OPINION BY DONOHUE, J.:
Scott D. Muir, D.O. ("Dr. Muir"), Fiorina Pellegrino, D.O. ("Dr. Pellegrino"), Hazelton Women's Care Center ("Hazelton") and Muir OB/GYN Associates, P.C. ("Muir Associates") (collectively, "Appellants") appeal from the order denying, in part, their motion for the entry of summary judgment against Baljinder S. Matharu ("Father") and Jessica A. Matharu ("Mother"), individually and as Administrators of the Estate of Milan Singh Matharu ("Child") (collectively, "Appellees"). This Court previously affirmed the trial court's order in an en banc decision dated June 28, 2011. On August 22, 2013, the Supreme Court of Pennsylvania vacated this decision and remanded the case to this Court for reconsideration in light of its decision in Seebold v. Prison Health Serv., 618 Pa. 632, 57 A.3d 1232 (2012). For the reasons set forth herein, we conclude that this case is distinguishable from Seebold. Accordingly, we again affirm the trial court's order.
In its written opinion, the trial court aptly summarized the relevant and undisputed factual background of this case:
Trial Court Opinion, 2/20/09, at 1-5 (footnotes in original).
After the completion of discovery, Appellants filed a motion for summary judgment. In an order dated February 20, 2009, the trial court granted the portion of the motion contending that Pennsylvania law does not allow a parent to recover for the loss of a child's consortium, but denied Appellants' demand for dismissal of Appellees' wrongful death and survival actions. Trial Court Order, 2/20/2009, at ¶¶ 1-2. On March 2, 2009, the trial court amended its order, adding that its decision involved a controlling question of law as to which there is a substantial ground for difference of opinion "and that an immediate appeal from the order may materially advance the ultimate termination of the matter." Trial Court Order, 3/2/2009, at ¶ 4.
On May 1, 2009, this Court granted Appellants' petition for permission to appeal. After oral argument before a three-judge panel, we determined that the case should be decided by the Court sitting en banc. On June 28, 2011, we issued an en banc order and decision affirming the trial court's March 2, 2009 order. Matharu v. Muir, 29 A.3d 375 (Pa.Super.2011) (en banc), vacated, ___ Pa. ___, 73 A.3d 576 (2013). On August 22, 2013, the Supreme Court of Pennsylvania granted Appellants' petition for allowance of appeal, vacated our decision and order, and remanded the case to this Court "for reconsideration in light of Seebold v. Prison Health Serv., 618 Pa. 632, 57 A.3d 1232 (2012)." Matharu v. Muir, ___ Pa. ___, 73 A.3d 576 (2013). In response, this Court ordered the parties to file supplemental briefs, which the parties completed on December 10, 2013.
Appellants' Brief on Remand at 5.
Our standard of review with respect to a trial court's decision to grant or deny a motion for summary judgment is as follows:
JP Morgan Chase Bank, N.A. v. Murray, 63 A.3d 1258, 1261-62 (Pa.Super.2013) (quoting Murphy v. Duquesne Univ. of the Holy Ghost, 565 Pa. 571, 590, 777 A.2d 418, 429 (2001)).
With respect to Appellants' first issue on remand, we begin with a detailed review of the Seebold case. Michelle Seebold ("Seebold") filed suit against Prison Health Services, Inc. ("PHS"), a company providing medical services at the state correctional institution at Muncy, Pennsylvania, pursuant to a contract with the Pennsylvania Department of Corrections. Seebold, 618 Pa. at ___, 57 A.3d at 1234. Seebold worked as a corrections officer at the prison and was assigned to strip search its female inmates before and after they received visitors. Id. According to Seebold's complaint, approximately twelve inmates contracted a contagious bacterial infection known as methicillin-resistant staphylococcus aureus ("MRSA"). Id. Seebold alleged that PHS doctors misdiagnosed the condition as spider bites. As a result of the misdiagnosis, the prison took no precautions against the spread of the infection and Seebold contracted MRSA. Id. Seebold averred that PHS's physicians owed a duty of reasonable care to the staff and inmates at the prison to warn and protect them from acquiring an MRSA infection,
The trial court granted PHS's preliminary objections to Seebold's complaint, finding that PHS physicians had no affirmative duty to Seebold as a third-party non-patient. Id. In a Memorandum decision dated December 1, 2009, this Court vacated the trial court's ruling, concluding that PHS physicians owed a duty to Seebold pursuant to section 324A of the Restatement (Second) of Torts, which provides as follows:
RESTATEMENT (SECOND) OF TORTS, § 324A.
