Court Opinion

ID: 9908686
Source: CourtListenerOpinion
Date Created: 2023-12-11 17:09:37.389466+00
Date Added: 2024-06-11T12:49:26.706895
License: Public Domain

J-E02003-23

                            2023 PA Super 262

 LESLEY COREY, AS ADMINISTRATRIX :           IN THE SUPERIOR COURT OF
 OF THE ESTATE OF JOSEPH COREY,  :                PENNSYLVANIA
 AND LESLEY COREY, IN HER OWN    :
 RIGHT                           :
                                 :
            Appellant            :
                                 :
                                 :
            v.                   :
                                 :
                                 :
 WILKES-BARRE HOSPITAL COMPANY, :
 LLC, D/B/A WILKES-BARRE GENERAL :
 HOSPITAL, WILKES-BARRE GENERAL :
 HOSPITAL EMERGENCY DEPARTMENT :
 AND J. CHARLES LENTINI, M.D.    :
                                 :
            v.                   :
                                 :
 PENNSYLVANIA PHYSICIANS         :
 SERVICES, LLC                   :
                                 :
            Additional Defendant :                No. 507 MDA 2021

              Appeal from the Judgment Entered March 24, 2021
               In the Court of Common Pleas of Luzerne County
                      Civil Division at No(s): 2015-07551

BEFORE: PANELLA, P.J., BOWES, J., OLSON, J., DUBOW, J., KUNSELMAN,
        J., MURRAY, J., McLAUGHLIN, J., KING, J., and McCAFFERY, J.

OPINION BY KING, J.:                      FILED: DECEMBER 11, 2023

     Appellant, Lesley Corey, as administratrix of the estate of Joseph Corey,

and Lesley Corey, in her own right, appeals from the judgment entered in the

Luzerne County Court of Common Pleas, in favor of Appellee, Wilkes-Barre
J-E02003-23

Hospital Company, LLC, d/b/a Wilkes-Barre General Hospital (“WBGH”).1 We

affirm the judgment and grant the application to dismiss Appellant’s second

issue, which was filed by the additional defendant, Pennsylvania Physicians

Services, LLC (“PPS”).

       The relevant facts of this appeal are as follows. On August 8, 2013,

Joseph Corey (“Decedent”) experienced chest pain and difficulty breathing.

During the early morning hours of August 9, 2013, Decedent called 911 and

requested emergency medical assistance.               Ambulances responded to

Decedent’s house and transported him to WBGH, where Decedent was treated

in the emergency department.              Approximately twelve (12) hours later,

Decedent was transferred to Milton Hershey Medical Center (“MHMC”). On

August 11, 2013, Decedent died at MHMC.

       Appellant commenced this action by filing a praecipe for writ of

summons on July 1, 2015. On November 25, 2015, Appellant filed a complaint

against WBGH. The complaint included claims for wrongful death, a survival

action, and corporate negligence. The complaint also advanced a theory of

____________________________________________

1 Appellant and J. Charles Lentini, M.D., reached a settlement prior to trial,

and Dr. Lentini is not a party on appeal. (See Appellant’s Brief at 5). To the
extent the caption also references “Wilkes-Barre General Hospital Emergency
Department,” the trial court noted that this entity “is neither a person nor a
legal entity….” (Trial Court Opinion, filed 6/21/21, at 6; R.R. at 1120a).
Consequently, WBGH’s praecipe for the entry of judgment requested the entry
of judgment in its favor only, making no mention of the “Wilkes-Barre General
Hospital Emergency Department.” (See Praecipe for Entry of Judgment, filed
3/24/21, at 1; R.R. at 1106a).

                                           -2-
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vicarious liability. (See Complaint, filed 11/25/15, at ¶140; R.R. at 27a).

      On July 22, 2016, WBGH filed a joinder complaint against PPS. The

joinder complaint stated that WBGH executed a contract for PPS to provide

“the physicians, physician assistants and nurse practitioners” to staff WBGH’s

emergency department. (Joinder Complaint, filed 7/22/16 at ¶9; R.R. at 57a).

Thus, WBGH asserted its “right to indemnification and/or contribution against

[PPS] … for the amount of any judgment entered in favor of [Appellant].” (Id.

at ¶22; R.R. at 61a).

      The trial court opinion set forth the remaining procedural history of this

appeal as follows:

         A jury trial was conducted beginning on October [2], 2020.
         On October 7, 2020, after the testimony of all of
         [Appellant’s] liability witnesses, including her only medical
         liability expert, Ronald A. Paynter, M.D. (hereinafter Dr.
         Paynter), PPS moved for a compulsory nonsuit on all claims
         against it and WBGH moved for a compulsory nonsuit with
         respect to [Appellant’s] claim based on corporate
         negligence.     [Appellant] did not oppose PPS’s motion,
         however, WBGH did.          [Appellant] did oppose WBGH’s
         motion, however, PPS did not. Ultimately, the court denied
         PPS’s motion for a compulsory nonsuit but granted WBGH’s.
         As a result, [Appellant’s] only claims remaining against
         WBGH were those based on vicarious liability. WBGH’s claim
         against PPS seeking indemnification and/or contribution also
         remained.

