Supreme Court gives physicians win on wrongful death suits, MCARE.  PA-ACP advocacy led to the decision.

The Pennsylvania Supreme Court in Reibenstein v Barax has accepted PA-ACP’s arguments on behalf of members that previously undisclosed communications between doctors about a patient’s fatal aneurysm cannot extend the statute of limitations in a civil suit from the current seven years.

“This opinion of the Supreme Court  is a solid win for internists, practitioners and hospitals, said Larry Jones, MD, FACP, the PA-ACP’s president.”  The Chapter had joined in filing an amicus curiae brief on the case, advocating for its members with the Court in the case, which involved interpretation of “cause of death” under the MCARE statute.

The case revolved around whether a previously undisclosed communication between doctors about a patient’s fatal aneurysm could toll the two-year statute of limitations, extending it from the current seven years.  The state Superior Court had ruled that the “cause of death” as it appears in MCARE’s statute of limitation refers to ‘conduct leading to death,’ not the medical cause of death and that the phrase "cause of death" is somehow ambiguous.

The MCARE Act provides that its two-year limitations period on death actions, which commences upon death, will be tolled when there is an affirmative misrepresentation or fraudulent concealment of the “cause of death.“

“If left to stand, the Superior Court’s ruling could have opened up the courts for hundreds of additional suits, revised the statute of limitations, and raised med mal insurance policy costs for all physicians,” Jones said.

In the majority opinion, Justice Wecht rejected a broad reading of the term “cause of death,” holding that it does not encompass considerations associated with the “manner” of death (i.e., legal cause).  “We hold that MCARE’s tolling provision cannot bear the breadth of that reading.”

The majority defended the MCARE Act by stating: “At some point the clock must run out, lest health care providers remain subject to liability exposure indefinitely, with the prospect of a trial marred by the death or diminished memory of material witnesses or the loss of critical evidence. And this increased uncertainty will be priced into malpractice insurance premiums, precisely the circumstance MCARE was designed to mitigate.”

In rejecting the “manner leading to death” or “legal cause of death” interpretation of “Cause of death,” the court found that a death action must be commenced within two years after the death in the absence of affirmative misrepresentation or fraudulent concealment of the “medical” cause of death only.

The Chapter had significant concerns that in the past four years, the statewide Courts have continually re-interpreted laws and language that the courts, the Administration and the General Assembly had all agreed to, by the creation of the MCARE Act and other legislation to resolve a crisis in medical malpractice lawsuits and med mal insurance costs in 2003.  These court rulings continue to chip away at provisions that assure reasonable costs for medical professional liability insurance.

Between 2000 and 2003 the average cost of medical professional liability insurance for internal medicine physicians in Pennsylvania rose from an average of $7,390 to $24,546 - more than a 330% increase.  Costs in Philadelphia, where more than half of all state med mal lawsuits were filed, rose even more and were higher.

Since 2018, the Court has – from the bench – changed legislation regarding venue, statute of repose, and now statute of limitations, as well as definitions – in this case what “cause of death” means.

The Superior Court's Opinion held that "cause of death" means "conduct the plaintiff alleges led to the decedent's death." It took an unambiguous medical term of art and redefined it with invented legalese. It took a law that was carefully negotiated and passed on an overwhelmingly bipartisan basis, repealed it, and unilaterally put a new law in its place, doing this in a total vacuum of support in either legislative history or legal precedent.

The phrase "cause of death," a medical term of art, is universally understood to reference an individual's medical cause of death, i.e., the specific injury or disease that leads to death.

Other filers included the American Medical Association, the PA Chapter of the American Academy of Pediatrics, the Pennsylvania Medical Society and the Pennsylvania Orthopedic Society.