[J-86-2022]

IN THE SUPREME COURT OF PENNSYLVANIA

MIDDLE DISTRICT

TODD, C.J., DONOHUE, DOUGHERTY, WECHT, MUNDY, BROBSON, JJ.

LINDA REIBENSTEIN, AS THE 

ADMINISTRATRIX OF THE ESTATE OF MARY 

ANN WHITMAN, DECEASED

v.

CHARLES BARAX, M.D.; AND MERCY 

HOSPITAL, SCRANTON 

______________________________________

LINDA REIBENSTEIN, AS THE 

ADMINISTRATRIX OF THE ESTATE OF MARY 

ANN WHITMAN, DECEASED

v.

PATRICK D. CONABOY, M.D.; AND COGNETTI 

& CONABOY FAMILY PRACTICE, P.C.

APPEAL OF: PATRICK D. CONABOY, M.D. 

AND COGNETTI & CONABOY FAMILY 

PRACTICE, P.C.

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No. 32 MAP 2021

Appeal from the Order of the 

Superior Court at No. 1624 MDA 

2019 dated July 30, 2020, 

reconsideration denied October 

5, 2020, Vacating the Order of 

the Lackawanna County Court of 

Common Pleas, Civil Division, at 

No. 2016-01716 dated August 

29, 2019 and Remanding.

ARGUED: October 26, 2021

RESUBMITTED: November 15, 

2022

OPINION

JUSTICE WECHT DECIDED: December 12, 2022

We have long recognized a material distinction between cause and manner of 

death, with the former referring to the immediate physiological processes that precipitate 
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the death of an individual and the latter speaking to the broader context of the surrounding 

circumstances and events that preceded and contributed to those fatal physiological 

processes.1 Here, we consider a similar distinction in a new context—counterposed as 

medical cause and legal cause—specifically concerning the operation of the statute of 

limitations for wrongful death and survival actions2 under the Medical Care Availability 

and Reduction of Error Act (“MCARE”).

3

 

MCARE § 513(d) provides that its two-year limitations period on death actions, 

which commences upon death, will be tolled when there is an affirmative 

misrepresentation or fraudulent concealment of the cause of death.

4

 Appellee Linda 

Reibenstein undisputedly brought her claims against Appellant Patrick Conaboy, M.D., 

after the two-year period had run, and the death certificate undisputedly and correctly 

noted the medical cause of Reibenstein’s decedent’s death. The trial court ruled that the 

phrase “cause of death” refers specifically and only to the direct medical cause of death. 

Accordingly, it granted summary judgment to Dr. Conaboy under Section 513(d). The 

Superior Court reversed, interpreting “cause of death” more broadly to encompass 

 

1 See Brenneman v. St. Paul, 192 A.2d 745, 748-50 (Pa. 1963) (distinguishing the 

traumatic cause of a fatal injury from the events leading to the traumatic event to 

determine whether the terms of a life insurance policy had been satisfied).

2 We primarily refer to these collectively as “death actions.”

3 Act of March 20, 2002, P.L. 154, No. 13, codified as amended at 40 P.S. 

§§ 1303.101-1303.910.

4 Section 513(d) limits wrongful death and survival actions as follows: “If the claim is 

brought under 42 Pa.C.S. § 8301 (relating to death action) or 8302 (relating to survival 

action), the action must be commenced within two years after the death in the absence 

of affirmative misrepresentation or fraudulent concealment of the cause of death.” 

40 P.S. § 1303.513(d) (emphasis added); see 42 Pa.C.S. §§ 8301 (wrongful death 

action), 8302 (survival action).
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considerations associated with the manner of death (i.e., legal cause) in the sense alluded 

to above.

5

 We hold that MCARE’s tolling provision cannot bear the breadth of that 

reading. Accordingly, we reverse.

Decedent Mary Ann Whitman consulted with Dr. Conaboy on April 12, 2010, 

complaining of a persistent cough, fever, and lower back pain. Dr. Conaboy ordered an 

aortic duplex ultrasound scan and a CT scan of Whitman’s abdominal area, both of which 

were performed on April 23, 2010. Charles Barax, M.D., a radiologist, reviewed the 

scans, identifying what he characterized as a poorly visualized aortic aneurysm. 

Dr. Barax’s report indicated that “Dr. Conaboy was contacted with this study [and] was 

read [sic] with the findings” and that the report was provided to Dr. Conaboy.

6

 Dr. 

Conaboy scheduled Whitman to meet with a vascular surgeon on May 10, 2010, but 

Whitman died when the aneurysm ruptured on April 28, 2010. The parties do not dispute 

that Whitman’s death certificate correctly identified the rupture as her cause of death.

On April 15, 2011, Reibenstein, administratrix of Whitman’s estate, brought a 

wrongful death and survival action against Dr. Barax and Mercy Hospital Scranton 

(collectively, “Dr. Barax”). The thrust of the suit was that Dr. Barax had misread 

Whitman’s CT scan, failing to recognize the urgency of her condition. As well, 

Reibenstein contends that she sought unsuccessfully to obtain the certificate of merit that 

would enable her to name Dr. Conaboy alongside Dr. Barax as a defendant in her original 

 

5 Reibenstein v. Barax, 236 A.3d 1162 (Pa. Super. 2020).

6 Whitman Radiology Report, 4/23/2010, at 2 (attached to Reibenstein’s Br. in Opp. 

to Summ. J., 5/24/2018, Ex. D at 2).
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action.7 For his part, Dr. Barax filed an answer with new matter, as well as a cross-claim 

against Mercy Hospital. However, he made no effort to plead Dr. Conaboy into the 

litigation.

Discovery progressed, but in fits and starts over several years. The substance and 

timing of Dr. Barax’s deposition is central to this case. The trial court indicated that 

Reibenstein “made several unsuccessful attempts to schedule Dr. Barax’s deposition,” 

and that the deposition was taken only after the court intervened.8 Dr. Conaboy observes 

that Reibenstein did not “officially notice” Dr. Barax’s deposition until May 22, 2013, well 

after Section 513(b)’s two-year time limit had run as to Dr. Conaboy.

9

 Three notices 

followed, with court intervention evidently sought only later in this period, over a year after 

the first notice was rebuffed. For her part, Reibenstein observes that she filed requests 

for written discovery “[i]mmediately after” filing her complaint against Dr. Barax; that it 

took motions to compel and for sanctions before Dr. Barax responded; and that, “[t]hrough 

no fault of Ms. Reibenstein, during the course of Dr. Barax’s months of obstructionist 

actions,” the statute of limitations expired as to Dr. Conaboy.

