Is Evidence of a Physician’s Judgment Still Admissible in a Medical Malpractice Trial in Pennsylvania?

For more than four decades, the attorneys at McCormick Law Firm have represented medical professionals, hospitals, and health systems in the defense of medical malpractice claims. Almost by definition, most medical malpractice claims present highly complex medical and legal issues for experts, lawyers, judges, and ultimately, juries, to resolve.

Anyone who has worked in health care, and/or worked with health care professionals, knows that doctors, physicians’ assistants, and nurses are routinely required to exercise their professional judgment in many aspects of their daily routines and patient interactions. However, in Pennsylvania, since 2009, trial courts have been barred from referencing a physician’s “judgment” when instructing the jury on the law regarding whether a defendant health care provider complied with the “standard of care” – – which is the key question that all juries are asked to decide in a medical malpractice trial.

In 2009, the Pennsylvania Superior Court decided the case of Pringle v. Rappaport, and held that reference to a defendant physician’s “judgment” should not be referenced in the context of the Court’s jury instructions regarding the applicable standard of care and breach. See Pringle v. Rappaport, 980 A.2d 159 (Pa. Super. 2009). Among its rationale, the Court found that injecting the concept of the physician’s judgment, was potentially confusing and misleading to lay jurors when presented in the context of the Court instructing the jury regarding the “medical standard of care.” In 2014, the Pennsylvania Supreme Court reached the same result in Passarello v. Grumbine (87 A.3d 285 (2014)).

Subsequent to Pringle and Passarello, plaintiff’s attorneys in numerous counties around Pennsylvania have attempted to convince trial judges that evidence of a defendant physician’s professional “judgment” should be entirely excluded from evidence and testimony at trial, in addition to its preclusion from the jury instructions per Pringle and Passarello. Specifically, attorneys who represent plaintiffs have argued that evidence of a defendant physician’s medical judgment should be excluded from all evidence at trial, based upon the same reasoning that precludes the Court from mentioning the physician’s judgment when instructing the jury regarding the applicable medical standard of care.

As attorneys who represent health care professionals in cases in which their client’s judgment is being criticized as “substandard” and “negligent,” it is difficult to imagine a trial without referencing our client’s judgment. Fortunately, to-date, in every case in which a plaintiff has raised this issue and McCormick Law Firm has been involved, the Courts have disagreed with the plaintiff, and have refused to automatically exclude such evidence and testimony, and have held that evidence of a defendant physician’s medical judgment can be relevant, and admissible.

For example, in 2021, in the Lycoming County case of Schnaufer v. Stutzman, the plaintiffs attempted to exclude evidence of the clinicians’ medical judgment in performing the delivery of a baby, when the baby became stuck in the birth canal because of a shoulder dystocia – a true obstetrical emergency. In the ensuing moments, the medical providers (a Certified Nurse Midwife; and, a third-year Family Medicine Resident/physician) had to exercise their judgment regarding the maneuvers used to deliver the baby, and how much pressure to apply to the baby and mother to make the delivery. The clinicians had only seconds to make numerous life-saving decisions. When the plaintiffs filed a pretrial motion to exclude evidence of, and reference to, the clinicians’ judgment, the Lycoming County Court found that the plaintiffs had “over-reach[ed] in their attempt to preclude reference to the [clinicians’] exercise of judgment.” The Court went on to say that the Pringle and Passarello decisions cited by the plaintiffs “do not stand for the proposition that physicians’ exercise of judgment is never relevant.”

Thus, a defendant physicians’ medical judgment can still be relevant, and play a role at trial to explain how or why a physician chose to engage in a certain course of treatment. As a practical matter, this approach recognizes the principle that a professional’s judgment is exercised in almost every decision made and action undertaken, and evidence and testimony at trial cannot be “sanitized” to exclude all references to a doctor’s judgment when the case is presented to the jury. Of course, whether that judgment complies with the medical standard of care is THE question that every jury is asked to decide, and for now, it appears that many Pennsylvania trial courts will continue to allow such evidence at trial.