Levine v. Rosen

Supreme Court of Pennsylvania · 1992 · Torts

TortsMedical malpracticeJury instructionsmedical malpracticejury instructionHealth Care Quality Improvement Actreporting requirementirrelevant considerations

Facts

The Levines sued Dr. Rosen for failing to diagnose Mrs. Levine's breast cancer after she allegedly reported that her right nipple had become discolored and inverted and after he failed to order diagnostic testing. Mrs. Levine's expert testified that failing to refer her for mammography based on those symptoms deviated from accepted standards and also testified that Dr. Rosen was negligent for not ordering yearly mammograms after she turned fifty. Dr. Rosen testified that Mrs. Levine never reported the nipple symptoms, and his expert testified that the applicable professional recommendation called only for "regular," rather than yearly, mammograms. At trial, the court gave the standard irrelevant-considerations instruction, then supplemented it by telling the jury that Dr. Rosen would have to report the result and surrounding circumstances to a licensing board, and it also gave a two schools of thought instruction.

Issue

Whether the trial court erred by supplementing the irrelevant-considerations instruction with a charge about the federal reporting requirements of the Health Care Quality Improvement Act, and whether the trial court erred in giving a two schools of thought instruction without limiting it to the allegation for which competing accepted medical approaches were actually shown.

Rule

In a medical malpractice case, the jury may not consider the effect a verdict may have on the defendant's reputation, practice, or license; federal reporting consequences are absolutely irrelevant to whether the defendant was negligent and should not be included in the charge. The two schools of thought doctrine applies only when there is more than one accepted method of treatment or procedure, and a physician is not liable if, in the exercise of judgment, he followed a course of treatment advocated by a considerable number of recognized and respected professionals in the relevant field.

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One of 10 multiple-choice questions for this case. Pick an answer to see why.

In a medical malpractice trial in Pittsburgh, Priya Desai alleges that Dr. Nolan Pierce negligently failed to diagnose appendicitis. During final instructions, the judge tells the jury that if it returns a verdict against Dr. Pierce, the result may have to be disclosed in later credentialing applications, but that this should not affect its fairness.

If Priya appeals after a defense verdict, what is the strongest argument regarding the instruction?

Explanation. The governing rule is that the jury’s sole task is to decide negligence, not to weigh any effect the verdict may have on the defendant’s reputation, practice, license, or similar collateral matters. Mentioning reporting or disclosure consequences introduces an absolutely irrelevant consideration that may influence the verdict. The problem is not whether the consequence is severe or mild; it is that the consequence should not factor into negligence at all. (Derived from Levine v. Rosen (n.d.).)