10

 

Reibenstein finally deposed Dr. Barax nearly five years after Whitman’s death, 

almost four years after filing suit against him. During that February 2015 deposition, 

Dr. Barax indicated that he spoke personally with Dr. Conaboy on the day that the CT 

scan was performed on Whitman. In that conversation, according to Dr. Barax, he 

 

7 See Reibenstein’s Br. at 6.

8 Trial Court Opinion Granting Summary Judgment, 10/23/2019, at 2 (“T.C.O.”). 

9 Conaboy’s Br. at 7. 

10 Reibenstein’s Br. at 8. 
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specifically informed Dr. Conaboy both of the presence of an abdominal aortic aneurysm 

and, importantly, explained that the poor quality of the visualization prevented him from 

determining whether the aneurysm was rupturing or bleeding.11 He “further testified that 

he conveyed to Dr. Conaboy his concerns of a potential rupture.”12 

Based upon this testimony, but over a year after the deposition, on March 1, 2016, 

Reibenstein filed a new wrongful death and survival action against Dr. Conaboy and his 

associated practice (collectively, “Dr. Conaboy”), which the trial court consolidated with 

the Dr. Barax action.13 This second suit was premised upon Dr. Conaboy’s alleged failure 

to act in light of more detailed information he received in conversation with Dr. Barax, the 

full substance of which, in Reibenstein’s view, was not fully explained in Dr. Conaboy’s 

response to written discovery. Dr. Conaboy ultimately sought summary judgment on the 

basis that MCARE’s statute of limitations for wrongful death and survival actions had longsince run on or about April 28, 2013, almost three years before Reibenstein sued 

Dr. Conaboy. The trial court heard argument and denied summary judgment, citing 

Nicolaou v. Martin,

14 a case that involved application of the discovery rule15 to a non-

 

11 T.C.O. at 2.

12 Trial Court Opinion Denying Summary Judgment, 11/15/2018, at 2. As explained 

herein, the trial court first denied Dr. Conaboy’s motion for summary judgment only to 

grant it upon reconsideration—hence the existence of two trial court opinions.

13 Dr. Barax is not a participant in this appeal.

14 195 A.3d 880 (Pa. 2018).

15 “In certain cases involving latent injury, and/or instances in which the causal 

connection between an injury and another’s conduct is not apparent, the discovery rule 

may operate to toll the statute of limitations until the plaintiff discovers, or reasonably 

should discover, that she has been injured and that her injury has been caused by another 

party’s conduct.” Wilson v. El-Daief, 964 A.2d 354, 361-62 (Pa. 2009); see Fine v. 

Checcio, 870 A.2d 850, 858 (Pa. 2005) (“[T]he salient point giving rise to [the discovery 
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death-related claim. In effect, the trial court determined that there were disputed issues 

of material fact affecting whether the discovery rule rendered Reibenstein’s claim against 

Dr. Conaboy timely. But upon considering Dr. Conaboy’s motion for reconsideration, 

which called particular attention to Section 513(d)’s MCARE-specific statute of limitations 

for death and survival claims and that section’s tolling provision, the court granted 

summary judgment for Dr. Conaboy. In doing so, the court deemed it “clear” that there 

“is no evidence of ‘affirmative misrepresentation or fraudulent concealment of the cause 

of death.’”16 

Reibenstein appealed, and the Superior Court rejected the trial court’s reasoning. 

Section 513, “Statute of repose,” provides, in relevant part:

(a) General rule.—Except as provided in subsection (b) or (c), no cause of 

action asserting a medical professional liability claim may be commenced 

after seven years from the date of the alleged tort or breach of contract.

* * * *

(d) Death or survival actions.—If the claim is brought under 42 Pa.C.S. 

§ 8301 (relating to death action) or 8302 (relating to survival action), the 

action must be commenced within two years after the death in the absence 

of affirmative misrepresentation or fraudulent concealment of the cause of 

death.

17

 

rule’s] application is the inability of the injured, despite the exercise of reasonable 

diligence, to know that he is injured and by what cause.”). 

16 T.C.O. at 4 (citing Molineaux v. Reed, 532 A.2d 792 (Pa. 1987); Pastierik v. 

Duquesne Light Co., 526 A.2d 323 (Pa. 1987)).

17 40 P.S. § 1303.513 (emphasis added). Notwithstanding its titular reference to 

“repose,” we have held that Section 513(d) operates as a statute of limitations. See 

Dubose v. Quinlan, 173 A.3d 634, 647 (Pa. 2017) (“Section 513(d) is a statute of 

limitations for medical professional liability death cases that sets the date of accrual at the 

date of decedent’s death.”). 
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The Superior Court noted that MCARE’s stated purpose “is to ensure . . . that high 

quality health care is available in the Commonwealth and [to] provide a person who has 

sustained injury as a result of medical negligence by a health care provider with fair 

compensation, while controlling the costs of medical malpractice insurance rates.”18 In 

determining the effect of Section 513(d), the court observed that MCARE itself offered no 

definition of “cause of death.”19 Dr. Conaboy maintained that the term referred strictly to 

medical cause of death, i.e., to the direct physical failure or processes that precipitated 

the patient’s death. Reibenstein contended that the phrase should be read also to 

incorporate the legal cause of death, capturing not only the medical cause of death but 

also the acts, omissions, or events having some causative connection with the death. 

Finding both interpretations reasonable, the court determined that the legislature’s 

chosen language was ambiguous.

20 The court turned to the factors employed in 

interpreting an ambiguous statute.21 The court deemed it “clear” that Section 513(d)’s 

 

18 Reibenstein, 236 A.3d at 1166. Compare “Declaration of Policy,” 40 P.S. 

§ 1303.102(3) (“To maintain [a comprehensive and high-quality health care system] 

medical professional liability insurance has to be obtainable at an affordable and 

reasonable cost in every geographic region of this Commonwealth.”) with id. 

§ 1303.102(4) (“A person who has sustained injury or death as a result of medical 

negligence by a health care provider must be afforded a prompt determination and fair 

compensation.”).

19 Reibenstein, 236 A.3d. at 1165.

20 “When the parties read a statute in two different ways and the statutory language 

is reasonably capable of either construction, the language is ambiguous.” 

Commonwealth v. Giulian, 141 A.3d 1262, 1268 (Pa. 2016).

21 See Reibenstein, 236 A.3d at 1165-66. The factors include, but are not limited to:

(1) The occasion and necessity for the statute.

