Maragos v. Bradley

• Court: Pennsylvania Superior Court
• Writing for the Court: LAZARUS, P.J.
• Docket Number: 2310 EDA 2023,J-A14008-24
• Decision Date: 30 August 2024
• Citation: Maragos v. Bradley, 2310 EDA 2023, J-A14008-24 (Pa. Super. Ct. Aug 30, 2024)
• Parties: CHRISTOPHER MARAGOS v. JAMES P. BRADLEY, UPMC COMMUNITY MEDICINE, INC. AND ROTHMAN ORTHOPAEDIC ASSOCIATES II, P.C. APPEAL OF: RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES, II, P.C.

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CHRISTOPHER MARAGOS v. JAMES P. BRADLEY, UPMC COMMUNITY MEDICINE, INC. AND ROTHMAN ORTHOPAEDIC ASSOCIATES II, P.C.

APPEAL OF: RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES, II, P.C.

No. 2310 EDA 2023

No. J-A14008-24

Superior Court of Pennsylvania

August 30, 2024

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT O.P. 65.37

Appeal from the Judgment Entered August 1, 2023 In the Court of Common Pleas of Philadelphia County Civil Division at No(s) 191100972

BEFORE: LAZARUS, P.J., STABILE, J., and LANE, J. Y.

MEMORANDUM

LAZARUS, P.J.

Reconstructive Orthopaedic Associates, II, P.C. (ROA)^[1] appeals from the judgment,^[2] entered in the Court of Common Pleas of Philadelphia County, on a $43.5 million jury verdict in favor of Appellee Christopher Maragos (Plaintiff) and against ROA and Defendants James P. Bradley, and UPMC Community Medicine, Inc., following the denial of post-trial motions.^[3] After careful consideration, we affirm on the basis of the well-reasoned opinion authored by the Honorable Charles J. Cunningham, III.

Plaintiff is a former NFL safety, special teams player, and team captain who signed a three-year/$4 million contract with the Philadelphia Eagles in 2014.^[4] Plaintiff's contract was extended in 2016 for three years/$6 million. Plaintiff was, at that time, the highest paid special teams player in the NFL.

During an October 12, 2017 game against the Carolina Panthers, one of Plaintiff's teammates collided with Plaintiff's right knee, causing it to hyperextend.^[5] The next day, October 13, 2017, Plaintiff had an MRI taken in Philadelphia. See Jefferson Outpatient Imaging MRI Right Knee, 10/13/17, at 1 (MRI Impression #3 states "[c]omplex tear of the posterior root attachment of the medial meniscus (new since 2015) with mild meniscal extrusion."); see id. at 1-2 (MRI Medial Compartment notes "[t]here is a complex, predominantly radial tear involving the posterior root attachment of the medial meniscus with a tiny 4 mm nondisplaced meniscal fragment. This tear is new since the prior MRI from meniscal extrusion."). ROA and at-the-time Eagles head team physician, Dr. Peter DeLuca, reviewed the MRI results with Plaintiff and explained that Plaintiff had a complete tear of his posterior cruciate ligament (PCL), a partial tear of the lateral collateral ligament (LCL), and "a tear of the posterior horn root of the medical meniscus [with] mild extrusion" and recommended surgical intervention. See N.T. Jury Trial, 2/9/23, at 53, 62-64. After consulting with his agent and team physician, Plaintiff selected Dr. Bradley, a Pittsburgh-based orthopedic sports medicine surgeon and head team physician for the Pittsburgh Steelers, to be his surgeon.

Doctor Bradley talked to Dr. DeLuca the day before he operated on Plaintiff and told Dr. DeLuca that Plaintiff's PCL was completely torn and that he was not sure if the meniscal root was torn, but that he would look at the root during the surgery to see if it needed to be fixed. Id. at 67. In particular, Dr. Bradley testified that Plaintiff had suffered a partial tear of the medial meniscus at the posterior horn that did not involve the meniscal root, a grade II LCL injury, and a completely ruptured PCL. Id., 2/7/23, at 156, 191. See also id. at 199, id., 2/8/23, at 100 (Doctor Bradley testifying Plaintiff had Type I "partial tear of the posterior horn of the root of [the] medial meniscus that was [] a partial tear").

On November 8, 2017, Dr. Bradley performed a right knee diagnostic arthroscopy and PCL reconstruction on Plaintiff's right knee, reserving the decision as to whether the posterior lateral corner and the LCL had to be repaired until Plaintiff was under anesthesia.^[6] Id., 2/7/23, at 192-93. Doctor Bradley specifically testified, after probing the area during surgery, the Type I partial root tear with which he had previously diagnosed Plaintiff did not require surgical intervention because it was a "stable tear." Id., 2/8/23, at 101-03; id., 2/7/23, at 200-01 (Doctor Bradley testifying Plaintiff's root was "totally intact" during November 2017 surgery).

Following surgery, Dr. Bradley ordered a course of physical therapy and rehabilitation for Plaintiff to take place in Philadelphia with ROA. See id. at 103 (Doctor Bradley testifying he provided overview of rehab program for Plaintiff to trainers who would then implement day-to-day protocol). Initially, Plaintiff's rehabilitative activities included muscle-strengthening exercises and, six weeks post-surgery, using a stationary bike. By January 2018, Plaintiff was walking unaided and putting his full body weight onto his knee.

