Court Opinion

ID: 9962063
Source: CourtListenerOpinion
Date Created: 2024-04-22 16:12:13.809753+00
Date Added: 2024-06-11T08:19:48.407141
License: Public Domain

J-A27011-23

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT O.P. 65.37

  JOHANNA SWART AND MADELEINE                  :   IN THE SUPERIOR COURT OF
  HEYNS                                        :        PENNSYLVANIA
                                               :
                       Appellant               :
                                               :
                                               :
                v.                             :
                                               :
                                               :   No. 387 MDA 2023
  UPMC PINNACLE HOSPITALS,                     :
  ORTHOPEDIC INSTITUTE OF                      :
  PENNSYLVANIA AND RONALD W.                   :
  LIPPE, MD                                    :

           Appeal from the Judgment Entered February 10, 2023
  In the Court of Common Pleas of Dauphin County Civil Division at No(s):
                           2020-CV-10091-MM

BEFORE:      LAZARUS, J., NICHOLS, J., and STEVENS, P.J.E.*

MEMORANDUM BY NICHOLS, J.:                               FILED: APRIL 22, 2024

       Appellants Johanna Swart and Madeleine Heyns appeal from the order

granting summary judgment in favor of Appellees University of Pittsburgh

Medical    Center     Pinnacle     Hospitals   (UPMC),   Orthopedic   Institute   of

Pennsylvania (OIP), and Ronald W. Lippe, M.D (Dr. Lippe). Appellants argue

that the trial court erred in concluding that the applicable statute of limitations

had expired. We reverse and remand for further proceedings consistent with

this memorandum.

       The trial court summarized the relevant facts and procedural history of

this matter as follows:

____________________________________________

* Former Justice specially assigned to the Superior Court.
J-A27011-23

     On October 9, 2020, [Appellants] initiated this action by filing a
     writ of summons against [Appellees]. They later filed a complaint
     sounding in medical negligence, in which the asserted that []
     Swart underwent her first total right hip replacement surgery
     November 17, 2015, performed by [] Dr. Lippe of [OIP] at
     [UPMC]. [Appellants] allege Dr. Lippe used implants of an
     improper length. On December 21, 2016, Dr. Lippe treated
     [Swart] for continued pain and conducted a right hip aspiration.
     At that time, [Swart’s] pain was worse with activities, standing
     and walking was difficult, that she was at the point that she could
     barely work, that her range of motion was decreased and that she
     was walking with a walker. Dr. Lippe diagnosed her with having
     a loose femoral component and that she needed a second total
     right hip replacement surgery. [Swart] understood this to mean
     that Dr. Lippe would be putting in a longer stem.

     On January 17, 2017, Dr. Lippe preformed a second total hip
     replacement surgery at [UPMC], allegedly failing to correct
     [Swart’s] leg length discrepancy.      [Swart] complained post-
     surgery that her right leg was still shorter than her left leg and
     that Dr. Lippe refused to address her concerns or measure her
     legs. [] Swart further pled:

        68. On or around December 4, 2017, [Swart] was fed up
        with being in pain almost constantly for two years since her
        first hip surgery by Dr. Lippe in 2015. So her primary
        physician referred her to Dr. Curran at OSS Health. He
        documented in his report that [Swart] was experiencing
        instability of her leg, her femoral head had collapsed, that
        she still uses a cane, and that her legs were two different
        lengths. He referred her to Dr. Margetas at his practice.

        71. On or around January 3, 2018, Dr. Margetas from OSS
        Orthopedic Health . . . treated [Swart] who told him that
        she could no longer deal with the pain and that she was
        experiencing numbness and tingling and weakness in her
        hip and thigh. He confirmed that her legs were different
        lengths which caused her limping[.]

        72. On or around January 3, 2018, [Dr.] Lippe treated
        [Swart] and upon her desperate request and her telling him
        that Dr. Margetas agreed with her, [Dr.] Lippe finally
        measured her leg lengths and agreed that there was a
        discrepancy in the lengths. He prescribed her to get a ¼
        inch shoe lift. This was the first time after the last surgery

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        that [Dr.] Lippe asked to see her walk. The last time he did
        this was right after her first surgery.