(2) The circumstances under which it was enacted.
[J-86-2022] - 8

tolling provision was intended “to protect patients who have pursued their rights, and 

despite this, ‘extraordinary circumstance prevents them from bringing a timely action.’”22 

Where that is the case, the court ventured, the limitations period does not “further the 

statute’s purpose.”23 In the court’s opinion, the legislature’s choice to include a tolling 

provision signaled its recognition that 

wrongful death and survival actions may involve situations where the 

patient’s interest in fair compensation outweighs the interest in limiting 

medical malpractice insurance costs. It is in furtherance of the stated 

purpose of fair compensation that we interpret ‘affirmative 

misrepresentation or fraudulent concealment of the cause of death’ to 

encompass those acts which caused the patient to die. Where a medical 

practitioner hides an action that was directly related to the cause of the 

patient’s death, the Commonwealth’s interest in redress outweighs the 

interest in control of medical malpractice insurance costs.24

Confronted with the competing goals of ensuring fair compensation while working to 

minimize frivolous litigation and associated increases in insurance premiums, the court 

determined that the tolling provision should be read as serving the legislature’s stated 

 

(3) The mischief to be remedied.

(4) The object to be attained.

(5) The former law, if any, including other statutes upon the same or similar 

subjects.

(6) The consequences of a particular interpretation.

(7) The contemporaneous legislative history.

(8) Legislative and administrative interpretations of such statute.

1 Pa.C.S. § 1921(c).

22 Reibenstein, 236 A.3d at 1166 (quoting Dubose, 173 A.3d at 645).

23 Id. (quoting Dubose, 173 A.3d at 645).

24 Id. (emphasis in original). 
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intention to ensure fair compensation. Thus, the “‘affirmative misrepresentation or 

fraudulent concealment of the cause of death’” tolling provision applied not only to 

obscurantist conduct in connection with the medical cause of death, but also to 

“affirmative misrepresentations about or fraudulent concealment of conduct the plaintiff 

alleges led to the decedent’s death.”25

The Superior Court concluded that the trial court erred when it entered summary

judgment on the basis that Whitman’s death certificate correctly recorded her medical 

cause of death. Thus, the appellate court vacated the entry of summary judgment and 

remanded to the trial court to consider whether “there was a fraudulent concealment or 

affirmative misrepresentation of an act by Dr. Conaboy related to Mrs. Whitman’s 

death.”26

We granted Dr. Conaboy’s Petition for Allowance of Appeal in order to determine 

the scope and meaning of the phrase “cause of death” as used in Section 513(d).27 

 

25 Id. Relatedly, this Court has held that fraudulent concealment “does not require 

fraud in the strictest sense encompassing an intent to deceive, but rather, fraud in the 

broadest sense, which includes an unintentional deception.” Fine, 870 A.2d at 860. 

However, “[t]he plaintiff has the burden of proving fraudulent concealment by clear, 

precise, and convincing evidence.” Id.

26 Reibenstein, 236 A.3d at 1166-67.

27 Specifically, we granted review of the following questions:

(1) Whether this Court should rule that “cause of death,” as it appears in 

MCARE’s statute of limitation, refers to medical cause of death, and not 

“conduct leading to death” (or legal cause of death)?

(2) Whether the statute of limitations on a wrongful death or survival act 

claim may only be tolled under section 513(d) of MCARE where a plaintiff 

proves that the defendant against whom the claims are asserted (and not a 

third party) affirmatively misrepresented or fraudulently concealed 

decedent’s cause of death?
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Because this is a question of law, we conduct our review de novo, and the scope of our 

review is plenary.28

[O]ur interpretive function requires us to identify the intent of the legislature, 

and we begin with the presumption that unambiguous statutory language 

embodies that intent, requiring no further investigation. We may not 

disregard the Act’s unambiguous language in service of what we believe to 

be the spirit of the law. Furthermore, while we must consider the statutory 

language in its full context before we assess ambiguity, we must not 

overlabor to detect or manufacture ambiguity where the language reveals 

none.29 

“[W]e should not interpret statutory words in isolation but must read them with reference 

to the context in which they appear.”30

The parties’ respective arguments run in two tracks. First, each maintains that the 

other’s proposed definition adds language to the statute. We can no more interpret a 

statute in a way that adds language than we can read it in a way that renders any statutory 

language ineffective.31 In the second line of argument, each party proposes that highly 

unfavorable results that are antithetical to MCARE’s purpose and design will follow from 

ruling in favor of the adversary. We address these arguments in turn.

 

Reibenstein v. Barax, 253 A.3d 209 (Pa. 2021) (per curiam) (simplified for clarity). Our 

resolution of the first issue obviates the need to resolve the second.

28 Allstate Life Ins. Co. v. Commonwealth, 52 A.3d 1077, 1080 (Pa. 2012).

29 Sivick v. State Ethics Comm’n, 238 A.3d 1250, 1263-64 (Pa. 2020) (footnotes 

omitted); see 1 Pa.C.S. § 1921(b). 

30 A.S. v. Pa. State Police, 143 A.3d 896, 906 (Pa. 2016); see King v. Burwell, 

576 U.S. 473, 486 (2015) (“[W]hen deciding whether the language is plain, we must read 

the words in their context and with a view to their place in the overall statutory scheme. 

Our duty, after all, is to construe statutes, not isolated provisions.”) (cleaned up).

31 See Commonwealth v. Rieck Inv. Corp., 213 A.2d 277, 282 (Pa. 1965)) (“[I]t is not 

for the courts to add, by interpretation, to a statute, a requirement which the legislature 

did not see fit to include.”).
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Dr. Conaboy argues that, in interpreting the statute broadly, the Superior Court 

effectively added language expanding the scope of the narrow phrase “cause of death”:

The Superior Court both added and removed words from the statute, as 

shown in brackets and delineation below: “[i]f the claim is brought under 

42 Pa.C.S. § 8301 (relating to death action) or 8302 (relating to survival 

action) the action must be commenced within two years after the death in

the absence of affirmative misrepresentation or fraudulent concealment of 

the [conduct leading to] cause of death.”32

Reibenstein disagrees, arguing that—far from adding or removing language—the 

Superior Court merely interpreted it. But she also suggests that the adding/subtracting 

language argument is a double-edged sword. “[Dr. Conaboy is] asking this court to find 

that ‘cause of death’ means ‘medical cause of death as identified on a death certificate.’”33 

Thus, she contends, Dr. Conaboy’s account no less entails the addition of material 

language to a statute in a way that alters its apparent meaning.