         Trial resumed and, on October 15, 2020, following the
         court’s instructions to the jury regarding the applicable law
         involved in the case and the closing arguments of counsel
         for the parties, the court … presented a verdict slip to the
         jury in which “Question No. 1” appeared as follows:

            Question No. 1

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              Do you find that the conduct of anyone listed below
              fell below the standard of care. In other words, was
              anyone listed below negligent?

              Laura Bond, RN[2]           ___ Yes        ___ No

              [PPS]                       ___ Yes        ___ No

              If you answer Question No. 1 “No” as to
              everyone, you have reached a verdict. The
              foreperson should sign the verdict slip and
              notify the tipstaff.

              If you answer Question No. 1 “Yes” as to
              anyone, go to Question No. 2.

          The court specifically instructed the jury regarding
          “Question No. 1” as well [as] the other five jury verdict
          interrogatories that were included on the verdict slip. At the
          conclusion of the court’s final instructions, the jury was left
          by themselves in the courtroom to deliberate (rather than
          retire to a separate room because of COVID restrictions in
          place at the time).

          After approximately fourteen minutes of deliberation, the
          jury informed the court’s tipstaff that they had reached a
          verdict. The parties who were present, counsel, and the
          undersigned returned to the courtroom. At no time prior to
          the jury announcing their verdict did counsel for any party
          raise an objection with respect to the length of time that the
          jury had deliberated. After the court reviewed the verdict
          slip and found it to be in order, the jury foreperson
          announced that the jury had answered “No” on “Question
          No. 1” as to both Laura Bond, RN and [PPS]. The request
          of [Appellant’s] counsel to poll the jury was granted and it
          indicated that ten of the twelve jurors were in agreement
          with [the] verdict. The court directed that the verdict be
          entered of record and the jurors were dismissed.
____________________________________________

2 As we will discuss in conjunction with Appellant’s first issue, Nurse Bond, a

WBGH employee, was the nurse who cared for Decedent following his
admission to WBGH’s emergency department. (See Trial Court Opinion at 5;
R.R. at 1119a).

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          On October 26, 2020, [Appellant] filed a motion for post-
          trial relief pursuant to Pa.R.C.P. No. 227.1 in which she
          requested a removal of the nonsuit with the respect to her
          corporate negligence claim, a “new trial on all issues of
          liability and damages” and the “scheduling of an evidentiary
          hearing with respect to issues of potential jury misconduct.”
          Both WBGH and PPS filed responses to the motion. All
          parties filed briefs, and oral argument on the motion was
          held before the court on December 23, 2020. Prior to the
          court ruling on the motion …, WBGH, on March 24, 2021,
          entered judgment on the verdict pursuant to Pa.R.C.P. No.
          227.4(1)(b).[3]

(Trial Court Opinion at 2-4; R.R. at 1116a-1118a) (some capitalization

omitted).

       Appellant timely filed a notice of appeal on April 22, 2021. The trial

court did not order Appellant to file a Pa.R.A.P. 1925(b) concise statement of

errors complained of on appeal. On January 20, 2023, a three-judge panel of

this Court vacated the judgment in favor of WBGH and remanded the case for

a new trial. WBGH timely filed an application for reargument on February 1,

2023. On March 31, 2023, this Court granted en banc review and withdrew

the prior panel’s decision.

       Appellant now raises three issues for this Court’s review:

____________________________________________

3 “Once a post-trial motion is timely filed, judgment cannot be entered until

the trial court enters an order disposing of the motion or the motion is denied
by operation of law one hundred and twenty days after the filing of the
motion.” Melani v. Northwest Engineering, Inc., 909 A.2d 404, 405
(Pa.Super. 2006) (citing Pa.R.C.P. 227.4). Here, the trial court had yet to rule
on Appellant’s post-trial motion prior to WBGH filing its praecipe for entry of
judgment. Nevertheless, at the time when WBGH filed its praecipe, more than
120 days had passed since the filing of the post-trial motion.

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         Did [Appellant] present evidence of corporate liability
         sufficient to have required the trial court to deny a nonsuit
         motion by [WBGH] and submit this claim to the jury?

         Did [Appellant] present evidence of [WBGH’s] vicarious
         liability for the acts and omissions of attending physician,
         Dr. Perry, and its staff in general, sufficient to submit this
         claim to the jury as against the hospital itself on question 1
         of the verdict slip?

         Given the overall record of trial proceedings, should an
         evidentiary hearing have been conducted by the trial court
         to determine whether juror misconduct influenced the
         verdict?

(Appellant’s Brief at 4).