In so ruling, this Court relied primarily on two cases, DiMarco v. Lynch Homes-Chester County, Inc., 525 Pa. 558, 583 A.2d 422 (1990) and Troxel v. A.I. Dupont Institute, 450 Pa.Super. 71, 675 A.2d 314 (1996), appeal denied, 546 Pa. 668, 685 A.2d 547 (1996). In DiMarco, our Supreme Court addressed "the issue of whether a physician owes a duty of care to a third party where the physician fails to properly advise a patient who has been exposed to a communicable disease, and the patient, relying upon the advice, spreads the disease to the third party." DiMarco, 525 at 559, 583 A.2d at 423. The plaintiff's girlfriend was a blood technician who was accidentally exposed to hepatitis B in the course of her employment. The defendant doctors informed her that if she remained symptom free for six weeks following exposure, then she had not contracted the virus. Id. Accordingly, the doctors advised her to refrain from sexual activity for six weeks. Id. The plaintiff and his girlfriend abstained from sex for eight weeks, but were both subsequently diagnosed with hepatitis B. Id. at 560, 583 A.2d at 423. The plaintiff filed suit against the girlfriend's physicians, alleging that they violated a duty of care to him in failing to advise his girlfriend about precautions necessary to avoid spreading hepatitis to others. Specifically, the plaintiff alleged that the doctors should have advised his girlfriend that she could spread hepatitis through sexual contact for up to six months after her exposure. Id.
Our Supreme Court reasoned as follows:
Id. at 562, 583 A.2d at 424-25.
This Court applied the Supreme Court's DiMarco decision in Troxel. In that case, the plaintiff's friend and the friend's baby suffered from a contagious disease known as cytomegalovirus ("CMV"). Troxel, 675 A.2d at 316. The plaintiff frequently visited her friend and her friend's baby during the plaintiff's pregnancy, not knowing that both suffered from CMV. Id. Subsequently, the plaintiff contracted CMV and the plaintiff's baby died from the disease several months after his birth. Id. The plaintiff sued her friend's doctor for failing to advise the friend regarding the risk of spreading CMV. Id.
In Troxel, this Court concluded that the plaintiff "has stated a cause of action, pursuant to Section 324A, even though there was no physician-patient relationship between [the plaintiff] and [her friend's] physicians." Id. at 318. We noted that our Supreme Court has "recognized that the essential provisions of Section 324A `have been the law of Pennsylvania for many years.'" Id. (quoting Cantwell v. Allegheny County, 506 Pa. 35, 483 A.2d 1350 (1984)). We disagreed with the suggestion that liability under Section 324A would render physicians liable for the spread of any infectious disease, like the common cold or the flu, concluding that where certain medical risks "may only be known within the medical community, it is essential that correct information be disseminated by the physician." Id. at 323.
In addition to DiMarco and Troxel, we also observed that our Supreme Court had recognized one additional circumstance wherein a health care provider owes a duty of care to third parties. In Emerich v. Philadelphia Center for Human Development, Inc., 554 Pa. 209, 720 A.2d 1032 (1998), our Supreme Court, relying in part on DiMarco, held that a therapist had a duty to warn his patient's intended victim of the patient's stated intent to kill the victim. Id. at 226, 720 A.2d at 1040. The Supreme Court was careful, however, to limit this duty to cases involving a "specific and immediate threat of serious bodily injury" against a "specifically identified or readily identifiable victim." Id.
