiff developed chronic diarrhe
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- Page 62 and 63: accomplished. In Valles v. Albert E
- Page 64 and 65: In 1980, the Pennsylvania Superior
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- Page 68 and 69: Plaintiff’s Contract ClaimsThe Co
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- Page 82 and 83: (a)HMO IssuesIn McClellan v. Health
- Page 84 and 85: affidavit submitted by Defendants o
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- Page 96 and 97: With respect to fraudulent concealm
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- Page 148 and 149: Barrick, at *34-35.Furthermore, the
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decision in Muhammad precluded Mr.
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considered speculative “only if t
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underlying cause of action involved
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In Capital Care Corp., the Superior
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The court found, however, to state
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of reasonable diligence. The standa
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not be set aside. On July 7, 2005,
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complete bar to recovery. Since a l
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On appeal, Plaintiffs claimed that
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In Liggon-Redding, 659 F.3d at 265,
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elieved of those minimum standards
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elevant to the proceedings, the com
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establish professional misconduct b
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Upholding the Superior Court’s Or
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Id.Rejecting revocation and suspens
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order as a sanction under Rule 4019
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