J-A01026-24

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT O.P. 65.37

CORI LARSEN 

Appellant

v.

WAYNE MEMORIAL HOSPITAL AND 

PAIGE CASTELINO AND JOHN DOE 1 

AND JOHN DOE 2 AND JOHN DOE 3

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 IN THE SUPERIOR COURT OF

 PENNSYLVANIA

 No. 1400 EDA 2023

Appeal from the Order Entered April 26, 2023

In the Court of Common Pleas of Wayne County 

Civil Division at No(s): 2020-CV--00433

BEFORE: LAZARUS, P.J., PANELLA, P.J.E., and COLINS, J.*

MEMORANDUM BY PANELLA, P.J.E.: FILED MARCH 20, 2024

Cori Larsen appeals from the order entered in the Wayne County Court 

of Common Pleas on April 26, 2023, granting summary judgment in favor of 

Wayne Memorial Hospital (“WMH”) and Paige Castelino (“Dr. Castelino”) 

(collectively “Appellees”). After careful review, we affirm. 

The trial court opinion set forth the relevant facts and procedural history 

of this case as follows: 

[Larsen] commenced this suit by filing a complaint on 

December 22, 2020 against [Appellees] for injuries she sustained 

in her capacity as an emergency medical technician for Cottage 

Hose Volunteer Ambulance Company. On December 30, 2018, 

[Larsen] was part of the EMS crew transporting a minor patient 

(initials T.D.) from Wayne Memorial Hospital (hereinafter, “WMH”) 

in Honesdale, Pennsylvania to a psychiatric facility in Pittsburgh, 

____________________________________________

* Retired Senior Judge assigned to the Superior Court.
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Pennsylvania. T.D. was involuntarily admitted to WMH on or about

December 25, 2018 pursuant to Section 7302 of the Mental Health 

Procedures Act. Paige Castelino, M.D. (hereinafter, “Dr. 

Castelino”) treated T.D. while T.D. was a patient of WMH. Dr. 

Castelino authored the discharge summary for T.D, as follows:

Patient admitted for suicidal intent and depression. Patient 

during admission had extremely combative behavior and 

medicated extensively and warranted multiple attempts at 

restraints including physical. Patient now accepted at the in 

patient psych in Pittsburg [sic]. Explained and warned EMS 

crew that patient is extremely combative can give IM Ativan 

and IM Haldol as per psych recommendations en route. 

Requested ALS for medical personnel however EMS crew 

stated psych facility won't accept a sedated patient and they 

would be ok with BLS transport. Patient d/c at this time.

Dr. Castelino was not present during T.D.’s discharge on 

December 30, 2018. During the ambulance trip that day, while en 

route to Pittsburgh, T.D. attacked and injured [Larsen]. [Larsen]’s 

alleged injuries include a detached retina, fractured teeth, 

concussion, and contusions of the knee and ribs.

In her Complaint, [Larsen] asserts professional medical 

liability claims against WMH and Dr. Castelino and brings the 

following counts: Count I — Gross Negligence, Negligence against

Dr. Castelino; Count II — Corporate Negligence, Gross Negligence 

against WMH; Count III — Negligent Performance of an 

Undertaking to Render Services, Gross Negligence against Dr.

Castelino and WMH; Count IV — Negligent Misrepresentation 

against Dr. Castelino, and; Count V — Res Ipsa Loquitor against 

Dr. Castelino. After multiple continuances, this matter is currently 

scheduled for a jury trial to commence on May 8, 2023. Discovery 

has been completed pursuant to the Court’s scheduling order of 

February 21, 2023.

On April 3, 2023, WMH filed six (6) motions requesting the 

[c]ourt to grant either partial summary judgment or complete 

summary judgment in its favor. On that same date, Dr. Castelino 

also filed a motion for summary judgment. Plaintiff provided 

timely responses thereto. On April 19, 2023, counsel appeared 

before this [c]ourt to conduct the scheduled pre-trial conference 

and argument on motions in limine. During a discussion in 

chambers with the undersigned and counsel, counsel represented 
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that they were prepared to argue the motions for summary 

judgment and agreed to do so if the [c]ourt’s schedule permitted. 

This was later confirmed on the record. Consequently, on April 19, 

2023, in addition to hearing argument on the parties’ motions in 

limine and conducting pre-trial conference, the [c]ourt heard 

argument on the motions for summary judgment[].

Trial Court Opinion, 4/26/23, at 1-3 (footnotes omitted). The court 

subsequently issued an opinion and order granting summary judgment in 

favor of Appellees and dismissing Larsen’s case with prejudice. This timely 

appeal followed. 

