Opinion ID: 1976643
Heading Depth: 2
Heading Rank: 3

Heading: Appeal of Ms. Corbett, 1105 Philadelphia, 1987

Text: In her appeal in this case, Ms. Corbett contends that the trial court erred in ruling as a matter of law that she was not entitled to recover from Dr. Weisband and ROPA any of the damages related to the subsequent care given by Dr. Greene, including the amputation of her leg in July 1983. Therefore, she seeks a new trial limited to the damage aspect of her case. Ms. Corbett relies upon the well-established Pennsylvania principle that a tortfeasor whose negligence is the legal cause of injury to a plaintiff is also liable for additional injury caused by the unskillful treatment that the plaintiff receives from a physician whom the plaintiff, exercising ordinary care, has selected. Lebesco v. Southeastern Pennsylvania Transportation Authority, 251 Pa. Super. 415, 422, 380 A.2d 848, 852 (1977). Accord, Embrey v. Borough of West Mifflin, 257 Pa.Super. 168, 390 A.2d 765 (1978) and Smialek v. Chrysler Motors Corp., 290 Pa.Super. 496, 434 A.2d 1253 (1981). See also Restatement (Second) of Torts § 457 and Prosser & Keeton on Torts, § 44 (5th ed. 1984), at 301 et seq. There is no dispute between the parties about this principle and Dr. Weisband and ROPA do not argue that it is not a correct statement of the law. They argue, however, that that principle is not applicable in this case for either one of two reasons. First, Dr. Weisband and ROPA contend that Dr. Greene's subsequent conduct in treating Ms. Corbett was so highly extraordinary that his intervening act constituted a superseding cause which insulates Dr. Weisband and ROPA from liability for the consequences of Dr. Greene's conduct. In the alternative, Dr. Weisband and ROPA argue that the injury caused by Dr. Greene is clearly apportionable and therefore liability for those injuries may not be imposed upon them. The trial court agreed with the arguments of Dr. Weisband and ROPA and refused to submit to the jury the plaintiff's claim for the damages and injury that were the proximate result of Dr. Greene's negligent conduct. We have concluded that the trial court erred in this regard for the reason that the issue of a superseding cause on the record before us is a jury question. As to the issue concerning apportionment, the record before us does not provide a reasonable basis for apportionment by either the Court or the jury and therefore a new trial must be held.
At the trial on damages, Dr. Weisband and ROPA argued, and the trial court agreed, that Dr. Weisband is not responsible, as a matter of law, for the damages suffered by Ms. Corbett after she came under the care of Dr. Greene because Dr. Greene's conduct was so highly extraordinary as to constitute a superseding cause of her subsequent injuries, i.e., aggravation and prolongation of her pain and the ultimate amputation of her leg. On appeal, Ms. Corbett essentially responds that although Dr. Weisband cannot, as a matter of law, be held responsible for damages flowing from a highly extraordinary act, i.e., a superseding cause, the question of whether an intervening act is highly extraordinary should properly be left to the jury, and the trial judge erred in making that determination and taking it from the jury under the facts of this case. The trial court held that the opinion testimony from every physician who commented on Dr. Greene's subsequent conduct  that a total knee replacement in a patient of Ms. Corbett's condition was highly unusual and constituted extraordinary negligence  was sufficient to remove the issue from the province of the jury. For the reasons which follow, we disagree with the trial court and award Ms. Corbett a new trial limited to the issue of damages. An exception to the general rule that a tortfeasor is responsible for injuries arising from his or her negligence may be provided by an intervening act, however, if it constitutes a superseding cause. A superseding cause is an act of a third person or other force which by its intervention prevents the actor from being liable for harm to another which his antecedent negligence is a substantial factor in bringing about. Restatement (Second) of Torts § 440. As Professors Prosser and Keeton have stated, the problem is one of whether the defendant is to be held liable for an injury to which the defendant has in fact made a substantial contribution, when it is brought about by a later cause of independent origin, for which the defendant is not responsible. Prosser & Keeton on Torts § 44 (5th ed. 1984), at 301. The law as to negligent intervening acts is set forth in Restatement (Second) of Torts § 447, which has been adopted in Pennsylvania. [11] The section outlines the circumstances under which a negligent intervening act is not a superseding cause: The fact that an intervening act of a third person is negligent in itself or is done in a negligent manner does not make it a superseding cause of harm to another which the actor's negligent conduct is a substantial factor in bringing about, if (a) the actor at the time