J-A10040-23

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT OP 65.37

KHALEED CRUMP 

Appellant

v.

CRAIG SOKOLOW AND FRAN 

GOLDSLEGER

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 IN THE SUPERIOR COURT OF

 PENNSYLVANIA

 No. 1750 EDA 2022

Appeal from the Judgment Entered August 19, 2022

In the Court of Common Pleas of Philadelphia County Civil Division at 

No(s): 200801434

BEFORE: PANELLA, P.J., KING, J., and STEVENS, P.J.E.*

MEMORANDUM BY STEVENS, P.J.E.: FILED JULY 24, 2023

Plaintiff/Appellant Khaleed Crump (“Appellant”) appeals from the 

judgment entered in the Court of Common Pleas of Philadelphia County at the 

conclusion of his personal injury trial after the jury found 

Defendants/Appellees Craig Sokolow and Fran Goldsleger (“Appellees”) were 

negligent, but that such negligence caused no compensable injury to 

Appellant. After careful consideration, we affirm.

The present case arises out of a motor vehicle collision that occurred 

during the early afternoon of January 26, 2020, in the City of Philadelphia, 

when Appellee Sokolow drove a motor vehicle at approximately 25 miles per 

hour into the vehicle of Appellant. On February 11, 2020, Appellant sought

medical treatment for what was diagnosed as a knee contusion, which,

____________________________________________

* Former Justice specially assigned to the Superior Court.
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Appellant reported, had occurred when his knee struck the steering column of 

his vehicle during the motor vehicle accident in question. 

On February 18, 2020, Appellant began a prescribed “course of therapy 

consisting of ultrasound, EGS manipulation and a structured therapeutic 

exercise program to tolerance.” Nevertheless, Appellant subsequently 

complained to his treating physician of progressively worsening right knee 

pain, stiffness, and clicking since the time of the accident. Plaintiff’s Trial 

Exhibit A, Report of Geoffrey W. Temple, D.O., 6/14/20, at 1-2. 

On April 28, 2020, Appellant underwent an MRI scan of the right knee. 

According to the interpreting radiologist, the MRI scan was “unremarkable,” 

as it showed all internal structures, ligaments, and tendons were intact. Id. 

Dr. Temple reviewed the MRI report and images and concurred with the 

radiologist’s impression. Id.

On June 3, 2020, Dr. Temple reassessed Appellant. In addition to 

sharing his impression of the normal MRI, he performed motion testing of 

Appellant’s right knee. His report indicated a normal range-of-motion without 

restrictions, the absence of effusion (fluid that causes swelling) or instability, 

and a demonstration of full strength at the joint, which he rated a “5/5.” Id. 

Dr. Temple noted further:

[Appellant] had anterior knee pain on deep palpation. . . . I do 

feel he suffered a deep knee contusion at that time [of the 

accident] and responded to the therapy provided with occasional 

pain. I released him from my active care at that time. He was 

asked to continue his own home exercises and return to the office 
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if there was any significant change in the residual pattern of 

symptoms around which he learned to adjust his daily activities.

. . .

The diagnosis in my report are directly related to the trauma of 

January 26, 2020. He has a guarded-good prognosis. . . . Also, 

he has suffered shearing forces to the myoligamentous supporting 

elements of the right knee which will pre-dispose him to joint 

laxity, joint instability, and also subsequent trauma. 

While he has improved maximally, he has not recovered 

completely. . . . He suffered a significant impairment of bodily 

function. . . . Again, he has a guarded-good prognosis. The 

opinions in my report are rendered within a reasonable degree of 

medical certainty.

Id. at 2.

On July 30, 2020, Appellant sought the care of Clifton Burt, M.D., to 

address what he reported as his continuing right knee pain. Dr. Burt noted a 

negative Lachman Test (to assess for ACL injury), no medial or collateral 

instability with the joint, and negative MRI findings. Plaintiff’s Trial Exhibit C, 

Report of Clifton Burt, M.D., 7/30/20, at 1. Nevertheless, given the duration 

of Appellant’s complaints of pain symptoms, Dr. Burt concluded that it was 

“medically necessary to perform right knee Geniculate nerve radiofrequency 

ablation.” Id. 

