Walter v. Magee-Womens Hospital

Decision Date12 April 2005
Citation876 A.2d 400
PartiesChristine WALTER and Sharon King, on Behalf of Themselves and all Other Similarly Situated Individuals, Appellants v. MAGEE-WOMENS HOSPITAL OF UPMC HEALTH SYSTEM, University of Pittsburgh Medical Center Health System, Trevor A. Macpherson and George Michalopoulos, Appellees
CourtPennsylvania Superior Court

Joseph R. Podraza, Philadelphia, for King, appellant.

William A. Pietragallo, Pittsburgh, for appellees.

Before: HUDOCK, MUSMANNO and TAMILIA, JJ.

OPINION BY TAMILIA, J.:

¶ 1 This case arises from a putative class action suit initiated by plaintiffs/appellants Christine Walter and Sharon King, on behalf of themselves and a similar situated class of women, against appellees Magee-Womens Hospital of the UPMC Health System, et. al, for medical monitoring, fraud, negligence, unjust enrichment, and violation of the Unfair Trade Practices and Consumer Protection Law (UTPCPL).1 According to the trial court:

The action was filed on behalf of a proposed class of women whose Pap smears were processed at Magee-Womens Hospital of the UPMC Health System (Magee) from 1995 through the present. Plaintiffs allege that Magee and the other Defendants intentionally misled and deceived Plaintiffs by issuing Pap smear reports bearing physicians' names although the reports had not been reviewed by a physician. Specifically, Plaintiffs assert that some computer-generated reports bore a reproduced signature or attestation of a pathologist when, in fact, the reports had been reviewed by cytotechnologists and not by pathologists. Cytotechnologists are medical professionals trained in the reading and analysis of Pap smears who screen the Pap smears for abnormal cells. Generally, any abnormality is marked for further evaluation by a pathologist. This procedure is in compliance with the Clinical Laboratory Improvement Amendments of 1988, 42 U.S.C. Section 263a et. seq.
The harm the Plaintiffs allege they have suffered as a result of Defendants' conduct is that the tests purportedly reviewed by physicians may have been incorrect and cancer and other serious conditions may have gone undetected. Plaintiffs make a claim for medical monitoring which would include rescreening the Pap smears by a qualified third party at Defendants' expense to assure the accuracy of the reports, identify errors and assume proper follow-up care.

Trial Court Opinion, Horgos, J., 4/15/04, at 1-2 (citations omitted).

¶ 2 On January 8, 2004, appellees filed preliminary objections to appellants' complaint, arguing that appellants lacked standing to maintain the cause of action and failed to state a claim upon which relief may be granted. On April 15, 2004, the trial court sustained appellees' preliminary objections, and dismissed appellants' complaint with prejudice. This timely appeal followed.

¶ 3 Appellants raise the following issues for our review:

A. In Dismissing the Complaint, the Trial Court Failed to Apply the Correct Legal Standard.
B. Plaintiffs Have Sufficiently Stated Each of their Claims for Relief.
1. The Complaint Properly States a Claim for Injury to the Plaintiffs Based on Economic Harm in the Form of Medical Surveillance Costs.
a. Plaintiffs' Injury Is The Cost of Retesting That They Would Not Otherwise Have Had to Incur But For Defendants' Wrongful Conduct.
b. The Trial Court Incorrectly Applied the Law by Requiring that Plaintiffs Show Current Physical Injury or Impact.
2. The Trial Court Erred in Holding That Plaintiffs Had Not Stated A Claim for Medical Monitoring and Negligence Under Pennsylvania Law.
3. The Trial Court Erred in Holding Plaintiffs Did Not State a Claim for Fraud.
a. The Trial Court Failed to Consider Plaintiffs' Specific Allegations Regarding Defendants' Material Omissions And Misrepresentations.
b. The Trial Court Incorrectly Applied the Law in Requiring That Plaintiff's Allege Individual Reliance.
4. The Trial Court Erred in Dismissing Plaintiffs' Unjust Enrichment Claim.
5. The Trial Court Erred in Dismissing Plaintiffs' UTPCPL Claim.
C. The Trial Court Erred in Dismissing the Complaint with Prejudice.

Appellants' brief at i-ii.

¶ 4 Our standard of review in determining whether a trial court erred in sustaining preliminary objections is well-settled. "[T]his court must consider as true all of the well-pleaded material facts set forth in the complaint and all reasonable inferences that may be drawn from those facts." Knight v. Northwest Savings Bank, 747 A.2d 384, 386 (Pa.Super.2000) (citation omitted). However, "[w]e need not accept a party's allegations as true to the extent they constitute conclusions of law." Fay v. Erie Ins. Group, 723 A.2d 712, 714 (Pa.Super.1999) (citation omitted). "In conducting our appellate review, we observe that preliminary objections, the end result of which would be dismissal of the action, may be properly sustained by the trial court only if the case is free and clear of doubt." Knight, supra. "[We] should affirm an order of a trial court ... sustaining preliminary objections in the nature of a demurrer where, when all well-pleaded material facts set forth in the complaint and all inferences fairly deducible from those facts are accepted as true, the plaintiff is not entitled to relief." Small v. Horn, 554 Pa. 600, 608, 722 A.2d 664, 668 (1998) (citation omitted).