        79. On or around July 9, 2018, [Swart] was treated by
        orthopedic doctor, Hennie Bosch. He diagnosed her with a
        loose femoral stem with unequal leg lengths.             He
        documented that the tip of the greater tuberosity[,] which
        [Dr.] Lippe inserted was quite high[,] which will cause the
        abductors not to function properly [and] subsequently
        present a shorter leg.

        81. On or around October 10, 2018, [Swart] underwent her
        third hip replacement surgery. This time the surgery was
        conducted by Dr. Joseph Alhadeff from OSS. He used a
        different system than [Dr.] Lippe. He reported that during
        surgery her femoral components were so loose that it lifted
        out easily and quickly.

        86. Diagnostics after the first two surgeries visually show
        the neck of stem Dr. Lippe implanted was too short and
        made her legs uneven; yet [Dr.] Lippe failed to ever address
        this on his own.

     In Counts 1, 2 and 3, [] Swart asserted a claim against each of
     the three [Appellees], respectively, for medical negligence,
     including claims against the corporate [Appellees] based upon
     vicarious liability and/or respondeat superior. In Counts 4, 5 and
     6, [] Heyns asserted a claim for loss of consortium against each
     of the three [Appellees].

     After preliminary objections were resolved, the [Appellees] Dr.
     Lippe and OIP, and [UPMC], separately, raised as affirmative
     defenses that [Appellants’] claims were barred by the two-year
     statute of limitations applicable to personal injury claims. 42 Pa.
     C.S. § 5524(2). After the pleadings were closed, the parties
     conducted discovery. On November 18, 2022, [Appellees] filed a
     joint motion for summary judgment and a brief in support, seeking
     dismissal of [Appellants’] action as having been filed beyond the
     two-year statute of limitations. [Appellants] filed a response and
     brief in opposition on December 27, 2022. After [Appellees] filed
     a reply brief, this court held oral argument. Following argument,
     this court granted summary judgment in [Appellees’] favor,
     issuing the following:

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                                    ORDER

         AND NOW, this 10th day of February 2023, with the benefit
         of briefs and oral argument, [Appellees’] joint motion for
         summary judgment . . . based on the statute of limitations
         is GRANTED.

         Recognizing that summary judgment is a drastic remedy to
         be granted only in the clearest cases, resolving all (if any)
         doubt in favor of denying summary judgment and viewing
         the evidence in a light most favorable to [Appellants], the
         court finds no genuine issue of material fact regarding the
         statute of limitations and timeliness of the writ of summons
         by which this matter was initiated. This is the clearest case.

         It is not disputed that [Appellants] initiated this matter more
         than two years after the date of [] Swart’s alleged injury
         and that [Appellants] rely upon the discovery rule exception
         to permit their action to proceed. The court will resist the
         temptation to find, as a matter of law, that [] Swart had
         actual knowledge of her injury and its precise cause well
         before October 10, 2018, as that need not be the focus of
         our analysis. In evaluating the timeliness of this matter, the
         court must apply the objective, inquiry notice standard and
         rejects the definitive diagnosis standard upon which
         [Appellants’] counsel relies, by which [Appellants] argue
         that the statute did not begin to run until October 10, 2018.
         The court finds, as a matter of law, that through the exercise
         of reasonable diligence, the injury and its cause were
         apparent to [] Swart and that the [Appellants] failed to
         initiate suit within the prescribed period.

         Summary judgment is thus entered in favor of [Appellees]
         on all claims pled against them. [] Swart’s direct claim and
         [] Heyns’ derivative claims are DISMISSED, with prejudice.

Trial Ct. Op., 5/3/23, at 1-4 (formatting altered and footnote omitted).

      Appellants filed a timely appeal, and both the trial court and Appellants

complied with Pa.R.A.P. 1925.

      On appeal, Appellants present the following issue:

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      Whether the trial court erred in granting Appellees’ joint motion
      for summary judgment based on the statute of limitations filed
      pursuant to Pa.R.C.P. 1035.2(1)?

Appellants’ Brief at 7 (formatting altered).