      In her first issue, Appellant insists that hospital personnel must

“recognize and report abnormalities in the treatment and condition of [their]

patients.” (Id. at 35). Appellant relies on the testimony from her liability

expert, Dr. Paynter, to establish that hospital personnel recognized Decedent’s

deteriorating condition, but they failed to take appropriate actions under the

circumstances. Appellant acknowledges WBGH’s argument that the record is

“devoid of evidence of [WBGH’s] actual or constructive knowledge of the

defects or procedures that caused harm” to Decedent. (Id. at 34). Appellant

emphasizes, however, that emergency department personnel knew that

Decedent was tachycardic, with falling blood pressure, and elevated

respirations. Appellant claims these symptoms were “reported on monitors

located in the patient’s room and at the central nurses’ station,” and these

monitors provided “actual, continuing notice” of Decedent’s deteriorating

condition. (Id. at 36) (emphasis omitted). Moreover, Appellant asserts that

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“constructive notice must be imposed when the failure to act to receive actual

notice is caused by the absence of supervision.”          (Id. at 44) (quoting

Brodowski v. Ryave, 885 A.2d 1045, 1057 (Pa.Super. 2005), appeal denied,

587 Pa. 680, 897 A.2d 449 (2006)).          In light of the relevant case law,

Appellant argues that Dr. Paynter’s testimony established a deviation from the

applicable standard of care. Appellant concludes that the trial court should

have submitted her corporate negligence claim to the jury, and the court

committed reversible error by granting WBGH’s motion for nonsuit.          We

disagree.

      The relevant standard of review is as follows:

         In reviewing the entry of a nonsuit, our standard of review
         is well-established: we reverse only if, after giving appellant
         the benefit of all reasonable inferences of fact, we find that
         the factfinder could not reasonably conclude that the
         essential elements of the cause of action were established.
         Indeed, when a nonsuit is entered, the lack of evidence to
         sustain the action must be so clear that it admits no room
         for fair and reasonable disagreement. The fact-finder,
         however, cannot be permitted to reach a decision on the
         basis of speculation or conjecture.

                                  *    *    *

         On appeal, entry of a compulsory nonsuit is affirmed only if
         no liability exists based on the relevant facts and
         circumstances, with appellant receiving the benefit of every
         reasonable inference and resolving all evidentiary conflicts
         in [appellant’s] favor. The compulsory nonsuit is otherwise
         properly removed and the matter remanded for a new trial.
         …    The appellate court must review the evidence to
         determine whether the trial court abused its discretion or
         made an error of law.

Munoz v. Children’s Hospital of Philadelphia, 265 A.3d 801, 805-06

                                      -7-
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(Pa.Super. 2021), appeal denied, ___ Pa. ___, 283 A.3d 1246 (2022) (internal

citations and quotation marks omitted).

      In Thompson v. Nason Hosp., 527 Pa. 330, 591 A.2d 703 (1991), our

Supreme Court “first adopted the theory that a corporation, specifically a

hospital, can be held directly liable for negligence.” Welsh v. Bulger, 548

Pa. 504, 512, 698 A.2d 581, 585 (1997). “Corporate negligence is a doctrine

under which a hospital owes a direct duty to its patients to ensure their safety

and well-being while in the hospital.” Ruff v. York Hospital, 257 A.3d 43,

49 (Pa.Super. 2021), appeal denied, ___ Pa. ___, 266 A.3d 1064 (2021).

         Under Thompson, a hospital has the following duties:

            (1) a duty to use reasonable care in the maintenance
            of safe and adequate facilities and equipment; (2) a
            duty to select and retain only competent physicians;
            (3) a duty to oversee all persons who practice
            medicine within its walls as to patient care; and (4) a
            duty to formulate, adopt and enforce adequate rules
            and policies to ensure quality care for the patients.

         Because the duty to uphold the proper standard of care runs
         directly from the hospital to the patient, an injured party
         need not rely on the negligence of a third-party, such as a
         doctor or nurse, to establish a cause of action in corporate
         negligence. Instead, corporate negligence is based on the
         negligent acts of the institution. A cause of action for
         corporate negligence arises from the policies, actions or
         inaction of the institution itself rather than the specific acts
         of individual hospital employees. Thus, under this theory, a
         corporation is held directly liable, as opposed to vicariously
         liable, for its own negligent acts.

Welsh, supra at 512-13, 698 A.2d at 585 (internal citations and quotation

marks omitted).

                                      -8-
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         With the four duties and the nature of a corporate
         negligence claim in mind, we now examine the three
         elements necessary to establish a prima facie case of
         corporate negligence. The plaintiff must establish all of the
         following:

            1.   [the hospital] acted in deviation from the
            standard of care;

            2.    [the hospital] had actual or constructive notice
            of the defects or procedures which created the harm;
            and

            3.    that the conduct was a substantial factor in
            bringing about the harm.