¶ 5 Proper appellate review dictates we scrutinize appellants' initial claims in conjunction with the trial court's ruling that appellants lack standing to maintain a cause of action. Trial Court Opinion at 3. It is well-settled that "a party seeking judicial resolution of a controversy in this Commonwealth must, as a prerequisite, establish that he has standing to maintain the action." Bergdoll v. Kane, 557 Pa. 72, 83-84, 731 A.2d 1261, 1268 (1999) (citation omitted). "The law of standing provides that one cannot invoke the jurisdiction of the court to enforce private rights or to maintain a civil action for the enforcement of such rights, unless he or she has, in an individual or representative capacity, some real interest in the cause of action, or a legal right, title or interest in the subject matter or controversy." Treski v. Kemper Nat. Ins. Companies, 449 Pa.Super. 620, 674 A.2d 1106, 1111 (1996) (citation omitted). To have standing, a party must: "(a) have a substantial interest in the subjectmatter of the litigation; (b) the interest must be direct; and (c) the interest must be immediate and not a remote consequence." Ken R. on Behalf of C.R. v. Arthur Z., 546 Pa. 49, 53-54, 682 A.2d 1267, 1270 (1996) (citations omitted).

¶ 6 Applying the above cited standards, the trial court found that appellants were not aggrieved parties and dismissed their complaint. In so ruling, the court reasoned that appellants failed to demonstrate that they or any members of the proposed class have suffered a legally cognizable injury. Trial Court Opinion at 3.

¶ 7 Appellants argue the trial court erred in finding "that the injury for which Plaintiffs sought compensation is the `fear of being at an increased risk of having a serious medical condition.'"2 Appellants' brief at 21-22, quoting Trial Court Opinion at 4. They contend this conclusion "directly contradicts Plaintiffs' allegations and argument" and is clearly not supported by the record. Id. at 21. They maintain their complaint properly states a claim for medical surveillance and retesting costs, and cite numerous examples in the record which enforce this claim. Id. at 21-24. Nonetheless, we find it was reasonable for the trial court to infer that appellants' subsequent retesting, although not specifically noted in their complaint, was motivated in part out of a genuine concern or fear that appellees' purported failure to administer reliable Pap smear reports could result in a serious medical condition, if in fact, the condition went undetected. See Id. at 15-16, 21. No relief is due. ¶ 8 Contrary to appellants' assertions, they have not satisfied the requisite elements of a medical monitoring claim. See Appellants' brief at 26-33. Redland Soccer v. Dept. of The Army, 548 Pa. 178, 696 A.2d 137 (1997) is the definitive case on medical monitoring claims in Pennsylvania. In Redland, our Supreme Court was faced with determining whether Redland Soccer Club was entitled to a medical monitoring trust fund as a result of the United States Department of Army's disposal of hazardous materials in a local park used by the club. Id. at 182, 696 A.2d at 139. The Court set forth seven elements that a plaintiff must prove in order to prevail on a common law claim for medical monitoring:

(1) exposure greater than normal background levels;
(2) to a proven hazardous substance;
(3) caused by the defendant's negligence;
(4) as a proximate result of the exposure, plaintiff has a significantly increased risk of contracting a serious latent disease;
(5) a monitoring procedure exists that makes the early detection of the disease possible;
(6) the prescribed monitoring regime is different from that normally recommended in the absence of the exposure; and
(7) the prescribed monitoring regime is reasonably necessary according to contemporary scientific principles.

Id. at 195-196, 696 A.2d at 145-146.

¶ 9 Similarly, medical monitoring was recognized as a viable cause of action in Simmons v. Pacor, 543 Pa. 664, 674 A.2d 232 (1996). In Simmons, the Court disallowed recovery for the increased risk and fear of cancer endured by asymptomatic plaintiffs exposed to asbestos-causing cancer, but adopted a limited rule of law permitting plaintiffs with asbestos-related, asymptomatic pleural thickening to recover for medical monitoring. Id. at 678-679, 674 A.2d at 239.

¶ 10 Appellants argue that the court narrowly interpreted Redland and Simmons to preclude recovery based on exposure to a hazardous condition. Appellants' brief at 26-28. They claim they were exposed to dangerous and unsafe medical care in the...

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