Thierfelder v. Wolfert

• Decision Date: 28 September 2012
• Citation: 52 A.3d 1251
• Parties: David THIERFELDER and Joanne Thierfelder, H/W v. Irwin WOLFERT, M.D. and Medical Center at Gwynedd and Abington Memorial Hospital. Appeal of Irwin Wolfert, M.D.
• Court: Pennsylvania Supreme Court

52 A.3d 1251

David THIERFELDER and Joanne Thierfelder, H/W

v.Irwin WOLFERT, M.D. and Medical Center at Gwynedd and Abington Memorial Hospital.

Appeal of Irwin Wolfert, M.D.

Supreme Court of Pennsylvania.

Argued March 10, 2010.

Decided Sept. 28, 2012.

John J. Hare, Kimberly A. Boyer–Cohen, Marshall, Dennehey, Warner, Coleman & Goggin, P.C., Philadelphia, for Irwin Wolfert.

Barbara S. Magen, Donald N. Camhi, Teresa Ficken Sachs, Post & Schell, P.C., Philadelphia, for Medical Center at Gwynedd and Abington Memorial Hospital.

Bruce Gerald Cassidy, Philadelphia, Michael W. Landis, Bruce G. Cassidy & Associates, P.A., Trevose, for David and Joanne Thierfelder.

BEFORE: CASTILLE, C.J., SAYLOR, EAKIN, BAER, TODD, McCAFFERY, JJ.

OPINION

Chief Justice CASTILLE.

The question presented in this case is one of first impression for this Court: whether a medical general practitioner who provides incidental mental health treatment to a patient, with whom he then engages in a sexual affair, may be held to a particularized “specialist duty,” applicable to mental health professionals, that prohibits consensual sexual contact with patients, such that the defendant general practitioner may be subject to medical malpractice liability in tort. For the following reasons, we decline to impose such a duty as a matter of Pennsylvania common law. Accordingly, we vacate and remand to the Superior Court for further disposition consistent with this Opinion, including consideration of whether any preserved issues remain that were not addressed as a result of the Superior Court's disposition.

This appeal arises from an order sustaining preliminary objections. In our review, we accept as true all well-pleaded material facts set forth in the complaint and all inferences fairly deducible from those facts. Stilp v. Commonwealth, 596 Pa. 62, 940 A.2d 1227, 1232 n. 9 (2007).

David Thierfelder (“appellee-husband”) began receiving treatment from Irwin Wolfert, M.D. (“appellant”), a family practitioner, in October 1996. Mr. Thierfelder's wife Joanne Thierfelder (“appellee-wife”) began treating with appellant about a month later. Both appellees saw appellant for several years, during which time appellant treated both for, inter alia, libido problems. Appellant's treatment of appellee-wife addressed various physical ailments but also symptoms of depression, anxiety, stress, attention deficit disorder, and other emotional problems. Eventually, appellee-wife came to believe that appellant had “cured” her problems; she told him that he was her “hero” and that she believed she was in love with him. In the spring of 2002, the two began a sexual relationship that persisted for almost one year. The encounters took place at the Medical Center at Gwynedd where appellant maintained an office, in an automobile, and at appellant's parents' residence. Appellee-wife became increasingly anxious and depressed; at one point, she attempted to break off the relationship, but appellant convinced her to continue until she finally ended the affair in January 2003.

In March 2003, appellee-wife told her husband about the sexual affair. In July, appellees together filed suit, along with a certificate of merit, naming as defendants appellant, the Medical Center at Gwynedd, and Abington Memorial Hospital.¹ Appellees' initial complaint alleged the following: During the course of appellant's treatment of appellee-wife for depression and anxiety, appellee-wife expressed that she believed she was in love with him; the two thereafter began a sexual relationship, during which appellee-wife became increasingly anxious and depressed; and as the affair continued, appellee-wife became obsessive and dependent on appellant before finally ending the relationship and telling her husband. The complaint further alleged that appellant was reckless, negligent, and careless and deviated from the “standard of care for physicians under the circumstances” by: instituting and continuing a sexual relationship with his patient; failing to end the sexual relationship; failing to insist that appellee-wife find another physician to treat her for her medical and mental/emotional problems; placing his own physical needs and desires before the psychological welfare of his patients; misusing confidential information given to him by both appellees; violating the fiduciary duty he owed to appellees; interfering with appellees' marriage; and violating the standards of ethics for physicians. The complaint asserted that as a result of appellant's conduct, appellee-wife suffered deterioration of her psychological condition, severe depression, mental anguish, physical pain, emotional damage and harm, and loss of the opportunity to obtain relief from her psychological condition. Appellees also asserted both intentional and negligent infliction of emotional distress and willful, wanton, and reckless conduct on appellant's part; appellees sought “exemplary damages” of five million dollars. Complaint, 7/2/03.