Brodowski, supra at 1057 (internal citation omitted). “[U]nless a hospital’s

negligence is obvious, a plaintiff must produce expert testimony to establish

that the hospital deviated from an accepted standard of care and that the

deviation was a substantial factor in causing the harm to the plaintiff.” Welsh,

supra at 514, 698 A.2d at 585.

      “To establish a claim for corporate negligence against a hospital, a

plaintiff must show that the hospital had actual or constructive knowledge of

the defect or procedures that created the harm.” Ruff, supra at 50 (quoting

Welsh, supra at 513, 698 A.2d at 585).

            It is well settled that a hospital staff member or
            employee has a duty to recognize and report
            abnormalities in the treatment and condition of its
            patients. If the attending physician fails to act in
            accordance with standard medical practice, it is
            incumbent upon the hospital staff to so advise hospital
            authorities in order that appropriate action might be
            taken.     A hospital is properly charged with
            constructive notice when it “should have known” of
            the patient’s condition. Furthermore, constructive

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            notice must be imposed when the failure to receive
            actual notice is caused by the absence of supervision.
            We interpret “failure to enforce adequate rules and
            policies” as an analog to “failure to provide adequate
            supervision.”

         [Rauch v. Mike-Mayer, 783 A.2d 815, 828 (Pa.Super.
         2001), appeal denied, 568 Pa. 634, 793 A.2d 909 (2002)]
         (citations omitted). For example, a hospital will be charged
         with constructive notice when its nurses should have known
         about a patient’s adverse condition, but failed to act. See,
         e.g., Whittington v. Episcopal Hosp., 768 A.2d 1144,
         1154 (Pa.Super.2001). In such cases, we have said that
         “constructive notice must be imposed when the failure to
         receive actual notice is caused by the absence of
         supervision.” Id.

Brodowski, supra at 1057.       “In a corporate negligence action against a

hospital, the element of actual or constructive notice is critical because the

corporate negligence doctrine contemplates a kind of systemic negligence in

the actions and procedures of the hospital itself rather than in the individual

acts of its employees.” Ruff, supra at 50 (internal citation and quotation

marks omitted).

      This Court has elaborated on these concepts as follows:

         [A] hospital is not directly liable under Thompson just
         because one of its employees or agents makes a mistake
         which constitutes malpractice. Just as regular negligence is
         measured by a reasonable person standard, a hospital’s
         corporate negligence will be measured against what a
         reasonable hospital under similar circumstances should
         have done. Thompson contemplates a kind of systemic
         negligence, such as where a hospital knows that one of its
         staff physicians is incompetent but lets that physician
         practice medicine anyway; or where a hospital should
         realize that its patients are routinely getting infected
         because the nursing staff is leaving catheters in the same
         spot for too long, yet the hospital fails to formulate, adopt

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         or enforce any rule about moving catheters. Thompson
         does not propound a theory of strict liability…. Though
         broadly defined, Thompson liability is still fault based.

Edwards v. Brandywine Hosp., 652 A.2d 1382, 1386-87 (Pa.Super. 1995).

      Instantly, Appellant relies on Dr. Paynter’s testimony to establish

WBGH’s knowledge of the defects and procedures that resulted in harm to

Decedent. (See Appellant’s Brief at 25-31). At trial, Dr. Paynter testified as

an expert “in the medical fields of emergency medicine and corporate

responsibility.” (N.T. Trial Part 2 at 34; R.R. at 165a). At the start of his

direct examination, Dr. Paynter opined that WBGH’s emergency department

“did not meet the standard of care.” (Id. at 35; R.R. at 166a). Dr. Paynter

explained that the paramedics who responded to the 911 call discovered that

Decedent “was very short of breath,” and they gave Decedent “breathing

treatments and then they put him on a CPAP machine.” (Id. at 36, 37, R.R.

at 167a, 168a). According to Dr. Paynter, these circumstances should have

prompted the emergency department to test Decedent’s arterial blood gas:

         Anybody who arrives in a hospital with either CPAP or BiPAP
         right off the ambulance is required to have a test called an
         arterial blood gas. Now, what is an arterial blood gas? …
         It’s taken from usually the radial artery in your wrist and it
         goes into your pulsing artery … and it takes blood that has
         just gone through your lungs and heart into the artery and
         it’s a much better measure. It’s the only real standard
         measure for the person’s respiratory status….

(Id. at 38; R.R. at 169a).

      Dr. Paynter posited that the arterial blood gas test “is a guide to how to

manage this person’s respiratory condition.” (Id. at 39; R.R. at 170a). If the

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test reveals that a patient is in so much respiratory distress that they might

stop breathing, then “you want to intubate the patient before they have

respiratory arrest.” (Id.) Dr. Paynter criticized the emergency department

for not following these protocols with Decedent:

          They didn’t do any of that. They just placed [Decedent] in
          a room and he got progressively worse to the point where
          he reached the point of in extremis, is the term we use in
          medicine, and that’s the time before you die. And he ripped
          his mask off and he stopped breathing and his blood
          pressure, his pulse all stopped.

