Senate Resolution 2019-20 (SR 20) directed Pennsylvania’s Legislative Budget and Finance Committee (“LBFC”) to conduct a study of the impact of venue for medical professional liability actions on access to medical care and maintenance of health care systems in Pennsylvania. The study was requested because the Pennsylvania Supreme Court’s Civil Procedural Rules Committee filed notice in the Pennsylvania Bulletin on December 22, 2018 that it was planning to propose to the Pennsylvania Supreme Court an amendment to Rule 1006 that would eliminate the subparagraph (a.1) special exception for venue in medical professional liability cases.
Pennsylvania’s Venue Rule
The Pennsylvania Supreme Court Rules of Civil Procedure Rule 1006 allows a civil action to be brought in a county where 1) the defendant may be served, 2) the cause of action arose, 3) a transaction or occurrence took place out of which the cause of action arose, or 4) venue is otherwise authorized by law. If property is the subject of the claim and equitable relief is sought, then venue may also be had in the county where the property is located.
In 2003, as part of medical malpractice tort reform, venue for medical professional liability actions was changed by adding subparagraph (a.1) to Rule 1006 to restrict venue to a county in which the cause of action arose (unless the cause of action arises out of state). Subparagraph (a.1) states: “Except as otherwise provided by subdivision (c), a medical professional liability action may be brought against a health care provider for a medical professional liability claim only in a county in which the cause of action arose.”
The Pennsylvania Supreme Court’s Civil Procedural Rules Committee stated in support of its proposal to remove subparagraph (a.1): “The current rule provides special treatment of a particular class of defendants, which no longer appears warranted. Data compiled by the Supreme Court on case filings on medical professional liability actions … indicates that there has been a significant reduction in those filings for the past 15 years. Additionally, it has been reported to the Committee that this reduction has resulted in a decrease of the amount of claim payments resulting in far fewer compensated victims of medical negligence … [t]he proposed rescission of subdivision (a.1) is intended to restore fairness to the procedure for determining venue regardless of the type of defendant.”
The LBFC study found:
– There is a lack of comprehensive and detailed data on the number of physicians practicing in Pennsylvania.
– Based on the available data, there were no statewide trends between medical malpractice insurance rates and the number of active medical staff with clinical privileges.
– The available data leads to the conclusion that medical malpractice insurance rates may have an effect on a physician’s decision on where to practice, however, there are many other factors outside the scope of this study, e.g., compensation, benefits, location, commute time, proximity to family, job satisfaction, work-life-balance, and access to continuing education, that may influence those decisions.
– The number of full-time medical interns/residents on payroll at hospitals appeared unaffected by the 2003 tort reforms.
– The data indicates there were no measureable effects of venue on the availability of physicians across the Commonwealth from the 2003 tort reforms; however, the health care landscape in Pennsylvania has significantly changed for physicians since that time.
– In 2018, a majority of Pennsylvania physicians received their graduate medical education in-state. Of the physicians who completed their graduate medical education in Pennsylvania, fewer than half practiced medicine in Pennsylvania after completing their education.
– The health care landscape, much like the national trends, has changed in Pennsylvania with the increase in the number of hospitals in health systems and those health systems that extend beyond a single county.
– Due to the multiple variables involved, such as the number of hospitals located in a region, the data did not lead to a conclusion about the effect the proposed change to venue would have on the availability of hospitals and/or hospital services.
– In Pennsylvania from the period 2000 to 2002 compared to the period 2015 to 2017 there was a 44.9 percent decrease in medical malpractice filings. The shift in claims from Philadelphia and Allegheny Counties is prominent and at least one surrounding county has also shown a dramatic increase in claims.
– The Medical Care Availability and Reduction of Error Fund (MCARE) total claims paid from 1996 to 2018, experienced an overall decrease of 21.9 percent. Pre-tort reform (1996 to 2002) total paid claims increased by 28.8 percent; and post-tort reform (2003 to 2018) total paid claims decreased by 44.2 percent.
– The effects of the proposed rule change on the number of medical malpractice filings and/or the value of medical malpractice payments in Pennsylvania could not be determined with any certainty. Due to the multiple variables involved in medical malpractice cases, we could not isolate the effect, if any, the proposed rule change to venue would have on the prompt determination of, and fair compensation for injuries as a result of medical negligence by a health care provider.
– The available data does not support a conclusion that changes in the availability, cost, and affordability of medical professional liability insurance are the result of changes in Pennsylvania law. The changes may be the result of national trends.
If you or a loved one may have been injured (or worse) as a result of medical negligence in Pennsylvania or in another U.S. state, you should promptly find a Pennsylvania medical malpractice lawyer, or a medical malpractice lawyer in your state, who may investigate your medical malpractice claim for you and represent you or your loved one in a medical malpractice case, if appropriate.
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