of his negligent conduct should have realized that a third person might so act, or (b) a reasonable man knowing the situation existing when the act of the third person was done would not regard it as highly extraordinary that the third person had so acted, or (c) the intervening act is a normal consequence of a situation created by the actor's conduct and the manner in which it is done is not extraordinarily negligent. Whether or not the intervening act of a third person is so highly extraordinary as to constitute a superseding cause is a jury question, as held by our Supreme Court in Estate of Flickinger v. Ritsky, 452 Pa. 69, 305 A.2d 40 (1973). There the Court adopted Comment b to § 453 of the Restatement (Second) of Torts: If . . . the negligent character of the third person's intervening act or the reasonable foreseeability of its being done is a factor in determining whether the intervening act relieves the actor from liability for his antecedent negligence, and under the undisputed facts there is room for reasonable difference of opinion as to whether such act was negligent or foreseeable, the question should be left to the jury. (Emphasis added.) This concept has been continuously reaffirmed in subsequent cases. See Ross v. Vereb, 481 Pa. 446, 392 A.2d 1376 (1978) (whether victim's intervening act of running away from school children and into path of skidding car constituted a superseding cause of harm was a matter for the jury's determination); Thompson v. City of Philadelphia, 320 Pa.Super. 124, 466 A.2d 1349 (1983) (whether City of Philadelphia, as first actor who installed guardrails, could have reasonably foreseen negligent operation by second actor truck driver who drove his rig through guardrail resulting in death to motorist, was a fact question for the jury); Harvey v. Hansen, 299 Pa.Super. 474, 445 A.2d 1228 (1982) (whether a reasonable person would find injured driver's conduct to have been highly extraordinary within the meaning of § 447 was a question for the jury); Amabile v. Auto Kleen Car Wash, 249 Pa.Super. 240, 376 A.2d 247 (1977) (whether vacuum pumps at car wash were negligently placed so as to expose injured party to unreasonable dangers was a question for the factfinder). In each of the above-cited cases, the recurring concept is that where reasonable minds could differ, resolution of such questions is properly left to the jury. Estate of Flickinger v. Ritsky, 452 Pa. 69, 76, 305 A.2d 40, 44 (1973). Thus, our task in the case at bar is to determine whether reasonable minds could differ on the question of whether Dr. Greene's decision to perform a total knee replacement in the absence of taking an adequate history was so highly extraordinary as to constitute a superseding cause which insulates Dr. Weisband and ROPA from liability for the harm resulting from Dr. Greene's care. Dr. Weisband and ROPA argue that all of the testimony elicited at trial regarding Dr. Greene's conduct establishes that Dr. Greene acted in a highly extraordinary manner. They point to the following: First, responding to a hypothetical fact situation in which the questioner postulated that Dr. Greene knew of the existence of the chronic osteomyelitis (which he did not, due to his failure to take an adequate history), Dr. Meinhard testified that it borders on insanity to go ahead and do a total knee [replacement]. He added that such a procedure would not be good medical practice, and agreed that it could be characterized as gross negligence. Second, Dr. John Sbarbaro, an expert witness for Dr. Weisband, testified, I cannot conceive of how [Dr. Greene] could have missed the diagnosis of osteomyelitis. He added that the total knee replacement was doomed to failure the day it was done because it was a totally and poorly conceived procedure. Third, Dr. Weisband testified that he would not have considered doing a total knee replacement on a patient with chronic osteomyelitis: That would be the most inhumane thing you could do to a patient with this condition. . . . [A]s soon as you put a foreign substance into a knee joint that has chronic osteomyelitis, it's going to flare up the chronic osteomyelitis, if not the day of the surgery, within a period of time. No sane orthopedic surgeon would ever do this without planning to amputate soon afterwards. T.T., December 12, 1985 at 48-49. Finally, Dr. Weisband and ROPA point to deposition testimony of Dr. Greene, admitted at trial, in which he admits that he was completely unaware of any infection in Ms. Corbett's left knee prior to performing the total knee replacement. The trial court held that the cumulative effect of the foregoing testimony was to establish as a matter of law that Dr. Greene had been grossly negligent in his treatment of Ms. Corbett and that reasonable minds could not differ. Trial court opinion at 20. This lack of skill or want of care, said the trial court, is so obvious as to be within the range of ordinary experience and comprehension of even non-professional persons. Trial court opinion at 21. We agree that the record establishes that, without