In our decision in Seebold, we recognized a difference between the facts of the case and those in DiMarco and Troxel, as Seebold alleged that the PHS physicians had failed to diagnose MRSA and thus had not provided any advice to anyone regarding the spread of the condition. DiMarco and Troxel, by comparison, did not involve a misdiagnosis but rather bad advice (DiMarco) or no advice at all (Troxel). We concluded that this distinction was not controlling:
Seebold v. Prison Health Serv., 20 MDA 2009 at 12-13, 990 A.2d 66 (Pa.Super. December 1, 2009) (unpublished memorandum). Accordingly, we held that Seebold had stated a cause of action against PHS pursuant to Section 324A of the Second Restatement, concluding that Seebold was "among a narrow class of highly foreseeable plaintiffs." Id. at 13, 16. We expressly recognized that DiMarco and Troxel ruled that physicians must provide accurate advice to
In an Opinion dated December 28, 2012, our Supreme Court reversed and remanded,
In addressing the issue of whether physicians have a common law duty to take affirmative measures outside of the physician-patient relationship, the Supreme Court recognized a clear difference between the factual circumstances presented in Seebold versus those presented in DiMarco and Troxel. In DiMarco and Troxel, the courts delineated a physician's duty to protect third-party non-patients by advising their patients properly. Id. at ___, 57 A.3d at 1243. According to the Supreme Court, "there is a patent, material difference between providing advice to a patient within the contours of a confidential physician-patient relationship and disclosing protected medical information to third-party non-patients." Id. While DiMarco and Troxel permitted third-party non-patients to bring suit against physicians, they did so based upon the physician's failure to advise the patient properly. DiMarco and Troxel did not, however, require the physicians in those cases "to undertake interventions outside the confidential physician-patient relationship." Id. Interventions with third-party non-patients have been required only in the very limited circumstances described in Emerich, namely where there is a targeted threat of imminent violence. Id.
For these reasons, the Supreme Court in Seebold concluded that the plaintiff had
Based upon our careful review of Seebold, we conclude that the present case is distinguishable and that our decision to affirm the trial court's denial (in part) of Appellants' motion for summary judgment should stand. In particular, in this case the alleged negligence (the failure to administer RhoGAM) occurred
To state a cause of action under Section 324A of the Second Restatement, a plaintiff must aver that the physician has undertaken "to render services to another which he should recognize as necessary for the protection of a third person." Cantwell, 506 Pa. at 41, 483 A.2d at 1353. As the Supreme Court emphasized in DiMarco, the physician's services to this end are "
In Seebold, the Supreme Court further described the nature of the duty outlined in Section 324A:
Seebold, 618 Pa. at ___, 57 A.3d at 1244-45 (emphasis in original).
Appellees in this case allege that the failure to administer RhoGAM during
Importantly, as in DiMarco and Troxel, the alleged negligence in this case, namely the failure to administer RhoGAM, occurred during the course of Mother's treatment of her pregnancy with Sandeep in 1998 and within the confines of her physician-patient relationship with Drs. Muir and Pellegrino. As a result, Seebold's prohibition against requiring physicians to undertake interventions outside the physician-patient relationship has no application in this case. Seebold, 618 Pa. at ___, 57 A.3d at 1244-45. Instead, as the Supreme Court in Seebold made clear, while liability cannot be based upon a failure to undertake interventions outside the physician-patient relationship, Section 324A of the Second Restatement continues to require physicians to provide reasonable care in the patient's treatment as is necessary for the protection of others, and establishes liability to certain third-parties when such reasonable care is lacking. Id. As such, Appellees' claim that the failure to administer RhoGAM during Mother's pregnancy with Sandeep in 1998 resulted in the death of Milan Matharu in 2005 states a claim under Section 324A, and the Supreme Court's decision in Seebold does not alter this conclusion.
For their second issue on remand, Appellants argue that a "newly created duty for a physician to a third party with whom the physician has no physician-patient relationship" circumvents the Medical Care Availability and Reduction of Error Act's ("MCARE") seven year statute of repose, 40 P.S. § 1303.513. Appellants contend that Appellees did not file suit until more than nine years after the alleged failure to administer RhoGAM, and thus the lawsuit is barred by the applicable statute of repose.