(Id. at 40-41; R.R. at 171a-172a).

       Dr. Paynter reviewed Decedent’s autopsy report, which “indicated the

factual cause of death was lack of oxygen to the brain.” (Id. at 46; R.R. at

177a). Appellant’s counsel questioned whether Decedent’s brain would have

had sufficient oxygen if WBGH’s emergency department had placed him on a

ventilator. Dr. Paynter responded:

          Well in order to answer that question I need to bring up this
          period of time in which [Decedent] was unobserved for 12
          minutes before he coded.

          He was getting oxygenated, but he was becoming more
          acidotic[4] to the point that he lost consciousness and
          stopped breathing and it was unnoticed apparently for a
          period of time. That’s a serious situation. It only takes six
          minutes for the brain not receiving oxygen to die. And
          anything over that time can lead to permanent brain
          damage.

____________________________________________

4 Earlier, Dr. Paynter asserted: “If you’re not breathing adequately, your blood

becomes acid, acidotic is the term we use.” (N.T. Trial Part 2 at 38; R.R. at
169a).

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(Id. at 46-47; R.R. at 177a-178a).         Ultimately, Dr. Paynter testified: “If

[Decedent] had been intubated prior to that [twelve-minute period], he would

have been protected.” (Id. at 47; R.R. at 178a).

      Thereafter, Appellant’s counsel shifted his focus to the medical

monitoring equipment in the emergency department. Counsel asked whether

Decedent “was hooked up to certain monitors” that have alarms. (Id.) Dr.

Paynter responded:

         Absolutely. Let me explain a little bit about them. You put
         a high/low on the heart rate. You put a high/low alarm on
         the respiratory rate. So if the respiratory rate goes down
         say below 10, it would beep, beep, beep and then somebody
         would run in and see within seconds. There was testimony
         that there were no alarms on.

(Id.) Later, Appellant’s counsel revisited the issue of the alarms:

         [COUNSEL]:         Did you hear Ms. Bond testify that she
         did not hear any alarms come from the monitoring
         equipment that was attached to [Decedent]?

         [DR. PAYNTER]:       I did; yes.

                                 *     *      *

         [COUNSEL]:         Whose responsibility is it to have
         working equipment in the hospital?

         [DR. PAYNTER]:       It’s the hospital’s responsibility.

(Id. at 53; R.R. at 184a).

      Significantly, this exchange regarding the alarms on the monitoring

equipment was based on a mischaracterization of Nurse Bond’s testimony.

Nurse Bond did not testify that the alarms were off or that they somehow

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malfunctioned. Rather, Nurse Bond did not remember hearing the alarms:

           [COUNSEL]:         Thank you. When you returned to the
           room to find [Decedent] in arrest there were no alarms
           sounding were there?

           [NURSE BOND]:        To my knowledge I cannot recall. That
           was in 2013.

           [COUNSEL]:          Ma’am, you seem to recall today a
           great deal about 2013. You just told the jury you remember
           that. Do you have any specific recollection of alarms
           sounding when you went back to the room in 2013 at 5:54?

           [NURSE BOND]:        I’m telling you I do not recall. I have
           been doing this for a long time. I hear them all the time. I
           cannot on oath tell you, yes, I specifically recall.

(N.T. Trial Part 1 at 337-38; R.R. at 116a).

      Further, Nurse Bond explained the circumstances that led her to step

away from Decedent’s bedside for the twelve-minute period referenced by Dr.

Paynter:

           The only time that I had to run was to grab meds quickly.
           He got multiple antibiotics and steroids. And then I had
           explained his systolic blood pressure had dropped into the
           70s and we were giving him antibiotics and such and I felt
           it was a need that needed to be addressed by Dr. Perry
           because this man was sick. I went out and spoke to Dr.
           Perry about it because we have been working together so
           long and I said what’s our next plan of action for this man.

(Id. at 310-11; R.R. at 88a). Nurse Bond emphasized that she needed to

notify Dr. Perry of the drop in blood pressure “[b]ecause he’s the team lead.

He’s the doctor who I report to.” (Id. at 314; R.R. 91a-92a).

      Nurse Bond also testified that she did not believe she was endangering

Decedent by leaving his bedside:

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         I was giving him IV fluids, medications. I inserted an IV and
         drew labs off of it. I was taking vital signs and there is clear
         documentation that [Decedent] was on his cell phone and …
         I said a silly comment to him about that and he was
         completely awake, alert, and oriented. And I had no reason
         to feel leaving him to get IV fluids or speak to Dr. Perry
         would be any danger to the patient.

(Id. at 321; R.R. at 99a).