In conjunction with Dr. Bradley's direction, ROA Doctors Peter DeLuca, Christopher Dodson,^[7] Paul Marchetto, and Matthew Pepe^[8] implemented and oversaw Plaintiff's rehabilitation from November 2017 through December 2018. See Deposition of James P. Bradley, M.D., 6/2/21, at 49 ("[I]t is a joint decision [among the ROA doctors and Philadelphia Eagles therapists/staff] and me when we should progress."). Doctor DeLuca testified that he "took care of the [team's] orthopedic injuries [and] made the final decisions when it came to orthopedic injuries." N.T. Jury Trial, 2/9/23, at 54. Specifically, Dr. DeLuca testified that his day-to-day duties included evaluating injuries, reviewing MRIs, and making decisions regarding whether injured players could return to play. Id. at 55-56.

Doctor Bradley reported back to Dr. DeLuca, post-surgery, that the meniscal root was completely stable and told Dr. DeLuca "specifically . . . not to examine [Plaintiff's] knee [a]nd [that he didn't] want [him] or any of [his] partners or any athletic trainer pulling on . . . the new PCL[.]" Id. at 68. In February 2018, Dr. DeLuca looked at Plaintiff's range of motion, but did not test his PCL due to Dr. Bradley's prior instructions. Id. at 72.

Doctor Bradley examined Plaintiff in March 2018 and noted that Plaintiff's reconstructed PCL was intact and that his MCL, LCL, and ligaments were healthy and stable. See N.T. Jury Trial, 2/3/23, at 45-46 (Plaintiff testifying Dr. Bradley told him "[h]e's doing quite well[, that [the] PCL repair] was tight, it looked good and he was happy with it); but see id. at 45 (Plaintiff testifying he "just wasn't quite feeling quite right[, he] was kind of getting swelling in that time and it was kind of concerning to [him]."); id. at 51 ("It was just swelling, like pinching, kind of [a] catching feeling in my knee."). Dr. Bradley "significantly increased" Plaintiff's activity level, id. at 47-49, and planned to see him again in two months. Plaintiff testified that his right knee "typically improv[ed]" after he took time off from exercising and strength-training. Id. at 50. Doctor DeLuca told Plaintiff that discomfort was normal and that he should "push through the discomfort." Id. at 51-52. Around April 11, 2018, Plaintiff reported that he was "feeling great" after running at 10 MPH on 65% of his body weight, "but still ha[d] some pinching." Id. at 53. On May 1, 2018, Plaintiff was unable to complete a lower body lift as part of his rehabilitative workout due to knee tightness, soreness, and fatigue. Id. at 56.

On May 10, 2018, while warming up in the weight room before a workout, Plaintiff twisted his knee and immediately felt "a jolt . . . in [his] knee and [a] pinching or catching [feeling.]" Id. at 59. Five days later, Dr. DeLuca ordered an MRI that showed "a little more extrusion of the meniscus[,] . . . no change in the [root] tear[,] a little more damage to the cartilage[,] and a [] bone bruise[.]" Id. at 79. Doctor Bradley prepared a diagnostic report of the MRI result, noting that Plaintiff has a posterior root tear, progressing arthritis, but that his graft looks "fine." Id. at 62-63 (emphasis added). Doctor Bradley's overall assessment noted, in part, that Plaintiff had "[p]rogressive medial compartment arthrosis [with] a root tear and meniscus is extruding and a PCL that is still healing." MRI Report of Dr. James P. Bradley, 5/15/18, at 10 (emphasis added). Doctor Bradley did not tell Plaintiff that the extrusion had gotten worse since his surgery, "mention anything at all about the meniscus extruding, [] discuss the meniscus root tear[, or] discuss the fact that [he] may need a surgery to repair [his] meniscus." N.T. Jury Trial, 2/3/23, at 63-64.

After examining Plaintiff and consulting with Dr. DeLuca, Dr. Bradley opined that Plaintiff's arthritis was progressing in his knee and ordered a series of platelet-rich plasma (PRP) and Euflexxa injections to decrease inflammation. Id., 2/8/23, at 117, 119-120, 124. Doctor Bradley testified that after shutting Plaintiff's rehabilitation down for a few months, he advised Plaintiff to "start to run [] on dry land [to] get him ready . . . to progress through camps and get him ready for the preseason." See id. at 122; see also MRI Report of Dr. James P. Bradley, 5/15/18, at 10.

On May 29, 2018, Plaintiff met with Dr. DeLuca, who had been overseeing his rehabilitation. Doctor DeLuca physically examined Plaintiff and administered another series of Euflexxa and PCP injections. N.T. Jury Trial, 2/3/23, at 65-66. Doctor DeLuca did not discuss Plaintiff's torn extruded meniscus with Plaintiff and continued to carry out Dr. Bradley's protocol. Id. at 67. Doctor DeLuca testified that, even when one of his players is operated on by a surgeon outside the organization, you don't "abandon the player[, but you] butt in" if there is a problem. Id. at 69. Doctor DeLuca conducted a posterior exam of Plaintiff's knee to test the PCL-the first physical examination Dr. DeLuca had done of Plaintiff's knee since the November 2017 surgery-and "got concerned that it was loose" and also looked like the meniscus had extruded more. Id. at 80.

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