## Facts

- Susan Yanakos had Alpha-1 Antitrypsin Deficiency (AATD) and was advised in 2003 that she needed a liver transplant.
- Because she was not eligible for a cadaveric liver, her adult son, Christopher Yanakos, volunteered as a living donor and underwent evaluation.
- During evaluation, Christopher told the evaluating physician that several family members had AATD and he was unsure whether he did.
- Additional testing allegedly showed Christopher had AATD and was not a suitable donor, but he was allegedly not informed of the results.
- In September 2003, a transplant surgeon removed a portion of Christopher’s liver and transplanted it into Susan.
- About eleven years later, the family allegedly learned Susan still had AATD, which they asserted should have been eliminated by a suitable transplant.
- In 2015 (about twelve years after surgery), Christopher, Susan, and Susan’s husband filed suit asserting medical malpractice, lack of informed consent/battery, and loss of consortium.
- Defendants invoked the MCARE Act’s seven-year statute of repose barring most medical professional liability actions filed more than seven years after the alleged tort.

## Issues

1. Whether MCARE Act § 1303.513(a)’s seven-year statute of repose for medical professional liability claims violates Article I, Section 11 of the Pennsylvania Constitution (open courts/remedies clause).
2. Whether the statute of repose is substantially related to an important governmental interest sufficient to justify extinguishing claims that may not be discoverable within seven years.

## Decision

- The Supreme Court of Pennsylvania held the MCARE Act’s seven-year statute of repose in § 1303.513(a) unconstitutional under Article I, Section 11.
- The Court reversed the Superior Court, vacated the judgment on the pleadings for defendants, and remanded for further proceedings.
- The Court distinguished statutes of repose from statutes of limitations, emphasizing that a repose period can extinguish a claim regardless of discovery.
- Although the asserted interests (insurance premium control, medical care availability/affordability, addressing a malpractice crisis) were important, the Court found insufficient support that a seven-year cutoff was substantially related to achieving them.
- The Court emphasized the statute’s effect on latent-injury plaintiffs whose claims may be barred before they can reasonably be discovered.

## Legal Principles

- A statute of repose can eliminate a cause of action after a fixed time, independent of when an injury is discovered, and thus may bar claims before they accrue in practical terms.
- Article I, Section 11 limits legislative power to curtail common-law remedies; when a law effectively abolishes a class of claims, it must be substantially related to an important governmental interest.
- Important governmental interests alone do not sustain a repose period absent a demonstrated substantial relationship between the specific cutoff chosen and the stated objectives.
- When a repose period forecloses recovery for injuries not reasonably discoverable within the period, heightened constitutional scrutiny under the remedies clause may apply.

## Conclusion

The Pennsylvania Supreme Court invalidated MCARE § 1303.513(a)’s seven-year medical malpractice statute of repose because the Commonwealth did not show the seven-year cutoff was substantially related to the asserted governmental interests, and it could extinguish latent-injury claims before discovery, contrary to Article I, Section 11.


Yanakos v. Univ. of Pittsburgh Med. Ctr., 218 A.3d 1214 (Pa. 2019)