question, Dr. Greene was negligent and that expert testimony is not necessary to establish that proposition as a fact. In fact, no one contends that Dr. Greene was not negligent. Whether or not he was negligent is not, however, the issue. The issue is whether his negligence was highly extraordinary. About that question, reasonable minds could differ. We hold, therefore, that the trial court erred, under the circumstances of this case, in reaching such a conclusion as a matter of law. First, the statements made under oath by Drs. Meinhard, Sbarbaro, and Weisband characterizing the conduct of Dr. Greene as border[ing] on insanity and a thing that no sane orthopedic surgeon would ever do are, in effect, expressions of opinion as to the ultimate issue, i.e., whether Dr. Greene's conduct was highly extraordinary. Our Supreme Court recently noted: For over a century, we have consistently held that an expert's comment on the totality of the evidence, where the evidence is in conflict, improperly impinges upon the jury's exclusive province. Kozak v. Struth, 515 Pa. 554, 559, 531 A.2d 420, 422 (1987). Therefore, although no objection was made to that testimony, it was inappropriate for the witnesses to express an opinion as to the ultimate issue, i.e., whether Dr. Greene's negligence rose to the level of being highly extraordinary. Dr. Greene testified that he was unaware of the osteomyelitis at the time he performed the total knee replacement. Whether or not such conduct was so extreme as to constitute a superseding cause was a question that should properly have been left to the jury. Furthermore, the court's function is not to decide issues of fact but merely to determine whether any such issues exist. Taylor v. Tukanowicz, 290 Pa.Super. 581, 586, 435 A.2d 181, 183 (1981), quoted in Petri v. Smith, 307 Pa.Super. 261, 268, 453 A.2d 342, 345 (1982) (emphasis added). The testimony upon which the trial court made its finding consisted primarily of opinion testimony, some of which was based on hypothetical facts not established of record. We hold that the jury should have had an opportunity to decide based on that evidence whether Dr. Greene's conduct was highly extraordinary. Therefore, the trial court erred in ruling as a matter of law that Dr. Weisband could not be liable for any damages sustained by Ms. Corbett following the commencement of care by Dr. Greene.
As an alternative basis for its ruling excluding from the jury's consideration damages for the injuries sustained by Ms. Corbett while under the care of Dr. Greene, the trial court concluded that it could, as a matter of law, apportion the damages sustained by Ms. Corbett between Dr. Weisband and Dr. Greene. The trial court apparently concluded that because the acts of negligence of Dr. Weisband and Dr. Greene were separate from each other in nature and/or time, the damages are accordingly apportionable. Trial court opinion at 18. Ms. Corbett argues on appeal that the trial court erred in so holding because (1) her injury was not capable of apportionment in this case and (2) even if it were, the actual apportionment should have been made by the jury under proper instructions from the trial court. Dr. Weisband argues that the question of apportionment is one solely for the trial court and under the facts of this case apportionment was proper. Our review of the record and consideration of the briefs have led us to the conclusion that the trial court erred based upon the record before it. The principles governing the apportionment of damages between multiple tortfeasors are set forth in the Restatement (Second) of Torts § 433 A, Apportionment of Harm to Causes. That section provides that: (1) Damages for harm are to be apportioned among two or more causes where (a) there are distinct harms, or (b) there is a reasonable basis for determining the contribution of each cause to a single harm. (2) Damages for any other harm cannot be apportioned among two or more causes. Further, comment (i) to subsection (2) states: Certain kinds of harm, by their very nature, are normally incapable of any logical, reasonable, or practical division. Death is that kind of harm, since it is impossible, except upon a purely arbitrary basis for the purpose of accomplishing the result, to say that one man has caused half of it and another the rest. The same is true of a broken leg, or any single wound, or the destruction of a house by fire, or the sinking of a barge. Such harms can be apportioned, if it (sic) all, only upon the basis of a prior reduction in value of what has been destroyed. By far the greater number of personal injuries, and of harms to tangible property, are thus normally single and indivisible. Where two or more causes combine to produce such a single result, incapable of division on any logical or reasonable basis, and each is a substantial factor in bringing about the harm, the courts have refused to make an arbitrary apportionment for its own sake, and each of the causes is charged with responsibility for the entire harm. Applying these principles to the present