The lack of definition naturally complicates a plain-language analysis, but it hardly 

precludes one. Among other sources, we may seek common understanding in 

dictionaries, which furnish insight into shared meaning.34 And, as we noted in Sivick, a 

contextualized view of a statute also may reveal its meaning without the convenient but 

unnecessary resort to ambiguity analysis.35 Such is the case here. The language of 

Section 513(d) and its statutory context compel the conclusion that “cause of death” 

should be understood narrowly to encompass only the accuracy of the medical cause of 

death noted on the certificate of death. 

 

32 Conaboy’s Br. at 18.

33 Reibenstein’s Br. at 33.

34 See In re Beyer, 115 A.3d 835, 839 (Pa. 2015).

35 See Sivick, 238 A.3d at 1264.
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Precisely because MCARE encompasses a panoply of interrelated topics, 

including both tort and quality of care, the most sensible places to seek the meaning of 

the term “cause of death” are medical contexts in which the General Assembly has used 

this language—that is, in the Vital Statistics Law and the various County Codes, where 

cause and manner of death (and their cadences of medical and legal causation) are 

treated as distinct—especially where those uses unambiguously evoke the medical 

dictionary definition. For example, Section 507 of the Vital Statistics Law of 195336 details 

circumstances in which a “professional nurse” may pronounce a patient’s death, notify a 

coroner, or release the decedent’s body to a funeral director. But that limited authority “in 

no way authorizes a professional nurse to determine the cause of death. The 

responsibility for determining the cause of death remains with the physician, certified 

registered nurse practitioner or the coroner.”37 The reason for this limitation on a 

professional nurse’s authority, informed by the class of professionals who are not so 

restricted, is clear: the physician, certified registered nurse practitioner, and coroner—

and no one else—are the persons qualified by training and by law to determine the 

medical cause of death. But notably, neither the statute nor common sense suggests 

that (with the exception of a coroner) they are qualified to speak to the legal cause of 

death.

38

 

36 See 35 P.S. §§ 450.101-450-1003.

37 Id. § 450.507(d) (emphasis added).

38 Providers’ lack of legal qualifications underscores the risk of broadening the 

expectations for what physicians must know about the law and share with survivors and 

investigating counsel in order to retain the benefit of the Section 513(d) statute of 

limitations. As mentioned supra n.26, fraudulent concealment in this context requires no 

wrongful intent as such. And as the facts of this case suggest, a plaintiff may argue that 
[J-86-2022] - 13

Further support for a narrow interpretation of the phrase that distinguishes medical 

from legal cause of death—much as the law has distinguished cause of death from 

manner of death—appears in provisions of Pennsylvania’s County Code that detail the 

duties of county coroners, which include investigating “the cause and manner of death” 

for purposes of determining criminal responsibility “by act or neglect.”

39 It is the coroner, 

rather than a health care provider, whose investigative authority and duties extend 

beyond the mere physiological mechanism by which death occurred and into the realm 

of legal causation.40 

To ensure that references to cause and manner of death are individually effective 

rather than redundant, we must assume that the legislature intended to impart to them 

 

a mere omission by a deponent physician of a detail that a clinician might reasonably 

think immaterial to a given deposition question is sufficient to trigger tolling under 

Section 513(d). Justice Mundy would obligate a well-intentioned physician who 

participated in a given patient’s care to record, and later to scour his or her records and 

memory, not only for what might be relevant in the clinical sense but also what might 

appear relevant to someone with legal training. Nothing in MCARE suggests that the 

legislature intended to saddle providers with such a burden. 

39 16 P.S. § 1219-B(a) (“Autopsy.—If, after investigation, the coroner is unable to 

determine the cause and manner of death, the coroner shall perform or order an autopsy 

on the body.” (emphasis added)); id. § 1219-B(b) (“Inquest.—If the coroner is unable to 

determine the cause and manner of death following an autopsy, the coroner may conduct 

an inquest,” at which “the coroner’s duty shall be to: (1) Ascertain the cause of death. 

(2) Determine whether an individual other than the deceased was criminally responsible 

by act or neglect . . . .”); cf. 16 P.S. § 9521 (“Coroner to investigate facts in deaths under 

suspicious circumstances”). Section 1219 is found in the County Code, but materially 

identical coroner-related provisions are found as well in the Second Class County Code. 

See 16 P.S. §§ 4237-38. Moreover, overarching provisions pertinent to all counties point 

the same way. 

40 See, e.g., 20 Pa.C.S. § 8657(a) (the Estates Code) (“This section shall apply in all 

cases when the coroner or medical examiner must determine the cause of death and

whether the death may have resulted from criminal acts or criminal neglect.”).
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distinct meanings.41 The only way to do so in the County Code without favoring Dr. 

Conaboy’s argument for a narrow interpretation of “cause of death” in MCARE would be 

to assume that the legislature intended the term to mean significantly different things in 

each of those statutes. Certainly, one can hypothesize contexts in which the legislature 

so intends. But we will not presume that to be the case without some quantum of 

evidence to suggest such intent. No such evidence appears in this case.42

As we observed above, we also may seek guidance in dictionaries. Dictionaries, 

too, recognize a cause/manner distinction. Black’s Law Dictionary, for example, defines 

cause of death as “[t]he happening, occurrence, or condition that makes a person die; the 

 

41 See 1 Pa.C.S. § 1921(a) (“Every statute shall be construed, if possible, to give 

effect to all its provisions.”); Ind. Oil & Gas Assn. v. Bd. of Assessment, 814 A.2d 180, 

183 (Pa. 2002) (“Because the legislature is presumed to have intended to avoid mere 

surplusage, every word, sentence, and provision of a statute must be given effect.”).

42 With little clarity as to why, Justice Mundy rejects our treatment of the Vital 

Statistics Law (and, ostensibly, the various county codes, which she does not address) 

as “context” for interpretive purposes. Instead, she offers 42 Pa.C.S. § 8301, governing 

wrongful death actions, one of two provisions cross-referenced in MCARE § 513(d), 

which, she argues, “shows that the concept of ‘cause of death’ in wrongful death cases 

may carry a broader meaning than the immediate physiological processes that precipitate 

death and may include wrongful acts or neglect that caused death.” Conc. & Diss. Op. 