As discussed, infra, an ablation of the geniculate nerves involves 

inserting into the knee three needles, one placed at each nerve, and delivering 

through the needles a radiofrequency wave that generates sufficient heat, 

approximately 115 degrees Fahrenheit, to burn the nerve and stop it from 

transmitting a pain signal to the brain. At the time of the procedure, Appellant 
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reported a 40% improvement in his pain level for 30 minutes. Dr. Burt thus 

made the decision to proceed with the radiofrequency ablation at the same 

level. Id.

On August 18, 2020, Appellant commenced the present personal injury 

action by filing a complaint in negligence, alleging that Appellee Craig Sokolow 

negligently or carelessly caused the parties’ motor vehicle collision, which 

resulted in serious and permanent personal injuries to, among other things, 

his right knee. During discovery, Appellant filed an expert medical report 

prepared on September 15, 2020, by his proposed medical expert, Lance 

Yarus, D.O. 

In his report, Dr. Yarus explained that although he had not personally 

seen or examined Appellant, he had reviewed Appellant’s relevant medical 

history and reports, which, he indicated, had described that Appellant suffered

an auto collision-related contusion, synovitis, and enthesopathy of the right 

knee that continues to cause him pain. Among the conclusions he drew from 

his records review was that Appellant suffered a “suspected internal 

derangement with structural tear, either meniscus, or cruciate, or both with 

cartilage surface injury of right knee.” Plaintiff’s Trial Exhibit B, Report of 

Lance Yarus, D.O., 9/15/20, at 3. Dependent on this conclusion were the 

“guarded” prognosis he assigned Appellant and his medical opinion regarding 

related future costs of medical care Appellant would incur. Id. at 4. His report 

indicated that he offered this and all conclusions to a reasonable degree of 

medical certainty. Id. at 5.
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On April 18, 2022, Appellees filed a Motion in Limine to preclude Dr. 

Yarus from testifying it was his expert medical opinion that Appellant had a 

“suspected” internal derangement of the right knee. Specifically, Appellees

contended that a “suspected” injury was not an injury that a medical expert 

can find to within a reasonable degree of medical certainty. This was 

particularly so, Appellees argued, given the MRI imaging and accompanying 

radiologist’s report, with which all reviewing physicians concurred, indicating 

a normal, “unremarkable” study showing all internal structures of the knee to 

be “intact.” 

On May 19, 2022, the trial court entered an order granting in part 

Appellees’ Motion in Limine. Pursuant to the order, neither Dr. Yarus’ opinion 

regarding the suspected internal derangement nor his opinion about any 

future medical treatments or costs of said treatments were admissible at trial. 

On May 20, 2022, Appellant filed a Motion for Reconsideration based on 

Dr. Yarus’ videotaped deposition. Therein, Appellant maintained that Dr. 

Yarus “testified, specifically, that he believes Plaintiff to have internal 

derangement based on Plaintiff’s symptomology, that is, the locking, popping, 

giving way, and stiffness of which Plaintiff complained, and that [Dr. Yarus] 

was ‘certain’ and ‘not guessing’ about the internal derangement.” Motion for 

Reconsideration, 2/20/22, at 3.

On May 23, 2020, the trial court heard oral arguments on Appellant’s

Motion for Reconsideration, and agreed with Appellees’ position that because 

Dr. Yarus had based his testimony regarding a continuing injury and the future 
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costs associated with such injury on his suspicion that Appellant has internal 

derangement of the knee, his medical opinion on both was inadmissible. 

Accordingly, the trial court denied Appellants’ motion for reconsideration of 

the May 19, 2022, order.

Also challenged by way of a motion in limine was Dr. Yarus’ use as of a 

stock photograph of a knee undergoing genicular nerve ablation as an 

illustrative aid to his testimony. The trial court asked if the photograph 

accurately depicted the procedure Appellant underwent, and counsel for 

Appellant confirmed that it was. Appellees objected to the admission of the 

photograph, arguing that it had not been produced during discovery despite 

Appellant’s request for such demonstrative evidence. After entertaining 

arguments on the point, the trial court granted Appellees’ motion, noting the 

demonstrative had not been available to Appellees’ doctor or any other expert. 