case, it is clear that the question to be decided is whether there is a reasonable basis for determining the contribution of Dr. Weisband's conduct and Dr. Greene's conduct to the loss of Ms. Corbett's leg. Ms. Corbett's contention in this case is that each of the doctors, although at a different time and place, negligently performed certain surgical procedures on her leg, each procedure of which was a substantial factor in causing the eventual loss of the leg. Our review of the record in this case does not disclose any reasonable basis for determining the contribution of each of the two doctors to that loss. See Prosser & Keeton on Torts, § 52, Apportionment of Damages (5th ed. 1984). The Pennsylvania Supreme Court recently had occasion to consider the principles set forth in § 433 A in the case of Martin v. Owens-Corning Fiberglas Corp., 515 Pa. 377, 528 A.2d 947 (1987). The plaintiff in that case filed suit to recover damages for asbestosis and related diseases allegedly resulting from his being required to work in proximity with asbestos products manufactured by the defendants. Evidence was presented at trial that plaintiff's condition was the result of both asbestosis and emphysema caused by the plaintiff's long-time use of cigarettes. The trial court concluded that apportionment of the damages was appropriate and submitted the issue to the jury under proper instructions. On appeal the Supreme Court held that the evidence presented did not provide a basis for the jury's consideration of the issue of apportionment and the case was remanded to the trial court for a new trial limited to the question of damages. The Court, after summarizing the testimony of the various medical experts who testified, noted that the jury had not been provided with any guidance in determining the relative contributions of asbestos exposure and cigarette smoking to appellant's disability. In fact, two experts testified that such a determination was not possible. 515 Pa. at 384, 528 A.2d at 950. The Court went on to point out that [t]he causes of disability in this case do not lend themselves to separation by lay-persons on any reasonable basis.(4) Thus, common sense and common experience possessed by a jury do not serve as substitutes for expert guidance and it follows that any apportionment by the jury in this case was a result of speculation and conjecture and hence, improper.(5) `Rough approximation' is no substitute for justice. (4) Compare, McAllister v. Pennsylvania Railroad Co., [324 Pa. 65, 187 A. 415 (1936)] (Medical testimony and other proofs made it possible for jury to arrive at a reasonable basis of apportionment), with Capone v. Donovan, 332 Pa.Super. 185, 480 A.2d 1249 (1984). (Apportionment on reasonable basis not possible where three physicians each failed to properly diagnose fracture of plaintiff's arm.) (5) Rice v. Hill, 315 Pa. 166, 173, 172 A. 289, 291-92 (1934). (A jury may not award damages based upon speculation or conjecture.) Id. (footnote 6 omitted.) The case before us is in much the same posture. The evidence of record does not differentiate between the relative contributions of Dr. Weisband and Dr. Green to Ms. Corbett's loss of her leg. Any attempt, therefore, to apportion damages between the two doctors would of necessity be based upon speculation. The most recent discussion of the subject of apportionment by this Court was in the case of Glomb v. Glomb, 366 Pa.Super. 206, 530 A.2d 1362 (1987). In that case the minor plaintiff had suffered brain damage, disfiguration, and certain physical disabilities at the hands of a baby-sitter. The child's guardian instituted suit against the baby-sitter and the child's parents who, it was alleged, had been negligent in employing the baby-sitter on the occasion in question. The parents argued that the minor child's damages should be apportioned between them on the one hand and the baby-sitter on the other. The trial court rejected that argument and a verdict of $1.5 million dollars was returned in favor of the child against all of the defendants. On appeal, counsel for the parents again argued that the trial court had erred in failing to submit the question of apportionment to the jury. An en banc panel of this Court rejected that argument and affirmed the judgment. We held that the record was void of any logical, reasonable, or practical basis to aid the jury in apportioning the damages resulting from the parents' negligence. The Court emphasized that each case is unique and requires a practical inquiry that analyzes the special circumstances of each case. Our Court said, Although most single, personal injuries defy objective apportionment . . . we should not allow one party to bear an entire liability if the particular facts of the case will support a reasonable alternative. On the other hand, we cannot allow an arbitrary apportionment merely to avoid imposition of entire liability. A Court should not limit the innocent plaintiff's ability to recover the full measure of damages unless the Court has some reasonable basis for doing so. Id., 366 Pa.Superior Ct. at 212, 530 A.2d at 1365. Again, in the case before us as in Glomb, there is no evidence in the record that would support a reasonable or rational determination by the factfinder of the percentage of Ms. Corbett's damages that are attributable to Dr. Weisband and that percentage attributable to Dr. Greene. In sharp contrast to Martin and Glomb is the decision of this Court in Embrey v. Borough of West Mifflin, 257 Pa.Super. 