at 4 (Mundy, J.). This is a dubious twist on Section 8301’s language, which describes a 

right of action “for the death of an individual caused by the wrongful act or neglect or 

unlawful violence or negligence of another.” 42 Pa.C.S. § 8301. While this alludes to the 

cause of death, the full internal context of Section 8301 expressly describes elements of 

legal causation. Unlike Section 8301, Section 513(d) does not codify a death action, it 

confines it. And that Section 8301 includes language clearly describing legal causation 

underscores that Section 513(d) does not. In our view, other statutory uses of “cause of 

death” are more informative than Section 8301’s use of similar phrasing, which is modified 

by a clear description of legal causation absent from Section 513(d). That Section 513(d) 

cross-references Section 8301 does nothing more than identify the scope of 

Section 513(d)’s application.
[J-86-2022] - 15

injury, disease, or medical complication that results directly in someone’s demise.”43 In 

isolation, “happening, occurrence, or condition” might hint at a broader inquiry than 

medical cause, but only in isolation. The more limited reference to “injury, disease, or 

medical complication”—with its suggestive use of the word “directly,” which implies “butfor” causation—critically narrows the scope of the definition. Dorland’s Medical Dictionary 

offers an equally strict definition of cause of death as “the injury or disease responsible 

for death.”44 And our constrained reading of “cause of death” in harmony with these 

dictionaries finds more support in the same dictionaries’ respective definitions of manner

of death. Black’s, for example, defines manner of death as “[t]he circumstances under 

which the cause of death arose,”

45 which jibes perfectly with Dorland’s definition: “the 

circumstances under which a death occurs, e.g., suicide or accident.”46

In sum then, the available textual evidence, especially viewed in light of broader 

statutory context and the common usage reflected in reliable reference resources, favors 

Dr. Conaboy’s narrower construction.

47

 The analysis also supports his contention that to 

 

43 Cause of death, BLACK’S LAW DICTIONARY (10th ed. 2014).

44 Cause of death, DORLAND’S MEDICAL DICTIONARY ONLINE, available at 

https://www.dorlandsonline.com/dorland/definition?id=63759.

45 Manner of death, BLACK’S LAW DICTIONARY (10th ed. 2014).

46 Manner of death, DORLAND’S MEDICAL DICTIONARY ONLINE, available at 

https://www.dorlandsonline.com/dorland/definition?id=87900.

47 Presumably, physicians and certified registered nurse practitioners do not consult 

legal dictionaries in order to discern their professional functions and responsibilities. They 

may not consult medical dictionaries, either. But if these medical personnel were to look 

anywhere, medical references, as well as statutes imposing parameters upon their 

responsibilities when a patient dies, would be more likely destinations than a dictionary 

of legal terms. And so a medical dictionary is an appropriate resource in the search for a 

contextually common understanding of the terms here at issue.
[J-86-2022] - 16

read “cause of death” as encompassing legal causation or manner of death would entail 

inserting language into the statute, an enterprise in which we are not free to engage.

48

 

The foregoing analysis, sufficient in itself to compel our conclusion, also 

harmonizes with our pre-MCARE decision in Pastierik. In that case, the decedent died of 

lung carcinoma, and, over three years later, the plaintiff filed two complaints against 

defendants alleging that the decedent’s cancer was caused by workplace exposure to 

asbestos—the first against decedent’s employer, and the second against an alleged 

supplier of the asbestos. Although decedent died in April 1978, the plaintiff contended 

that she did not know until March 1981 that asbestos exposure caused her husband’s 

death, hence the discovery rule applied to render her suits timely even though they were 

filed more than two years after the decedent’s death. The trial court found both of the 

plaintiff’s suits barred on the basis that the statute of limitations began to run upon death. 

The Superior Court reversed, holding that the discovery rule applied.

On appeal, this Court rejected the Superior Court’s application of the discovery 

rule to a death action. The Pastierik Court recognized that the typical circumstances that 

call for resort to the discovery rule do not, indeed cannot, apply to death actions, 

explaining:

Statutory references to the occurrence of an “injury” or the accrual of a 

“cause of action” are subject to judicial interpretation as to the degree of 

knowledge a plaintiff must possess before the statute will start to run. In 

contrast, the requirement that a wrongful death action be brought within a 

 

48 See Rieck Inv. Corp., 213 A.2d at 282 (“[I]t is not for the courts to add, by 

interpretation, to a statute, a requirement which the legislature did not see fit to include.”).
[J-86-2022] - 17

specified number of years after a definitely established event,—“death”—

leaves no room for construction.

49

The discovery rule applies when critical information about an injury eludes detection 

through no lack of diligence on the plaintiff’s part, and the “discovery” of that information 

accordingly dictates when a claim accrues and the limitations period begins to run. But 

when potential malpractice leads to death, there is no question that injury has occurred—

death alone is a signal event, a sufficient impetus to investigate the prospect of 

malpractice diligently.

50

 

Even before MCARE’s enactment, that principle was subject to an equitable 

exception. Then (under the common law) as now (under MCARE), where “cause of 

 

49 Pastierik, 526 A.2d at 325 (quoting Anthony v. Koppers Co., 436 A.2d 181, 184 

(Pa. 1981)) (Pastierik’s emphasis; cleaned up). In Wilson, 964 A.2d 354, this Court 

conducted a thorough survey of how Pennsylvania courts and courts in other jurisdictions 

have interpreted claim accrual in discovery rule situations, which run the gamut from the 

point at which the plaintiff knew or should have known that she was injured all the way to 

when the plaintiff knew or should have known that she was injured, and knew that a claim 

might lie, and knew something about who caused the harm. We made clear in Wilson

that our history was consistent with “the narrower of the two overarching approaches to 

determining accrual for limitations purposes.” 964 A.2d at 364. We further observed that 

the 2005 edition of Pennsylvania’s Suggested Standard Civil Jury Instructions found 

accrual occurred when “the plaintiff could have first reasonably discovered [his or her] 

injuries and that it [sic] was caused by the conduct of another person”—but not, notably, 

a specific person. Id. at 365 (citation omitted).

50 At times, the Pastierik Court seemed to question whether “accrual,” as such, is a 

relevant concept in death actions: “[W]hile the concept of accrual may have usefulness in 

delaying the point at which the statute of limitations begins to run with respect to 

injuries, . . . because injuries are of a nature that they may be inflicted without immediate 

symptoms or immediately determinable causes, causes of action for death must be 

regarded in a different light since they are not similarly shrouded by indefinite factors.” 

526 A.2d at 326. But later, in Dubose, this Court applied the concept of accrual to death 

actions: “Section 513(d) is a statute of limitations for medical professional liability death 

cases that sets the date of accrual at the date of decedent’s death.” 173 A.3d at 647

(emphasis added).
[J-86-2022] - 18

death” was obscure to a potential plaintiff due to an act or omission, estoppel principles 

compelled tolling the two-year statute of limitations. But the tolling remedy for death 

claims was more limited than the broader discovery rule for precisely the same reason—

death invites immediate investigation.