N.T. at 16.

Trial commenced on May 23, 2020, and featured the testimony of fact 

witnesses Appellant and Appellee Craig Sokolow, and a video replay of Dr. 

Yarus’ deposition testimony. On May 24, 2022, the jury returned a verdict in 

favor of Appellees, finding Defendant Craig Sokolow negligent but that his 

negligence was not a factual cause of injury to Plaintiff/Appellant. N.T. 

5/24/22, at 69; Verdict Sheet, p. 1.

On June 3, 2022, Appellant timely filed a Motion for Post-Trial Relief in 

which he charged the trial court had erred and abused its discretion in 

precluding part of Dr. Yarus’ deposition testimony and the stock photograph 
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depicting a close up of a knee ablation patient’s knee with three needles 

inserted. The trial court denied the motion on June 23, 2022. This timely 

appeal followed.

Appellant raises the following issues for this Court’s consideration:

1. Whether the trial court abused its discretion and otherwise 

committed an error of law when it precluded [Appellant’s] 

medical expert, Dr Lance Yarus, D.O., from testifying that 

[Appellant] suffered internal derangement of the right knee as 

a result of the subject accident, and subsequently denied 

[Plaintff/Appellant’s] Motion for Reconsideration of same?

2. Whether the trial court abused its discretion and otherwise 

committed an error of law when it precluded [Appellant’s] 

medical expert, Dr. Lance Yarus, from testifying that 

[Appellant] would require future medical treatment for injuries 

sustained in the subject accident, and subsequently denied 

[Appellant’s] Motion for Reconsideration of same?

3. Whether the trial court abused its discretion and otherwise 

committed an error of law when it precluded [Appellant’s]

medical expert, Dr. Lance Yarus, D.O., from presenting a 

demonstrative photograph of the procedure [Appellant] 

underwent following the subject accident?

4. Whether the trial court abused its discretion and otherwise 

committed an error of law when it improperly denied 

[Appellant’s] Motion for Post-Trial Relief by way of Order dated 

June 23, 2022, and Supporting Opinion dated January 4, 2023?

Brief for Appellant, at 8.

At the center of Appellant’s first two issues is his challenge to the trial 

court’s ruling that precluded Dr. Yarus from offering at trial his opinion that 

the car collision in question caused Appellant to suffer an internal 

derangement of the right knee. As discussed, preclusion was based on the 
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trial court’s determination that Dr. Yarus failed to support his opinion with an 

adequate degree of medical certainty when he could opine only that the injury 

was “suspected.”

It is well-settled that in Pennsylvania, “our Supreme Court has 

emphasized [that an] expert must base the substance of her opinion on a 

reasonable degree of certainty instead of mere speculation.” 

Commonwealth v. Gonzalez, 109 A.3d 711, 727 (Pa. Super. 2015), appeal 

denied, 125 A.3d 1198 (Pa. 2015) (citation omitted); Accord,

Commonwealth v. White, 285 A.3d 912 (Pa. Super. Ct. 2022), appeal 

denied, No. 263 EAL 2022, 2023 WL 2579748 (Pa. Mar. 21, 2023). On this 

point, we have long observed:

an expert need not testify with absolute certainty or rule out all 

possible causes of a condition. [Mitzelfelt v. Kamrin, 584 A.2d 

888, 891 (Pa. 1990)]. Likewise, the testimony need not be 

expressed in precisely the language used to enunciate the legal 

standard. See In re Jones, 432 Pa. 44, 246 A.2d 356 (1968) 

(medical testimony need not conform to precise statutory 

definitions). Rather, expert testimony should be reviewed in its 

entirety to assess whether it expresses the requisite degree of 

medical certainty. McCann v. Amy Joy Donut Shops, 325 Pa.