      Appellants argue that the trial court erred in concluding that the statute

of limitations had expired and granting summary judgment in favor of

Appellees. Appellant’s Brief at 15. Appellants contend that when the record

is viewed in the light most favorable to them as the non-moving party, genuine

issues of material fact exist as to whether Appellants knew or should have

known that Swart’s injuries were caused by Appellees more than two years

prior to the date they filed their writ of summons on October 9, 2020. See

id. at 15-16. In support, Appellant Swart alleged that she was in pain, but

she continued to treat with Appellee Dr. Lippe who repeatedly assured Swart

that her complaints were extended results of her surgery.       See id. at 20.

Subsequently, in July of 2018, Appellant Swart saw Dr. Bosch in South Africa.

Dr. Bosch did not testify. Swart relayed that, Dr. Bosch noted that Swart had

a leg-length discrepancy, and he equivocally stated that Swart’s femoral stem

may have been inserted too high. See id. at 20-21. However, Appellants

assert that Dr. Bosch did not state or suggest that the condition of Swart’s hip

was due to a medical mistake by Dr. Lippe, and Dr. Bosch did not conduct any

imaging or procedures to confirm his position. See id. at 20-21. Appellants

argue that it was not until Dr. Alhadeff performed surgery on October 10,

2018, and confirmed the existence of grossly loose femoral components as

the cause of Swart’s pain and disability. See id. at 20. Appellants contend

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that there is a genuine issue of material fact concerning whether Swart was

on inquiry notice prior to Dr. Alhadeff’s surgery on October 10, 2018.1 See

id. at 17-22. Accordingly, Appellants argue that their writ of summons, which

was filed on October 9, 2020, was filed within two-years from the date

Appellants discovered the injury on October 10, 2018. See id. at 23-26.

         Appellee OIP/Dr. Lippe argues that summary judgment was proper as

there is no genuine issue of material fact that Appellants’ claims are barred

by the two-year statute of limitations set forth in 42 Pa.C.S. § 5524(a)(2).

See Appellees’ Brief (OIP/Dr. Lippe) at 30-31.         Appellee OIP/Dr. Lippe

contends that Swart had actual knowledge as well as constructive notice of a

causal injury by July of 2018 at the latest when she treated with Dr. Bosch.

See id. at 34. Similarly, Appellee UPMC argues that Appellants were informed

that Swart had a loose femoral stem and a leg-length discrepancy by Dr.

Bosch, at the latest, on July 9, 2018. See Appellees’ Brief (UPMC) at 42.

Alternatively, both Appellee UPMC and Appellee OIP/Dr. Lippe assert that

Appellants waived application of the discovery rule because they failed to raise

it and plead facts in support. See id. at 45; Appellees’ Brief (OIP/Dr. Lippe)

at 52.

         Our standard of review of an order granting or denying summary

judgment is as follows:

____________________________________________

1 Appellants further assert that they could not have obtained a certificate of

merit pursuant to Pa.R.C.P. 1042.3, prior to Dr. Alhadeff’s surgery on October
10, 2018. See Appellants’ Brief at 20-21.

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     When considering a motion for summary judgment, the trial court
     must take all facts of record and reasonable inferences therefrom
     in a light most favorable to the non-moving party and must
     resolve all doubts as to the existence of a genuine issue of material
     fact against the moving party. An appellate court may reverse a
     grant of summary judgment if there has been an error of law or
     an abuse of discretion. Because the claim regarding whether
     there are genuine issues of material fact is a question of law, our
     standard of review is de novo and our scope of review is plenary.

Nicolaou v. Martin, 195 A.3d 880, 891-92 (Pa. 2018) (citations omitted).

The Pennsylvania Rules of Civil Procedure provide:

     After the relevant pleadings are closed, but within such time as
     not to unreasonably delay trial, any party may move for summary
     judgment in whole or in part as a matter of law

        (1) whenever there is no genuine issue of any material fact as
        to a necessary element of the cause of action or defense which
        could be established by additional discovery or expert report[.]

Pa.R.C.P. 1035.2(1).

