HARRISBURG – In a divided ruling sure to impact future medical malpractice litigation statewide, the Supreme Court of Pennsylvania recently ruled that the Medical Care Availability and Reduction of Error (MCARE) Act’s repose statute violates access to the courts, as assured by the Pennsylvania State Constitution.
In Yanakos Et.Al v. UPMC Et.Al, the state Supreme Court justices arrived at a 4-3 ruling which declared as unconstitutional the seven-year statute of limitations on filing medical malpractice lawsuits in Pennsylvania.
The Supreme Court decision reversed an earlier ruling from the Superior Court of Pennsylvania and reverts the statute to 12 years.
Authoring the Court’s majority opinion was Justice Sallie Updyke Mundy, who was joined in her ruling by fellow justices Debra Todd, Kevin Dougherty and for the most part, Christine Donohue. They disagreed with the reasons why the seven-year statute was imposed by the Legislature earlier this century.
Justices David Wecht, Max Baer and Thomas Saylor dissented.
In his dissent, Justice Wecht said he was “unable to agree” to agree with the majority because the concurring justices “flout” the state legislature’s policymaking authority. Wecht also argued in his dissent, “It is not this court's role to upend duly enacted legislation simply because we might sometimes deem it imperfect or unwise.”
Wecht also claimed that the majority opinion was essentially “constitutionalizing and imposing a standard that neither the text nor the history of our Constitution supports.”
“Because existing jurisprudence supplies a different standard, and because it is not this court’s role to upend duly enacted legislation simply because we might sometimes deem it imperfect or unwise, I must respectfully dissent,” Wecht said.
In September 2003, plaintiff Christopher G. Yanakos chose to donate part of his liver to his mother and fellow plaintiff, Susan Yanakos. As part of pre-donor preparation, Christopher participated in testing which showed that his liver did not have full function – but, the Yanakos plaintiffs say they were not made aware of this result for 11 years, until 2014.
At that time, both Christopher and Susan were suffering from a severe liver disease, Antitrypsin Deficiency (AATD).
In December 2015, the Yanakoses sued the University of Pittsburgh Medical Center and two physicians for negligence, lack of informed consent, medical malpractice and loss of consortium, arguing the 2003 tests should have disqualified him as a prospective donor.
The high court’s decision reversed the Superior Court’s ruling in favor of UPMC in July 2017 that affirmed an Allegheny County Court of Common Pleas decision the previous August. Both courts found that Christopher, his mother Susan and his father William Ronald Yanakos had waited too long – 12 years – to file their case.
Now, the Yanakos family plaintiffs are free to pursue action against the defendants.
Mundy said it was the defendants who needed to prove that the MCARE Act’s statute of repose was “substantially or closely related to an important government interest" but added they did not do so.
“There was no evidence to show the initially proposed four-year statute of repose would provide actuarial certainty, except that it ‘seemed like a reasonable resolution’ to ‘provide some stability and predictability’ to insurers,” Mundy stated.
“There is no evidence in the legislative history as to how the General Assembly arrived at a seven-year statute of repose with exceptions for foreign objects cases and minors. The legislature did not cite any statistics on the number of medical malpractice actions that are commenced after seven years of the occurrence giving rise to the action. There is no indication that such a time period, as opposed to a longer or shorter period, will have any effect on malpractice insurance costs.”
Pa. Hospital Group States Opposition to Supreme Court’s Ruling
Hospital & Health Systems Association of Pennsylvania (HAP) Media Relations Director Rachel Moore issued a statement from the organization in response to the decision.
“A sharply divided state Supreme Court struck down the seven-year statue of repose provision in the Medical Care Availability and Reduction of Error (MCARE) Act that established a deadline for filing medical actions in Pennsylvania. Statutes of repose exist without challenge in many contexts, and this ruling is unprecedented. The same can be said for the more commonly understood statute of limitations,” Moore said.
“The Supreme Court applied a completely new level of scrutiny to the statute in question and many organizations have questioned this ruling. HAP – with approval from its Board of Directors – will join a number of these organizations in an amicus brief that urges the Supreme Court to reconsider its decision.”
Bruce Ledewitz, a professor at the Duquesne University School of Law in Pittsburgh, says the state legislature may have lost some leeway on the topic of tort reform.
“The law of Section 11 [of the Pennsylvania State Constitution] was hardly clear before and is certainly clearer now, as least as a stated standard of review. The justices have never acknowledged that this ‘intermediate review’ was mistakenly transferred in James (1984) from federal group equal protection to rights cases. As far as I know, there are no ‘important’ rights under federal constitutional law,” Ledewitz said.
“As to practical implications, the legislature has lost some flexibility in tort reform. How much is not clear. This intermediate standard did not mean much in James itself, which upheld a notice provision.”
Ledewitz continued that Justice Mundy’s opinion indicated requiring some evidence from the legislature that tort reform is needed, but since there was little legislative history in Yanakos, it currently isn’t clear how much or whether the court would quibble with an evidence-based legislative judgment.
“Because of the Justice Wecht dissent, you would only need to pick up one more vote to uphold a reform (that would not be Justice Donohue, who would go further than the lead opinion and apply strict scrutiny),” Ledewitz said.
Ledewitz further speculated on whether the decision could potentially have effect on efforts to reinstate time-barred cases of abuse filed against the Catholic Church in Pennsylvania.
“On the one hand, traditionally, the court has treated causes of action and defenses similarly – you can’t extinguish either one if vested. So, if the court protects causes of action more vigorously, maybe it would protect defenses also and all such efforts are unconstitutional,” Ledewitz said.
“On the other hand, this was not a vested rights case, nor a defense. If you read the case as suggesting sympathy for plaintiffs and victims, Yanakos might even indicate the opposite for such efforts.”
Supreme Court of Pennsylvania case 10 WAP 2018
From the Pennsylvania Record: Reach Courts Reporter Nicholas Malfitano at nick.malfitano@therecordinc.com