Super. 340, 343–44, 472 A.2d 1149, 1151 (1984) (en banc “An 

expert fails this standard of certainty if he testifies ‘that the alleged 

cause “possibly”, or “could have” led to the result, that it “could 

very properly account” for the result, or even that it was “very 

highly probable” that it caused the result.’” Kravinsky v. Glover,

263 Pa.Super. 8, 21, 396 A.2d 1349, 1356 (1979) (citations 

omitted).

Hoffman v. Brandywine Hosp., 661 A.2d 397, 402 (Pa. Super. 1995) 

(superseded by statute on other grounds).
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Here, Dr. Yarus opined during his deposition testimony that both 

Appellant’s enduring subjective complaints of pain, clicking, and stiffness and 

medical records describing a contusion of his right knee at initial presentation 

caused Dr. Yarus to “suspect” a derangement of the knee’s internal structures. 

Deposition, 5/11/22, at 23-24. He acknowledged Appellant’s normal MRI 

study of April 28, 2020, which, he admitted, “didn’t show any evidence . . . of 

disruption of the internal structures” and showed that the ligaments, menisci, 

and tendons all “were intact”, but he opined that the normal MRI did not 

eliminate reason to pursue Appellant’s persistent complaints. N.T. at 27.

Dr. Yarus continued, “[S]ometimes MRIs don’t show you, uh, 

structurally or morphologically what may be causing a person’s symptoms. 

“When people present with . . . locking, popping, giving way, stiffness, things 

that [Appellant] described, and after treatment,[1] he has a continuing of those 

symptoms, those are internal derangement until proven otherwise.” N.T. at 

27. Dr. Yarus opined that with respect to the value of diagnostic studies,

“[w]hether the MRI is normal or not doesn’t really matter in the big picture[,]”

and he dismissed the notion that repeating such imaging would be of any 

value. N.T. at 35. 

Instead, he maintained that consideration of Appellant’s post-collision 

history coupled with a diagnostic arthroscopy was required to discern the 

____________________________________________

1 Elsewhere in his deposition testimony, Dr. Yaris discussed his review of 

records from “Premier Pain & Rehab”, which indicated that Appellant 

underwent a July 30, 2020, genicular block or ablation procedure of three 

nerves in his knee to reduce pain. N.T. at 28-29.
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injury in this case. “[I]t’s the [patient] history that drives the . . . ability to -

- to recommend care[,]” he opined, and “[y]ou have to look directly with the 

scope; that’s what it’s for.” N.T. at 27-28. [T]he scope is a diagnostic tool.” 

N.T. at 35. In other words, Dr. Yarus opined that only an arthroscopy would 

reveal whether Appellant sustained internal derangement of the knee

consisting of a structural tear with cartilage injury. He concluded his direct 

examination by affirming that he offered this opinion within a reasonable 

degree of medical certainty. N.T. at 36.

The degree of certainty regarding his opinion of Appellant’s injury, 

therefore, became the subject of cross-examination, during which Dr. Yarus 

conceded that in his written report he described his findings as “suspected 

internal derangement.” N.T. at 36.2 He confirmed further that his findings

derived from Appellant’s persistent subjective complaints both documented in 

medical records and conveyed to him during a phone conversation, as he 

neither met nor examined Appellant in person. He stated, “I believe it’s there 

because of his symptoms[,]” N.T. at 41, and he also agreed that Appellant’s 

subjective complaints were the source of such recorded symptoms.

The speculative nature of Dr. Yarus’ inferences, however, were 

underscored when he opined that only an arthroscopic evaluation of the knee 

would reveal the presence and extent of Appellant’s suspected injury. 

____________________________________________

2 His complete entry stated, “Suspected internal derangement with structural 

tear, either meniscus or cruciate or both, with cartilage surface injury of the 

right knee.” N.T. at 37.
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Specifically, when asked on redirect examination to explain the need for 

arthroscopic evaluation of the knee, he offered that Appellant’s persistent

complaints after reasonable care are the reason to do the scope, regardless 

of the MRI, and the presence and extent of the injury was “a part of the 

equation, uh, that, uh, will not be understood until a scope is placed in the 

knee. There has to be a reason for his continuing complaints and his inability 

to function.” N.T. at 47.