In reviewing a trial court’s grant of summary judgment, we are guided 

by the following principles:

We view the record in the light most favorable to the nonmoving 

party, and all doubts as to the existence of a genuine issue of 

material fact must be resolved against the moving party. Only 

where there is no genuine issue as to any material fact and it is 

clear that the moving party is entitled to a judgment as a matter 

of law will summary judgment be entered. Our scope of review of 

a trial court’s order granting or denying summary judgment is 

plenary, and our standard of review is clear: the trial court’s order 

will be reversed only where it is established that the court 

committed an error of law or abused its discretion.

Good v. Frankie & Eddie’s Hanover Inn, LLP, 171 A.3d 792, 795 (Pa. 

Super. 2017) (citation omitted).

“In order to set forth a cause of action in negligence, [a plaintiff is]

required to plead sufficient facts which would establish that: (1) the doctor 

owed them a duty of care; (2) the doctor breached that duty; (3) they were 

injured; and (4) the injuries were proximately caused by the doctor’s breach 

of duty.” Crosby v. Crosby v. Sulz, 592 A.2d 1337, 1340 (Pa. Super. 1991)
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(citation omitted). “Moreover, the plaintiff must offer an expert witness who 

will testify to a reasonable degree of medical certainty, that the acts of the 

physician deviated from good and acceptable standards, and that such 

deviation was the proximate cause of the harm suffered.” Eaddy v. Hamaty, 

694 A.2d 639, 642 (Pa. Super. 1997) (citation and internal quotation marks 

omitted). 

In its opinion, the court concluded that Appellees owed no duty to Larsen 

pursuant to a medical professional liability claim. See Trial Court Opinion, 

4/26/23, at 5. Further, the court concluded that even if a duty were owed to 

Larsen, Larsen failed to meet her burden of producing a qualified expert report 

to establish that the care and treatment provided fell short of the required 

standard of care and that the breach proximately caused Larsen’s injury, 

pursuant to the Medical Care Availability and Reduction of Error (MCARE) Act, 

40 P.S. § 1303, et seq. See id. at 7-8. 

On appeal, Larsen argues the trial court erred in granting Appellees’ 

motion for summary judgment because (1) Appellees owed Larsen a duty, 

notwithstanding the fact that Larsen was not Appellees’ patient, and (2) 

Larsen’s liability expert was qualified to opine on breaches of the standard of 

care by Appellees. 

Due to our disposition on the second issue, we need not reach the first 

issue – as even if we assume, arguendo, that Appellees owed Larsen a duty, 
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we agree with the trial court that Larsen failed to meet her burden of producing

a qualified expert to opine on a breach of the standard of care by Appellees.1

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1 Although we do not reach the issue, we note briefly that the case law cited 

by Larsen in support of her proposed duty of care is distinguishable and 

unavailing to the facts presented here. Larsen cites to Crosby, Emerich v. 

Philadelphia Center for Human Development, Inc., 720 A.2d 1032 (Pa. 

1998), and Matharu v. Muir, 86 A.3d 250 (Pa. Super. 2014), for their 

rejection of the broad notion that a health care provider can never owe a duty 

to someone other than that provider’s patient. Larsen asks us to apply the 

rationale in a line of cases imposing liability on a physician where the plaintiffs 

relied on a failure to warn theory. Here, Larsen did not proceed under a failure 

to warn theory, as she conceded numerous times at the hearing, but rather a 

negligence theory.

We are unaware of any precedent that supports Larsen’s proposed duty of 

care between a medical professional and an unrelated third-party, in terms of 

treatment of a mental health patient. As such, we view Larsen’s arguments as 

a request for the imposition of a new, affirmative, common-law duty in tort. 

This request for imposition of a new duty is reinforced by Larsen’s suggestion

that we consider the multifactorial test set forth in Althaus ex rel. Althaus 

v. Cohen, 756 A.2d 1166 (Pa. 2000). However, while Larsen cites to Althaus, 

she notably does not provide any analysis of those factors herself. 

In the absence of policy arguments or a request for an opportunity 

to develop a record, the court did not err in applying the default 

approach of declining to impose upon professional undertakings 

new affirmative common-law duties running to third-parties to the 

professional relationship. Moreover, the present appeal does not 

afford an adequate foundation to make an informed social policy 

assessment which would support the imposition of a new 

affirmative duty on physicians to make third-party interventions.

Seebold v. Prison Health Services, Inc., 57 A.3d 1232, 1250-51 (Pa. 

2012). As Larsen failed to develop the record in the court below, we simply 

are unable to properly assess such a broad claim as imposing a new duty in 

tort. 
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Larsen contends her liability expert is qualified to offer his opinion on 

the standard of care of Appellees. Accordingly, Larsen argues the record 

contains sufficient expert testimony to survive summary judgment. 