51

 

To be sure, the discovery rule and equitable tolling are conceptually distinct. In 

discovery-rule cases, claims accrue only upon discovery of the injury and its cause, while 

the equivalent of accrual in death cases happens upon death as a matter of course. But 

the statute of limitations will be tolled when the cause of death is obscured by some 

affirmative act or omission that lulled the plaintiff into neglecting his or her duty to 

investigate to determine whether there was an actionable claim in malpractice.52

That distinction, though, lacks a difference when it comes to the concerns 

implicated by the question that this case presents. The discovery rule begins to run upon 

the discovery of injury and the prospect that it was caused by malpractice (if not, as 

explained immediately above, necessarily whose malpractice). But once the claim 

accrues, the clock ticks inexorably, no matter how difficult it may be to trace that injury 

back to a tortious act. Even on the broadest available reading of our discovery-rule 

jurisprudence, the statute of limitations begins to run—at the latest—once one discovers

an injury, its cause, and an agent of the harm. And there is no assurance that some 

 

51 Pastierik, 526 A.2d at 325-26; see 42 Pa.C.S. § 5502 (relating to the method of 

computing limitations periods).

52 See Molineaux, 532 A.2d at 794 (“Where, through fraud or concealment, the 

defendant causes the plaintiff to relax his vigilance or deviate from his right of inquiry, the 

defendant is estopped from invoking the bar of the statute of limitations.” (cleaned up)).
[J-86-2022] - 19

additional reprieve from the passage of that time will apply where, during the course of 

litigation, a second potentially liable party enters the picture.

In death actions, death itself is the watershed event, analogous to satisfying the 

discovery-of-injury and tortious-causation requirements relative to the discovery rule. So 

it is upon death that any potential claim accrues, triggering a would-be plaintiff’s duty of 

inquiry. What follows in either case may be a frustrating, uncertain investigation, which 

may yield insufficient evidence of malpractice even where it has occurred. And as noted 

in one form above, one of the problems that Reibenstein claims in this case—that 

identifying a responsible party may not occur in the discovery process until after the 

statute of limitations has run against that responsible party53—may occur in a non-death 

case. The fact remains, though, that the triggering event for the discovery rule is the 

discovery of injury and the prospect that it was caused by malpractice itself, not the certain 

discovery of all responsible parties. Naturally, the average injured party or survivor may 

not be equipped to assess quality of care, the presence of treatment alternatives, or other 

considerations relevant to the presence or absence of a viable malpractice claim. But the 

critical consideration is “inquiry notice” and the duty of diligent inquiry that follows: in most 

cases, it is uncertainty or specific concerns, based perhaps on a review of medical records 

or the content of interactions with treating health care providers, that will raise a potential 

plaintiff’s suspicions. Beyond that, it is likely that further appraisals will require the 

involvement of an attorney and/or outside expert review.54 

 

53 See Reibenstein’s Br. at 9, 35.

54 Justice Mundy maintains that, “[w]hen [concealment or misrepresentation 

regarding a legal cause of death] is present, the Majority eliminates the remedy of 

equitable tolling.” See Conc. & Diss. Op. at 8 (Mundy, J.). While Justice Mundy is correct 
[J-86-2022] - 20

What matters is the point in time at which the injured party or survivor has sufficient 

information to recognize that the matter warrants further pursuit. The aim is to ensure 

that a veil of total ignorance impenetrable by mere diligent effort does not result in the 

loss of a meritorious claim.

55 It is not to guarantee that all of the information necessary 

to sustain a claim will be gathered in the limitations period that commences upon that 

discovery. At some point the clock must run out, lest health care providers remain subject 

to liability exposure indefinitely, with the prospect of a trial marred by the death or 

diminished memory of material witnesses or the loss of critical evidence.56 And this 

 

regarding the consequence of this ruling, she imputes responsibility to this Court when it 

properly lies with the General Assembly, which chose the language that we interpret. To 

the extent that Justice Mundy implies that we eliminate the intended benefit of equitable 

tolling, we have no trouble identifying scenarios in which such tolling (and its benefits) 

would apply. For example, a provider might misrepresent a medical cause of death to 

align with a decedent’s pre-existing medical condition, leading a survivor (or, at least as 

importantly, a lawyer or expert reviewing the decedent’s file) to conclude that the death 

reflected a natural progression of that known condition. Where that assessment obscures 

a true medical cause of death that is less readily reconciled with the decedent’s condition 

and presentation at the time of treatment, the misidentification may undermine a 

survivor’s inclination to investigate whether negligence contributed to the decedent’s 

death, or may lead reviewing professionals to overlook evidence of negligence. Simply 

put, the intended benefit of equitable tolling is not rendered illusory merely because the 

domain of the remedy is limited. 

55 See Pastierik, 526 A.2d at 326 (“Upon the death of an individual, survivors are put 

on clear notice thereof, and they have the opportunity to proceed with scientific 

examinations aimed at determining the exact cause of death so that a wrongful death 

action, if warranted, can be filed without additional delay.”)

56 See, e.g., Johnson v. Stuenzi, 696 A.2d 237, 242 (Pa. Super. 1997) (“The 

limitations of actions period represents a balancing of interests between an allegedly 

aggrieved party and the alleged wrongdoer. Fairness requires that an individual who 

believes he has been wronged have a sufficient period of time to recover from his injury, 

if any, investigate the circumstances surrounding a potential claim and decide whether 

legal action is warranted. On the other side of the equation, it is recognized that 

individuals should not be subjected to claims so remote in time that defending against 

them will be greatly hampered and, further, that people should be free to live their lives 
[J-86-2022] - 21

increased uncertainty will be priced into malpractice insurance premiums, precisely the 

circumstance MCARE was designed to mitigate.57

Reibenstein warns that the narrower account of “cause of death” would encourage 

conspiratorial conduct on the part of physicians aiming to conceal their culpability for a 

patient death while the clock runs out. This, she argues, would invite plaintiffs 

prospectively to sue indiscriminately any physician who treated the decedent in any way 

that might be connected to the events leading to death, in direct contravention of the 

legislature’s intention to discourage frivolous or overbroad malpractice suits. 

For his part, Dr. Conaboy suggests that the Superior Court’s view leads to an 

untenable, indefinite extension of the time during which any number of physicians and 

their insurers will dangle in limbo regarding their potential liability exposure, owing not 

only to the prospect of delay but to questions pertaining to how attenuated the medical 

chain of causation might grow.

