Court Opinion

ID: 9750697
Source: CourtListenerOpinion
Date Created: 2023-08-28 15:23:05.897253+00
Date Added: 2024-06-11T07:26:18.759818
License: Public Domain

Justice EAKIN,
dissenting.
I respectfully dissent. I would find the Superior Court’s holding conflicts with Flanagan v. Labe, 547 Pa. 254, 690 A.2d 188 (1997), which held a nurse is precluded from offering expert opinion testimony regarding a medical diagnosis, thereby extending the constraints of The Professional Nursing Law1 to the courtroom.
The Superior Court noted Pennsylvania’s liberal standard for qualifying an expert witness, set forth in Pa.R.E. 702, and the application of this standard in qualifying non-medical expert witnesses to give medical opinions. Freed v. Geisinger Medical Center, 910 A.2d 68, 73-74 (Pa.Super.2006) (citing Miller v. Brass Rail Tavern, Inc., 541 Pa. 474, 664 A.2d 525, 529 (1995) (holding coroner with years of experience had specialized knowledge regarding time of death and qualified as expert to testify regarding same) and McClain v. Welker, 761 A.2d 155, 157-58 (Pa.Super.2000) (holding neuroscientist qualified as expert to testify regarding causation of cognitive disorders)).
In concluding the trial court’s refusal to qualify Nurse Pershall as an expert witness was improper, the Superior Court framed the issue as “whether a breach of the standard of nursing care for an immobilized patient proximately caused the unrelieved pressure that in turn caused [Appellee]’s pressure wounds to develop and/or worsen[,]” similar to the causation issue in McClain. Freed, at 74 n. 5. The court held Pershall was qualified to give expert testimony “on the causative relationship between breaches in the standard of care and [Appelleej’s pressure wounds” because “[h]er education *255and experience provide[d] her with ‘more expertise than is within the ordinary range of training, knowledge, intelligence, or experience’ concerning the cause of pressure wounds.” Id., at 75 (citing Flanagan, at 185). The Superior Court’s attempt to distinguish Flanagan on the basis a medical diagnosis was not at issue was erroneous, as medical causation of Appellee’s pressure wounds was clearly at issue, constituting a medical diagnosis. Thus, I agree with the majority to the extent it found the Superior Court’s holding contravenes Flanagan. Majority Op., at 242-43, 971 A.2d at 1207.
Unlike the majority, however, I would uphold Flanagan because it deferred to the Professional Nursing Law’s limitations, and acknowledged nurses are competent to provide testimony regarding applicable standards of nursing care. Flanagan, at 185 (emphasis added). The nurse in Flanagan was precluded from rendering an expert medical opinion because “the normal test of competency is constrained by a statutory provision limiting the deemed competency of nurses.” Id. Flanagan reasoned nurses may not testify concerning a medical diagnosis because the Professional Nursing Law expressly prohibits them from doing so. Id., at 186; 63 P.S. § 212(1), (4). Despite Pennsylvania’s liberal standard for the admission of expert testimony, because the legislature has prohibited nurses from rendering a medical diagnosis in the scope of their profession, it simply does not follow that a nurse would be qualified to render expert opinion as to a medical diagnosis in a court of law.
I agree Flanagan did not, as the majority states, “preclude the scientist’s testimony in McClain because the scientist was not a registered nurse.” Majority Op., at 244, 971 A.2d at 1208 (emphasis in original). Additionally, Flanagan relied on Miller in carving out an exception to the normal test of expert competency as applied to nurses. Flanagan, at 185. Miller and McClain are easily distinguishable from cases invoking the Professional Nursing Law, such as Commonwealth v. Jennings, 958 A.2d 536 (Pa.Super.2008), which the majority cites in support of its holding. See Majority Op., at 248-49, 971 A.2d at 1210-11. However, a medical diagnosis was not at *256issue in Jennings. Jennings found the “nursing diagnosis ” at issue was “essential to the effective execution and management of the nursing regimenJennings, at 540 (emphasis added).
The majority reasons expert testimony offered in a court of law does not implicate a nursing regimen — “there is no patient under treatment, no actual or potential health problem, no diagnosis or treatment, and no care is affected.” Majority Op., at 248, 971 A.2d at 1210. In this context, however, as the majority concedes, a nurse would not qualify as an expert to offer testimony on medical diagnosis or causation in light of the MCARE Act. Id., at 251 n. 8, 971 A.2d at 1212 n. 8 (“We recognize that our decision to overrule Flanagan may have limited impact in light of the legislature’s enactment of the MCARE Act____”). Prior to this concession, the majority cites the MCARE Act as supporting its finding “[h]ad the legislature intended that the Professional Nursing Law supersede the common law and duly enacted rules with regard to the standard for admission of expert testimony, it could have expressly indicated this intention, as it subsequently did in its enactment of the [MCARE Act]____” Id., at 247, 971 A.2d at 1210. In my view, the MCARE Act only serves to support Flanagan’s reasoning that the Professional Nursing Law’s limits extend to apply to nurses in the courtroom.
For the foregoing reasons, I would reverse the Superior Court and remand for reinstatement of the trial court’s grant of a compulsory non-suit in Appellants’ favor, pursuant to Flanagan.
Justice SAYLOR joins this dissenting opinion.

. 63 P.S. § 211 etseq.