We disagree. We first note that Appellees' lawsuit is not based upon any "newly created duty," but rather a duty recognized under Section 324A of the Second Restatement. Moreover, while no physician-patient relationship existed between Drs. Muir and Pellegrino and Milan Matharu, Section 324A requires no such relationship between the physician and the injured third-party non-patient. Seebold, 618 Pa. at ___, 57 A.3d at 1244-45; DiMarco, 525 Pa. at 562-63, 583 A.2d at 424-25; Troxel, 675 A.2d at 318. A physician-patient relationship existed between Drs. Muir and Pellegrino and Mother, and the allegation that the failure to provide reasonable care within this relationship to protect certain readily identifiable third parties (including Milan Matharu) adequately states a claim under Section 324A.
In our prior (now vacated) en banc decision in this case, we concluded that the
MCARE's statute of repose provides as follows:
40 P.S. § 1303.513.
On remand, Appellants argue that in our prior decision we mistakenly relied solely upon subsection 1303.513(d), and should also have applied the seven-year statute of repose in subsection 1303.513(a). Appellants' Brief on Remand at 42-43. According to Appellants, subsection (a) lists only subsections (b) and (c) as exceptions to the broad seven-year general limitation on all medical professional liability claims, and does not provide that subsection (d) constitutes an exception to the seven-year limitation. As such, Appellants contend that the proper interpretation of section 1303.513 as a whole for wrongful death and survival actions is to require compliance with both subsections (a) and (d) — such that wrongful death and survivor lawsuits must be brought within two years of the death of the person
Statutory interpretation presents a question of law subject to plenary review. See, e.g., Mohamed v. Com., Dept. of Transp., Bureau of Motor Vehicles, 615 Pa. 6, 18, 40 A.3d 1186, 1193 (2012). The goal and purpose of statutory interpretation is to ascertain legislative intent and give it effect. 1 Pa.C.S.A. § 1921(a). In discerning that intent, our inquiry begins with the language of the statute itself. If the language of the statute unambiguously sets forth the legislative intent, this Court will apply that intent to the case at bar and not look beyond the statutory language to ascertain its meaning. 1 Pa.C.S. § 1921(b) ("When the words of a statute are clear and free from all ambiguity, the letter of it is not to be disregarded under the pretext of pursuing its spirit."). We will resort to the rules of statutory construction only when there is an ambiguity in the statutory language at issue. Oliver v. City of Pittsburgh, 608 Pa. 386, 394, 11 A.3d 960, 965 (2011).
Reviewing the language of section 1303.513, including in particular its subsections (a) and (d), we conclude that there is a clear ambiguity, as it may be interpreted in at least two ways. First, it may be read as Appellants suggest, such that wrongful death and survival actions must be commenced within seven years of the date of the alleged act of medical negligence (pursuant to subsection (a))
Alternatively, rather than construing subsection 1303.513(d) as an
Having concluded that an ambiguity exists, we must apply rules of statutory interpretation. Of relevance here, "[b]ecause the legislature is presumed to have intended to avoid mere surplusage, every word, sentence, and provision of a statute must be given effect." Allegheny County Sportsmen's League v. Rendell, 580 Pa. 149, 163, 860 A.2d 10, 19 (2004). Statutes are considered to be in pari materia when they relate to the same persons or things, and statutes or parts of statutes in pari materia shall be construed together, if possible. 1 Pa.C.S.A. § 1932; Allstate Life Ins. Co. v. Com., 617 Pa. 1, 52 A.3d 1077, 1080 (2012). We may also assume the legislature does not intend a result that is absurd, unreasonable, or impossible
Applying these rules, we cannot agree with the interpretation of section 1303.513 proposed by Appellants, as Appellants' interpretation violates our obligation to avoid mere surplusage and to give effect to every word, sentence, and provision of a statute. In this regard, we must first distinguish between statutes of repose and statutes of limitation. In Vargo v. Koppers Co., Inc., 552 Pa. 371, 715 A.2d 423 (1998), our Supreme Court held that the distinguishing feature between the two is that "statutes of repose potentially bar a plaintiff's suit before the cause of action arises, whereas statutes of limitation limit the time in which a plaintiff may bring suit after the cause of action arises." Id. at 375, 715 A.2d at 425. As such, statutes of repose begin to run at the time of the negligent act, while statutes of limitation do not begin to run until the cause of action accrues.
