Pennsylvania Supreme Court Expands Medical Malpractice Recoveries

On December 22, 2011, the Supreme Court of Pennsylvania issued a decision in a medical malpractice case in which it considered “whether a cause of action for negligent infliction of emotional distress, hereinafter NIED, exists where the emotional distress results from a “negligent breach of a contractual or fiduciary duty,” absent physical impact or injury.”

The Supreme Court of Pennsylvania concluded, “After review of the development of the tort of NIED under Pennsylvania law and that of our sister states, we conclude that it is appropriate to extend liability for the infliction of emotional distress to a limited species of cases. As more fully defined below, we would hold that NIED is not available in garden-variety “breach of contractual or fiduciary duty” cases, but only in those cases where there exists a special relationship where it is foreseeable that a breach of the relevant duty would result in emotional harm so extreme that a reasonable person should not be expected to endure the resulting distress. We further conclude that recovery for NIED claims does not require a physical impact.”

The Underlying Facts Of This Case

In this case before the Supreme Court of Pennsylvania, a pregnant woman had a pelvic ultrasound on March 3, 2003, which the medical malpractice Defendants interpreted and reported to the expectant mother as normal. When the woman  gave birth on July 3, 2003, the baby had profound physical abnormalities (including the absence of all four extremities below the elbow or knee joint). The woman suffered severe shock when she observed her baby’s physical abnormalities at the time of birth that she claimed that she would not have suffered had the ultrasound been correctly interpreted and reported to her so that she could have prepared herself for seeing her son’s physical abnormalities at the time of his birth.

Prior Pennsylvania Law

The Supreme Court of Pennsylvania in its earliest cases involving NIED claims had determined that the wrongdoer was required to impact the victim physically in order for the victim to recover damages, which was the requirement until 1970 (known as the “impact rule”). In 1970, the Supreme Court of Pennsylvania expanded the requirement to allow a NIED claim if the victim was in close proximity of the physical impact (known as “zone of impact liability”). In 1979, the Supreme Court of Pennsylvania further expanded the law to permit recovery if the victim personally witnessed a wrongdoer physically impact a close relative (known as “bystander liability”).

The present Supreme Court of Pennsylvania case expanded NIED claims to include claims where the alleged wrongdoer has a particular contractual or fiduciary relationship with a victim and it is foreseeable that the wrongdoer’s carelessness could cause severe emotional harm to the victim and that harm occurs (a “contractual or fiduciary duty” not to inflict foreseeable emotional distress upon a victim).

In expanding liability in NIED claims, the Supreme Court of Pennsylvania stated in this case, “we find it prudent to limit the reach of this NIED claim to preexisting relationships involving duties that obviously and objectively hold the potential of deep emotional harm in the event of breach….the special relationships must encompass an implied duty to care for the plaintiff’s emotional wellbeing. The potential emotional harm must not be the type that a reasonable person is expected to bear….we would hold that some relationships, including some doctor-patient relationships, will involve an implied duty to care for the plaintiff’s emotional well-being that, if breached, has the potential to cause emotional distress resulting in physical harm.”

Hereafter, No Requirement For A Physical Impact

The Supreme Court of Pennsylvania concluded, “we conclude that the physical impact requirement is a flawed tool to distinguish between true emotional distress deserving recovery and the trivial or fraudulent emotional distress claims that should not result in liability. The existence of a physical impact or the fear of such impact may certainly result in emotional distress as we have seen on repeated occasions. However, we acknowledge that severe emotional distress can arise equally from situations without any physical impact. Accordingly, we would hold that NIED claims do not require a physical impact as an element of the tort. A plaintiff asserting a special relationship NIED cause of action absent physical injury, however, must still demonstrate the genuineness of the alleged emotional distress, in part, by proving the element of causation. Unlike cases involving a physical impact, a plaintiff in a non-impact case faces a more difficult task of convincing a court of the legitimacy of the emotional distress and the causal nexus between the negligent action at issue and alleged distress.”


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This entry was posted on Friday, February 10th, 2012 at 11:11 am. Both comments and pings are currently closed.


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