Bukowski v. Heim

• Decision Date: 23 December 2022
• Docket Number: 1344 MDA 2021,J-A19010-22
• Parties: JOHN BUKOWSKI Appellant v. WILLIAM HEIM, M.D., AND HEMATOLOGY AND ONCOLOGY ASSOCIATES OF NORTHEASTERN PA, P.C.; SCRANTON QUINCY HOSPITAL COMPANY, LLC D/B/A MOSES TAYLOR HOSPITAL; SCRANTON QUINCY HOME CARE SERVICES, LLC D/B/A COMMONWEALTH HEALTH OF MOSES TAYLOR
• Court: Pennsylvania Superior Court

JOHN BUKOWSKI Appellant
v.
WILLIAM HEIM, M.D., AND HEMATOLOGY AND ONCOLOGY ASSOCIATES OF NORTHEASTERN PA, P.C.; SCRANTON QUINCY HOSPITAL COMPANY, LLC D/B/A MOSES TAYLOR HOSPITAL; SCRANTON QUINCY HOME CARE SERVICES, LLC D/B/A COMMONWEALTH HEALTH OF MOSES TAYLOR

No. 1344 MDA 2021

No. J-A19010-22

Superior Court of Pennsylvania

December 23, 2022

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37

Appeal from the Judgment Entered October 19, 2021 In the Court of Common Pleas of Lackawanna County Civil Division at No(s): 2015-03662

Joseph D. Seletyn, Esq.

BEFORE: BOWES, J., KING, J., and STEVENS, P.J.E. ^[*]

MEMORANDUM

BOWES, J.

John Bukowski ("Plaintiff") appeals from the judgment entered in this medical malpractice action upon a jury verdict in favor of William Heim, M.D., Hematology and Oncology Associates of Northeastern Pa, P.C., Scranton Quincy Hospital Company, LLC d/b/a Moses Taylor Hospital, and Scranton Quincy Home Care Services, LLC d/b/a Commonwealth Health of Moses Taylor (collectively "Defendants"). We affirm.

1

We provide the following background information, taken from the trial testimony viewed in the light most favorable to Defendants as the verdict winners. Plaintiff was born with hemophilia and was primarily treated for his condition at Hershey Medical Center ("Hershey"). Specifically, Plaintiff's blood at baseline contained only ten percent of the expected level of Factor VIII, one of the factors necessary for his blood to clot properly, while normal levels are between fifty and 100 percent. Plaintiff utilized a Factor VIII blood product to remedy the deficiency and had in the past administered infusions of the product at home.

Plaintiff also suffered from hemorrhoids and was referred by Hershey to Dr. Joseph R. Bannon, who performed hemorrhoidectomy procedures at Moses Taylor Hospital ("Moses Taylor"). Hershey, contemplating an in-patient procedure, indicated that the hospital would have to stock up on Factor VIII product to administer to Plaintiff in the event of an active bleed. Dr. Bannon, in turn, referred Plaintiff to Dr. William Heim, a hematologist/oncologist with Hematology & Oncology Associates of Northeastern Pennsylvania, P.C., to formulate a plan for managing Plaintiff's care.

Ultimately, Dr. Heim developed the following plan. Dr. Bannon would perform the procedure at Moses Taylor on an out-patient basis, as was usual for that type of surgery. A five-to-seven-day supply of Advate, a brand of Factor VIII product, was shipped directly to Plaintiff's home, and he was given instructions on how to manage his twice-daily infusions. Plaintiff was to bring

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a dose of Advate with him to Moses Taylor for infusion one hour before the surgery. Afterwards, Moses Taylor would leave the IV port in for Plaintiff to administer a post-operative Factor VIII infusion at 2:00 a.m. at home. Thereafter, Plaintiff would have his blood tested daily to monitor his Factor VIII levels and follow up with Dr. Heim to manage the dosages.

Plaintiff underwent the surgery at Moses Taylor on June 6, 2013, and was discharged with pain medication, stool softener, and instructions to proceed with his Advate infusions. His blood tested at fifty-nine percent on next day, with no bleeding. On June 8, 2013, Plaintiff had his first post-surgery bowel movements, causing him to begin bleeding at the surgical site. Plaintiff went to the emergency room at Moses Taylor, where Dr. Manoj Das, a first-year resident, erroneously informed Plaintiff that the hospital had no Factor VIII products available. In actuality, what Moses Taylor lacked was the Advate brand of Factor VIII, but had available in its pharmacy over 6,000 units of Helixate, a comparable Factor VIII product, and Humate-P, another product used to treat a Factor VIII deficiency. Plaintiff had an infusion of Advate at Moses Taylor from his home supply, bringing his Factor VIII level up to 135 percent. However, rather than remain there to investigate the cause of the bleeding, Plaintiff chose to check himself out against medical advice so he could seek treatment at Hershey.

Plaintiff collapsed shortly after returning home and was taken back to Moses Taylor by ambulance. As Plaintiff steadfastly expressed his desire to

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be treated at Hershey, arrangements were made to fly Plaintiff there via helicopter after he was stabilized through, inter alia, the administration of 4,000 units of Helixate from the Moses Taylor pharmacy. When his blood was first tested upon arrival at Hershey, Plaintiff's Factor VIII level was at 282 percent, yet his bleeding continued. More Factor VIII product was administered to bring his level to 524 percent, but his bleeding did not stop. After Plaintiff had additional sutures placed at the surgical site and the affected area was packed, the bleeding ceased. Plaintiff developed pneumonia at Hershey and was hospitalized for two weeks. He thereafter complained of experiencing weakness and incontinence.

Plaintiff sued Dr. Heim, Moses Taylor, and their related entities for malpractice.^[1] Specifically, Plaintiff claimed that "due to various 'lack of communication' issues, impermissible and improper record keeping and medical chart practices, and other deviations from accepted standards of care," Moses Taylor did not, or believed that they did not, have sufficient Factor VIII product to prevent and treat his bleeding, and Dr. Heim failed to ensure that the hospital would have an adequate supply. See Trial Court Opinion, 10/13/21, at 3. Plaintiff sought both compensatory and punitive damages.

4

Discovery produced evidence that Moses Taylor's recordkeeping was imperfect. For example, the records from Plaintiff's emergency visit with Dr. Das repeatedly referenced an attending physician who was on vacation, notes concerning Moses Taylor's final administration of Factor VIII product to Plaintiff indicated that...