      The court analyzed this testimony and determined that the entry of a

nonsuit on Appellant’s corporate negligence claim was warranted:

         During his testimony, Dr. Paynter was specifically critical of
         Nurse Bond and the “Wilkes-Barre General Hospital
         Emergency Department” but mentioned no other individual,
         including [Dr. Perry], who was the attending emergency
         room physician when [Decedent] arrived at WBGH on
         August 9, 2013. Much of Dr. Paynter’s testimony was given
         in generalized, non-specific terms of what he believed
         “they” should have done differently without identifying who
         “they” were. Since the “Wilkes-Barre General Hospital
         Emergency Department” is neither a person nor a legal
         entity and this was not a case of res ipsa loquitur, the only
         fair inference regarding who “they” were in the context of
         [the] testimony was Nurse Bond and Dr. Perry. In his own
         words, Dr. Paynter’s criticism of their care was essentially
         limited to two issues: “One, they didn’t get ahead of it
         [Decedent’s worsening condition] by doing the [arterial]
         blood gas and doing an elective intubation. And two, when
         he did finally peter out and stopped breathing on his own,
         they were not there to help him.”

                                   *     *      *

         Even assuming, arguendo, that the jury had concluded that
         Nurse Bond and/or Dr. Perry were negligent (which they
         obviously did not given their answer to “Question No. 1” on
         the verdict slip), [Appellant] provided no evidence to
         establish that WBGH as an institution had actual or
         constructive notice of such negligence during the
         approximately twelve hours that [Decedent] was treated
         there. … Finally, while Dr. Paynter did speculate that there

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         may have been some issues regarding the alarms on some
         of the monitoring equipment in the emergency room, his
         testimony fell well short of what would be required to make
         out a case under the first prong of Thompson.

(Trial Court Opinion at 5-7; R.R. at 1119a-1121a) (some capitalization

omitted).

      Here, the court correctly entered a nonsuit on Appellant’s corporate

negligence claim. This case did not involve “a kind of systemic negligence” on

the part of WBGH. See Ruff, supra; Edwards, supra. The trial evidence

centered on the individual decisions and actions of a doctor and nurse in

conjunction with their care of a critically ill patient. Our review of the record

reveals that Appellant did not provide any expert testimony that Nurse Bond’s

medical care of the patient fell below acceptable medical standards to warrant

the imposition of constructive notice onto WBGH. See Brodowski, supra.

Nurse Bond was providing the medical care that the doctor had ordered for

Decedent, and this care led her to observe that Decedent’s systolic blood

pressure had dropped.      Rather than sitting back and watching Decedent

deteriorate, Nurse Bond proactively sought advice from the attending

physician on the next steps for treatment. Compare Welsh, supra (holding

plaintiff established prima facie case of corporate negligence against hospital

based on its failure to oversee all persons practicing medicine within its walls;

expert testified that hospital nurses breached applicable standard of care in

connection with delivery of infant, in that they must have been aware of

problem with delivery but failed to act on that knowledge). Likewise, when

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viewed in the context of Nurse Bond’s testimony about the night at issue, and

her testimony that she did not remember if any alarms went off, the court

properly determined that Dr. Paynter’s statements about the purported

failures of the alarms on the monitoring equipment amounted to speculation.

Based upon the foregoing, the court did not abuse its discretion or make an

error of law by entering the nonsuit on Appellant’s corporate negligence claim.

See Munoz, supra. Accordingly, Appellant is not entitled to relief on her first

claim.

      In her second issue, Appellant asserts that she “made a deliberate

decision in 2015 to bring suit against the hospital and not to file claims

against Dr. Perry, Nurse Bond or any other individual hospital employee.”

(Appellant’s Brief at 45-46) (emphasis in original).         As such, Appellant

contends that the “trial court’s decision to substitute PPS and Laura Bond on

the verdict slip, in place of [WBGH], was inconsistent with the pleadings,

[Appellant’s] theory of the case and the evidence presented at trial.” (Id. at

45). To the extent the verdict slip asked the jury to determine whether the

conduct of Nurse Bond or PPS violated the standard of care, Appellant

maintains that she did not “offer a theory of liability, an expert report or expert

opinion testimony contending that either Nurse Bond or … PPS violated a

specific standard of care[.]” (Id. at 46). Instead, Appellant’s “standard of

care evidence was directed at the hospital.” (Id.)

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       Further, Appellant argues that her complaint included “general

negligence allegations against WBGH separate from its corporate negligence

theory of liability.” (Id.) Appellant insists that she proved WBGH’s negligence

by presenting “sufficient evidence of the vicarious liability of [WBGH] for the

acts and omissions of Dr. Perry[.]” (Id. at 48). Appellant concludes that “it

was the hospital and not PPS that should have been named on the verdict

slip.” (Id.)

       As a prefatory matter, on October 11, 2021, PPS filed an application to

dismiss this issue, pursuant to Pa.R.A.P. 1972(a)(5). 5       PPS argued that

Appellant “failed to object to placing PPS on the verdict slip during trial,” and

Appellant could not salvage this claim by raising it for the first time at the

post-trial stage. (Application to Dismiss, filed 10/11/21, at ¶15). By order

entered October 25, 2021, this Court deferred PPS’s application to the merits

panel. We also provided time for Appellant to respond to PPS’s application.