     Further, in Pennsylvania, tort claims for negligence are subject to a two-

year statute of limitations. See 42 Pa.C.S. § 5524(a)(2) (providing that “[a]n

action to recover damages for injuries to the person or for the death of an

individual caused by the wrongful act or neglect or unlawful violence or

negligence of another” must be commenced within two years).

     The Judicial Code provides that limitations periods run from the
     time the cause of action accrued.          42 Pa.C.S. § 5502(a).
     Generally, a cause of action accrues, and thus the applicable
     limitations period begins to run, when an injury is inflicted. Once
     a cause of action has accrued and the prescribed statutory period
     has run, an injured party is barred from bringing his cause of
     action. The discovery rule is an exception to this rule that tolls
     the statute of limitations when the plaintiff is reasonably unaware
     that she has been injured and that her injury has been caused by
     another party’s conduct. A cause of action accrues upon actual or

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      constructive knowledge of at least some form of significant harm
      and of a factual cause linked to another’s conduct, without the
      necessity of notice of the full extent of the injury, the fact of actual
      negligence, or precise cause.

      The discovery rule requires the plaintiff to exercise reasonable
      diligence in investigating the cause of her injuries. The reasonable
      diligence standard is objective, as the question is not what the
      plaintiff actually knew of the injury or its cause, but what he might
      have known by exercising the diligence required by law. That
      being said, the objective reasonable diligence standard is
      sufficiently flexible to take into account the differences between
      persons and their capacity to meet certain situations and the
      circumstances confronting them at the time in question, and, as
      such, is to be applied with reference to individual characteristics.

      Under this reasonable diligence standard, a plaintiff’s actions are
      examined to determine whether the plaintiff demonstrated those
      qualities of attention, knowledge, intelligence and judgment which
      society requires of its members for the protection of their own
      interest and the interest of others. It is the party that asserts
      application of the discovery rule that bears the burden of proving
      that reasonable diligence was exercised.          Finally, as noted,
      because the reasonable diligence determination is fact intensive,
      the inquiry is ordinarily a question for the jury.

Carlino v. Ethicon, Inc., 208 A.3d 92, 103-04 (Pa. Super. 2019) (some

citations omitted and formatting altered).

      Although the reasonable diligence standard is an objective one, it
      is to be applied with reference to individual characteristics.
      Pursuant to the application of the discovery rule, the point at
      which the complaining party should reasonably be aware that
      [s]he has suffered an injury is a factual issue best determined by
      the collective judgment, wisdom and experience of jurors.

      Indeed, the polestar of the Pennsylvania discovery rule is not a
      plaintiff’s actual acquisition of knowledge but whether the
      information, through the exercise of due diligence, was knowable
      to the plaintiff. The failure to make inquiry when information is
      available is failure to exercise reasonable diligence as a matter of
      law.

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DiDomizio v. Jefferson Pulmonary Assocs., 280 A.3d 1039, 1046 (Pa.

Super. 2022) (citations omitted and formatting altered). Further,

      A plaintiff who wishes to assert the discovery rule may do so in
      one of two ways: 1) by pleading in the complaint sufficient facts
      to sustain application of the rule; or 2) by waiting until the
      defendant asserts a statute of limitations defense in new matter
      and then raising the discovery rule in a responsive pleading.

Id. at 1045 n.5 (quoting Prevish v. Northwest Med. Ctr. Oil City Campus,

692 A.2d 192, 197 (Pa. Super. 1997)).

      With these principles in mind, we must determine whether the trial court

erred or abused its discretion in concluding that Appellants knew or should

have known of the injury more than two years prior to the date that they filed

their writ of summons. See Nicolaou, 195 A.3d at 892; DiDomizio, 280

A.3d at 1046; Carlino, 208 A.3d at 103-04.

      In Nicolauo, our Supreme Court found that it is within the province of

a jury to determine whether an untrained lay person should have known that

she suffered from a disease after a obtaining a “probable” diagnosis, and

concluded that it is for the jury, not a court, to determine whether a person

acted reasonably in delaying testing to confirm a “probable” diagnosis.

Nicolaou, 195 A.3d at 895.

