## Facts

- An elderly patient underwent left-knee surgery and developed a post-operative infection.
- An orthopedic surgeon treated her from July to October 1978 for the infection and related knee problems.
- Beginning in December 1978, a second orthopedic surgeon treated her through August 1981 and performed an attempted left-knee fusion that was unsuccessful.
- A later physician performed a total left-knee replacement; the patient’s expert opined this later surgery fell below the standard of care.
- Approximately 11 months later, the patient fractured her left leg, was hospitalized for an extended period, the knee implant was removed due to infection, and the infection persisted.
- In July 1983, the patient underwent an above-knee amputation.
- The patient alleged negligent treatment of the knee infection by the earlier and later treating orthopedic surgeons, and vicarious liability of the later surgeon’s practice group, caused the progression of infection and ultimate amputation.

## Issues

1. Whether the trial court properly entered a compulsory nonsuit for the first treating surgeon at the close of the plaintiff’s case.
2. Whether the statute of limitations barred the claims against the second treating surgeon and his practice group, or whether the discovery rule and continuing-treatment doctrine tolled accrual.
3. Whether the later physician’s treatment was a superseding cause, as a matter of law, breaking the causal chain from the second treating surgeon and his practice group.
4. Whether the damages verdict against the second treating surgeon and his practice group was inadequate and required a new trial on damages.

## Decision

- Reversed the compulsory nonsuit for the first treating surgeon and remanded for a new trial against him.
- Affirmed the liability verdict against the second treating surgeon and his practice group.
- Held the statute of limitations did not bar the claims against the second treating surgeon and his practice group under the discovery rule and continuing-treatment principles.
- Rejected the argument that the later physician’s conduct was a superseding cause as a matter of law; causation and allocation were for the jury on this record.
- Vacated the damages award as inadequate and ordered a new trial limited to damages against the second treating surgeon and his practice group.

## Legal Principles

- A compulsory nonsuit is proper only where, viewing the evidence and all reasonable inferences in the plaintiff’s favor, no reasonable minds could differ that the plaintiff failed to establish a prima facie case.
- In medical malpractice, asserted inconsistencies in an expert’s testimony generally go to weight and credibility for the jury, not to legal sufficiency justifying nonsuit, unless the testimony is so contradictory as to be without value.
- Under Pennsylvania’s discovery rule, limitations may be tolled where the patient neither knows nor reasonably should know of the injury and its causal connection to wrongful conduct.
- Under the continuing-treatment doctrine, a course of ongoing treatment for the same condition may delay accrual where the patient reasonably relies on continuing care and lacks the capacity to recognize negligence during treatment.
- An intervening act constitutes a superseding cause only if it is so extraordinary that it was not reasonably foreseeable; successive treatment by physicians for the same condition typically presents a jury question on causation and allocation rather than a complete bar to prior liability.
- When evidence permits multiple inferences regarding causal contribution among medical actors, allocation of responsibility is for the factfinder, and a court should not substitute its own apportionment.

## Conclusion

The court held that the plaintiff presented sufficient expert evidence to submit her claims against the first treating surgeon to a jury, that limitations defenses could be rejected under discovery and continuing-treatment principles, that later medical negligence did not automatically sever causation as a superseding cause, and that the modest damages award required a new trial limited to damages against the second treating surgeon and his practice group.


Corbett v. Weisband, 380 Pa. Super. 292, 551 A.2d 1059 (Pa. Super. Ct. 1988)