168, 390 A.2d 765 (1978). In that case Mr. Embrey was injured in an automobile accident at an intersection. He was taken from the scene of the accident to a hospital. Five days after the accident, while he was still in the hospital, Mr. Embrey died of pulmonary edema. Suits were filed against the motor vehicle defendants and the medical care providers. The suits were consolidated for trial and the question of apportionment of damages between the motor vehicle defendants and the medical care providers was submitted to the jury by the trial judge. The jury, in response to special interrogatories, awarded $5,000 in damages as a result of the automobile accident and more than $600,000 resulting from the medical malpractice. On appeal in Embrey, the medical defendants contended that the trial court had erred in permitting apportionment and contended that the total judgment should be against all of the defendants equally. This Court rejected that argument and affirmed the trial court's ruling. We held that there existed in the record [c]redible evidence, however, [which] clearly delineates the damages which were suffered as a result of [the motor vehicle] negligence and those which were suffered as a result of the medical malpractice which followed. Id., 257 Pa.Superior Ct. at 177, 390 A.2d at 770. Our Court noted that among the evidence was the testimony of a doctor who expressed the opinion that the decedent's injuries sustained in the motor vehicle accident were not life threatening. He further expressed the opinion that the decedent, had he been given proper medical care, would have returned to work within three months of the date of the accident. The doctor testified that in his opinion the decedent's life could have been saved up until at least one hour prior to his actual death had proper medical attention and care been provided. This Court noted that the jury's decision, placing the responsibility for the decedent's death and a considerable amount of his pain and suffering on the medical provider defendants, was appropriate. A similar result was obtained in Smialek v. Chrysler Motors Corp., 290 Pa.Super. 496, 434 A.2d 1253 (1981) where this Court noted that one of the medical experts who testified had expressed an opinion that the decedent probably would have survived the accident absent the [succeeding] negligence of medical personnel. . . . Id., 290 Pa.Superior Ct. at 509, 434 A.2d at 1260. [12] There is no similar evidence in the case before us. The trial court and the appellees [Dr. Weisband and ROPA] rely primarily on the decisions of this Court in Harka v. Nabati, 337 Pa.Super. 617, 487 A.2d 432 (1985), Capone v. Donovan, 332 Pa.Super. 185, 480 A.2d 1249 (1984), Voyles v. Corwin, 295 Pa.Super. 126, 441 A.2d 381 (1982), and Lasprogata v. Qualls, 263 Pa.Super. 174, 397 A.2d 803 (1979). However, the issue before this Court in those four cases was entirely different from the issue before us in this case. All of those cases were before this Court to review the trial court's entry of summary judgment for one of multiple tortfeasors and determine the effect to be given a release executed and delivered by the plaintiff in each case to the released tortfeasor. In Harka, Voyles, and Lasprogata the injured party had filed an action against one or more subsequent tortfeasors. In each case, the subsequent tortfeasor(s) sought to join the initial tortfeasor as an additional defendant. Moreover, in each case the initial tortfeasor, after having been joined, pled a release from the plaintiff. In each instance summary judgment was entered in favor of the released, initial tortfeasor. This Court, in each of those cases, concluded that the various tortfeasors were not joint tortfeasors and that at the ensuing trial against the subsequent tortfeasor(s) the injured party's damages should be apportioned to the extent to which they were capable of being divided. However, in none of those cases did the Court have before it, as it does here, a record containing evidence upon which a determination could be made concerning apportionment. In Capone the situation before the Court was reversed but the issue similar in that the effect of a release given by the plaintiff was determinative. In Capone the case before this Court was that of the plaintiff who had been injured against the initial tortfeasor. In that case it appeared that the plaintiff had earlier settled a claim against a subsequent tortfeasor and had given that tortfeasor a release. The initial tortfeasor pled the release given by the plaintiff to the subsequent tortfeasor. The trial court, upon request, entered summary judgment for the initial