Appellees filed an amended complaint shortly thereafter, which contained no substantive changes, but separated the allegations in the original complaint into four untitled, enumerated sections. Amended Complaint, 8/7/03. Appellant responded by filing preliminary objections asserting that appellees had failed to state causes of action for negligent and intentional infliction of emotional distress; willfulness, wantonness, and recklessness; tortious interference with a marital contract; breach of fiduciary duty; and breach of physician-patient confidentiality. Appellant also argued that appellees failed to state a cause of action for medical negligence because their allegations stated only that the sexual relationship arose after appellant's “rendition of medical care” to appellee-wife, as demonstrated by her statement that appellant had “cured” her; according to appellant, a cause of action for medical negligence must assert sufficient facts that the harm claimed arose “from” (and not “after”) the rendition of medical care. Appellant's Preliminary Objections, 8/26/03.

Next, appellees filed a second amended complaint, which provided titles for the enumerated sections; relevant to this appeal, the first two sections were now titled “Negligence” and “Medical Malpractice.” In the “Negligence” section, appellees repeated their original allegations to the effect that appellant was reckless, negligent, and careless and deviated from the “standard of care for physicians under the circumstances” by: instituting and continuing a sexual relationship with his patient; failing to end the sexual relationship; failing to insist that appellee-wife find another physician to treat her; placing his own physical needs and desires before the psychological welfare of his patients; misusing confidential information; violating a fiduciary duty; interfering with appellees' marriage; and violating the standards of ethics for physicians. The complaint asserted that as a result of appellant's conduct, appellee-wife suffered deterioration of her psychological condition, severe depression, mental anguish, physical pain, emotional damage and harm, and loss of the opportunity to obtain relief from her psychological condition. The “Medical Malpractice” section of the second amended complaint pertained to appellee-wife only, and alleged that appellant “deviated from the standard of care for physicians under the circumstances” by: misusing drugs during the course of her treatment, breaching patient confidentiality, failing to treat her appropriately, practicing therapeutic techniques beyond the scope of his competence, terminating her treatment without appropriate follow-up or referral, failing to warn her that “certain treatment has been harmful,” failing to properly recognize, diagnose, and treat the “transference” that befell her,² and failing to timely refer her to another physician. Second Amended Complaint, 9/17/03.

Appellant responded with additional preliminary objections reiterating that his sexual relationship with appellee-wife “commenced outside of the course and scope of the rendering of medical services,” and thus, appellees had not established a cause of action for either ordinary or medical negligence. Appellant also referred to a recent trial court decision in which the Honorable Sandra Mazer Moss of the Court of Common Pleas of Philadelphia County held that, lacking a mental health therapist-patient relationship, sexual relations between a physician and a patient's estranged wife did not constitute medical malpractice. Appellant's Preliminary Objections to Second Amended Complaint, 10/15/03 (citing Long v. Ostroff, 63 Pa. D. & C. 4th 444 (Pa.Com.Pl.2003)). Appellees answered the preliminary objections, stating that their certificate of merit expressed that appellant's conduct departed from acceptable medical standards and was the cause of appellees' harm; appellees also argued that contrary to appellant's assertions, a mental health therapist-patient relationship did arise and develop between appellant and appellee-wife. Appellees' Answer to Appellant's Preliminary Objections, 10/31/03. The court overruled appellant's preliminary objections, but ordered appellees to file another amended complaint pleading their asserted material facts with greater specificity. Trial Ct. Order, 1/16/04.

Appellees filed a third and final amended complaint in February 2004. In the section titled “Negligence,” appellees set forth a detailed account of the manner in which the affair between appellant and appellee-wife began and how appellee-wife grew increasingly more anxiety-ridden, obsessive, and dependent as the relationship progressed. Appellees also alleged that appellant made attempts to convince appellee-wife to continue the relationship when she attempted to end it. Appellees also added allegations that appellant made certain statements to appellee-wife that worsened her already fragile emotional state over the affair. In the ...