58

 Long-delayed suits would remain available indefinitely 

 

without worrying that they will be summoned into court and possibly subjected to civil 

liability for events occurring some time ago.”).

57 Justice Mundy’s observation that an equitable tolling exception creates actuarial 

uncertainty, regardless of how we interpret the statute, is true as far as it goes. See Conc. 

& Diss. Op. at 8 (Mundy, J.). The very idea of pooling risk that animates the insurance 

industry makes no sense absent uncertainty. But to observe that no interpretation will 

eliminate uncertainty entirely tells us nothing about the degree or duration of such 

uncertainty. Our view of the statute decreases the number and duration of lingering 

malpractice claims while imposing nothing more upon survivors than the time-honored 

duty of diligent inquiry.

58 MCARE was enacted with a seven-year statute of repose that, presumably, was 

intended to preclude such suits after seven years, regardless of when the injury or the 

concealment of the cause of death was discovered. See 40 P.S. § 1303.513(a). This 

Court deemed the statute of repose unconstitutional in Yanakos v. UPMC, 218 A.3d 1214 

(Pa. 2019), and the General Assembly has yet to enact a substitute provision. Thus, there 

remains no statutory limit of any kind upon delayed suits.
[J-86-2022] - 22

to any plaintiff who contends, however tenuously, that a treating physician concealed a 

potential legal cause of death such that a duly diligent plaintiff—through no fault of his or 

her own—remained unable to identify an available claim or promising line of inquiry. This 

path would require only the bare showing necessary to establish a disputed issue of fact, 

the low bar for which is evident in the Superior Court’s decision to remand this case for 

further examination of the tolling claims based upon Reibenstein’s conclusory allegations 

of misconduct, allegations that the trial court roundly rejected for want of supporting 

evidence.59 This necessarily enmeshes physicians in a quagmire that agglomerates 

determination of medical cause of death, unquestionably their province, with identification 

of potential legal causes of death, which is more properly entrusted to the legal system.60

We do not reject entirely the salience of Reibenstein’s claim that limiting the tolling 

provision to medical causation will force plaintiffs to cast their nets more widely in 

determining whom to sue. But while a plaintiff may at least begin suit against a bevy of 

health care providers with writs of summons, the certificate of merit requirement will nip 

unsubstantiated threats in the bud, as it evidently did in this case, when Reibenstein was 

unable to obtain a certificate of merit against Dr. Conaboy early in this litigation. Plaintiffs 

will have an opportunity to conduct timely, rigorous investigations of potential malpractice 

actions arising from fatal events, in keeping with MCARE’s objective.

 

59 See T.C.O. at 4.

60 See Conaboy’s Br. at 17 (“[T]he Superior Court discarded the established medical 

procedures for stating what caused death in the death certificate—i.e., the medical 

explanation of the order, type, and association of physiological events resulting in death—

and substituted an examination of who caused [Decedent’s] accidental death.”)

(emphasis in original). 
[J-86-2022] - 23

Reibenstein also does not account for the availability of pre-complaint discovery. 

Since 2007, the Pennsylvania Rules of Civil Procedure have provided for discovery in 

furtherance of preparing a complaint, a mechanism that Reibenstein apparently did not 

explore in this case. Pursuant to Rule 4003.8, which was adopted in the wake of our 

decision in McNeil v. Jordan,

61 “[a] plaintiff may obtain pre-complaint discovery where the 

information sought is material and necessary to the filing of the complaint and the 

discovery will not cause unreasonable annoyance, embarrassment, oppression, burden 

or expense to any person or party.”62 This general rule is bolstered by companion 

provisions in Pennsylvania Rules of Civil Procedure 4001(c), 4005(a), and 4007(c), which 

collectively provide for pre-complaint interrogatories and depositions. Reibenstein could 

not have ruled out the prospect that the trial court in its discretion would allow her to seek 

such discovery.63 It would be unreasonable to deny Dr. Conaboy the benefit of MCARE’s 

statute of limitations merely because Reibenstein failed to investigate Dr. Conaboy’s 

putative role in Decedent’s death more diligently. 

Reibenstein would have us believe that she never had any chance of identifying 

Dr. Conaboy as a proper defendant in this action within the limitations period. But the 

facts and circumstances of this case suggest otherwise. Reibenstein’s own complaint 

indicates that, in the days before Decedent’s death, at least three physicians, including 

 

61 894 A.2d 1260 (Pa. 2006).

62 Pa.R.C.P. 4003.8(a).

63 Reibenstein herself concedes that “one of the purposes of the well-established 

Writ of Summons is to afford litigants the opportunity to properly investigate a case even 

after the statute of limitations has passed.” Reibenstein’s Br. at 35.
[J-86-2022] - 24

Dr. Conaboy, examined Decedent.64 Reibenstein clearly was conscious of the possibility 

of malpractice, and had no reason at the outset to exclude any of the treating physicians

from her preliminary investigations. Indeed, she “obtained expert review and opinion 

regarding the medical care and treatment provided by all health care professionals 

identified in [her medical] records.”

65 It is true, as Reibenstein emphasizes, that she could 

not file a complaint against Dr. Conaboy (or any provider) without first securing a 

certificate of merit, and Reibenstein asserts that she sought one unsuccessfully. But this 

tells us nothing about the quantum and quality of the information and guidance that she 

gave her chosen expert, and, in any event, disregards the alternative course of filing a 

writ of summons and seeking pre-complaint discovery.66

Collectively, these considerations leave unclear the reason for the slow progress 

of Reibenstein’s investigation; indeed, they highlight what perhaps should have been

perceived as urgency.

67

 Among other things, we do not know why so much time passed 

 

64 See Complaint at 2-5.

65 Reibenstein’s Br. at 5 (citing 231 Pa. Code Rule 1042.3 (setting forth MCARE’s 

certificate of merit requirement)) (emphasis in original).

66 It also confounds the persistent undertone of Reibenstein’s argument that she 

lacked cause to investigate Dr. Conaboy until she took Dr. Barax’s deposition. 

67 We highlight these concerns to rebut the overarching theme of Reibenstein’s 

argument that this case exemplifies the sort of putative injustice that will follow from a 

narrow understanding of the term “cause of death.” While the exceptions that the statute 

affords to the two-year limitations period are explicitly narrow, and the burden of 

establishing those exceptions is weighty, the effect is by no means draconian, especially

when evaluated in light of the competing interest in finality. See Fine, 870 A.2d at 860

(“The plaintiff has the burden of proving fraudulent concealment by clear, precise, and 

convincing evidence.”). What is more, the “fraudulent concealment” exception is not 

limited to affirmative conduct, inasmuch as “defendant’s conduct need not rise to fraud or 

concealment in the strictest sense, that is, with an intent to deceive; unintentional fraud 
[J-86-2022] - 25

between the filing of the complaint against Dr. Barax and the conclusion of discovery. 