Dr. Kenneth Robinson authored a report in which he concluded “that Dr. 

Castelino and [WMH] failed to meet the standard of care, and that these 

failures caused the significant injuries sustained by [] Larsen.” Brief in Support 

of Motion for Summary Judgment, 4/3/23, at Exhibit P. 

In its opinion, the trial court concluded Dr. Robinson is not qualified to 

render an opinion regarding the standard of care of Appellees, explaining as 

follows: 

Dr. Robinson is board certified in emergency medicine while 

Dr. Castelino is board certified in internal medicine. Dr. Castelino, 

in her role as a specialist in internal medicine, treated T.D. and 

monitored her mental health over the course of T.D.’s multi-day 

commitment at WMH. Dr. Castelino is a hospitalist who 

coordinates the care of a patient during his or her stay. This is 

much different than the role of Dr. Robinson, chief of a hospital's 

department of emergency medicine. Further, Dr. Robinson states 

generally in the conclusion of his report that he has years of 

experience treating "a wide variety of patients" including 

"Behavioral Health patients." However, his curriculum vitae, while 

replete with experience, certifications and acclaim in the areas of 

emergency medical services and trauma, is silent with regard to 

internal medicine and experience coordinating care of mental 

health patients.

While the Court does not discredit Dr. Robinson's accolades 

and expertise in the field of emergency medicine, he does not 

meet the qualifications of an expert in this case, specifically with 

regard to Section 512(c)(1)-(2). Further, the waiver allowed by 

Section 512(e) is not satisfied. The Court finds that Dr. Robinson 

is not qualified to testify as it pertains to the standard of care of 

Dr. Castelino and WMH in their treatment of T.D. Therefore, 
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summary judgment is appropriate on this basis because without a 

report from a qualified expert, [Larsen] has not met her burden.

Trial Court Opinion, 10/13/2016, at 3–4 (unnumbered). 

Pursuant to the MCARE Act, a professional testifying to a physician’s 

standard of care must satisfy several requirements. 

Expert qualifications

(a) GENERAL RULE.—No person shall be competent to offer an 

expert medical opinion in a medical professional liability action 

against a physician unless that person possesses sufficient 

education, training, knowledge and experience to provide 

credible, competent testimony and fulfills the additional 

qualifications set forth in this section as applicable.

(b) MEDICAL TESTIMONY.—An expert testifying on a medical 

matter, including the standard of care, risks and alternatives, 

causation and the nature and extent of the injury, must meet the 

following qualifications:

(1) Possess an unrestricted physician's license to practice 

medicine in any state or the District of Columbia.

(2) Be engaged in or retired within the previous five years from 

active clinical practice or teaching. Provided, however, the 

court may waive the requirements of this subsection for an 

expert on a matter other than the standard of care if the court 

determines that the expert is otherwise competent to testify 

about medical or scientific issues by virtue of education, 

training or experience.

(c) STANDARD OF CARE.—In addition to the requirements set 

forth in subsections (a) and (b), an expert testifying as to a 

physician's standard of care also must meet the following 

qualifications:

(1) Be substantially familiar with the applicable standard of 

care for the specific care at issue as of the time of the alleged 

breach of the standard of care.
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(2) Practice in the same subspecialty as the defendant 

physician or in a subspecialty which has a substantially similar 

standard of care for the specific care at issue, except as 

provided in subsection (d) or (e).

(3) In the event the defendant physician is certified by an 

approved board, be board certified by the same or a similar 

approved board, except as provided in subsection (e).

(d) CARE OUTSIDE SPECIALTY.—A court may waive the same 

subspecialty requirement for an expert testifying on the standard 

of care for the diagnosis or treatment of a condition if the court 

determines that:

(1) the expert is trained in the diagnosis or treatment of the 

condition, as applicable; and

(2) the defendant physician provided care for that condition 

and such care was not within the physician's specialty or 

competence.

(e) OTHERWISE ADEQUATE TRAINING, EXPERIENCE AND 

KNOWLEDGE.—A court may waive the same specialty and board 

certification requirements for an expert testifying as to a standard 

of care if the court determines that the expert possesses sufficient 

training, experience and knowledge to provide the testimony as a 

result of active involvement in or full-time teaching of medicine in 

the applicable subspecialty or a related field of medicine within the 

previous five-year time period.