Based upon this distinction, as the title to section 1303.513 portends, subsection 1303.513(a) sets forth a statute of repose for medical professional liability claims. It sets forth a maximum allowable period of time (seven years) to file such claims, and this time period commences on the date of the act of alleged negligence or the breach of contract. Although the phrase "tort or breach of contract" is not defined in MCARE, the phrase "medical professional liability claim" is defined as a claim "arising out of any tort or breach of contract
In significant contrast, subsection 1303.513(d) does not set forth a statute of repose at all, but rather is a statute of limitation. Pursuant to subsection (d), wrongful death claims under 42 Pa.C.S.A. § 8301 and survival claims under 42 Pa.C.S.A. § 8302 must be commenced within two years after the death, unless there is fraudulent misrepresentation or concealment as to the cause of death. This provision is a statute of limitation because the period within which the claim must be filed begins to run not at the time of the act of alleged negligence, but rather at the time of the accrual of the cause of action. In other words, the two-year time period under subsection (d) does not begin to run until the injury (death) occurs, unless there is fraud relating to the cause of death, in which case the two-year period is tolled until the plaintiff knows or reasonably should have known of the cause of death. Krapf v. St. Luke's Hospital, 4 A.3d 642, 649 (Pa.Super.2010), appeal denied, 613 Pa. 670, 34 A.3d 832 (2011).
Moreover, and importantly for present purposes, the statute of limitations set forth in subsection 1303.513(d) is the exact same statute of limitation that was already applicable to wrongful death and survivor claims at the time the Pennsylvania Legislature passed MCARE (including its section 1303.513) in 2002. Pursuant to 42 Pa.C.S.A. §§ 5524 and 5502(a), death claims must be commenced within two years of the date of accrual, and 42 Pa. C.S.A. § 5504(b) provides for the extension of the two-year limitations period in the event of fraud. 42 Pa.C.S.A. §§ 5524, 5502(a), 5504(b). And while a fraudulent misrepresentation or concealment will toll
With these points established, it becomes clear that Appellants' preferred interpretation of section 1303.513 results in subsection (d) being mere surplusage. As explained above, Appellants contend that wrongful death and survival actions must be commenced within seven years of the date of the alleged act of medical negligence and within two years of the death at issue. If the legislature had so intended, subsection (d) would not have been included in section 1303.513, and wrongful death and survival actions would have been controlled by the seven year statute of repose set forth in 1305.513(a). Thus, wrongful death and survival actions would have to be commenced within seven years of the date of the alleged act of medical negligence (per subsection 1303.513(a)) and within two years of the death at issue, absent fraud relating to the cause of death (per 42 Pa.C.S.A. §§ 5524, 5502(a), and 5504(b)). As such, under Appellants' preferred interpretation of section 1303.513, subsection (d) is mere irrelevant verbiage. Such an interpretation does not comport with the rules of statutory interpretation. 1 Pa.C.S. § 1921(c); Walker v. Eleby, 577 Pa. 104, 123, 842 A.2d 389, 400 (2004) (no provision should be "reduced to mere surplusage").
Instead, to give effect to all of the provisions of section 1303.513, including its subsection (d), it must be interpreted to provide that wrongful death and survival actions are not subject to the general statute of repose in subsection 1303.513(a). No other interpretation offers a cogent explanation in our attempt to discern the legislature's intention in enacting subsection 1303.513(d), as no other interpretation explicates why the legislature would restate the then-existing statute of limitation for death actions immediately after setting forth a new statute of repose for medical liability claims generally. As such, we conclude that the general statute of repose in subsection 1303.513(a) does not apply to wrongful death and survival actions, and Appellees' claims are thus not time-barred in this case.
Appellants complain that this interpretation unfairly subjects them to potential liability for many years after the date of the negligence in 1998. Having interpreted the legislative intent in enacting section 1303.513, we leave the consideration of further time restrictions to the Pennsylvania Legislature. We note, however, that while one of the purposes in enacting MCARE was to provide additional time limitations on malpractice suits in order to ensure that medical professional liability insurance is "obtainable at an affordable and reasonable cost," 40 P.S. § 1303.102(3),
Order affirmed.