Steltz v. Meyers

• Decision Date: 22 December 2021
• Docket Number: No. 10 EAP 2021,10 EAP 2021
• Citation: 265 A.3d 335
• Parties: Craig STELTZ, Appellee v. William C. MEYERS, M.D. ; Vincera Core Institute and Vincera Institute, Appellants
• Court: Pennsylvania Supreme Court

265 A.3d 335

Craig STELTZ, Appellee

v.William C. MEYERS, M.D. ; Vincera Core Institute and Vincera Institute, Appellants

No. 10 EAP 2021

Supreme Court of Pennsylvania.

Argued: September 21, 2021

Decided: December 22, 2021

John Jacob Hare, Esq., Marshall Dennehey Warner Coleman & Goggin, Shane Haselbarth, Esq., for Appellants.

Clifford E. Haines, Esq., Haines & Associates, P.C., for Appellee.

BAER, C.J., SAYLOR, TODD, DONOHUE, DOUGHERTY, WECHT, MUNDY, JJ.

OPINION

JUSTICE MUNDY

We granted allowance of appeal to consider whether the Superior Court erred in affirming the trial court's award of a new trial. Because we conclude that the trial court did not abuse its discretion in denying a mistrial based on a single, unanswered question proposed to an expert witness, that decision alone cannot later serve as the basis for granting a new trial. Accordingly, we reverse the order of the Superior Court and remand for further proceedings.

I. FACTUAL AND PROCEDURAL HISTORY

In 2016, Craig Steltz filed this medical malpractice action against Dr. William Meyers, Vincera Core Institute, and Vincera Institute (collectively Appellants). On May 1, 2014, Dr. Meyers performed surgery to repair Steltz's athletic pubalgia.¹ That surgery is not the basis of the alleged malpractice. Instead, while rehabilitating from that surgery, Steltz, who was a player for the Chicago Bears of the National Football League, felt a pop in his right leg on June 19, 2014. This led him to return to Dr. Meyers on June 30, 2014, after the Chicago Bears’ team physicians performed a magnetic resonance imaging

(MRI) on June 27, 2014. At the June 30th follow-up appointment, Dr. Meyers also performed an MRI on Steltz, discussed the MRI with Dr. Adam Zoga, a musculoskeletal radiologist, and concluded Steltz had scar tissue breakup, a normal postoperative finding, and not a new injury to his adductor muscle. However, Dr. Paul Read, a second musculoskeletal radiologist, also independently reviewed the June 30th MRI shortly after the June 30th appointment and issued a report concluding the MRI showed a complete tear of the adductor tendon. Based on these conflicting interpretations of the June 30th MRI, Steltz alleged Dr. Meyers was negligent in failing to diagnose and disclose the existence of the tear as reported by Dr. Read.

The case proceeded to a two-week jury trial, from July 31, 2018 to August 13, 2018. Steltz presented Dr. Read as a fact witness, who testified that on July 3, 2014, Dr. Zombor Zoltani, a resident, authored the primary report interpreting the June 30th MRI as showing a complete tear, with which Dr. Read agreed and approved in his capacity as the attending radiologist. N.T., 7/31/18, a.m. session, at 61-62; 7/31/18, p.m. session, at 13-14. At the time he interpreted the June 30th MRI, Dr. Read was unaware that Dr. Meyers and Dr. Zoga had previously interpreted it as scar tissue breakup. N.T., 7/31/18, p.m. session, at 13. At trial, Dr. Read substantially affirmed the conclusion of his report, with the exception that he would classify the injury not as a "tear" but as a complete "discontinuity" of the common adductor tendon origin because "tear" connotes trauma, and he was not certain the injury was traumatic. Id. at 22-23.

Steltz also presented Dr. Meyers, as if on cross examination, as part of his case-in-chief. Dr. Meyers testified that he had interpreted the June 30th MRI with Dr. Zoga, and he had concluded that Steltz "absolutely did not have a new injury to his adductor muscle. He had scar breakup." Id. at 50, 66. Dr. Meyers acknowledged that Dr. Zoga did not issue a report of his read of the June 30th MRI. Id. at 49. Further, Dr. Meyers stated that he did not see Dr. Read's report "until much later," when Steltz requested his medical records, and he told Steltz that Dr. Read's report was not correct. Id. at 51, 56.