      In Nicolauo,

      the plaintiff suffered a tick bite in 2001 and underwent four Lyme
      disease tests over the next several years. The test results for
      Lyme disease were negative; instead, she was diagnosed with
      multiple sclerosis [(MS)]. In 2009, another health practitioner,
      Nurse Rhoads, suggested that the plaintiff’s Lyme disease tests
      yielded false negatives and recommended that the plaintiff

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     undergo a different test. At first, the plaintiff declined because
     she lacked health insurance and could not pay for it out of pocket,
     but she later agreed to take the test. On February 13, 2010, the
     test came back positive for Lyme disease. On February 10, 2012,
     she filed a complaint against various medical providers alleging
     that they were negligent for failing to diagnose Lyme disease. The
     trial court granted summary judgment to the providers. Our
     Supreme Court summarized the trial court’s ruling as follows:

        The trial court reasoned that prior to [the plaintiff’s] last visit
        with Nurse Rhoads on February 1, 2010, [the plaintiff] was
        aware that her symptoms arose after a tick bite; that a 2006
        MRI indicated that she had either MS or Lyme disease; that
        treatment for MS had been unsuccessful; that Nurse Rhoads
        believed she probably had Lyme disease based on her
        clinical symptoms and prior MRI; that Nurse Rhoads treated
        her for Lyme disease by administering antibiotics, after
        which [the plaintiff] saw an improvement in her symptoms;
        and that Nurse Rhoads had urged [the plaintiff] to confirm
        the diagnosis with a different type of Lyme disease test.

        The trial court reasoned that not only would a reasonable
        person have suspected that [the plaintiff’s] injuries could
        have been caused by [the providers’] failure to diagnose and
        treat her Lyme disease, but that [the plaintiff] actually
        suspected such connection, as demonstrated by her
        Facebook post, stating that she suspected she had Lyme
        disease before she received the positive test results.
        Finally, the trial court rejected the contention that [the
        plaintiff’s] inability to pay for a fifth Lyme disease test tolled
        the statute of limitations, finding that [the plaintiff] “could
        have confirmed her suspicion regarding the Lyme disease
        diagnosis on or about the December 7, 2009 visit, but she
        opted not to.”

     [Nicolaou,] 195 A.3d at 886-87.

     Our Supreme Court reversed and remanded for further
     proceedings, reasoning that genuine issues of material fact
     prevented the providers from obtaining summary judgment under
     the statute of limitations . . . . Id. at 895 (quotations and citations
     omitted).

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      In a nutshell, despite the evidence pointing to Lyme disease in
      Nicolaou, other evidence precluded judgment as a matter of law
      by creating a genuine issue of material fact as to whether the
      plaintiff reasonably should have known that she suffered from
      Lyme disease more than two years before she filed suit. Id.

Carlino, 208 A.3d at 105-06 (some formatting altered).

      Here, the trial court explained:

      [Appellants’] allegations of negligence against Dr. Lippe, upon
      which all claims of negligence are based as to [Appellees], rest
      upon assertions that Dr. Lippe inserted prosthetics that were too
      short during each of [Swart’s] right hip replacement surgeries, on
      November 17, 2015 and January 17, 2017, respectively, which
      resulted in her right leg being shorter than her left. . . . Swart
      asserted that after her second surgery, her pain remained
      relentless until her third surgery on October 10, 2018.
      [Appellants] initiated their action on October 9, 2020, when they
      filed their writ of summons, two years less a day from the date of
      . . . Swart’s third surgery.

      [Appellees] argued that the record clearly showed that the very
      latest [Appellants’] action accrued was on or around July 9, 2018,
      after . . . Swart obtained a third orthopedic surgeon’s opinion,
      confirming earlier opinions she obtained from two other doctors in
      late 2017 and early 2018, that the hip replacement components
      used by Dr. Lippe were too short and caused . . . Swart’s shorter
      right leg and corresponding pain.          Thus, the latest that
      [Appellants] could have instituted their action, according to
      [Appellees], was July 8, 2020. [Appellants] argued that under the
      discovery rule, their negligence action did not accrue until after
      Swart’s third surgery on October 10, 2018, during which Dr.
      Lippe’s negligence was confirmed. As such, [Appellants] argued
      they had until October 9, 2020, to commence their action, and
      that they so complied.