Appellant timely filed her response on November 2, 2021. In it, Appellant

argued that she preserved this claim during the court’s charging conference

on October 15, 2020.          We now consider the parties’ various arguments

regarding this issue of waiver.

       “Issues not raised in the trial court are waived and cannot be raised for

____________________________________________

5 Generally, a party may move “[t]o dismiss for failure to preserve the
question below, or because the right to an appeal has been otherwise waived.”
Pa.R.A.P. 1972(a)(5).

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the first time on appeal.” Pa.R.A.P. 302(a). “A party ‘may not, at the post-

trial motion stage, raise a new theory which was not raised during trial.’” E.S.

Management v. Yingkai Gao, 176 A.3d 859, 864 (Pa.Super. 2017) (quoting

Keffer v. Bob Nolan’s Auto Service, Inc., 59 A.3d 621, 630 (Pa.Super.

2012)).

          On appeal the Superior Court will not consider a claim which
          was not called to the trial court’s attention at a time when
          any error committed could have been corrected. In this
          jurisdiction … one must object to errors, improprieties or
          irregularities at the earliest possible stage of the
          adjudicatory process to afford the jurist hearing the case the
          first occasion to remedy the wrong and possibly avoid an
          unnecessary appeal to complain of the matter.

McManamon v. Washko, 906 A.2d 1259, 1274 (Pa.Super. 2006), appeal

denied, 591 Pa. 736, 921 A.2d 497 (2007) (quoting Hong v. Pelagatti, 765

A.2d 1117, 1123 (Pa.Super. 2000)). More specifically, an appellant’s failure

to object to the verdict slip at trial waives a subsequent challenge to the

verdict slip on appeal. See Kimble v. Laser Spine Institute, LLC, 264 A.3d

782, 794 (Pa.Super. 2021) (en banc), appeal denied, ___ Pa. ___, 274 A.3d

722 (2022).

      Instantly, the court conducted a charging conference on October 15,

2020. At that time, the parties extensively discussed how the court should

instruct the jury regarding the legal relationships between WBGH and Dr.

Perry and Nurse Bond.      Initially, counsel for PPS stated, “I think the only

relevant inquiry is whether the physician provided by [PPS], Dr. Perry, was an

ostensible agent of [WBGH].”       (N.T. Trial Part 2 at 848; R.R. at 1050a).

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Ultimately, PPS’s counsel agreed to a stipulation “to the effect that it is

undisputed that Dr. Adam Perry was the emergency room physician provided

to [WBGH] during the relevant time period.” (Id. at 850; R.R. at 1052a).

      Thereafter, the parties continued to address the use of the term

“ostensible agent” during their review of the defendant’s proposed verdict slip.

The court asked Appellant’s counsel:

         [W]ell, let’s talk about question four on the defendant’s
         [proposed verdict slip]. Do you find that the emergency
         room physician supplied to the emergency department by
         [PPS] was an ostensible agent of [WBGH]. Now, … is
         [Appellant] okay with that?

(Id. at 858; R.R. at 1060a). Appellant’s counsel replied, “I believe that in

order for them to answer [questions] one and two, they will have already

considered the court’s instructions and it is unnecessary.” (Id.) Appellant’s

counsel expressed his preference for the term “apparent agent,” as opposed

to “ostensible agent.” (Id. at 859, 861; R.R. at 1061a, 1063a). The court

agreed to use the term “apparent.” (Id. at 862; R.R. at 1064a). At that point,

Appellant’s counsel immediately shifted the focus of the discussion from PPS

and Dr. Perry to the proposed verdict slip’s “substitution of Laura Bond for

[WBGH].” (See id. at 862-65; R.R. at 1064a-1067a).

      We detail these discussions because Appellant now relies upon this

portion of the transcript to support her claim that she raised a timely objection

to PPS’s placement on the verdict slip.        (See Appellant’s Response to

Application to Dismiss, filed 11/2/21, at ¶7). We cannot agree, however, that

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counsel’s questioning of the terminology in the defendant’s proposed verdict

slip equates to the issue Appellant now raises on appeal, which is a specific

objection to the substitution of PPS for WBGH. Moreover, the court gave the

parties one more opportunity to object to the verdict slip, immediately before

it provided the verdict slip to the jurors:

          THE COURT:                  I want to confirm that the court
          has furnished all counsel with a copy of the revised verdict
          slip, and except for objections, which were previously
          memorialized on the record, such as [the] defendant’s
          objection to the lack of comparative negligence, are counsel
          now satisfied with the verdict slip?

          [APPELLANT’S COUNSEL]:                   Yes.