Under our cited jurisprudence, an expert’s suspicion of an injury does

not meet the requisite threshold of rendering an expert opinion to a 

reasonable degree of medical certainty. Here, Dr. Yarus admitted he only 

suspected Appellant had internal derangement of the knee because Appellant

continues to complain of pain and suffered a contusion and swelling of the 

knee at the time of the accident. This despite an MRI that showed all 

components of the knee to be intact and a June 3, 2020, examination in which 

Dr. Temple found Appellant’s right knee displayed a normal range of motion

without restrictions, full strength (rated “5/5”), no sign of instability, and no

evidence of effusion. Dr. Yarus conceded it was his opinion, moreover, that it 

is impossible to discern whether an internal derangement exists without 

conducting an arthroscopy, which has not been performed in this case. 

Confronted with this evidence, therefore, the trial court appropriately ruled 

Dr. Yarus’ opinion was speculative and, thus, inadmissible at trial. 

Accordingly, Appellant’s first two issues are devoid of merit. 
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The remaining two issues coalesce to assert that the trial court erred 

and abused its discretion when it deemed inadmissible a stock photograph of

a genicular nerve ablation procedure that Dr. Yarus used as an illustration 

during his videotaped testimony discussing the same procedure performed on 

Appellant. At the deposition of Dr. Yarus, counsel for Appellees raised an 

unfair surprise objection to the picture when it was presented, partly because 

Appellant had not produced or disclosed it previously during discovery, as 

required under Pa.R.C.P. 4009.11, in response to Appellee’s requests for 

production of documents.3 The objection was preserved for trial court review, 

and Dr. Yarus continued his deposition testimony in which he referred to the 

photograph to aid his explanation of Appellant’s knee ablation procedure.

The trial court entertained argument on Appellees’ motion in limine to 

exclude the photograph in question. Counsel for Appellees reiterated that 

Appellant failed to produce the photograph during discovery and, thus, unfairly 

surprised Appellees when Dr. Yarus referred to it during his expert testimony. 

Counsel for Appellees emphasized that “a surgery photograph is very 

prejudicial. It shows a person having surgery on their knee. It’s obviously 

not the plaintiff. It was never produced. I don’t think that that picture should 

be shown to the jury.” N.T., 5/23/22, at 12. 

____________________________________________

3 During discovery, Appellant’s “Request for Production of Documents” asked 

for “Any and all documents . . . which Plaintiff(s) plan to have marked for 

identification at a deposition or trial, introduce into evidence at a deposition 

or trial, or about which Plaintiff(s) plan to question a witness at a deposition 

or trial. R. 543.
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Counsel for Appellant countered that Dr. Yarus explained Appellant

underwent a genicular nerve ablation procedure to his knee, and then used a 

stock picture of such a procedure to assist the jury in understanding what such

a procedure entails. Indeed, the question initially posed to Dr. Yarus was, 

“Do you have a model or anything to show us to indicate what the procedure 

was, where it was performed?” N.T. at 12.

Counsel argued that the picture was “literally a [photograph] of 

somebody’s knee with the needles in it to show what the ablation procedure 

was.” N.T. at 13. He continued, “This is a demonstrative Dr. Yarus used. It’s 

aiding the jury to better understand the procedure that Mr. Crump went 

through, the ablation. That’s all it was. It’s not a moving film of anything. 

It’s just a picture of a knee to show what the ablation was. . . . I believe the 

standard is if it aids the jury to better understand what the doctor is talking 

about, it’s admissible. I would argue it’s admissible.” N.T. at 13. When asked 

by the trial court if the photograph was a true and accurate representation of 

Appellant’s procedure, counsel for Appellant reiterated that Dr. Yarus showed 

the photograph while explaining what Appellant underwent. N.T. at 14.

The trial court reserved ruling until it viewed the picture for unduly 

graphic or irrelevant content. N.T. at 14. While waiting for the videographer 

to retrieve the photograph, counsel for Appellees repeated his objection that 

the photo was never produced in discovery, was of a different person, and 

was a “picture of a man with iodine all over his knee and surgery and medical 
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instruments.”4 N.T. at 14. To his latter objection, counsel for Appellees added

that the photograph depicted a surgical procedure “clearly” performed in a 

hospital, which would be materially different from the outpatient procedure 

Appellant described in his testimony. Counsel for Appellant replied accurately, 

“You can’t tell that. It’s just a picture of a knee.” N.T. at 15.