tortfeasor and dismissed plaintiff's claim. On appeal the summary judgment was reversed. This Court held that the various tortfeasors were joint tortfeasors and therefore the plaintiff's release given to the subsequent joint tortfeasor did not release the initial tortfeasor. The Court also concluded that the damages claimed could not be apportioned. Once again, however, there was no trial record before the Court from which a determination could be made regarding the apportionability of the plaintiff's damages. In other words, the issue in those cases was not the sufficiency of the evidence taken at trial to support a claim of apportionment but on the contrary, dealt with whether the various tortfeasors were joint or not and the effects of a release given by the plaintiff to one of them. The trial court in this case, in determining that apportionment was proper and excluding all evidence pertaining to damages resulting from the treatment and care rendered by Dr. Greene, focused on the nature of Dr. Greene's conduct, describing it as gross negligence. The Court reviewed at some length the testimony of the various witnesses and the opinions regarding Dr. Greene's conduct. In this respect the trial court erred. The primary focus and inquiry in deciding the question of apportionment should not be on the nature of the various tortfeasors' conduct but rather on the injury and whether, when that injury is a single one, there is any rational basis in the evidence of record to aid the factfinder in deciding what portion of fault should be attributed to each of the contributing tortfeasors. This the trial court did not do. For example, in Martin v. Owens-Corning Fiberglas Corp., supra , the basis of the defendant's liability was strict liability as a result of the production and distribution of the various products containing asbestos. On the other hand, the plaintiff's conduct was alleged to be negligent. Importantly, our Supreme Court did not focus on the distinction between negligence versus strict liability in deciding whether apportionment was or was not appropriate. Rather, the focus was on the record evidence to determine whether there was any such evidence that would provide an adequate or reasonable basis for the jury to make a determination apportioning damages without merely speculating. The same analysis is evident in Glomb v. Glomb, supra . The parents' conduct was described as being negligent. However, the baby-sitter's conduct was characterized as an intentional tort. This Court did not focus on the distinction between a negligent act on the one hand and an intentional, harm-producing act on the other. Instead, as in Martin, the focus was on the quality of the record evidence to determine whether or not once again an appropriate guideline had been presented to enable the jury to do any more than speculate in attempting to pro-rate or apportion the damages between the defendants. The burden in the case at bar was on the defendants, Dr. Weisband and ROPA, to present evidence of such a nature that damages could be apportioned. Martin v. Owens-Corning Fiberglas Corp., supra . As already pointed out, there is no such evidence in the record before us. Therefore, it is necessary that the plaintiff be given an opportunity to present evidence regarding her subsequent injuries at the hands of Dr. Greene and the ultimate loss of her leg. Obviously, Dr. Weisband will be entitled, at that time, to present any evidence, if available, from which a jury could reasonably and rationally apportion the damages sustained between the various tortfeasors. In this regard we note that while it is true the initial determination as to whether apportionment is appropriate is to be made by the Court, that does not mean that the Court is then to make the actual apportionment. The cases are clear on this. On the contrary, if the trial court concludes that there is sufficient evidence presented for the jury to make a reasonable determination apportioning damages, then the actual apportionment is to be left to the jury under appropriate circumstances. For these reasons we will reverse and remand for a new trial.
Ms. Corbett also requests that a new trial, limited to damages, be awarded. A new trial may be awarded solely on the issue of damages if (1) the issue of liability has been fairly determined, and (2) the question of damages is readily separable from the issue of liability. McIntyre v. Clark, 314 Pa.Super. 552, 461 A.2d 295 (1983). As previously noted, this trial was bifurcated, and the jury decided the issue of liability before any evidence regarding damages was presented. We have already found that liability in this case was fairly determined. In the trial court, the issues of liability and damages were argued to be readily separable. Under these circumstances, a new trial on damages alone is appropriate. Martin v. Owens-Corning Fiberglas Corp., 515 Pa. 377, 528 A.2d 947 (1987); see also Troncatti v. Smereczniak, 428 Pa. 7, 235 A.2d 345 (1967); Ecksel v. Orleans Construction Company, 360 Pa.Super. 119, 519 A.2d 1021 (1987).