The Pennsylvania Superior Court recently considered whether an out-of-state doctor and hospital that rendered care outside of Pennsylvania could be sued in Pennsylvania. April Mendel underwent laminectomy surgery with Drs. Eric Williams and Andrew Beaver (physicians licensed in Pennsylvania) at Albert Einstein Medical Center in Philadelphia. Subsequently, after developing a fever postoperatively at home, she presented to the Underwood Memorial Hospital emergency room in Woodbury, NJ, where she was diagnosed with an infection from the surgical site and admitted to the service of a Dr. Robert Ocasio. April’s conditioned worsened overnight and, the following morning, she was transported to back Einstein where Dr. Williams performed a second surgery in an effort correct the infection. However, by that point, the infection had extended to the spinal cord. April is now paralyzed from the waist down. April sued Drs. Williams, Beaver and Ocasio, as well as the Einstein and Underwood hospitals, in Philadelphia. The court dismissed Dr. Ocasio and Underwood from the case, however, finding that Pennsylvania had no personal jurisdiction over these out-of-state defendants. On appeal to the Superior Court, in Mendel v. Williams, 2012 PA Super 171 (2012), the Superior Court found that the providers had neither engaged in a systematic or continuous course of conduct in Pennsylvania, nor purposely established minimum contacts with Pennsylvania. As such, Pennsylvania lacked personal jurisdiction over them and dismissal was affirmed.
Noteworthy, was the Court’s consideration of the issue of whether medical treatment by a provider outside the Commonwealth, which later results in injury to a patient inside the Commonwealth, is sufficient to give rise to specific personal jurisdiction. This question had yet to be considered by Pennsylvania appellate Courts. The Court, taking guidance from Pennsylvania Federal Courts, found that in order for above scenario to create personal jurisdiction, the negligent conduct outside the jurisdiction must actually cause the injury inside the jurisdiction. It is not enough that injury merely manifests or is discovered inside the jurisdiction. Here, the Court concluded that April’s injury was actually caused at Underwood in New Jersey, it just was not discovered until April was later transferred back to Einstein in Philadelphia. Therefore, causation inside Pennsylvania did not provide a basis for personal jurisdiction in this instance. The Court also took note of an overall reluctance on the part of many states generally to extend specific personal jurisdiction over out-of-state medical providers. In one instance, the Federal 9th Circuit Court of Appeals, explained one public policy basis for this: “Medical services in particular should not be proscribed by the doctor’s concerns as to where the patient may carry the consequences of his treatment and in what distant lands he may be called upon to defend it. The traveling public would be ill served were the treatment of local doctors confined to so much aspirin as would get the patient into the next state.” Wright v. Yackley, 459 F.2d 287, 289-90 (9th Cir. 1972). Read: you don’t want doctors making treatment decisions based on where they might end up getting sued.