Trial Ct. Op., 5/3/23, at 5-6.

      The trial court also concluded:

      Swart consistently testified at her deposition, without any
      contradiction or ambiguity, that she knew no later than July 9,
      2018, that she was suffering from significant pain, leg length

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      discrepancy[,] and corresponding physical limitations following
      her second surgery and that she believed that this harm was
      caused by Dr. Lippe’s second surgery, which beliefs were
      confirmed to her by other doctors. [Appellants] have failed to
      otherwise show by specific facts in their depositions, answers to
      interrogatories, admissions or affidavits that there are any
      genuine issues for trial.

      The record clearly showed that [Appellants’] action accrued no
      later than July 9, 2018. Because [Appellants] did not commence
      their suit until October 9, 2020, the action was filed beyond the
      two-year statute of limitations. Accordingly, this court entered
      judgment in favor of [Appellees] and dismissed [Appellants’]
      complaint.

Trial Ct. Op., 5/3/23, at 19.

      Following our review of the record, we are constrained to disagree with

the trial court’s findings, and we conclude that the trial court abused its

discretion in granting Appellees’ motion for summary judgment.            See

Nicolaou, 195 A.3d at 892; see also DiDomizio, 280 A.3d at 1046; Carlino,

208 A.3d at 103-04.

      Although Swart testified that Dr. Bosch discussed his observations

regarding her hip, the femoral stem, and noted that Swart’s legs were not of

equal length, Swart stated that Dr. Bosch never asserted that Dr. Lippe erred

or that Swart’s condition was caused by any mistake on the part of Dr. Lippe.

See N.T., Swart Dep., 4/8/22, at 106-08. Further, while Swart was aware

that she was in pain and had a leg length discrepancy, there is a genuine issue

of fact concerning whether she knew or should reasonably have known that

her pain and symptoms were caused by Dr. Lippe prior to October 10, 2018.

See Carlino, 208 A.3d at 103-04; see also Appellants’ Compl., 12/7/20, at

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¶¶ 81-89.      As noted previously, “the point at which the complaining party

should reasonably be aware that [s]he has suffered an injury is a factual issue

best determined by the collective judgment, wisdom and experience of

jurors.” DiDomizio, 280 A.3d at 1046 (citation omitted).

       Under the circumstances presented here, a determination concerning

when Appellants knew or should have known whether Dr. Lippe caused injuries

is a question best left to a jury. See DiDomizio, 280 A.3d at 1046; see also

Nicolaou, 195 A.3d at 895. Indeed, it is not for the trial court to decide issues

of fact on summary judgment, but only to decide whether there is an issue of

fact to be tried. See Nicolaou, 195 A.3d at 895; Pa.R.C.P. 1035.2(1). After

review, we conclude that there is a genuine issue of material fact regarding

whether Appellants should reasonably have been aware that Swart’s pain and

symptoms were caused by Appellees more than two years before Appellants

initiate the underlying action.       See Nicolaou, 195 A.3d at 892; Pa.R.C.P.

1035.2(1).2

       In sum, we conclude that the factual issues pertaining to Appellants’

notice and diligence must be decided by a jury. See Nicolaou, 195 A.3d at

895. Accordingly, we are constrained to reverse the order granting summary
____________________________________________

2 With respect to Appellees’ alternate claim that Appellants waived the
discovery rule, we disagree. As noted above, in their complaint, Appellants
plead that they did not discover Appellees’ negligence until after Dr. Alhadeff
performed surgery on October 10, 2018, and Dr. Alhadeff concluded that
Swart’s pain was due to Dr. Lippe’s surgery. See Appellants’ Compl., 12/7/20,
at ¶¶ 81-89. We conclude that Appellants’ assertions in her complaint were
sufficient to preserve her discovery rule claim. See, e.g., DiDomizio, 280
A.3d at 1045 n.5.

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judgment and remand this matter to the trial court for further proceedings

consistent with this memorandum.

      Order reversed. Case remanded for further proceedings. Jurisdiction

relinquished.

Judgment Entered.

Benjamin D. Kohler, Esq.
Prothonotary

Date: 4/22/2024

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