However resistant Dr. Barax may have been, the passage of time was substantial, which 

may suggest relative inaction and delay, given what Reibenstein alleges was a flagrant 

pattern of obstruction of discovery. One would expect a zealous attorney to seek judicial 

intercession when confronted with persistent obduracy, and our law requires nothing 

less.68 It is incongruous at best that Reibenstein humored delay in scheduling the 

deposition for years before seeking court intervention, especially after she had filed a 

 

or concealment is sufficient.” Molineaux, 532 A.2d at 794 (citing Walters v. Ditzler, 

227 A.2d 833 (Pa. 1967); Nesbitt v. Erie Coach Co., 204 A.2d 473 (Pa. 1964)). 

68 See Fine, 870 A.2d at 860-61. Instead of addressing her evidently years-long 

inaction except in the vaguest of ways, Reibenstein alleges fraudulent and conspiratorial 

concealment and misrepresentation by either or both of Dr. Conaboy and Dr. Barax. But 

she supports these accusations with, at best, highly attenuated circumstantial evidence. 

The trial court expressly rejected Reibenstein’s aspersions as unsubstantiated, a 

conclusion that we have no cause to question and that we need not review. See T.C.O. 

at 4 (quoting 40 Pa.C.S. § 1303.513(d))(“Applying the law to the facts it is clear there is 

no evidence of affirmative misrepresentation or fraudulent concealment of the cause of 

death.”). Reibenstein, undeterred, continues to level these accusations before this Court, 

commencing oral argument before this Court not with legal analysis but by attacking 

Dr. Conaboy’s and Dr. Barax’s integrity:

One thing is clear beyond a reasonable doubt on this record before you: A 

physician licensed to practice medicine in the state of Pennsylvania raised 

his right hand and lied under oath in an attempt to avoid the consequences 

of killing one of their patients. . . . [A] second doctor also lied and/or 

conspired with that first doctor to also hide the malpractice that had 

occurred.

Oral Argument, Reibenstein v. Barax, 10/26/2021, at 36:50, available at 

https://www.youtube.com/watch?v=hkCzYtvSU2U; cf. id. at 47:25 (“I’m not convinced 

there wasn’t a conspiracy here.”). It is by no means clear whether the late discovery of 

the information upon which Reibenstein would rely in seeking to hold Dr. Conaboy liable 

was the product of deliberate individual or concerted actions by Dr. Barax or Dr. Conaboy

or something else entirely. The mere fact of inconsistent sworn testimony does not prove 

prevarication. More importantly, this Court is not the venue in which to litigate such 

matters. 
[J-86-2022] - 26

motion to compel at a much earlier stage upon encountering similar resistance in 

response to her written discovery requests.

69

 

Ultimately, the statute requires what it requires. The phrase “cause of death” as 

used in MCARE Section 513(d) refers specifically to the medical cause of death. Only an 

affirmative misrepresentation or fraudulent concealment of such medical cause of death 

will toll the two-year statute of limitations that MCARE prescribes for medical malpractice 

claims sounding in survival or wrongful death.70 

 

69 Notably, in Molineaux, supra, this Court declined to find sufficient concealment to 

toll the statute of limitations where the defendant hospital’s delay in divulging important 

records was a consequence of an error of form in counsel’s request.

70 Justice Dougherty’s Concurring and Dissenting Opinion comprises almost 

exclusively observations establishing the uncontroversial proposition—acknowledged 

above at length—that the Section 513(d) statute of limitation for death cases, which is 

tolled only in the event of fraudulent concealment, differs from the discovery rule, which 

tolls the limitations period for negligence cases involving non-fatal injuries. See Conc. & 

Diss. Op. at 2-6 (Dougherty, J.). As we explain above, death and non-death cases differ 

only in two ways, neither of which precludes drawing a useful analogy between them. 

See generally supra at 17-20. The first way they differ is that, in wrongful death cases,

death itself has been deemed sufficient to put a would-be plaintiff on inquiry notice of the 

prospect of wrongdoing and to commence the running of the statute of limitations. In nondeath cases, by contrast, inquiry notice and the running of the statute of limitations occurs 

when an injury was or could have been discovered by the plaintiff after diligent 

investigation. The second distinction, which follows from the qualitative difference 

between death and injury that underlies the first, arises because the discovery rule must 

address a wider array of obscuring circumstances that might, in the interests of fairness,

reasonably warrant its application, while the limitations period in death cases warrants 

tolling only when fraudulent concealment or affirmative misrepresentation obscures the 

cause of death and leads a would-be plaintiff to rest rather than investigate the 

circumstances of the death—or perhaps prompt an expert or attorney to decline a case 

that he or she might examined more closely if the medical cause of death had been 

accurately recorded, Our point is that the respective doctrines serve the same core 

purpose, for the same general reasons, and do so by the same mechanism—the tolling 

of the statute of limitations, whether for equitable or statutory reasons. Both, that is to 

say, reflect the judgment that when even diligent inquiry is confounded, relief from the 

statute of limitations is due. This analogy between the case law that preceded MCARE 

§ 513’s enactment, as informed both by discovery rule and death cases that addressed 

tolling, arguably supports the narrow construction of “cause of death” that the statutory 
[J-86-2022] - 27

We reverse the Superior Court’s contrary ruling, and we remand for restoration of 

the trial court’s grant of summary judgment in Dr. Conaboy’s favor.

Chief Justice Todd and Justice Brobson join the opinion.

Justice Dougherty files a concurring and dissenting opinion.

Justice Mundy files a concurring and dissenting opinion in which Justice Dougherty 

joins.

Justice Donohue did not participate in the consideration or decision of this matter.

 

language itself requires. Notably, Justice Dougherty does not confront the point upon 

which we disagree directly: why, strictly as a matter of statutory interpretation, MCARE’s 

use of the phrase “cause of death” necessarily incorporates both medical and legal cause 

of death. In this regard, he merely reiterates Justice Mundy’s observation that the 

narrower view will result in fewer plaintiffs benefitting from equitable tolling, which is likely 

correct. See Conc. & Diss. Op. at 7 (Dougherty, J.); Conc. & Diss. Op. at 7-8 (Mundy, 

J.). Be that as it may, this consequence reveals nothing more than a policy preference 

that the legislature implied in drafting Section 513(d), a preference that is not ours to 

displace.