40 P.S. § 1303.512 (“Section 512”). 

Larsen readily concedes that Dr. Robinson does not meet all the 

requirements of Section 512(c). See Appellant’s Brief, at 37 (“[Larsen] 

acknowledges that unlike Dr. Castelino, her expert is not board-certified in 

internal medicine. Therefore, [Larsen] cannot satisfy the requirements of 

Section 512(c)(3).”). Instead, Larsen argues Dr. Robinson is qualified 

pursuant to the waiver allowed by Section 512(e). 
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[Section 512(e)] allows a court to waive the same specialty and 

board certification requirements for an expert testifying as to a 

standard of care if the court determines that the expert possesses 

sufficient training, experience, and knowledge to provide the 

testimony as a result of active involvement in ... medicine in a ... 

related field of medicine within the previous five-year time period.

George v. Ellis, 911 A.2d 121, 131 (Pa. Super. 2006) (citation omitted). 

The trial court concluded that the waiver allowed by Section 512(e) was

not satisfied. Relevantly, the court found that although Dr. Robinson “states 

generally in the conclusion of his report that he has years of experience 

treating ‘a wide variety of patients’ including ‘Behavioral Health patients’”, his 

curriculum vitae (“CV”) did not reflect that experience. Trial Court Opinion, 

4/26/23, at 8. Instead, the trial court found “his [CV], while replete with 

experience, certifications and acclaim in the areas of emergency medical 

services and trauma, is silent with regard to internal medicine and experience 

coordinating care of mental health patients.” Id. (emphasis added).

Larsen argues the trial court failed to follow the applicable MCARE 

provision “by focusing on the practice of internal medicine [] in a vacuum, and 

not as it relates to the specific care at issue in this case.” Appellant’s Brief, at 

21-22. However, as the plaintiff bringing a medical negligence claim, it was 

Larsen’s burden to produce a qualified medical expert’s opinion. The trial court 

adequately reviewed everything that was provided, which only included Dr. 

Robinson’s report and his CV. Based on those documents, the court was 

unable to conclude that Dr. Robinson had the necessary background in order 

to provide an opinion pursuant to the waiver allowed by Section 512(e). 
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Larsen could have provided the court with other documentation, or 

testimony from Dr. Robinson at the hearing, to prove this background. After 

hearing scheduled arguments on the motions in limine and the issue of 

bifurcation, the court asked counsel for each party whether they were ready 

to proceed with summary judgment argument or if counsel wanted to schedule 

argument for another date. See N.T., Argument on Defendant’s Motions for 

Summary Judgment, 4/19/23, at 4. Counsel for each party indicated they 

were ready to proceed at that time. See id. (court indicating that counsel had 

agreed they were ready to proceed both in chambers and on the record, and 

counsel for Larsen and Appellees agreeing they were ready to proceed). 

Larsen did not request more time to prepare or gather more evidence. 

Larsen suggests that even if the trial court were inclined to grant 

Appellees’ motions based on Dr. Robinson's qualifications, it still erred by not 

affording Larsen an opportunity to develop a detailed record through extensive 

questioning of Dr. Robinson during voir dire at trial. See Vicari v. Spiegel, 

989 A.2d 1277, 1284 (Pa. 2010) ("Determining whether one field of medicine 

is related to another with respect to a specific issue of care is likely to require 

a supporting evidentiary record and questioning of the proffered expert during 

voir dire."). 

“Summary judgment motions under new Rule 1035.2(2) are intended 

to prevent just such a scenario: The purpose of the rule is to eliminate cases 

prior to trial where a party cannot make out a claim or a defense after relevant 
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discovery has been completed....” Eaddy v. Hamaty, 694 A.2d 639, 642-43 

(Pa. Super. 1997) (citations and internal quotation marks omitted). 

Accordingly, an appellant “must state a prima facie case before [she] will be 

allowed to proceed to trial.” Id. at 643 (emphasis in original).

We note that Larsen’s reliance on Vicari for her analysis of Section 

512(e) is misplaced. The court in Vicari was not tasked with ruling on a 

summary judgment motion. Rather, the case in Vicari went to jury trial, and 

only after the plaintiff rested his case, was an oral motion for compulsory 

nonsuit presented. Accordingly, the standard of review for summary judgment 

did not apply there. As such, we do not find Vicari guides our review here.

We have examined the certified record, including Dr. Robinson’s report 

and CV, and agree with the trial court that Larsen has not satisfied the waiver 

allowed by Section (e). 

Therefore, based upon our examination of the certified record, we 

discern no error in the court’s decision to grant Appellees’ summary judgment 

motions. Larsen needed to produce a qualified medical expert’s opinion, and 

without one, Larsen could not establish a prima facie case of medical 

negligence. On this basis, the court properly granted Appellees’ summary 

judgment motions. Accordingly, we affirm. 

Order affirmed. 

Judge Colins joins the memorandum.

President Judge Lazarus concurs in the result.
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Date: 3/20/2024