The Pennsylvania Supreme Court is set to determine the legal definition of “cause of death” in medical malpractice cases.
On April 28, 2010, Mary Ann Whitman died as the result of a ruptured abdominal aortic aneurysm. Five days prior to her death, her primary care physician, Dr. Conaboy, requested that Whitman have a CT scan, which was reviewed by Dr. Charles Barax. Dr. Barax reviewed the scan and drafted a report that stated that Whitman had an abdominal aortic aneurysm that was “poorly visualized.” His report did not mention any possible rupture.
The Underlying Case
In April 2011, the administratrix of Whitman’s estate, Linda Reibenstein, filed a Wrongful Death Act and Survival Act lawsuit against Dr. Barax and his employer, Mercy Hospital, Scranton. During discovery, Reibenstein made many attempts to depose Dr. Barax. She was finally able to depose Dr. Barax in February 2015, with the intervention of the court. At Dr. Barax’s deposition, he testified that he had spoken with Dr. Conaboy about the CT scan, told him that it showed a previously undocumented abdominal aortic aneurysm, that he could not visualize it very well, and that he could not confirm whether it was bleeding or rupturing.
In March 2016, following Dr. Barax’s deposition, Reibenstein initiated a separate wrongful death and survival suit against Dr. Conaboy and his medical practice. The trial court consolidated the two lawsuits.
The Conaboy defendants filed a motion for summary judgment, arguing that the two-year statute of limitations for personal injury actions prevented the lawsuit. Initially, the trial court denied the motion, concluding that there were genuine issues of material fact. On reconsideration, the court granted summary judgment because it found “no evidence of affirmative misrepresentation or fraudulent concealment of the cause of death.” Reibenstein appealed.
Reibenstein appealed to the Superior Court of Pennsylvania. There was one issue on appeal: whether the trial court erred in granting summary judgment in favor of the Conaboy defendants on the ground that the statute of limitations governing the wrongful death claim could not be equitably tolled because Whitman’s medical cause of death was correctly identified on her death certificate.
Specifically, Reibenstein argued that Dr. Barax’s concealment of his communications with Dr. Conaboy regarding Whitman’s aneurysm is directly related to her death; therefore, the two-year statute of limitations should have been equitably tolled according to subsection 40 P.S. § 1303.513(d). She noted that the statute did not define “cause of death” or explain how the defendant must conceal the cause of death for equitable tolling to be applied.
Dr. Conaboy responded that the statutory language was clear, Whitman died of a ruptured abdominal aortic aneurysm, the cause of death was correctly recorded on her death certificate, and that the statute of limitations should not be tolled.
Upon review, the Superior Court noted that “cause of death” was never defined in the statute and there was a question as to whether it meant the immediate medical cause of death listed on a death certificate or whether it also included conduct leading up to the decedent’s death. The Superior Court reasoned that both interpretations were reasonable.
The Superior Court noted that the stated purpose of the Medical Care Availability and Reduction of Error Act was to ensure that high quality health care is available and to provide compensation to persons who sustain injury as the result of medical negligence, while controlling the costs of medical malpractice insurance rates. The court adopted the broader interpretation of “cause of death” and found that the trial court erred in concluding that no equitable tolling applied. Reibenstein v. Barax, 236 A.3d 1162 (Pa. Super. 2020).
Reaction to the Case
The American Medical Association and other physician advocacy groups heavily criticized the Superior Court’s opinion. They argue that “cause of death” is a term so common in the medical community that it is unambiguous and should not be subject to the court’s interpretation.
The case is currently pending before the Supreme Court of Pennsylvania, where it will be up to the highest court in the state to determine the legal definition of “cause of death.”