As additional medical expert witnesses, Steltz presented Dr. David Treen and Dr. Benton Emblom. Dr. Treen was qualified as an expert "in the area of sports hernia

and athletic pubalgia." N.T., 8/1/18, a.m. session, at 28. Dr. Treen testified that, as a general surgeon, he does not interpret MRIs and relies on radiologists’ interpretations. Id. at 22. As he does not interpret MRIs, he stated that he could not resolve the conflicting interpretations of Steltz's MRIs. Id. at 92-93. Instead, based on his August 16, 2016 visual inspection of Steltz, Dr. Treen opined that "it looked as though the muscle had torn away from the pelvis," and it "would not be a salvageable reconstruction" at that time but it was "more probable than not" that it could have been repaired closer to the time of the injury, two years earlier. Id. at 56, 60-61. Dr. Treen also opined that it was below the standard of care to not disclose the results of the June 30th MRI, assuming it showed a complete tear of the adductor longus muscle, to Steltz. Id. at 62. Likewise, Steltz presented the videotaped deposition of Dr. Benton Emblom, an orthopedic surgeon, whose expert opinion, based on a September 2014 physical examination, was that Steltz had a torn adductor muscle that was surgically unsalvageable and required physical rehabilitation. N.T., 8/2/18, a.m. session, at 40-41; N.T., 8/2/18, p.m. session, at 83-84. After presenting other witnesses not relevant to the issue in this appeal, Steltz rested his case-in-chief. N.T., 8/6/18, p.m. session, at 27. Notably, Steltz did not present an expert in radiology to support Dr. Read's interpretation of the June 30th MRI and did not attempt to present Dr. Read as an expert.

Appellants began their case by presenting Dr. Jana Crain, a musculoskeletal radiologist whose practice involved reading MRIs for multiple professional, college, and amateur sports teams. N.T., 8/6/18, p.m. session, at 39-40. On cross examination of her voir dire, Steltz's counsel inquired as to the number of radiologists in the United States whose subspecialty was musculoskeletal radiology, to which Dr. Crain responded that she did not know. Id. at 44 (asking "how many radiologists are there in the United States that are musculoskeletal radiologists?" and how many radiologists are members of the society of musculoskeletal radiologists). Further, Steltz's counsel established that there is not a board certification for the subspecialty of musculoskeletal radiology, which is essentially a self-declared specialty. Id. at 46. Following voir dire, the trial court accepted Dr. Crain as an expert in musculoskeletal radiology. Id. at 52. Dr. Crain testified that, based on her review of the June 30th MRI in conjunction with Dr. Meyers’ operative report, she disagreed with Dr. Read's report that there was a complete tear of the common adductor tendon origin. Id. at 64. Instead, her opinion was that the June 30th MRI was consistent with Dr. Meyers’ postoperative report and showed "either the post[-]op release area hasn't healed or he's torn some scar tissue in this area of post[-]op release." Id. at 66.

Appellants next presented Dr. Zoga as a fact and expert witness. N.T., 8/7/18, a.m. session, at 43. During voir dire, Dr. Zoga explained that in 2005-2006 he had worked with colleagues, including Dr. Meyers, to develop an MRI imaging protocol for musculoskeletal groin injuries. Id. at 11-12. Further, he studied postoperative MRI cases and "realized that some of the MRI findings in the postoperative patient that most of us [radiologists] who didn't know any better would think are new injuries actually are expected. They're just a result of the surgery." Id. at 24. During Steltz's counsel's cross-examination of Dr. Zoga on voir dire, he elicited testimony from Dr. Zoga regarding Dr. Read's qualifications, specifically that Dr. Read is a musculoskeletal radiologist in Dr. Zoga's division at Thomas Jefferson University, that Dr. Read is a board-certified radiologist who had completed a fellowship in musculoskeletal radiology, and that Dr. Read continues to read MRIs and report on them. Id. at 35-37. Further, in response to Steltz's counsel's questioning about Dr. Read's continued employment, Dr. Zoga stated that although he did not have the ability to terminate other employees, he did not believe Dr. Read should be fired for misreading Steltz's June 30th MRI. Id. at 35. Dr. Zoga acknowledged that Dr. Read's report regarding the June 30th MRI was still part of the medical record and that no addendum or correction had been issued. Id. at 44. Ultimately, the trial court accepted Dr. Zoga as an expert in musculoskeletal radiology. Id. at 47.

Appellants’ counsel's first line of questioning to Dr. Zoga on direct examination, which follows in its entirety, precipitated this appeal:

[Appellants’ counsel]: Dr. Zoga, how many musculoskeletal radiologists did you say there are in this country?

[Dr. Zoga]: I can only guess based on the membership of the Society of Skeletal Radiology. I did check yesterday. I believe the membership of the Society of Skeletal Radiology, which means radiologists who have to spend at least 50 percent of their clinical effort in the musculoskeletal arena, is about 950. I'm sure there are some others. I don't even know how to guess that.

[Appellants’ counsel]: So 950 nationwide that spend about at least 50 percent of their time reviewing musculoskeletal images, that's what you just told us?

[Dr. Zoga]: That's correct.

[Appellants’ counsel]: So if you were to lump them altogether, those who spend 50 percent of their time and those like Dr. Read who spend only 5 to 10 percent of their time, how many musculoskeletal radiologists do you think there are in this country ballpark?

[Dr. Zoga]: So if the definition is radiologists who interpret musculoskeletal imaging

, it has to be five thousand.

[Appellants’ counsel]: Five thousand. Five thousand of those radiologists and plaintiff couldn't find one of them to come into this courtroom to support Dr. Read, did you know that?

[Steltz's counsel]: Your Honor --

[Appellants’ counsel]: Not one, couldn't find one?

[Steltz's counsel]:

...