(N.T. Trial Part 2 at 955-56).6

       Based upon our review of the record, we agree with PPS that Appellant

failed to make a timely and specific objection to the naming of PPS on the

verdict slip. See Kimble, supra; E.S. Management, supra; McManamon,

supra. Consequently, Appellant’s second issue is waived, and we grant PPS’s

application for relief.

       In her third issue, Appellant complains that “the jury returned a verdict

within 14 minutes after the case was given to it for decision.” (Appellant’s

Brief at 49). Appellant “does not believe that the ‘conference’ resulting in a

verdict should be considered ‘deliberations’ within the meaning of our civil

justice system.” (Id.) “[G]iven the complex nature of the case, the extensive

____________________________________________

6 This portion of the transcript was omitted from the reproduced record.

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proofs and the unusually brief period of time in which the verdict was secured,”

Appellant concludes that this Court must remand the matter for “an

evidentiary hearing to examine whether an improper outside influence, or

other misconduct, influenced the jury’s final hour of service to the [c]ourt.”

(Id. at 51). We disagree.

       “[I]n instances of post-verdict allegations of extraneous information

and/or outside influence affecting jury deliberations, we adopt the objective

test for prejudice as well as the associated guidelines that are set forth in the

lead opinion in [Carter by Carter v. U.S. Steel Corp., 529 Pa. 409, 421-22,

604 A.2d 1010, 1016-17 (1992), cert. denied, 506 U.S. 864, 113 S.Ct. 186,

121 L.Ed.2d 130 (1992)].”7 Pratt v. St. Christopher’s Hosp., 581 Pa. 524,

541, 866 A.2d 313, 324 (2005). “The procedure for development of such

claims and their ultimate disposition remain vested, in the first instance, within

the sound discretion of the trial courts.” Id. In post-trial proceedings alleging

____________________________________________

7 In Carter, a plurality opinion, Justice Larsen wrote the opinion announcing

the judgment of the Court. Significantly, Carter provided a framework for
determining whether an outside influence on a jury created “a reasonable
likelihood of prejudice” warranting a new trial:

          In determining the reasonable likelihood of prejudice, the
          trial judge should consider 1) whether the extraneous
          influence relates to a central issue in the case or merely
          involves a collateral issue; 2) whether the extraneous
          influence provided the jury with information they did not
          have before them at trial; and 3) whether the extraneous
          influence was emotional or inflammatory in nature.

Carter, supra at 421-22, 604 A.2d at 1016-17 (footnote omitted).

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that a jury was influenced by extraneous information or outside influence, the

burden of proof is allocated to the party contesting the verdict. See id. at

541, 866 A.2d at 323.

      Instantly, the court recognized that the only basis for Appellant’s

“outside influence” claim was the amount of time spent in deliberations:

         In the present case, unlike those relied upon in [Appellant’s
         post-trial] brief, there has been no indication to the court or
         counsel, by a juror or anyone else, that extraneous
         prejudicial information was brought to the jury’s attention
         or that an outside influence was improperly brought to bear
         on any juror. Instead, [Appellant] urges this court to take
         “judicial notice” that the length of the jury’s deliberations,
         standing alone, is per se evidence of jury misconduct and
         requests an evidentiary hearing in which all sixteen jurors
         (12 members and 4 alternates) can be questioned regarding
         the nature of their deliberations.

(Trial Court Opinion at 10; R.R. at 1124a) (some capitalization omitted).

      Although Appellant correctly cites Pa.R.E. 606(b) for the proposition that

a juror may testify about whether prejudicial information or outside influence

was improperly brought to bear on the jury, the trial court correctly

determined that Appellant failed to offer any good reason to justify further

inquiry into the validity of the verdict. Appellant does not cite any relevant

authority to establish that quick deliberations are evidence of outside

influence.   Absent more, we agree with WBGH’s assertion that Appellant’s

request constitutes “a wholesale fishing expedition by her counsel in the face

of a defense verdict.” (See WBGH’s Brief at 41). See also Pratt, supra at

543, 866 A.2d at 324-25 (Justice Newman dissenting) (explaining that general

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rule that jurors may not impeach verdict was formulated to, inter alia,

discourage harassment of jurors by losing parties). On this record, the court

did not err in finding that Appellant failed to satisfy her burden and cannot

demonstrate the need for further evidentiary proceedings. See Pratt, supra.

Accordingly, we affirm the judgment entered in favor of WBGH.

      Judgment affirmed. Application to dismiss Appellant’s second issue is

granted.

      Judge Bowes, Judge Olson, Judge Dubow, Judge Murray

joined this Opinion.

      Judge Olson files a Concurring Opinion in which Judge Bowes

and Judge Dubow joined.

      Judge Kunselman files a Dissenting Opinion in which President Judge

Panella, Judge McLaughlin and Judge McCaffery joined.

Judgment Entered.

Benjamin D. Kohler, Esq.
Prothonotary

Date: 12/11/2023

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