After reviewing the photograph, the trial court sustained Appellees’ 

objection, agreeing with Appellees’ initial position that Appellant’s failure to 

produce the photograph pursuant to Appellees’ discovery request unfairly

handicapped Appellees in the preparation of their defense. Specifically, the 

trial court explained, “Dr. Yarus used a demonstrative during his testimony 

that hadn’t been used with their doctor or any other expert. And as a result, 

I sustained the objection that it not be presented to the jury.” N.T. at 16.

With regard to discovery disputes, we have explained:

Preliminarily, we note the “‘[t]he purpose of the discovery rules is 

to prevent surprise and unfairness and to allow a fair trial on the 

merits.’” Pennsylvania Rule of Civil Procedure 4019 provides for 

sanctions if a party fails to provide discovery. “The decision 

whether to sanction a party, and if so the severity of such 

sanction, is vested in the sound discretion of the trial court.” When 

a court refuses to impose sanctions, we must review the evidence 

to determine whether the court abused its discretion.

Dominick v. Hanson, 753 A.2d 824, 826 (Pa.Super. 2000) (internal citations 

omitted). According to Pa.R.C.P. 4019, a trial court may “make an appropriate 

____________________________________________

4 As discussed more fully, infra, the photograph in question is a close-up of a 

patient’s knee in which three long needles have been inserted. As explained 

by Dr. Yarus, a radiofrequency wave then is directed through the needle to 

the targeted nerve.
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order” if a party “fails to make discovery or to obey an order of court 

respecting discovery.” Pa.R .C.P. 4019(a)(1)(viii). “[T]he decision whether 

to sanction a party for a discovery violation and the severity of such a sanction 

are matters vested in the sound discretion of the trial court.” Philadelphia 

Contributionship Ins. Co. v. Shapiro, 798 A.2d 781, 784 (Pa. Super.

2002). . . . This Court has held that when a party has failed to produce 

evidence during discovery, an appropriate sanction is prohibiting admission of 

the evidence at trial. Duncan v. Mercy Catholic Med. Ctr. of Southeastern 

Pa., 813 A.2d 6, 12 (Pa. Super. 2002).

As noted above, the trial court had entered a Case Management Order 

during discovery requiring Appellant’s counsel to identify all exhibits that were 

to be used at trial. Within the court’s order was the admonition, “Counsel 

should expect any exhibit not listed to be precluded at trial.” There is no 

dispute that the picture in question was neither submitted during discovery 

nor included in Appellant’s pre-trial memorandum but was, instead, first 

presented at the videotaped deposition of Dr. Yarus to be used at trial. 

Referencing, inter alia, that Appellees’ expert had been deprived of the 

opportunity to examine the photograph, the trial court acted on its prior 

admonition and ruled the photograph was inadmissible at trial. We discern no 

error with the trial court’s decision to enforce the terms of its Case 

Management Order. 

Even assuming, arguendo, that any unfair surprise was de minimus and, 

thus, provided insufficient reason to preclude use of the photograph, we would 
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decline to find reversible error in this instance where Appellant’s medical 

expert, Dr. Yarus, provided the jury with a detailed and comprehensive 

explanation of the procedure.

Appellant argues that the purpose of introducing the photograph of the 

ablation procedure was to show he chose to undergo such an invasive 

procedure because he was genuinely experiencing pain in his knee following 

the accident. Nevertheless, he acknowledges that the photograph illustrated 

the testimony of Dr. Yarus, which not only detailed the invasive ablation 

procedure completely for the jury but also explained that the procedure is 

undertaken to remedy a patient’s complaints of pain. 

