In a decision causing quite a stir among medical professionals, the Pennsylvania Supreme Court decided to change a twenty-year-old rule regarding venue for medical malpractice actions. On August 25, 2022, the Court adopted amendments to Pennsylvania Rules of Civil Procedure 1006, 2130, 2156, and 2179, which govern venue in medical malpractice actions. Prior to this decision, medical malpractice cases could only be brought in the county where the medical care or treatment occurred.
With the new changes, effective January 1, 2023, healthcare providers in Pennsylvania can be sued in any county where they regularly conducts business or have significant contacts, regardless of where the actual care took place. The result? It is anticipated that larger counties, such as Philadelphia and Allegheny, will see a significant increase in the number of actions because several major healthcare providers which based in those metropolitan areas also provide care in their surrounding suburban counties. Now, even though the care may have taken place in a suburban county, the claim can be pursued in the Court of Common Pleas of Philadelphia County or Allegheny County.
History of the Venue Laws for Medical Malpractice Claims in Pennsylvania
Only 20 years ago, in 2002, Pennsylvania enacted the Medical Care Availability and Reduction of Error Act (MCARE Act). This legislation was aimed directly at addressing two key issues: the high number of medical malpractice claims which were being filed within the Commonwealth and the issue of forum shopping which led to a concentration of medical malpractice actions being filed in Philadelphia and Allegheny counties. Moreover, there were concerns that the medical malpractice litigation environment was so toxic that it was causing medical malpractice insurance carriers to no longer write policies for Pennsylvania healthcare providers which was, in turn, creating concerns about the viability of certain healthcare providers and patient access to quality care.
The MCARE Act created a carve-out provision under the Rules of Civil Procedure addressing venue with regard to actions filed against medical providers. The MCARE carve-out stated that "a medical professional liability action may be brought against a healthcare provider for a medical professional liability claim only in a county on which the cause of action arose." Pa. R.C.P. 1006(a.1). In effect, patients and others could only file a claim in the county where the primary portion of the medical care occurred. After the passage of the MCARE Act statistics demonstrated a significant drop in medical malpractice claims, especially in Philadelphia County.
The Upcoming Change to the Law
The Pennsylvania Supreme Court’s determination to eradicate the carve-out will, as of January 1, 2023, allow a plaintiff to bring a medical malpractice action in any county:
- Where the medical care in question occurred;
- Where a defendant could be subject to service of process; or
- Where any transaction or occurrence that gave rise to the action took place.
With the recent consolidation of healthcare systems, particularly in the Philadelphia area, the new venue rule will allow Plaintiffs to bring suit against healthcare systems who have a presence in Philadelphia in Philadelphia County, regardless of whether the subject care occurred in Philadelphia or one of its surrounding counties.
Those in favor of eliminating the MCARE carve out for venue asserted that given the significant decrease in filings of medical malpractice claims since 2002, the venue carve out was no longer necessary. Proponents for change further asserted that the venue rule not only resulted in fewer medical malpractice claims being filed, but also lower awards for victims for the injuries that resulted from the negligence of their healthcare providers. Finally, it was claimed that the carve out essentially provided for special treatment for healthcare providers that was not afforded to defendants in other industries. Thus, those advocating for the elimination of the venue carve out asserted that Plaintiff were being denied “justice” because major healthcare providers were providing care to patients in Philadelphia, they could not be sued there if the care in question to this particular patient was provided in another county. As Philadelphia’s neighboring counties are all considered to be more conservative and restrained in their jury awards than Philadelphia, proponents for changing the venue rule claim that under the MCARE Act’s venue provision their clients were being denied a full and complete measure of justice.
Those in favor of leaving MCARE’s venue provisions in place argued that its reversal will cause medical malpractice claims to skyrocket back to pre-2002 levels thereby causing medical malpractice insurance rates to rise and potentially drive quality medical providers out of the state in search of lower malpractice premiums. Further, the volume of additional claims in Philadelphia County may again create a backlog in the judicial system, something that the Court of Common Pleas of Philadelphia County worked years to eliminate.
- The Pennsylvania Supreme Court decided to eliminate the carve-out for medical malpractice claims in the state’s venue rules.
- Previously plaintiffs could only file a medical malpractice claim in the county where their medical care primarily took place.
- With the changes set to go into effect on January 1, 2023, medical malpractice plaintiffs will be bound by the same broader venue rules that are applied to other individuals and corporations.
- As of January 1, 2023 medical malpractice claims may be filed in any county in the Commonwealth of Pennsylvania where a healthcare provider regularly conducts business or has significant contacts.
- Proponents of the new rule argue that this change is long overdue and that is unfair to treat medical malpractice claimants differently than other types of defendants. They assert that whatever healthcare crisis existed in 2002, it is no longer present and these special venue rules are no longer necessary to protect the healthcare industry.
- Opponents fear that the number of medical malpractice claims filed in Philadelphia County will skyrocket thereby creating a serious backlog in the civil justice system and potentially driving quality healthcare providers out of Philadelphia County and/or the Commonwealth in an attempt to lower their malpractice insurance premiums and/or limit their potential liability.
It is interesting to note that only a year ago, our healthcare providers were being seen as “heroes” for their Herculean efforts during the COVID-19 pandemic. With this rule change, it is apparent that whatever goodwill was earned by our medical community for leading us through a pandemic was short-lived as this rule change certainly does not do healthcare providers in Philadelphia and its surrounding suburbs any favors.