To this end, Dr. Yarus indicated that Appellant presented at Premier Pain 

& Rehab on July 30, 2020, to treat with Dr. Clifton Burt, who performed 

genicular blocks on three nerves located inside Appellant’s knee to try to 

reduce pain. N.T. at 28.5 The jurors first observed Dr. Yarus refer to a medical 

drawing illustrating the internal anatomical structures of the knee, and they 

watched him use the illustration to identify the location of the nerves, 

explaining they were the ones blocked or ablated during Appellant’s 

radiofrequency ablation procedure. N.T. at 29-30.

The doctor then transitioned to the second illustration, which consisted 

of a still, color photograph of an actual knee ablation procedure. The depiction 

is limited to a close-up of a bare knee with three small needles or probes 

____________________________________________

5

It was at this time that Appellees’ counsel noted his objection to “any kind 

of models or pictures or anything like that, that wasn’t produced.” N.T. at 28. 
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inserted. Iodine appears to have been applied to the surface of the knee, and 

some of the iodine appears to have run onto the edge of the paper dressing. 

Although the photograph was “blacked out” in the video pursuant to the 

trial court’s ruling, the jury still observed the video of Dr. Yarus describing in 

detail what was depicted in the obscured photo and how the ablation 

procedure is performed. Specifically, Dr. Yarus related the photograph to the 

previous medical drawing—which the jury had viewed—that illustrated the 

location of each genicular nerve among the internal structures of the knee, 

and he described how three ablation probes, or needles were placed in the 

knee to ensure each would contact its corresponding nerve and deliver the 

radiofrequency wave to burn the nerve and block the pain signal it was 

emitting to the brain:

And, then, uh I have another demonstration. This is actually a 

placement of the needles, uh, that were the nerves that are going 

to be ablated. 

[a brief delay occurs while the videographer retrieves the 

photograph]

So, this is representing the three, uh, nerves that, uh, would be 

ablated. Certainly, again, this is not Mr. Crump. This is a live, 

uh, person that, uh, is being used just to show where the needle 

placement is. 

Through the needle will come a device that’s hooked up to a 

machine that will generate energy at the tip of the probe that goes 

through down to nerve. . . . In some cases, uh, I believe in the 

case of Dr. Burt [who performed the procedure on Appellant], they 

outline the nerve with dye using a fluoroscope, and that’s how you 

know where the placement is. Once you’re up on the nerve, this 

probe is sent down, and then, energy is placed through the probe. 

It's about 80 degrees Celsius, which is 115 Farenheit, and that’s 
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enough to burn those nerves right where the needles are. It takes 

about 30 minutes, total, to do the procedure. 

N.T. at 31-32. 

Dr. Yarus concluded his presentation of the genicular ablation procedure

by offering his opinion that it was “medically necessary, reasonable, and 

related to the accident[,]” and that he would recommend repeating it to

“knock[] out the pain” to enable Appellant “to function a little better[.]” N.T. 

at 32, 34.

This record establishes that the photograph in question was largely 

cumulative of Dr. Yarus’ detailed testimony, particularly when one considers 

that the photograph’s purpose, according to Appellant, was to convince the 

jury that he was genuinely in pain by showing he was willing to undergo an 

invasive procedure to address it. The photograph thus offered little if any 

probative value beyond Dr. Yarus’ detailed testimony describing the invasive 

nature of the ablation procedure. Therefore, we conclude that any prejudice 

Appellant incurred by the court’s ruling precluding the admission of the 

ablation photograph was de minimus and cannot support his claim of 

reversible error.6 Accordingly, we discern no merit to Appellant’s challenge. 

Judgment affirmed.

____________________________________________

6 We thus distinguish the present matter from decisions acknowledging that 

an expert medical witness’s testimony, conveyed in appropriate clinical 

language, regarding the nature of injuries or cause of death does not render 

photographic evidence merely duplicative. See, e.g., Commonwealth v. 

Pruitt, 951 A.2d 307, 319 (Pa. 2008) (discussing cases in which photographs 

depicting the brutality of beatings and the deep and gaping wounds involved 

were essential to prove criminal intent, even when a medical examiner had 

described the nature of the victims’ injuries). 
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Judgment Entered.

Joseph D. Seletyn, Esq.

Prothonotary

Date: 7/24/2023